Bill opens door for additional discussion; Kim wants to see end to cuts in island health care funding

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The sponsor of legislation to transfer management of Hilo Medical Center to the County of Hawaii says he proposed it to help Mayor Harry Kim expand health services.

The sponsor of legislation to transfer management of Hilo Medical Center to the County of Hawaii says he proposed it to help Mayor Harry Kim expand health services.

But the mayor wants a bigger discussion — about funding East Hawaii’s health care safety net.

State Rep. Mark Nakashima, D-Hamakua, said he and Kim had a conversation and he thought Kim was frustrated the hospital doesn’t offer a wider array of services.

Currently, Hilo Medical Center is overseen by Hawaii Health Systems Corp. as part of the state of Hawaii’s health system. Its staff handled 47,000 emergency room visits in 2016.

Hawaii County does not currently manage any Big Island hospitals.

“What I suggested to the mayor is, if he wanted to put his money where his mouth is, we should transfer the hospital to (the county),” Nakashima said.

Nakashima’s bill would transfer management of the East Hawaii Regional System, including Hilo Medical Center, to the county.

That, Nakashima said, would let the county prioritize which health services are most needed and direct hospital resources to them, with the county potentially funding support for expanded services, such as cardiology.

But, Nakashima said, the mayor has “kind of since said he was not interested in doing that.”

Thus, Nakashima thinks the bill is unlikely to gain traction.

“There’s no interest in turning the hospital over to somebody who doesn’t want it,” he said.

Kim, though, said during a telephone interview Monday that he is thrilled Nakashima proposed the bill.

“I’m supportive of anything that will try to rectify the situation that we’re in,” he said.

Repeated cuts in state funding to HHSC, according to Kim, have had a negative impact on health care. Kailua-Kona’s hospital cut long-term care services and critical-care nurses. Hilo’s hospital cut long-term care and home health care services.

Kim said he hopes those cuts can be halted “to stop the bleeding, so to speak.”

His greatest desire for Nakashima’s bill is that it triggers cessation of health care funding cuts until a deep discussion can be had about unmet needs and how to pay for them. Much needed services, Kim said, include dental care for children, especially homeless children, and mental health care.

Nakashima was chairman of the labor committee when the first privatization of a state hospital was proposed on Maui. That experience taught him that privatization is not a good answer, he said.

Similarly, Kim said the concept of privatization worries him, and he thinks Big Island hospitals might be next. The privatization effort on Maui has been drawn out because the process was so complicated.

“Funding is a critical issue here, and there must be a real good discussion,” Kim said.

Hilo Medical Center, for example, had to make budget cuts again last year.

“After 20 years of working on a very successful home health care program, they cut it,” Kim said. He called it a short-sighted answer to a funding shortage but asked, “what else could they do?” He noted he’s proud of the work that’s being done at Hilo Medical Center with limited resources.

It was the state that said the HHSC would be a safety net, regardless of ability to pay, Kim said. But the state hasn’t kept that commitment, he said, noting he won’t support a bill that doesn’t meet that commitment.

Nakashima’s bill, he said, “opens a door for more discussion on an issue we must have more discussion on, instead of just cutting funds.”

Email Jeff Hansel at jhansel@hawaiitribune-herald.com.