Hilo Medical Center is one step closer to its proposed 55-bed expansion, thanks to nods of support from Gov. Josh Green along with state and lawmakers.
The $50 million project, started in 2017, would add 36 acute beds for nonemergency patients and 19 ICU beds, one more than previously proposed due to an adjustment to the plans.
HMC currently has 166 acute beds, 24 temporary acute beds, and a 28-bed Emergency Room, all of which have been consistently filled for years, according to HMC CEO Dan Brinkman.
“I haven’t ever seen it this busy in the 15 years I’ve been with Hilo Medical Center,” he said, adding there were 21 holds for emergency beds on Wednesday. “Our ICU is full — it’s been full pretty much every day for the last several years.”
Green, a Big Island physician, recently voiced support for the expansion.
“We are going to authorize $50 million in capital improvements to expand Hilo hospital,” Green said last month during a livestream with the Honolulu Star-Advertiser. “Hilo hospital wants more medical surge unit beds. These beds take care of people when they’re in deep crisis so that people don’t have to be transferred from Big Island to Oahu.”
District 1 state Rep. Mark Nakashima of Hamakua said the expansion will be a top priority for him during the upcoming legislative session state starts Jan. 18.
“Based on a limited stay I had there several months ago, they are in need of space,” Nakashima said. “We’re looking at building the ICU extension and a maternity wing. That will be a huge improvement, and as far as district priorities go, that’s at the top of the list.”
While the new beds and expansion will benefit Hawaii County patients, reducing the need to fly patients to Oahu for medical care will help alleviate overcrowding statewide.
“Because you want the neighbor islands to be able to do as much as possible to care for their own, I think we’ve heard a lot of support from Oahu political leaders as well as our own on Big Island,” Brinkman said. “The state is short on in-patient beds, and hospitals are full on all the islands. Oahu doesn’t have the capacity that it used to have.”
Brinkman is worried an aging population will only increase the demand for hospital beds in the future.
“Here on Big Island, we’re experiencing the aging of the population, and we’re starting to see this wave that might be with us for the next 10 or 15 years of patients who need more hospital services,” he said. “They are starting to get into their late 60s and early 70s, into the time when people have the most need for hospital care.”
HMC also is dealing with a backlog of patients who delayed services over the last few years out of fear of the COVID-19 pandemic.
“There’s a lot of speculation out there that for two or three years, our elderly population put off care,” Brinkman said. “They forego regulator visits for preventative care because of their concerns about getting COVID, and that perhaps has caught up with us.”
HMC continues to struggle with staffing shortages as well, with one report from September indicating the hospital was short 75 full-time positions. But Brinkman believes bed capacity is still the number one issue.
“For us, capacity is number one, workforce is number two,” he said. “I’m hopeful all those pieces will line up so that when we move in, we’ll have enough physicians, nurses, aides, respiratory therapists to staff it properly, but it will take legwork starting almost two years in advance.”
Brinkman confirmed designs for the project are complete and it is “shovel ready.” Construction would take place in two phases. The first would include the ICU bed expansion, followed by a maternity ward expansion.
Brinkman estimates the project could be completed by spring of 2026.
“It’s a pretty complex project, so we figure around nine months to a year for permitting, and that will get us to the end of 2023,” he said. “Then our hope is to start construction in spring of 2024. It takes two years to build a project of this size, so we’re looking at, if everything goes well, spring of 2026 we would be able to move in.”
The project would be the first major expansion of HMC since its construction in the mid-1980s.
“After 35 years, it would be really good to add onto our facility,” he said. “In the last five to six years, the state has invested a lot in keeping the facilities maintained, but we need to add to the facility proper.”
Any final approval for construction funds will come down to legislative action, and Brinkman remains hopeful.
“We are ready to go, but at the end of the day, it’s up to our legislators and our governor,” he said. “I’m cautiously optimistic that they will see our priorities.”
Email Grant Phillips at gphillips@hawaiitribune-herald.com.