Shortfall ails public hospitals
By Kristen Consillio, The Honolulu Star-Advertiser | |
McClatchy-Tribune Information Services |
The aging hospital, part of the
You'd never know Nakamura has dementia with her well-kempt hair, light pink lipstick and pearly smile, though she requires 24-hour care that her daughter,
"My daughter takes good care of me. I'm very grateful to her," Nakamura said. "There's nothing like home, but I know she can't handle (24-hour care)."
Yoshizawa, 62, cared for her mother for seven years until she moved to Leahi.
"This is a good place to be," Nakamura said.
Leahi and 11 other facilities are at a critical stage, having to reduce costs after the state Legislature cut the hospitals'
"There's a concern it's going to be even worse here, and at that point we may have to cut back some of the beds at long-term care," said
HHSC relies on state money for 15 to 20 percent of its annual
Nakamura is among the majority of HHSC patients who pay for care via
HHSC acts as a "safety net" for the state's neediest population -- many of the poor and chronically ill. Its aging facilities are in a unique situation with nearly all HHSC patients on
"We take a lot of the patients that the private homes won't take," Hall said, adding that if there were cutbacks "there certainly will be people who will not have a place to go -- a great deal of them."
Part of HHSC's financial problems result from its rural facilities that are unable to generate sufficient revenue to support operations.
HHSC had hoped to partner with a private entity to rescue the mostly rural hospitals that appeal for state subsidies year after year. Public funding through the general fund tripled to
Earlier this year lawmakers explored legislation that would have paved the way for either a public-private partnership or the sale of some facilities to the private sector, but the bill stalled in the closing days of the session.
Without additional state support, HHSC officials have said the system won't be able to meet payroll or make payments to vendors.
In addition to the state not giving HHSC its full budget request,
The dire situation has already forced HHSC -- the largest provider of health care in the islands -- to begin cutting services and staff on the neighbor islands.
It recently announced plans to close its
HHSC hasn't been filling open positions that were budgeted and has laid off some non-civil-service employees, as well as temporary workers, and is delaying payments to vendors, Hall said. She didn't have a total number of layoffs, but said cost-cutting measures have reduced HHSC's projected cash-flow deficit to
In cutting the
"The state says it can't afford us. We're in this sort of bind without having full control of labor costs," she said. "Our costs are going up while reimbursements are going down. The cycle has to change soon, or it will impact our ability to provide safety-net services to our communities."
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