Posted on: Friday, June 29, 2001

Island Voices
Privatize the State Hospital

By State Rep. Charles Djou
R-47th District (Kane'ohe, Kahalu'u)

Many of the issues facing the hospital regarding patient services, public safety and hospital personnel operations can better be addressed by a private entity.

The state Legislature recently passed a bill allowing for the privatization of government services. Privatization will help Hawai'i taxpayers better manage the cost of government and improve the efficiency of services to the public.

Hawai'i should now seriously consider privatizing the Hawai'i State Hospital in Kane'ohe.

The operation of the State Hospital, located in my district, has recently been the subject of intense scrutiny and criticism. Many of the issues facing the hospital regarding patient services, public safety, hospital personnel operations and court oversight can better be addressed by a private entity instead of state government.

Over the past six months, there have been eight escapes from the State Hospital. These appear to occur with such seeming regularity that while covering striking professors at Windward Community College, KGMB-TV caught one hospital escapee on film "comically" fleeing the property. Another escapee, however, burglarized several homes and cars in the Kahala area before finally being apprehended by police.

These escapes and how to address them concern me and my community, and they should concern the state.

The State Hospital is hamstrung by conflicting policies and goals in both the Department of Public Safety and the Department of Health. Although Health and Public Safety are sincerely trying to find a resolution to this matter, a private party unencumbered by the rules and regulations governing these government agencies can better manage the security of the State Hospital.

Use of Act 90 to privatize the State Hospital will help address this public-safety issue by finally giving the hospital both the authority and responsibility for public safety.

Hawai'i taxpayers pay nearly 600 employees to look after a mere 160 patients at the State Hospital. Several news reports, in addition, have identified abuse of sick leave provisions by State Hospital staff.

Hospital administrators have told me that management of the hospital is stymied by government civil service rules. These administrators say that the personnel rules they must work under are ill-suited for operating a hospital and create enormous inefficiencies.

Better and more efficient management of the State Hospital could redirect much of the staff and resources to other areas of greater need in public health, such as children with mental disabilities.

Privatization can facilitate better management of government resources, superior oversight of personnel operations and increase cost savings to the taxpayer. Actions needed to achieve real efficiency at the hospital can best be realized through the use of privatization.

Management of patient care at the State Hospital has made progress under the federal consent decree, and the hospital has recently been re-accredited. Nevertheless, complaints about mismanagement of patient care still regularly crop up regarding the State Hospital.

Several states, including Pennsylvania, California, Arkansas, Vermont, Connecticut, Illinois and Massachusetts, have successfully privatized their mental hospitals, and as a result, they better serve patients at a reduced cost to taxpayers.

Because the Hawai'i State Hospital still operates under a federal consent decree, the state does not have complete freedom to direct operations of the State Hospital. Nevertheless, Hawai'i must begin exploring all of the state's options regarding the State Hospital, particularly privatization under the newly enacted privatization bill.

In 1999, the administration considered privatizing the State Hospital, but the Legislature imprudently rejected the idea. Now is the time to revisit and reconsider this pressing issue.

Hawai'i must come to grips with the problems at the State Hospital, and privatization is a serious proposal to examine. We need a proactive solution to the issues facing the State Hospital, instead of merely watching the state react to crisis after crisis with no strategy to fix the root cause of those problems.