Posted on: Sunday, May 20, 2001
Editorial
State must take control of State Hospital future
State Health Director Bruce Anderson said last week he welcomed tougher federal court supervision and monitoring of the Hawai'i State Hospital in Kane'ohe.
He had best be careful. This is the kind of help Hawai'i has too often received and far too often regretted.
The court, in the form of the by-now-familiar U.S. District Judge David Ezra, has ordered U.S. Magistrate Kevin Chang to serve as a special master overseeing the hospital's efforts to improve conditions and services for the mentally ill.
Ezra is unhappy with the progress made by the state in the wake of a 1991 consent decree in which the state agreed to make certain improvements to settle a Justice Department lawsuit. At the time, conditions at the hospital were deplorable.
Since then, there is general agreement that the hospital has made tremendous strides. Particularly impressive has been the improvement in physical facilities and a shift in patient treatment standards so that shackling and medication are not the primary management tools.
But based on the information provided to him, Ezra said he is convinced that more could be done to bring the hospital up to the standards expected by the federal government.
It must be. Those who are sent to Kane'ohe are there through no fault of their own. They suffer mental or emotional problems that make them a threat to themselves or others.
Even criminal patients are at Kane'ohe because the state has found them in need of treatment and has sent them there.
As a society, we have a responsibility to ensure that these patients are housed humanely and given proper treatment.
Part of the problem at Kane'ohe may be a longstanding "it's-not-my-problem" syndrome. Lawmakers say they have put aside enough money for the hospital, but that policies and procedures are not up to snuff. But hospital administrators say their real problem is lack of enough money to do the job they are required to do.
If a special master can cut through this buck-passing, the effort will have been worthwhile.
But the danger of any kind of court takeover — even a tentative one such as this — is that policymaking and priority-setting are taken out of the hands of those most responsible to Hawai'i's taxpayers.
As we have learned in the very similar situation of special-needs children in public schools (the so-called "Felix" case), this is a prescription for disaster. The primary responsibility of the court, or its representatives, is to see that the federal law is met, come hell or high water.
There is little attention paid to the impact on the rest of the state's obligations. Nor should there be. The court's obligation is to enforce the law or the agreements made by the state to settle lawsuits charging violation of that law.
Bit by bit, piece by piece, Hawai'i is giving up its political sovereignty to outside forces, simply because it has for too long failed to live up to its obligations to the least among us.
If the appointment of a special master steps up the pace at Kane'ohe and grabs the attention of both administrators and lawmakers, that's good.
But the sooner the state retakes control of its own destiny in this and other matters, the better. We should be in charge of our own destiny, and the best way to make that happen is to do things right.
