Judge cites 'dramatic' progress at state hospital

By Robbie Dingeman
Advertiser Health Writer

Chief U.S. District Judge David Ezra yesterday said the Hawai'i State Hospital has made "dramatic" progress in the past six months, but said the mental hospital will likely miss its deadline next year to complete all of its goals.

He said he would be open to extending the deadline if improvements continue.

Ezra yesterday got a report from attorneys for both the state and the U.S. Justice Department, which sued the state in 1991 to improve conditions and staffing at the facility.

"It is a substantially safer environment than it was several years ago," Ezra said. "Are we where we should be yet? No."

In 1991, the federal court stepped in and appointed a court master to oversee the state hospital, which had been criticized for overcrowding, a rash of escapes in recent years and for keeping people at the hospital longer than necessary.

Ezra praised attorneys, hospital staff and state officials for working together to make the improvements. In years past, Ezra said, "we had a mental health system that was barbaric." But he said Hawai'i is working toward having one of the best in the nation.

U.S. Magistrate Kevin Chang is serving as the court-appointed special master overseeing the state hospital's improvement plan. In his fourth report to the court, Chang said the hospital has continued to improve.

Chang called the February hiring of Reneau Kennedy as forensic director a positive step, noting that about 90 percent of the patients are admitted or committed through the courts. He also praised a new "treatment mall" program that gets most patients out of their rooms and into some activities on weekdays.

Ezra said outstanding concerns include patient and staff safety stemming from the presence in the general hospital population of patients who had been involved in violent crimes; and a shortage of registered nurses.

Chang cited the hiring of Dr. Rupert Goetz as clinical director as part of a plan to evaluate and resolve the safety issues.

However, Ezra said those outstanding concerns appear unlikely to be resolved by the compliance deadline of Feb. 21, 2004. He encouraged the attorneys to get together and propose a set of realistic guidelines for completing the plan.

After the hearing, state deputy health director Jane Kadohiro said state officials will strive to meet every deadline.

"We feel we will be able to technically meet the timelines that had been imposed. We will be keeping very vigilant to do so," she said.

Dr. Tom Hester, chief of the adult mental health division, said the state was happy with Ezra's "remarkably positive and encouraging report," and said the staff feels more committed to improving the mental health system for the long haul, "to build a sustaining system that can endure beyond the time of court involvement."

Reach Robbie Dingeman at rdingeman@honoluluadvertiser.com or 535-2429.