Malulani board president Dr. Ron Kwon yesterday said the organization is negotiating the final details for financing, and has an option on 40 acres of privately owned land adjacent to the Maui Research & Technology Park in Kihei. He said Malulani will apply for a certificate of need from the State Health Planning and Development Agency by the end of the year. The certificate-of-need process requires public hearings, and is meant to prevent new operations from jeopardizing existing facilities that provide vital health care.

Maui Memorial Medical Center officials have used the process to oppose any medical facilities that might compete with services it provides, arguing that such operations would diminish the hospital's financial health and ultimately affect the availability of care to Maui residents and visitors.

The 196-bed hospital is run by the quasi-public Hawai'i Health Systems Corp., which oversees 10 Neighbor Island hospitals and two on O'ahu. Maui Memorial has been one of HHSC's few profitable facilities, and some of its revenue helps keep smaller hospitals open in rural communities.

Wesley Lo, chief executive officer of Maui Memorial, yesterday referred to "the difficult healthcare environment" facing hospitals, and said HHSC "is extremely concerned about Maui's ability to have adequate resources to sustain two hospitals."

"We believe that it would not only negatively impact the quality of healthcare for Maui County, but for all outlying districts in Hawai'i, by degrading and diluting a finite amount of healthcare resources," Lo said in a statement.

He said Maui Memorial is effectively responding to the community's needs, and is working to develop a 80,000-square-foot wing, a medical office building, and a 250-car parking structure.

Kwon, who has served on various Maui Memorial committees, said there is room for two hospitals on Maui, judging from a chronic bed shortage at the Wailuku facility. "Maui really needs a new hospital that provides services that aren't currently provided and expands services to areas that aren't being served," he said.

"The beauty of the project is that it's not going to cost a cent of public funding," he said. And, because it's a nonprofit, "we will service everyone regardless of whether they can pay. This is not going to be a place just for the rich" residents of the Kihei and Wailea resort areas, he said.

Designs for the Malulani hospital call for a low-rise facility and a landscaped campus "with a very different feel," Kwon said. In addition to the usual hospital units, it will have an inpatient hospice, a spiritual center, and a helipad for medical air transports, he said.

If the approval process goes smoothly, Kwon said the hospital could open in three to four years.

Joe Pluta of the West Maui Taxpayers Association, who has been working for years get a hospital built on that side of the island, said he doesn't think the Malulani project will threaten his efforts. He said the Lahaina area will remain geographically isolated from critical medical care until a West Maui facility is built. "It does verify what we've already known. We've got to do more ... Maui Memorial just isn't going to make it," he said. "Lives are at risk and people have just had it."

Pluta and the nonprofit West Maui Improvement Foundation secured 15 acres from Ka'anapali Development Corp. for a small hospital as part of a 1,154-acre development that would include 2,800 residential units, a golf course, parks, a school and commercial space. Pluta said a number of companies have expressed interest in building a minimum 35-bed hospital, and he hopes to apply soon for a certificate of need.