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The Honolulu Advertiser
Posted on: Monday, October 9, 2006

Appeal process for 2nd Maui hospital could take months

By Audrey McAvoy
Associated Press

The emotionally charged debate over whether Malulani Health Systems should be allowed to build a new hospital on Maui could potentially drag on for a few more months.

It all hinges on whether a state panel agrees to hear an appeal of an official decision to shoot down Malulani's plans for a 150-bed acute care community hospital in Kihei.

A significant share of Maui's residents have rallied behind Malulani out of frustration with the quality of care at the state-subsidized Maui Memorial Medical Center, the only hospital on the island.

Dozens of local residents including several of Maui Memorial's own doctors testified before state panels this summer, saying Maui needs a new hospital because Maui Memorial was incapable of adequately meeting the county's medical needs.

Even so, Dr. David Sakamoto, the head of the State Health Planning and Development Agency, last week denied Malulani's application. His ruling, which followed hearings by three state panels, said the proposed facility threatened to drag down the overall quality of healthcare in Maui County by competing with Maui Memorial for scarce resources.

Sakamoto also expressed doubts about Malulani's ability to find enough doctors and nurses to staff the new hospital.

Two of the state advisory panels had voted against the medical center, while one voted for approval.

Malulani must appeal the decision to the agency by Oct. 16.

If Malulani does ask for reconsideration something its chairman, Dr. Ron Kwon, has vowed to do a committee of five healthcare industry experts will decide within 30 days if the request has merit.

The agency's rules say Malulani must fulfill one of the following criteria for its appeal to be considered:

  • Present significant relevant information not already considered by the agency.

  • Demonstrate that there have been significant changes in factors or circumstances.

  • Demonstrate the agency failed to follow its own rules in reaching its decision.

  • Provide any other basis for a public hearing that the agency determines constitutes good cause.

    The five-member committee, which includes Sakamoto and a Maui County healthcare panel representative, must hold a public hearing within 30 days of the appeal "to the extent practicable" if the request for reconsideration is deemed to have merit.

    The committee must then issue its decision 45 days after the hearing.

    That decision is final.

    Gov. Linda Lingle has spoken out forcefully in Malulani's favor, warning the state wouldn't have the money to pay for future infrastructure or service upgrades at Maui Memorial.

    But even though Lingle appointed Sakamoto, she doesn't have the power to override his ruling nor the agency's final committee decision.