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The Honolulu Advertiser

Posted at 12:22 p.m., Tuesday, May 1, 2007

Vote boosts chances for local control at Maui Memorial

The Maui News

WAILUKU — A key legislative vote has boosted the prospects for more local decision-making at Maui Memorial Medical Center, the island's only acute-care hospital.

The action took place late last week at the state Capitol in Honolulu, where hospital Chief Executive Officer Wesley Lo lobbied state lawmakers for a bill opposed by his own boss.

"The hard work is done," Lo told The Maui News Monday morning during a break from administrative meetings at the hospital.

Senate Bill 1792 was introduced by Maui Sens. Roz Baker, Shan Tsutsui and J. Kalani English in an effort to achieve more local autonomy from the Hawaii Health Systems Corp., the managing agency of the state's 12 community hospitals.

HHSC Chief Executive Officer Tom Driskill has said he and his board support the intent to improve community-based governance, but not an attempt to devise separate corporations within the overall system.

Driskill lobbied against semiautonomous status for community hospitals. He pushed instead for legislation that would create regional affiliate boards for each area of the HHSC network.

"Not only do you have a regional board empowered to conduct the day-to-day management of the centers in a region, but the same people are sitting on the board," Driskill had said in mid-April when a House makeover of SB 1792 had been approved.

Baker said she believes the amended version of the bill has achieved the autonomy Maui officials were seeking, while addressing statewide concerns about how the legislation could affect other HHSC hospitals that might not be as prepared to take on a new kind of governance.

"It's accountability as well as empowerment," Baker said in describing the effects of the legislation.

Among other things, the conference committee approved a bill that:

  • Creates boards for five regions within the Hawaii Health Systems Corp. by Jan. 1, 2008. The Maui region would cover Maui Memorial Medical Center, Lanai Community Hospital and Kula Hospital.

  • Gives the regional boards custodial care of all financial assets and real property, including land, structures, fixtures or other physical assets.

  • Makes the regional boards responsible for local governance, operations and administration of the delivery of services in each respective region.

  • Exempts regional boards from state procurement laws.

  • Provides for $750,000 to fund the transition of the regional boards.

  • Assigns duties and powers of the corporate board to corporationwide matters, including corporationwide budgeting, personnel policies, strategic planning and issuance of revenue bonds.

    Sets budgetary guidelines that call for the corporation board and the regional system boards to "collaboratively develop budgetary guidelines and annual operating and capital budgets for each facility."

    Baker said she expects a floor amendment to be introduced Thursday to change some of the "minor" language in the bill. Typically, legislation approved by the House-Senate conference committee gets passed by both sides of the Legislature. However, both Baker and Lo would not declare victory before Thursday's final vote.

    "The important part is that it's coming to a vote," Lo said.

    Baker said that, if approved, Senate Bill 1792 would serve as a tribute to Herbert Sakakihara, a longtime Maui Memorial supporter and leader on the hospital's Management Advisory Council who died late Sunday in Honolulu.

    Sakakihara long had advocated for local governance for Maui hospital operations, appointing Wayne Lu last year to chair a subcommittee that would fight for "some level of autonomy."

    "I'm sure that Herb would have been happy to hear about this," Lu said Monday afternoon. Lu dispatched word about the conference committee action to Sakakihara's wife to make sure her ailing husband knew about it.

    "I couldn't agree more that this bill is a tribute to Herb. ... He was always supportive of the cause of the hospital," Lu said.

    About 10 years ago when legislation created the Hawaii Health Systems Corp., Sakakihara and Lu had hoped for the kind of regional boards set up in SB 1792. It didn't happen.

    That appears to be changing with advocates like Lu, Sakakihara and attorney Tony Takitani, a Management Advisory Council member who also has been lobbying for the bill.

    "It could be the greatest thing for patient care," Takitani said.

    Lu said that, under the HHSC, Maui Memorial has made major strides in developing new services and acquiring the latest technological advances in medicine in places like the new Heart, Brain and Vascular Center. However, both Lu and Takitani said they believe that such improvements could have been done at a faster pace had a regional board already been formed.

    As an example, they point out that the HHSC board meets once every two months to deliberate on issues affecting the entire network. A local regional board probably would convene more often and could respond more quickly to emergency situations by focusing on just one facility's needs.

    "We definitely could make decisions faster than a cumbersome HHSC system," Lu said.

    Lo credited Maui lawmakers for the bill's passage, noting the instrumental influence and work by Baker, Tsutsui and state Rep. Bob Nakasone. "The whole Maui contingent was very supportive," Lo said.

    Takitani pointed out that the new regional board's makeup will include three physicians, all of whom he hopes will take the board responsibility seriously.

    "We can only make things better," he said.

    For more Maui news, visit The Maui News.