Gov. Linda Lingle yesterday asked the Legislature to grant an immediate exemption from the certificate-of-need process to allow a second acute-care hospital to be built on Maui.

The request came after a State Health Planning and Development Agency committee on Monday rejected an appeal of an earlier decision denying a certificate to the $212 million Malulani Health & Medical Center, planned for Kihei.

Lingle said the committee's decision "does not make medical or economic sense," since the new hospital would be built with private money.

In earlier statements expressing support for Malulani, the governor said it is unlikely taxpayers will be able to provide adequate funding to help state-subsidized Maui Memorial Medical Center meet the island's current and future healthcare needs.

Dr. Ron Kwon, who is heading the effort to build the second hospital, said yesterday that if lawmakers do not clear the way for the project, there are other options, including legal action. Malulani developers also may decide to submit a new certificate of need application for a hospital to replace Maui Memorial, Kwon said.

SHPDA head Dr. David Sakamoto rejected Malulani's application in October, saying its planners failed to meet several criteria for approval, including providing proof there would be enough nurses, doctors and other employees available to staff the new 115-bed hospital. He also said a second hospital "would undermine and weaken the community's healthcare system by duplicating and diluting services."

But Sakamoto also pointed to the need for one large, well-run, strategically located hospital as a more efficient and effective means of addressing Maui's acute-care needs. Kwon said he is taking that as a signal that the SHPDA administrator is open to a proposal for a replacement hospital.

The Malulani project cannot be built without SHPDA approval. The agency is charged with ensuring that major new medical services and facilities fit within the state's healthcare priorities and don't threaten existing vital services.

Lingle also asked lawmakers yesterday to change the certificate-of-need approval process to make it easier for communities to benefit from state-of-the-art medical facilities and services.

The Malulani project is a partnership between the Maui nonprofit Malulani Health Systems Inc. and Triad Hospitals Inc. of Plano, Texas. Triad offered to pay 80 percent of construction costs for a healthcare facility that would include a comprehensive imaging center, an emergency department, a heliport, open-heart surgery facilities and a neonatal intensive-care unit not now available on Maui.

At hearings last year on Malulani's certificate-of-need application, dozens of physicians, nurses and residents testified about their frustration with Maui Memorial's services and its 50-year-old facilities.

Maui Memorial officials oppose the Malulani project, saying their hospital would lose $55 million annually, threatening its ability to act as a "safety net" provider to the poor. They also said they are making progress toward significant improvements, including a newly opened $46 million wing and a cardiovascular services center.

Reach Christie Wilson at cwilson@honoluluadvertiser.com.