David Y. Ige

HONOLULU — The Hawaii State Hospital in Kaneohe, which for more than a decade has been challenged with overcrowded patient conditions, an ever-increasing number of high-risk patients, and concerns about employee safety, now has a solution to address these issues.

The Hawaii State Department of Health has updated its master plan to optimize use of the hospital’s 103-acre property and maximize operational efficiency to improve safety for patients, staff and the public.

To address the need to separate the high-risk patients from the other patients, the hospital plans to replace the dilapidated Goddard Building at the top of the campus with a new, $160 million, 144-bed patient care facility.

The updated master plan creates a two-hospital model to effectively serve both high-risk patients as well as low- to medium-risk patients. High-risk patients are those who behave violently and can potentially harm other patients and staff.
Construction of the new building on the Goddard building site is contingent upon conducting an Environmental Assessment, with opportunities for input from the public.

Background

In 2014, a Senate investigation revealed that the challenges facing Hawaii State Hospital stemmed from the hospital’s mandate to admit all types of patients ordered to the hospital without regard for the number of available licensed hospital beds. The judicial court system orders patients, including those charged with committing violent crimes, to Hawaii State Hospital for evaluation, care and custody. By law, the hospital must admit these high-risk patients.

“Almost every day, new forensic patients are admitted and this creates a ‘wide open front door’ with a ‘narrow back door,’” said Virginia Pressler, MD, director of the Hawaii State Department of Health. “These patients can only be discharged after a complex, comprehensive evaluation process and a judge’s written authorization.”

First Step
The new patient care facility that will replace the current Goddard Building will feature a rehabilitation mall and dining room exclusively for high-risk patients. A secure exterior wall and high-security fencing system will reduce the risk of these patients escaping to enhance community safety.

Demolition of the existing Goddard Building, which has been approved by State Historic Preservation Division of the Hawaii State Department of Land and Natural Resources, is targeted to begin in 2016.

The new patient care facility will be modeled after the design used by the Colorado Mental Health Institute at Pueblo, a 451-bed psychiatric hospital that provides treatment for patients at different risk levels. The behavioral health facility, where Hawaii State Hospital administrator William May previously served as director, provides clear lines of sight from a central nursing station. This same design in the new building will help reduce the risk of patients harming themselves or each other and assaulting hospital staff.

The 144 beds in the new patient care facility will be added to the hospital’s existing 108 beds located on the lower campus for a total of 252 beds.

Patients in the deteriorating Guensberg Building located adjacent to the Goddard Building on the upper campus will be moved to the newer units.

Long-Term Plan
Under the updated master plan, phases are outlined which will permit the hospital to incrementally increase its total capacity over time to 516 beds. This will occur as more buildings are added or renovated and repurposed, depending on the changing needs of the hospital and available resources.

A future phase of the master plan calls for the Guensberg Building, adjacent to the Goddard Building, to be demolished and replaced with another 144-bed patient care facility. The Guensberg Building built in the 1950’s is the oldest unit in operation at the hospital. The replacement patient facility for the Guensberg Building will allow the 40 Hawaii State Hospital patients who reside offsite at Kahi Mohala in Ewa to be relocated to the Kaneohe hospital campus.

Bishop Building to Become New Skilled Nursing Facility

As a separate initiative under the master plan, the Bishop Building on the hospital’s lower campus will be demolished and replaced with a skilled nursing facility that will be independently operated.

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