The proposed West Maui Hospital and Medical Center appears to be arising as promised after the project was shelved about a year ago when the economic meltdown knocked down the hospital's champion.
California-based developer Brian Hoyle, who owns Newport Hospital Corp., has informally teamed up with the West Maui Improvement Foundation.
The foundation is seeking a $50 million loan from the U.S. Department of Agriculture's rural hospital program, said foundation President Joe Pluta. The nonprofit would own the hospital if all goes as hoped on the still tentative third try, he said.
"We now expect to have final approval of the West Maui hospital USDA loan by early next year, at which time we will initiate preliminary development of the site," Hoyle said via email last week.
However, while the plan looks good and organizers want to have the hospital running by 2015, there are still a number of obstacles.
It relies greatly on federal insiders and politics and has its critics, or at least people wondering exactly what form it will take this time around.
The proposed facility would provide more than 200 jobs, Hoyle said. The idea is for the nonprofit to give the funding to Hoyle, and "then sign lots of official partnership agreements" for the facilities located about 1,000 feet above Honoapiilani Highway on Kakaalaneo Drive, Pluta said.
"My plan is to develop the West Maui hospital, (40-bed) skilled-nursing facility/(40-bed) assisted-living facility and (25,000- to 30,000-square-foot) medical office/clinic building all at the same time for a total development cost now estimated at $75 million," said Hoyle, whose ideas also include a behavioral-care facility and biomedical research.
Initial site work will begin next year, Hoyle said, for "a prefabricated, modular-built design for the same 25-bed, critical-access hospital that has always been the West Maui hospital operational plan."
That plan called for a 50,000-square-foot hospital, emergency room and surgery suites.
Hoyle said he has additional financing commitments from the Hawaiian Island Regional Center, which is an "EB-5 approved lender," referring to a visa program that allows foreign nationals to live here as long as they provide jobs in high unemployment or rural areas.
While the newly created jobs are welcome, they come with a caveat because there is a dearth of health care professionals, particularly nurses.
"Staffing for any health care facility in America is a challenge," Hoyle said. "It has always been our plan to work with the (University of Hawaii) Maui College and the local Maui health care community to find the best staff possible."
Rep. Angus McKelvey, D-West Maui-north Kihei, said that the USDA told the foundation to seek support letters from political leaders, the higher up the better. U.S. Sen. Daniel Inouye is chairman of the powerful Ways and Means Committee and recently told McKelvey he'll push for the hospital.
A statement from Inouye's office Saturday said, "Senator Inouye supports increased access to health care for all Hawaii residents, and he has consistently supported the network of federal health care centers on Maui."
The location of the proposed hospital changed three times for cost and legal reasons. When Hoyle lost his $70 million line of credit in spring 2011, the sides said at the time they'd pursue the project separately.
Pluta now says those statements were taken out of context, and that the foundation always remained a Hoyle "cheerleader." Hoyle declined to comment on the issue.
One of the challenges is that the plan calls for the hospital and medical center to be located on 6 acres within an overall 14.99-acre medical campus parcel. The land is owned by the Kaanapali Land Management Corp. and is inside the master-planned 913-acre Kaanapali 2020 development.
Pluta said the land needs to be carved out and given a tax map key first. Then it needs Maui County zoning and entitlements, including an updated environmental assessment.
"I haven't seen anything about it," said county Planning Director Will Spence. "I know there was a lot of activity a couple years ago."
Pluta said there's just not much to do until the funding comes through and the land deal is sealed. He is collecting donations for the environmental assessment.
"I am very much in favor of the West Maui hospital, for improving health care all over Maui," Mayor Alan Arakawa said Saturday.
Hoyle said he expects to get the entitlements within a year and has already spent more than $1 million on planning and designs.
"We have not heard from the West Maui hospital folks for years and are still unsure of what their plans are or how they may have changed," said Wesley Lo, chief executive officer of Maui Memorial Medical Center in a statement Friday. "With the changes in the health care landscape . . . it will be interesting to see what they are now planning.
"We need to make sure that whatever is being proposed is sustainable and coordinated in the best interest for all of Maui County."
Pluta said that the nonprofit hospital would operate in the black since it would qualify for complete Medicare and Medicaid reimbursements. Proving sustainability is a loan requirement, he added.
"The current plan is to hire a qualified hospital management company to operate the West Maui hospital," Hoyle said. "To date, several candidates have been explored, but no decision yet."
Hoyle also has the key to building any West Maui hospital: the certificate of need from the Hawaii State Health and Planning Development Agency.
Hoyle received the certificate in part because of West Maui's precarious and isolated location in the case of natural disaster. The community's primary highway is located on a cliff, frequently seeing traffic backed up by accidents or brush fires, the board noted.
Maui County Paramedics Association spokesman Ryan Joslin said that if the hospital has an emergency room, it would free up the west side's two ambulances, possibly saving lives. For example, people suffering from dehydration could be taken to Kaanapali in minutes instead of an ambulance having to return from Maui Memorial, then head back, he said.
"Having stroke, cardiac and trauma programs at MMMC lends us to think that MMMC will still be receiving many (if not then all) of these patients despite a west side hospital being in service," according to a MCPA board statement.
Former Maui Memorial Chief of Staff Dr. Peter Galpin, however, has different idea: build another helipad instead. The county has an EMT helicopter, which is used for critical cases north of the Kapalua airport. "From a medical standpoint, in no way will it enhance the delivery of urgent or definitive care," Galpin said. "I'll go even further and say people will die because of it."
Pluta said the group is not trying to replace Maui Memorial. "We're just doing this to save lives," Pluta said. "People are dying over here."
He said that the state told him the average trip to MMMC takes at least an hour.
"The 'golden hour' that Pluta keeps talking about to scare people refers to getting you to definitive care, and anything that delays you to getting to definitive care can be lethal," Galpin said. "This is a glorified ER."
Dr. Steven London, who's also a former Maui Memorial chief of staff, said that the hospitals would complement each other.
"I see the highway, and I see the population growth," the Kahului doctor said. "It's not a matter of 'if' but 'when.'"
What everyone does seem to agree on, at least, is the need for more long-term beds for a growing - and aging - population.
* Chris Hamilton can be reached at firstname.lastname@example.org.