One of two Hawaii Health Systems Corp.’s long-term care facilities on Oahu is in jeopardy of closing if the public hospital network doesn’t receive additional state assistance by year’s end.

That’s the message HHSC officials relayed to lawmakers at a legislative hearing Tuesday at Leahi Hospital in Kaimuki, which along with Maluhia long-term care facility is facing a combined shortfall after state appropriations of $4.9 million for fiscal 2015, $9.5 million for 2016 and $13.3 million for 2017.

"If we continue to run these kinds of deficits, we’re looking at possible closure of one facility in fiscal year 2016," said Edward Chu, HHSC’s chief financial officer. "It may happen as early as fiscal year 2015, but for sure if we don’t get funding it will happen in fiscal 2016."

The 2016 fiscal year starts on July 1.

HHSC is facing a crippling $48 million deficit, mostly from collective bargaining increases negotiated by the state administration, and is urging lawmakers to fund it. The Oahu region is seeking about $4.3 million.

The long-term care facilities have a difficult time staying afloat as almost all of its elderly or disabled patients are on Medicaid, the government health insurance program for low-income residents.

"They struggle because patients are almost all Medicaid, which is the worst payer," Chu said. "It doesn’t cover the costs. We lose about $164 a day on Medicaid per patient."

The Legislature cut the hospitals’ $150 million budget request to $102 million for the fiscal year that began July 1, resulting in the shortfall that is projected to grow in subsequent years.

The hospitals rely on state money for 15 to 20 percent of their annual $650 million budget, with the bulk of the money coming from patients and their insurers.

Leahi has 155 beds, while Maluhia has 158 beds. Combined, the long-term care facilities have 460 employees. Leahi is the state’s only acute tuberculosis hospital with 11 beds designated for patients with the disease.

Manoa resident Annette Dung, a 74-year-old caregiver, testified before the panel of lawmakers Tuesday about the critical need for the facilities in the community.

Her 100-year-old mother is a resident at Maluhia and her 81-year-old aunt goes to day care there weekly, providing her some respite at home.

"If it wasn’t for Maluhia’s support to me and my mother, I don’t think I would be here today and neither would my mother," she said. "Without them, I wouldn’t be able to survive."