The University of Hawaii Cancer Center deserves a chance to succeed. Most Hawaii residents have or will have a family connection to cancer at some point, so there’s a wellspring of public sympathy for the mission of fighting the disease.
However, the taxpayer also has the right to expect the institution to stand with far less state assistance at some point, and not too far in the future. An institution with a $10 million annual deficit can’t be carried forever. Already, too much time has been lost in the now-infamous administrative dysfunction at the center, time that could have been invested in building capacity for self-sufficiency.
And now the center faces a short deadline if it hopes to renew its National Cancer Institute certification, which qualifies it for federal grants.
So the release last week of a report showing the insufficiency of the financial foundations of the cancer center must prompt a thorough examination of options that can put the facility on firmer ground, strengthening the private partnerships that will make operations more affordable for the taxpayers now underwriting it.
To that end, state lawmakers have the correct instinct to demand a rational and realistic business plan from the UH officials now overseeing the center, and to take a reading of commitment to the project — from the private health-care industry as well as the general public.
The legislation this session seem to run the gamut. At one end is Senate Bill 808, introduced by Senate Health Committee Chairman Josh Green, proposing a reorganization of the Kakaako complex, now home to the cancer center and the John A. Burns School of Medicine.
Under this bill, the complex would become a separately administered "Hawaii health sciences campus," one that would share debts that would be financed through general obligation bonds, serviced by the taxpayer-funded general fund.
At this point this seems a risky commitment. The requirement for an approved business plan mitigates that risk somewhat, but given the university’s debt- and facilities-management record, it’s still a concern.
At the other end, the preferred route by state Rep. Isaac Choy is to consider selling or leasing the heavily mortgaged cancer center building.
Choy, who chairs the House Higher Education Committee, champions House Bill 544, which would direct the UH Board of Regents to study the feasibility of selling or leasing the structure. It comes up for a hearing Tuesday.
This should be an option on the table, but not the only one.
"I am not going to entertain rearranging the deck chairs," Choy said last week. "This is a sinking ship and they must plug the hole. … Getting a larger share of tobacco taxes or an allocation of the master settlement is not something I will entertain."
Choy has brushed off other alternatives, but the rest of the community, the beneficiaries of a nationally certified cancer center, would like to have a comprehensive discussion.
Before any final decisions are made, lawmakers must consider the new business plan for the center. UH administration wants that document in March, said Jerris Hedges, dean of the medical school and interim director of the cancer center.
The current blueprint, according to a recent report from a UH task force assembled to evaluate the center’s status and prospects, is flawed and can’t make operations sustainable. Partly that’s because a share of the cigarette tax revenue was projected as a principal source of revenue, but has declined from those $20 million annual levels. And the cancer center has annual debt service of $8 million it can’t afford.
Hedges said center officials always knew they had to find other revenue streams as smoking decreased — and the construction of a new facility was, in fact, necessary because the center’s old home on Lau-hala Street was deteriorating and its lease was ending.
But surely there could have been a more realistic pairing of the structure costs with revenue sources to pay the bills.
Hedges also said part of the new business plan will be much closer ties between the medical school and the center to enhance efficiencies. This would be wise, especially if it means money can be saved on the high administrative costs.
But such a "merger" is not the entire solution. Other obstacles that must be overcome have been identified by the task force as well as the cancer center’s staff and faculty. The consortium — the group of hospitals and practitioners who provide the clinical service for cancer drug trials — must be further developed to enhance support and community outreach. And the team of researchers and clinicians who do the important work of the center must thrive, yielding more innovative lines of research and new therapies.
That is the whole reason Hawaii wants this center. It brings state-of-the-art cancer research and treatment within reach of residents, many of whom can’t afford travel to another institution. What the state needs is a reasonable path toward that goal.
