Cancer Center worth saving but needs time

The University of Hawaii Cancer Center should be an asset. It would have been, had it grown more organically rather than taking on an $8 million mortgage for a beautiful but outsized facility in Kakaako Makai that has proven to be an unsustainable financial burden.

There’s still hope the center can become more manageable and worth some level of ongoing public subsidy, but it will take an overhaul in the way the center is operated and supported.

It needs a plan that involves all sectors, from labor unions and UH administration to the private entities being eyed as potential investors.

One such plan is the “Proposed Business Plan Update” for the center unveiled to lawmakers last week. The basic vision of the plan is for the center eventually to become a semiautonomous “enterprise model” with a private consortium of investors providing the financial underpinnings.

Whether this blueprint will work for the center is an open question; but it’s clear that success will require a similarly radical change.

Dr. Jerris Hedges, dean of the UH John A. Burns School of Medicine, said there’s precedent for such a model elsewhere, and even in this state. He remains hopeful that the plan has merit as a long-term strategy, but acknowledged it will take a great deal of negotiations to accomplish.

Hedges has been focused on near-term solutions: working to merge the administration of the cancer center and the medical school to boost efficiencies, and to lease out empty sections of the center as UH research space and offices.

The university plainly faces an uphill slog in the coming weeks to persuade lawmakers to come along. State Rep. Isaac Choy, chairman of the House Higher Education Committee, remains unenthused about the potential and said so at the legislative briefing Thursday.

The committee previewed the business plan update and got the “ask” from Hedges: $5 million to help cover the center’s budget over the coming year.

Legislators should neither reject this request nor dismiss the concept presented in the business plan.

University administrators have made some effort to rein in costs through their merger plan, and deserve the breathing room an appropriation would give them.

Further, a show of faith at this juncture is needed to give any new business plan a chance.

That’s because the current five-year period for the facility’s National Cancer Institute designation is nearly up, and the funds to continue work will be critical to securing a renewal.

The fact that the UH administration is finding this such a hard sell speaks to the fact that the taxpayers providing the support really don’t understand the importance of an NCI designation, or even the public good served by the Cancer Center.

The Cancer Center is awarded more than $1 million annually to ensure adherence to NCI centers, which is one way it secures up to $23 million in annual research funding, according to the business plan prepared by Warbird Consulting Partners for UH.

Hedges said having a cancer center here helps provide better access to drugs undergoing clinical trials. Some of them tested here already have shown promising results in treatment.

He also underscored another key argument bolstering the case: Enabling Hawaii research advances therapies that are effective in the population here, whose cancer vulnerabilities are shaped by ethnicity, culture and diet.

Demonstrating these benefits to the community at large must be part of any effort to chart a new course.

The “enterprise model” is analogous to the structure of the Research Corporation of the University of Hawaii, the agency founded to simplify the execution of federal research grants across the UH system, Hedges said.

Putting this model in place required coordination with unions and other stakeholders as well. What UH has in mind here will require out-of-the-box thinking from faculty: changing the pay structure and incentives for researchers who draw more of their salary from research funding grants than from the taxpayer.

Hedges also acknowledged a big difference in the cancer center business plan: It will take actual private-sector buy-in. The consultants did talk with administrators for the Honolulu hospitals who could be part of the cancer center’s ownership and governance, Hedges said, and were met with some interest.

This path should be explored, in the same deliberate, painstaking way that the state moved to privatize Maui Memorial Medical Center. That process required an investment of years, and this path may be every bit as rocky.

The UH Cancer Center represents a commitment to research and clinical treatments that Hawaii needs. With more responsible management, the investment should be worth the cost.