Long-range expansion plans for the Hawaii State Hospital have been approved by the Honolulu City Council after the facility’s staff gave assurances that improvements would include a perimeter fence and other public safety measures prompted by the recent escape of a patient deemed to be dangerous.

The Council voted unanimously Wednesday to approve Resolution 17-329, granting a Plan Review Use permit to the state for the 2015 master plan expected to meet the Kaneohe facility’s needs through 2050.

Before the vote, Council members inserted language requiring the Department of Health to request from the Legislature the funds necessary to transition its existing facilities “into a fully secure hospital facility.”

William May, Hawaii State Hospital administrator, told Council members that plans call for a perimeter fence around the main portion of the hospital, and in particular, a planned 144-bed new patient facility.

“A good portion” of the rest of the campus “will be utilized by patients in a less restricted setting,” May said. Following last month’s escape, hospital officials spent significant time with Department of Public Safety officials, who recommended a series of policy changes including the installation of a perimeter fence, he said.

May told the Council Zoning Committee on Tuesday the fence is proposed to be 12 feet high.

The proposal is an update of a 2005 master plan and “designed to address increases in patient population, safety concerns and aging infrastructure,” according to documents the hospital submitted.

First built in 1932 when it was known as the Territorial Hospital, the facility is the only one in the state where psychiatric patients are admitted and discharged according to judicial order.

Plans for the next 15 years include:

>> A four-story, self-contained 144-bed patient facility to replace the recently demolished Goddard Building on the “upper campus” next to the Guensberg Building.

>> An on-site privately run skilled-nursing facility, which would still need an additional permit from the Council before construction can begin.

>> Plant operations and warehouse buildings, including expanded parking.

More long-term projects that are planned include a second, 144-bed patient care facility and two additional 72-bed facilities.

The grounds currently house 178 beds “with overflow,” according to plans submitted by the hospital.

During a lengthy discussion before the Zoning Committee on Tuesday, May said the campus now is not secure, although seven buildings are locked. Two of the units are within a security fence, but five are not.

Most of the patients had some kind of on-grounds escorted or unescorted privileges “up until a few weeks ago,” May said.

The new, 144-bed building “will be a self-contained, forensically designed building,” he said. “Patients will get all of their treatment — they’ll be fed, they’ll be treated, they’ll be housed, in an extremely secure facility.”

The master plan calls for the rest of the campus “to not be a secure facility,” May said. But after the escape of patient Randall Saito on Nov. 12, the Department of Public Safety was asked to provide a complete audit of the facility and policies, he said.

DPS gave hospital staff a list of recommendations late Friday, and administrators are reviewing them now, May said. “They include things such as physical enhancements, the potential use of some technology for monitoring our patients maybe better than we do now.”

Councilman Ikaika Anderson told hospital officials that “ensuring the health and safety of the community” is a priority. He led the effort to insert the language requiring that the improvement include making the campus “a fully secure hospital facility.”

The hospital has 666 full-time staff positions, 607 of which are now filled, May said.

Saito was able to leave the hospital grounds, hail a cab, fly to Maui and then hop on a flight to California before he was captured Nov. 15. At least seven hospital employees were placed on unpaid leave following the escape.