Editorial: State must account for hospital snafus

A long-awaited and critically needed state hospital may open in two weeks, finally, after more than a year of delays due to the lack of operational procedures, difficulty in filling positions and, perhaps most egregiously, various serious building flaws. The fact that this is greeted as a positive sign by state legislators shows just how far our standards have fallen.

Even then, it wasn’t clear at Monday’s joint briefing before Senate and House health committees that people could quite believe the promises of doors starting to open in mid-April at the new Hawaii State Hospital in Kaneohe.

“I don’t know why it has taken so long,” said state Sen. Sharon Moriwaki. “But if you are actually opening up, that is good news.”

What would be better news: a full accounting to the public of why things went so wrong, and what will be done to see that such mistakes aren’t repeated.

Of course, providing accountability had been the purpose of the legislative briefing. But committee members did not get any clear satisfaction after 90 minutes of questioning state officials linked to the project, especially the state Department of Accounting and General Services (DAGS), which oversaw construction.

Lawmakers’ essential query — how could this have happened? — still needs an explanation, something they should seek through an audit. More to the point, Gov. David Ige should demand full disclosure on the snafus, and see that the public is informed through a published report.

These were costly errors, on more than one front.

To start with, this is a $160 million, state-of-the-art building designed to overcome longstanding problems, which persisted while the state waited for it to open.

The Health Department’s struggles there date back years, many of the issues stemming from the overcrowded, outdated facility for mentally unstable patients, many ordered there by the courts.

In 2014, for example, three hospital employees filed a class action lawsuit asserting that the unsafe work environment fostered attacks by patients on the workers. That same year, a special legislative committee was convened to investigate such complaints, as well as the shortcomings in hospital design and infrastructure.

Among other functions, the hospital accommodates forensic patients referred by the criminal courts for mental health treatment. There have been multiple escapes of patients, including, most notoriously, Randall Saito. In 2017, he left the psychiatric hospital, having arranged transportation to the airport, and managed to board a chartered flight to Maui then a commercial flight to San Jose.

That was the most stunning case, but there have been many other escapes, most recently on March 6.

The hospital had security problems stemming from its aging infrastructure, but they are as much procedural and training failures as a lack of adequate equipment and structure. In October, the Hawaii Government Employees Association complained that policies and procedures had not been put in place, even after months since the state initially signed off on construction.

That was time wasted, a failing that the Health Department has acknowledged.

The construction-related delays stemmed from defects that DAGS did not identify on walk-through inspections, including dozens of showers that didn’t work or drain correctly. Surely, competent project management should have uncovered such flaws at each step of the way.

There is now a plan for the move-in, floor by floor, so that staff is fully trained.

Just as important, however, is a plan for avoiding such a colossal mess in the future. The public that invested its money in this project will be watching for such a disclosure, and for the doors to finally open, as promised.