A contract dispute between the state and Queen's Medical Centerforced some young patients with mental illnesses to scramble for new services last week.
Hawaii News Now was first alerted to the situation by a worried parent who described the situation as "chaotic" and "stressful."
The hospital's Family Treatment Center cares for young people with mental illness, including violent behavior, post traumatic stress disorder and depression. Last Thursday, the families of five young patients were told they were being transferred to Kahi Mohala Sutter Health in Ewa Beach.
A day later, the youth went by ambulance, leaving parents reeling from the news.
"I can understand the sadness and feelings that patients and families felt, but I feel we did a great job in providing compassionate care," said Kathy Morimoto, vice president of Patient Care at the Queen's Health Systems.
Lynn Fallin, deputy director of Behavioral Health, told Hawaii News Now that state officials "had ongoing meetings with the Kahi staff, the parents and our own staff to ensure the transition is smooth."
The reason for the move: The contract between the state Child and Adolescent Mental Health Division and Queen's expired on Aug. 31, and no new deal could be made.
The Family Treatment Center has the 24 beds. The state contract was on the residential side and included eight beds.
The state says it paid Queen's $832 per bed each day -- and that Queen's wanted a 68 percent increase.
"What we proposed was moving from $832 to $915, which we felt addressed what we could afford to pay them," Fallin said.
The state says the contract's end did not discontinue any services provided to its 1,500 youth clients.
"When the contract ended, we did a lateral move to another service provider," said Scott Shimabukuro, assistant administrator of operations in the Child and Adolescent Health Division.
Queen's said rates hadn't gone up in a decade.
"Our contract with the state expired and it was by mutual agreement that we needed to take a step back. It was a dated contract and it was about time that we looked at it," said Morimoto.
The contract dispute shows the challenges of the growing cost of health care.
Kumi Macdonald, executive director of the National Alliance on Mental Illness, called the system "really flawed."
She described how kids are often caught in the gap in care between crisis hospitalization and long-term facilities.
"We often get phone calls from family members who are at a loss of what to do next," said Macdonald.
Both the state and Queen's say they are working to add services for mentally ill youth. The state Health Department will be using a new grant to bring mentally youth back from mainland facilities and keep them here at home.
Queen's, meanwhile, is investing $8.1 million into its psychiatric ward.