HILO, BIG ISLAND (HawaiiNewsNow) - Nearly 90 layoffs at three publicly-funded hospitals on the Big Island are causing elimination and reduction of some medical services, including psychiatric beds that one advocate worried could be "deadly."
More job losses and service reductions are coming in the next two months at other public hospitals across the state because the system faces a $55 million dollar shortfall.
A total of 87 employees -- seven percent of the workforce at Hilo Medical Center and hospitals in Ka'u and Hamakua are being laid off. Nurses, aides, secretaries and managers will lose their jobs because the three facilities are projecting a $7 million deficit in the next year.
"Seventy-five percent of our patients are Medicare-Medicaid and their insurance does not cover the cost of providing care," said Dan Brinkman, the interim CEO of the East Hawaii region of the Hawaii Health Systems Corporation.
The Hilo hospital is eliminating its Home Care Services department that provides nursing care to about 350 homebound patients a year.
Also in Hilo, eight beds – equal to 40 percent of Hilo's psychiatric hospital spots at its Hale Hoola facility will close down.
The hospital said 90 percent of the time the remaining ward can handle the load of mental patients there.
"We felt, though, in making some tough choices, that we could only afford to keep the 12-bed wing open," Brinkman said.
Brinkman said the psych unit average eight to nine patients a day now, and the number of mental patients there exceeds 12 only once or twice a month.
The head of Mental Health America's Hawaii office worried the effects of the cutback will be deadly.
"More people will be homeless and more people will be in jail and more people will die, actually," said Marya Grambs, the executive director of Mental Health America of Hawaii.
Dr. Linda Rosen, CEO of Hawaii Health Systems Corporation, who oversees the state-funded public hospitals said the reduction of the psychiatric ward "It will mean a limitation on the capacity so that on some days, they may not be able to accommodate patients to be admitted right away. They may have to wait in the emergency department longer or in some cases, they may have to be transferred to Honolulu."
"I think we're going to definitely have criteria that we're not going to eliminate psychiatric services in any of our hospitals, because they are too critical," Rosen added.
Grambs said it's not practical to send a patient having a psychotic break or a schizophrenic episode on a plane to Honolulu.
"Where are they going to go? I'm hearing right now from homeless providers that they cannot get their clients into Castle or Queens or Kahi Mohala because they're full a lot," Grambs said.
Rosen said more layoffs and service cuts are coming at other facilities, such as Leahi Hospital and Maui Memorial in the next two months.
"There could be some services that won't be as convenient. So for instance, the region might be looking at reductions in services such as oncology," Rosen said.
In Hilo, all nine nurses' aides and clerical support staff in the Home Care Services department are losing their jobs.
With home care, Rosen said, "There are some other providers of those services, so while that's a reduction in what they provide, hopefully patients can still get assistance from other providers."
Out of the 87 employees on the layoff list on Hawaii Island, about 23 of them are traveling nurses and other contracted employees, hospital officials said.
"We're having to do some surgical selection of things to not do to keep the facilities open," Brinkman said.
"Eighty percent of our revenues is on personnel cost, so we just can't close the gap without some reductions in personnel," Rosen added. "Each service that they look at is a balance between is it something that we could save money and is it something that patients could maybe get somewhere else?"
The HHSC East Hawaii Region comprises the Hilo Medical Center, Hale Ho'ola Hamakua, Ka'u Hospital and Rural Health Clinic and the Yukio Okutsu State Veterans Home. In 2014, the East Hawaii Region experienced 49,000 emergency room visits, 39,000 clinic visits, 9,000 admissions and over 1,100 births. The East Hawaii Region operates on a budget of $160 million and, with a current payroll of over $100 million; it is Hawaii Island's second largest employer.