Officials say they have been urgently trying to reduce the patient population after the killing of a nurse last year drew new attention to problems at the hospital.
Health officials are seeking $14 million in emergency funding to try to improve security and reduce the patient population at the Hawaii State Hospital, but the psychiatric facility may soon have to make room for an influx of even more patients from the privately run Kahi Mohala facility.
The hospital has contracted for years with the nonprofit Kahi Moha to house 40 of its patients there, and most or all of those patients are “forensic” patients. That means they were committed to Hawaii State Hospital by the courts after being arrested.
Sutter Health network is now pursuing a deal to sell Kahi Mohala to The Queen’s Health System, and “Queen’s has indicated that the forensic patients will no longer be serviced at that campus,” said Marian Tsuji, deputy director for behavioral health for the state Department of Health.
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The Hawaii State Hospital is licensed for 297 beds, but as of Wednesday morning had 345 patients. That census may increase even more if other patients who were hospitalized by the courts are returned to the hospital from Kahi Mohala. (Anita Hofschneider/Civil Beat/2021)
Tsuji told lawmakers Wednesday that the department is trying to reduce the number of patients at Kahi Mohala to prepare for the movement of patients from that facility back to Hawaii State Hospital. But the loss of the Kahi Mohala beds seems likely to aggravate already severe crowding at the hospital.
Kahi Mohala referred questions to a public relations firm, which said it didn’t have any information. Queen’s didn’t respond to a request for comment.
‘A Very Challenging Time’
Dr. Kenneth Luke, administrator of Hawaii State Hospital, told members of the House Health and Homelessness Committee on Wednesday the hospital is licensed for 297 beds, but as of Wednesday morning had 345 patients. That does not include the patients now at Kahi Mohala.
Public attention has focused on problems at Hawaii State Hospital since Nov. 13, when a patient stabbed to death 29-year-old nurse Justin Bautista with what hospital staff have described as a pocket knife.
The attack occurred on the hospital grounds in an unsecured cottage used for a state-operated specialized residential program, which functions much like a halfway house. Tommy Kekoa Carvalho has been charged with second-degree murder in the case and is being held at the Oahu Community Correctional Center.
The case was the first killing of a staff member on the hospital campus, but the hospital has long been the subject of complaints about abuse of patients and threats and violence against staff.
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Luke said after the attack on Bautista that the hospital has been urgently trying to reduce the patient count, but the census numbers he announced Wednesday suggest the facility has made little progress on that front in recent months.
“Hawaii State Hospital is going through a very challenging time right now,” Luke told lawmakers.
“The types of patients that we’re getting are much sicker than we got maybe a decade ago. These are patients that have not only a chronic and severe mental illness, but they also have co-occurring conditions, oftentimes a substance abuse disorder, primarily methamphetamine,” Luke said.
“This really complicates their conditions, makes them much more acute, much more difficult to treat,” he said. Luke said 70% of the patients were “houseless” on the street, and are therefore less stable than patients of past years.
He described the hospital staff as “the best staff that any hospital could ask for … but I feel that we owe them what we can to make the place safer.”
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Backlog In Evaluations
One problem has been the long delays in processing people sent by the courts to Hawaii State Hospital for evaluations to determine if they are mentally fit to proceed with their criminal cases, Tsuji said.
Marian Tsuji, deputy director for behavioral health for the state Department of Health, and Hawaii State Hospital Administrator Kenneth Luke brief House lawmakers on the emergency appropriation request. Tsuji said the process of evaluating patients for the court system needs to get quicker.
Those patients sometimes remain at the hospital for many months because of a backlog in the evaluations, which contributes to the high patient counts.
“We need to process people a whole lot quicker than what we’ve been doing,” Tsuji said. “We’re short forensic psychologists, evaluators at the courts as well as at the hospital, and so if we can get those evaluations done quicker, we can process them quicker.”
Crisis Shelters And Metal Detectors
House Health and Homelessness Committee Chairwoman Della Au Belatti questioned Luke and Tsuji about the request for an emergency appropriation to finance improvements to Hawaii State Hospital.
The original funding request in House Bill 1941 was for $5.975 million, but Gov. Josh Green is about to submit a governor’s message that will increase that request to $14.2 million, Luke said.
A consultant’s report last month recommended changes in hospital operations, and the money would be used to finance a reorganization, according to hospital staff. It would also pay for an expansion of the hospital’s existing network of community-based treatment facilities, Tsuji said.
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Those facilities are used to transition patients back into the community after they have completed treatment at the hospital. But some patients cannot be placed in group homes because they are full, which contributes to overcrowding as patients remain at the hospital until a community slot opens, Tsuji said.
She said the governor’s message will ask lawmakers to fund two licensed crisis shelters for patients, and two additional houses with 24-hour supervision. The state plans to award contracts to operate those facilities, Tsuji said.
Additional money is also being requested to increase the rates the state pays for existing group homes because in some cases those payments have not been increased in a decade, she said. Tsuji said she expects those rates will go up by 20% to 25%.
The hospital reorganization would involve creating a new “safety and security team” at the facility, and improving information technology, according to Naomi Yanagishita, associate administrator for administrative and support services at the hospital.
Another $650,000 would be committed to upgrading communications and information technology within the hospital, including fixing video cameras that no longer function, Yanagishita said.
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Tsuji said some of the new funding would also be used to buy wand-type metal detectors to screen patients such as Carvalho who are allowed to come and go from the hospital campus. The hospital is also requesting money for drug testing, Tsuji said.
Tsuiji said the governor’s message will request $700,000 in construction funding to relocate the hospital’s guard shack to better control access to the facility.
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A boy was killed after being struck by a vehicle today in Hawaii Kai, police said.
At about 11:02 a.m., a 37-year-old woman “was attempting to travel northbound” on Kukuau Place when the vehicle hit a boy who was in the road in front of the vehicle, according to a Honolulu Police Department’s Traffic Division news release. The child was taken to a hospital in critical conition where he was pronounced dead.
The driver remained at the scene and was uninjured, police said.
HPD did not release the boy’s age or say whether speed, drugs or alcohol were possible factors in the collision.
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This was Oahu’s ninth fatality in 2026, compared with 15 at the same time last year.
Leaders from Pacific Island nations and territories gathered this week at the East-West Center in Manoa for an inaugural diplomatic and business summit aimed at promoting private sector investments and contracts across island communities in Oceania.
Through Monday and Tuesday the Pacific Agenda summit brought representatives from more than a dozen countries and more than 80 companies, as presidents and prime ministers from across the region rubbed shoulders and held meetings with American corporate executives, investors and experts to discuss everything from infrastructure, energy, tourism, telecommunications and satellite technology.
Among the companies participating were national giants like Salesforce, Boeing, Google, SpaceX and JP Morgan along with local companies like L&L Hawaiian Barbecue, Hawaiian Airlines and Hawaiian Electric.
“Over these past two days, we have listened and shared through the roundtables and dialogues,” said Solomon Islands Prime Minister and Pacific Islands Forum Chair Jeremiah Manele as the summit wrapped up Tuesday evening. “I have noted some candid and frank discussions centered on the topics of this summit. Whilst the past and present may have influenced our perspectives, what we take forward as partners in commercial diplomacy following this summit is critical. Indeed, investment and security are inseparable and critical for prosperity.”
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The summit was hosted and co-organized by the East-West Center, U.S. State Department and Oahu-based U.S. Indo-Pacific Command. It’s part of a long effort that is in part aimed at countering China’s growing influence across the Pacific Islands as the U.S. and its allies work to maintain a footing in strategically important island chains.
Many Pacific Island countries have signed onto China’s Belt and Road Initiative, a series of Beijing-funded infrastructure projects aimed at promoting trade with China. Some analysts argue that many of the projects are “dual use” endeavors that also may be supporting Chinese intelligence and military operations in the region.
“We’ve seen other countries coming in the Pacific in quite an aggressive manner,” said U.S. Deputy Secretary of State Christopher Landau. “And in a sense, maybe that’s not a bad thing, and it’s given us a little bit of a kick in the butt to up our game in this region.”
Palauan President Surangel Whipps Jr. told the Honolulu Star-Advertiser that it’s been something he’s brought up frequently with American officials, saying that U.S. government agencies are “helping us build infrastructure, schools, health care facilities, roads. But when it comes to private sector, we don’t see you. You’re absent, but China’s there. So what we want to see is we want to see U.S. investment. We want to see Taiwanese investment. We want to see Japanese investment in our islands. We want to see Australian investment.”
The U.S. military has been investing heavily in Palau on infrastructure to support its operations as it pursues port renovations, building radars and stockpiling weapons and equipment for a potential Pacific conflict.
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It also has begun building a new fuel depot in Papua New Guinea to offset effects of the ongoing shutdown of Red Hill and working on airstrips and other facilities across the region.
INDOPACOM Commander Adm. Samuel Paparo told attendees and the summit “we do need you in the private sector to move in and to help us build the vibrant commerce that brings this infrastructure to life. I ask you to work with our partners to develop and connect markets, to lower risk, to enhance transparency and to ensure a level playing field.”
As the summit concluded, the U.S. Trade and Development Agency announced it would fund a “hospital relocation project feasibility study” around Palau’s Belau National Hospital — the only hospital in the small island nation — in hopes of rebuilding and modernizing the aging facility, with local company Architects Hawaii Ltd. taking on the work.
Several other Pacific Island leaders told the Honolulu Star-Advertiser they had reached memorandums of understanding with companies to work on future projects across the region. Manele said top issues for island communities included “whether our child has electricity to study at night and whether farmers can reach markets, whether digital connections allow young people to participate in the global economy.”
Gov. Josh Green, who sits on the EWC’s board of governors, called the summit “an extraordinary success from the East-West Center perspective to gather all of these leaders … a lot of serious business partners that are interested in looking at Hawaii as a potential bridge deep into the Pacific.”
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Landau said that he foresees looking to the EWC more to engage with Pacific Island nations, saying “the location here in Hawaii makes it a natural choice.” But he said that it would ultimately take years as deals discussed at the summit actually take shape before anyone can measure the impact of the summit.
“We welcome the realignment of foreign policy, and this is the first step in engaging us,” Tongan Prime Minister Fatafehi Fakafanua told the Star-Advertiser. “I think it’s a smart move to use the private sector to encourage investment into the Pacific. Evidently, there is not that much U.S. investment in the Pacific Islands, and we think this is a great catalyst for us to deepen our relationship.”
During closing remarks, Manele told Landau he would like him to “to help us with the establishment of a Pacific trade investment office in the U.S. similar to those that we have in New Zealand, Australia, China, Japan and in Geneva. It will greatly help our efforts in connecting trade and investment opportunities for us into the future.”
But while Pacific Island leaders welcomed the attention of American officials and companies, many still have deep disagreements with the United States. This month President Donald Trump’s administration rescinded the 2009 Endangerment Finding, which allowed the U.S. Environmental Protection Agency to regulate greenhouse gas emissions that contribute to climate change.
Trump and much of his Cabinet have insisted that climate change is a hoax. The White House has been rolling back environmental regulations while seeking to boost production of fossil fuels, encouraging other countries to import American oil and coal and deriding renewable energy sources.
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In a keynote opening the summit, Manele said “climate change remains the greatest security threat impacting our livelihoods, communities and economic prosperity. Rising seas and intensifying disasters erode development gains and strain national budgets. A flooded school or damaged hospital is not only a humanitarian issue, that is strategic one.”
Fakafanua said that during the conference his delegation had conversations with an American company on the prospect of underwater geothermal energy, a renewable source that could help Tonga become less dependent on imported fossil fuels.
“United States administration has prioritized some key areas that they’re focusing on,” Fakafanua said. “But at the same time, it’s a free conversation, and we’re also putting on the table our own priorities.”
The third-ranked Hawaii men’s volleyball team had no problem recording its 11th sweep of the season, handling No. 6 BYU 25-18, 25-21, 25-16 tonight at Bankoh Arena at Stan Sheriff Center.
A crowd of 6,493 watched the Rainbow Warriors (14-1) roll right through the Cougars (13-4) for their 11th straight win.
Louis Sakanoko put down a match-high 15 kills and Adrien Roure added 11 kills in 18 attempts. Roure has hit .500 or better in three of his past four matches.
Junior Tread Rosenthal had a match-high 32 assists and guided Hawaii to a .446 hitting percentage.
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UH hit .500 in the first set, marking the third time in two matches against BYU it hit .500 or better in a set.
Hawaii has won seven of the past eight meetings against the Cougars (13-4), whose only two losses prior to playing UH were in five sets.
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Hawaii has lost six sets all season, with five of those sets going to deuce.
UH returns to the home court next week for matches Wednesday and Friday against No. 7 Pepperdine.
