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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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.
Hawaiian Airlines’ passengers are back in federal court trying to stop something most people assumed was already finished. They are no longer arguing about whether they are allowed to sue. They are now asking a judge to intervene and preserve Hawaiian as a standalone airline before integration advances to a point this spring where it cannot realistically be reversed.
That approach is far more aggressive than what we covered in Can Travelers Really Undo Alaska’s Hawaiian Airlines Takeover?. The earlier round focused on whether passengers had standing and could amend their complaint. This court round focuses on whether harm is already occurring and whether the court should act immediately rather than later. The shift is moving from procedural survival to emergency relief, which makes this filing different for Hawaii travelers.
The post-merger record is now the focus.
When the $1.9 billion acquisition closed in September 2024, the narrative was straightforward. Hawaiian would gain financial stability. Alaska would impose what it described early as “discipline” across routes and costs. Travelers were told they would benefit from broader connectivity, stronger loyalty alignment, and long-term fleet investments that Hawaiian could no longer fund independently.
Eighteen months later, the plaintiffs argue that the outcome has not matched the pitch. They cite reduced nonstop options on some Hawaii mainland routes, redeye-heavy return schedules that many readers openly dislike, and loyalty program changes that longtime Hawaiian flyers say diminished redemption value. They frame these not as routine airline integration but as signs that competitive pressure has weakened in our island state, where airlift determines price and critical access for both visitors and residents.
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What is different about this filing compared with earlier debates is that it relies on developments that have already occurred rather than on predictions about what might happen later.
The HA call sign has already been retired. Boston to Honolulu was cut before competitors signaled renewed service. Austin’s nonstop service ended. Multiple mainland departures shifted into overnight red-eyes. And next, the single reservation system transition is targeted for April 2026, a process already well underway.
Atmos replaced both Hawaiian Miles and Alaska’s legacy loyalty programs, and readers immediately reported higher award pricing, fewer cheap seats, no mileage upgrades, and confusion around status alignment and family accounts. Each of those events can be described as aspects of integration mechanics, but together they form the factual record that the plaintiffs are now asking a judge to examine in Yoshimoto v. Alaska Airlines.
The 40% capacity argument.
One of the more interesting claims tied to the court filing is that Alaska now controls more than 40% of Hawaii mainland U.S. capacity. That figure strikes at the core of the entire issue. That percentage does not automatically mean monopoly under antitrust law, but it does raise questions about concentration in a state that depends exclusively on air access for its only industry and its residents.
Hawaii is not a region where travelers have options. Every visitor, every neighbor island resident, and every business traveler depends on our limited air transportation. The plaintiffs contend that consolidation at that scale reduces competitive pressure and gives the dominant carrier far more leverage over pricing and scheduling decisions. Alaska says that competition remains robust from Delta, United, Southwest, and others, and that share shifts seasonally and by route.
Competitors reacted quickly.
While Alaska integrated Hawaiian’s network under its publicly stated discipline strategy, Delta announced its largest Hawaii winter schedule ever, beginning in December 2026. Delta’s Boston to Honolulu is slated to return, Minneapolis to Maui launches, and Detroit and JFK to Honolulu move to daily service. Atlanta also gains additional frequency. Widebodies are appearing where narrowbodies once operated, signaling Delta’s push into higher capacity and premium cabin layouts.
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Those moves complicate the monopoly narrative. If Delta is expanding aggressively, one argument is that competition remains active and responsive. At the same time, Delta filling routes Alaska trimmed may reinforce the idea that structural changes created openings competitors believe are profitable, and that markets respond when gaps appear.
What changed since October.
In October, we examined whether the case would survive dismissal and whether passengers could refile. That moment felt more procedural than what’s afoot now. It did not alter flights, fares, or loyalty programs.
This filing is different because it is tied to post-merger developments and seeks emergency relief. The plaintiffs are asking the court to prevent further integration while the merits are evaluated, arguing that each added step toward full consolidation this spring makes reversal less feasible as systems merge, crew scheduling aligns, fleet plans shift, and branding converges.
Airline mergers are designed to become embedded quickly, and once those pieces are fully intertwined, unwinding them becomes exponentially more difficult, which is why the plaintiffs are pressing forward now rather than waiting any longer.
The DOT conditions and the defense.
When the purchase of Hawaiian closed, the Department of Transportation imposed conditions that run for six years. Those conditions addressed maintaining capacity on overlapping routes, preserving certain interline agreements, protecting aspects of loyalty commitments, and safeguarding interisland service levels.
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Alaska will point to those commitments as evidence that consumer protections were built into the core approval. The plaintiffs, however, are essentially claiming that those conditions are either insufficient or that subsequent real-world changes undermine the spirit of what travelers were told would remain. That tension between formal commitments and actual experience is at the core of this dispute.
Hawaiian had not produced consistent profits for years.
That is the actual financial situation, without sentiment. Alaska did not spend $1.9 billion to preserve Hawaii nostalgia. It purchased aircraft, an international and trans-Pacific network reach, and a platform it thinks can return to profitability under tighter cost control.
What this means for travelers today.
Nothing about your Hawaiian Airlines ticket changes because of this filing. Flights remain scheduled. Atmos remains the reward program. Integration continues unless a judge intervenes.
However, Alaska now faces a renewed court challenge that points to concrete post-merger developments rather than speculative harm. That scrutiny alone can bring things to light and influence how aggressively future route decisions and loyalty adjustments occur.
Hawaiian Airlines’ travelers have been vocal since the start about pricing, redeyes, lost nonstops, and loyalty devaluation. Others have said very clearly that without Alaska, Hawaiian might not exist in any form at all. Both perspectives exist as background while a federal judge evaluates whether the integration should be impacted.
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You tell us: Eighteen months after Alaska took over Hawaiian, are your Hawaii flights better or worse than before, and what changed first for you: price, schedule, routes, interisland flights, or loyalty programs?
