Hawaii
The Packed Hawaii State Hospital May Soon See A Surge In Patients From A Private Facility
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.
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.
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.”
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.
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.
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.
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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Hawaii is home to a wide range of towns that give older adults relaxing ways to enjoy their retirement years. Across the islands, retirees can find communities with easy access to healthcare and outdoor recreation. Coastal towns like Kailua-Kona and Līhuʻe offer ocean views and nearby medical care. Inland communities such as Waimea and Makawao provide cooler weather and an easier rhythm. Retirees may be drawn to smaller places with a strong community feel, while those wanting more services may prefer regional hubs like Hilo. Together, these Hawaiian towns offer a mix of natural beauty and everyday comforts.
Kailua-Kona
Kailua-Kona is a coastal town on the Big Island of Hawaii with fewer than 25,000 residents. It continues to attract retirees thanks to its warm weather and ocean access. Areas like Kealakehe and Holualoa are still growing, with new subdivisions adding more housing options for people who want to stay long-term.
Most medical care is provided by the nearby Kona Community Hospital, and clinics throughout the Kona district offer additional services. Some of the main landmarks are Kailua Pier, Huliheʻe Palace, Kamakahonu Beach, and Kona Commons Shopping Center. These spots help residents stay active year-round.
Hilo
Hilo is a well-known retirement-friendly community on Hawaii Island, known for being easy to walk around. With about 48,000 residents, according to recent Census data, Hilo is a regional center for healthcare, education, and government services, which helps create long-term stability for residents.
Hilo Benioff Medical Center is the main hospital for East Hawaii and provides most of the area’s healthcare. There are also outpatient and senior care services, such as the nearby Life Care Center of Hilo.
People in Hilo often spend time at places like Wailoa River State Recreation Area, Hilo Farmers Market, Liliʻuokalani Gardens, and Rainbow Falls. These spots are close to neighborhoods like Waiākea and Keaukaha.
Waimea
Waimea is a small inland town on Hawaii Island with fewer than 10,000 residents. Because it sits at a higher elevation, the weather is cooler, with daytime temperatures usually between 70 and 80°F and nights that feel much cooler.
Residents have access to healthcare through local clinics and services linked to Queen’s North Hawai’i Community Hospital in Waimea, which provides essential care for the area. The town has strong connections to Parker Ranch, one of the country’s largest ranches, as well as nearby ranchlands. Waimea attracts retirees who want a quieter inland setting, strong community organizations, and fewer people.
Līhuʻe
Līhuʻe serves as Kauai’s administrative and service center and has fewer than 10,000 residents. The town plays a central role in healthcare and government operations across the island. It is just 30 minutes from Hanapepe and offers retirees a small-town feel, with natural scenery all around.
Wilcox Medical Center is the largest hospital on the island and provides care for residents throughout Kauai. Notable landmarks include Kalapaki Beach, Nawiliwili Harbor, Kauai Museum, and Kilohana Plantation. Together, these sites support recreation, tourism, and community events across the area.
Kapa’a
Kapaʻa sits on the east side of Kauai and has about 11,000 residents. It is easy to get around on foot, with everything you could need close by. The town serves as both a place to live and a hub for businesses in the area.
Residents can access healthcare at local clinics such as The Clinic at Kapaa or at Wilcox Medical Center in Līhuʻe. Some well-known spots in Kapaʻa are Kapaʻa Beach Park, the Sleeping Giant Trail, Coconut Marketplace, and Wailua River State Park. Coconut Marketplace has a Farmer’s Market twice a week, plus live local music. Hula classes and shows are also a local favorite offered at Coconut Marketplace.
Kailua
Kailua is a residential area on the windward side of Oahu with fewer than 50,000 residents. The town is known for its easy access to beaches and well-established neighborhoods such as Enchanted Lake and Coconut Grove.
Residents have access to healthcare through nearby hospitals in the Honolulu area. Adventist Health Castle, which is located in Kailua, is one of the main options. In addition, Kalapawai Market is a local favorite to grab coffee, ube scones, and other treats.
Kailua is home to many beaches for swimming and watersports, including Kailua Beach Park. Lanikai Beach is a public beach within a residential neighborhood, with no lifeguards, restrooms, or public parking lot. For walking and biking, Kawainui Marsh Wildlife Sanctuary is a popular dog-friendly wildlife sanctuary with a scenic trail.
Haleʻiwa
Hale’iwa is known for its slower pace and strong connection to Oahu’s North Shore coastline. This historic North Shore town is said to be the quirkiest and has a population of under 5,000. It maintains a small commercial core while serving nearby rural communities.
Healthcare is available through clinics in Waialua and through The Queen’s Medical Center – Wahiawā in central Oahu.
Notable landmarks in Haleʻiwa include Haleʻiwa Beach Park, a popular spot for fishing and sunset views, and Waimea Bay, known for its large winter surf and summer swimming conditions. The nearby Banzai Pipeline draws surfers from around the world during big-wave season on Oahu’s North Shore. Residents also spend time at Haleʻiwa Aliʻi Beach Park, which has picnic areas and shoreline walking paths.
Wahiawa
Wahiawa is a central Oahu community with a population of roughly 17,000. It sits between the island’s north and south regions, and provides a quieter inland setting while still allowing access to both Oahu’s north and south coasts.
Healthcare in Wahiawa is available through in-town facilities, such as The Queen’s Medical Center – Wahiawā.
Local landmarks include Lake Wilson, where residents fish and kayak, and the Wahiawa Botanical Garden, known for its large tropical trees and walking paths. Nearby Schofield Barracks remains one of the largest military installations in Hawaii and shapes much of the area’s economy. Residents also rely on Whitmore Village for local businesses, neighborhood services, and access to agricultural areas outside town.
Makawao
Makawao is a small town in upcountry Maui with fewer than 10,000 residents. Its higher elevation gives the area cooler temperatures than much of coastal Maui, especially during the evenings.
Makawao maintains a rural atmosphere while still keeping residents close to shopping and healthcare in nearby Kahului and central Maui for routine and specialized care.
Residents enjoy art galleries, and nearby access routes to Haleakalā National Park, which draw both residents and visitors into Maui’s upland landscapes. The community also gathers around Oskie Rice Event Center, which hosts rodeos and local events throughout the year, while Pukalani Country Club provides golf and recreation with views of central Maui.
Pāhoa
Pāhoa is a small town on Hawaii Island with fewer than 1,000 residents. The community has a slower pace of life and a strong local character shaped by East Hawaii’s volcanic landscape. Residents access healthcare through clinics in nearby Hilo and facilities connected to Hawaiʻi Health Systems Corporation in East Hawaii.
Local landmarks include Lava Tree State Monument, where lava formations surround walking paths through tropical forest, and the historic downtown which still contains several older storefronts and small local businesses such as Tin Shack Bakery. Nearby Pohoiki Black Sand Beach has become a popular coastal gathering area following recent volcanic activity, while the former Ahalanui Park site (destroyed by the Kīlauea lava flow in 2018) remains an important part of the region’s history and shoreline identity.
Honoka’a
Honokaʻa is a small plantation-era town on the Big Island of Hawaii. With fewer than 3,000 residents, its historic main street reflects its sugar industry past with preserved storefronts and a compact town center that still serves the surrounding Hamakua Coast communities.
Residents access healthcare through Queen’s North Hawai’i Community Hospital in nearby Waimea, which provides essential services for the region.
Along the main corridor, residents frequent shops such as Tex Drive-In, known for its malasadas, and Cafe Il Mondo, a long-running local café. The nearby Kalōpā State Recreation Area offers forest trails and native vegetation, while the Hamakua Coast provides scenic coastal drives with waterfalls and ocean views. Routes toward Akaka Falls connect the town to one of the island’s most visited natural landmarks.
Hawaii Retirement Across the Islands
Retirement spots in Hawaii are found across the islands, each with its own pace of life. Towns like Kailua-Kona and Līhuʻe keep residents close to healthcare, services, and coastal scenery, while places such as Waimea, Makawao, and Honokaʻa offer quieter inland settings with strong local character. Others, including Hilo, Kapaʻa, and Haleʻiwa, balance everyday conveniences with beaches, parks, markets, and community gathering places. As people in Hawaii look for more space, fewer crowds, and reliable access to care, these towns show how varied retirement living can be across the state.
HONOLULU (HawaiiNewsNow) – A new optical illusion is taking shape in Kalihi.
Commissioned by Kamehameha Schools, the mural will feature plants and trees native to the area. The artwork aims to highlight how forestry can exist within urban areas.
Coincidentally, the new artwork sits adjacent to one of Kalihi’s most famous murals: Wave 01/101.
The artist Kai’ili Kaulukukui plays with depth and shadow, creating an optical illusion on the flat face of a building.
“The painting style is called ” trompe-l’œil”, it means ‘trick the eye’,” says Kaulukukui. “It’s been around for 2000 years. They have images of trompe-l’œil style murals at Pompeii, so it’s a very old style.”
Kaulukukui said he’s always been intrigued by the art style, though this is his first time painting it.
“They’re both kind of environmental themed murals,” he said. “This is bringing an image of what a forest could look like in the city. That is like an homage to Pipeline and our beautiful waves that we have here.”
The 55-foot-tall mural is expected to be completed by Sunday, May 31.
After this project, Kaulukukui will start an ocean-themed mural just one street over, bringing a bit more nature into urban Honolulu.
Copyright 2026 Hawaii News Now. All rights reserved.
A former Hawaii County housing development specialist was sentenced Thursday in federal court to 46 months in prison for taking bribes to facilitate a multimillion-dollar affordable housing credits scam.
Alan Scott Rudo, 59, who now lives in Cathedral City, Calif., was given until July 9 to surrender to the federal Bureau of Prisons when he was sentenced by U.S. District Judge Jill Otake in Honolulu.
Otake also ordered Rudo to pay $483,265 in a forfeiture judgment.
In a deal with prosecutors, Rudo pleaded guilty in August 2022 to conspiracy to commit honest services wire fraud and admitted to accepting about $1.9 million in bribes from Hilo attorneys Paul Sulla Jr. and Gary Zamber and former Big Island businessman Rajesh Budhabhatti, who now lives in Morrow Bay, Calif.
In return, Rudo agreed to use his official position in the Office of Housing and Community Development to ensure the county approved three affordable housing agreements (AHAs) benefiting the defendants’ development companies, Luna Loa Developments LLC, West View Developments LLC and Plumeria at Waikoloa LLC.
Through those AHAs, the development companies fraudulently raked in more than $11 million worth of land and excess affordable housing credits (AHCs).
Sulla, 79, Zamber, 56, and Budhabhatti, 65, were charged with conspiracy to commit honest services wire fraud and nine counts of honest services wire fraud. Sulla was also charged with money laundering.
Rudo was the prosecution’s star witness at their trial, and on June 4, 2025, a federal jury in Honolulu convicted all three on all charges.
Zamber was sentenced on Jan. 30 to 70 months in prison. Budhabhatti was sentenced on Feb. 6 to 90 months in prison. And Sulla was sentenced on April 23 to 60 months in prison.
Zamber’s and Sulla’s law licenses also have been suspended, prohibiting them from practicing law in Hawaii.
“This sentencing marks the closing of an unfortunate chapter and underscores the importance of strong internal controls, clear segregation of duties, and effective program oversight,” said county Housing Administrator Kehaulani Costa in a statement. “The Office of Housing and Community Development remains committed to strengthening accountability and program integrity through enhanced compliance monitoring, improved documentation practices, and continued staff professional development.
“We are proud of the work undertaken to implement stronger safeguards, increase transparency, and reinforce public trust in the delivery of affordable housing programs serving Hawaii Island communities.”
A series of articles by Hilo resident Pat Tummons in her Environment Hawaii newsletter exposed questionable dealings in OHCD that ultimately led to an FBI investigation that resulted in these convictions.
When announcing charges in July 2022, then-U.S. Attorney Clare Connors praised the reporting by Environment Hawaii that first raised red flags about Rudo’s and his co-defendants’ schemes and, she said, led a county employee to alert the FBI.
The resultant public flap caused the County Council to order an internal audit, which in 2013 found OHCD had “inadequate internal controls” over its affordable housing credits program.
Costa said OHCD has since “strengthened internal controls, enhanced oversight and compliance monitoring, improved documentation and review procedures, expanded staff training, and implemented additional safeguards to support greater accountability, transparency, and long-term program integrity.”
Email John Burnett at john.burnett@hawaiitribune-herald.com.
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