Over the past two years, the pandemic taught us the limits of our health care capacity. Maui Memorial Medical Center, our only full-service acute care hospital, has 219 licensed beds and 29 ICU beds. During pre-pandemic times, 90 percent usage of bed capacity was normal. Under crisis conditions, Maui Memorial can expand to 300 beds plus a medical tent with 10 more beds. Remember, it’s much easier to add more beds than to find trained medical personnel needed to care for patients in those beds.
Even if we assume COVID-19 is entering its endemic phase, what happens if there is a sudden disaster with traumatic injuries? Since 2015, weather-related disasters have increased by 17 percent in the US We know from recent wildfires, floods, hurricanes and tsunami warnings that Hawaii is not immune to such threats.
At first glance, the shortage of medical workers appears to have a simple solution – just hire more health care workers. It sounds simple, but it’s not.
Even with growing interest in health care careers, hiring qualifications often include higher education, certification and / or specialized training. Aside from the cost of tuition, students must pay for day-to-day living costs, which are often out of financial reach. Maui County helps to break these barriers through collaborations and partnerships with Maui Health, University of Hawaii Maui College, Hale Makua and others.
Maui Health offers training programs for entry-level positions and paid training for nurse’s aides and provides tuition reimbursement for those who pay for education and training. Maui Health works closely with the college to recruit as many local nursing graduates as possible.
My Office of Economic Development partners with Hale Makua to help fund a collaboration with other health care agencies to upgrade the skills of employed medical workers in addition to placing program graduates into career positions. The goal is to get Maui County people to care for Maui County people. With enough local talent, we hope to reduce the need for hiring temporary talent from elsewhere. Problem solved? No, it’s not that simple.
The long-term shortage of medical personnel throughout Maui County is mostly due to the cost of living, more specifically, the high cost of housing. The median price of a single-family home now exceeds $ 1 million, putting homeownership out of reach for most medical professionals, including highly trained registered nurses, nurse practitioners, physician assistants and physicians themselves.
“Build more affordable housing” is offered as the solution, but again, it’s not that simple.
Developing more housing in all price ranges calls for large-scale construction of market-priced homes, affordable rental units and attainably priced multifamily and single-family homes for purchase. Maui County’s supply of developable fee-simple land is limited and high demand drives up prices. This scale of development also triggers requirements for new infrastructure, including roads, water and wastewater facilities, utilities, schools, parks and retail to support residents.
That’s why I have two requests pending before the Maui County Council.
The first is for the Maui County to enter into a private-public partnership with the developers of Waikapu Country Town. In exchange for the county taking on the responsibility of building the required Waiale Road extension and the new Central Maui wastewater treatment plant, the developers would build an additional 213 workforce units for a total of 500. Let’s take advantage of a rare opportunity as Hawaii is anticipated to receive $ 2.8 billion in federal infrastructure funds in the coming months and years.
More recently, I asked the council for the authority to convey 16 lots in the Fairways at Maui Lani to the nonprofit Maui Health Foundation to build workforce housing needed to attract and retain health care professionals, and 19 lots to nonprofit Na Hale O Maui to build workforce housing for anyone who is qualified.
We can no longer kick the can down the road.
Quality health care will not happen here unless we make the tough decisions now and put in the hard work of solving complex problems without simple fixes.
* “Our County,” a column from Maui County Mayor Michael Victorino, discusses county issues and activities of county government. The column alternates with “Council’s 3 Minutes” every other weekend.