The Honolulu Advertiser from Honolulu, Hawaii • 3

PM EDITION 19, 2004 lueuouuiuiUAuvtiusei Kahulcu: Hospital looks for money, stronger partner FROM PAGE ONE Public meeting WHAT: Hospital Information meeting WHEN: 7 p.m. today WHERE: Kahuku Town Hall i.i. fc i.e ii? i 's'': 'ill-' Only 22 percent to 25 percent of the population has used the facility, and that isn't enough to stop the losses, Beaver said. Besides a 24-hour, seven-day-a-week emergency room, Kahuku's 25-bed hospital offers general acute care, skilled nursing care, obstetrics, outpatient surgery and physical therapy. It provides low-cost services for people without health insurance.

Rural hospitals across the nation are having financial problems, said Dr. Linda Rosen, state Department of Health deputy director for health resources administration. One of the major reasons is that the population is too small to sustain the facility, Rosen said. Losing services, especially emergency services at Kahuku, would be a big concern to the state because ambulances would have to take patients to Kailua or Wahiawa in an emergency, Rosen said. "We value the services at Kahuku and, from a public health point of view, we would certainly want to look at what could be done," she said.

"I do not know what we would do exactly, but we would be concerned." For Beaver, if clear what must be done. He said the community needs to use the facility more and the hospital must find a partner for the long term. "I think without an affiliation, the long-term picture for a sustainable model isn't possible," he said. Reach Eloise Aguiar at eagui arhonoluluadvertiser.com or 234-5266. ministrator and CEO.

The hospital also has more than $2 million in debts and IRS liabilities. Like other rural hospitals across the nation, Kahuku has struggled for years because its surrounding population is too small to sustain the facility. Kahuku Hospital mounted something of a financial rally several years ago, but it wasn't enough. The result today is a financial situation that has reached a critical level, and the hospital's board of directors is looking at options that include affiliating with a larger healthcare provider, cutting services and, ultimately, closure. The hospital will continue operating for now, said Olden, but a partnership is necessary if it is to survive.

"An affiliation is a real critical link in the process and the future of the Olden said. "The second thing after that is continued growth in the community." But Kahuku Hospital must act now and will seek community support immediately, asking residents to choose its services over other institutions' when needed. The hospital administration will discuss the financial predicament during a series of community meetings beginning today. Kahuku Hospital is the only critical access medical facility between Kane'ohe and Wahiawa, and an estimated 22,500 people in the Ko'olauloa district of O'ahu have relied on it for 50 years for everything from low-cost medical exams to emergency care. The hospital is also the third-largest employer in ADVERTISER LIBRARY PHOTO July 2002 Kahuku Hospital has struggled for years because the rural population of Ko'olauloa is too small to sustain the facility.

It's the only critical access medical facility between KSne'ohe and Wahiawa. creased to $750,000 last year, and the hospital hopes the Legislature will raise it to $12 million this year, Olden said. However, even that would only buffer the hospital from old debt and it would still need to make changes to survive, he said. Growth in the community would help and there are about 500 new homes planned for the area, Olden said. But that help is not coining soon enough.

Civil: Debate returns to San Francisco could provoke a backlash, gay-rights advocates fear An affiliation or partnership with a larger organization would mean reduced administrative costs and potentially other savings where duplicate services can be eliminated. However, the hospital has tried several times in recent years to find an affiliation, only to learn mat other organizations were not interested. In spite of the hospital's financial problems, business has improved, said R. Eric Beaver, chairman of the hospital's board of directors. In the past two years, patient use has increased from 13 to 16 per day, a key number because every increase of one to two patients a day boosts net income by $250,000 a year, he said.

Surgery cases have grown from almost zero to 20 per month. And in 2001, the hospital received an increase in annual operating funds from the Medicare program when it received accreditation as a critical access hospital Beaver said. However, increased labor and insurance costs have eroded those gains. It costs $600,000 a year to run the full-time emergency room, which in turn brings in only $200,000. And the emergency room is the one service the community cannot do without, he said.

cisco's move might actually help the cause in Massachusetts by showing the world that activists there aren't alone, said Kendall, who was upset that Frank has been critical. "It may well be that Congressman Frank, seeing homophobic bigotry every day, comes from a place of fear," she said. Frank isn't the only Democrat worried about a backlash, although no others have said so publicly. San Francisco Mayor Gavin Newsom contacted several top Democrats, including House Minority Leader Nancy Pelosi, to alert them about what was coming, but neither the mayor nor the congresswoman were willing to discuss their conversation. "We are cognizant that Democrats disagree on this issue," said Peter Ragone, the mayor's spokesman.

Sen. Barbara Boxer, who is up for re-election this year, is an outspoken liberal and a champion of gay rights. But she has turned down numerous interview requests since the wedding march began, instead issuing a terse statement through her spokesman. "The mayor has decided to test state law," Boxer's statement read. "My opinion is that state law is fair and appropriate because it gives equal rights to all citizens." Chicago's Mayor Richard Daley, who like Newsom has no immediate need to seek re-election or pursue higher office, said yesterday that he would have no problem with giving gay couples marriage licenses there, but he stopped short of saying he would follow San Francisco's lead.

"Marriage has been undermined by divorce, so dont tell me about marriage," said Daley. SEEDS AlVaptabk HW Fbw flip. FEB. 19-25 lIHHo the area, with about 70 employees. Its shutdown would be a blow to the community, area residents said.

"If you live here, you're five to seven minutes away from help," said Junior Ah You of La'ie. "Without that, you're an hour away from the nearest help. You can be dead already." Kahuku Hospital operates with an annual budget of $6.5 million, relying heavily on state financing, Public hearing The House Judiciary Committee will hear testimony on the bill on civil unions at 7 tonight in Room 325 at the State Capitol. Rice said the bill was a good call by lawmakers seeking to address a 1996 Circuit Court decision that required the state to extend the same rights, benefits and obligations to same-sex couples as those given to married people. The decision by the state judge was based on a landmark 1993 Hawai'i Supreme Court ruling that the same-sex marriage ban violated the state constitution unless the state could justify the prohibitioa Rice said distinguishing civil unions from marriage as currently defined is a form of "second-class citizenship," but "it's better than the third-class citizenship we have now." Gay rights activist William Woods called civil unions "unequal, unfair, but a step in the right direction" toward the goal of legalizing same-sex marriages.

Civil unions are "simply not the goal" he said. "Separate but equal is not really equal at alL" Woods said a civil-unions bill, from a legal standpoint, does not give gay couples all the benefits of opposite-sex alliances, particularly in the area of federal and international laws tied to the definition of marriage. For instance, he said, a spouse who is a legal alien or immigrant would become a U.S. citizen automatically upon marrying one. A civil union would not allow that, but legalizing same-sex marriages would, he said.

Gabbard said lawmakers should not try to pass the civil-unions bill "Trying to legalize same-sex marriage by disguising it is a betrayal of the public trust," he said. 0 grants and private donations. Though Kahuku is a private hospital, it receives state money because it serves a rural area. There are six other critical access hospitals in the state and four of them belong to the state hospital system. From 2001 to 2003 Kahuku received only $350,000 a year while five other rural hospitals received more than twice mat, Olden said.

Money going to Kahuku was in Capitol Deacon Walter Yoshlmitsu, interim director of the Hawai'i Catholic Conference, echoed Gabbard's comments. "The bill going through the committee Is a civil-union bill which is just another name for same-sex marriage he said, Yoshlmitsu said lawmakers should work on addressing concerns raised to the reciprocal benefits law approved by the Legislature in 1997 and heavily criticized by gay rights advocates who pointed out that only 50 to 60 benefits were Included. Woods described the law as "a joke" that offered very little. Since 1997, the Health Department reported, 864 couples have registered for reciprocal benefits; 56 have since terminated the arrangements. Rep.

William "Bud" Stonebraker, R-17th (Hawai'i Kai, Kalama Valley), said he would not support the civil-union measure if it made tt out of committee. "The people of Hawai'i have made their opinion clear on the issue of homosexual marriage, and to be further trying to advance this cause just doesn't flow with the opinions of the state," he said. Senate Judiciary and Hawaiian Affairs Committee Chairwoman Colleen Hanabusa, D-21st (Nanakuli, Makaha), was surprised to learn mat her House counterparts were hearing the civil-unions bill, and said it was unknown whether the House and Senate had enough votes to pass such a measure. Linda Smith, senior policy advisor to Gov. Linda Lingle, said the administration was focused on its core issues and would not be offering testimony on the bill tonight.

Gay rights advocates say Lingle has told them she supports the concept of dvil unions. Reach Cordon Y.K. Pang at gpanghonoMuadvertiser.com or IT 20 (11 :00 am 6:00 pmj 21 (10:00 am 5:00 pmj Milot WMki Hotel Aia Moarta 8otilevard Honolulu FREE admission fur TWO? pieasa call (86li) 434 5644 xfHbitor "Don't blame the gay and lesbian, transgender and transsexual community." Aside from Daley, elected officials have been reluctant to publicly support San Fran DALEY cisco action, which Newsom compares to the U.S. Supreme Court's Brown v. Board of Education decision 50 years ago that integrated public schools.

Meanwhile, President Bush, who opposes gay marriage, said his decision on whether to support a constitutional gay marriage ban would depend in part on San Francisco's actions. Sens. John Kerry and John Edwards, seeking the Democratic presidential nomination, say they oppose gay marriage but strongly support civil unions fence-straddling that may no longer have the same voter appeal after San Francisco's bold action. "Civil unions, not gay marriage thaf nice and comfortable for politicians," said political analyst Stu Rothenberg. "This makes me wonder how long people would allow politicians to sit in that comfortable chair." Rothenberg said the issue could influence key swing voters such as the elderly and middle-class suburbanites.

Winnie Stachelberg, political director of the Human Rights Campaign, a national gay-rights organization, said San Francisco's move has succeeded in launching a dialogue that the American people are now ready to handle. "It educates us about what's at stake," Stachelberg said. "The more this country grapples with the tough questions, the better." QPH. 947-2661 1 935 S. BERETANIA ST.

Sot S-5 Sm t-4 FROM PAGE ONE It wasn't clear yesterday whether the bill would have enough support to pass this sessioa "There is support, but I wouldn't say it's overwhelming," Oshiro said. Td say if a close call." The bill allows two adults who are not related by blood but live together, who agree to be jointly responsible for each other's basic living expenses, to file a declaration of civil union with the Department of Health. Such a declaration would extend the same rights and obligations as spouses in marital relationships and prohibit discrimination based on a civil-union partnership status. Dissolving a civil union would require a court process similar to divorce. "The civil-unions bill says basically that any time you're going to give a benefit in law to a married couple, the same benefits would carry over to a civil-unions couple," Oshiro said.

The debate returns to the Capitol as the sensitive topic is exploding on the national scene. Two weeks ago, the Massachusetts Supreme Court ruled that it went against the state's constitution to bar gay marriages. President Bush called the Massachusetts ruling "deeply troubling" and suggested he might propose a constitutional amendment to ban gay marriages if judges persist in approving them. In San Francisco, city officials have openly defied California state law by issuing more than 2,000 marriage licenses to gay couples since late last week. In Hawai'i, House Majority Leader Scott Saiki, D-22nd (Mc-Cully, Pawa'a), said the issue had been under discussion among lawmakers for some time, but "given recent events, it's important for us to evaluate civil-rights issues like this one." jf And Affordability jt g.

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By Beth Fouhy Associated Press SANFRANOSCO San Fran-Cisco's brazen experiment in same-sex marriage has shaken up the gay-rights movement at a critical time, just when Massachusetts appears poised to legalize gay marriages and conservatives are pushing a constitutional amendment to ban them Some advocates worry that the Image of thousands of gays and lesbians bucking California law to get married could backfire, giving conservatives a powerful wedge issue this election year. For Democrats who support gay dvil unions, San Francisco's move may force them to make an uncomfortable choice between alienating a key Democratic party constituency gays who support full marriage rights and risking the wrath of other voters at a time when national polls show Americans overwhelmingly oppose same-sex marriage. "San Francisco being in sort of a free-for-all will be used against us politically," predicted Rep. Barney Frank, one of few openly gay members of Congress, in an interview with the Associated Press. Kate Kendall, executive director of the National Center for Lesbian Rights, sounded out her colleagues.

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