Planning for the future; Proposed capital improvements measure includes bond funding for HMC expansion project



  • Hilo Medical Center is pictured in this 2018 Tribune-Herald file photo.

A proposed expansion of Hilo Medical Center is a capital improvement priority for one local legislator.

State Rep. Mark Nakashima, whose district encompasses Hamakua, North Hilo and a portion of South Hilo, on Wednesday introduced House Bill 1260, which, if approved, would authorize the issuance of nearly $100 million in general obligation bonds for a slew of capital improvement projects in the House District 1 during the next two fiscal years.


The bill calls for more than $60 million of the bond funds — $33 million to be appropriated in the 2021-22 fiscal year and $30 million in fiscal year 2022-23 — to be allocated for the hospital expansion.

“The nice thing about that project is that Dan Brinkman has gotten it to a point where it (is) almost shovel ready,” Nakashima said Thursday. “So if the money is available, they could break ground within a year.”

Nakashima said the project would help the hospital address the growing health care needs of Hawaii Island.

Brinkman, East Hawaii Regional CEO, Hawaii Health Systems Corp., which includes HMC, said the hospital is seeking to expand its intensive care unit and replace its obstetrics unit with a family birthing center — work that has a price tag of about $60 million.

HMC typically receives between $4 million and $6 million each year for capital improvement projects, he said.

“This is a major investment, or really an expansion of the hospital,” Brinkman said. “The hospital has been pretty much the same for the last 35 years. It was built in 1985, and there hasn’t really been any major expansions or change to its capacity.

“We’re planning on the needs of the hospital really for the next 20 to 30 years, and an investment of $60 million will pay dividends over the course of the next 20 to 30 years.”

According to Brinkman, the hospital is more than halfway through the design and blueprinting process. He expects plans to be ready for permitting no later than July 1.

The goal is to break ground by late spring 2022.

Hospital spokeswoman Elena Cabatu said the ICU would expand from 11 beds to 22 and span more than 22,000 square feet.

Brinkman said it became clear early in the COVID-19 pandemic that the ICU capacity was inadequate, he said.

The ICU’s beds are routinely filled, and Brinkman said only 2%-3% of patients admitted are flown to hospitals on Oahu for treatment.

“We have to care for them here,” Brinkman said. “So if we’re full now, then if we don’t plan for having capacity in the future, we’re going to be in a world of hurt from just normal operations, let alone when we come across health care emergencies like COVID-19 or any other type of strain to the system. We really have no excess (capacity). The wise and prudent thing is to plan for the future, and this is a really great time to do that.”

Relocating the ICU into the expanded area of the hospital would give HMC more room for noncritical patients, he said.

Meanwhile, Cabatu said the obstetrics unit would be transformed from separate labor and delivery and postpartum recovery rooms to nine mother/child/family-friendly birthing suites with three postpartum rooms.

“I believe our moms, our mothers, should give birth to their children, to our future, in a modern, frankly beautiful, space that creates a really great experience for mom and dad when they have their babies,” Brinkman said. “Our current space is adequate, but the exact same space that was built in 1985. We can do better for our moms in East Hawaii.”

Similar to the ICU move, Brinkman said the space vacated by the obstetrics unit when it moves into its new space also would be used to create capacity for noncritical patients.

“So this is a way to increase the capacity of the hospital across the board and allow us to do a great job caring for our community in the future.”

But funding is not guaranteed because the state faces unprecedented budgetary shortfalls due to the ongoing pandemic.

“One of the things we look at in times of economic downturn are being able to float bonds to keep the economy moving,” Nakashima said.

However, state debt and lack of revenues because of the pandemic have restricted the amount of bonds the state can float, he explained.

The legislator, though, is “hopeful this project will be seen in favorable light, and we’re able to put the resources into this project.”

Brinkman said HMC is aware of the state’s revenue shortfalls and that there are limitations on how much the state can borrow.

The project, though, could be a good investment to keep the East Hawaii construction industry working, “and it also is a great investment in our health care future,” he said.

“We are in this for the long haul, meaning that this project is something the East Hawaii Regional board feels is important for the long-term future of the hospital, and we will be persistent in trying to achieve funding for this project and getting this expansion built,” Brinkman said.

Other capital improvement projects included in Nakashima’s proposed legislation include:

• $18 million for plans, design, construction and equipment for six classroom buildings at E.B. de Silva Elementary.

• $4.5 million for plans, design and construction of a covered play court, retaining wall and covered walkway at Honokaa Elementary.

• $10.2 million for plans, design and construction of a retaining wall along Mamane Street at Honokaa High School.

• $580,000 for plans, design and construction for the installation of a photovoltaic system at Laupahoehoe Community Public Charter School.


• $4 million for the plans, design, construction and equipment for a redesign and renovation of the ‘Imiloa Astronomy Center planetarium.

Email Stephanie Salmons at

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