The estimated cost for a new outpatient medical facility to be built in Keaau by Hilo Benioff Medical Center has increased from $60 million to as much as $90 million.
That’s according to a draft environmental assessment released last week, which has an anticipated finding of no significant environmental impact from the facility’s construction.
Keaau Benioff Health Center, previously planned as a single-story 36,000-square-foot-building, is now envisioned to be a 40,000-square-foot-facility, according to the draft EA prepared by consultant John Pipan of Land Planning Hawaii LLC of Hilo.
The proposed site of the facility also has changed, from a parcel across from Keaau High School on the Keaau Bypass Road to 20 acres of agricultural land owned by W.H. Shipman on the mauka side of Highway 11, between Shipman Business Park and the Herbert C. Shipman Park, roughly across the highway from the Keaau Loop subdivision.
The clinic would be built on 13 acres of the 20-acre parcel, with another 4.4 acres set aside for the driveway. The plans call for 204 paved perpendicular parking stalls, with 22 of those stalls compliant with the Americans with Disabilities Act.
“This cost estimate is a range, and $90 million is the high end of that estimate,” HBMC spokeswoman Elena Cabatu told the Tribune-Herald on Thursday. “That said, the move to the larger Shipman site does require additional site infrastructure such as water, road and electrical services. Some of those costs will be shared.
“Options for completing the funding are being explored, but we haven’t settled on the final configuration. We are confident, though, that the project will be completed.”
It’s been previously reported Hilo Benioff Medical Center has at least $59 million of the original $60 million estimate earmarked for the project. The state Legislature approved $25 million last session, in addition to $9 million it had previously set aside for the project, and Salesforce CEO Marc Benioff and wife Lynne have pledged $25 in matching funds.
Selected clearing and grubbing are proposed to maintain a buffer around the facility and optimize the appearance of the site.
The proposed facilities will provide urgent care services seven days a week, including holidays, from 8 a.m. to 8 p.m. Primary care services, specialty clinic services such as cardiology, imaging services for X-rays, CT scans and ultrasound, laboratory services and behavioral health and counseling services will be available Monday through Friday from 8 a.m. to 4 p.m.
The facility would provide outpatient care only but not an emergency room or provider of drug rehabilitation services, the draft EA states. The clinic will not receive ambulances, although ambulance transportation of patients from the facility to the Hilo Benioff Medical Center may occur when warranted.
“The completion of the new clinic will significantly benefit the Puna community by providing a comprehensive suite of health care services close to home,” Cabatu said. “These services will include primary care, urgent care, rotating specialty services, outpatient behavioral health, advanced imaging, laboratory services and a retail pharmacy that will be conveniently located within the Keaau community. Residents of Puna will no longer need to routinely travel to Hilo for essential health services.
“This new clinic will help alleviate Hilo Benioff Medical Center’s emergency room, one of the largest emergency departments in the state by volume, by providing appropriate outpatient and urgent care services. Together, this expansion strengthens the overall health care infrastructure on Hawaii Island.”
It is anticipated that the Keaau facility, which is expected to be built by the end of 2028, will serve over 100 patients per day and that the facility will have 100 employees or more by its fifth year.
“The new clinic will require additional physicians, nurses and other medical professional to support the expanded growth of our outpatient services,” Cabatu said. “As a result, we anticipate the recruitment of additional family medicine physicians, advanced practice providers — nurse practitioners and physician assistants — behavioral health professionals and support staff.
“We are well positioned to meet much of this workforce demand through our established family medicine residency program, which serves as a strong pipeline for physician recruitment and retention the community,” she continued. “In addition, our recently developed medical assistant training program and clerical training programs are designed to build a local workforce, creating career pathway for members of the community while supporting staffing in the clinics.”
Puna is the fastest growing region in the state. According to census data, it has seen population increase from about 31,000 people in 2000 to nearly 52,000 people in 2020 and is expected to top 75,000 residents within the next six years. Its rapid population growth has increased pressure on the existing health care services, which are currently insufficient to serve the growing population, especially with regard to urgent health care and specialty services.
The entire Puna District currently contains two East Hawaii Health Urgent Care clinics — the East Hawaii Health Clinic in Keaau and the East Hawaii Health Clinic in Pahoa — and Keaau Urgent Care. Urgent care services are only provided by these clinics between 7 a.m. and 7 p.m., and 9 a.m. and 7 p.m., respectively. Additionally, access to specialty care, electrocardiogram and imaging services in Puna also are very limited and currently only offered at the Keaau East Hawaii Health Clinic.
Insufficient access to health services in Puna requires many Puna residents to seek care in Hilo. As a result, Hilo Benioff Medical Center has strained to accommodate the influx of patients, resulting in long wait times and overcrowding. Development of the new Hilo Benioff Medical Center facilities in Keaau will help to fill in existing gaps in availability of urgent care, specialty care and imaging services for Puna residents, the document states.
The EA identifies two major challenges to making sorely needed social and health care services available to Puna residents.
As a rural area with a rudimentary transportation system and dispersed population, it is difficult for residents in need to reach the services. And Puna’s high percentage of low-income residents tends to increase the need for social services, yet discourages private health care providers from locating in Puna due to insurance issues.
“The facility, and the associated development, is a big win for the Keaau/Puna communities, not only for health care, but for overall economic growth and development,” Dan Brinkman, CEO of Hilo Benioff Medical Center, said in a statement. “We are excited to work with W.H. Shipman, Marc and Lynne Benioff, Gov. (Josh) Green, our Big Island legislators, Mayor (Kimo) Alameda and many other stakeholders to make this project a reality.”
The publication of the draft EA, which can be viewed at bit.ly/4tV7oyG, begins a mandatory 30-day public comment period, with comments due by March 25. Those comments can be emailed to Kris Wilson, assistant hospital administrator for Hilo Benioff Medical Center, at kwilson@hhsc.org.
Email John Burnett at jburnett@hawaiitribune-herald.com.