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UPDATE: Land Board Approves Medical Center Lease in Concept

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UPDATE: The Board of Land and Natural Resources on Friday voted to approve in concept the lease, which will not be granted until the Puna Community Medical Center completes an environmental assessment and receives a finding of no significant impact.

The Puna Community Medical Center is looking to expand its horizons, and medical care for the lower Puna community as well.

The first step – a new home – will be among the agenda items when the state Board of Land and Natural Resources meets Friday in Honolulu.

The land board will consider granting the PCMC a lease on a 5-acre parcel of state land located on the Pahoa side of the Keonepoko water tank on Highway 130.

According to Dan DiDomizio, the medical center’s clinical programs director, the plan is to expand the facility into a fully functioning emergency room.

Dan DiDomizio

Dan DiDomizio. PCMC photo.

DiDomizio said the center originally proposed building on the parcel that contains the new Pahoa fire and police stations, but geological issues in the form of multiple lava tubes made that impossible.


He said the Department of Land and Natural Resources then recommended the new location, which is the site of a former nursery that has been vacant since the old lease expired in 2002.

The land board will consider granting PCMC a lease of at least 35 years. The cost would be $480 annually, with the rent amount to be revisited every 10 years.

DiDomizio  said if the lease is granted, as the DLNR staff has recommended, the next step would be fundraising. He estimates it will cost up to $70,000 to pay for initial planning efforts including a required environmental assessment.

Construction of the facility, which would include x-ray and laboratory facilities, would be done incrementally as funding becomes available, DiDomizio said. The final price tag is expected to be between $3 million and $4 million.

The center would immediately begin seeking funding through a variety of sources including public and private grants and donations. It has already been in contact with a firm that specializes in designing emergency rooms.


DiDomizio said the model the center is following is that of the Waianae Coast Comprehensive Health Center on Oahu’s leeward side.

Like the Puna center, that facility began with a grass-roots effort to meet the needs of a rural community lacking medical facilities, in the Waianae facility’s case because the sugar plantation had closed and with it went the medical care it provided.

The Waianae Coast Comprehensive Health Center started out with a skeleton staff in the 1970s and today its more than 400 employees provide a wide array of medical services.

DiDomizio said there is no question about the need for such a facility in lower Puna. He said that is demonstrated daily by the amount of traffic that comes through the existing center’s doors.

Since opening in the Pahoa Marketplace in early 2009, more than 8,000 patients have made 15,000 visits for a variety of medical needs from cuts to infections to physical exams, and they keep coming in at a rate of more than 500 a month.


But for more serious injuries such as broken bones or more involved lab work, the patients must eventually be driven 20 miles to the Hilo Medical Center emergency room.

“(The center’s) fine for what it does, but what it does is not adequate for the community,” DiDomizio said.

The current acute-care facility has a staff of eight working in an 800-square-foot space.

“And every millimeter of it is used,” he said.

Having an emergency room in lower Puna would mean patients in the area could avoid the trip to Hilo for a variety of tests and procedures, he said.

“That would be available to the community,” DiDomizio said.

It may not be possible initially to staff the emergency room around the clock, but every hour it is open would mean fewer trips necessary to Hilo’s ER.

The request before the land board notes that buying land for an emergency room is not feasible.

“As a non-profit corporation serving a rural population in an economically depressed area, PCMC cannot afford the commercial land prices in order to expand and provide greater services,” it said. The DLNR staff report also noted that Puna has the fastest-growing population in the state.

DiDomizio said support for the center’s expansion has been widespread.

“There is nobody that doesn’t want this to happen, and that is remarkable,” he said.

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