Windward Planning Commission approves permit for future Keaʻau health center

Hilo Benioff Medical Center is one step closer to building a $90 million, 40,000-square-foot health center in Keaʻau.

Earlier this month, the Windward Planning Commission approved a use permit application for the outpatient care facility, which will be located on 20 acres of agricultural land owned by W.H. Shipman on the mauka side of Highway 11. It will be built between Shipman Business Park and the Herbert C. Shipman Park, roughly across the highway from the Keaʻau Loop subdivision.

The health center originally was to be built on land near Keaʻau High School, but local pushback two years ago caused the plans to move to the agriculturally-zoned land.

The new permit allows the clinic to 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.

The commissioners also approved a special permit for a 1.5-mile paved driveway on a 3.27-acre corridor, which includes 2.65 acres zoned agricultural and 0.62 acres zoned urban.

Construction is set to begin in spring 2027 with completion near the end of 2028 or early 2029.

The estimated cost of the future health center also increased from $60 million in 2024 to $90 million due to the change in location that requires added infrastructure and it will be a slightly larger facility, going from 36,000 feet to 40,000.

At the new location, the project will require building driveways and more infrastructure to connect to electricity and water. It also will require new wastewater disposal facilities, with an on-site facility to be built to provide secondary treatment, as required by the state Department of Health.

About two-thirds of the estimated $90 million cost has been raised, said Elena Cabatu, spokesperson for the Hilo Benioff Medical Center.

The state Legislature approved $25 million last year, in addition to $9 million it had previously set aside for the project, and Salesforce CEO Marc Benioff and wife Lynne have pledged $25 million in matching funds.

“Options for completing the funding are being explored, but we haven’t settled on the final configuration,” Cabuto said. “We are confident, though, that the project will be completed.”

While the facility will provide urgent care services from 8 a.m. to 8 p.m. seven days a week, including holidays, it will not be an emergency room and will not receive ambulances.

Primary care services, specialty clinic services such as cardiology, imaging services for X-rays, CT scans and ultrasounds, laboratory services, and behavioral health and counseling services will be available from 8 a.m. to 4 p.m. Monday through Friday.

The project was given a favorable recommendation by Planning Director Jeff Darrow, and testimony from employees of Hilo Benioff Medical Center and East Hawaiʻi Health Clinics in Keaʻau and Pāhoa were universally in support.

During testimony, Dr. Shauna Paylor, a physician at the East Hawaiʻi Health Clinic in Keaʻau, reported that the current Keaʻau clinic serves more than 2,000 primary care patients and East Hawaiʻi’s health clinics lack the space and resources to meet existing demand.

Dr. Mindy Prows, a psychiatrist and medical director of outpatient mental health for East Hawaiʻi Health Clinics, echoed this sentiment in her testimony by discussing the need for behavioral health services in Puna.

“We simply do not have the space or resources to meet the need that is already here,” Prows said. “Across Hawaiʻi, about one in five adults experiences mental illness, and about one in three high school students report persistent sadness or hopelessness. But these are not just statistics to me. These are the people that I see in my office every single day.”

Cabatu anticipates that the Keaʻau facility will serve more than 100 patients per day and will have 100 employees or more by its fifth year.

“The new clinic will require additional physicians, nurses and other medical professionals to support the expanded growth of our outpatient services,” Cabatu said. “We have been able to see where our patients are coming from, and I foresee our physicians working a couple of days in Hilo and a couple of days in Keaʻau, depending on where their patients are located.”

Prows said the new Keaʻau facility, when built, “would give us room for up to 17 behavioral health providers and allow us to offer much more comprehensive care, including psychiatry, individual, family and group therapy, psychological assessment and newer treatments available for treatment-resistant depression.”

Dan Brinkman, East Hawaiʻi Regional CEO of Hawaiʻi Health Systems Corporation and Hilo Benioff Medical Center, said the new health center has been in the works for several years as a “fundamental extension” to Hilo Benioff Medical Center and will continue the momentum to improve healthcare.

“There are numerous benefits that come with a project of this scope and size that will improve access to healthcare for many generations to come and provide opportunities for meaningful careers in healthcare,” Brinkman said.

Commissioners Chantel Perrin, Paul Montz, Louis Daniele III, Jonelle Fukushima and Tom Fratinardo all voted to approve the project during the meeting on Sept. 3. Commissioners Lauren Balog and Kanoe Wilson were absent from the vote.