On the west side of Hawaii island, Kona Community Hospital serves a growing population in a facility that’s almost 50 years old but desperately seeks funding for much-needed repairs, according to its leaders.

Kona Community Hospital CEO Clayton McGhan says he is seeking $20 million from the state to address some “risk of closure” infrastructure repairs critical to keeping services in operation.

Among the most critical are an expansion of the pharmacy, including a compounding facility so that it can mix drugs needed for cancer patients. This is needed for regulatory compliance, he said, and without it the hospital would not be able to continue providing cancer care to hundreds of patients on the west side.

Additionally, the hospital needs to repair its heating, ventilation and air-conditioning system to keep its operating rooms up and running with climatized control. If one of the chillers were to go down, he said, the hospital would not be able to provide lifesaving trauma treatments or surgical procedures.

That would put the hospital at risk of losing its “Level III trauma” designation, and those patients potentially would have to travel to Hilo or off-island.

Additionally, there are aging electricity systems, and plumbing issues that need to be addressed.

“We have items that keep us up at night,” said McGhan. “They have the potential of closure or reduction of serv­ices we’re providing to the community.”

The hospital, a state-funded facility run under the Hawaii Health Systems Corp., has sought $26.2 million in capital improvement plan funding over the previous three fiscal years for urgent hospital upgrades and repairs but received only about half of that amount, $14.4 million.

In 2022 the hospital also received a $2.5 million appropriation for the planning and design of enhanced oncology services.

The hospital, which was built in 1974 in Kealakekua, has been able to use funds to renovate bathrooms and repair its wastewater treatment plant. And it has made a number of quick fixes that might be considered a “Band-Aid” approach, McGhan said, but they do not resolve the longtime need to upgrade and replace certain equipment and systems.

“We’ve been chronically underfunded, and essentially, have not been able to address these long-standing issues,” he said.

This year Kona Community Hospital is looking for $20 million over two years to cover these “risk of closure” infrastructure projects.

Like hospitals statewide, Kona Community Hospital also has been quite full, serving a population of more than 90,000 on the west and north sides of Hawaii island. The hospital has 94 inpatient care beds, including nine in its intensive care unit.

Though the hospital has not been packed with COVID- 19 patients, it has been operating at full capacity.

“We’ve been extremely busy,” said McGhan. “We thought with COVID-19 we’d have a little bit of reprieve, but it’s actually been quite the opposite. We have more patients that are sicker coming to our hospitals.”

Many patients are more ill, possibly due to years of deferred care during the COVID-19 pandemic, he said.

At the same time, approximately 30 of the 94 inpatient care beds are occupied by waitlist patients — patients who are waiting to get into a long-term care facility. But those facilities, which are short of staff, are unable to accept new patients.

Like other hospitals, Kona Community also faces staffing challenges and is short of nurses.

On Hawaii island it is difficult to bring in staff, especially due to the lack of affordable housing, he said. The hospital has offered jobs to those with specific skill sets needed, but when they see how much it costs to live in the area, they change their minds — and some have even canceled their contracts.

On the east side of island, Hilo Community Hospital, also part of HHSC, seeks $50 million from the state to carry out long-awaited expansion plans.

During a conversation Friday on the Honolulu Star-Advertiser’s “Spotlight Hawaii” livestream program, McGhan said he continues to meet with state legislators and is hopeful the state will come through with the funding.

“We understand there’s a lot of asks out there,” he said, “but we hope they will make health care the No. 1 priority in all of their asks. It affects everyone from the top down.”