Hawaii Health Systems Corp. will eliminate around 35 positions, mostly on Kauai and other neighbor islands, as early as mid-December in the first round of cuts to make up for an anticipate deficit this year.

The state’s quasi-public hospital system, facing a $48 million shortfall for fiscal 2015, announced the impending cuts Thursday after an extensive review of operations and programs and services at each of its 12 facilities.

"We value our employees tremendously and we really tried to avoid this," Alice Hall, HHSC’s acting president and chief executive officer, said in a press release. "Unfortunately, the current financial situation in some regions is not sustainable without significant changes, some of which have resulted in cost-saving measures that include a reduction in force."

HHSC has 4,500 full- and part-time employees. Hall didn’t immediately respond to a request for comment.

HHSC said it will notify employees whose positions will be cut by Sept. 2. The notification begins a 90-day process in which affected employees may choose to be placed in vacant positions. If none exists, workers can exercise the "bumping" process as part of collective bargaining agreements. 

The process, which allows workers with more seniority to take a less senior employee’s position, could take up to nine months. Further reductions may occur later in the year, the company said.

HHSC facilities are bracing for decreased state subsidies and health insurance reimbursements, as operating costs and the need for health care in rural areas continues to rise.