KILAUEA, Kauai — A year ago Kauai officials celebrated the construction of the island’s first inpatient drug treatment facility since Hurricane Iniki ripped through the island in 1992.
Built on donated land with $7 million in state and county funds, Kauai’s Adolescent Treatment and Healing Center would have filled a glaring gap for drug-dependent youth in a community starved for mental health and addiction resources.
But last month the county canceled its contract with Oahu-based Hope Treatment Services to operate the eight-bed youth rehabilitation center, citing problems with the company’s “performance and responsiveness.”
Kauai County Managing Director Michael Dahilig wouldn’t provide specifics about why the county’s agreement with Hope Treatment Services went south. But in a letter to the vendor earlier this year, the county rendered an ultimatum: Open the rehab facility by March 31 — or lose the contract.
Donald Perpignan, facility manager at Hope Treatment Services, said the county set an unrealistic deadline that did not account for how long it takes to obtain a license to operate an adolescent drug rehab program from the Hawaii Department of Health’s Office of Health Care Assurance.
Now, a new vision is taking shape to turn the facility into a hub for preexisting adolescent drug prevention and jail diversion services, as well as programming for crime victims and witnesses.
An inpatient drug rehab center is, for now, almost certainly off the table.
First proposed in 2003, a facility to house an inpatient drug treatment program for youth on Kauai had been a long time coming.
One in four Kauai high school students is at high risk for drug and alcohol abuse, according to the 2018 Kauai Youth Report. Although the rate has declined in recent years, it is still problematic.
Young people on Kauai who experience a drug, alcohol or mental health crisis typically must fly to Oahu for treatment. But when all of the state’s drug rehab and psychiatric beds are full, which happens periodically, there’s no place for neighbor island patients to go.
“It’s kind of a heartbreaking story on one hand, which is that the county went through all the effort to build this treatment center and they can’t use it,” said Dr. Graham Chelius, a Kauai doctor who said he has 170 patients who are using medication to treat their opiate addiction.
“On the other hand, here’s a community that wants to do something, created an asset and now we have to figure out what’s the best use of this asset.”
A Surprise Cancellation
Stanley Perpignan, director of Hope Treatment Services, which runs a 22-bed residential treatment center for adults in Wahiawa, said he was surprised when the county canceled the company’s contract. He said he was in the home stretch of the state licensure process when county officials informed him that it would temporarily repurpose the building as an isolation center for people infected with COVID-19.
Perpignan said he did not hear back from the county after he sent a letter asking officials to reconsider.
“Every day that it sits vacant is going to be a missed opportunity.” — Kauai Prosecutor Justin Kollar
Earlier this year, Stanley Perpignan said county officials expressed to him that they were frustrated by how long it was taking him to open the center.
“From my understanding, they said the licensing was taking too long and I’m not too sure where they got that information from because the average time for licensing a drug treatment facility, especially for adolescents, is about a year,” Stanley Perpignan said.
“The Department of Health was expediting the process for us because they knew it was a need for the community,” he added.
Donald Perpignan said he had furnished the building, hired a full-time counselor and was expecting to receive a state license to start operating the center sometime in April.
But he said he could not fulfill “relatively outrageous requests” made by the county, including monthly progress reports on the licensure process, while working to open the center as quickly as possible.
In a February letter to Stanley Perpignan, Kauai County Housing Director Adam Roversi cited a clause in the vendor’s operating agreement that states “time is of the essence” and wrote, “If Hope fails to secure the required state licensure, have state certified employees on site staffing the facility, and in fact be housing treatment clients and operating the (treatment center) by 9:00 a.m. on March 31, 2020, the County Housing Agency will formally terminate the operating agreement with Hope Treatment Services.”
Then COVID-19 hit, all but promising further delays in the licensing process.
Meanwhile, the virus created a need for the county to secure an isolation facility for visitors who test positive for COVID-19 and cannot travel back home until they’ve recovered.
The empty adolescent treatment center was a natural fit.
The county confined two coronavirus-infected people vacationing from Indiana to the facility in March.
“For us in many ways it’s, ‘Did you use this pandemic as a way out?'” Donald Perpignan said. “On our end we feel like we were doing everything we could do to get this facility open in a timely manner but it wasn’t fast enough or good enough for them.”
When the threat of COVID-19 subsides, Dahilig said the county’s priority will be to fill the building with badly needed services for at-risk youth and families as quickly as possible. An inpatient treatment program is not an impossibility for the future, but he said the county doesn’t want the building to continue to go unused.
“Our expectation with the center was that it was meeting an immediate need,” Dahilig said. “Before COVID, we were already concerned that the immediate need relating to juvenile support services for drug addiction was not being met.”
Justin Kollar, the county prosecutor, said he’s working with county officials to formulate a plan for his office to take over the building’s management.
His vision for the center includes co-locating preexisting services for at-risk youth and families in one place, like a family justice center. These programs might include crime victims and witness protection services, Kauai Teen Court and Life’s Choices Kauai, a substance abuse prevention program that was recently absorbed by Kollar’s office.
Kollar said he’d also like his office to manage subcontracts with outside providers. His plan calls for redesigning what would have been bedrooms into classrooms for public school students who have been suspended for drug violations or offices for private outpatient drug treatment and mental health services.
“It is incredibly rare for a county our size to be able to marshal the kinds of resources that it took to make that building happen,” Kollar said. “Every day that it sits vacant is going to be a missed opportunity.”
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