KAHUKU — A critical meeting that could extend the life of Kahuku Hospital will take place today with board members expected to decide whether to change course and restructure rather than shut down.

The decision is in the hands of nine unpaid volunteer board members, professionals who have tried for years to find a viable solution to end the facility's financial hemorrhaging and place it on the road to recovery.

Last month the board concluded that to continue to operate and accrue debt — which stands at $3.5 million — without hope of repaying would be fiscally irresponsible. But the announcement that emergency and other medical services at the only hospital within an hour's drive would cease at year's end stunned the community and set legislators into action.

On Monday, legislators told hospital officials that if its board would reconsider filing for bankruptcy and seek a Chapter 11 reorganization instead, the state would have time to adopt the rural hospital into the Hawai'i Health Systems Corp., which manages the state hospitals.

That would mean money and probably a new model of healthcare at the facility that could translate into fewer services.

The board wants assurances that include an infusion of emergency money to keep the hospital operating, a memorandum of agreement that key state legislators support inclusion of Kahuku into the state hospital system, a financial commitment for a Chapter 11 that could cost hundreds of thousands of dollars, and board protection against liability.

Board members polled this week said everybody wants to save the hospital but until they hear the details of a state proposal today, they couldn't say how they would vote.

"It's been emotional for a lot of us," said Eric Shumway, board member and president of Brigham Young University, Hawai'i. "We've raised seven children in this community, four of them were born at Kahuku. We kept the emergency room solvent just with our family."

Shumway said he's also concerned about meeting the health needs of the 2,500 students at his campus and the planned development in the community, with hundreds of new homes slated for construction.

But the board and the hospital staff can no longer carry the burden, he said.

"We want to see it on firm footing," Shumway said. "We feel the state needs to assume the responsibility."

Dr. Chiyome Fukino, director for the state Department of Health, said the hospital board's request for assurance are reasonable.

I believe we should have some kind of medical facility there, Fukino said after Monday's meeting. "The big question is what that something will look like."

Operating an emergency room, which many people are calling for, is expensive, and if that is what the legislators want they must fund it, she said. In the past the Legislature cut funds to the hospital that were requested by the governor, Fukino said.

"If the Legislature feels that this is a reasonable position to take ... than they have to follow with financing," she said.

Under the state hospital system, Kahuku Hospital would most likely change, continuing to provide some of the services that are there now and cutting others.

Norman Brand, a Kahuku Hospital board member, said many professionals and "the powers that be" say a hospital isn't necessary.

"I think an emergency room and urgent care and an up-to-date facility with state-of-the-art equipment is what this community as well as those people who come out here for recreational purposes need," Brand said, adding that becoming part of the state hospital made the most sense.

Eric Beaver, president of the hospital board, said some board members might feel a little apprehensive about the proposal because of the Legislature's political process.

Every year the hospital has had to go to the Legislature to ask for funding for its hospital and emergency room service and that should change, said Beaver, president and CEO of Hawai'i Reserves Inc.

Emergency room services should be considered a basic need like police and fire service and not be subject to the political process every year. Perhaps every five years would be better, he said.

"To me, any solution that requires the hospital to come back every year doesn't make sense," Beaver said.

Reach Eloise Aguiar at eaguiar@honoluluadvertiser.com.