Kaiser Permanente Hawai'i announced yesterday that it will reduce its workforce by 90 positions as it attempts to streamline operations while increasing services to its members.

The state's largest health maintenance organization said it will cut 2 percent from its payroll of 4,500 employees effective mid-November. Janet Liang, Kaiser president, said the affected workers will have the opportunity to apply for more than 100 positions in the company.

Kaiser did not specify which positions will be eliminated, but the head of the Hawai'i Nurses Association said that nearly a third of the layoffs will involve nurses.

Hector Ramos, interim executive director, said Kaiser informed the union yesterday that 28 nurses will be laid off. Ramos said that many of the other employees are members of UNITE HERE Local 5.

Local 5 officials could not be reached for comment yesterday.

Ramos said the layoffs came as a surprise to the union. He said he was not told by Kaiser how many of the 100 openings will be nurse positions.

"We're going to aggressively fight to retain those positions," Ramos said. "They have announced to us that they have a hundred openings and we don't understand why they're having these nurses that are about to be laid off apply for these positions, rather than just transferring them."

Ramos said he also was confused because Kaiser announced it was reducing staff, but increasing hours at some community clinics.

Liang said the changes will require "different skills in some cases, and in other cases different locations." She said Kaiser will be hiring no more than 10 physicians to accommodate the expanded hours.

"We've been spending time talking to our members, people in the community and business leaders about what we can do to really improve our care and services here at Kaiser," Liang said. "We made some decisions to respond to their needs."

Liang also acknowledged that Kaiser's financial situation and a decline in membership were factors leading up to the layoffs.

Kaiser Permanente Hawai'i reported a second quarter loss of $3.2 million, in part because of higher medical expenses. Kaiser also said its membership was lower than expected at 219,000, compared with 225,000 a year earlier.

Nearly a year ago, Kaiser cited declining membership and rising costs when it announced it would let go 45 employees. The cut represented 1 percent of Kaiser's full- and part-time workforce.

"We're not immune to the financial challenges in the healthcare industry here in Hawai'i," Liang said. "It was what led us to begin to ask ourselves what could we do to really be more attractive to the people of Hawai'i and to improve our services and care."

Reach Curtis Lum at culum@honoluluadvertiser.com.