WAILUKU — The proposed West Maui Hospital and Medical Center received its third and final unanimous recommendation for approval yesterday.

"I'm floating," said West Maui Improvement Foundation President Joe Pluta in reaction to a 6-0 vote by the Certificate of Need Review Panel. "Triumph of hope over adversity — that's what this is."

Pluta and dozens of West Maui residents have been advocating for 10 years for the development of a hospital in Lahaina. The foundation and the West Maui Taxpayers Association forged a relationship with Newport Hospital Corp. President Brian Hoyle in the last few years to come up with the proposal that appears to be heading for approval.

Hoyle was also smiling yesterday following the third consecutive favorable review of plans to build a 25-bed acute-care facility and a 40-bed skilled nursing home on 14.9 acres neighboring the Lahaina Civic Center.

"Could we do any better?" Hoyle quipped.

All that remains is decision-making by State Health Planning and Development Agency Administrator Ronald Terry. State law requires him to issue a decision by early May, which is within 90 days of when Hoyle's application was deemed complete and ready for review.

An SHPDA administrator usually follows the recommendations of the panels. In addition to yesterday's recommendation for approval from the Certificate of Need Review Panel, the hospital project also received favorable votes from the Tri-Isle Subarea Health Planning Council on Feb. 13 and the Statewide Health Coordinating Council on Feb. 26. Members of all the panels who have a wide range of expertise and interests in Hawaii health care services, posed numerous questions about the project's financing, need, accessibility and staffing.

Yesterday, a few panel members expressed some nervousness about recommending approval, but all agreed that Hoyle's proposal met the certificate criteria established by law.

"It sounds a little bit too good to be true," said Maui District Health Officer Dr. Lorrin Pang.

In the end, Pang made the motion to recommend approval of the project and questioned his fellow panelists about what more they needed to be confident about a yes vote.

CON Review Panelist David Peters said he wished the $45 million project's viability did not rest solely on Hoyle.

"I would like to see a stronger portfolio of cash in place," Peters said.

After the meeting, Hoyle said that while he has committed to providing as much as $20 million of his own money, he has confidence other private investors will support him if needed. Hoyle also plans to seek funding assistance from the U.S. Department of Housing and Urban Development.

At yesterday's meeting at Maui Economic Opportunity Inc. in Wailuku, panelists heard widespread support for the project from politicians to private citizens.

However, surgeon specialist Dr. Peter Galpin reiterated his opposition to the project and his concern that West Maui residents are not getting the definitive care facility they have been lobbying for for years.

Former Mayor James "Kimo" Apana pointed out in his testimony that two former mayors — Alan Arakawa and Gov. Linda Lingle — and current Mayor Charmaine Tavares have all agreed that West Maui needs a hospital.

"We don't always see eye to eye, but on this particular issue, we're in unison," Apana said.

May Fujiwara, president of the Lahaina-Honolua Seniors Club, spoke for nearly 50 club members, in asking for the facility to be built "in our lifetime."

Residents such as Pluta and Fujiwara have argued for years that the hospital is their community's biggest need, and that the lack of medical facilities has resulted in inconvenience and sometimes tragic outcomes for West Maui residents who travel about 35 miles or 45 to 65 minutes "on a good day" by automobile or ambulance to get to Maui Memorial Medical Center.

The project's target date for opening would be March 2012.