From Dan Brandes:

"Having worked in the MMMC ED for 15 years (1998-2013), and served on the Medical Executive Committee (2008-2012), I attained a good understanding of our Hospital’s history and functioning and with that in view, I would very much like to commend Dr. Yan for her courage and heartfelt sincerity for initiating this much needed and long overdue petition.

The present Administration’s blatant lack of support for bedside caregivers is not a new problem, but it certainly has caused morale to be at an all time low. The Administration’s "top-down" chain of command and “we know everything" attitude is ever present and unfortunately ignores important feedback from the bedside caregivers who are trained in medicine and are typically dedicated, idealistic, and trying earnestly to give the best possible patient care.

If only the Administration would work hand in hand with the frontline medical teams, and ask for and act on their feedback, the low morale and high attrition rate of these caregivers would be a non-issue. We would not need to import costly temporary “Locums" doctors and "traveler" nurses ...but instead, we would be better able to retain (and not drive away) our very own local Maui medical professionals.

The dire state of affairs present in this, our only acute care hospital on Maui, in my view, is directly related to the lack of leadership displayed by the Hospital administrator, Mr. Rembis. His apparent over-riding objective is to optimize the “bottom line", a worthy goal for most any business …but NOT in healthcare, and certainly not at the expense of the well being of the members of the community that he is supposed to be caring for. His lack of leadership and questionable credibility during the COVID –19 crisis and his ongoing inability to communicate or work meaningfully with the staff is destroying an institution we cannot afford to see fail.
As President Truman was often quoted as saying: “The Buck Stops Here”.

Applying this to Mr. Rembis …I believe it’s time for him to move on."

I also feel like Rembis needs to go, but the issue here is even deeper.  What is this experiment that Kaiser Foundation Hospitals is doing in Maui?  It's failing our hospital and it's failing our community.  Many people say that Rembis only reports to one person in Kaiser and that is to Greg Adams; that there is no board of directors or any oversight over Rembis in the Kaiser enterprise than Greg Adams.  This is likely a move from Kaiser Foundation Hospitals to separate itself from the Kaiser Permanente Medical Groups (just like what has happened in Washington), so no more physician oversight and checks and balances to their business model. (Remember what happened to Boeing when the business folks didn't have any checks and balances from the engineers (watch https://www.netflix.com/title/81272421   And what is the business model?  Have an independent subsidiary like Maui Health Systems manage the hospital under the parent company of Kaiser Foundation Hospitals (a nonprofit).  Contract out to independent companies like RIMA  (the radiology company here in Maui based in California) and EMA (the Emergency department private group based in California), so therefore the administration can claim that they can't open these private companies' financials and look into these companies because they are private and not nonprofits (like Kaiser Foundation Hospitals) and they can't interfere in their business. Guess what? Maui Health System can also claim that they can't look inside who the investors are into these companies. 

So let's break that down.  

Kaiser Foundation Hospitals is a nonprofit- they are required by law to have their financials open to the public.  Also the Hawaii law to privatize Maui Memorial Medical Center only allowed nonprofits who are already conducting business in Hawaii to bid.  It had to be a nonprofit. 

So they create a subsidiary like Maui Health Systems (but it could be any LLC in any place in the country)

Then Maui Health Systems contract out each lucrative department to a private management company like RIMA or EMA.  These companies then are a black box- they have investors and they make profits, but because they are private, they can't be made to open up their books to see if the people involved at the Kaiser Foundation Hospitals, for example,  are also investors of these private companies. 

Full circle.

But here in Maui, the RFP requires that private companies like EMA can be forced to open their financials if the Maui Health System Board demands it.  We need to have transparency . We need to demand the Board of Directors of Maui Health Systems demand that EMA and RIMA show their financials to the community because this is still a public-private partnership.  Without the Kaiser Permanente Physician Group giving the check and balance to the Kaiser Foundation Hospitals, the people running this experiment can and have run amok.  Running the hospital to the ground,  and it maybe so lucrative. In a letter sent by Maui Health as a rebuttal for my petition , they state that Gov. Ige's administration has stated that having Maui Health Systems run this hospital saves the state $260 million dollars for 10 years.  If the savings each year is $26 million, imagine what the profits look like?

Here are the names of the Board of Directors of Maui Health Systems.  

Go to each personally and request for them to support us Healthcare Workers Take Back Maui Memorial Medical Center and bring good governance and check and balances to the administration intent on only getting profits out of this hospital.  

Board of directors
Mary Hew
Kathy Lancaster
Tamar Goodfellow
Kim Horn
Steve Miller, MD
Bryan Smith, MD
Clay Sutherland
Tony Takitani
John Yamamoto

While you are at it also speak to the Maui Health Foundation Board of Directors too: 
Tamar Goodfellow - President, Community Volunteer
Vince G. Bagoyo, Jr. – Vice President, V. Bagoyo Development Group, LLC
Karen Williams – Vice President, Community Volunteer
Beverly H. Kurokawa, CFP ® - Treasurer, Accountant
Jon A. Fujimoto – Assistant Treasurer, Bank of Hawaii
Bard E. Peterson – Secretary, First Hawaiian Bank
Melinda Sweany – Chief Development Officer, Board of Directors
Nane Aluli- Vice President & General Manager, The Mauian
Karen Christenson- Vice President – Marketing Mama's Fish House
Chris Kulis- Executive Chef Makena Golf & Beach Club
Colin D. Lee, MD- Cardiologist
Maggie Martin- Community Volunteer
Saedene K. Ota-Owner, Sae Design
Nancy Leis Overton-Vice President Dorvin D. Leis Co., Inc.

Here's the breakdown of the Medical Executive Committee.  These are doctors involved in having a voice in the functioning of the hospital:

Medical Executive Committee
Vijak Ayasanonda, MDChief of Staff (EMA Administrator)
Cordia Wan, MDVice Chief of Staff
Constantin Novoselsky, MD,Past Chief of Staff
Aaron Altura, MD Secretary/Treasurer
Nicholas Goehner, MD Member-at-Large
Jennifer Mathieu, DO Member-at-Large
Jason Bluth Anesthesiology Chair
Jay Parikh Cardiology Chair
Lee Weiss Emergency Medicine Department (EMA Regional Director)
Adam Protain Department of Medicine Chair
Tiffinie Mercado OB/GYN Chair
Barry Shitamoto Pathology Chair
Holly Romero Pediatrics Chair
Rosaleen Parsons Department of Radiology Chair (hired by RIMA)
Christopher Taleghani Surgery Chair