About

ABOUT THE TOD MASTER PLAN UPDATE

Click here to view a full size version of the SMMH Conceptual Master Plan.

In 2021, the Hawaiʻi Health Systems Corporation (HHSC) - Kauaʻi Region contracted the planning, design, and landscape architecture firm, PBR HAWAII & ASSOCIATES, INC. (PBR HAWAII), to update the 2020 master plan previously completed by G70. The Samuel Mahelona Memorial Hospital (SMMH) Transit-Oriented Development (TOD) Master Plan Update (Mahelona TOD MP, Proposed Action) incorporates adjacent State lands and community needs into a wellness village concept that supports TOD. The Mahelona TOD MP was identified as a TOD priority project in the State TOD Strategic Plan.

The Mahelona TOD Master Plan creates an integrated wellness community that expands healthcare services at SMMH, addresses Kauaʻi's critical housing shortage, and provides essential community facilities. The plan transforms the existing hospital campus into a comprehensive wellness village that supports behavioral and mental health services, allowing patients to transition from intensive treatment to independent living. With Kauaʻi County requiring approximately 5,400 to 6,600 additional housing units by 2045—primarily for households earning 140% Area Median Income (AMI) and below—the Mahelona TOD MP incorporates diverse affordable housing options to serve underserved residents. The Mahelona TOD MP's strategic location near existing neighborhoods, schools, and churches, combined with its elevation above anticipated sea-level rise (SLR) impacts, makes it ideal for TOD. The Mahelona TOD MP also accommodates critical community needs including a relocated Kapaʻa Public Library (due to flooding threats at its current coastal location), additional preschool classrooms, a new Department of Health (DOH) Satellite Service Center, expanded space for Hoʻōla Lāhui, and a permanent police substation. Through new transit connections, multimodal paths, and roadway improvements, the master plan links existing and new communities to healthcare, wellness services, and public amenities in alignment with State and County goals.

A WELLNESS VILLAGE is an active, multi-generational, community engaged place that provides a continuum of quality care serving the healthcare, behavioral health, and long-term care needs.

TOD is compact, mixed-use development that takes advantage of and helps build transit ridership—creating more options for where we live and how we travel. TOD results in a mix of housing choices, employment and commercial opportunities, new recreational spaces, and provides the opportunity to walk, bike, and take transit for daily travel needs.

ABOUT The Hospital

SMMH is the oldest operating hospital on Kaua‘i and is federally-designated as a Critical Access Hospital that provides essential access to high-quality healthcare in rural communities. Built and founded in 1917 as a tuberculosis hospital, it received its name from a member of the Wilcox family, who died of tuberculosis as a young man. In the 1960s, with a cure for tuberculosis well established, SMMH gradually transitioned to providing acute care, psychiatric care, skilled nursing care, and ancillary inpatient and outpatient services (HHSC, 2021)

The current hospital building was built in 1951. Other buildings on the 34-acre campus include a private residence that once served as the physician’s residence but is currently vacant, SMMH staff housing, Hoʻōla Lāhui Hawai‘i – Kaua‘i Community Health Center, and a Kaua‘i Police Activities League (KPAL) facility. The hospital has strong ties with the neighboring community, holding events such as bon dances and an annual Christmas tree lighting, for example. The hospital became part of HHSC - Kaua‘i Region in 1996.

CRITICAL ACCESS HOSPITALS provide essential access to high-quality healthcare in rural communities. This designation was created in response to a series of rural hospital closures during the 1980s and 1990s. The designation reduces the financial vulnerability of Critical Access Hospitals while improving access to care. It also allows healthcare to remain local instead of shifting to facilities further away.

Southeastern view from center of campus.

Main SMMH facility.

Former physician's residence.

Looking west from northwest corner of campus.

Ho‘ola Lāhui Hawai‘i.

KPAL facility.

ABOUT THE PROJECT AREA

The original 120 acres of the SMMH property were ceded lands in Kapa‘a, set aside by the Territorial Legislature for the purpose of establishing and maintaining a County Farm and Sanatorium for the treatment and care of persons afflicted with tuberculosis. Under Governor George Ariyoshi in 1987, further subdivision of the ceded lands occurred so that 60 acres were set aside to the DOH for the Samuel Mahelona Hospital. In 1998 the Board of Land and Natural Resources (BLNR) deeded the current 34 acres that make up the SMMH Campus to HHSC. The remaining portions were returned to BLNR’s land inventory, and eventually dispersed to other State agencies (G70, 2020).

Location map of the SMMH Campus and surrounding area. Click map for a full size version.

CEDED LANDS are the lands that were Crown Lands or Government Lands during the Kingdom of Hawai‘i, that were illegally taken from the native Hawaiian monarchy at the time of the 1893 overthrow, and that were subsequently ceded to the United States as public lands in 1898 without any compensation to Native Hawaiians. Upon statehood in 1959, the federal government returned to the State of Hawai‘i all ceded lands not set aside for its own use. The Office of Hawaiian Affairs (OHA) is authorized to collect, administer, and expend 20% of all funds derived from the lands for the betterment of the conditions of Native Hawaiians.

The Mahelona TOD MP includes six contiguous State-owned parcels and portions of Kūhiō Highway, Iwaena Road, Kawaihau Road, and Mimilo Road, totaling approximately 77 acres:

Samuel Mahelona Memorial Hospital (TMK (4) 4-6-014:113): This ~34-acre parcel contains the existing SMMH campus, which includes the hospital, occupational therapy clinic, staff housing, the Kauai Police Activities League (KPAL) Youth Center, the Hoōla Lāhui Hawaii Community Health Center, warehouse and storage buildings, parking areas, and the former Doctor’s Residence, which is currently vacant.
Hale Hauʻoli (TMK (4) 4-6-014:112): This parcel contains the Hale Hauʻoli facility, which was originally developed by the DOH and currently houses Easterseals Hawaiʻi (ESH), a State contracted service agency supporting individuals with developmental disabilities. Title for the parcel was transferred from the DLNR to HHSC on December 13, 2024. The northwest portion of the parcel includes a driveway that provides access from Kawaihau Road to the Hale Hauʻoli facility. It is used by Kapaʻa Elementary School for access to staff parking areas along the north side of the parcel and student pick-up/drop-off. Shoulder areas along the driveway are also used as informal parking areas for students and faculty. HHSC will continue leasing roughly half of the Hale Hauʻoli facility to ESH and is in the process of executing a lease with Liberty Dialysis for the remainder of the building. Previously, the DOH managed the parcel and facility under Governor’s EO No. 4623 (dated February 12, 2020), which was cancelled by the Governor on December 13, 2024. Fee conveyance by Land Patent Grant will be issued to HHSC as an addition to the SMMH campus. In the interim, a Right-of-Entry (ROE) to HHSC Kauaʻi Region for health and health systems purposes was issued on December 13, 2024.
Kaiākea Fire Station Parcel (TMK (4) 4-6-014:026 (por.)): TMK 4-6-014:026 is a 13.9-acre parcel upon which the Kaiākea Fire Station sits and is makai and downslope of the SMMH parcel. The northern portion of the parcel is undeveloped and overgrown. DLNR owns the parcel but under Governor’s EO 4216 dated January 31, 2008, the County was granted control of it specifically for the fire station. To develop the proposed housing on the flat area makai of Hale Hauʻoli and the connector road between the SMMH campus and Kūhiō Highway, the roughly 8.65-acre northern portion of the parcel is proposed to be incorporated into the Mahelona TOD MP.
Hale Nana Kai O Kea (TMK (4) 4-6-014:105): This 3.46-acre parcel is located to the east and makai of SMMH. Developed in 1977 as elderly housing, Hale Nana Kai O Kea is owned and managed by the HPHA. It is held under a Declaration of Trust by HUD and therefore must remain separate from the rest of the Proposed Action properties and be used for public housing. However, HPHA is considering redeveloping the property through their Statewide Ka Lei Momi Redevelopment effort with up to 100 units and expanding the housing stock to include mixed-income residents.
County Kawaihau Elevated Boardwalk (TMK (4) 4-6-014:030): This DLNR-owned parcel lies to the south of the SMMH campus. It features a County boardwalk connecting Kawaihau Road with Kūhiō Highway within a 0.717-acre perpetual non-exclusive easement. The County of Kauai (County) maintains the boardwalk as well as 10 feet on either side of the boardwalk. DLNR first granted an easement to the County on May 8, 2009, for a bike/pedestrian right-of-way, followed by another perpetual non-exclusive easement on May 22, 2019, specifically for the elevated bike/pedestrian boardwalk construction.
Gore Park (TMK (4) 4-6-029:001): This triangular County park sits on a parcel to the southeast of the SMMH campus opposite Iwaena Road. Known as Gore Park, it is grassed with a few trees and shrubs and fence on the downslope side along Kawaihau Road. DLNR owns the land and has transferred control and management of the parcel to the County under Governor’s EO 876 for park purposes.
Portion of Kūhiō Highway (No TMK): A 1.3-acre section of Kūhiō Highway will be improved with roundabout construction and approach modifications. This segment is located northeast of the Kaiākea Fire Station and is owned by the HDOT Highways Division.
Portion of Iwaena Road (No TMK): A 0.24-acre portion of Iwaena Road runs between the Former Doctor's Residence (east side) and Gore Park (west side). This County-owned road segment will be removed to improve pedestrian connectivity between the SMMH campus and Gore Park.
Portion of Mimilo and Kawaihau Roads (No TMK): A combined 2.1-acre area encompassing portions of both Mimilo and Kawaihau Roads will receive traffic calming measures, intersection improvements, and mini roundabout installation. These segments are located north of Hundley Heights and west of the Proposed Action boundary, respectively. Both roads are owned by the County.