The imminent closure of Kahuku Hospital has lit a fire under state officials, who have correctly shifted into high gear in the hopes of heading off a healthcare crisis for O'ahu's North Shore.

The tiny facility has been struggling for years to serve its franchise, some 27,000 residents between Kualoa and Waimea Bay, due to rising operating costs and a $3 million debt, among other factors. Kahuku has faced particular financial vulnerabilities, as the only federally designated "critical access hospital" in the state unaligned either with the state hospital system or one of the larger medical centers.

Whatever the reason for its precarious economic circumstances, elected lawmakers have rightly concluded that it's the state's responsibility to provide a medical safety net, especially where emergency care is concerned. Lawmakers have been meeting with hospital executives and the Lingle administration, pressing for a stop-gap grant of about $1.5 million in state support, and working to persuade the hospital to table its plans for Chapter 7 bankruptcy. The money would keep the hospital operating while the Legislature decides whether to bring the Kahuku operation under the state's wing with other rural hospitals.

This appears to be the most pragmatic way to keep a critical service running. Shutting down the hospital means it will lose its certificate of need, the permit required for significant healthcare facilities and improvements. It could take months or years to get a new one, so it would be irresponsible for the state to let this one lapse.

Fortunately, work is already under way to salvage at least the most essential aspects of the hospital. Elected leaders also need to consider federal grants, as well as foundations and other funding sources in the private sector, to help underwrite the solution.

And planning needs to begin now on ways to foster collaboration among the state's rural health facilities to strengthen them for the long term. Some discussions already have begun along these lines among health officials.

For the short term, when Hawai'i lacks a permanent medical air ambulance service, there is no way the state can leave this gap in our critical care safety net unattended.