A Medical Committee for the new hospital project says, the proposed 40-bed specialty hospital cannot be built with the allotted funds and is the wrong type of facility for American Samoa.
An executive summary by the committee that was to be presented to the Senate Health Committee, last Friday, says this:
“Proposing a free standing specialty hospital to perform the most complicated orthopedic, urologic, cardiac, ICU and ophthalmologic services is likely to fail, due to the high operational costs and the local clinical volumes present in American Samoa.
“Such a 40-bed “mini LBJ” facility cannot be built with the allotted funds—that fact has already been confirmed with the Hawaii Architectural Firm. It is the wrong type of facility for a population of nearly 50,000 people, living hours away from any other supporting hospitals. That is a data driven conclusion.”
The ARPA grant provided $300 million to LBJ for service improvements and facility upgrades. The Governor split the grant allocating $100 million to LBJ for repairs and service expansion and $200 million was allocated for the 40 bed-hospital.
“The agreement splitting the grant was not done in consultation with a team of medical planning experts,” said the Medical Committee. “The LBJ Board was excluded. Critical stakeholders, including physicians and nursing staff were not consulted until very late in the process. This grant was improperly left in the hands of well meaning but inexperienced advisors…Most of the medical planning input was provided by two LBJ doctors with no experience or training in health care planning,” says the Committee’s executive summary. The two doctors are not named.
It goes on to say that the original proposal is “flawed and unworkable. It does not meet the health care needs of American Samoa.” According to the Medical Committee, the language in the initial grant proposal is very clear about what services were to be provided by the new facility but they are not supported by data. “Most of these types of highly specialized services require extensive lab, radiology and pharmacy services. The proposal even included ICU beds which are expensive to build and staff.”
The committee says the US Army Corps of Engineers are the experts in health care planning. “They performed an all inclusive survey and review of the unmet medical service needs of American Samoa. In their comprehensive review, they never recommended to open a second specially hospital. Such a decision is not cost effective…A second facility would duplicate resources and have difficulty in generating revenue.
“Either we build a proper facility to meet the needs of our population, or we risk wasting the $200 million.”
The committee’s top recommendation is to return the $200 million to LBJ and to not build a second hospital, but to follow the recommendation of the Army Corps and build up the existing hospital.
If Option A is not followed, the Medical Committee’s second option is to build a new chronic care/rehabilitation specialty hospital which, it says, is the best medical use of the ARPA grant funds and will not risk the loss of this “once in a generation healthcare investment of $200 million.”
The Medical Committee consists of four senior nurses and nine medical doctors from LBJ and DOH. It is to provide the Governor with professional advice and recommendation on the planned new hospital. For their report, the committee relied extensively on the US Corps of Engineer’s report, reviewed multiple years of health data from LBJ and DOH, as well as additional data from the off island referral program funded by Medicaid. They also consulted with other stakeholders and experts in the area.
