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Disagreements between House, Senate and CHC delays passage

By Haidee V. Eugenio

SAIPAN, CNMI (Saipan Tribune, March 2, 2012) – Despite a two-hour talk with medical practitioners and acting governor Eloy S. Inos on the financial, management, and employee morale crisis at the Commonwealth Healthcare Corp. (CHC), Commonwealth of the Northern Marianas (CNMI) Senate and House of Representatives members were unable to agree on the fate of an $11.58 million line of credit bill and another bill on a $5 million Medicaid state share.

For one, there's no telling when the House will act on the Senate-substituted bills.

Lawmakers present yesterday didn't agree on passing or rejecting the bills in their latest forms, although some assured of "working together."

After the meeting ended in the House chamber, the lawmakers went their own ways. As of press time, there was no other meeting between the House and Senate to discuss the bills.

CHC Medical Affairs director Dr. Michael Deary, among 10 CHC medical affairs staff and private doctors at the meeting with lawmakers, said every single day that legislative action on the line of credit bill is delayed is another day that worsens the situation at the hospital.

Senators led by President Paul Manglona (Ind-Rota) wanted the House to either accept their version of the bills that originated from the House or reject them and call for a conference committee so they can "work together."

At least six House members led by Rep. Ray Basa (Cov-Saipan) said they don't want to accept the Senate versions of House bills 17-278 and H.B. 17-261, and asked the Senate to reconsider its action on the two measures.

Basa wants the CHC line of credit and all others that the Senate wants to be separated into two bills.

In a later interview, Basa said he would like to reintroduce his line of credit bill, hoping to get a different result from the Senate.

The acting governor, for his part, said he could sign the bills as substituted by the Senate, or the two bills that could come out of a conference committee once the House and Senate "get their heads together" and reach a compromise.

The medical staff present at the meeting asked that the House version of the $11.58 million bill be passed and signed into law so that the corporation could have immediate access to funding that will buy medical supplies to treat patients and pay CHC employees and vendors on time, among other things.

CHC's Dr. Michael Hart said the hospital is unable to provide a lot of services because it lacks a lot of things that could have been addressed had the line of credit bill been passed "yesterday."

"Otherwise I must say that if this corporation fails, we're going to have an unprecedented historical mess in this place because the hospital is without staff, without physicians, without lab technicians, without anything. It's just going to be a building," he said.

Some of them also straight out asked senators not to "micromanage" CHC by wanting to decide who should get hired and fired, and instead asked senators to talk to the CHC management team about these things.

CHC chief executive officer Juan N. Babauta is off-island, while CHC executive officer James E. Phillips was not at the meeting.

Some of the physicians also feared that politics is getting in the way of helping CHC get over the crisis.

Inos, who oversees government finances, said the Senate version of HB 17-278 would make available at least $6 million for CHC. The bill authorizes the Marianas Public Land Trust to provide up to $11.58 million line of credit to CHC.

Dr. Tony Stearns of the Marianas Medical Center, at the start of the meeting, hoped that there would be quick and effective solutions to CHC's problems by fostering communication among parties involved.

CHC inpatient pharmacist Anthony Raho said among the root causes of the crisis CHC finds itself now is the lack of planning in transitioning the hospital into a corporation to begin with.

Raho said that CHC thought that HB 17-278 would be a last-ditch effort to "save" CHC, to "give us that necessary capital for us to operate until such time we can improve the procedures and billing and collections." He also said many of the staff thought the House bill "was a very viable source of revenue to help the corporation survive in the next few months."

"What we perceived as a workable piece of legislation came out of the House, went to the Senate, the Senate introduced some things that are understandable, but some things are completely non-understandable, and we can't really support," he said.

He said either the bill passes, or CHC will have to reduce its operations by 40 percent, which he said is "drastic" and would be detrimental to CNMI healthcare.

Raho, Hart, and other doctors said CHC and the community cannot wait for the bills to go back and forth like "ping pong" between the House and Senate.

Deary, who caught the ire of senators for a "letter to the editor" said that, "had the Senate chosen to accept that bill and approve it as is, the hospital would currently have funds where they could draw down on and we could be paying our vendors and we could be satisfying our obligations to employees."

Deary and Manglona had a heated exchange, each one accusing the other of being unprofessional. Deary said Manglona and the senators need to respect his right to freedom of expression, while Manglona said that Deary should have gotten all information first before writing a letter to the editor and accusing the senators that they do not know what they're doing.

Another CHC doctor asked lawmakers to give CHC "autonomy" and "independence."

Dr. Leticia Borja, for her part, said that this has been the worst she has seen of CHC since 2005 when she started working there. She said what the staff is also asking for is "stability."

"There is a solution available but there are delays. It makes us hopeless. We want to get basic lab supplies, we want to get basic lab reagents so we can care for our patients. We want to get paid, we don't want to be threatened not to get paid," he said.

Sen. Ralph Torres (R-Saipan), chairman of the Senate Committee on Health, Senate Vice President Jude Hofschneider (R-Tinian) and Sen. Frank Cruz (R-Tinian) also took turns addressing the crowd.

Hofschneider brought up the issue of CHC recently hiring an individual for $49,500 a year, when the person holding that post for 15 years was paid only $38,000. He said somebody hired years back for $30,000 was replaced with someone doing the same thing for $60,000.

Inos also asked whether CHC would be able to repay $6 million or $10 million, as it wishes, in 180 days from the date it draws down the amount. He also wanted CHC staff and House members to understand that CUC and PSS also need help.

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