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Uncertainty, anxiety decreases morale of hospital staff

By Tammy Doty

SAIPAN, CNMI (Marianas Variety, April 13, 2012) – Given the Commonwealth of the Northern Marianas (CNMI) Attorney General Edward T. Buckingham’s statement this week that the Commonwealth Healthcare Corp. -International Consulting Services (CHC-ICS) billing and collections contract is unlawful the question on the community’s mind is "what now?"

Since Gov. Benigno R. Fitial declared a state of emergency for CHC nearly five weeks ago the situation by all accounts has continued to deteriorate and quickly.

Although a CHC-Marianas Public Land Trust (MPLT) agreement was reached for a $3 million line of credit last month only one drawdown of $1 million was approved to date.

CHC has access to an additional $2 million from the MPLT line of credit, but the department of finance and office of management and budget were given oversight powers under the memorandum of agreement (MOA) as part of the overall MPLT-CHC.

MPLT issued a second check for $700,000 a week ago but it sits un-cashed because CHC has failed to provide the financial data required by the MOA.

According to the two-page MOA "the security provided by CHC for the loan is of such importance to the health, wellbeing and security of the people of the Commonwealth that default would be catastrophic; and because of the threat that default presents to the Commonwealth, the Commonwealth central government finds that it is necessary to make sure that the funds made available to the CHC by the loan are spent wisely and in such a way to avoid default."

Additionally, the MOA stipulated that CHC must submit a cash flow statement, bank balance sheet and a spending plan, and other financial documents or statements as requested by the special assistant for management and budget and the department of finance.

What morale?

Since Variety broke the story of the illegal CHC-ICS deal on Tuesday there was another bottoming-out of confidence in CHC’s viability without a major government cash infusion of millions.

"I didn’t think the situation could go any lower and it did… CHC leadership kept repeating that the MPLT line of credit and the new billing company were THE PLAN A and there was no plan b," said one dejected physician.

The overall sentiment among the medical staff Variety spoke to was confusion and disbelief.

"The ICS deal was presented as a ‘saving-grace’ for CHC and then we hear the deal’s dead… now what do we do?" queried one confused and angry employee,

Many interviewed medical staff noted no improvement in communication between the CHC administration and staff concerning notification as to whether allotments, benefits and third-party payments for the last period were met.

"We were told by the CEO in a meeting with him a month ago that if CHC could not cover all contractual obligations for a pay period then no salaries would be released… It was all or nothing," one physician explained anonymously.

The return of uncertainty so soon after threats of cancellation from third-party benefit providers was driving many of the doctors to continue "aggressively pursuing other positions."

The news was no better on the nursing side.

CHC’s Director of Nursing Leticia Reyes confirmed 17 nurse resignations or 11 percent of the 150 professionals.

With regard to the resignations one doctor commented that the nursing exodus "was almost worse" than the doctors looking for a way out of the CNMI.

Reyes remained positive and said CHC had called in for interviews all 11 on-island nurses who had submitted employment applications in the last year.

The hourly pay range for nurses at CHC ranges between $12 and $18 an hour depending upon education and work experience.

In her opinion CHC was still an attractive employer although it was regrettable that so many professional and caring staff saw fit to pen their resignations from the corporation.

CHC is actively recruiting from the Philippines too and as one medical staffer noted "it will be interesting to see what the response to working at CHC will be considering the chaotic situation."

To date, the Tinian and Rota health centers have not experienced any resignations and still count 14 nursing staff at each facility.

"We’re very lucky to have such dedicated people," sated Reyes.

The resigning nurses agreed to provide a 90-notice period as a professional courtesy so CHC has time to recruit and train replacements.

"The transition will not affect patient care," replied Reyes when asked if the re-staffing was a concern.

However, Reyes seemed to be in the minority camp.

"CHC is far worse than when the governor declared a state of emergency…and we still have no decent leadership and the plan to save the hospital just went up in smoke," replied an employee shaking her head.

Variety contacted CHC CEO Juan N. Babauta for comment on the issues facing CHC but none was forthcoming as of press time.

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