CNMI Hospital CEO Concerned New Board Will Micromanage Healthcare Corporation

Muña frustrated legislature approved bill turning board members into political appointees

By Erwin Encinares 

SAIPAN, CNMI (Marianas Variety, Dec. 8, 2016) – Opponents of a bill that transforms the Commonwealth Healthcare Corp. board from being merely advisory to a governing one believes the measure would ultimately be detrimental to the Commonwealth Health Center.

Hospital CEO Esther Muña, who was joined by other CHCC officials to oppose the bill, expressed frustration yesterday over the Legislature’s passage of the measure.

The Senate passed the bill Tuesday a week after the House eased it through.

In a telephone call yesterday to the Saipan Tribune, Muña said the proposed board of trustees governing the corporation would not pass the next Centers for Medicare and Medicaid Services survey, resulting in the cancellation of CMS funding to run the lone hospital service provider of the CNMI.

“When CMS comes in, they are not just looking at the governance of the hospital. What they are going to look at is the evaluation of these members on their roles and their responsibilities,” said Muña.

She believes creating a politically appointed board to govern the affairs of the CHCC would work against the hospital.

“[CMS is] going to evaluate if they understand how [the board’s] decision…are linked to infection control, quality control, utilization review, medical staff, nursing services, and more. Those are the things that our current governing board of the hospital…decide on to communicate with all the staff about on a quarterly basis,” she added. “It’s actually comprehending how it links to everything else in the organization.”

The hospital’s governing board consists of the CEO, chief financial officer, and chief medical officer.

A consultant on the bill, Pedro Deleon Guerrero, confirmed that House Bill 19-186, HD1, would affect CMS recertification, but went on to say that it depended on the hospital’s ability to comply with CMS requirements.

Muña also believes that closely managing the people instead of the hospital itself—as what happened under a governing board at CHC—is a bad idea in general.

“The reason why we are against that bill is the fact that you are allowing micro-management of healthcare services and hospital services. This bill, the way it is written, allows micro-management to occur,” she said.

Muña thinks that having a governing body—as opposed to an individual governing over operations—is not efficient, especially for matters that are time-sensitive such as healthcare.

“If you’re on the surgery table and you need to make a decision, I cannot authorize [the sudden purchase of medicine and equipment] anymore. You’ve got to wait for the board to meet and make a decision. Is that the kind of system that we want in place? I just can’t fathom that people think it’s okay,” said Muña.

Muña said that before making decisions, there are at least two things that she considers. “First of all, is it going to save a life? Do we have the money for it? If not, when we provide it, do we get reimbursed for it? That is something that we eventually see later on,” she said.

Despite all the comments that opposed the passage of the bill, the Senate unanimously passed it and Muña can’t help but feel disappointed with the Legislature’s decision.

“It is disappointing that our lawmakers disregarded our concerns on the bill: technical concerns, the question of legality, and even the consequences of health in the CNMI,” said Muña in an email. “These are the people that are elected to protect our people so you can imagine the disappointment.”

Muña said that no matter what happens to CHCC, the goal would stay the same—to provide proper medical healthcare to the people of the CNMI.

“My goal now is to lead the CHCC team to continue with the same passion to help with improving the health of our people. Our mission is the same—just a little harder when you know what’s in the horizon,” she said.

One of the bill’s authors is Rep. Felicidad Ogumoro (R-Saipan).

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