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“Shock and awe” reported as reaction to DoH changes

“The Department of Health has operated without a stable leader, poor leadership skills, and the absence of a strong management team, which has led to the lack of coordination of key initiatives, mismanagement of grant funds, missed opportunities and broken partnerships with local agencies and external stakeholders that need to be mended,” according to the DoH Second Quarterly Report for Fiscal Year 2013.


The report states that “activities in the past quarter with the DoH have focused on reinforcing compliance with cost containment measures, repairing DoH relationships with grantors and federal stakeholders as a result of irresponsible and reckless financial management practices jeopardizing future grant opportunities, the continuous realignment of staff to streamline efforts and eliminate duplication and to install a brand new team of public health leaders to restore pride, dedication and service as health care providers.”


The ultimate goal of DoH, according to the report, is to significantly improve the delivery of healthcare services to the people of American Samoa.




DoH has created a grants management committee which will provide actionable recommendations and establish departmental policies with regards to grants management. DoH is currently drafting policies and procedures for its grants.


DoH now has weekly essential administration and finance staff meetings to open communication, discuss issues, address problems and disseminate announcements from internal and external sources. DoH has also prepared an FY13 supplemental budget to fund critical hires to address the nursing shortage, a Chief Financial Officer, a Grant Writer, an Executive Assistant and other much needed positions.


According to the Second Quarterly Report, DoH also needs to support medical missions for Aunu’u and Manu’a for the remainder of the year; however, approximately 50%-60% of the territory had completed home visits, which includes to Aunu’u and Manu’a islands.


It also reports that DoH has completed their training of the electronic process for the department to go paperless.


Of further note, the report says that DoH is moving to develop a regular rapport with grantors and project officers to regain their trust. They are working to mend and repair strained working relationships from past leadership and immediately respond to grantors and project officers regarding grants that were frozen and at risk and they will continue to increase communications with grantors.




The report noted that many personnel changes and reassignments have occurred but regardless of the counseling sessions held, employee reprimands and insubordination addressed, the employees are still being treated with dignity and respect.


According to the Second Quarterly Report, DoH has a new Deputy Director and a Director of Nursing has been appointed; DOH has moved to reinstate the Performance Improvement Manager, reinstated a Comprehensive Cancer Control Program manager, IT manager, hired an experienced Finance and Billing specialist to manage grants, a Procurement Officer, hired a Veteran to Serve as Lead Compliance Officer for Environmental Health Division, created a Chief of Dentistry Services Division — appointing the most senior dentist in DoH, and created the position of Department Safety Officer/Energy Conservation utilizing a current employee.




Recovering from the mismanagement and reckless administration of grant funds and repairing reputational damages by the previous management has been the focus of the past quarter, according to the report.


“The new beginning is the message being conveyed to grantors, project officers, and regional and federal partners in order to regain their trust in the department’s new leadership,” states the report.




According to the report, the new director is introducing positive and long overdue changes in such a short time, that "shock and awe" probably best describes the reaction of many DoH employees still trying to cope with the fast and furious tempo. “Over the past quarter, the changes are settling in and employees are establishing comfortable routines as they adjust to their new leader."


Noted is that new changes are impacting personnel pay promised in the previous administration that must unfortunately be canceled or re-negotiated under this new leadership. “But in resolving these issues, equality and unity must be a part of the solution,” stated the second quarterly report.




The DoH will comply with all the governor's mandates pertaining to cost containment, which may or may not be viewed as an impediment. “Impediments have been created by the previous DoH management’s irresponsibility to manage grants funds and lack of leadership to empower employees.


“Time and leadership will ultimately create a comfort level to embrace the new administration's changes and ensure the government is transparent and accountable.”