Territory-wide health action plan due end of April

Lolo looking for ways to transform health care system

In an effort to identify policy direction and strategies to transform American Samoa’s health care system, Gov. Lolo Matalasi Moliga has established the ASG Health Care Transformation Task Force (or HCTF), whose duties include coming up with an action plan to control health care expenditures, and keep them from escalating.
The new task force was established in a three-page memo by the governor dated Feb. 10, and supersedes the Medicaid Task Force set up via memorandum last December. The new task force is given a wider range of duties and responsibilities.
HCTF is charged with developing a territory-wide action plan for transforming the local health care system in order to improve affordability, quality, access, and the health status of local residents, according to the memo, adding that as health care is one of the top priorities of the Lolo administration, time is of the essence, given the implementation of the federal Patient Protection and Affordable Care Act (also known as the ACA, or Obamacare).
The final action plan must be completed and submitted to the governor by Apr. 30 this year.
“As a territory, we must engage in the transformation of our health system because there is a growing body of evidence that prove costs can be controlled while increasing quality and access with the right investments in successful models of healthcare,” Lolo said in the memo. “The federal government expects us to undertake such efforts.”
Such models include investment in Primary Care and Patient Care Home Models (PCHM) that work particularly well in small rural and remote communities, he said and pointed out that the task force shall review available research to “determine our community’s values, preferences, opinions and perceptions related to health care.” The findings are to be presented to the governor for review.
For the action plan submitted to the governor by the end of April, the memo says such a plan may consist of possible legislative actions, administrative actions of government entities, collaborative actions, and the actions of individuals and organizations. The action plan must include specific and measurable goals and deadlines and outline specific tasks to be carried out.
For example, they are tasked to identify actions that will control health care expenditures from escalating to no more than 2% of budgetary increase—for example, recommending the restructuring of the Health Department and LBJ Medical Center and whether to transfer or privatize services such as Primary Care clinics, Dental clinics, pharmacy, morgue, food services, or EMS.
Additionally, they are to design a PCHM to provide a process for entering patients at the community levels for primary care tied into LBJ and other social behavior services.
The task force is also to identify actions that will increase the affordable health coverage options for all residents and other strategies that will ensure all residents will have health access to universal health coverage by January 2015: e.g. a reform of the State Medicaid Plan to better serve the needs of the territory, such as requiring individual enrollment, expanding a provider network; and designing self-insurance programs through the Insurance Commissioner’s office.
Further, they must identify actions to improve the quality and safety of health care and reduce racial and ethnic disparities in access and quality—such as investing in public outreach programs through DOH, DOE and DOC.
Moreover, it will be their task to identify actions that will improve the health status of local residents and reduce the rate of preventable chronic illness or non-communicable diseases — for example, to mandate at public schools a health and nutrition curriculum from K-12 and all schools participating in the school lunch program.
Additionally, they are to identify proposed changes to legislative and regulatory provisions to advance actions to transform the territory’s health care system, including the proposal for a self-insurance program.
Other actions to be identified are those that will: 
•            promote appropriate and cost-effective investment in new facilities and technologies;
•            develop a workforce development program to help create a sustainable pool of workers to support the local health care system; and
•            determine culturally relevant social behavioral interventions to help improve health care behaviors.
According to the governor, the task force is co-chaired by the Director of DOC and the head of the Medicaid State Agency, while DOH provides staff support to the task force, which may accept outside resources to support its efforts.
Other task force members are: the Secretary of Samoan Affairs; LBJ chief executive officer; the Insurance Commissioner; Human Resources director; Agriculture director; Dr. Fred Uhrle with the Veterans Affairs Clinic; Dr. Malouamaua Tuiolosega with Vida Medical Clinic ( a private medical clinic); Sarah Tuitele, medicare consultant; a Chamber of Commerce representative; psychologist Dr. Jean Anderson Asuega; David Robinson, chair of the Hope House board; and the governor’s executive assistant Iulogologo Joseph Pereira.


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