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Admin resubmits bill to fund LBJ off-island medical

The Togiola administration has resubmitted to the Fono, with appropriate amendments, the $10 million supplemental bill to fund the LBJ Medical Center off-island medical referral program, while the bill to return the hospital back to the government was introduced in the House yesterday.

In his Feb. 9 letter, Gov. Togiola Tulafono thanked Senate President Gaoteote Tofau Palaie for the Feb. 7 letter that was in response to the governor’s letter of Jan.13 — which was when the the administration first submitted the $10 million bill.

Funding is to be gained with tax hikes on alcohol, beer, and cigarettes; the new $2,000 corporate tax; and a hike in business license fees — with 75% of the revenue from the business license fees going to the hospital referral program, and a portion of the revenue from alcohol, beer and cigarettes also going to the referral program — the rest being earmarked for other government expenditures.

The $10 million appropriation is also to be funded with a new 4% wage tax — which is in addition to the current minimum income tax of 4%. None of the new wage tax is specified for the medical referral program.

The governor in his letter noted the delay in introducing his bill despite his expressed request for urgency.

“As with other proposals that are sent to the Fono for submission, these bills are not meant to be absolutely ready for introduction,” the governor wrote in his Feb. 9 letter.

“With the ongoing crisis and the need for a swift legislative fix, I expressly noted in my accompanying letter the urgency of the proposal and that I was making my staff available to discuss any clarifications regarding the legislation, inclusive of developing funding sources.”

“Yet, this is the second letter from you pointing out with specificity now, the outdated code sections, which could have been pointed out in your first letter to speed introduction,” the governor said.

Furthermore, the administration has submitted bills in the past that were corrected and/or amended in committee, said Togiola, who points out that this is one of the purposes of multiple readings and hearings in the Fono.

This $10 million proposal, even if submitted with the outdated language, could easily have been corrected in either of these established, institutional legislative forms, he said.

The governor agreed with and supported the Constitutional provision, which was  pointed out by Gaoteote that laws should not be amended or revised by reference. However, for this particular proposal, Togiola said each amended code section was set forth with changes marked.

It is clear that the intent was not to amend or revise any law by reference, as each of the coded sections that were amended were set forth. “Unfortunately, one of the sections was outdated — something which could have been fixed easily and painless [sic] in light of the crisis before us,” he said.

The governor went on to point out another Constitutional provision (R.C.A.S. Art. II, Sec. 9), which states that “The governor may propose legislation to the Legislature ‘for consideration by it’,” and noted that “I have submitted legislation to the Fono. Whether the legislation is faulty or imperfect, this Constitutional provision requires that the whole Fono consider it.”

“Your refusal to even introduce this proposal directly frustrates this Constitutional Executive privilege, which is granted in the Legislative article of our Constitution,” said Togiola.

“Consequently, I am hopeful that you will reconsider our position on this, as well as future bills that come from the Executive, especially where the solution is one that need not implicate the supreme law of the land,” he said.

Nevertheless, the governor said he is confident that “we can and will work together to resolve many, if not all of the challenges that lie ahead of this government”. He also said that the health care needs of the territory are at risk at this time.

Copies of the letter were sent to House Speaker Savali Talavou Ale and to all senators.



In the House yesterday, the administration bill to return the hospital back to the government — under the jurisdiction of the Health Department — was introduced and assigned to the House Health/LBJ Committee for review. No date set for a hearing yet.

The bill’s preamble states that the hospital has chosen to adopt increased fees at LBJ and the fees charged to residents are far in excess of what families can afford, given that the average income per capital in the territory is about $8,000.

Additionally, the population of the territory, because of the prevalence of chronic disease and the high cost of off island health care, are in critical need of the services and prescription medication provided by LBJ.

The “Executive is committed to finding a resolution to the short term and long term causes of current shortage of funds” for LBJ operations, it says, adding that there is currently before the Fono an administration bill seeking $10 million in revenue from ASG to provide much needed off island medical care to local residents.

The current increase of fees to be paid at LBJ “represents a clear emergency that affects the private and public health of all residents of the territory that must be dealt with swiftly,” it says.

The bill amends current statute dealing with the Medical Center, where the hospital will be an agency of the Health Department, whose executive director will oversee this entity instead of a board of directors. Also to be deleted is the post of Chief Executive Officer, while no changes are proposed being made to current personnel, including the Chief Financial Officer.

In order to deal with urgent medical care issues for the territory, and owing to the increase in fees at the medical center, this act is effective immediately upon passage by the Fono and approved by the governor, according to the bill.