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EMS stays at LBJ — for now

Governor Lolo Matalasi Moliga has opted to hold the Emergency Medical Services under the wing of the LBJ Hospital for the time being, says LBJ Chairperson Sandra King Young, following their meeting last week.


In response to Samoa News questions regarding the discussion to transfer EMS to either the Department of Homeland Security or the Department of Health, Young said, “the governor decided that EMS will remain for the time being at LBJ until Homeland Security provides a list of potential grants to help fund the EMS "if" transferred over there.”


Last week Young provided a memorandum to the Director of DHS, Utuali’i Iuniasolua Savusa and DOH Director, Motusa Tuileama Nua to outline the procedures of legally transferring the EMSC (Emergency Medical Services for Children) grant in anticipation that EMS may be transferred.


The memo, which was leaked to Samoa News, was dated April 24, 2013 and indicates “the transfer of EMS to another government agency should not be difficult in terms of interagency procedures within (American Samoa Government) ASG.”


Young noted the move may require an Executive Order from the governor as was done when EMS was transferred to and from DPS.


“However, the medical Emergency Medical Services for Children (EMSC) program grant cannot be transferred to another agency without the federal grantor’s approval, in this case the Health Resources and Services Administration (HRSA) at the US Department of Health and Human Services," she noted.


“In anticipation of the confirmation to transfer EMS to another agency, I have prepared a checklist of federal agency procedures and requirements provided by HRSA to ensure the legal and smooth transfer of the EMS grants from the LBJ hospital to either DHS or DOH” she wrote.


The letter also stated that the HRSA Procedure for transfer requires a directive from the governor to transfer EMS to DHS or DOH and this should also include in the same directive an order to transfer all grant programs awarded to EMS as well.


In an email to Samoa News, Young stated that EMS can be transferred by the Governor as was done before through an executive order, however any federal grants administered by EMS under the hospital cannot be transferred without going through a very involved process with the federal grantor, which was the purpose of the memo.


“I think the other agencies (DOH/DHS) learned that if EMS is transferred, they must also absorb the personnel and administrative costs of EMS, which is about $1.2 million at the hospital — $800k of it being payroll. This is paid from local funds. The only grant that EMS has is the EMSC (Emergency Medical Services for Children) grant, which I believe is about $110,000 — which is on hold by HRSA. So even now, EMS is not getting that grant."


“So if EMS moves, the receiving agency has to put EMS into its budget, but since the 2013 budget is already obligated, there isn't much the agencies can do at this point, other than wait for the 2014 budget to include EMS in their budget" she explained.


“The other directors don't mind taking on EMS, but I think when they realized that they would then have to come up with a payroll budget, they had some reservations. You know, all the agencies are struggling financially, as is the government overall."


“I cannot speak to what happened when EMS went to DPS," she continued,


“I’m not sure they knew the consequences of moving EMS back then, without any thought to the legality of moving a federal grant that is awarded to the LBJ hospital and administered by EMS.The LBJ hospital was the legal entity for the EMSC grant back then and still is, now.”


“Which is why, as I learned, it was easy to move EMS to DPS, but the EMSC grant could not be moved, so it stayed at the hospital.”


Young stated following their meeting, she asked DHS Director how soon he can get that list (potential grants) to the hospital board, and he said he would get it “asap" — and we are still waiting. So EMS for the foreseeable future is still at LBJ.”


“As the board looks to the long term future of the hospital, moving EMS to another agency is not necessarily a bad thing, but if it is locally funded anyway, why not keep it at LBJ where it makes sense. I think the Governor would like EMS to be well-funded, and Homeland Security has made assertions that they can get more federal funding for EMS if it comes under them. That's why the Governor asked for a list of potential grants.”


According to a senior official within EMS, who wished to stay anonymous, during their meeting with the LBJ Board 100% of the staff voiced their support to stay with LBJ during that meeting, and during a recent EMS meeting they were told by management that LBJ planned to cut EMS because of a pending LBJ layoffs, if they would not be transferred.


“Between EMS management and the LBJ Board it has gotten to the point where we don't know who to believe anymore. It’s just a sad ongoing saga,” said the senior official. Calls to EMS Manager Galumalemana Popo Avegalio were not returned as of press time.


EMS had been under DPS when it was transferred back to LBJ on Jan. 1, 2012, in accordance with a Dec. 29, 2011 executive order signed by then Gov. Togiola Tulafono, who had transferred EMS to the Department of Public Safety more than two years earlier, also by executive order.


As Samoa News reported last year, the transfer back to the hospital came amid reports from LBJ and lawmakers about discussions being held among government leaders to have EMS returned to the hospital, where it had been located for many years. Part of the problem was funding for the EMS budget, which even then was problematic.


While EMS was officially transferred to DPS under an executive order in October 2008, the main station for EMS remained at the LBJ compound.