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LBJ needs additional funding to address critical issues

The LBJ hospital will be submitting a supplemental budget of $7.5 million or more to carry out its mandates, said Hospital CEO Joseph Davis Fleming in an interview with Samoa News during the bilateral health summit in Samoa. The hospital’s budget which was approved for Fiscal Year 2014 was $52.57 million.


During the September hearing for the hospital’s FY 2014 budget, the hospital submitted a revised proposal of $57.9 million, but it was not considered “official” by the Fono since it was not part of the entire ASG budget document signed by Gov. Lolo Matalasi Moliga.


Samoa News also interviewed Fleming regarding his view of NCDs and how they affect the hospital’s budget, and in response he said there’s a big need to have this epic trend reversed because it’s so costly for the government.


He said the number of dialysis patients is "hitting the roof".  The LBJ CEO called the rise in dialysis patients "very alarming" and "a wake-up call".


 From FY 2007-to-2011 NCDs accounted for 37% of the hospital budget, however from 2008-2012 it increased to 77% which is the reason for the hospital's need to expand their services.  However, he noted that “the services are not expanding fast enough” — there’s a waiting list in Apia, Samoa and in Hawai’i, said Fleming.


He further noted there is a need to have the dialysis program on 24-7 because of its growing demands; and said the hospital’s new dialysis care facility should be up and running by February 2015.


Another issue with the hospital, which calls for the need for more funding, he told Samoa News is the staffing. Fleming said patient safety and quality issues must meet high Federal Standards or else the federal government will move in to shut down the hospital.


“Just like what happened with the lab recently — when we don’t have adequate staffing or certified trained employees in certain areas, we always hire from off island.  Why don’t we train the ones we currently have and utilize their skills and invest in the people we have on board?


“We need to do a better a job investing in local talent, that’s what we need. There are those who have never been adequately trained, not just doctors and nurses but those who do rehab, surgery techs and administrators," he said.


 “We need to be smart — we need to secure funding and work smarter, instead of hiring unqualified people, we should train those we have, and we need to invest in them.”


Fleming strongly emphasized the need to train the local work force, saying that hiring people from off-island is not a solution.


"There must be a comprehensive long term workforce development plan and strategy like the hospital used to have 15 years ago… we have about 20 years of catch up and it's required.”


He pointed out there’s a need for a “biomedical engineer which isn’t optional — and yet it was never funded and we either provide those things or stop operating a hospital."


 “I’m fighting tooth and nail to get us up to the standards that our people expect of us, because they have nowhere else to go," Fleming stated.


Also, "we need computerized systems, so we can cut down on error- filled paperwork, which requires a lot of people pushing paper around," he said.


"Instead, these people could be working on something else. Not only will we reassign people, we will streamline the system, where we don’t need a lot of people doing clerical work and administrative tasks that are currently being done at every level."


The LBJ CEO also commented on his disappointment on how the budget is handled within the government. He said that with budgets that he’s worked on previously, he's usually given six months — however to his surprise — he was only given two weeks for the LBJ budget.


“The revenue streams are only half of the budget, and it's the cost side we have missed over the years;  because there’s a lot of those, it explains why we have a deficit — those costs were not captured and were not included in the budget."


Fleming said the supplemental budget is not just for staffing but for other critical needs in the hospital. He said the supplemental should be ready by December.


The supplemental budget was initially $ 5.2 million however he noted there have been a lot of "after the fact" issues, and that's why the supplemental will be more than the initial amount.