During his testimony before the members of the Subcommittee of Indian, Insular and Alaska Native Affairs this week, LBJ Medical Center CEO Taufete'e John Faumuina focused on areas of challenges or needs at the local hospital.

They are: Compliance with CMS standards; inadequate staffing and workforce development; healthcare facilities; and financial condition.

Taufetee first provided a brief history of the LBJ, telling the congressional panel that the hospital was erected in 1968 and opened its doors to provide comprehensive high quality and low cost effective health care and related services that address the health needs of the people.

However, he added, in order to keep the LBJ open, there is a need to retain medicare certification through CMS. "We must comply with conditions of participation," the CEO said. 

With regards to "Compliance with CMS standards" Taufetee said LBJ needs to adopt a suitable budget to address all non-compliance issues pertaining to medical staffing, nursing staffing, and supporting services across the board, to meet the standard of care.

He said the need to comply comes with substantial financial commitment and involves offering better compensation; recruiting qualified doctors, nurses, certified technicians and supporting staff; having an appropriate budget to properly provide maintenance for the facility and schedule preventive maintenance and repairs for all equipment.

On the issue of inadequate staffing and workforce development, Taufetee told the Subcommittee members that with 150 beds at the LBJ Medical Center, 95 physicians are required but currently, there are only 57.

Additionally, the 73 registered nurses at LBJ don't fulfill the requirement of 110, and LBJ is also required to have 11 pharmacists but there are only 3 on staff.

He told the congressional panel that the LBJ must contract off island services to read the diagnosis for the radiology department.

For healthcare facilities, Taufetee said that presently, 41 percent of the facility has been renovated to meet CMS standards, but upon completion of the labor and delivery, nursery, and other expansion and renovation projects, the facility will be 65% renovated.

The CEO urged the Subcommittee members to consider the plea to fund a new hospital to meet the need for quality care in American Samoa. (See story for full details of new hospital discussion during the Congressional committee meeting).

On the issue of financial condition, Taufetee said the annual budget appropriation is quite inadequate and there is a need to increase federal appropriations, explore other revenue sources, lift the cap on Medicaid, restructure the Federal Medical Assistance Percentage (FMAP) so it is favorable for American Samoa, and extend the expiration of the Affordable Care Act (ACA) funds beyond 2019.

The oversight hearing on “Assessing Current Conditions and Challenges at LBJ in American Samoa” took place in the nation's capital this past Tuesday.

Witnesses included Thomas Bussanich Director of the Budget Office of Insular Affairs, Department of the Interior; Taufete’e John Faumuina CEO of Lyndon B. Johnson Tropical Medical Center; and Sandra King-Young, Medicaid Director for the American Samoa Medicaid Agency.

Two other local witnesses who were invited — Dr. Reese Tuato’o LBJ's Chief of Internal Medicine, and Motusa Tuileama Nua, Director of the AS Department of Health — were not present during the hearing.

According to Doug LaMalfa, Chairman of the Subcommittee on Indian, Insular and Alaska Native Affairs, the oversight hearing was to "evaluate and discuss the current state of the healthcare facility and the quality of the treatment accessible to American Samoans."