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Vocal group attend hearing over LBJ rate hikes

During the public hearing at the LBJ Tropical Medical Center Chapel Monday afternoon, which lasted until 7 p.m., about the hike in medical fees proposed to go into effect on Christmas Eve, light was again shed on the funds comprising the subsidy the local government is required to give to the medical center.

In a statement made earlier this month, the LBJ Medical Center said the last facility fee hike was in 2006 and the proposal will ‘significantly raise facility fees for self-pay patients’ at the hospital, which includes both residents and non-residents. The lack of consistent funding sources for the hospital was the major reason given for the hikes. Two of the main funding sources of the hospital are the ASG subsidy and the DOI subsidy.

Most of those who attended the hearing, which numbered under 40 people, were against the hike, a few loudly stating the reasons why.

During the hearing, one of the questions asked concerned funds that come from the Department of Interior (DOI).

CEO Michael Gerstenberger was asked: “Do you keep 50% of those funds that are allocated to you… maybe $7 million… and 50% goes to the government? Is that true?”

Gerstenberger replied, “Not entirely. Historically, the amount of money that came to the hospital, used to be in the 13 to 14 million-dollar a year range. Because of the Medicaid issue and the local match that you are talking about, you cannot use other federal money to match the federal Medicaid program. It has to be local money. So, what was agreed upon a number of years ago was that the Department of the Interior would reduce the amount of money they give directly to the hospital and give some of that to the government, which they (the government) could co-mingle with other tax revenues and other government funds.

He went on to say, “ASG would then pass on money to us, which because of the co-mingling, would have become local money, and that was eligible to be used as the Medicaid match. It allowed the hospital at that time to leverage the amount of money that we were able to draw from Medicaid,” he said.

(There was a similar explanation about the Medicaid matching funds given during the time of CEO Patricia Tindall, who was replaced by Gerstenberger when the board did not renew her contract. It was during Tindall’s tenure that Medicaid and Medicare issues came to light, which resulted in a reimbursement agreement between the hospital and the federal program for overpayments, as well as the ‘wink and a nod’ agreement between DOI-ASG-LBJ that would allow LBJ to pay the Medicaid match with local funds.)

Samoa News asked Gerstenberger via telephone, yesterday afternoon, if he was speaking about the LBJ subsidy from ASG — meaning the subsidy which comprises the DOI funds that used to go directly to LBJ, but are now given to the local government to ‘co-mingle’ and then give back to LBJ to pay for the Medicaid match? The hospital CEO said, “yes” — more or less.

However, Samoa News notes that neither the governor or the treasurer has ever indicated that the subsidy is part of the DOI funds it receives to be budgeted to LBJ for the Medicaid match—or that any such ‘wink and a nod agreement’ between DOI-ASG-LBJ exists.

As reported by Samoa News back in November, LBJ said in its fourth quarter performance report for FY 2011, the Medical Center lost $2.89 million in subsidy funding and then failed to qualify for an additional $2.89 million in Medicaid dollars.


During the more than 4-hour hearing, Gerstenberger said that they had been expecting hundreds of people, and were surprised at the lack of attendance. He said the people who did attend, were vocal but not strident.

Samoa News observed during the hearing that members of the American Samoa Organization on Aging (ASOA) were the most vocal.

“What happened to life itself? We can all volunteer to help until we do have the funds available, to our seniors, to our mothers that are expecting… Where is ”life” in this so called menage of money, money, money?” said an ASOA member. “I think this is where we have to start. We have to end this, and represent life itself… Let’s go back to our ancestor's days, because the ones back then are the ones that said ‘let’s accept America, because they will give us free medical and free education.’ ”

“To us life is important, but to you guys, money is important” the ASOA member stated. “You want to drain money out of a rock. That is what you are doing right now. Low income families cannot afford this. What do you want them to do — die out there before coming here to the emergency room?”

Perhaps the most telling comments were made to Samoa News by participants at the hearing.

‘No matter what is said here today by the public, it appears that our words will be said in vain. The mind of LBJ is already made up. I guess it’s — we either start making more money so we can afford the higher fees if we get sick — or we just die.”

Another said, “We will just show up at their door steps no matter if we can pay or not. They can’t turn us away. This is just going to put them into a bigger mess than they are already in”.