Pago Pago, AMERICAN SAMOA — After the late submission which caused the reshuffling of department budget hearings so Fono members could study it, lawmakers were still not satisfied on Monday, with the LBJ Hospital’s proposed budget for Fiscal Year 2024 and unanimously voted to return it so that several discrepancies could be corrected.

Appearing before the Fono’s joint Budget and Appropriations Committee were the Chairman of the LBJ Board, Dr. Malouamaua Tuiolosega, CEO Dr. Akapusi Ledua and CFO Sefanaiya Kaumaitotoya, to answer lawmakers’ questions about the hospital’s $91.2 million proposed budget, an increase of over $21 million compared to the $70 million approved FY2023 budget.

CFO Kaumaitotoya apologized for the late submission of their proposed budget because they had to update some of the information in their reports.

Faipule Larry Sanitoa stated that he noticed that there was $4 million in ARPA funds for the Personnel services and asked if this was earmarked for the hiring of employees and if these new positions were career service or contract.

The LBJ CFO explained that there were very few options to pick from to solve the acute nurse shortage problem and one of the feasible choices was to hire from outside the Territory.

He stated that they have already hired seven nurses from Thailand through an off-island consultancy firm, 21 nurses from Fiji which they have prepared to sit the mandatory US requirement nurses’ license exam, using ARPA funds. He also revealed that they anticipate a total of 13 nurses from Thailand.

Sanitoa then pointed out that according to the hospital’s organizational chart, there was a position for Executive Officer in between the Board of Directors and the CEO.

“This is a new position,” Sanitoa stated. “Was this put together by the Board or the CEO? And what exactly is the Executive Officer as opposed to the CEO?

Board Chairman Dr. Malouamaua Tuiolosega answered that the creation of this position was the decision made by the Board because the CEO had too many responsibilities.

He explained that the current CEO Dr. Akapusi Ledua is a medical doctor who had been the Acting Chief Medical Officer when the Board appointed him to be acting CEO.    

“Every CEO has deputies and executive officers to help him or her in carrying out their work efficiently,” said Dr. Malouamaua. “So the Board decided to help CEO Ledua out because he was treating patients which would earn revenue for the hospital, while also carrying out his duties as CEO.”

The LBJ Board chairman also pointed out that the role of the executive officer is very important in office administration and pointed out that it was the executive officer who had followed up on the whereabouts of the $4.5 million of hospital funds at Treasury which led to the discovery of the fake resolutions.

Sanitoa however questioned the Board’s authority in appointing an Executive Officer and stated that in his opinion this position’s job description was a duplication of the CEO’s duties.

“Under the law, the LBJ Board only has the statutory authority to appoint three management positions which are the CEO, CMO and the CFO,” he clarified. “That’s it. It says appoint. Not create another position. So how much is the Executive Officer paid?”

Dr. Tuiolosega revealed that the contract amount that their Board agreed to for the position was $134,000 but the amount proposed in the FY2024 budget is just $80,000 plus.

He explained that, “This is a private contractor and will be paid when a work report is submitted to the Board.”

Sanitoa pointed out that the previous two CEO’s were payed salaries of $120,000 and $135,000. However, according to the hospital’s proposed budget, the current CEO would be paid a salary of $220,000 plus fringe benefits.

“What are the criteria you use or is there a formula you use to work out the CEO’s salary?” he asked. “Because it wasn’t too long ago that we had a CEO who was on contract for $120,000, and now we hire a new one and there’s already a hundred percent increase in his salary!”

The Tualauta faipule also raised the issue of compensation for board members.

“I heard that every time the board has a special meeting, everyone gets a stipend of $1,000. Is this true?” Sanitoa asked.

Board Chairman Dr. Tuiolosega said that it was true and that it was within their statutatoral rights as Board members to be paid compensation for having to meet every two weeks.

Sanitoa clarified that the law was clear about the Board’s compensation, which was $6,000 a year for the chairman and $5,000 for the Board members.

“Only $27,000 is earmarked in the budget for Board member stipends,” Sanitoa explained. “But now you have already made your own decision on the amount of the stipends and the number of these special meetings to the point where you have overspent. So if you have three or four special meetings a month, where is the money to pay for your stipends?”

Vice House Speaker Fetu Fetui, Jr. stated that it was obvious that the proposed budget was not well prepared and he moved a motion to return it to the hospital to rectify the areas that need more work and clarification.

This was supported Senator Togiola Tulafono who pointed out the discrepancies in the organizational chart as well as errors in fringe benefits listed.

He also did not support the performing of two professional positions by one person referring to CEO also practicing medicine.

“If he is the CEO, then he should stick to the duties of a CEO, not treat patients,” Sen. Togiola stated.