American Samoa’s ballpark figure of $200 million for a new hospital, with a request to be funded by the federal government, has no supporting documents, but it’s an “unofficial” amount for the proposed facility on ASG’s “wish list”, according to testimony by American Samoa Medicaid Agency director Sandra King-Young, in response to questions at this week’s Congressional panel hearing.

King-Young along with LBJ Medical Center chief executive officer Taufete’e John Faumuina and US Interior Department’s Office of Insular Affairs (OIA) director of budget, Thomas Bussanich were witnesses invited to testify before the US House Natural Resources Subcommittee on Indian, Insular and Alaska Native Affairs this past Tuesday, assessing the current conditions and challenges at LBJ.

Building a new hospital has been mentioned several times by the Lolo Administration in the last two years and early this year, ASG made known its clear intention of looking to the federal government for money to fund a new hospital.

In his official written statement to the subcommittee Gov. Lolo Matalasi Moliga pointed out that the hospital's deteriorating condition continues to become more expensive and necessary repairs for health and safety are done as best as possible with limited resources.

He said the best option for the territory to ensure immediate compliance with federal laws is to construct a new hospital located in a tsunami-free zone. He explained that during the 2009 tsunami, the hospital sustained significant damage and it needs to be relocated to higher ground.

“To continue to repair a deteriorating facility that is nearly 50 years old is not a good long-term investment in financial resources,” said Lolo, but didn’t provide an estimated cost of the new hospital.

As part of his verbal testimony, as well as his official written statement, Taufete’e told the subcommittee that there is a need for a new hospital to replace the current aging facility, which has undergone repairs and renovations — thanks to grant funding from DOI over the years.

With the completed expansion and extensions of existing infrastructure, Taufete’e said LBJ is still struggling to cut down on patient waiting time in ER and Clinical Services because of the overwhelming number of patient visits, with ER seeing an average of over 2500 visits per month.

The patient admission process is also delayed due to overflow and non-availability of beds in the wards because of constant high census, he said.

“One of the solutions that we are presently exploring is a new 200-bed hospital to accommodate increase in population, as well as inpatient and outpatient visits,” Taufete’e said in both his verbal and written testimony. “Space in the present location is severely limited, and we are unable to expand the existing building, which in turn limits services.”

In her verbal testimony, King-Young said that when it comes to challenges faced by LBJ, the Medicaid Agency “is most concerned about the hospital’s compliance” with the US Center for Medicaid and Medicare Services (CMS) conditions of participation and compliance under the American Samoa State Medicaid Plan. She added that non compliance puts at risk Medicaid and Medicare funding for the LBJ hospital.

“The biggest help to ensure LBJ meets compliance is the construction of a new hospital. Thus we respectfully recommend the committee should introduce authorizing legislation to provide funding for the construction of a new hospital for American Samoa,” she said, adding that the territory has already secured a potential site for the construction.

While the 50-year old hospital was repaired after the 2009 earthquake and tsunami, King-Young said the hospital continues to struggle with infrastructure standards to maintain CMS certification.

“It would be more cost effective to replace the current facility so it meets the modern standards of CMS conditions of participation under a new hospital facility,” she said, but didn’t specify the cost of the proposed new facility.

In her official written statement to the subcommittee, King-Young said “American Samoa needs from Congress an appropriation of $200 million for a state of the art hospital that would be fully compliant with Medicare Conditions of Participation and CMS standards for infrastructure.”

Puerto Rico Congresswoman, Jennifer Gonzalez-Colon, who is also the subcommittee chair, asked King-Young, “how did you arrive at this figure [$200 million]?” to which the Medicaid director responded, “that’s the number that we have thrown round, amongst ourselves locally, talking about what it would take to build a new hospital on our wish list. But there’s no official documentation.”

King-Young said that Congresswoman Aumua Amata had suggested — earlier in the hearing — “a really great idea” for a report from the US Government Accountability Office (GAO), working with the US Interior Department “and our local government to come up with a realistic estimate on how much it would take us to build a new hospital.”

“You don’t have supporting document that establishes that $200 million, correct?,” Gonzalez-Colon asked again, and King-Young replied, “that’s an unofficial estimate that we came up with on our own.”

Congresswoman Aumua Amata announced at the hearing that she will be introducing a bill which calls for a GAO study, in partnership with DOI, US Veterans Administration and the US Department and Health and Human Services “to assess the feasibility of either a new or updated facility, and I encourage my colleagues to support the measure.”

The hearing followed a Congressional Delegation (CODEL) visit to American Samoa in February this year and the visit included LBJ.

“I wanted it in the record, that our doctors and nurses who work there do an excellent job with the limited resources they have available,” Amata said at the hearing. “And they should be commended for their efforts to maintain the good health of our people.”

She also noted that getting qualified staff to the island “has proven to be difficult and  an issue that I hope we can find a solution to through this hearing and the work that would follow.”

Samoa News will report in future editions on other issues pertaining to the hearing as well as the rest of the governor’s official written statement to the subcommittee. Tuesday’s hearing, which lasted nearly 90-minutes, was streamed live (4a.m. American Samoa time).