Pago Pago, AMERICAN SAMOA — Senate President Tuaolo Manaia Fruean has urged the Senate Select Investigate Committee (SSIC) to investigate whether a new hospital is warranted.

 “A study conducted by the U.S. Army Corps of Engineers (USACE), Honolulu District in 2019 outlines recommendations to renovate the hospital, but not build a new hospital,” said Tuaolo.

The healthcare of our people is a paramount concern,” said the Senate President. Tuaolo is referring to the proposed new 40-bed facility in Tafuna. LBJ has allocated $50 million of the $300 million in funding  from the federal American Rescue Plan Act for recruitment, retention, and retraining of staff at LBJ and the proposed new 40-bed facility in Tafuna.

There were five recommendations by the U.S. Army Corps of Engineers (USACE), Honolulu District following a directive by the U.S. Department of the Interior, Office of Insular Affairs, to produce a report to Congress addressing the condition of the Lyndon Baines Johnson (LBJ) Tropical Medical Center in Pago Pago, American Samoa and estimating the cost of renovating and modernizing the current facility, constructing a new facility, and whether a renovated facility will have sufficient capacity to meet American Samoa’s needs.

According to the 278 page report, the LBJ Tropical Medical Center is a 50 year old single story 150,000 square foot (SF) facility, consisting of eighteen (18) buildings in a campus setting, which resides in a harsh environment of constant high temperature and humidity.

 “Since its original construction, the facility has been repaired, renovated and expanded (an ongoing project will add an additional two story building).

 “The current infrastructure of the LBJ TMC hospital is in a state of failure due to age, environmental exposure, and lack of preventative maintenance.

 “Extensive repair and/or replacement of facility sections is required to ensure compliance with hospital accreditation standards and to ensure the life, health, and safety of staff, patients, and visitors. While the facility structure has held up relatively well, it is not in compliance with current seismic and wind requirements and retrofits would be expensive and disruptive.

 “The electrical and mechanical systems are in poor condition and in need of immediate repair. Architectural deficiencies have led to mold and mildew growth in critical areas, exposing staff and patients to significant health risks.

 “The nurse call system is inoperable in key locations, plumbing, water treatment and medical gas systems are all in failed or failing condition.

 “Based on an extensive review of clinical capabilities, the existing facility is incapable of providing enough space to meet the long term needs of the patient population.

 “The facility is dependent upon funding from the Center for Medicare and Medicaid Services (CMS), further degradation of the infrastructure will result in non-compliance with standards and will result in denial of accreditation.”

LBJ Tropical Medical Center is the only full-service healthcare facility in the territory and further degradation of the plant infrastructure will hamper the delivery of care to American Samoa’s population.

The options outlined are proposed for facilities infrastructure capital investment;

(A) to repair the infrastructure of the current facility with no additional space expansion.

The estimated construction cost is $161.4M.

 (B) Construct a new multi-story hospital (150,000 SF) on a proposed site on the western side of the island. “The estimated cost for a new hospital is between $325-390M.

 (C) Construct a new multi-story hospital (150,000 SF) on the current LBJ campus. The estimated cost for this option varies from $375 to $425M, depending upon the course of phasing to ensure minimal disruptions to the current facilities and accessibility.

 (D) Construct a new multi-story hospital (370,000 SF) on a proposed site on the western side of the island. The estimated cost for a new hospital is $700M. “The site location for a new facility would require land transfer, upgrade to island infrastructure, and would increase travel distance from Pago Pago and the eastern side of the island, potentially impacting the delivery of immediate care.

Further analysis is required to determine additional infrastructure costs.

 (E) To construct a new multi-story hospital (370,000 SF) on the current LBJ campus. The estimated cost for this option varies from $750 to $900M, depending upon the course of phasing to ensure minimal disruptions to the current facilities and accessibility.

“The facility would also be properly sized to support the clinical needs of American Samoa for the next 20-30 years. “This would require interim life safety measures and continual coordination with the existing operations to minimize impacts to clinical delivery.