CHCC’s biggest problem: Funding

Imagine if you were running a store and had at least one-third of your customers come in and purchase goods and, after you ring everything up, these customers pay only 55 percent of their total.

That is essentially what has been happening to the Commonwealth Healthcare Corp. since 2012. Approximately one-third of CNMI residents depend on Medicaid for healthcare coverage. For every dollar spent on a Medicaid patient for medical services at CHCC, Medicaid reimburses CHCC 55 cents. The 45 cents that our local government is obligated to pay under the Federal Medical Assistance Percentage has not been paid since 2012. CHCC loses about $10 million annually because our local government does not pay its share. If you include uncompensated care (charity care), which last year totaled more than $13 million, then you are looking at CHCC taking a loss of $23 million annually.

This and other information is readily available from CHCC. Perhaps, instead of accusing CHCC of “not meeting the needs of the people” (as stated in House Bill 20-149), my colleagues and I can look at the facts, figures, and data from CHCC and do all we can to address CHCC’s needs, which, at the top of the list is, adequate funding. Like director of Medical Services Jesse Tudela said in his public comments, “The problem is not the corporation. The problem is funding.”

On Friday, my colleagues and I heard some powerful public comments from CHCC doctors, staff, and constituents. I just hope we all listened intently. We also have written comments that were submitted as well, and I urge my colleagues to read them, most especially the letters from Tinian Health Center resident director Marjorie Daria and Rota Health Center resident director Vanessa Quitugua.

CHCC is far from perfect and, in my meetings with them, the administrators, doctors, nurses, and staff acknowledge that. But they have made tremendous strides and improvements and could do so much more if we work with them in addressing their needs and challenges. It is important to note that CNMI taxpayers spent more than $11.5 million in fiscal year 2017 on medical referral, and that excludes their operations and personnel costs. Based on my meetings with Medical Referral director Ron Sablan and CHCC CEO Esther Muña and chief financial officer Derek Sasamoto, we could cut medical referral costs if we invest more in our only hospital in the CNMI.

I plead with the public not to let politicians run CHCC, because none of us (including myself) have the credentials or the experience to run a hospital. What we elected officials should do is provide the financial support CHCC so desperately needs. Additionally, we legislators can conduct oversight hearings if we seek to improve the efficiency and effectiveness at CHCC. We also hold the power to investigate in cases of alleged corruption, incompetence, or mismanagement, but thus far, I have seen no such evidence.

In closing, I want to remind the general public that the CHCC governing board just started operating last month on Dec. 16, 2017. Under its rules and regulations, CMS (Center for Medicaid and Medicare Services) requires “an effective governing body that is legally responsible for the conduct of the hospital governing board” (42 CFR 482.12).

To the CHCC management, doctors, nurses, and staff, thank you for all you do. Your professionalism and ability to do so much with so little speaks volumes. I remain committed to funding CHCC and continue to ask the public to support and lobby for HB 20-136, a bill Rep. Edmund Villagomez and I introduced, that will allocate at least 20 percent of casino revenues to CHCC.

Thank you for allowing me to share my thoughts on CHCC and H.B. 20-149.

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Ed Propst is a member of the House of Representatives in the 20th Legislature.