33.5-pct. increase in medical referrals in 2017

With less than a month left before the fiscal year ends in October, the CNMI had a total of 1,405 off-island medical referrals as of August 2017.

This is already a 33.5-percent increase from last year, which saw the CNMI Medical Referral Services send 1,052 patients off-island.

Broken down, the 1,405 patients were sent to the following: Guam, 1,018; Hawaii, 74; Philippines, 267; San Diego, 53; and Los Angeles, three.

By the time the fiscal year ends on Sept. 30, the CNMI Medical Referral Services figures they will probably hit 5,500 patients, according to director Ronald Sablan.

To date, they have already spent $8.7 million for medical referral assistance, he said.

This is an increase of 6.1 percent from last year’s $8.2 million expenditure on medical referral assistance.

Sablan hopes the Medical Referral Services’ unfunded liability and the governor reprogramming of funds from other agencies will cover this discrepancy.

“We have never been budgeted based on our needs, although we submit data that are within 5 percent of what we ask for. Every fiscal year we go on the red because of the fact that we don’t get enough appropriation for our operational needs.”

“Our total funding for fiscal year 2017 is $2.6 million and right now, just on medical referral for patients, excluding operations and personnel, we have already exceeded $8.7 million,” Sablan said.

It would be best if they get budgeted so they can stay and work within that budget, he said.

“We work with government agencies. This re-programming thing that the governor does works for us compared to 10 years ago when we were restricted with a lot of things. We were having problems getting airline tickets, problems getting accepted, and financial issues, especially when the economy was tough. But right now, for the last five years, we’ve been very fortunate that we are able to swing things around without delay due to financial issues,” he added.

Despite the challenges that Medical Referral faces, Sablan said they try to help as much as they can.

“Funding is always a challenge for us but we do what we can so we can get people out and be treated accordingly,” he added.

The procedure for medical referral is still the same. The only update is that the family escort must show competency in terms of overall health.

“The procedure is still the same, complete documentation. The only thing that we added on was making sure that the family escort, designated by the patient, is medically, mentally and physically fit to be an escort. We have had cases in the past where the escort was sicker than the patient,” he said.

Sablan said Medical Referral incurred a lot of expenses doing that.

“They need a medical clearance or an affidavit stated and signed by escort that they are medically fit to be an escort and that they take full responsibility,” he said.

The new requirement was added so any expenses incurred that are not exposed during the process of getting a medical referral will exonerate Medical Referral from any liability.

“Accidents happen and that we can take into account. But let’s say the person has diabetes or a heart problem and they did not disclose that during the process and ends up having that problem as an escort, then we would not be responsible,” Sablan said.

Currently, patients are sent for medical care and assistance to Guam, the Philippines, Hawaii, San Diego, and Los Angeles. Anticipating patient needs, Medical Referral has expanded their providers to South Korea and Taiwan.

“In terms of expansion, we just signed a contract to start sending patients to South Korea and Taiwan. There is a lot of logistics involved. The major reason for the delay is really waiting for an appointment because we cannot just pick up the phone and say we are sending a person out,” Sablan said.

“We try our best and the facilities we work with are world-class, that is why we have expanded elsewhere so we can have better options and not delay a person’s referral because hospital destinations are too busy,” he added.

Sablan said that not all patients that they send out are dependent on government funds to assist with their medical needs.

“Even if our obligation is to send out patients, we still have to protect the government. We are sending out people who are unable to cover their medical costs. If a person is able to pay, we make sure that they pay for it. We can assist logistically but when they can pay financially, then they should pay for their own,” Sablan said.

“Our role here is to assist people as fast as we can. But we have obstacles and processes to deal with providers but we are trying our best. Our team is composed of six case workers. Each one of them is working at least 30 cases at any given time, not including patients that they have already sent out that they still need to monitor,” he added.

According to Sablan, they used to average 20 cases a week that have to go through with the committee whether they are going to be referred to or not. “Right now, we are hitting 50 cases a week.

“My staff is trying their best and we ask for the cooperation of the public. The faster they can provide and complete documentations, our job is to get them out as soon as we can,” he added.