State of emergency at CHC

The Commonwealth Health Center was placed under a state of emergency yesterday afternoon by acting governor Eloy S. Inos, less than three months before the Oct. 1 deadline for it to transition to the Commonwealth Healthcare Corp.

This marks the second time that the hospital was placed under a state of emergency. The first time was in 2009 and only covered the hospital and the Department of Public Health.

The new declaration now also covers the Tinian and Rota health centers and was made because of the “imminent threat of disruption in the delivery of critical healthcare services and its ability to keep the doors open to ‘healthcare facilities’ due to a severe cash shortage.”

This cash shortage, the declaration said, has resulted in arrears in payments to vendors of pharmaceutical, medical, dialysis, and food supplies.

“If these vendors are not paid, the healthcare facilities would be unable to furnish necessary medicines to its patients. In many instances this would result in immediate life-threatening risks to patients, particularly newborn premature infants with special dietary needs,” the emergency declaration reads.

It said a number of vendors have already stopped deliveries to CHC and the Tinian and Rota health centers and many more are threatening to do the same because of the lack of payment.

The shortage of supplies, meanwhile, has resulted in physicians unable to furnish many services that may only be safely furnished by a hospital.

“The Commonwealth Health Center is the only hospital in the Commonwealth. The entirety of the population of the Commonwealth would be placed at potential risk should the Commonwealth Health Center be unable to function, particularly those needing emergency medical services,” the emergency declaration adds.

On top of these, many Medicaid physicians and suppliers have not been paid, the CNMI Medical Referral program is in serious jeopardy, and many travel agents that arrange for medical referral transport will no longer deal with the Medical Referral Office because of the cash shortage, the declaration continued.

Proper cleansing and operation of the reverse osmosis water machines essential for dialysis treatment, drinking water for patients and staff, laundry services, and cleaning supplies, among others, are also affected by the cash shortage.

In all, the emergency declaration states that revenues are insufficient to cover operating costs and that CHC has nearly $3 million in unpaid bills.

Inos signed the state of emergency declaration a couple of hours after Senate Standing Committee on Health and Welfare chair Sen. Ralph DLG. Torres (R-Saipan) sent him a letter requesting a medical emergency at CHC.

Torres’ letter came after he and Senate President Paul A. Manglona (R-Rota) paid a visit to CHC last July 19 and found that the “hospital is incapable of providing basic medical supplies and services to our people.”

He wrote in his letter to Inos that the CHC laboratory lacks medical supplies and 21 different kinds of reagents necessary for tests such as etoh, carbamazapine, cultures (except blood), and creatinine.

Torres also wrote that CHC’s emergency room lacks physicians necessary to treat emergency patients and those who were available are “incapable of properly diagnosing and treating patients to prevent disability and death because important diagnostic tests such as CBC, cultures, lytes, kidney tests, and heart attack tests are not available at CHC.”

Because the CHC laboratory is unable to perform diagnostic tests, patients are asked to bring their specimens to the Diagnostic Laboratory Services for testing, Torres said. DLS, however, will not accept specimens from CHC because of nonpayment of services rendered to CHC. “This causes longer delays in diagnosis and treatment.”

He also lamented that the new dialysis center is still not open. “Assistant Secretary for Insular Affairs Tony Babauta informed the Senate that he is extremely concerned about the status of the new dialysis center because over $12 million [Capital Improvement Project] funds have already been invested in the new facility.”

The senator also said the crisis is compounded by the fact that the bill that extends the law mandating the transition of the Department of Public Health into the new Commonwealth Health Corp. to Oct. 11, 2011, has yet to be acted on by the House of Representatives.

Even with Inos’ state of emergency declaration, the Saipan lawmaker said he still plans to push through with an emergency informal meeting on the issue today at 9:30pm in the Senate chamber. DPH officials, the Procurement and Supply director, and the secretary of Finance have been invited to take part in the discussion.