Muña says board will micromanage CHCC
Opponents of a bill that transforms the Commonwealth Healthcare Corp. board from being merely advisory to a governing one believes the measure would ultimately be detrimental to the Commonwealth Health Center.
Hospital CEO Esther Muña, who was joined by other CHCC officials to oppose the bill, expressed frustration yesterday over the Legislature’s passage of the measure.
The Senate passed the bill Tuesday a week after the House eased it through.
In a telephone call yesterday to the Saipan Tribune, Muña said the proposed board of trustees governing the corporation would not pass the next Centers for Medicare and Medicaid Services survey, resulting in the cancellation of CMS funding to run the lone hospital service provider of the CNMI.
“When CMS comes in, they are not just looking at the governance of the hospital. What they are going to look at is the evaluation of these members on their roles and their responsibilities,” said Muña.
She believes creating a politically appointed board to govern the affairs of the CHCC would work against the hospital.
“[CMS is] going to evaluate if they understand how [the board’s] decision…are linked to infection control, quality control, utilization review, medical staff, nursing services, and more. Those are the things that our current governing board of the hospital…decide on to communicate with all the staff about on a quarterly basis,” she added. “It’s actually comprehending how it links to everything else in the organization.”
The hospital’s governing board consists of the CEO, chief financial officer, and chief medical officer.
A consultant on the bill, Pedro Deleon Guerrero, confirmed that House Bill 19-186, HD1, would affect CMS recertification, but went on to say that it depended on the hospital’s ability to comply with CMS requirements.
Muña also believes that closely managing the people instead of the hospital itself—as what happened under a governing board at CHC—is a bad idea in general.
“The reason why we are against that bill is the fact that you are allowing micro-management of healthcare services and hospital services. This bill, the way it is written, allows micro-management to occur,” she said.
Muña thinks that having a governing body—as opposed to an individual governing over operations—is not efficient, especially for matters that are time-sensitive such as healthcare.
“If you’re on the surgery table and you need to make a decision, I cannot authorize [the sudden purchase of medicine and equipment] anymore. You’ve got to wait for the board to meet and make a decision. Is that the kind of system that we want in place? I just can’t fathom that people think it’s okay,” said Muña.
Muña said that before making decisions, there are at least two things that she considers. “First of all, is it going to save a life? Do we have the money for it? If not, when we provide it, do we get reimbursed for it? That is something that we eventually see later on,” she said.
Despite all the comments that opposed the passage of the bill, the Senate unanimously passed it and Muña can’t help but feel disappointed with the Legislature’s decision.
“It is disappointing that our lawmakers disregarded our concerns on the bill: technical concerns, the question of legality, and even the consequences of health in the CNMI,” said Muña in an email. “These are the people that are elected to protect our people so you can imagine the disappointment.”
Muña said that no matter what happens to CHCC, the goal would stay the same—to provide proper medical healthcare to the people of the CNMI.
“My goal now is to lead the CHCC team to continue with the same passion to help with improving the health of our people. Our mission is the same—just a little harder when you know what’s in the horizon,” she said.
One of the bill’s authors is Rep. Felicidad Ogumoro (R-Saipan).

Take Phil. Hospitals, the board of directors are ALL Medical Doctors in the private Hospitals which are very good on the whole. Many of the Doctors also practice in other hospitals while being on the board of one.
The costs of selective medical procedure is priced out and collected “prior” to any medical procedures. Same with the Govt. hospitals.
Private Hospitals will treat emergency patients on their ability to pay based on immediate cash or a promissory note by a responsible person(s)
Same with Govt. Hospitals.
It would seem that this CHC has not the ability to be able to ascertain the costs of medical procedures along with the ability to collect on such. (as is evident with the billings over the decades, lack of timely ones)
Muna has no medical degree and her or any other person without any degree should not be the CEO due to the inability to comprehend and carry out what is required in certain medical procedures, this also encompasses what supplies are need to be on hand for emergencies and also scheduled procedures.
BUT one thing that I do agree with Muna on, is this political appointed “board” will be a mirror of the CUC “board” a most useless bunch of oxygen thieves as there ever was in the NMI or elsewhere.
Watch and see how this pans out. Watch and see the names and past accomplishments (failures) of those that will be appointed.
All true. The CUC board is the current example of a politically appointed board gone bad. Imagine a board half as bad at CHCC, then realize the direct impact on life and death and it’s very sobering.
Board members will use the back channels to make sure their familia are put at the front of every waiting list, be it medical referral, colonoscopy, dialysis, or a painful toothache.
After the hospital had turned the corner and progress has been made in the positive direction, enter politicians to muddy the water, infuse nepotism, and set the entire organization back ten years or more.
Those in precint three who authored and supported this bill will not receive my votes during the next election cycle.
Also watch just how many of this “Boards” incompetent family members will be new hires at the CHC.to further complicate matters.