SIXTEENTH LEGISLATURE
COMMONWEALTH NORTHERN MARIANA ISLANDS
Honorable Jesus P. Mafnas Memorial Building,
Capitol Hill
Saipan, MP 96980
September 18, 2009
Honorable Benigno R. Fitial
Governor
Commonwealth of the
Northern Mariana Islands
Capital Hill
Saipan, MP 96950
Re: Public Health Crisis at the Commonwealth Health Center
Dear Governor Fitial:
The situation at the Commonwealth Health Center (CHC) has reached a state of crisis
that demands your immediate action, As a result of continued stafling shortages, regular
physician turnover, and low employee morale, the quality of care at CHC has steadily
declined. Commonwealth residents are reluctant to seek treatment following a series of
unfortunate and high-profile reports of accidents involving CHC patients. ‘The modest
resources of the Department of Public Health are continually drained by expensive off
island referrals, the practice of engaging medical headhunters (at cost of $25,000 per
successful physician hire), and an inefficient billing system, Finally, the CNMI
Government continues to pay out malpractice judgments that in many cases could be
avoidable under proper operating conditions.
We are alarmed by the absence of a competent management team at the Department of
Public Health and CHC. We understand that the Secretary of Public Health is currently
unable to discharge his official duties. We do not understand, however, the failure to
appoint qualified interim managers to oversee the Department's and CHC’s daily
operations. We call upon you to act immediately to hire these critical staff members
before the crisis escalates. ‘As a point of reference for identifying and hiring a capable
healthcare manager, we direct you to the provisions establishing a “Chief Executive
Officer” proposed in House Bill 16-9, HS1 §2807(a)-(c) (referenced below).
In addition to our request for the immediate retention of qualified public health
professional/s, we wish to inform you that the Commonwealth Legislature will soon
begin CHC oversight proceedings. We feel it is our constitutional duty to protect the
health and welfare of our residents through diligent monitoring of the Commonwealth's
financial outlays. ‘To this end, the House Standing Committee on Health, Education, and
Welfare and the Senate Standing Committee on Health and Welfare will conduct public
input and CHC oversight hearings beginning next week, We are aware that thecommencement of oversight proceedings could be perceived as political posturing,
particularly during an election year. At the same time we are sure that you agree that the
situation at CHC is now so acute that any and all remedial measures must be explored.
Not only are patients potentially at tisk, so too are payments from the Medicare and
Medicaid programs.
The Legislature is ready to work with your administration to develop both immediate and
longterm solutions to the problems at CHC, provided that swift, effective action is our
guiding: principle. We feel that any corrective action must begin with the retention of a
Qualified médical management team, but there are other measures that may be taken as
well: The comprehensive assessment of CHC begun by Dr, Donald Bader (but not
complétéd due-to a lack of funding) is an important first step in identifying systemic
problems, in the department and conftonting them before they adversely impact public
‘health, For our part, we are willing to support corrective legislative action, including but
riot limited to House Bill 16-9, HS1, entitled, a bill for an act establishing a corporation
for public-healthcare and related public health services, H.B. 16-9, HS1, now pending in
{the Senate, is a top legislative priority that has received support from your office in the
past,
At its core the CHC crisis is a problem of effective governance, In the long term, ILB.
16-9, HS1 provide a foundation for a “high quality, efficient, and market-oriented
public healthcare delivery system” for the people of the CNMI. In the near term the task
is more pressing: the Executive Branch must recruit qualified professional staff to
effectively manage CHC operations. We urge you to give this effort top priority,
‘Thank you for you for your immediate attention to this serious matter. We look forward
to working together to develop a solution that will best protect the health and welfare of
the people of the CNMI.
Sincerely,
th P. REYES. ee tive La I. PALACIOS
President of the Senate Sfeaker of the House of Representatives
CC: Senate Memory ~
House Members
Senate and House Clerk
Senate and House Legal Counsels