Gov. Benigno R. Fitial has taken control of the Department of Public Health after declaring a state of health emergency for the CNMI late Tuesday afternoon, paving the way for the hiring of physicians from the Philippines and other countries outside the U.S. and Canada to help address the shortage of specialists on the islands.
“Immediately, the Department of Public Health shall adopt appropriate recruitment strategies to restore an adequate level of medical services to the client population,” Fitial said in his one-page declaration of health emergency signed on Oct. 20.
The governor said the Commonwealth “is experiencing an increasing rate of deaths among community members that can be attributed to lack of health care.”
Health Secretary Joseph Kevin Villagomez, who is now back from months of medical leave, met with key DPH personnel yesterday afternoon “to discuss and begin work required by the declaration,” DPH chief financial officer Esther Muna told Saipan Tribune when asked for comment.
Muna served as acting health secretary for days when other DPH officials designated as acting health secretaries, including Pete Untalan, went off island-also for medical reasons-or went back to their original job at the department. Muna also led DPH personnel who testified at the House Health, Education and Welfare Committee oversight hearing on Capital Hill last week.
Press secretary Charles Reyes said the emergency declaration is valid for 30 days.
“The governor will have all powers available to him under the Constitution for such emergency declarations,” he said.
As of yesterday, neither the Fitial administration nor DPH could provide details on the number and types of doctors that needed to be hired, the countries where they will be hired from, the salary levels, the start of the hiring process, whether it would involve direct hiring or the use of manpower agencies, and reprogramming of funds, among other things.
“The governor supports the temporary recruitment or use of qualified and proficient foreign doctors, preferably with U.S. training,” Reyes said.
He added that the details will be addressed shortly.
The Fitial administration had said that it would be less costly to hire specialists from outside the CNMI than to send patients to off-island medical facilities such as Guam, Hawaii, the Philippines and the U.S. mainland.
Medical referral costs reached $7.4 million in Fiscal Year 2009, a 17-percent increase over FY 2008's $6.3 million, even as appropriations totaled only $5,000.
The $7.4 million includes the actual costs of treatment and other medical care, as well as expenses related to transporting and accommodating patients and their family and medical escorts to health care facilities in Guam, the Philippines, Hawaii, and the U.S. mainland.
Currently, DPH is restricted from hiring doctors that are not from the U.S. mainland or Canada due to the CNMI Medical Profession Licensing Board regulations. The CNMI also cannot hire doctors from foreign countries due to the standards and requirements mandated by the federal government. The Commonwealth Health Center, which receives Medicare and Medicaid funding, is required to hire U.S.-trained doctors.
CHC, the only hospital in the CNMI, is one of the component units of DPH.
However, the CNMI has been sending hundreds of patients to the Philippines every year for medical referrals.
Fitial directed the Medical Profession Licensing Board “to review and revise regulations so that expanded medical services may be provided to the client population of the Commonwealth” within 15 days of the declaration.
The governor also directed DPH to submit within 10 days of the declaration a written plan to move the CNMI from its present “medical emergency” status to an acceptable level of care.
In an earlier interview, Fitial specifically said that doctors, including those who are U.S.-trained or certified, will be hired from the Philippines. He said they would include cardiologists and nephrologists or kidney doctors. The controversy-plagued $22 million dialysis center also could not open due to a lot of problems that include the lack of kidney doctors.
Rep. Ralph Torres (R-Saipan), chairman of the House Health, Education and Welfare Committee, earlier said he supports the health emergency declaration. He is expected to issue a comment today.
DPH has an arrangement with a U.S.-based headhunting firm for $25,000 per doctor hired from the U.S. and Canada. Fitial had said that the CNMI will hire foreign doctors “based on necessity.”
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