State-of-the-art or limited emergency-care-only CHC?

As the new director of Medical Affairs at the Commonwealth Health Center Corporation, I wanted to take the time to address some concerns held in the community, in the government, and among our staff alike. Transitions are difficult for any corporation, and since around mid February we have been riding an emotionally charged financial roller coaster.

So far we have maintained all critical services. We are working overtime to ensure that we continue to provide the standard of care in all of these services. There have been some close calls. There have been some resignations. But overall, we are dedicated to the community and will do what what we can to keep these doors open.

But this community deserves more than just urgent and emergency care. We have ambitious plans for revitalizing our outpatient services, partnering with current resources in the community, tapping into new models of care that focus on prevention and wellness. These are cost effective ways of maintaining the health of our community, and are self-sustainable. We have exciting plans in the pipeline, but we are mired in the act of putting out fire after fire due to insufficient funds. We are trying to get past the emergencies so we can reorganize for success, gain some traction, and start picking up speed.

This brings us to the recently aired issue of the ICS contract. I want to assure you that our intentions behind this contract are genuine. Louis Kraml, the CEO of BMH, has already provided substantial expertise and has invigorated our billing process in mere weeks- all in good faith with the CNMI. We desperately need his services. He is knowledgeable, credible, and charitable. He has worked with failing healthcare institutions throughout rural Idaho. We need to bring in resources like him to the CNMI. We have references to back this up I know there are questions. I know there are concerns. There are a few things that we need to clarify. Please bear with us as we work to create an open, honest, and efficient system, for vetting these contracts. If needed, we can put together a public document that clarifies these concerns in detail.

This brings us to the question of how we bring in the expertise required to make quality health care in the CNMI a reality. Currently we are tasked with:

“rely[ing] upon Commonwealth procurement and supply regulations or adopt[ing], pursuant to Commonwealth law, procurement and supply regulations…” (PL 16-51, pg 4, line 28-29)

In February, the governor was filing the state of emergency for the hospital, and we felt we had to move forward with this contract in order to ensure that we had access to a consistent funding stream that would allow us to keep our doors open through the fiscal year. What we may have failed to do, was submit the documentation necessary to justify our emergency need. We are willing to work with our legal counsel to address this and ensure that this much needed ICS contract is properly procured.

Currently we have an urgent issue at hand. The current billing contract that we have with GMCA was made for a different era. It is unfavorable to our current operations at CHCC, and does not include the helpful supporting role that ICS promises that will help us restructure and help us maintain our fiscal due diligence. We need a new contract, and we need to determine the process to do this. If it requires the AG to sign it, as our legal counsel, great! Let’s work together. If it involves further procurement review, then let’s expedite it on an emergency basis. We are at the point where, if we can finalize this contract, we can start having revenue flowing in as soon as tomorrow. This is money that we have rightfully earned, and desperately need. The MPLT allotment that was due to come to us last week, that we are currently paying interest on, is mired in red tape. We need that allotment, and a billing contract in place by this Friday for payday.

Dear community of CNMI. This is your hospital. It is time to decide. Do we want a state-of-the-art health system that brings growth and esteem to the CNMI? Or are we content with letting CHC collapse into a limited emergency-care-only center? The potential is here for either path-but there is only a small window of opportunity left for the greater way. It is time to decide. We have located the resources that can help make CHCC into a reputable regional medical center, and for one reason or another, the resources remain just beyond our reach. We are hoping to be allowed to do the job we have been hired or appointed to perform. We want to be open. We want to be legal. We are awfully busy, but we will continue to strive to improve our communication with the public, because we desperately need and ask for your support in creating sustainable and quality health care for the CNMI. We must clear up the MPLT and the ICS contract by Friday. I urge you to contact your elected and appointed representatives, including the governor and attorney general to voice your concerns and needs for the Commonwealth Health Center Corporation.

Jeremy Richards, MD
Director of Medical Affairs, CHCC