CHC pharmacy under a state of emergency

Gov. Benigno R. Fitial has placed the in-house pharmacy at the Commonwealth’s only hospital under a state of emergency to prevent it from closing due to the lack of licensed pharmacists.

The emergency declaration is intended to allow the Commonwealth Health Center to recruit a pharmacist for a salary over the existing $50,000 cap. It will remain in effect for 30 days, or sooner if the Legislature passes a law exempting pharmacists from the salary cap.

“By today’s disaster emergency declaration, I intend to immediately protect the citizens of the CNMI and its many visitors by maintaining a viable and operational Commonwealth Health Center hospital,” the declaration states.

CHC lost its head pharmacist, Anthony Raho, after Fitial did not renew his contract earlier this year, leaving the in-patient pharmacy with only one pharmacist and forcing it to close on the weekends.

The last full time pharmacist employed at the hospital, Lorraine Liwiski, is leaving on Oct. 8, 2008; she has taken a job with a private pharmacy on Saipan.

CHC cannot easily hire replacements because there are very few licensed pharmacists in the Commonwealth and the $50,000 salary limitation is too low to attract them to work for the hospital.

Earlier this year, the Legislature passed a bill lifting the salary ceiling for pharmacists. But Fitial vetoed the measure because of add-on provisions that would have raised the salary cap for unspecified professionals under the legislative and judicial branches.

Citing advice from Health Secretary Joseph Kevin Villagomez, the governor said that unless one or more pharmacists are immediately hired to run the pharmacy, “the health care operations of CHC will be severely curtailed and patient lives will be put at extreme risk.”

CHC pharmacist Raho, who had just been re-hired, said yesterday that the low salary cap for pharmacists and other heath care professionals continues to hinder the CNMI’s health care system.

Raho, who has worked at the pharmacy for 12 years, said the salary cap is inhibiting the hospital from hiring pharmacists.

In the U.S., entry-level pharmacists start at a salary of $105,000 to $120,000, he said.

“It’s a no brainer, we just can’t compete,” he said, adding that the United States is also experiencing a lack of pharmacists but pharmacies are addressing the situation by raising salaries 5 to 6 percent.

Even locally, he said, a pharmacist can work at a private pharmacy and make 60 percent more. The other CHC pharmacist, Liwiski, is leaving in a few weeks to work at PHI, the private pharmacy located within CHC. The last six CHC pharmacists left due to salary issues, noting that there should be a minimum of three pharmacists working, but since 2004 there have only been one or two.

For now, Raho said he is only staying for 30 days, and he has yet to sign a contract. Without a pharmacist, drugs can’t be managed, dispensed or evaluated, he said. CHC could also end up spending more money because, for example, cancer patients would have to be sent off-island if they couldn’t get the necessary medications, and there would be no one to scrutinize the differential costs between pill brands.

But Raho said he feels health care in the CNMI is not where it should be, and the politicians and the government bureaucracy are to blame.

“I feel elected officials are elected to provide services to the community…elected officials have a responsibility to provide assistance to the community,” he said. “The slow manner of bureaucracy is frustrating.”

Unfortunately, Saipan is going through financial difficulties and there is a lot of infighting, he said, but health care must be a priority.

“Yes, people are getting inconvenienced by [the power outages]. It’s affecting their livelihoods, but is it really affecting their health in life-and death-situations?” he asked.

Lynn Tenorio, Deputy Secretary for Public Health Administration, said she is pleased that Fitial declared a state of emergency.

“Naturally, we are pleased that the Governor addressed the concerns the Secretary had relayed with respect to the health and well-being of the patients at CHC. The need to protect patients necessitates retaining Mr. Raho, who has been an incredible asset to CHC and its patients,” she said in an e-mail. [B][I](with Kristi Eaton)[/I][/B]