CHCC’s Medical Referral Program and recommendations

I’m sure many in the community are glad to see the Medical Referral program is finally being addressed to make it “fiscally responsible, sustainable and always functioning as the last resort to assist patients.” I have no doubt that Ms. Muna is a good administrator who is doing the very best that she can, especially when she already has a hospital to run and making sure “everyone, every primary care giver and every patient is fiscally responsible” comes with the job. The explanation given about the program was truly informative, which shed a lot of light on the program and I want to thank Ms. Muna and the CHCC board for all they are doing to try and help patients with referrals.

However, while there was some mentioning of patients coming to CHCC for referrals, I think it is prudent to address the fact that some patients were adversely affected by the new rules. I wish the recently shared information on the program had been shared when CHCC first started to implement the new rules for the program back in January. Not to condemn what CHCC is doing but there was some confusion and even a conflict with the Kagman Community Health Clinic’s referral, which is federally funded that seems to be in some kind of a conflict with the new rules regarding referrals. To date, this conflict has not been fully resolved but I would like to strongly suggest that CHCC send something official in writing to the Kagman clinic, as the director told me they were still waiting on something official so they can take the appropriate action that will allow their patients to be sent on referrals to Guam or wherever by the Medical Referral program or by the Kagman Community Health Center.

In the meantime, I would like to respectfully suggest: Any patients from the KCHC or any private clinic who needs a referral and is denied need to change your primary care to another clinic and/or even to the CHCC’s Family Clinic that will make you eligible to be referred if the services or specialists are not at CHCC until the conflict is resolved. Adversely affected patients were never told or given this option, which is why I’m sharing this very important option to patients. Hopefully no other patients will be faced with being denied solely because of their primary care facility is unable to send you on a referral.

But I do want to reiterate my sincere appreciation to CHCC and all they are doing to make sure the Medical Referral program will function like it should with real fiscal responsibility and accountability. I must also thank Rep. Tina Sablan for truly being dedicated in trying to help and get to the bottom of the conflict and I pray she can help fix the problem, especially if the Senate will act on her bill–but we know the chances are not good for the bill given she is running for governor and trying to really fix the program for the people–I hope the Senators are reading this as voters are.

Food for thought
The audit on the Medical Referral program showed that tens of millions have literally been wasted and the CHCC board needs to check this out. The program was never properly structured with virtually no checks and balance nor any kind of reconciliation of the expenditures. I actually shared with the governor and the Medical Referral program director back in 2013 based on what I saw as a patient that it would be prudent for CHCC to immediately restructure the program with the appropriate governance system and to seriously look at making a permanent footprint with the program in Guam. It’s clear the CNMI will be dependent upon specialists in Guam for a very long time and shouldn’t remain a renter class but owners of a CNMI hotel and/or a complex. I know that a previous Guam governor with whom I briefly discussed this was open to making a land swap with the CNMI to build a hotel without having to purchase the land, so please work at having a permanent footprint in Guam and not remain a renter. The CNMI can even get a loan using the hotel for collateral, which would truly make it cost-effective to build, as thinking “sustainability” is truly having a permanent ownership-footprint in Guam.

The referral program is paying more than enough in renting rooms to build our own hotel for patients, and there is only one hotel in Guam that’s really suited for patients but they only have six kitchenette rooms. Having our own CNMI hotel/complex will be better for patients. We will save tens of millions over time and it will also be the epicenter for reuniting CNMI relatives with Guamanians, especially if Guam will build some kind of a liaison center/hotel on their land in the CNMI that will encourage Guamanians to visit Saipan through the swap that will be the focal point for reuniting the people and promoting cultural practices on Saipan and in Guam. Pretty soon, locals in Guam won’t have a real connection to the locals in the CNMI as the cost of travel has all but ended social visits between islands and people get old and time has a way of changing and even devastating cultures and entire societies, especially if there is no maintenance to keep them functioning and connected. I pray my recommendations will be seriously considered, as they are well-thought-out and based on real facts on the issues facing the Medical Referral program.

Ambrose M. Bennett
Kagman, Saipan