The perennially troubled Guam Memorial Hospital is getting more attention this election year. A number of new bills have been introduced in the 35th Guam Legislature, seeking to cure the ailments of the island’s only public hospital that seems to be always on the brink of collapse and beset by mismanagement issues.
During a recent session, Sen. Therese Terlaje, chair of the legislative committee on health, tackled a proposal to transfer funds to GMH for capital improvement projects.
Bill 210-35 seeks to appropriate $10 million from the Hospital Capital Improvement to assist GMH in its numerous longstanding challenges, particularly its top three urgent projects which include the roof repairs, the electronic health record, and the electrical panel.
Terlaje noted that for two fiscal years in a row, the hospital administration was denied funding requested for capital improvement projects and was appropriated significantly less than its total budget request.
In 2019, the GMH requested a total of $242 million but only received $30 million. In 2020, the GMH requested a total of $192 million but only received $28 million. The appropriations from both years did not include funding for capital improvement projects, Terlaje said.
The GMH Capital Improvement Fund is part of the FY2020 budget law, which sets aside $10 million of excess 2019 revenues for capital improvement projects, specifically to be used to repair or replace the electrical panel and necessary generator. The Bureau of Budget Management Research has suggested that the $10 million not be deposited into the Hospital Capital Improvement Fund, but instead be used to pay down the cumulative general fund deficit.
Sen. Amanda L. Shelton has introduced Bill 301-35 to authorize certain tax credits for a new electric health records system and critically needed medical equipment for GMH.
Shelton said Bill 301-35 seeks to assist in providing the funds to replace the nearly-obsolete electric health monitoring system and purchase various life-saving medical equipment. The proposed tax credit program has the capacity to encourage further private sector assistance to meet the healthcare needs of the island.
“As we begin to stand up the Hospital Planning Task Force, and the administration has shared their desire to build a new hospital, the idea here is that this tax credit will allow GMH to obtain equipment and software it can use today bring with them to a new facility tomorrow,” Shelton said.
While tax credit bill might not address all the pressing needs for equipment at GMH, Shelton said, “this is a step forward that can jump start the procurement to meet critical needs at our hospital.”
Yet another measure, Bill 288-35, was introduced by Sen. James C. Moylan to help jump start not only a provision in Public Law 35-36, but also the intent of the recently passed Bill 210-35, which would provide the Guam Memorial Hospital $10 million.
The monies identified in PL 35-36 and cemented in Bill 210-35 were to come from excess revenues derived in fiscal 2019.
Moylan has been following up on the status of those monies. In response, the Department of Administration stated that an audit continues on the FY2019 budget, and that the governor has indicated that she intends on utilizing any excess revenues to pay down a debt.
“Enough is enough on this run around. The hospital needed the money yesterday, as we have broken elevators and leaking roofs,” Moylan said. “Elected officials talk about making healthcare a priority during an election year, so let’s back the talk with some action. While $10 million doesn’t solve all the problems with GMH, it is a start, but we can’t even get the decency of a response from the administration on when the monies will be provided to the hospital.”
But funding is not the hospital’s only challenge. The way it is being managed— or mismanaged— contributes to the hospital’s woes. Addressing this part of the problem is key to improving the operation of GMH, whose administration is often assigned to political appointees.
To this end, Moylan introduced Bill 305-35 to authorize the GMH Board of Trustees to prepare a request for proposal for a performance management contract in the management of the hospital.
This would initiate a process summarized from 2016, where the former administrator of the Guam Economic Development Authority, Jay Rojas, requested that the legislature authorize the pursuing of a public-private partnership for the management and operations of GMH.
This was based on the results of a Request for Information that was mandated by Public Law 33-143, and which authorized GEDA to pursue what interest options for GMH existed in the market. Three parties responded with interest in seeking the public-private partnership in managing the hospital. No actions were pursued since.
“Just as it was then, the problems at GMH continue today, and while there are fiscal issues, there are also concerns on a management aspect,” Moylan said. “Allowing an outside entity with experience in hospital management would not only remove politics from the public hospital, but would provide it a breath of fresh air.”
Moylan said the government should allow a professional entity, with experience in managing public hospitals, to oversee the operations and management of GMH.
“Establishing a public-private partnership does not end the pursuit of a new hospital facility, because that will take years, but in the meantime the community deserves a decently managed public hospital,” Moylan said. “Plus. we need to set the parameters, because if we do not establish a certain bar now, even a new hospital will end up where we are today, not during the time frame of two generations from now, but literally the next one.”
Gov. Lourdes Leon Guerrero said GMH’s “bullet holes” can’t be fixed by band aids year after year.
In her state of the island address on Feb. 24, the governor said there are several public and private financing options available for a co-located new GMH and public health facility.
“This will take planning, and the option we choose will be driven by our government’s financial health, the amount that needs to be raised, our partnerships with the private sector, and the comprehensiveness of the plan we propose,” she said.
The first step in drawing up that plan, the governor said, is an in-depth analysis of the current hospital from the U.S. Army Corps of Engineers, w hose final report is due soon. “We know that repairs to GMH alone will cost between $20 million to $30 million,” Leon Guerrero said. “This need is my central priority.”
Meanwhile, Sen. Wil Castro has been appointed to head the six-member GMH Planning Task Force created through Public Law 35-58, originally Bill 5-35 and introduced by Minority Leader Telo Taitague.
“This planning task force is a step in the right direction because it brings together stakeholders and previous improvement plans to guide us on the best way forward for the Guam Memorial Hospital,” Castro said.