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Pacific Islands Development Program, East-West Center

With Support From Center for Pacific Islands Studies, University of Hawai‘i

Federal Officials Acknowledge CNMI Hospital’s Progress
Long-term ‘sustainability’ sought for public healthcare facility

By Tammy Doty

SAIPAN, CNMI (Marianas Variety, Jan. 31, 2013) – A large group of high-ranking federal employees exited the Commonwealth of the Northern Mariana Islands yesterday after a final morning discussion with Gov. Benigno R. Fitial, Lt. Gov. Eloy S. Inos and numerous administration staff.

The hour-long conversation among U.S. Health and Human Services, Office of Insular Affairs, CNMI government and Commonwealth Healthcare Corp. (CHC) representatives concluded a three-day visit to assess the hospital’s progress and long-term future.

Eileen Sobeck, acting deputy assistant Interior secretary for insular areas, and Sally Howard, chief of staff to HHS Secretary Kathleen Sebelius, spoke with Variety before their departure.

Visit’s purpose

"Secretary Sebelius asked me to make the trip because she takes the hospital’s critical situation very seriously," said Howard.

The chief of staff along with Sobeck and other accompanying staff followed a jam-packed schedule that included briefings with government officials ranging from the attorney general to the governor, tours of the hospital and one-on-one conversations with front-line CHC staff.

"There’s a consensus that the hospital has made good strides in addressing the issues identified by CMS [Centers for Medicare and Medicaid]," Howard replied on the general take-away from the visit.

Last Wednesday, CHC submitted a massive 200+-page "plan of correction," or PoC, to CMS in an effort to maintain federal certification that was scheduled to be pulled on Feb. 11 worth over $10-million in annual funding.

Howard noted the careful timing of the group’s visit only days after CHC’s PoC submission deadline.

"We didn’t want to interrupt the hospital administration during such an important timeline but arrived thereafter to assess the situation and improvement first-hand," explained Howard.

Appreciation for the federal visit was obvious from both the government and CHC.

"Our discussions went very well," noted Inos, "Now we need to look forward and focus on CHC’s permanent stability."

Chief executive officer Juan N. Babauta echoed the sentiment by commenting, "Federal support has been exceptional…. We could not have survived without it and we thank them."

Babauta’s reference related to the lengthy conversation with CMS yesterday morning just prior to the meeting with the visiting federal officials and the governor.

"We held an extensive tele-conference with CMS this morning and they were generally pleased with our PoC submission.... We have more work to do, but CHC’s improvements were acknowledged," explained Babauta.


While short-term progress at the hospital is recognizable the new buzz-word on everyone’s lips concerning CHC is "sustainability."

"HHS in partnership with Interior and other federal agencies will continue to search for resources to assist the hospital in order to maintain the improvements," said Howard, "That could include additional technical assistance staff such as a chief financial officer or lab personnel etc."

The federal government’s commitment to help save the commonwealth’s lone hospital, however, should not be understood as a blank check.

"All [federal] agencies have limited resources…CHC needs to fix its finances and billing system, which they realize," Howard explained as Interior’s Sobeck nodded in agreement.

HHS and interior are working in close coordination to maximize idea-sharing and financial support for CHC’s survival.

Currently, a team of seven federal healthcare experts are embedded in a variety of positions at the hospital for a 90-day mission.

Since the technical team arrived in early December, CHC’s laboratory and pharmacy have stabilized and quality control processes and procedures have begun to take shape to address a large chunk of CMS’ citations levied against the hospital.

Interior’s insular office agreed that the integrated federal support for CHC is reaping dividends.

"This approach is showing results," added Sobeck, "The HealthTech report provided a road-map that was very helpful."

HealthTech’s $160,000 CHC assessment, completed last September, was funded by Interior’s Office of Insular Affairs.

One of the report’s recommendations was to replace CHC’s leadership team with a cadre of experts, but Howard emphasized a consensus between the federal and local governments that "utilizing and nurturing local resources [people] was the best way forward."

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