HAGÅTÑA (The Guam Daily Post) — Speaker Therese Terlaje, head of the legislative committee on health, has scheduled another oversight hearing on the Guam Memorial Hospital Authority to take place on Tuesday.
Terlaje said she was compelled to convene the hearing after attending a recent meeting with GMHA officials, in which she recognized that there are several issues at the hospital authority requiring both legislative and public attention.
“In the spirit of public accountability and transparency, Speaker Terlaje also wants to use this oversight as an opportunity to review expenditures of the cumulative $50 million recently received by GMHA,” the speaker’s office said in a press release.
Topics to be discussed at the oversight hearing include:
- Billings and collections
- Proposed base pay increase for nurses
- Above-step recruitment
- Recruitment of experienced hospital management
- Failure in the Electronic Health Records system
- Request for proposals for a new EHR system
- Expenditure reports on $30 million received by GMHA through Public Law 37-43 and $20 million in ARPA funds
- Office of Public Accountability Audit Report 24-01 GMHA Revenue Cycle Management
- Notice of hiring for attorney positions.
“The discussion and inquiry into these topics are extremely important to monitor the operations of GMHA, to address community concerns, and to uphold the values of accountability and transparency which are necessary in government,” the speaker’s office stated in the release.
Nurse pay and possible use of $30 million leftover
Regarding nursing pay, Terlaje introduced Bill 225-37 in late December 2023, which proposes to appropriate $5 million to GMHA from fiscal year 2024 general fund excess revenues for the purpose of funding a six-step base pay increase for nurses.
The fiscal note for Bill 225 states that unobligated general fund revenues for fiscal 2024 amounted to a little more than $13 million as of the November 2023 Consolidated Revenue and Expenditure Report. P.L. 37-58, which extends a moratorium on certain liquid fuel taxes and surcharges, takes away about $7.8 million from the excess, leaving behind about $5.2 million, according to the fiscal note.
That should leave enough for Bill 255, but there are other measures looking to make use of fiscal 2024 excess. Bill 208-37, which seeks to extend a long-standing energy credit program three more months, from January through March, would use about $15.8 million. Another measure, Bill 221-37, would appropriate $350,000 from the general fund to Guam Community College to fund a construction planning study to convert the former headquarters of the Department of Public Health and Social Services to a GCC workforce annex.
“As such, the proposed appropriation of $5 million in Bill 225-37 will likely be dependent on the legislative action taken on the measures introduced that utilize the same funding source,” the fiscal note for Bill 255 stated.
However, it also noted that the speaker suggested an alternative, to reprioritize any remaining amount from the $30 million appropriated to GMHA through P.L. 37-43 for nursing salaries. The fiscal note said this suggestion would be “a prudent approach.”
OPA audit
A more recent issue regarding the hospital was the audit on GMHA’s Revenue Cycle Management.
The Office of Public Accountability found several issues with a former RCM services contract for the hospital authority, with MedHealth Solutions.
These included deficiencies in GMHA’s procurement process regarding compliance with procurement law, factors indicative of preferential treatment toward hiring the contractor for RCM services, unreasonable bases included in the contractor’s 12% compensation and ineffectiveness of the RCM consultancy due to continuing cash flow and patient receivable issues.
In an official statement on the OPA report, GMHA said the audit clearly indicated the contract was approved by the Office of the Attorney General, including the legality of its terms, before its execution.
“The attorney general of Guam is responsible for reviewing the contract as to legality and form. GMHA worked with the Office of the Attorney General on this contract and, once it was approved, the hospital acted in accordance with that approval,” GMHA stated in the release.
“The OPA’s findings in its audit of the GMHA contract with Medhealth/RCM do not fully reflect the extent to which GMHA benefited from the contract, and the lengths to which GMHA went to ensure its procurement and the resulting contract complied with Guam law. The intent for procuring the contracted services was to enhance the efficiency of the hospital’s collections division, with the immediate goal of training collections staff in identifying inefficiencies and taking corrective measures to bolster internal processes. GMH has historically struggled with its finances due in large part to the challenges it faces with collections. The purpose of this contract was to address those challenges and improve collections,” the hospital authority added in the release.
Guam Memorial Hospital is seen Tuesday, Dec. 12, 2023, in Tamuning.
