State of Healthcare
By Governor Eddie Baza Calvo
Ladies and gentlemen, my fellow Guamanians, I will not mince words. The state of our island's healthcare is no where near what our people deserve. It hasn't been for quite some time. You see it every day. A family member risks their own health by standing out for hours in the sun, so they can collect donations for their loved one. Others sell tickets to fundraisers. Others solicit prizes. They all are suffering under the status quo. Our needy don't have the access to quality healthcare they deserve. And I know many of you go above and beyond, sometimes to your financial detriment, in order to help your fellow man.
Quality healthcare is not a luxury. People expect it because they need it. We should not have to fundraise or beg for money. We should not have to leave our homes to undergo lifesaving procedures. For far too long, this government has made our people settle for mediocrity and demanded they be satisfied.
I will get into the solutions that help the island tremendously, but I would not forgive myself if I didn't mention a huge problem staring us in the face: the insufficient budget our government is operating under. I have submitted a supplemental budget that addresses all the critical shortfalls. I must caution that inaction, or inappropriate action will result in a major blow to the state of healthcare on Guam.
Even though some in the Legislature knew it would not be enough, the current budget severely shorted the appropriation for health insurance for government workers, retirees, and their families.
The last time I spoke before this body, my character and my integrity were called into question. I was demonized, my family was used for political smut. Needless to say, it was a stressful time for me, my wife, and my children. I want to again state for the record, that the people who were the least involved—the people who had the least amount of knowledge of this health insurance contract were Ray and I. But we still had the honesty to vote against the budget that jeopardized the health and welfare of thousands of families. Some people knew about it way back in July, yet chose to ignore it, so they could take part in a heartless political game. Those decisions led to the consequences we face today.
But insurance isn't the only important health service at stake. We also need more money to fund Medicare premiums—nearly $300,000, and more money for the food stamp program and the Hinemlo program. The Guam Fire Department's emergency medical services are in jeopardy.
My fellow Guamanians, we are one government. The shortfall of one agency should not be viewed in a vacuum. A shortfall anywhere affects operations everywhere. Senators will be addressing the supplemental budget in the coming days. The Legislature can do one of three things. They can pass the budget in its form. They can reject the budget. Or they can pass a budget that is markedly different from the one I introduced. Rejecting the budget or passing a different version will cause shutdowns throughout the government.
I know that's not exactly what you asked me to talk to you about, but I want to impress upon you tonight—that this government needs the budget to pass. It's not a manufactured problem. I'm not the "Governor who cried wolf." I'm asking all of you to realize how important this supplemental budget is, and ask your senators to pass it.
Looming crisis or not, this administration continues to push to provide Guam the healthcare it deserves. And thanks to the hardworking men and women in the government, and the generosity of the private medical community, things are changing for the better.
My primary concern when coming into office was the Guam Memorial Hospital. I fought as a Senator to support it. I fought to fund improvements and renovations. I knew there was so much I could do to give our people better healthcare at GMH, things I could only do as a Governor.
A better hospital starts with better handling of its finances. The new management team and board of trustees are doing a fantastic job. Gross payroll has resumed, including being current on the hospital's obligations to the retirement fund and Department of Revenue and Taxation. Aggressive collection efforts have resulted to additional revenues. The hospital has also cut costs, by reducing on-call pay and overtime, without compromising delivery of care. Also, service contracts including professional service agreements are being re-evaluated for cost-effectiveness and efficiency.
The days of runaway spending at GMH are gone. I don't understand how financial mismanagement could be tolerated at an institution where every dollar is needed to help save lives. Well, that's in the past. We never want to return to those days, and I assure you: under my watch, we never will.
More than dollars and cents, GMH is improving patient care. They're maintaining stock of critical items, supplies and drugs. It's a seemingly insignificant move, but we all know about panic that swept through the community in years past, when we ran out of medicine, or clean linens, or any other seemingly insignificant piece of inventory. Ladies and gentlemen, when your mandate is to save lives, everything is significant.
With the hard work of the women in the Guam Memorial Hospital Volunteers Association, our sick have constant comfort and love. They assist the employees at the hospital, who work hard every day to maintain the excellence our people expect.
I'm also proud to be a part of the wonderful progress being made at the Department of Public Health and Social Services. These folks are professional, driven, and kind-hearted. It is so touching to see the fruits of their labors, and to see their mission to bring quality healthcare and social assistance to everyone succeed.
Just last week, a diamond in the south was opened: the Southern Regional Community Health Center. This project was personal for me. I've followed it very closely since that spitfire, Linda DeNorcey asked for help. She told me about an opportunity to build this facility, and how she would need some money to get it done. Well, we sent her millions of dollars through the tobacco tax bond, and she used that, along with federal money to build a dream facility. Now, people won't have to go far to get quality medical care. This is wonderful news to our Southern residents, especially during a time when gas prices put the additional squeeze on our wallets.
I'm always happy to help motivated and hardworking employees who show initiative with innovative ideas that help Guam's families. It's a testament to the good work we can do for our people when we all come together for the common good. This state-of-the-art facility will augment the CHC in Dededo, and hopefully will ease the burden on our main facility in Mangilao, and the Guam Memorial Hospital.
The department is also focused on technology and training-based programs that will help make public healthcare more relevant, more accessible, and more effective than ever before.
Beginning mid-June, DPHSS will implement the Public Health Improvement Initiative (PHII). This project is fully funded by the Centers for Disease Control. It will bring approximately $3.1 million to develop Management Information Systems and Quality Assurance and Quality Improvement programs to the Healthcare operations of the Department. Management Information will require the upgrade of computer hardware and software. As you all know, this means the Department of Public Health will be able to service their clients quicker, with the accuracy and attention they deserve.
Additional CDC dollars will be earmarked for developing programs at GCC and UOG to train government staff in Public Health. In fact, a Degree in Public Health program is now being developed at UOG. Continuing individual enrichment programs with a Web-based feature will also be available.
The development of Electronic Health Records (EHRs) will enhance patient care and deliver efficiencies. Proper development will dovetail into the Health Improvement Initiative as e-prescribing and more detailed problem-focused patient charts will help patients wherever they may be.
The two Regional Community Health Centers in Dededo and Inarajan are already testing the EHRs. Central Public Health will move in that direction within next fiscal year. When that is accomplished, the next step will be to feed into the Health Information Exchange (HIE) which will allow participating providers to have access to patient care records. The program will be used to exchange certified electronic health records for island patients between local, regional, and national health institutions.
These two initiatives will pave the way for more accurate and convenient medical care in the near future, and is important to the overall future of patient care. These records are critical to patients when their primary doctors are not available at a time of medical need.
These are just some of the examples that show how this administration is aggressively moving toward even better healthcare. But there are more goals we are aiming for—more things to accomplish so Guamanians get the healthcare they deserve here at home. I want to touch on some of them right now.
I've often spoke of my admiration for the system of care concept. I've talked briefly about the achievements of our health agencies, but it's not necessarily the institutions that matter, but the manner in which they are able to help and provide health services for Guamanians. It is the consumer who counts—the patient, the customer, the client. They come to us because they need help. They shouldn't have to navigate their way around the bureaucracy. The system must wrap its services around them.
Public Health's Nutrition Outreach should watch GMH's disease statistics. Are children whose parents are in the food stamp program getting the attention they deserve—are they up to date with immunizations? We should follow the example put forth by I Famagu'on-ta—and extend this concept to the health system, and have agencies talking to each other. This is a concept I will implement wherever I can in this administration. I've seen first-hand the positive affect it has had on children. I want to see those results replicated throughout the government.
Federal health reform, or Obama-Care is a big issue all states and territories are facing. I've empaneled a Health Reform Advisory Task Force that will research and address this issue so Guam's healthcare can be made better, not worse. This group is focusing on a number of issues, like the health insurance exchange, Medicaid expansion, and consumer outreach. I believe the public understanding these new policies are just as important as the government understanding them. We all want to increase the accessibility to quality healthcare, but it reform must be implemented in a responsible and informed manner.
Because of years of research and work, Guam is closer than ever to open another civilian hospital. Many of you here have been there from the start, and I want to let you know I support your efforts to bring more options for medical services.
We are also pursuing federally-funded improvements to GMH and the Central Regional Health Center, to address additional burdens Guam will face during and after the military buildup. These two projects alone amount to $182 million in benefits to the community.
I could go on and on, but I won't bore you. You know best about the healthcare needs of our community, because you're on the front lines. You know what needs to be improved, and what is getting better. I look to you as experts, as advisors. If you didn't want to be here, you wouldn't. That's why I have the full faith and respect for those of you here tonight. Many times, without praise or thanks, you go above and beyond the call of duty to save a life, to maintain a high quality of life, and to make people happy to be alive.
These solutions we are implementing and proffering are not novel concepts. As a matter of fact, some are the products of our ability to listen carefully to you. Yes, we've been listening to your ideas. We've considered all the problems you've raised and the solutions you've proposed. It is your desire to give patients better care that has led to our initiatives for transparency, greater use of technology, efficiency, and accountability.
Despite the financial cards we were dealt, there are a lot of things that can be done and that we are doing. Sometimes all it takes is a little more initiative and out-of-the-box thinking. It also takes a commitment to excellence to do the work the people rely on us to do. How could we expect any less of ourselves? At the end of the day, you are the heroes who save lives. We are the support system you have; a government that helps you and your patients and removes all politics and roadblocks.
I know you're not happy with the status quo—and neither am I.
We can't settle any longer. We can't settle for a mediocre government, mediocre leadership, or mediocre healthcare. Our people are tired of excuses and tired of the rhetoric. The last time I was at a GMA event, I asked you to believe in a new direction. Tonight, I stand here before you, asking you to join this unified effort, this Team Guam approach to leadership. We all want the same thing: to live happy, safe, and healthy on this paradise of ours. If you ask me, that's just what the doctor ordered.
Good night, and God bless.