by Mindy Aguon

Guam - The Government of Guam's cash shortage has resulted in near payless paydays and even threats of furloughs and reduction in services. But the lack of money in government coffers has hit vendors that provide services to the island's public sector the hardest.

The trickle down effect for Medically Indigent Program recipients though could be a matter of life or death, if the government can't come up with funds to pay vendors.

Even though lawmakers annually appropriate $15 million to fund MIP, if the government is behind in collections, vendors won't get paid. This is evidenced by the fact that there is currently $5.8 million in outstanding invoices that have been processed sitting at the Department of Administration awaiting payment to various MIP vendors.

Public Health Bureau of Healthcare Financing Administrator Tess Archangel said, "Basically at this point, I know they're currently not getting paid because of the cash flow problem of the Government of Guam."

The government's chronic cash condition and the lack of revenues coming in has exacerbated a problem that has existed for quite some time. The situation has resulted in public health constantly getting letters demanding payment and threatening to stop services for those very patients who can't afford it.

Continued Archangel, "It's frustrating because sometimes you will receive a letter stating that they will close their business they're going to close their clinic for our MIP clients and open to Medicaid clients, technically I feel bad for our clients because they cannot receive the service that's needed. But what can I do?"

Those letters include one from National Cornerstone Health Care Services, Inc., which recently wrote to DOA asking for the government to start making payment on a $904,000 bill. Archangel says the company is threatening to stop providing services if the government doesn't pay up soon, saying, "The clients we refer to National Cornerstone are...hemophilia patients that need those Factor 8, and they're the only ones who are basically providing that services to our client."

Hoping to place pressure on Adelup, Senator Eddie Calvo (R) wrote a letter to the Camacho Administration asking for their assistance in facilitating immediate payment. Calvo wrote, "I do not want the government to place the lives of its most vulnerable patients in jeopardy if this company is forced to stop servicing the government of Guam due to lack of reimbursements."

"The necessity and importance of paying these vendors is clear," reinforced Archangel.

But when the 126 MIP vendors, including National Cornerstone, will be paid remains unclear - leaving MIP recipients in jeopardy of losing out on the very services that are, in some cases, critical to their survival.