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Kagman health center may shut down on May 1

THE Kagman Community Health Center may have to temporarily shut down on May 1 if the Department of Public Lands is unable to  transfer the property title from the Commonwealth Healthcare Corp. to KCHC.

KCHC Medical Director Dr. Katherine Elstun said Gov. Ralph D.L.G. Torres wants them to stay in the building, which is on public land owned by CHCC.

KCHC will become a private non-profit entity on May 1.

The federal grant from U.S. Human Resources and Services Administration in which KCHC and  CHCC were co-applicants will end on April 30.

KCHC, according to its former executive director Vince Castro, was able to get a new  three-year grant from HRSA.

KCHC intends to operate independently of CHCC.   

Elstun said the governor is now working with DPL to help with the transition. “But the legal process will take a long time and we’re not sure if it will all be completed by May 1,” she said, adding that if DPL fails to resolve the land issue “we will probably close temporarily.

The other option is to set up a temporary location somewhere else, she added.

Elstun said under the new three-year grant from HRSA, they have 120 days to establish an independent Kagman clinic.

CHCC Chief Executive Officer Esther Muna, for her part, said: “It is up to the governor to use his authority to give public land to a private entity.”

She added, “We know CHCC is barred from giving, leasing or transferring public land to any private entity. KCHC, by May 1, will become a private, non-profit entity.   If the governor wants to give public land away to a private entity, that’s up to him and only he can answer to the public. As for the other assets, including equipment, CHCC will ensure to follow the grant requirements in asset disposition.”

On Saturday, KCHC celebrated its fifth anniversary. 

KCHC board chair Velma Palacios and Elstun announced that the center will be run independently from CHCC but will continue to serve, not just the community of Kagman, but the entire island.

According to Elstun the KCHC board has many plans for the clinic.

She said the clinic has a sliding fee scale, which means patients with no insurance, or with insurance but with high deductibles, or those who are non-U.S. residents, will only pay $5 for any services.

“CW workers come here. They work hard, they work all day. They hurt their back, they have injuries…. We take care for all people, even if they are not U.S. citizens,” she added.

Kagman Community Health Center staff and medical workers pose with Saipan Mayor David M. Apatang, Lt. Gov. Victor B. Hocog and U.S. Congressman Gregorio Kilili Camacho Sablan during the center’s 5th anniversary celebration on Saturday. Photo by Lori Lyn C. LirioKagman Community Health Center staff and medical workers pose with Saipan Mayor David M. Apatang, Lt. Gov. Victor B. Hocog and U.S. Congressman Gregorio Kilili Camacho Sablan during the center’s 5th anniversary celebration on Saturday. Photo by Lori Lyn C. Lirio

But the sliding fee scale is limited only to doctor visits, basic checkups and pregnancy tests.

“We have not been able to provide any medication for our sliding fee patients. We want to also provide low-cost or free medications to our sliding fee patients. We want to include basic imaging — X-ray or ultrasound which can cost $300 or $400,” Elstun said.

“If you don’t have insurance, if you are not a U.S. citizen and you can’t get Medicaid, it is a lot of money. Our center wants to be able to pay for those services for our patients and to be able to pay for X-ray or ultrasound and to get medications,” she said, adding they were not able to do that under the previous grant.

They also plan to have a pharmacy. Elstun said Brabu is getting closer to opening a pharmacy in the clinic.

“It won’t be our pharmacy. It is Brabu’s. But it will be in the building. It will take a few months because of licensing requirements. It might be ready for the summer. We will soon have a pharmacy here for our patients.”

Elstun said they want to have financial freedom “to be able to do these things.”

“We have been asking to do these things. Since I came here one and a half year ago, I have been asking for [KCHC] to be able to pay for X-rays, for us to be able to set up a drug program. I kept asking and asking and the answer has always been ‘no.’”

Elstun said continuing their current partnership with CHCC will mean running into a barrier. “We are here to break down the barrier. The reason for this clinic is to provide high-quality health services but people can’t afford them. We are tired of barriers and we are just tired of not helping people.”

Muna said the Kagman board approves the clinic’s budget before submitting  it to HRSA.

“I do recall discussing expansion and purchase of new lab equipment with the former executive director [Vince Castro] and I recall specifically instructing him to work with the CHCC facility director and the procurement director. This is simply because we need to make sure new equipment and expansion meet  healthcare building standards and there are obviously procurement regulations,” Muna said.

“Let me make it clear: if it was budgeted, we could not deny anything from Kagman for patient care.  We may have deferred action because we needed  more information or documentation, but that’s just to make sure we follow our own regulations.”

She said CHCC did deny requests for a corporate Visa card and corporate PIC passes. 

Elstun said the federal grant for KCHC went straight to CHCC. “Their role in the co-applicant agreement was to provide financial services and provide human resources. They provided all the staff — like me, for instance.”

She added, “Since the clinic started, our board of directors never signed checks. They never had any financial control. They set a budget at the beginning of the year. They turned the budget to the [U.S] government, which approves or disapproves, and funding for the budget is given to CHCC. CHCC has been solely responsible for managing the money. I think they have not done an adequate job. They got our federal accounts frozen. The money has to go back to the federal government. They didn’t allow us to spend for services. It was just mismanaged.”

Muna said the accounts were restricted but were never frozen. “We required them to just submit an expense report before we could draw down the funds. They were restricted because there were conditions of the grant that were not met and some of them should have been fixed by the KCHC executive director himself.   CHCC staff were the ones who fixed those conditions for them.”

Muna added, “We would love to show Dr. Elstun and the Kagman board the story of what’s truly been happening…so they can see for themselves.  If there is money going back to the federal government, it’s because they haven’t submitted the purchase requests.  Like any other federal grant, we have a responsibility to follow procedures.  One of the top priorities of the CHCC board of trustees is addressing the audit findings and we are not going to dismiss the procedures and risk more findings just because they want to circumvent the process.”

Source: Marianas Variety : http://www.mvariety.com/cnmi/cnmi-news/local/103885-kagman-health-center-may-shut-down-on-may-1

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