Ame Sene Tanielu

Freelance for Samoa News

Chair of the Senate Standing Committees for the Hospital/ Public Health, Tuiasina Salamo Laumoli, told the joint hearing on day one of the FY 2024 Budget hearing that the Hospital being the most important Institution (in American Samoa) is a joke (le falema’i ua pei ose mea tausua).

Tuiasina said he’s grateful for the opportunity to see those from the Governor’s office, the Budget Director and a representative of the Treasury to share his recorded figures of the past years.

Rewinding to five years ago, he said in 2019 there was so much money received, without transparency, in expenses and returned funds due to problems with matching funds.

Then came the COVID-19, and from 2020-2021 until now, there is money for the COVID-19 Program.

What concerned the Senator was the matching funds as Medicaid funds are part of the budget. 

 “It’s been used but not included in the budget,” he told the Fono, “the Medicaid is part of the budget.” 

Tuiasina noted, “Several funds have been returned due to the lack of matching funds,” but he’ll ask the Medicaid and LBJ when it’s their turn for the hearing. However he said, they don’t have the authority to put aside money for the matching funds.

The senator also said $55million was returned in the year 2020; and, then in 2021, $42 million was returned according to the Medicaid office.

"In the year 2022, the amount of $37 million was also returned, and the United States of America never fails to care for us.”

Furthermore he said, for 2022- 2023 let’s hear how much will be returned and wondered if the hospital is the most important institution (in American Samoa)? And why were the funds being returned?

Program Planning & Budget Director Catherine D Salelua told the joint Fono budget hearing, Monday, the projected amount for the 2023 has been met and it’s the same with 2024 — its being met.

Co-Chair Senator Utu Sila Poasa of the Budget and Appropriation Committee brought up the budgets of the two newly established departments — Search & Rescue and Correctional — suggesting that these two departments should go back under Police following the law, and called it the Department of Police, as “public safety” no longer exists.

The lone female Senator, Fonoti T Aufata for District No 8, chair for Human & Social Services of the House Senate Standing Committee, accused the department directors of coming in with figures — without money.

She said that the money belongs to God and the people of American Samoa, the taxpayers.

However she raised her voice when said, money is the root of all evil (tupe o le pogai o mea leaga uma i lenei lalolagi).

Titialii K Vaiau chair for the TAOA/ Election/ Youth & Women of the House Standing Committee stated his reasons why funding ran out — it’s because the government is “too greedy”.

There is no better time to request a pay raise than during the budget discussion, apparently.

After 58 years of sitting on a $25,000 a year for the Fono members, the chair of the Senate Standing Committee for Retirement, Soliai T. Fuimaono asked Budget Director Saelua to relay their request to the governor for a pay raise.

The governor gets paid $120k, Lt Governor at $100k, Directors are at $85k, he pointed out.

The proposed FY 2024 Joint Budget Hearings continue. 

BACKGROUND

The matching funds for Medicaid are a part of the government budget submitted annually. The problem is not that it is not part of the budget, the problem lies in the amount set aside as local Medicaid matching funds — it’s just not enough according to the ASG Medicaid Office.

In the ASG Medicaid Office summary of the agency’s financial report presented to the Fono during the 2023 budget hearing, it states that there is a need for an increase in local matching funds and notes that it’s not a issue.

For the new fiscal year 2023, with $3 million in local match, the report said, “we will only be able to draw down $3 million in federal funds under the 67% Public Health Emergency (PHE) Declaration for American Samoa.

“After the PHE, if Congress does not adjust our regular FMAP of 55%, we will return to a 45% match requirement resulting in a $6 million federal drawdown.”

The reports points out that “the ability of the Medicaid office to utilize the $86 million of the program and to provide new services is incumbent on the availability of a local match.

“For FY2023, Medicaid anticipates the same federal funding level of $86 million for 12 Months.”

The report emphasized that: “Having an adequate local match to support the federal Medicaid grants each year helps to achieve the agency's goals and ensures uninterrupted access to care for Medicaid beneficiaries.”

“Once the local match is depleted, Medicaid will be forced to suspend all services to protect our credit with our providers,” the report said.

It stated, “Due to the limited local match, Medicaid returned back to CMS” — $55 million in FY 2020; $42 million in FY 2021 and an “anticipated” $37 million for FY 2022, which officially ends on Sept. 30, 2022.

It also pointed out that Medicaid services, outside of LBJ Medical Center and the Health Department’s Federally Qualified Health Care Facility (FQHC), are entirely dependent on the availability of the cash for the local match.