Pago Pago, AMERICAN SAMOA — A federal assessment of the LBJ Medical Center, commissioned by the US Department of Interior’s Office of Insular Affairs (OIA), found that the 50-year-old one-story facility is not in compliance with current seismic and wind requirements; and retrofits would be expensive and disruptive.

Instead of repairing the current facility, the assessment report says ASG prefers a new multi-story hospital at the current LBJ location, with an estimated cost of $750 million to $900 million.

OIA requested the U.S. Army Corps of Engineers’ Honolulu District office’s assistance in producing a report to the US Congress addressing the condition of LBJ, estimating the cost of renovating and modernizing the current facility, constructing a new facility, and whether a renovated facility will have sufficient capacity to meet American Samoa’s needs.

The assessment is required under provision of the federal Consolidated Appropriations Act, 2019. Army Corps carried out the assessment between Apr. 22-24 and the final report released recently provides five options — including costs  for policymakers to consider.

According to the 278-page report, current LBJ hospital infrastructure “is in a state of failure due to age, environmental exposure, and lack of preventative maintenance”. It notes that extensive repair and/or replacement of facility sections is required to ensure compliance with hospital accreditation standards and to ensure the life, health, and safety of staff, patients, and visitors.

It also points out that while facility structure has held up relatively well, it is not in compliance with current seismic and wind requirements; and retrofits would be expensive and disruptive. Additionally, the electrical and mechanical systems are in poor condition and in need of immediate repair.

Architectural deficiencies have led to mold and mildew growth in critical areas, exposing staff and patients to significant health risks. The report notes that the nurse call system is inoperable in key locations; and plumbing, water treatment, and medical gas systems are all in failed or failing condition.

According to the report, current facilities infrastructure and the need for enhancement of clinical services to support the present and future health care needs of American Samoa “support the replacement of the existing facility”

It explains that repairs to the infrastructure alone in the existing facility without properly supporting space expansion is not a complete solution and will introduce a higher level of risk to patients and staff with exposure to mold, dust, and other harmful contaminants during construction.

“Interim Life Safety Measures and enhanced Infection Control Management is critical now to ensure the life, health, and safety of patients, staff, and visitors,” the report says.

Five options are proposed in the report for facilities infrastructure capital investment:

•     Option A calls for repair to infrastructure of the current facility (which is 150,000 square feet)  with no additional space expansion, with the estimated construction cost of $161.4 million. The report gave description of what’s involved in the repairs, which would require numerous utilities outages and interim life safety measures that could impact the delivery of immediate patient care services.

“While individual systems could be brought up to current code standard through such a repair, this does not address the existing clinical space deficiencies nor meet the future end-state of clinical services,” it says.

•     Option B suggests construction of a new multi-story hospital (150,000 square feet) on a proposed site on the western side of the island. Estimated cost for this option is between $325 million and $390 million. The site location for a new facility would require land transfer and upgrade to island infrastructure.

“Further analysis is required to determine additional infrastructure costs,” the report says, noting that this option does not address the existing clinical space deficiencies nor meet the future end-state of clinical services.

•     Option C would construct a new multi-story hospital (150,000 square feet) on the current LBJ campus with an estimate cost between $375 million to $425 million depending upon the course of phasing to ensure minimal disruptions to the current facilities and accessibility.

However, the report says this option also does not address the existing clinical space deficiencies nor meet the future end-state of clinical services.

•     Option D suggests construction of a new 370,000 square foot multi-story hospital on a site on the western side of the island with an estimated cost of $700 million. The proposed facility would be properly sized to support the clinical needs of American Samoa for the next 20-30 years.

However, further analysis is required to determine additional infrastructure costs.

•     Option E calls for the construction a new multi-story hospital (370,000 square feet) on the current LBJ campus with an estimated cost from $750 million to $900 million —depending upon the course of phasing to ensure minimal disruptions to the current facilities and accessibility.

Like Option D, this proposed facility would also be properly sized to support the clinical needs of American Samoa for the next 20-30 years.

“A further site assessment is required to ensure space is available for a multi-story facility on the existing campus,” the report says. “This is the preferred option of the American Samoa Government.”