Pago Pago, AMERICAN SAMOA — Senators yesterday heard explanations from the LBJ Board chairman, regarding the abrupt termination of former Chief Executive Officer Dr. Akapusi Ledua and former Chief Operations Officer Dr. Jean Anderson, and testimonies from the two former top officials explaining their side of the controversial scenario.

LBJ Board Chairman Dr. Aifili Tufa, accompanied by CFO Sefanaia Kaumaitotoya and HR Director Stanley Iakopo, appeared before the Senate Health Committee in the first hearing scheduled for yesterday morning.

The second hearing where Dr. Ledua and Dr. Anderson were scheduled to testify was held after the Senate regular session following the first hearing.

FIRST HEARING

During the first hearing of the day, LBJ Board Chairman Tufa told senators that the decision to terminate the former CEO's contract was not easy. The board had deliberated on it for several months and in the end, they had all agreed that it was the only course of action to take.

LBJ Board Chairman Mualeava Dr. Aifili Tufa (second from left) and LBJ top officials during the Senate Health Committee hearing on Monday morning. (l-r) Acting CEO/CMO Dr. Aitofele James Sunia, Mualeava Dr. Aifili Tufa, CFO Sefanaia Kaymaitotoya, HR Director Stanley Iakopo. The hospital board chair said they had no choice but to let Dr. Akapusi Ledua go as CEO, but offered to keep him on as a medical doctor. [photo: Asi A. Fa'asau]

He emphasized that the board did not question Dr. Ledua's qualifications, skills, dedication, and long service to the people of American Samoa as an orthopedic surgeon which spans more than two decades.

However, he revealed that one of the reasons for his termination was for not following procurement rules in his role as CEO.

He explained that according to board policies and regulations, any procurement that exceeds $25,000 requires a proposal that must be submitted to the board for review and approval.

Tufa stated that the board found out that many procurement decisions had been made by the former CEO and payment had been completed without the board's knowledge. He said that this had been going on for some time and the board had subsequently advised Dr. Ledua to adhere to procurement rules.

"He was reminded of the procurement rules and advised to comply with them," Tufa said. "This was regarding the selection of local companies for various hospital projects and he readily agreed."

However, Dr. Tufa said it became clear to the board after several months that he was not following the policies.

Committee Chairman Senator Tuiasina Laumoli intervened and asked for the names of the companies, but Tufa said he could not name them because there is threatened litigation against the hospital at this point by the two former LBJ officials.

But he said, an example he can reveal was the employment contracts of the pharmacists hired by the former CEO but had not been approved by the board. He said another example was the contract for US company Renasolve Inc. to provide dialysis services for patients in the community and in their homes.

Dr. Tufa reiterated that the board did not question Dr. Ledua's dedicated service and exemplary reputation as a doctor and orthopedic surgeon. He added that the board has informed Dr. Ledua that he can continue his services as a doctor.

Concerning the termination of former COO Dr. Jean Anderson's contract, Tufa told senators that the board decided that her services were no longer needed.

SECOND HEARING

Dr. Ledua and Dr. Anderson appeared before the committee in the second hearing held after the Senate regular session and according to the former CEO, he was informed verbally by the LBJ Board chairman that he was no longer the CEO after a board meeting on August 21, 2024.

He said he had initially attended the meeting which had taken place in the morning and had been excused while the board deliberated on the appointment of a Chief Medical Officer.

Ledua said it was at the end of the day that he was informed by the board chairman about their decision which was to be effective immediately. He was also told to vacate his office and to return the hospital vehicle that he had been using.

Two days later, he received a termination letter from the board which stated that the basis for his termination was "failure of duty and unsatisfactory performance, as well as violations of the American Samoa Medical Center's policies and procedures."

He said it was generalized and "it specifically stated that he did not follow the directives set forth by the board regarding the management of contacts, committed LBJ financial assets without prior approval from the board of directors, did not adhere to local immigration laws for foreign contract workers and engaged in other similar conduct."

Dr. Ledua declared that since he started to work at LBJ Hospital in 2002, his focus and role have been to take care of patients and save people's lives. He emphasized that since 2002 up to the day he was told that he had been terminated from his role as CEO, has never changed.

Senate President Tuaolo Manaia Fruean asked whether the board chairman's claim that the contract with the US company for dialysis treatment in communities and homes had been signed by him and other unnamed LBJ officials without prior approval from the board.

"Is that true or not?" Tuaolo asked.

Ledua answered, "No it is not."

He said before the contract was signed, he had contacted the board if they would allow the CEO of the US dialysis company to present his proposal at their next meeting. He added that this was after the proper bidding process had been completed.

The board consented and after the presentation, he recalled that the board was very impressed and recommended that he present it also to the Fono.

He said that after the presentation, he had asked the board if it was okay to go ahead and sign the contract. He argued that he was given the green light and that the board had informed him they would not be a part of the signing because they had other things to do.

Ledua said during the interview with local media after the contract was signed, he had acknowledged the board for approving the contract.

Former COO Dr. Jean Anderson in her testimony questioned the timing of the board's decision to terminate their services.

"It comes at a time when Dr. Ledua and myself were uncovering issues regarding grant funding and spending of grant monies," she revealed. "Specifically, we have uncovered issues related to two EMS grants that have been coming through LBJ, as well as EMS funding that comes to LBJ from the Medicaid Office."

She stated that in January of this year, she was contacted by the Department of Search & Rescue EMS Division pleading for help in acquiring EMS funds at LBJ to purchase new tires for their vehicles. They could not access the funds.

Dr. Anderson said that she started to work on getting the funds to SAR/ EMS but was told by the LBJ Board that she could not do this and that any communication or meetings with them was to stop immediately.

She said the board also told Dr. Ledua that they were not happy with her and to instruct her to stop what she was doing.

"I was trying to understand the situation I was in because there was also evidence to show that one of the board directors gave instructions to the LBJ CFO to make a payment of $80,000 to a vendor using funds from the EMS grant," she revealed.

"In addition, we found that one of the board director's wife was being paid under another EMS grant and this has been going on as far back as 2013. This same board director was on the LBJ board back in 2013 when this same issue was brought up by two previous CEOs."

Dr. Anderson also stated that she used to directly oversee the engineering and maintenance department in her role as COO. This department of the hospital is responsible for the projects and one of those projects is the construction and renovation of the morgue and the chapel.

Senate President Tuaolo asked her for the record if she had received any call from himself or any member of the Fono for a chance to get an LBJ project.

Anderson replied no, and that she also never received any call or request from any local contractor.

"However, I received a call from a board director to sole source the morgue and chapel project to a particular individual," she revealed.

She did not give the name of the board member or the contractor.

Tuaolo asked if she was planning legal action against the LBJ Board for her removal, she stated that she had no intention of suing the hospital, in fact, she wants to return to the hospital if LBJ needs her help.

"If not, I have a private practice and I'm very busy with the work I do, but my heart is with LBJ," she said.

Several senators thanked Dr. Ledua for his dedicated service to the people of American Samoa and asked that he continue to work as a doctor at LBJ Hospital.

Senator Alo Paul Stevenson commended him for his service and expressed sympathy for his unfortunate situation, noting that his credibility and future are at stake.

"I don't know what we can suggest, but you have no choice," said Alo. "You've been fired, you've been accused of certain things and this could be in your record. It could be very damaging. I would suggest that you pursue what you need to pursue to clear your reputation.

“But we don't want you to go, we want your service and as always, thank you for the job you do.”

Dr. Ledua thanked the senators for their compliments and stated that just like any other employee, he had worked his way up the corporate ladder until he reached the pinnacle of his career as CEO of LBJ Hospital.

"I am at the stage where I envision my goal of what I want to do in the future," the former CEO said. "And it is my goal that one day, instead of taking care of a patient, I can be taking care of an organization, which has got more impact in a community than a single person that I am taking care of."

He said that his ultimate goal was to improve the quality of healthcare in the Territory so that patients did not need to travel to Hawaii or New Zealand for treatment, but would be treated right here at home.

Tuaolo commented that ever since the hospital was run by a board of directors, many problems have surfaced compared to when it was a government department under the control of the executive branch.

“What is your opinion if the Fono decided to dissolve the LBJ Board and bring the hospital back under the control of the governor just like other directors?” the Senate president asked.

Dr. Ledua replied, “I believe that anything that hinders the progress to better healthcare on this island should be taken care of.

“The goal is not an individual or the board — the goal is healthcare for our people in the years to come.

“We need better healthcare for our people and if there is anything that is going to prevent this from happening, we should seriously think about it and make a decision.

“It is my prayer that God will grant us that wisdom to make the right decision.”

Senator Soliai Tuipine Fuimaono echoed Tuaolo’s sentiments saying that they had worked with the hospital in past years when it was still a government department, and the running of the hospital under the administrator and the medical director had gone smoothly without any major problems.

Soliai said that if Ledua agreed to dissolve the board, the Fono will discuss the motion and if it is approved, they will send a resolution to the governor to return the running of the hospital to the way it was before.

He asked the former CEO what had transpired in his meeting with Governor Lemanu.

“The governor asked me what my plans were and whether I can return and I told him yes I can,” Dr. Ledua said.