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Latest LBJ Hospital budget hearing postponed again — to today

Senate President Tuaolo M. Fruean

Pago Pago, AMERICAN SAMOA — LBJ Hospital’s CEO Dr. Akapusi Ledua apologized to the Senate and House Joint Budget Hearing for the late submission of their budget last week.

However, the same LBJ team from last week —  Chairman of the LBJ Board, Dr. Malouamaua Tuiolosega, LBJ CEO Dr. Ledua and CFO Sefanaiya Kaumaitotoya — showed up this week Monday with a different budget total, from “$95 million as of Friday last week, to a $97 million this week Monday” as noted by Representative Larry Sanitoa.

 The Budget Committee co-Chair, Vailoata Eteuati Amituana’i pointed out that three items, "a thick book, that was received from LBJ last Friday, and an envelope with several new documents, along with a letter from Executive Director of the LBJ board, Dr Jean Anderson received today [Monday Sept 18, 2023]” had not been reviewed by the Committee.

Senate President Tuaolo M. Fruean suggested postponing the LBJ hearing again to Wednesday [today] this week to allow them time to view LBJ’s budget proposal.  

In the meantime, the LBJ Board Chair excused himself for a trip off island to see his brother overseas and while there to see about the availability of doctors, saying he most likely would be coming back Monday next week. “but there are other board members who’d be able to sit in.”

The House agreed that with or without him, the Budget Committee would go ahead with the LBJ hearing for today, Wednesday, Sept. 20, 2023.


At last week’s joint budget hearing, Faipule Larry Sanitoa was the first to question the LBJ team, raising several concerns:

1.  The source of LBJ’s revenue numbers with Medicaid that are listed at $43 million, Medicare at $8 million, and the DOI subsidy of $9 million, and noted an increase of $3 million, and the missing $4.5 million.

2.  What the employment status of new employees hired using ARPA funds  was — contract or career service.

3.  The board or CEO did not have the authority to create a new position, in this case an Executive Officer, that was listed in the hospital’s organizational chart in between the Board and the CEO.

4.  The responsibilities of the newly created Executive Officer position seems to duplicate those of the CEO.

5.  The salary of the EO position.

6.  The criteria used for the salary of the LBJ CEO.

7.  The current amount of compensation — stipends — of the LBJ Board of Directors was not within the law and the source of funding if the stipends exceed the amount currently listed in the FY 2024 budget.

In discussion of whether the LBJ FY 2024 budget should be returned to the hospital to be ‘re-worked’, House Vice Speaker Fetu Fetui said that he had spent the night looking over the LBJ budget, and stated that it was obvious that the proposed budget was not well prepared and he moved to return it to the hospital to rectify the areas that need more work and clarification.

However, Senate President Tuaolo Manaia Fruean disagreed, instead suggesting for members to look at what's wrong, as they have the power to cut down salaries, but about the stipend funding, Faipule Faimealelei Anthony Allen is a member of the LBJ Board himself. 

Sen. Soliai T. Fuimaono also disagreed with Fetui, saying there are two most important departments in the government, the Health department and Education.

Sen. Togiola Tulafono, in support of Fetui, said they should allow the LBJ team time to look at their numbers. As even with the budget for employees, if they accept this budget as is, there'd be a shortage of a million dollars.

He pointed to the discrepancies in the organizational chart as well as errors in fringe benefits listed, and also did not support the performing of two professional positions by one person referring to the CEO also practicing medicine.

“If he is the CEO, then he should stick to the duties of a CEO, not treat patients,” Sen. Togiola stated. It’s “the most ridiculous thing I have ever heard."

The LBJ team responded to the comments about their FY2024 budget needing more work, saying this is the first time they've cleared a LBJ hospital audit with an unqualified opinion and audit, and that it’s also the first time the hospital leaders had asked different divisions of LBJ to write up their own divisional or departmental budgets, with help from the steering committee (fesoasoani iai le komiti faafoe ma taitai). 

In the end, the LBJ Team was told to return on Monday, Sept. 18, 2023 with their ‘adjusted’ or ‘corrected’ FY 2024 budget.