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Senate rejects governor's choice to head Department of Health

The Senate yesterday rejected the governor's nomination of Seiuli Elisapeta Ponausuia as director of the Health Department, after the nominee failed to garner a majority vote to get confirmation.The vote was 6-yeas and 7-nays, with Seiuli needing to get at least the majority vote of 10 yeas to be confirmed. She was confirmed by the House on Monday following a House committee confirmation hearing last week. Senate rules do not allow a motion for reconsideration once a nominee is rejected.Seiuli's rejection comes on the heels of the Senate also denying Dr. Jacinta Galeai confirmation for the post of director of Department of Education two weeks ago Thursday. In both cases, the next step now for the administration is either to re-submit the same nomination, or submit a new name for the directorship of each of these departments.CONFIRMATION HEARINGPrior to the Senate vote, the nominee appeared earlier in the day before the Senate Health/LBJ Committee for her confirmation hearing.During the hearing, Seiuli informed senators of her 24 years of experience with DOH, and testified that her focus is to further improve services in preventive care, and to work closely with federal and regional partners in the prevention of communicable and non-communicable diseases.Also during her time with DOH, Seiuli said, she has heard the the public outcry over the high cost of health care and medication and this is one of the reasons the department has forged ahead with improvements to the DOH clinics, working closely with LBJ Medical Center to improve service to these clinics (or community health centers) on Tutuila.She said that these were just some of her plans at this point, while a more comprehensive plan for DOH is in place and she was prepared to distribute copies to senators for their review. Seiuli said the comprehensive plan covers the next 12 months and it includes services for Manu'a.It was mentioned several times throughout her confirmation hearing that Seiuli is not a physician, with Sen. Paogofie Fiaigoa pointedly asking her if a DOH director is required to be a physician, to which she replied, the director does not need to be a physician.She pointed out during the hearing that there is a DOH physician who oversees the eight physicians currently employed by DOH, and the director works with those physicians.Seiuli was also asked by Sen. Velega Savali Jr. and Sen. Paogofie Fiaigoa about some problems she had in the past while with the DOH.Sen. Velega wanted to know if the nominee told the governor about them. She replied that she did, and the final decision was left up to the governor. Specific details of the \problems\ in the past were not mentioned; while Sen. Paogofie asked if she was ever involved in a scheme at the DOH, to which the nominee said \no\.Seiuli, who under local law, as director of DOH, would also be the chairperson of the health regulatory board, which overseas the certification of local physicians and medical professionals, was asked by Sen. Fuata Dr. Tagiilima Iatala how she plans to address the issue of having non-U.S. certified physicians be in compliance with the U.S. Medical Licensure Exam (USMLE)Fuata, a retired LBJ physician, said his big concern is the shortage of physicians at LBJ because of the USLME requirement.Seiuli replied that the shortage of health care professionals is not a new issue for American Samoa, and said this is also occurring all over the world, which is faced with a shortage of doctors and other medical professionals.As for the health regulatory board, she said the board is \dominated\ by physicians and other health care professionals who will provide appropriate assistance to address the certification and other health issues, and her role is to facilitate and assist the board.As for LBJ, she said she understands the hospital has plans in place to address the USMLE issue in order to ensure quality care at the hospital.(Through an Aug. 23 executive order, Gov. Togiola Tulafono placed a one-year moratorium on the enforcement of local law pertaining to the licensing of physicians to work in the territory under the USMLE provisions. For more details see