EMS on its own until Ex Order for Search and Rescue rescinded

Pago Pago, AMERICAN SAMOA — LBJ Tropical Medical Center’s hands are tied despite the budget issues faced by the Emergency Medical Service’s (EMS), which has created a lack of supplies and services.

“Until the Governor’s Executive Order is rescinded the hospital cannot do anything about their situation,” said the LBJ Chief Executive Officer, Moefaauo Bill Emmsley in an interview with Samoa News.

The operation of EMS is in a limbo due to the lack of necessary “supplies” required to carry out their work, as confirmed by EMS Chief Galumalemana Popo Avegalio during a phone interview with Samoa News on Monday.

Samoa News received complaints from several EMS personnel saying that sometimes they are paying for fuel to move the ambulances, out of their own pocket and they deem this unacceptable.

 “I can confirm we have not received our budget for the last four months for our supplies, which is critical to our operation,” said the EMS chief.

 “We are in a limbo because we don’t have a budget. We don’t have medical supplies, pharmaceutical supplies; medical gasses such as oxygen and fuel, which is critical to our line of work.

 “We are rationing now our supplies and it’s evident from the Fono leaders that our budget had since been transferred back to the LBJ hospital and we are still waiting,” said the EMS chief.

A sit down interview with Moefa’auo at his office yesterday confirmed that the hospital is paying for EMS personnel salaries up to December 2022, which amounts to half a million dollars for the first quarter of the current financial year.

 “We understand the EMS performs a vital service, but the hospital cannot help them and that is just the way it is,” he said.

Put to the CEO that the budget for Fiscal Year 2023 for the EMS submitted by the govt was channeled through the Search and Rescue Agency, however the lawmakers transferred it back to the LBJ — so where is the funding?

Moefaauo said when the EMS was transferred to the Search and Rescue Agency via the Governor’s Executive order, the transfer was only personnel and assets, not funding.

 “The hospital does not operate on a paper budget, we operate on real money. Let me elaborate on that, when we submit a budget it’s just for the [lawmakers] to review what we’re going to spend it on and why as required by law. But in reality it’s what’s in the bank that matters. 

 “This is what I mean about paper money (referring to the budget) and what matters to us is the real money that is in the bank that we can write checks on. The budget is more of a guidance for us, but the real money is in the bank,” he said.

Asked whether the budget proposed by the hospital to the fono for the current fiscal year matches the funding the hospital has in the bank, Moefaauo said no.

 “What we have in the bank consists of grants and revenues, so that is how we operate and what’s in the budget does not fund the hospital. It is just a guide for the hospital on how to use the funding.”

He gave an example. Government Departments don’t have money in the bank and when they need something they have to go through the Treasury to get the money, whereas the hospital goes directly to the bank for their money.

 “So when the Fono said the budget for EMS has been returned to the hospital, there is no money.”

He said prior to the transfer the EMS budget was between $1.8 million to $2 million.

Asked why was the EMS transferred without funding, Moefaauo said they made a deal with the Search and Rescue Agency Director, Faamasino Upuese Galoia when the Governor’s Executive Order came in play back in July.

 “There was some leftover money by July and we funded the EMS salaries right up to the closing of the last financial year September 31, 2022 but then we felt sorry for the EMS and carried on paying their salaries up until December 31, 2022.

 “Their salaries are covered for the first quarter for the current financial year and that’s out of the hospital’s budget,” explained the CEO.

According to Moefaauo, the Search and Rescue Agency pleaded with the hospital to pay the EMS personnel salaries for the first quarter and that’s what they did.

Samoa News reached out to Galoia for comments on the issue at hand and to date there has been no response.

The hospital CEO reiterated that as long as the Governor’s Executive Order exists they cannot lend a hand to the EMS.

Samoa News asked whether the hospital will entertain the idea of taking the EMS under their wing, the CEO said he would need to get clearance from the hospital Board.

 “The removal of the EMS is nothing new this is the second time it’s happened. Not too long ago, the EMS was transferred away from the hospital, but then it was transferred back.”

The CEO said in his professional opinion is the EMS sould be a stand alone agency.

 “In other states and counties, EMS is not attached to any hospital. Their service is independent and that they fall under the government. For example, for Honolulu the EMS falls under the government services and they are not attached to any hospital, all they do is uplift patients and drop off to the nearest hospital.

But in our case, we are unique as we are the only hospital on island.

 “I guess some arrangement could be made for the EMS to be a stand alone agency, but then there is the issue of funding which is a key component. EMS operations is quite expensive but it is a vital service that should be available to our people,” said the CEO.

Moefaauo also commented on the legal authority empowering the Governor’s Executive Order.

The Executive Order at hand is a prerogative given by the law to the Governor and in this case it’s a short -term solution until the Search and Rescue Agency is established by statute.