Chapter 01 - American Samoa Medical Center Act
Chapter 01 - American Samoa Medical Center Act
American Samoa Medical Center, hereinafter "Medical Center" is established as an independent agency of the Executive branch of the American Samoa Government.
The Medical Center has the powers and duties:
(1) to provide quality medical attention within the constraints of available resources as required by statute;
(2) to operate, manage, and supervise all hospital facilities and functions of the Medical Center; and other medical facilities that may in the future become part of the Medical Center through construction, purchase, or lease;
(3) to provide mobile emergency services;
(4) to hire, supervise, and discipline health service professionals and other employees as necessary to fulfill its duties in accordance with the laws and rules applicable to American Samoa Government employees and 13.0108 of this act;
(5) to obtain expert advice and consultation in matters related to the operation of the Medical Center;
(6) to procure, purchase, lease or otherwise acquire personal property of every kind in accordance with American Samoa Government procurement laws and rules and regulations promulgated by Medical Center pursuant to this act;
(7) to hold, enjoy, inventory, and account for personal property of every kind;
(8) to sell and convey personal property of every kind in accordance with American Samoa Government procurement laws and rules or rules and regulations promulgated by Medical Center pursuant to this act;
(9) to obtain, manage, and expend financial gains for the purpose of transacting its business;
(10) to directly receive, and expend, federal grant funds as a sub-grantee of the American Samoa Government;
(11) to operate Medical Center financial accounts and to provide accounting therefore in accordance with generally accepted accounting principles;
(12) to establish and publish schedules of charges and fees for services in accordance with the Administrative Procedures Act, 4.1001 et seq. A.S.C.A.;
(13) to provide the Governor and the Legislature with quarterly financial reports, and an annual report each;
(14) to adopt administrative rules pursuant to the Administrative Procedures Act, 4.1001 et seq. A.S.C.A., as are necessary for the efficient and effective administration of the powers and duties of the Medical Center;
(15) to work with the Department of Health to coordinate activities directed toward health promotion and illness prevention; and
(16) to take such other action as is necessary to accomplish the full and convenient exercise of the foregoing powers and duties.
(a) The Medical Center shall be governed by a Board of five Directors.
(b) The members of the Board of Directors shall be appointed by the Governor and confirmed by the Senate, and may be removed by the Governor only for cause.
(c) The Board of Directors shall be constituted as follows:
(1) two members with extensive financial or business management experience;
(2) one member who is an active or retired Medical Doctor;
(3) one member who has extensive health care administration, or public administration experience; and
(4) one member at large.
(d) No more than two Directors may have their primary residence outside of American Samoa.
(e) No director may serve while also employed by the Medical Center.
(f) The Medical Director, Chief Executive Officer, and Chief of Nursing Services, of the Medical Center, may serve as ex officio board members, without vote, at the invitation of the five voting members.
(g) Upon the effective date of this chapter, the Governor shall appoint five Directors for terms of one, two, three, four, and five years respectively, in order to establish staggered terms. Subsequently, the Governor shall make appointments for such periods as will maintain staggered terms, but with no term exceeding four years.
(h) Any vacancy arising during an unexpired term shall be filled by appointment of the Governor. Recess appointments may be made to fill vacancies caused by death, resignation, or removal for cause if the vacancy occurs while the Legislature is not in session. Recess appointments shall expire at the conclusion of the next following regular or special session of the Legislature if they are not confirmed during that session. Incumbents may continue to serve after the expiration of their terms until a successor is appointed and confirmed.
(i) The Board shall meet at least once per quarter. A quorum is three Directors. The Board may meet via video teleconference or by telephone.
(j) Board members shall be compensated at the rate of five thousand dollars per year, except the chairperson, who shall be paid six thousand dollars per year. Non-resident board members shall also receive compensation for necessary travel, lodging, meals, and telecommunication expenses incurred in the performance of their duties.
All powers and duties vested in the Medical Center shall be exercised by the Board. In carrying out its functions, the Board shall also:
(1) elect officers at its first meeting, including a chairperson, vice-chairperson and others as the Board deems advisable. Thereafter, the Board shall elect officers annually at the first meeting of each fiscal year;
(2) appoint, supervise, and prescribe duties and compensation for the Chief Executive Officer, Chief Financial Officer, and Medical Director;
(3) ensure that the Medical Center employs well-qualified, competent medical and other professional, ancillary, and clerical staff;
(4) ensure that all Medical Center facilities and equipment are kept up-to-date and in good condition;
(5) adopt criteria and implement a process which ensures that decisions for making off-island medical referrals are based upon a rational, consistent, informed, and fair determination of medical necessity in accordance with the existing diagnostic and treatment capabilities of the Medical Center;
(6) provide for an accurate accounting and financial management system, and review the monthly operation statements and other financial reports as it deems necessary;
(7) negotiate agreements to make Medical Center resources available to the Department of Health when necessary to perform public health duties and respond to public health emergencies; and
(8) submit reports to the Governor as he directs from time to time.
The Chief Executive Officer shall be responsible for the overall management of the Medical Center's operations under the direction and control of the Board of Directors. The Chief Executive Officer shall report directly to the Board of Directors.
The Chief Financial Officer shall be responsible for the financial management of the Medical Center's operations under the direction and control of the Chief Executive Officer. The Chief Financial Officer shall report directly to the Chief Executive Officer.
The Medical Director shall be a physician who shall be responsible for maintaining the quality of professional medical care provided by the Medical Center. The Medical Director shall report directly to the Chief Executive Officer. For the purposes of this act, a physician is defined as a medical doctor, or equivalent; an osteopath; or, a medical officer, who is also licensed to practice medicine in American Samoa.
All officers and employees of the Medical Center other than the Chief Executive Officer, Chief Financial Officer, and Medical Director, are hired and compensated in accordance with the requirement of the American Samoa Government personnel laws, 7.0101 et seq., except that the Board may adopt administrative rules, pursuant to 4.1001 A.S.C.A., et seq., to supplant government employee rules in the specific categories of personnel recruitment, employment, termination of employee services, disciplinary action, and compensation at levels comparable to prevailing medical service levels. The status of Medical Center career service employees remains unchanged by this act.
The Medical Center shall establish Medical Center financial accounts. The use of the accounts shall be restricted to transactions authorized by the Medical Center and no funds deposited into the Medical Center accounts may be withdrawn for any other purpose. All revenues generated by the Medical Center, third party payments, federal medicaid funds, medicare reimbursements, grants specifically allocated to the Medical Center and its purposes, tax revenues specifically earmarked by law for Medical Center purposes, donations, gifts, and funds appropriated by the Legislature for the Medical Center, shall be deposited into the Medical Center accounts. One twelfth of the amount annually appropriated by the Legislature for the Medical Center shall be deposited into the Medical Center accounts no later than the fifth of each month. The Medical Center shall use its accounts to pay all of its debts and liabilities, including payroll and operating expenses.
The Medical Center is responsible for the program planning, accounting and financial management of its operations and shall administer all accounting systems, including general ledger, fixed assets, accounts receivable, accounts payable, payroll, revenues, and cash through the Medical Center revenue fund.
The Medical Center may contract for the procurement of supplies, equipment, materials, personal services, and construction, with any public or private entity upon the terms and conditions it finds necessary to the full and convenient exercise of its purposes and powers, subject to all applicable laws and rules of American Samoa. The Chief Financial Officer of the Medical Center shall act as the procurement officer for the purposes of this act. A.S.C.A., 12.0209 is amended to reflect this change. The Medical Center shall receive and account for its inventory of materials, supplies and equipment.
The Medical Center shall prepare an annual budget sufficient to support its operations and planned improvements, and to provide basic health care services of acceptable quality and scope. The annual Medical Center budget shall be submitted to the Governor, for submittal to the Legislature as a part of the Governor's budget.
The Attorney General of American Samoa, as the attorney for the American Samoa Government, shall represent the Medical Center with respect to all legal matters. The Medical Center at its own discretion may retain the services of a private attorney.
The Medical Center shall have control of all personal property used in connection with the operations of the existing hospital. The Medical Center shall have the right to occupy all real property currently occupied by the existing hospital, but the authority to control the future use of such real property shall remain with the Governor. Property jointly used for hospital and other government functions must be equitably allocated between government agencies and the Medical Center. All American Samoa Government employees currently assigned to the hospital shall be under the control of the Medical Center. In the event of a dispute, the reallocation of existing resources shall be determined by the Governor. Upon completing the re-allocation of existing resources, the Medical Center shall provide the Governor with an inventory summarizing the disposition of all property and employees affected.
The Medical Center shall pay all debts and liabilities incurred in its operation. The Medical Center shall itemize all existing debts and liabilities and submit allocated to the Medical Center and which debts should be allocated to the general fund.
This act is effective immediately upon passage by the Legislature and approval by the Governor, due to the emergency need to satisfy the federal requirements for continued eligibility of American Samoa's Medicare and Medicaid funding for the LBJ Tropical Medical Center.
Notwithstanding the effective date of this act, the Medical Center shall adopt a transition timetable and schedule for the reasonable and prudent transfer of administrative and financial management functions required by this act.