L&L Platform

Welcome to our healthcare accomplishment platform, where we celebrate and showcase the incredible achievements and advancements in the healthcare field. Join us as we highlight innovative initiatives, infrastructure improvements, and human capital development strategies that have shaped the healthcare landscape in American Samoa. We are committed to improving healthcare for the people of American Samoa.

ACCOMPLISHMENTS

Infrastructure Improvements The Lemanu and La’apui administration has invested $100M into the LBJ Tropical Medical Center to improve and expand medical services for our people. These significant improvements include:

• They have successfully designed an expansion for the Emergency Room and ICU facilities, significantly enhancing their capacity to provide critical care. In addition, they have increased the number of ICU beds to ensure that each patient benefits from the privacy and comfort of a separate room.
• LBJ Hospital has recently upgraded its COVID-19 and pediatric wards and operating rooms to manage infectious diseases and children’s medical needs and handle various procedures, including labor and delivery.
• Additionally, the hospital has acquired new medical equipment, including an MRI machine and an extra CT scanner, to enhance its diagnostic capabilities. The hospital has established a state-of-the-art COVID-19 Negative Pressure Lab Unit to further improve its response to the pandemic.
• The administration has made significant strides in healthcare infrastructure development. They have broken ground on a state-of-the-art two-story training center, which, upon completion, will house advanced Emergency Medical Services (EMS) facilities and administrative offices. In addition, they have successfully drafted plans for the future development of a cutting-edge physical therapy rehabilitation center and an innovative amphitheater-style meeting room.
• They are upgrading their medical records management and information systems to help them better serve their patients. Additionally, they are optimizing their dialysis services, renovating the surgical ward showers and isolation rooms, modernizing the cafeteria, and improving the efficiency of their billing and coding office.
• The Lemanu and La’apui administrations have allocated an investment of $200 million to create a new specialized hospital to expand the medical services available on the island. in underserved areas on the island. The construction of a fully equipped specialized hospital are part of the Lions Park medical and telecom development project.
• They have successfully designed an expansion for the Emergency Room and ICU facilities, significantly enhancing their capacity to provide critical care. In addition, they have increased the number of ICU beds to ensure that each patient benefits from the privacy and comfort of a separate room.
• Development and design of a 36-bed specialized medical hospital.
• Services designed to address underserved or expansion of services available on the island.
• Services include: Cardiology, Oncology, Urology and other critical medical services.
• New Specialized Hospital will help expand overall healthcare services, allowing our patients and their loved ones to receive more services on island
• The administration has made significant progress in improving the communication infrastructure and emergency preparedness, reflected in the following achievements:
• TEnhancement of Communication Infrastructure and Emergency Preparedness: We have significantly improved our communication infrastructure and emergency preparedness, increasing our ability to manage information effectively.
• Lab renovations are 80% Complete: DOH lab hired two new microbiologists and three medical lab scientists.
• Our administration has successfully allocated $43 million from the American Rescue Plan Act (ARPA) to improve the territory’s preventative health services and strengthen Community Health Centers. This significant investment is expected to support various important initiatives and represents a major achievement in our ongoing efforts to enhance public health.
• Laboratory Conversion: Our administration is undertaking a comprehensive laboratory conversion project. Ofu and Olosega Clinic: Our administration is establishing the Ofu and Olosega Clinic to extend comprehensive healthcare services to underserved areas. This new establishment will mark a significant milestone in our mission to ensure every community member has access to quality healthcare.
• COVID-19 Administration Building: In response to the ongoing COVID-19 pandemic, the administration prioritizes public health by establishing a dedicated COVID-19 Administration Building. This state-of-the-art facility will have the necessary resources to effectively coordinate efforts to mitigate and manage the pandemic's impact.
• Aunu'u Community Health Clinic: We are proud to announce the building of the new Aunu'u Community Health Clinic. This project, scheduled to begin in 2024, is part of the administration's commitment to enhancing healthcare services across regions. Building a state-of-the-art Behavioral Health facility to provide critical mental health services such as in-patient care, comprehensive addiction treatment (drug & alcohol), counseling services, and other essential services. This accomplishment marks a milestone in our commitment to expanding our healthcare infrastructure.
• Secured $5.8M in funding through a strategic alliance with the Department of Health and Medicaid to offer complimentary healthcare services at various community health centers.
• We were awarded a grant of $556,177 for a comprehensive three-year initiative that will address the pressing needs of mental health and substance abuse crises.
• Additionally, we have received substantial funding of $431,000 from the Centers for Disease Control and Prevention (CDC) to strengthen prevention and control programs for HIV, STDs, VH, and TB.
• Received $105,034 in the Maternal and Child Health Program (MCH) funding. This funding will ensure high-quality care for mothers and children in our community.
• We were awarded a substantial grant of $7.2 million from the U.S. Department of Health & Human Services (HHS) to enhance the routine medical care available to our residents and allow us to strengthen our healthcare infrastructure and workforce.
• In the first year of our administration, we were awarded a grant of $725,568 from the Health Resources and Services Administration (HRSA), facilitated by the American Rescue Plan Act. This substantial financial support was instrumental in broadening the scope and capacity of our healthcare infrastructure. It enabled us to undertake capital improvements encompassing construction, expansion, alteration, and renovation projects that have significantly enhanced service delivery and accessibility.

Helping Babies Hear Program (Early Hearing Detection and Intervention) Our administration has achieved significant success with the Early Hearing Detection and Intervention program, with the following accomplishments:

• Deaf Awareness Month: For the first time, Deaf Awareness Month was celebrated in American Samoa. This event underscores our dedication to inclusivity and raising awareness about the deaf community.
• Audiological Evaluations: Despite the border closure in 2019, the administration has persevered in conducting audiological evaluations for children. This commitment ensures the ongoing health and well-being of our younger population.
• Tele-Audiology Services:The acquisition of tele-audiology equipment has been a game-changer, enabling real-time services and significantly enhancing our healthcare delivery system.
• Parent Engagement Activities: The administration has initiated activities to engage parents in their children’s hearing and speech development. These efforts foster a supportive environment for growth and learning.
• Media Outreach: Through media outreach initiatives, including short videos and articles in Samoa News and Talanei News, we have spread awareness and information about our initiatives to a broader audience.
• Deaf Night: Introducing a monthly activity, Deaf Night has provided a platform for deaf adults to participate and foster community and support.
• Partnerships: Establishing an ongoing partnership among the HBH program, Deaf Night, and Parents of Children with Special Needs demonstrates our commitment to collaboration and community support.

Rheumatic Heart Disease Control & Prevention Division 

Our administration has made significant strides in public health and welfare by successfully implementing the Rheumatic Heart Disease (RHD) Program, led by the Department of Health (DOH). As part of the program, we've identified 139 individuals, both children and adults, suffering from this condition and enrolled them in the RHD Program, which is based at the Tafuna Community Health Center.

To ensure that financial constraints do not hinder access to essential medication, we're providing Bicillin free of charge to those enrolled in the program. We've also adopted a systematic approach to healthcare, reminding these clients every 21 days to ensure adherence to their cardiologist's advice. This approach fosters a supportive environment for recovery and ensures continuity of care. Regular medication is crucial for managing this condition.

Tobacco and Diabetes Program & Preventative Health Health Promotion Programs: Our administration, through the Department of Health (DOH), has successfully implemented comprehensive programs to combat smoking, obesity, and diabetes. These initiatives, conducted in local churches and elementary schools, have significantly contributed to promoting healthier lifestyles and preventing diseases. Community Wellness Programs: In collaboration with local wellness organizations, we have completed two community wellness programs at two locations specifically designed for children and adolescents aged 2-19. These programs have played a crucial role in combating obesity in our area.

NURSING

There are notable accomplishments in the nursing services given that we are always short of nurses to provide the necessary medical services and care for our patients. The significant improvements in this important service are:

• The Nursing Division of the Department of Health has successfully completed its Nurses and CNAs Reclassification Proposal, which, once implemented, will help nurse retention and improve health care in the territory.
• Conducted training and courses for Registered Nurses (RNs) and Licensed Practical Nurses (LPNs), such as hyperbaric chamber training and wound care courses.
• One of our significant accomplishments has been the successful recruitment of 36 Registered Nurses from Thailand.
  • Moreover, our administration has helped local nursing staff to grow professionally, resulting in six RNs and seven LPNs passing the NCLEX exam.
  • Our efforts have also extended to Fiji, where three nurses have passed the NCLEX-RN exam, and 18 more are enhancing their skills through a review program at Chaminade University.
  • The Nursing Education team has conducted a comprehensive NCLEX-RN review program for Fijian nurses.
• The administration has prioritized staff development and resource enhancement throughout their tenure. Two registered nurses and two licensed practical nurses completed Hyperbaric Chamber Training, while Nancy Morgan provided wound care education.
  • A total of 12 physicians and 34 nurses received their Neonatal Resuscitation Program certification from AAP, and the same program's in-service was extended to the respiratory therapy staff.
  • The administration created Hemorrhage Carts for the Labor/Delivery room and Maternity unit to prepare for emergencies.
  • Furthermore, two new incubators were purchased for the Nursery/NICU, and nurses and physicians received relevant training.
  • In terms of staff progression, ten phlebotomists were promoted to Lab Assistants, while lab staff were trained to perform COVID testing using PCR and ABBOT ID NOW machines.
  • Lastly, the administration celebrated the achievement of four phlebotomists who passed the Phlebotomy Technician certification.
• The DOH Nursing Homebound Team made significant strides in healthcare. They administered COVID-19 and flu vaccinations to elderly individuals, their caregivers, and family members right in their homes. These home visits were conducted efficiently across all districts, ensuring that older adults received the necessary care.
• Additionally, five students completed the ASCC practical nursing program, with three passing the NCLEX exam.
• Furthermore, the team’s approval to expand Aiga Manuia HOME visits to Manu’a Island in 2022 demonstrates their commitment to reaching underserved communities.

SERVICE IMPROVEMENT

The LBJ TMC successfully enhanced its Community Health and Development services through collaborative efforts to secure services through Faith-Based initiatives:

• The administration has made significant progress in improving community health services. A productive partnership has been established with the LDS Missionary Physicians from the Church of Jesus Christ of Latter-day Saints, who bring diverse medical expertise to the island. Additionally, the hospital's service capacity has been expanded with the addition of various medical providers and specialists. The inclusion of 13 new doctors, in addition to the LDS Mission Physicians, has further strengthened our commitment to enhancing community health.
• Under the Clinician Scholarship program funded by the Governor's office, seven student scholars are pursuing medical education at Fiji National University.
• We demonstrated our commitment to continuous learning and development when our Community Health Center (CHC) staff participated in the annual Uniform Data System (UDS) training held virtually in October. Up to ten staff members attended the training, ensuring our team remains knowledgeable about industry trends and best practices.
• Additionally, our CHC underwent a Virtual Operation Site Visit (OSV) between June and July, resulting in an impressive 82% program compliance score. We quickly addressed the remaining 18% unmet requirements related to the Governing Board, Clinical, and Quality Improvement aspects. As a result, our program is currently under review by HRSA, and we're proud to report that our current compliance status stands at 100%.
• We also invested in a cost-efficient, HIPAA-compliant EHR system exclusively for the Community Health Center (CHC). This purchase marks a significant step towards improving reporting and data quality, enhancing our ability to serve our community effectively.
• In addition, our 340-B program at the CHC has been providing free Bicillin medication to over 150 patients with Rheumatic Heart Disease. Furthermore, we offer free Nicotine Replacement Products to adults who are referred from the CHC primary clinic for smoking cessation. This initiative allows individual patients to enroll in the Tobacco Cessation Clinic, where they receive counseling and free Nicotine Replacement products for eight weeks, supporting them on their journey to a healthier lifestyle.
• Continuing to support the Off-Island Medical Referral program to maintain essential healthcare access for residents. This support ensures that our people can access specialized medical services and treatments that may not be available locally due to limited resources or expertise.
• Additionally, our CHC underwent a Virtual Operation Site Visit (OSV) between June and July, resulting in an impressive 82% program compliance score. We quickly addressed the remaining 18% unmet requirements related to the Governing Board, Clinical, and Quality Improvement aspects. As a result, our program is currently under review by HRSA, and we're proud to report that our current compliance status stands at 100%.
• Continuing to support the Off-Island Medical Referral program to maintain essential healthcare access for residents. This support ensures that our people can access specialized medical services and treatments that may not be available locally due to limited resources or expertise.

The LBJ TMC successfully enhanced its Community Health and Development services through collaborative efforts to secure services through Faith-Based initiatives:

• We established and maintained quarantine sites, ensuring affected individuals had a safe, isolated place. Nutritious meals were provided during their stay.
• Rigorous measures were implemented to maintain clean and safe facility environments.
• We rented facilities, tents, and essential resources to efficiently conduct vaccination and testing operations, streamlining access to crucial healthcare services.
• Passengers and resource support received rental transportation, facilitating mobility and accessibility.
• Adequate staffing and expertise were ensured through personnel costs, allowing us to manage all health-related initiatives effectively.
• Implementing the Talofa Pass program enhanced secure transit options for travelers.
• Continuing to support the Off-Island Medical Referral program to maintain essential healthcare access for residents. This support ensures that our people can access specialized medical services and treatments that may not be available locally due to limited resources or expertise.
• We invested in facilities integral to executing health and safety protocols, reinforcing our pandemic response.
• Procurement of supplies, contractual services, capital outlays, and IDC further strengthened our operational efficiency.

Laboratory Practices in Infection Control and Prevention Services Enhanced safety for healthcare staff by modernizing Personal Protective Equipment (PPE) with the strategic acquisition of Powered Air Purifying Respirators (PAPRs) from 3M. We have also provided dedicated training programs and revised policies and procedures to fortify our defenses against spreading infections.

Increased Funding for Training and Professional Development Services

• LBJ hired a certified health compliance specialist as the Chief of Business Affairs and Auditing to increase revenue collection for services provided.
• Secured a USDA grant for Maternal-Fetal Medicine Telehealth equipment and a TAP grant for specialized training and consulting. Our innovative solution increases prenatal care access through Telehealth medicine. We provide comprehensive training to enhance expertise and service quality. The successful implementation of these telehealth programs has significantly improved healthcare accessibility, advancing quality and reach.
• Obtained funding for the Life Safety Codes Training project, which will assist healthcare facilities in complying with CMS Conditions of Participation by enhancing their hospital's Safety Office program.
• Received funds for the Property Management: Facilities, Engineering & Support Staff Training project to enhance the hospital's Safety Office program to meet healthcare facilities' CMS Conditions of Participation requirements. Adding new doctors and specialists has expanded our capability to provide a wider range of services.
• Obtained funding for HR software and staff training to enhance healthcare HR management. Employees will be taught to meet CMS HR mandates and obligations using evidence-based toolkits.
• Initiated a project to improve financial management in healthcare, develop the workforce, and increase information systems performance. Our evidence-based approach built financial accountability and improved the revenue cycle.
• Successfully trained and certified 5 Patient Care Technicians as CCHT. This is part of our efforts to build a workforce for these services due to the increase in Non-Communicable Diseases, Diabetes, and ESRD patients.
• LBJ employees completed the respiratory care therapy program at Independence University. This shows our commitment to continuous learning and development and is a pivotal step forward in our healthcare services. The employee is eligible to take the Respiratory Technician and Therapist licensing exam, underscoring our dedication to excellence and improving our healthcare services.
• Successfully trained and certified 5 Patient Care Technicians as CCHTs to improve the service needs of patients with Non-Communicable Diseases, Diabetes, and ESRD.
• Upgraded the DOH Tafuna Laboratory facilities, enabling us to conduct tests on the island. This is a significant step forward in our efforts to provide timely and efficient healthcare services.
• Our ASDOH now operates independently, which shows our commitment to self-reliance and efficiency.
• Provision of Communication Equipment to ASDOH: We have recently equipped ASDOH with various communication equipment, including six repeaters and 50 handheld radios. These resources have played a crucial role in supporting our COVID-19 response operations.
• The administration has secured a substantial grant of $2 million from the Substance Abuse and Mental Health Services to improve prevention measures and treatment options, significantly contributing to our ongoing efforts in these critical areas.
• LBJ Pharmacy partnered with the Department of Health to administer vaccines to the staff and the public, resulting in a 98% employee vaccination rate.
• Established a pathway for non-certified pharmacy technicians, with two already enrolled and preparing for the National Board Exam for Technicians Certification, showcasing our commitment to professional development.
• Established a strong partnership with the American Samoa Community College to expand healthcare career opportunities for students and empower the local workforce with training programs.
• We have implemented a unique approach to dialysis treatments that has yielded positive outcomes, including reversed stages for Chronic Kidney Disease (CKD) patients. We have a U.S. Nurse Practitioner with a team of physicians and clinical providers dedicated to providing comprehensive and quality care for our patients.

Dietary Services

• We achieved significant milestones in the kitchen at LBJ. 87% of the kitchen employees completed Servsafe online training. We introduced the Retherm System to different wards, aligned with our sustainability goals and CMS food safety standards.

Laboratory Practices in Infection Control and Prevention

• Enhanced safety for healthcare staff by modernizing Personal Protective Equipment (PPE) with the strategic acquisition of Powered Air Purifying Respirators (PAPRs) from 3M. We have also provided dedicated training programs and revised policies and procedures to fortify our defenses against spreading infections.

Animal Services

• Community Neuter clinics were held at several sites across the island.
• Conducted training for Animal Control Officers (ACO) to allow them to work according to animal services policies and procedures.
• Improved collaboration and teamwork with relevant authorities to provide reports, data, and services related to sheltered animal care, adoptions, animal retrieval, surgeries, and consultation.
• Recognizing the importance of animal health in our community, this administration also allocated funds to establish a modern Veterinary Clinic. This clinic will provide premium healthcare services to animals, ensuring their well-being and contributing to public health.

Breast & Cervical Cancer Program Early Detection Program (BCCEDP) 

• We completed Year 1 (July 2022 - June 2023) of the new 5-year cycle, exceeding our goal of screening 600 women by screening 824 (unduplicated). We conducted Women's Health Village Screening in 35 villages and now offer Women's Breast and Cervical screenings at 4 locations regularly and after-hours.

Environmental Health Services Division

• The Environmental Health Services Division is another area where our administration has made significant strides.
• Sanitary Regulations: For the first time, we have mandated all food and non-food businesses to adhere to sanitary regulations. This has led to over 100 food businesses closing due to unsanitary conditions.
• Government Sanitary Inspections: In a historic first, government agencies and offices have been subject to sanitary inspections. Some of these establishments have been closed or condemned due to unsanitary and hazardous conditions, while others have been given recommendations for corrective actions to prevent further deterioration.

COVID-19 Response Under the administration’s leadership, we have successfully maintained the safety of our community in American Samoa since March 20, 2020. Our borders have been securely closed and diligently adhered to COVID-19 protocols. These measures, crafted with the expert guidance of our federal partners and local healthcare professionals, have been instrumental in safeguarding our community during these challenging times. As we look forward to the future of American Samoa, we take pride in our journey and progress.

• Guided by the COVID-19 Task Force, the administration made difficult decisions that kept COVID-19 in check for almost two years, achieved by no other state or territory. We improved vaccination rates, healthcare response capabilities, quarantine facilities, and pandemic management. Our efforts safeguarded our community's health and well-being.
• In response to our people's heartfelt pleas, the administration undertook the monumental task of bringing our loved ones home. The administration's successful implementation of the Repatriation program, with its chartered flights, quarantine in Hawaii, and travel documentation clearances upon arrival, provided our returning residents with the necessary support during their transition home. This multi-department endeavor, which truly tested our capabilities, brought relief and security to our community and underscored our ability to overcome all challenges and difficulties.
• While posing significant challenges, the global pandemic and border closure also brought to the forefront the long-standing issues the territory has faced: the limited healthcare services available on the island, the need to improve our educational system, meeting the territory's infrastructure needs, and diversifying our economic pillars. The administration has demonstrated its unwavering commitment in the face of these challenges. It has utilized the totality of COVID-19 funding not just to address these challenges but to pave the way for a brighter future for our territory.
• In January 2021, we proactively took decisive action to secure government funding and initiated efforts to repatriate stranded family members. Additionally, we fortified American Samoa against COVID-19 through the COVID-19 Task Force, implementing stringent public health measures and outlining our goals in the multi-phase initial Repatriation Plan. We spared no effort in shielding our shores from the virus.
• In 2021, the second year of COVID-19, over $40 million was meticulously allocated and spent to safely return our family members home, protect our community, and prevent the spread of the virus.
• The Environmental Health Services Division is another area where our administration has made significant strides.
  • In 2021, during our first year in office, we achieved significant healthcare and community service milestones. We received a substantial grant of $187,297 from the Federal Communications Commission, which was used to offset the costs of providing essential telehealth services during the COVID-19 pandemic.
  • COVID-19 Pandemic Response Plan: We have successfully developed and implemented a comprehensive plan to tackle the pandemic, primarily focusing on vaccination.
  • Cloud-based COVID-19 Registry System: We have launched a state-of-the-art cloud-based registry system for COVID-19, significantly enhancing our ability to track and manage the pandemic.
  • Funding for Immunization Program Operations: We have secured a substantial grant of $3.1 million to strengthen our immunization program operations, reflecting our unwavering commitment to public health.
  • COVID-19 Call Center: We have established a dedicated call center for COVID-19, ensuring efficient reminder and recall operations and enhancing our communication with the public.
  • Training for Public Schools in COVID-19 Testing: We have ensured that all elementary and secondary public schools have the necessary training to administer COVID-19 tests proficiently.
  • COVID Tests Conducted: Our relentless efforts have resulted in the conduction of 136,694 COVID tests, marking a significant stride in our ongoing battle against the pandemic.
• The following are the Administration's Funding Accomplishments under the COVID-19 Health Disparities Grant:
  • Successfully recruited three IT technicians to enhance our technical workforce.
  • Established a dedicated helpdesk to support our IT infrastructure and health programs better.
  • Onboarded a Systems Administrator to construct an informative and user-friendly website.
  • Implemented comprehensive training for doctors on Carevue EHR to optimize patient care processes.
  • Initiated specialized training for registration and reporting on Insight to streamline administrative procedures.
  • Invested in funding Cost Share subscriptions amounting to $144,000.00 to LBJ to ensure uninterrupted access to the EHR license.