[{"_1":2,"_123":-5,"_124":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,75,87,99,111],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":72,"_74":72},"mediaId",6551461,"mediaKeyId","5335873-35760f3626ccac78ab58260e3272c909","parentId",5335873,"title","CHCC tells House committee budget shortfall risks services without full Medicaid match and Health Network funding","audioSeconds",1161,"startMs",772000,"endMs",1933000,"viewUrl","/Search/View?dp=1&key=5335873-35760f3626ccac78ab58260e3272c909&start=772&end=1933","thumbnailUrl","https://assets.pipeline.soar.com/5335873-35760f3626ccac78ab58260e3272c909/thumbnail_772000.jpg","articleUrl","/articles/6551461/CHCC-tells-House-committee-budget-shortfall-risks-services-without-full-Medicaid-match-and-Health-Network-funding","mediaUrl","https://secure.pipeline.soar.com/6551461-e6061f9b87b36704385bcf1b8643ab86/orig.mp4?Expires=1775400484&Signature=X2qiplQKXK8FR5phGQdZZQHfdt78J1NVpYXgrrFGar~gGUdRn25rYIDCpoX0VU6ukWHvFhq2Nke9wkxCWLGuGBKgKGTULLqVjon0ewZulMYpS1wJUbZcfLtq96yUdFffG1DGvCgJSl9f3dRObNAoJ21n6YIehwpR81k51kpzjZw6VGgpcQnojERnMXmfInEHIip88vLN3dEh9ct5lVaxG-2GmAlzCsuix0WTziAShhFfUNssu6EmXJZC9IWyHALX5IhvjsED7TP9KooLbStRNPkFdvzVcItmnq-d7q495ujwurhpEcn7rxjjNENbSLdA8SmZ-NbxjQQhbk4cPMcvDA__&Key-Pair-Id=KUT5TJCACFTXG","author","House - Northern Marianas Commonwealth Legislature","date","2025-07-08T21:52:52Z","article","Commonwealth Healthcare Corporation leaders told the House Committee on Ways and Means on Aug. 11 that the hospital system faces a projected shortfall unless the commonwealth provides the full Medicaid local match and larger appropriation for the Health Network Program (HNP), the off‑island medical referral program.

The matter was presented by Eleanor Cabrera, chief strategy officer for the Commonwealth Healthcare Corporation (CHCC). “We remain the only hospital and public health provider in the CNMI, serving patients across Saipan, Tinian and Rota,” Cabrera said. She told the committee CHCC delivered “over a 124,000 patient encounters” in 2024 and that Medicaid and Medicare account for nearly 80% of CHCC patient revenue.

Why it matters: CHCC said the commonwealth’s local Medicaid match unlocks federal funding at about a 1:5 ratio; if the local match is not fully funded, CHCC risks leaving federal dollars on the table and absorbing more uncompensated and Medicaid shortfall costs. The corporation reported that when the federal Medicaid cap was reached in FY23 the commonwealth had to cover costs locally, and CHCC absorbed risk and costs as a result.

Key discussion points and figures presented to the committee:
- CHCC’s fiscal 2026 budget request seeks funding to sustain services and support an electronic health record rollout, specialty care expansion and workforce investments. CHCC reported that personnel costs dominate spending (more than $70 million in salaries and benefits in FY24).
- Health Network Program appropriations and spending: The legislature appropriated $1.2 million for HNP this fiscal year; CHCC said it had received $820,000 of that appropriation so far. CHCC reported expenditures for the HNP program in the current fiscal year of $3.4 million and cumulative advances of $3.8 million since it took responsibility for the referral program. CHCC said it has been using hospital revenues to cover the gap.
- Grants and federal funding: CHCC reported $115,000,719 in federal grant awards (performance periods ranging from one to five years) and said grant instability remains a risk (CDC, HRSA, SAMHSA, Medicaid changes noted).
- Uncompensated care: Year‑to‑date uncompensated care was reported at about $7 million for FY25.

Questions from legislators pressed CHCC on where HNP shortfalls had been covered; Aprilita Santos, CHCC chief financial officer, said the hospital used internal operating revenues to cover referral and subsistence costs when local appropriations lagged. Several legislators asked whether the corporation could continue to use hospital funds for HNP. CHCC officials said doing so risks operational stability and that the HNP rules and state plan amendment (SPA) changes will affect cost and reimbursement going forward.

On reimbursement changes, CHCC told the committee the Medicaid SPA that became effective Oct. 1, 2024, should expand coverage to subsistence lodging and ground transportation for off‑island referrals; CHCC said it is awaiting reimbursement processes to be established so the hospital can claim those costs.

Discussion vs. decision: Committee members asked for additional documentation (white paper on MRI impact, updated regs/memos on income guidelines for HNP, detailed HNP overspend by island). CHCC did not receive additional appropriations during the hearing; no formal legislative decision was made at the meeting.

The committee adopted the day’s agenda at the start of the hearing by voice vote.

Closing: CHCC leaders reiterated the link between local investment in Medicaid match and drawing federal dollars: “For every dollar in local match, we unlock nearly $5 in federal support,” Cabrera said. They urged the legislature to consider the full match and HNP funding to prevent service reductions and economic ripple effects.

","mediaType","Video","parentTitle","250709 24th NMCL HoR W&M [2:00pm]","oneSentenceSummary","Commonwealth Healthcare Corporation leaders told the House Committee on Ways and Means that a shortfall in the local Medicaid match and partial funding for the Health Network Program are forcing CHCC to use internal revenues and could reduce services unless the commonwealth increases support.","taxTitle","House, Northern Mariana Legislative Sessions, Northern Mariana Islands","taxId",20281,"location","","headline","shortSummary",{"_33":76,"_35":36,"_37":38,"_39":77,"_41":78,"_43":79,"_45":80,"_47":81,"_49":82,"_51":83,"_53":84,"_55":56,"_57":58,"_59":85,"_61":62,"_63":64,"_65":86,"_67":68,"_69":70,"_71":72,"_73":72,"_74":72},6551442,"CHCC reports hospital passed recent CMS inspection; dialysis findings corrected and accepted",51,2094000,2145000,"/Search/View?dp=1&key=5335873-35760f3626ccac78ab58260e3272c909&start=2094&end=2145","https://assets.pipeline.soar.com/5335873-35760f3626ccac78ab58260e3272c909/thumbnail_2094000.jpg","/articles/6551442/CHCC-reports-hospital-passed-recent-CMS-inspection-dialysis-findings-corrected-and-accepted","https://secure.pipeline.soar.com/6551442-4fe8c7eb17d0951e431abe51a3d3840a/orig.mp4?Expires=1775400484&Signature=Ic2Z5oCkMyeUNfYftMyICEWvswx4-E8olURlS9BIdT5OaFk7fjGLJpt~bh55VYjt5WGIa4zxZPDZvv0~l37rkEVxu1PEiMKj9Oju~2Zs3kBjgzgJnE2Gx3FavTJAV6jZFBoFYS1bsTncQ2s2WTxy7WHnyBbsYBzNRWc1RK4AvVPSKCPSSYyrnKcg3F1InNzMVaj0dbFK5QCyb-O1Mor70W9JGTNzvm16sVhGOhl7Bm0mDqPuJsWz6U6a9F2FLylNA0P630j6Y7t7IZmQw1NSwi6djPY96drd6dIIb~5z4~b5oseaUpCi-PsjveknV7lSi5DbvnxXP9prDzDkNAyf4A__&Key-Pair-Id=KUT5TJCACFTXG","CHCC officials reported to the House committee that federal Centers for Medicare & Medicaid Services inspections found the hospital side met standards during the most recent hospital inspection and that dialysis findings have been corrected.

According to testimony, CHCC was inspected on the hospital side in September of the prior year and officials said the survey found zero conditions of noncompliance for that component. CHCC also reported that a separate dialysis inspection produced findings; CHCC said it submitted corrective actions that CMS accepted.

Legislators expressed relief at the hospital survey result and pressed CHCC on readiness for future inspections and ongoing compliance work. CHCC said it continues work on quality, safety and workforce investments that are part of its budget request.

No legislative action was taken in the hearing; CHCC said it will continue to report on CMS readiness as part of its regular updates to the committee.

","CHCC told the committee that the hospital side was inspected last September and had zero conditions cited; dialysis had findings that CHCC said it corrected and which CMS accepted.",{"_33":88,"_35":36,"_37":38,"_39":89,"_41":90,"_43":91,"_45":92,"_47":93,"_49":94,"_51":95,"_53":96,"_55":56,"_57":58,"_59":97,"_61":62,"_63":64,"_65":98,"_67":68,"_69":70,"_71":72,"_73":72,"_74":72},6551446,"CHCC tells committee it manages dozens of grants, received foundation start‑up donations, and has audit backlog to resolve",3819,2263000,6082000,"/Search/View?dp=1&key=5335873-35760f3626ccac78ab58260e3272c909&start=2263&end=6082","https://assets.pipeline.soar.com/5335873-35760f3626ccac78ab58260e3272c909/thumbnail_2263000.jpg","/articles/6551446/CHCC-tells-committee-it-manages-dozens-of-grants-received-foundation-startup-donations-and-has-audit-backlog-to-resolve","https://secure.pipeline.soar.com/6551446-eb002d84dd2391e74b0b60cd375cb546/orig.mp4?Expires=1775400484&Signature=VKXfBtPQdqdtPsCg8tw46jPJeHrb7GsnUa2856e8dYGI8B4EgpWrBQelc4My0KFmBDM1~8CddGeN2zm2cQNKV9BcWrPgPVNJySl7-UcAPO8tAnts~Zw2x9nBdUhOWpyMDBb6mirRgdb~QuXvyqDrVYaQ5ssHzuYAznv09bPgU3xV~Mnb-gxEcGv5RF4qcl2TQFquo8US5V8ItpBEyGUgdPH84Cv2QtQKz9bQ3zu1H0kVK0fhyRivKQpVeToObp1bWWHQM2yezoGc0BcJyb0ygSGk4-uTWk2k~a4GOtDLA11zNhoWm3DKQQjHz5kfQX8OvgX6zBGy00ErDjpJuAIV~g__&Key-Pair-Id=KUT5TJCACFTXG","CHCC officials described grant activity, the nascent CHCC Foundation, and outstanding audit and financial‑systems issues during the budget hearing.

Grants office and indirect cost: CHCC said it has a five‑person grants management office overseeing more than 50 grants. The CFO said not all grants include indirect cost; CHCC reported receiving about $1,500,000 in indirect cost recoveries that are used to fund cross‑cutting support functions including HR, accounting, procurement, audit and the grants office.

CHCC Foundation fundraising: CHCC said the CHCC Foundation was recently recognized by the IRS as a 501(c)(3) and has begun forming a board. The foundation had a small initial donation (about $5,000 in December) but will need time to build membership and fundraising capacity.

Audit status and Munis: CHCC said the FY2019 audit was completed, auditors are working on FY2020–2021, and FY2022–2023 audits had not yet been contracted. CHCC said there are two qualified auditing firms on island and that limited audit capacity has delayed full audit completion. CHCC also said it now runs Munis on its own server and pays an annual Tyler Munis fee (reported at about $120,000) for that enterprise resource planning service.

Outstanding invoices and OPA fee: The CFO told the committee an outstanding invoice from OPA totaling about $1,300,000 had not been paid from operations; CHCC said it recognizes the liability and prioritizes operational needs such as medication purchases. CHCC requested clarity on funding flows so statutory fees tied to appropriations can be paid.

Receivables and uncompensated care: CHCC said accounts receivable are trending similarly to prior years and that a formal receivable figure would be provided to the committee on request. CHCC reported about $7 million year‑to‑date in uncompensated care.

Legislators asked for follow‑up documentation, and CHCC agreed to provide receivable totals, corrected personnel schedules and its white paper on MRI cost savings.","CHCC said a five‑person grants office manages more than 50 awards and reported roughly $1.5 million in indirect cost recoveries; the CHCC Foundation has begun fundraising but has minimal donations to date; CHCC has an audit backlog and will provide receivable and audit updates to the committee.",{"_33":100,"_35":36,"_37":38,"_39":101,"_41":102,"_43":103,"_45":104,"_47":105,"_49":106,"_51":107,"_53":108,"_55":56,"_57":58,"_59":109,"_61":62,"_63":64,"_65":110,"_67":68,"_69":70,"_71":72,"_73":72,"_74":72},6551451,"CHCC outlines EHR rollout, MRI target date and solar savings; water supply ownership flagged as priority",3302,1459000,4761000,"/Search/View?dp=1&key=5335873-35760f3626ccac78ab58260e3272c909&start=1459&end=4761","https://assets.pipeline.soar.com/5335873-35760f3626ccac78ab58260e3272c909/thumbnail_1459000.jpg","/articles/6551451/CHCC-outlines-EHR-rollout-MRI-target-date-and-solar-savings-water-supply-ownership-flagged-as-priority","https://secure.pipeline.soar.com/6551451-62075f6d03bd3f887f940eb7726f0305/orig.mp4?Expires=1775400484&Signature=bvOEvyJs1GwXz8yhkWMDQpRVzVghuYiEztK-ofsdCFo-~ADGIL1dxmxGSJGjKOTHHxr059OZBI0vAX5RlEsQp~3Mcm3cCa-uimC6vsEm8zUdbgdAJhQxEVS5OMW~C0oc-e3G22f0s~ObyOxQs0bJSp4SleO-RBy12cM8hKqwoEZuV5UJbtmlehcVyaTKDpVyxLMozySuTP9GbXgz5-La8YLpkiJ3T~tTiSO6nyJhq46aA9Bv5ZcmL0XCYWSzDcEotzaGPrY8rl7Q7b4gv69tvHur980~Yyz5yory8mJULOQCKZje3jl416knkDCtBsH44D1wfLbl4MkLuYzdUzTEsQ__&Key-Pair-Id=KUT5TJCACFTXG","CHCC leaders told the House committee they are moving forward on several capital and infrastructure projects that are intended to expand local specialty care and cut off‑island referrals.

EHR and certification: CHCC said it plans to implement a new, class‑awarded electronic health record (EHR) system that will meet TEFCA and CMS certification and help streamline care delivery and reporting. The rollout is part of fiscal‑year planning and was listed among CHCC’s key investments for FY26.

MRI facility timetable: CHCC told the committee the new MRI facility is expected to be operational in about a year, with the CEO stating a projected opening of July 2026. CHCC said it has prepared a white paper on the MRI’s potential to reduce off‑island diagnostic referrals and will provide that paper to the committee on request.

Solar and utilities: CHCC reported a multi‑phase solar project. Testimony said phase 1 was connected in November 2024 and phase 2 was connected in April 2024; CHCC reported nearly $39,000 in electricity savings over the last eight months. CHCC said the system currently lacks batteries, so benefits accrue only during daylight hours. CHCC plans additional phases pending USDA Rural Development approvals and noted that CUC regulation limits the percentage of facility load that may be served by on‑site generation.

Water supply and well ownership: Committee members raised hospital water reliability and a single RO supply line. Representative Vincent O'Don urged CHCC and the legislature to establish ownership or title to the parcel and well that feed the hospital RO system to enable CHCC to pursue water system independence and potential infrastructure funding. CHCC said the lot number is D09 and that ownership and title clarification remains outstanding; CHCC and committee members discussed pursuing legislation or agency action to clarify title and rights.

No formal committee action was taken; CHCC agreed to share the MRI white paper and to continue pursuing grants and approvals for further solar phases and battery procurement.

","CHCC said it plans an EHR rollout and an MRI facility opening in July 2026, reported roughly $39,000 in solar savings over eight months and urged resolution of a well/land title to secure hospital water supply; legislators recommended legislative or interagency action to clarify ownership and pursue grants.",{"_33":112,"_35":36,"_37":38,"_39":113,"_41":114,"_43":115,"_45":116,"_47":117,"_49":118,"_51":119,"_53":120,"_55":56,"_57":58,"_59":121,"_61":62,"_63":64,"_65":122,"_67":68,"_69":70,"_71":72,"_73":72,"_74":72},6551456,"CHCC uses short‑term locum staffing and housing for coverage; legislators press for salary and budget clarity",226,2702000,2928000,"/Search/View?dp=1&key=5335873-35760f3626ccac78ab58260e3272c909&start=2702&end=2928","https://assets.pipeline.soar.com/5335873-35760f3626ccac78ab58260e3272c909/thumbnail_2702000.jpg","/articles/6551456/CHCC-uses-shortterm-locum-staffing-and-housing-for-coverage-legislators-press-for-salary-and-budget-clarity","https://secure.pipeline.soar.com/6551456-0a44fdb4efb3e7db7ae6cfe86b1c136a/orig.mp4?Expires=1775400484&Signature=nmyi~nZV68yZQAbpRR1GwHaPcJMQfcTT6lQpM7GEZDe16tgeIgI9sTslI-l1ZXLKWSeoAGqzxRGEcIaFLX5YRf~Lkr6fcycduirsdzUDYVm8Xu3HrUwZLZytEeR61yQKX0rn50Azy44fouoNlqr7549TBil5hbTzeiSatcec7DFu-STJThL4G8dRBj2uM0wmdLHygHDAMYtZH1IYjtvbc2ZIFiMu5H1VcWS-k0IO3uGfJSd6IcL9qcubgke0Vh3f0xMNRPcDnwXFeR-xdUL7dscCHTrauEFjMEulg7zmIkmgq7GlQJzZEGlawMRIDPVOIUUZrn~owrTNvz5TSfN5BA__&Key-Pair-Id=KUT5TJCACFTXG","Legislators pressed CHCC leaders about staffing, locum physicians and housing during the budget hearing, seeking clarity on where recruitment and housing costs appear in the hospital budget.

CHCC officials said the hospital supplements recruitment with locum physicians for short coverage periods and provides basic housing and short‑term vehicle rental for those contracts. “We provide housing for short‑term coverage,” CHCC leadership said, explaining that locum assignments can be as short as one month or two months and that housing is not provided for hires committed to one year or more.

CHCC reported that the line item in question includes two separate categories: roughly $46,000 per year is budgeted for housing provided to locum providers, while roughly $400,000 in the same subaccount supports inter‑island medical‑referral patient housing for off‑island referrals (rooms for patients from Rota and Tinian while they receive care in Saipan).

On pharmacy staffing, CHCC acknowledged an error in its submission: pharmacy technicians are paid substantially less than pharmacists. The CFO confirmed pharmacy technicians earn about $30,000 annually, while recruited medical providers earn significantly more (CHCC earlier cited national provider hourly averages for recruited providers). CHCC said it will correct budget schedules to fix titles and pay lines.

Legislators asked whether housing or other benefits are included in salary calculations. CHCC answered that housing and short‑term vehicle rental for locums are separate from base salary and that locums do not accrue regular leave benefits. For recruited providers with contracts of a year or longer, housing is not provided as part of compensation.

The committee requested corrected personnel schedules and clearer documentation on the $400,000 housing subaccount to distinguish provider housing from patient subsistence housing. CHCC agreed to update and resubmit corrected tables.

","Committee questioned CHCC on locum physician contracts, housing and pay levels for clinical staff; CHCC said housing for short‑term locums is provided, long‑term hires receive salaried pay without housing; pharmacy staffing titles and pay classifications require correction in budget materials.","actionData","errors"]

Article not found

CHCC tells House committee budget shortfall risks services without full Medicaid match and Health Network funding

CHCC reports hospital passed recent CMS inspection; dialysis findings corrected and accepted

CHCC tells committee it manages dozens of grants, received foundation start‑up donations, and has audit backlog to resolve

CHCC outlines EHR rollout, MRI target date and solar savings; water supply ownership flagged as priority

CHCC uses short‑term locum staffing and housing for coverage; legislators press for salary and budget clarity