FOR IMMEDIATE RELEASE (February 24, 2021 – Hagåtña, Guam) – Bill No. 42-36 (COR), The GMHA Nurse Recruitment and Retention Act of 2021, authored by Health Oversight Chair, Speaker Therese Terlaje and co-sponsored by Senator Joe San Agustin, had its public hearing today under the Committee on Appropriations.  The measure proposes to address perennial nursing shortages at Guam Memorial Hospital Authority (GMHA) which have impacted the hospital’s ability to maximize bed capacity in its ICU, Emergency, and Clinical Areas.

Recently, the GMHA Board of Trustees explored increasing the 16% differential pay for nurses to 22% in order to achieve parity at Guam Memorial Hospital with competing nursing salaries on and off island. However, additional funding was needed to implement this recruitment and retention strategy. The Chairperson of the Board estimated that approximately $827,000 is needed annually to increase the 16% differential pay for RN and LPNs to 22%. Unlike other nurse pay bills, Bill 42-36 fully funds this increase.

The measure proposes to redirect a portion of the GRMC Annual Community Contribution mandated by the terms of their Qualifying Certificate (QC) for the sole purpose of increasing the nursing differential pay at GMH.  The terms of the QC state that community contributions may benefit healthcare with a priority to GMH and DPHSS.

GEDA would also retain $200,000 annually from the GRMC community contribution, which could still be disbursed to various non-profits on-island through the Qualifying Certificate Community Contribution Grant Program. The discretion of these funds would fall under the purview of GEDA.

“With the general fund tracking $100 Million below projections for this fiscal year and the 2022 Executive Budget Request proposing zero dollars ($0) from the General Fund for GMH, it is imperative that a tangible and stable source of funds is identified for Nurse Pay, to shore up gaps in patient care while long-term solutions to expand recruitment and retention are planned and executed,” said Speaker Terlaje.

It was also clear during discussions on the Nurse Licensure Compact that improving pay and the work environment for nurses needed to be addressed concurrently with the implementation of the Compact to stave off potential out-migration of nurses. While this bill does not raise wages for all nurses on island, it does prioritize GMH and ensures there is a viable funding source to pay for this long overdue increase.  It gives GMH more tools and is a step in the right direction towards recruitment and retention of nurses which is sorely needed to find real solutions to our nursing shortage.

“Bill 42-36 provides a 15-year funding bridge for the government of Guam and GMH to build a more sustainable model for patient care which starts with keeping local nurses on Guam,” stated Speaker Terlaje.

To watch the full public hearing, click below:

FOR IMMEDIATE RELEASE (February 21, 2021 – Hagåtña, Guam) – Bill No. 42-36, introduced last month by Speaker Therese Terlaje and co-sponsored by Senator Joe San Agustin, will be heard publicly on February 24, 2021 at 2pm at the Guam Congress Building by the Committee on Appropriations.

Guam Memorial Hospital Authority (GMHA) has faced perennial nursing shortages for decades which have impacted the hospital’s ability to maximize bed capacity in its ICU, Emergency, and Clinical Areas.  Each year GMHA loses nurses due to transfer to off-island and on-island  public or private entities  or retirement, and is forced to recruit at higher costs from off-island. In 2019, the GMHA Board of Trustees implemented a 16% differential pay for all nurses and  specialty pay as part of an overall nurse recruitment and retention strategy.  Unlike other nurse pay bills, this Bill 42-36 fully funds an increase in GMH nurse differential pay to 22%  in order for GMH to better compete with nursing salaries on and off island .  

Bill No. 42-36 (COR) would redirect to GMHA a portion of the GRMC Annual Community Contribution mandated by the GRMC Qualifying Certificate (QC)  for the sole purpose of increasing the nursing differential pay at Guam Memorial Hospital Authority to adequately recruit and retain nursing staff at Guam’s only public hospital.  The Annual Community Contribution was  recommended in §3.12.02 of QC No. 252 to be allocated to health care (priority to Guam Memorial Hospital and Department of Public Health and Social Services), Medicaid matching, MIP payments; public safety; economic development with a priority on the promotion of the medical industry and small business; higher education, and cultural preservation.

“We can immediately improve patient care at GMH by retaining enough nurses for all of the available beds in the ER, ICU and critical care units. An immediate, fully-funded increase in nurse pay for our local nurses at GMH is an ideal retention tool and ideal healthcare use of over $1.2 M from QC contributions for the next  15 years while we build a new hospital, ” stated Speaker Terlaje.  

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See February 18, 2021 article below that appeared in the Guam Daily Post for quotes from Speaker Terlaje during session

Lawmakers close to voting on whether to clip governor’s emergency powers

John O’Connor | The Guam Daily Post

Lawmakers continued to debate Bill 11-36 Wednesday, ultimately moving the legislation into the third reading file for later voting, but not without a few amendments.

Bill 11 proposes to remove the governor’s power to extend public health emergency declarations and place that authority into the hands of the Legislature. 

Guam has operated under an emergency declaration since March 2020, but concerns have mounted with the extended declaration, particularly as some businesses find themselves restricted more than others.

Lawmakers could vote to end the declaration at any time under current law, but that needs majority support and there has so far been no such resolution on the table.

Meanwhile, lawmakers have advocated for additional information from the executive branch on its decision-making during the pandemic, which Bill 11 would allow by requiring the governor to seek the Legislature’s approval for renewals.

An initial emergency declaration lasts 30 days before expiring unless renewed by the governor, or the Legislature – if Bill 11 becomes law. 

Lawmakers extended that initial deadline to 90 days through an amendment from Sen. Telena Nelson on Wednesday, which she proffered in order to grant the government time to develop a “battle rhythm” in terms of combating public health threats.

However, the adopted amendment maintains the 30-day limit for any renewals granted by the Legislature.

Speaker Therese Terlaje proposed to maintain renewals at 30 days, and while she generally supported the intent of the bill, she also asked that the findings be deleted from the measure. 

Terlaje said she disagreed with the finding that the governor has acted “in an arbitrary and capricious fashion” while using her authority during the COVID-19 pandemic. 

“I believe she’s acted in very good faith and tried to protect the people of Guam, but I still believe that all of policymaking and policy rearranging and exemptions from policy would benefit from consultation with the Legislature,” Terlaje said. 

Even if the bill passes, the governor has been against the measure, stating that it violates the separation of powers doctrine and could undermine responses to an emergency. 

Several agencies related to public health and emergency response submitted joint testimony to the Legislature on Tuesday, asking that lawmakers reject Bill 11. 

“Perhaps most importantly, our ability to respond to COVID-19 is contingent on continued funding of our response effort,” the joint testimony stated. “All of our agencies, particularly (the Department of Public Health and Social Services), found their budgets drastically cut in the last session.”

The agencies continue to operate with assistance from the federal government, through the Coronavirus Aid, Relief and Economic Security Act as well as reimbursements from the Federal Emergency Management Agency, according to the joint testimony.

Krystal Paco-San Agustin, the governor’s spokeswoman, said federal aid packages are being provided “because every state and territory is in a public health emergency.” 

“Every state and territory has responded differently and the effects on each community (are) different. On Guam, we have done our best to respond to the pandemic, keeping in mind that our highest priority is the health and safety of our people,” Paco-San Agustin said. “Even the CNMI who has not had any community spread of COVID-19 for months is still in a state of emergency. Until we reach herd immunity nationally and internationally a true public health emergency will exist.”

The agencies that wrote to the Legislature stated that if Guam were to end the public health emergency, then it will be essential to identify local resources to support community needs.

That may prove difficult as budget cuts were adopted due to reduced revenue expectations and even then, fiscal year 2021 is tracking to end with a shortfall. 

The local government may receive another $661 million in federal aid through the third round of federal COVID-19 aid.

Terlaje stated that “from all indications” the receipt of this potential funding is “not contingent on the declaration of a health emergency according to Chapter 19” of Guam law, nor would Bill 11 affect the receipt of those funds, she added. 

“What might be affected by this bill is how we move forward in recovery, and how we allocate the $661 million. And it might affect who on Guam will be taken care of and who won’t be. I think it’s a very legitimate question for the Legislature to be involved in because it is the Legislature who’s going to have to allocate remaining government of Guam funds as necessary to those not covered by federal funds.” 

FOR IMMEDIATE RELEASE (February 15, 2021 – Hagåtña, Guam) – With the support of her colleagues, Speaker Therese Terlaje successfully moved Bill 39-36 (COR) to the voting file during the first regular session of the 36th Guam Legislature.  The measure seeks to strengthen enforcement of terms imposed by the Guam Land Use Commission (GLUC) for conditional use permits, variances and zone changes.  Often the GLUC imposes conditions or covenants to address concerns about projects that were brought up at municipal public hearings or through the regulatory agency review process.

Because these conditions are difficult to enforce after a project is completed, the measure would amend the law to increase the Department of Land Management’s (DLM) role in ensuring compliance at three additional stages: during the building permit phase, at the certificate of occupancy phase, and at the approval of business licenses.

There are many examples of projects that despite media and community outcry have not followed through on the conditions placed on them by the GLUC.  Additionally, DLM testified that they do not have a ready list of projects that aren’t in compliance with these conditions and the authority to enforce zoning resides with the Building Official at the Department of Public Works.

“I found it difficult to even track down the conditions of several projects, let alone monitor if those conditions have been met years later.  This bill could close these potential gaps in the ability to ensure projects are compliant by creating opportunities at multiple layers to catch any violations and work with project managers to rectify these issues before it’s too late,” said Speaker Terlaje.

In addition, the Bureau of Statistics and Plans Coastal Management Program also testified at the public hearing that there is no clear mechanism to enforce compliance for stormwater management and environmentally based requirements other than directly through the Territorial Seashore Protection Commission, which is the Guam Land Use Commission, and asked that TSPC enforcement be strengthened as well.

Speaker Terlaje stated, “This bill seeks to remedy the enforcement of terms and conditions of conditional use permits, variances and zone changes by actively including the Department of Land Management to be another check as to whether those conditions or terms are being applied in the project to protect our communities, residents and businesses in our villages and to keep them safe.”

Bill 39-36 proposes to give more authority to the Department of Land Management to enforce terms and conditions imposed by the GLUC even if the property is transferred. The Oversight Chair of the Committee on Health, Land, Justice and Culture added co-sponsors on the bill during session including Senators Chris Duenas, Joanne Brown, Telo Taitague and Sabina Perez.

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FOR IMMEDIATE RELEASE (February 3, 2021 – Hagåtña, Guam) – Guam Memorial Hospital Authority (GMHA) has faced perennial nursing shortages for decades which have impacted the hospital’s ability to maximize bed capacity in its Acute, Emergency, and Clinical Areas.  Each year GMHA loses nurses due to retirement, resignation, or transfer to other public or private entities on island or off-island opportunities. Recently, the GMHA Board of Trustees have explored increasing the 16% differential pay for nurses to 22% in order to achieve parity at Guam Memorial Hospital with competing nursing salaries on and off island but were lacking a funding source to implement this recruitment and retention strategy.  

Bill No. 42-36 (COR), introduced by Speaker Therese Terlaje and Senator Joe San Agustin would redirect a portion of the Annual Community Contribution amount mandated in the Qualifying Certificate (QC) to GRMC to GMHA for the sole purpose of increasing the nursing differential pay at Guam Memorial Hospital Authority to adequately recruit and retain nursing staff at Guam’s only public hospital.  The Annual Community Contribution were recommended in §3.12.02 of QC No. 252 to be allocated to health care (priority to Guam Memorial Hospital and Department of Public Health and Social Services), Medicaid matching, MIP payments; public safety; economic development with a priority on the promotion of the medical industry and small business; higher education, and cultural preservation.

“The nursing shortage at GMH has been well documented for years, underscoring the need for long-term solutions that incentivize filling and maintaining these crucial positions at our only public hospital.  We cannot afford to lose our local nurses to off-island opportunities and must attract and retain our most talented nurses in order to provide the best patient care possible for our community,” stated Speaker Terlaje.  

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FOR IMMEDIATE RELEASE (February 2, 2021 – Hagåtña, Guam) – On behalf of the Guam Legislature, we join the people of Guam and the family of former Democratic Senator Edward T. Charfauros in mourning his passing. Senator Charfauros was elected by the people of Guam to serve our island in the 13th, 14th, 15th, 16th, and 17th Guam Legislatures from 1975 to 1983 and served as a member of the second Special Commission on Political Status from 1975 to 1976.

“I extend my most sincere condolences to the Charfauros family. Senator Charfauros’ legacy lives on through them and the impacts that his work has had on the people of Guam – from supporting our children’s educational needs to ensuring that residents had access to essential utilities and that a responsible and visionary policy for the development of tourism was established,” stated Speaker Terlaje.

During his tenure in the Guam Legislature, Senator Charfauros dedicated his time and work in sponsoring laws that established a vehicle registration notification program, renovated the Inarajan Pool, reserved land for Inarajan Junior High School, provided assistance to non-profit corporations organized for the furtherance of the CHamoru culture, paid public safety officers their overtime pay, provided uniforms, supplies, and equipment for the Police Reserve Command, completed the construction of Agat Junior High School, installed adequate waterlines and pumps in Talofofo, and established a policy for the orderly planned growth of tourism to result in the maximum benefit to the people of Guam.

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