FOR IMMEDIATE NEWS RELEASE (April 17, 2019 – Hagåtña)

Senator Therese Terlaje and Senator Sabina Perez were concerned after hearing several government agencies’ comments on the Mariana Islands Training and Testing (MITT) draft Supplemental Environmental Impact Statement (SEIS) and are encouraging all to have a say in the health and well-being of our livelihood and environment as impacted by military testing and training in our region.  The April 17^th deadline has been extended to April 27^th for the public to submit comments to the Department of the Navy on the proposed actions in the draft Supplemental Environmental Impact Statement (SEIS). 

The draft SEIS is an update to the 2015 Final MITT Environmental Impact Statement/Overseas Environmental Impact Statement (EIS/OEIS) and is intended to assess potential environmental impacts that would be caused by the Navy’s training and testing activities that include the use of active sonar and explosives.  This study area encompasses 984,601 square nautical miles of the entire ocean across and beyond the Mariana Islands, which is larger than the states of Washington, Oregon, California, Idaho, Nevada, Arizona, Montana and New Mexico combined.

Currently, the Navy’s permit allows 12,580 detonations of various magnitudes per year for 5 years, and 81,962 takings (or killings) of 26 different marine mammal species per year for 5 years. 

On August 15, 2019, Senator Therese Terlaje and Senator Sabina Perez conducted a joint informational briefing on the 2019 MITT Draft Supplemental EIS and invited Bureau of Statistics and Plans, Guam Environmental Protection Agency, Department of Agriculture, Guam State Historic Preservation Officer, Guam Preservation Trust, Guam Historic Preservation Review Board, Guam Waterworks Authority, and Guam Solid Waste Authority to share their expertise and comments on the potential impacts of the MITT on Guam’s environment, resources, cultural sites, and health.

Agencies highlighted various concerns:

Brent Tibbets, Biologist with Fisheries Section of Guam Department of Agriculture

He states, “reviewing the EIS, there are several portions of it that are comment worthy. I guess I would say one, of course, is the potential to interact with marine mammals with the activities that we see being proposed. Sonar, vessel interactions, explosive detonation in the water, all of these have the potential to impact marine mammals. One of the concerns from the EIS is that for all of the marine mammals that are mentioned, I don’t think there’s a single one that has the most current information available listed with it. We have information on strandings, on sightings, on whales sighted giving birth that were not mentioned in the EIS anywhere. And I’m not certain where that information was gotten from, but all of this information that was provided to our federal partners as well as that we have available, was not mentioned in the EIS.”  He continues to state, “We do have additional stranding records. We have additional records of marine mammals identified giving birth in the region. One of particular concern is the mention of the Agat offshore mine detonation site. That’s almost precisely where we have photographic evidence of sperm whales giving birth which are both marine mammal and endangered species listed organisms. Though it’s not listed anywhere in the EIS that incidents like that. Another area of concern is vessel strikes. Vessel strikes with marine mammals are addressed in the EIS but we have a greater incidence of vessel strikes with sea turtles on Guam. We’ve had at least five sea turtles killed by vessel strike in the last seven years on Guam that we’ve been able to identify. It’s difficult to identify the vessel that did strike the turtle. Nearly all of these occurred in inner Apra Harbor which is pretty much closed to all activity except military vessel activities. So the implication is that it could be military vessel strikes that are causing the sea turtle mortality. Another area in the EIS is mentioned… a large area to southeast of Guam Whiskey 517 is an area it was mentioned. It was very closely related to some offshore fishing banks where we documented a fair amount of fishing activity. In the last two years those banks have been off-limits about a 120 days, an average for the last two years which is about a third of the year for activity and primarily for fishing activity. Now they do fall just outside the range that is delineated but we’ve had fishermen report that when they get down to the banks there are military vessels that are telling them to not enter while activities are going on even though they’re outside the area.”

Edwin Reyes, Administrator, Guam Coastal Management Program, Bureau of Statistics and Plans

He states during his slide presentation regarding the MITT process, “it’s going to be a discussion on mitigation or project adjustments.  So this is an engagement process where we can understand the project fully but then also work to ensure that the resources of the territory are protected.”  He further states, “so the initial concepts that we’ll be looking at just by reading the executive summary (of the SEIS) one of them is marine habitat. So we want to ensure that military expended material will not pose contamination threats as material breaks down. This is not only a direct impact as the detonation occurs but any particles that may be consumed by organisms that can affect the food chain.  We’re not looking at just the moment but what could happen after the activity takes place.  We are concerned about any kind of seafloor detonations within our coastal zone and this doesn’t matter if there’s no corals on hard bottom or substrates.  With or without the presence of coral we know that the hard bottom substrate is an important area where coral polyps can settle and we want to be sure that that habitat is protected.”

Jesse Cruz, Administrator, Guam EPA’s Environmental Monitoring and Analytical Services

He mentions 12 different issues with the draft SEIS.  Two of the 12 issues are the following: “At minimum, a yearly report should be produced summarizing all activities identified in the MITT.  There is no current mechanism to evaluate if the activities and quantities identified in the MITT are met or exceeded.  Report should also address any impacts to stressor types.”  Additionally, he states, “Neither the 2015 MITT nor the 2019 Supplemental MITT have a discussion on the rational for an increase from a 10 lbs. underwater mine charge to the new standard of a 20 lbs. charge for the listed mine detonation activities.  What is the justification for the increase?  This needs to be further explained and justified.” 

Joe Quinata, Chief Program Officer, Guam Preservation Trust and

Dave Lotz, Member of Guam Historic Preservation Review Board

Regarding the Cultural Resources section of the draft SEIS, the State Historic Preservation Officer was not present at the informational briefing but did relay to her oversight chair that her concern was that the list of cultural resources referenced in the SEIS does not fully incorporate all the cultural resources that may be impacted.  Representatives from the Guam Preservation Trust and the Guam Historic Preservation Review Board echoed the SHPO’s sentiments.

The draft SEIS for the MITT is available at https://mitt-eis.com/.  The public is encouraged to submit their comments at https://mitt-eis.com/ by April 27, 2019.

Terlaje and Perez both reiterate, “Guam does not have a seat at the table to say yes or no to the detonations or use of sonar in our lands and waters.  But we can, for the sake of our children, make it very clear on the record that we individuals and agencies object to the cumulative harm.  We are looking to our government agencies and all of our leaders to do whatever it takes to protect our resources and health.”

See copies of all of the written comments from the agencies present at the informational briefing below:

FOR IMMEDIATE NEWS RELEASE (April 10, 2019– Hagåtña) – Senator Therese M. Terlaje introduced Bill No. 78-35 (COR) to address the $5.6 million dollar shortfall the Department of Public Health and Social Services (DPHSS) is facing to pay Medicaid claims to private entities through the end of Fiscal Year 2019.

Based on claims received, current processing, and expenditure projections, DPHSS needs approximately $5.6 million dollars for local matching requirements and only has enough funding through the first week of April for regular Affordable Care Act (ACA) Medicaid and Medicaid Childless Adults claims from private medical providers.

The Medicaid Program subsidizes health care costs for approximately 43,549 low-income individuals. Appropriating $5.6 million dollars for local matching requirements for the Guam Medicaid program will allow DPHSS to access an additional $6.8 million dollars in federal Affordable Care Act (ACA) grant funds.

Senator Therese Terlaje first called attention to this shortfall in Medicaid funding during a February 7, 2019 informational briefing with DPHSS and with her introduction of Bills No. 35-35 and 36-35.  At that time, DPHSS reported a potential $13.3 million dollar shortfall for local matching funds for Medicaid.  Since then, an Executive Order was signed by the Governor to redirect $7.7 million dollars of the FY 2019 GMHA Pharmaceutical Funds back to DPHSS to pay GMH Medicaid claims, leaving a shortfall of approximately $5.6 million dollars for non-GMH Medicaid claims. 

Still left untapped is approximately $61 million in federal ACA Medicaid funds that DPHSS is unable to tap due to a lack of local matching funds. All federal ACA funds expire in September 2019. This year Guam has already used $13.1 million of local funds to access $15.6 million of the ACA funds for Medicaid claims. A $10.5 million decrease in federal funds is indicated in the Governor’s 2020 budget request, and $3 million in Compact Impact funds are allocated towards Medicaid.

“With the many and current competing interests on our island, I still believe that one of our top priorities should be the health and wellness of our most vulnerable families who are eligible for Medicaid. There is an urgent need to invest in the local match requirement for Medicaid in this fiscal year, in order to access federal grant funds to pay for Medicaid claims.  If we do not prioritize this now, we may lose our opportunity to tap into those federal ACA grant funds and many of our low-income families may not get the care that they need,” stated Senator Terlaje.

She further stated, “Clearly this situation was a priority months ago and today it is a potential crisis. DPHSS has exhausted its FY19 local Medicaid appropriation with five months left unfunded and $61 million in federal funds waiting to be tapped. The government cannot afford to cover these patients without the federal match, and our community cannot afford the risks of even a temporary shutdown in health services to these patients. The government must immediately allocate additional funds to DPHSS through this bill or the bill introduced two months ago, through the Governor’s transfer authority, or by redirecting Compact Impact funds.”

FOR IMMEDIATE NEWS RELEASE (April 3, 2019– Hagåtña)- Senator Therese M. Terlaje, with the full backing and sponsorship of all senators of the 35^th Guam Legislature, introduced Legislative Resolution 94-35 (COR) in support of S. 947, “The Radiation Exposure Compensation Act Amendments of 2019,” which includes Guam residents exposed to radiation during nuclear testing in the Pacific from 1946 to 1962.

S. 947 was introduced in the U.S. Senate by Senator Mike Crapo (R- Idaho) and would expand eligibility requirements and increase compensation for persons suffering health problems related to cancer caused by radioactive fallout from nuclear bomb tests. Idaho, Arizona, Colorado, Montana, New Mexico, Nevada, Utah and Guam would be added to existing areas where victims can apply for compensation under the federal Radiation Exposure Compensation Act program (RECA). Qualified claimants are entitled to free medical care, health screening, and $150,000 compensation for certain illnesses.

In 2004, The National Academies of Science confirmed Guam’s exposure to radiation as “downwinders” and recommended that Guam be included under RECA. Fifteen years later, Guam still fights an uphill battle for inclusion. S. 947 is the eighth (8) version of the RECA Amendment bill introduced in the last twelve (12) years.

“Guam has been united in this effort for many, many years through the leadership of the Pacific Association of Radiation Survivors (PARS), Mr. Robert N. Celestial, the late Dr. Chris Perez, the late Senator Angel Santos, former Speakers Ben Pangelinan, Mark Forbes, Judith Won Pat, BJ Cruz, and many others. Justice is long overdue and given the high cancer rates and other radiation related illnesses in Guam, the additional healthcare resources under this bill are urgent,” stated Senator Therese Terlaje. 

FOR IMMEDIATE NEWS RELEASE (March 26, 2019 – Hagåtña)

Please see the transcript of Senator Therese Terlaje’s session remarks regarding Bill No. 32-35 (COR).

“It has been an almost surreal experience, the past few days since last Friday we have been in this legislative hall and over the weekend as well with constituents discussing nothing but gambling and marijuana. A part of me felt a little sad. It’s as if we had no other dreams for our children on our beautiful island or pursuit of any other priorities or industries.

I have reviewed carefully the testimony and the comments to the petition submitted in favor of this new bill and it is my assessment that many, maybe even up to 75% of those asking us to pass this bill today are really after cannabis for their medical or psychological health purposes and frustrated that the medicinal marijuana program is delayed. I have been in full support of Guam’s current laws authorizing medicinal cannabis for our cancer patients and others suffering from illness, and the Legislature has passed legislation for work-arounds to implemented medicinal cannabis which improved the law that was passed by referendum.

The new Director of DPHSS, who was confirmed less than a month ago at our first legislative session, held a briefing on March 18, just 8 days ago, on the medicinal marijuana law, and she promised that DPHSS would focus and finally do its part after years of inaction to get the program in place asap. She proposed a budget of approximately $800,000 to begin to shore up the medicinal cannabis program and she made a concrete recommendation that the Legislature remove the residency restrictions on lab owners so that Guam can attract an off-island investor for the required lab. A lab or cannabis testing facility was found necessary by the people of Guam for the protection of patients. I would think that it is also necessary to protect recreational users as well.

But today in this bill we are asked to take a huge departure from the medicinal cannabis approach and legalize cannabis for all purposes for anyone over 21. I support decriminalizing marijuana. I support the current government of Guam policy that already allows the possession of marijuana, that de-prioritizes the prosecution of marijuana offenses, that expands treatment courts instead of jail time for drug offenses. This is what other states like Vermont have done in legalizing marijuana. But way beyond legalizing it, we are asked in a very short time period to pass this bill to stand up a retail marijuana industry, including cultivation, manufacturing, and distribution, at the same time protection of our children from access to this substance, protection of our roads from further tragedy due to impaired driving, protection of our people from pesticides, poison, dependency and other harm from the use. This is a much bigger task than agreeing that precious government resources will not be used for prosecution of marijuana cases, or that our prisons and court system would not be overcrowded due to marijuana infractions. Changing course to a retail marijuana industry is a task that involves a myriad of public policy decisions along the way, and a lot of work in advance of implementation. Most importantly, it requires and necessitates the consensus of the community for its success, and it requires dedication by our government agencies, the enforcement agencies whom we will be leaning and relying on even more than we do today. We as a community can and must determine the best ways to do this given the restrictions we face under federal law, our unique political status, what we have learned from other jurisdictions, and by keeping focus on what we hope for our children along the way. The key for me, however, is that this switch to a retail industry is something that in every other jurisdiction in the U.S. except for Vermont and the CNMI, was done with consensus of the residents, as evidenced by a referendum. I do not necessarily think we need a referendum if a consensus is readily apparent, but it does appear as it stands today that a consensus is not readily apparent in our community.

The fact is that this bill is opposed by many, some are veterans, some are older, some who have committed their lives to law enforcement, the judicial system, public health, behavioral health. Some are nonprofit advocates against disease and abuse. Some from the generation who built Guam from rubble, who built our economy to what it is today while resisting fast cash of gambling, and other industry, and who have sacrificed and persevered through hardship and preserved for us the beauty of what Guam is today.

The author of the bill, when motioning for its adoption on Friday, stated that any legislator who wants a referendum or to refer the bill back to committee to flush out the details is a coward, not a problem-solver. I have heard on talk shows hosts say that anyone who doesn’t vote in favor of this bill as is, is an obstructionist, and would not get his support. I have been sent emails from my some of my closest younger friends, partners in the promotion of CHamoru culture and the arts, advocates in the change of status for Guam, protectors of ancient villages and our beautiful natural resources, fighters for justice and the cleanup of past contamination, who claim that they do not have a debilitating or painful illness, but marijuana is so important and necessary in their lives on a daily basis and they did not want to feel like criminals for using it, that if I did not vote for this bill as is I was simply not a leader, and they and their friends would never support me again. This line-drawing, the pitting of our community against each other, and a division over a simple substance not even native to Guam, in the face of destruction of thousands of acres of limestone forest and native medicinal plants, in the big picture, is, to me very perplexing.

This bill is a huge policy change, a risk, and significant resource shift that requires respect for all in our community, and additional opportunity for them to be heard, and for them to hear and gain confidence in what the proponents of this bill have been convinced of, that passage of this bill will not exacerbate what they legitimately fear because of what they have lived through, the very real and devastating impacts of drug use on our families, loss of identity, lack of inspiration and role models for our youth, that the industry will spiral out of control due to the inability of our current government to regulate and plan, and react as necessary to the impacts. These elder generations are not stupid, are not cowards. It is they who have built us up, who when heroin and ice ravaged our island, dealt with the painful consequences. I believe they are entitled to be comfortable with our decision, to be fully informed, to be paid respect. It is part of our job here to bring the community along with us, to show them that they can trust us to hear them, and we CAN reassure them if we work harder at it and stick to facts instead of threats or rushing, if we actually get our agencies involved and approach this in a concerted way, step by step, instead of the politically expedient passing a bill that passes the buck and then the benefits of the industry be held in abeyance or operate in chaos for years while the agencies scramble without resources to deal with the mess.

I have read the bill over and over, and I want acknowledge that some of the best that we can learn from other jurisdictions from their adoption of recreational cannabis has been incorporated in this bill such as:

• restricting the use for only adults age 21 and older
• restrictions on the amount of marijuana and marijuana plants that can be possessed for personal use
• not allowing marijuana to be consumed in public or for the marijuana plants to be enclosed in a locked place
• not allowing driving under the influence of cannabis
• restricting the display of cannabis items visibly to the general public from a public right of way
• involving different government agencies in the Cannabis Control Board

I want to assure all the advocates in our community that have worked so hard to educate themselves and the rest of us, that I have read all the material sent in the committee report, and those sent to me by email or text message and done a lot of research on my own of course with the assistance of my staff. I don’t think it I could have done it by myself which I think is significant for us at the Legislature. However, as evidenced by the various commissions and advisory boards mandated to continuously assess the implications for their jurisdictions, I think it is fair to say that there remain many unknowns in this relatively new industry and certainly unknowns for this industry on Guam. Requiring that two agencies come up with rules and regulations for the entire government is unrealistic and I’m glad we included more on the Board. We should take the time we need and use all experts in the government and beyond to truly determine the executive branch’s collective vision and ability to implement a retail cannabis industry on Guam at this time. This bill was introduced on January 31 and had its first and only public hearing on March 7, although there were two on that day, but the bill that was reported out did not incorporate any of the suggestions made during that public hearing. Only two government agencies testified at the hearing, the Department of Revenue and Taxation who was neither in support or against but said they are up for the challenge of their role in this industry and Department of Agriculture who said they support the bill.

Since the hearing, the Guam Visitors Bureau has asked for 2 months to complete a study of potential response from their top Asian markets, instead of merely relying on the hypotheses of some of the marijuana proponents that our tourism industry will flourish, or that we should rely on Colorado tourism to predict changes in Guam tourism. Should we also rely on the changes in Colorado’s homeless populations to predict an increase in Guam’s homeless population? We have heard from the news that the Governor supports the bill, “in concept.” Yet, the committee report after the hearing is devoid of any input or review of the bill from our public health institutions and experts, our behavioral health institutions and experts who will undoubtedly bear the burden of protecting our youth from the adverse effects of marijuana on their young brains, protecting our residents and tourists from poisoning from pesticides or other harmful products, protecting our families from drivers that are impaired, and we must ensure that we do not impede or detract from the time and resources the government of Guam has already dedicated in critical fights against effects from smoking tobacco, alcohol consumption, high incidence of disease, all while dealing with federal restrictions. These agencies will no doubt be brought in to work on the rules and regulations but without advanced assurances of support from this Legislature. I have also noticed that the Social work community, normally very clear advocates for programs that they believe will help those in need in our society, has been silent on this bill.

Colorado’s recreational marijuana industry law was not enacted overnight. It came after four years of active medicinal marijuana policies and tweaking, after two years of decriminalizing the use and allowing home growing of marijuana. It incorporates studies and data to track its progress. Colorado’s electorate were asked whether to transition from medicinal to legal recreational marijuana and asked again whether to transition to retail marijuana industry. Still, a review of Colorado’s program by Public Health experts points to a lack of baseline data and suggests that any other jurisdiction thinking of similarly legalizing marijuana first conduct pre-implementation baseline studies of its residents in order to accurately assess changes caused after enactment.

Since July 1, 2018, recreational use of marijuana has been legal in Vermont. The law allows people age 21 and older to possess up to 1 ounce of marijuana and also two mature and four immature plants per household. Despite the revenue being generated by Colorado and Washington, Vermont did not immediately adopt retail sales. In December 2018 they finalized a report regarding moving forward with retail sales, recommending a 20% excise tax and $1M be set aside to study the effects of cannabis use, and their Governor has promised to hold off on any retail sales until highway safety measures can be agreed on because there is no clear scientific way currently to measure impairment to driving by cannabis or cannabis in conjunction with alcohol or other drugs.

We have a consensus in our community on medicinal use. It took other states years to effectively implement their programs, and we know that a lab is crucial. We can and should pursue a testing facility immediately. It took some states like Hawaii years to effectively implement their medicinal cannabis programs, and we should not be discouraged but work harder under our new agency directors and our new governor. We also have a consensus in our community to decriminalize and remove penalties for possession of marijuana, to alleviate the judicial and law enforcement systems from marijuana cases. Where we must work to gain consensus is in the details of how a retail industry will move forward, how it will be regulated effectively despite program after program on Guam that is ineffectively regulated, other taxes that are ineffectively collected, and protections for our youth that are currently not in place or not up to par. This is the hard work of this Legislature and the Executive Branch, which must include transparency and deliberation along the way.

I am very thankful that debate on this bill has I think made some excellent improvement in the bill. It is my experience that collaboration always makes things better here on the floor and out in the community. I have utmost respect for my colleagues and the hard work already put into this, however I would move that this bill be moved back to committee with all of the amendments intact for future input from GVB and executive branch agencies who will be tasked with upholding and regulating this new industry. So that we are not surprised after passage from departments like DYA and most especially that we can hear from the Department of Public Health and Social Services and Guam Behavioral Health and Wellness Center before we put it to a final vote. And so I especially ask that on this motion all the amendments be left intact because I do recognize that the bill has been improved I believe and that there has been a lot of hard work put in but GVB has asked for a mere a couple months so they can get their data back and so I would ask my colleagues to consider that motion madam Speaker.”

FOR IMMEDIATE NEWS RELEASE (March 21, 2019 – Hagåtña)

Senator Therese Terlaje’s Bill No. 27-35 (COR) that will require the timely publication of environmental violation notices and settlement agreements on the Guam Environmental Protection Agency’s website and require regular reporting of these notices and agreements to the GEPA Board of Directors was unanimously passed by the 35th Guam Legislature.

Bill 27-35 requires the online publication of Notices of Violations, Orders of Compliance, Notices of Defense, Voluntary Compliance Agreements, Settlement Agreements and Referrals to the Office of the Attorney General for Prosecution, allowing the public to follow the enforcement process from start to finish.

“By increasing agency transparency, we are prioritizing active participation by the public in their government and ultimately making agencies and their boards accountable for the level of enforcement that our entire community is depending on,” stated Senator Therese Terlaje.

Please see the transcript of Senator Therese Terlaje’s opening remarks and closing remarks during today’s session regarding Bill No. 27-35 (COR). 

Opening remarks on Bill No. 27-35 (COR)

“Bill No. 27-35 if passed into law will require the online publication of environmental violation enforcement documents and the timely reporting of these documents to the Guam EPA’s Board of Directors.  It will specifically mandate that all Notices of Violations, Orders of Compliance, Notices of Defense, Voluntary Compliance Agreements, Settlement Agreements, and Referrals to the Office of the Attorney General for prosecution will be published online no later than 15 days from service and those documents will also be reported to the Board of Directors at the next scheduled regular Board meeting. These documents are already public documents and they are subject to the FOIA requests.  The bill would also amend the EPA enabling statues to include all of their mandates so that the publication mandate would apply to all of EPA’s current enforcement duties including the Guam Food Drug and Cosmetic Act, the Toxic Substances Exposure Compensation Act, the Water And Wastewater Operators Mandatory Certification Act, the Safe Drinking Water Act, the Guam Lead Ban Act, the Environmental Pollution Control Act, the Guam Oil Spill Responder Act, the  Choose to Reuse: Munga Ma Ayek I Plastek Act of 2018, the Underground Storage of Regulated Substances Act, the Above Storage of Regulated Substances Act. I would like to thank Guam EPA’s public information officer Nic Rupley for his testimony at the public hearing in support of the bill and the Administrator Leon Guerrero’s written testimony and feedback from Guam EPA and its legal counsel the during the drafting of this bill. I would also like to thank the co-sponsors Senator Sabina Perez and Senator Clynt Ridgell for their support and for the committee’s support in moving this forward. The bill is consistent with Guam EPA Board’s recently adopted policy that would put violations online. I wholeheartedly support EPA’s efforts towards transparency and open governance, and I ask that my colleagues do the same by increasing agency transparency especially in these enforcement agencies.  We are hoping to build the trust of the public and prioritize active participation by the public in protecting the environment and ultimately making agencies and their Boards accountable for the level of enforcement that our entire community is depending upon. Si Yu’os ma’åse’.”

Senator Joe San Agustin, Senator Amanda Shelton, Senator Kelly Marsh Taitano, and Vice Speaker Telena Nelson also provided remarks in support of the bill during session.

Closing remarks on Bill No. 27-35 (COR)

“I’d like to thank my colleagues for their really well-thought-out remarks on the bill.  It’s true madam Speaker that this bill was introduced because of events that had occurred in the past where the public was shocked to find out what the penalties were for violations. In looking more closely at how that could occur, we have to understand that we have given these agencies – they are regulatory agencies – we have given them great discretion, a great power, and also a great discretion to impose penalties also to enforce.  But along with that they have some discretion whether the violator responds quickly and suitably or efficiently and for different factors.  They give different penalties and so we’ve given them a range of penalties and so I agree with prior speakers that we want EPA to be harsh with their penalties because we want it to be a deterrent.  We also want the discretion to be less personally based versus actual system-based.  And I think, now, they do have factors that they evaluate in determining penalties and that’s the other reason why the Board is now going to get notice of all of these different actions promptly because the Board is there for oversight of an administrator and with changing administrators the Board should always be in the know and be able to act if they think the discretion was not to their liking.  I thank again my colleagues and the Committee Chair for their support of this bill.  Si Yu’os ma’åse’.”

FOR IMMEDIATE NEWS RELEASE (March 14, 2019– Hagåtña)- Senator Therese M. Terlaje introduced Legislative Resolution 71-35 (COR), which expresses the support of the 35^th Guam Legislature for the passage of H.R. 1713, the “Lonnie Kilpatrick Central Pacific Herbicide Relief Act,” introduced today by Guam Delegate Michael San Nicolas and Florida Representative Gus Bilirakis.

H.R. 1713 seeks to correct injustice, clarify the eligibility of affected veterans, and expedite the processing of veteran claims of health conditions caused by Agent Orange exposure on Guam, American Samoa, Johnston Atoll or while serving in the territorial waters thereof.

Terlaje’s Resolution 71-35 (COR) further implores Congress to correct injustice by resolving the numerous health care needs of civilians exposed to Agent Orange on Guam.

“I want to thank Guam Delegate San Nicolas and Florida Representative Bilirakis for introducing this bill in Congress on behalf of the veterans who served in Guam. I am also deeply grateful for the advocacy of the Agent Orange Survivors of Guam Veterans’ group and the Military-Veteran Advocacy, Inc., who were instrumental in getting this legislation introduced. Their pursuit of justice for Mr. Kilpatrick, our Veterans and the people of Guam is admirable and greatly appreciated.

The Department of Defense continues to deny the existence of Agent Orange on Guam, despite the overwhelming testimony from veterans and residents. However the VA and the Court of Appeals have recognized in several cases, service connection associated with Agent Orange exposure on Guam,” stated Terlaje.

The late Lonnie Kilpatrick was a Navy veteran stationed on Guam in 1971-1972, who later in life, suffered from heart disease, kidney cancer and skin conditions he believed to be connected to Agent Orange exposure on Guam. Kilpatrick, who had never been stationed in Vietnam, recalled living near a jungle area on Guam that was sprayed at night and had turned brown by the next morning. For seven (7) years, the Veterans Administration denied Kilpatrick’s claim before a reversal in April 2018, granting him service connection associated with Agent Orange exposure on Guam. 

FOR IMMEDIATE NEWS RELEASE (February 26, 2019 – Hagåtña)

Please see the transcript of Senator Therese Terlaje’s session remarks regarding Bill No. 30-35 (COR). 

“Good Morning and welcome back, Madam Speaker and good morning to my colleagues.

The government of Guam health insurance plan is the largest procurement by the government of Guam in a year and annually.  It’s estimated to be approximately $91 million dollars. It is also one of the most complex solicitations and negotiating schemes in government procurement.  The health insurance industry is a complex industry.  Experts make a living consulting state governments and our own local government in this field.  And I know that the negotiating team hires consultants every year to advise them and states hire consultants to advise them as to the impacts of different health policies.

We are, I wouldn’t say drowning, but we are being bombarded with arguments all around for and against the bill, even doctors seem to be divided on the issues.  The debate, of course, has highlighted many issues that must be solved.  Problems that exist in our current negotiation or contracts, problems in billings, problems in collections, all kinds of problems that the government of Guam must do better on.  And I believe that we can solve those, but they are not solved in this bill.  We cannot solve these issues with less competition in our procurement and we cannot solve our problems with unequal bargaining power in negotiations.

We know for a fact that federal law requires in emergency situations that the Emergency Medical Treatment and Labor Account (EMTALA) explicitly forbids the denial of services to any patients in an emergency situation and thus GRMC must provide care to patients in an emergency situation regardless if whether the patient’s health insurer has an agreement with GRMC or if GRMC is part of its contracted network.  Also, we know that the current and previous GovGuam Health Insurance contract includes a provision that states, if “a carrier does not contract with the provider of any sole service in Guam, it must reimburse the sole source provider by such Guam provider as if the sole source provider were a participating provider.”  So, there is a lot of debate in the community about coverage at GRMC and access to it in emergencies, access to it under those circumstances.  And I think that, wisely, the negotiating team has ensured that there is access.

The bill that we are looking at today is very similar if not identical to the mandate that was proposed in the last legislative term by former Speaker Benjamin Cruz. That bill received considerable opposition from health insurance providers, by the Department of Administration and was withdrawn. This bill is a result of Bill 3-34, which was passed (P.L. 34-83) in the 34th Legislature, which requires that the Health Insurance Negotiating Team forward only the “lowest cost option of either the exclusive or non-exclusive proposal” to the Governor.  That was a huge change in our policy for negotiating health insurance. That law was intended to save $18 to 20 million.  It was passed in the midst of a fiscal crisis and the Legislature was making some very hard choices at the time to save money. We were cutting; we were foregoing the renovation of a labor and delivery ward at GMHA and many other things in our government.

I attended the public hearing for this bill and also was in attendance of a public hearing on the bill introduced during the 34th Legislature.  There were many concerns presented then from several health insurance providers and many of those concerns still remain regarding higher costs for the government and its employees and retirees, a reduction in choice because of the higher costs, and potential legal challenges that may delay the negotiating and selection process. Which is exactly what happened last year when the negotiating team put a very similar requirement in their RFP and it was contested. That was never really resolved because they settled, and the settlement was to carry over with the prior contract. So, that is what we are operating with for Fiscal Year 2019.

By mandating all health insurance providers to include the private hospital in their network, it creates a potential competitive advantage for that private hospital to negotiate whatever fees they may choose, potentially tying the hands of GovGuam and its employees and retirees.  The private hospital may be empowered to set their fees at whatever level they choose and as a private entity, they are not bound to the same requirements that GMH has in monitoring its fees through public hearings and transparency.

The fiscal note from BBMR in February (and we have since received two others) said that “there is a potential for cost escalation due to reduced competition” and “a potential for the overall pricing bases proffered by the qualified insurance providers to increase.”  It did not give an exact amount of the potential increase due to lack of data. Now, they are saying that they can’t do that due to the confidentiality of the information. 

However, there were estimates provided by Take Care which estimate an additional $20 M to the total premium for GovGuam and that some policy premiums for families would increase by $120 per month for employees and $140 per month for retirees.  Currently about 16% of GovGuam employees and retirees choose a health insurance plan that does not include the private hospital. We wonder why and are speculating that they feel that they cannot afford the premiums to go any other way.

We know at the very least, this 16% will see increased rates and it’s unclear if the other insurance companies’ negotiated rates will be affected if there is lack of competition or no incentive to negotiate lower rates. Should we speculate as to the impact of whether it would wash away the $18 to 20 million in savings that we were trying to obtain in the last term of the prior legislature?  This is really the crux of the issue here. In that bill we were trying to save money by forcing, perhaps, an exclusive contract with only one provider. And now, we are trying to undo that by forcing mandates with insurance providers we are going to contract with.

Perhaps, I think it is better for us to reconsider that choice instead of this bill. If we have this extra money, I would much rather go back and reconsider that choice and allow the government employees to have a choice of health insurance companies again. I think that would be a better use of a potential $18 to 20 million dollars rather than ending up with an exclusive insurance company. At this point, we do not know the impacts of other insurance company being left out and how that will impact the rest of the community in other ways. We don’t know the impacts to the government of Guam as to amounts. There are just too many unknowns.

If we want our employees and retirees to avail themselves of Government of Guam health insurance, we have to do all in our power to hold down the cost. Some suggestions have been made to allow the negotiation of prices before mandating a provider.

There have also been allegations that this bill will negatively impact GMHA. It is my understanding, hope and expectation that the government’s fiscal team is scrambling to find money the $13 million in Medicaid matching funds that we are going to need beginning April 1, 2019 and the critical GMHA CMS improvements that we have been discussing for years and the new maternity ward that we had to forego. They have not given their input as to whether funding this private hospital benefit for government of Guam employees should be prioritized over all of those other projects or if the Guam Memorial Hospital is at this point, foregoing its desire to rise to the challenge and provide services that it currently does not provide to the people of Guam. And of course, they are going to need our assistance to do this.

I believe it is imperative that we as policy makers, with the power of the purse strings, take the time necessary to be fully briefed about the fiscal impacts before we act. There has been much testimony received, even after the public, from different members of the community. A few of these are:

•                    SelectCare stated that the bill would be better if amended to “ensure that the requirement to include all private hospitals is fully vested and left in the hands of the negotiating committee.  They also mentioned they are “concerned with what would potentially become negotiating advantages for the new private hospital and the consequences of potentially higher fees” and recommended implementing safety nets and limits to cost increases. But none of these recommended amendments have been included at this time in this bill.

•                    Take Care’s testimony and concerns were the same as their testimony on the prior measure. Take Care testified that including the private hospital in their network would cause rates to rise exponentially. They outlined equal protection rights, violation of due process rights of health insurers, improper delegation of power and negative impacts to revenues at GMHA.

•                    The Guam Federation of Teachers has opposed the bill as written, citing potential cost increases to employees and retirees.

•                    Dr. Thomas Shieh has registered his opposition to the bill. His testimony suggests that if we are going to do this for a private hospital, why are we not going to do this for private providers such as his clinic, which has services that are not available anywhere else in Guam? I thought that example was very interesting.

•                    Other government of Guam employees have also expressed their concerns with being unable to afford increases in premiums.

•                    There have also been community members who have registered their support for the bill but have suggested we put a cap on GRMC fees. Unfortunately, that cap is not part of this bill.

I understand and commend the intent of the bill to ensure that GovGuam employees and retirees can access to the private hospital on Guam, however I am concerned that the costs to the Government of Guam and GovGuam employees and retirees may be too high and would preclude them from seeking all together, or preclude GMH from expanding its services.

I know that time is of the essence if the Legislature is to dictate the terms of the new solicitation for health insurance by the GovGuam negotiating committee.  Yet, I can’t help but feel that if all the insurance companies and some physicians are warning us to significant increase in costs and change in negotiating power, we should go back to the public hearing process and work some more to come up with the language that will avoid a spike in premiums or deductibles for both the employees and retirees and the government of Guam.

I believe we can do better if we do not buckle to pressure, act uninformed or to embed the government in another legal battle or forgo other solutions such as allowing negotiating team to negotiate private hospital rates. Those were just some of the suggestions that were made.

For these reasons, Madam Speaker, I would move that the bill go back to committee so that we consider the caps that have been suggested on the GRMC rates, consider who should negotiate rates if we are going to mandate that this private hospital be included in the contract or consider the rest of the testimony. Most of all, consider the financial impact on the government of Guam, which I feel is not available to us today.”