Lawmakers question delayed funding at LBJ Tropical Medical Center

Employees at LBJ Tropical Medical Center face uncertain paychecks, and essential services are at risk. Months after Fiscal Year 2025 ended in September, the hospital still hasn’t received approved government funding, prompting the American Samoa House of Representatives to question officials for answers. 

LBJ Tropical Medical Center is American Samoa’s singular and primary hospital, serving a population of approximately 46,000. The healthcare facility provides emergency services, inpatient care, and specialty clinics. However, unlike US hospitals, LBJ is heavily dependent on direct government subsidies to cover operational costs, staff salaries, and medical supplies. 

The territory’s geographical isolation has empirically caused difficulty recruiting medical professionals, leading to workforce shortages and rising healthcare costs. Funding delays directly impact the hospital’s ability to pay employees and maintain services, a critical vulnerability for an area with no alternative options. 

At a House Health Committee hearing on October 14, CEO Scott Anesi confirmed that LBJ Hospital had not received any of the $2 million in subsidy funding approved for the fiscal year 2025, which ended on September 30. Combined with $300,000 still owed from the previous fiscal year, the hospital is owed $2.3 million in funding overall. 

The hearing, chaired by Representative Manumaua Wayne Wilson, addressed concerns about medical staffing shortages and complaints regarding doctors prescribing incorrect medication. Vice Speaker Fetui Fetu and Representative Avagafono Maiava stated that despite infrastructure upgrades, medical staffing remains inadequate.

The committee was scheduled to address whether 14 ARPA-funded infrastructure projects would meet the December 2026 federal deadline. These projects were financed through the federal pandemic relief law American Rescue Plan Act, enacted in 2021 and designed to support infrastructure and public services. Several projects were still less than 10 percent complete. 

Representative Fagaima Larry Sanitoa questioned whether ASG procurement laws were properly followed in awarding the contracts. He pointed out that the legislation doesn’t authorize the hospital board to select contractors, and that contractors handling multiple projects simultaneously may struggle to complete them all on time. Anesi said materials for some projects had already arrived on the island. Each project has a manager, and contractors are financially liable if they fail to complete work on time.

American Samoa residents are less optimistic about the timeline, with one stating, “It’s no surprise the status of LBJ’s projects to date, given the replacement of and long internal discord amongst the hospital’s management team and the Board.”  

The hearing concluded without a definitive answer for when the delayed $2.3 million subsidy funding would be released. Lawmakers concluded they would continue monitoring both the subsidy release and ARPA project completion to ensure accountability as the hospital enters its second month without funding.