Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1697808310831.pdf (Micronesia, Federated States of)
STANDING COMMITTEE REPORT NO.

15-53 RE: C.R.

NO.

15-64/HESA SUBJECT: CONFIRMING THE NOMINATION OF VITA AKAPITO SKILLING TO BE THE SECRETARY OF THE DEPARTMENT OF HEALTH AND SOCIAL AFFAIRS OF THE FEDERATED STATES OF MICRONESIA NOVEMBER 21, 2007 The Honorable Isaac V. Figir Speaker, Fifteenth Congress Federated States of Micronesia Second Regular Session, 2007 Dear Mr. Speaker: Your Committee on Health, Education and Social Affairs ("HESA"), to which was referred C.R.

No.
No.

15-65 entitled: "A RESOLUTION CONFIRMING THE NOMINATION OF VITA AKAPITO SKILLING TO BE THE SECRETARY OF THE DEPARTMENT OF HEALTH AND SOCIAL AFFAIRS OF THE FEDERATED STATES OF MICRONESIA.

", begs leave to report as follows: The intent and purpose of the resolution are expressed in its title.

Dr. Vita Akapito Skilling has been nominated by the President of the Federated States of Micronesia to be the Secretary of the Department of Health and Social Affairs.
Title 2, section 207(1) of the Code of the Federated States of Micronesia sets out that this nomination is subject to the advice and consent of Congress.

Dr. Skilling’s curriculum vitae is included in Presidential Communication 15-100.

Some points are summarized here.

Dr. Skilling is originally from the State of Chuuk and currently resides in Kosrae with her family.

Dr. Skilling completed medical training at the University of Hawaii and a residency in Pediatrics at the Fiji School of Medicine.
She has also completed post-graduate distance learning from the University of Otago in New Zealand.

Dr. Skilling has been working with the Kosrae Division of Public Health and Community Health for more than fifteen years, primarily in pediatrics and as a cancer resource person.

PUBLIC HEARING Your committee held a public hearing on the nomination on the morning of Friday, November 16, 2007.
The hearing was conducted in two sessions, the first with the nominee herself and the second with staff members and employees of the FSM who have studied and worked for the nominee.

Present at the second STANDING COMMITTEE REPORT NO.

15-53 RE: C.R.

NO.
15-53 RE: C.R.

NO.

15-64/HESA SUBJECT: CONFIRMING THE NOMINATION OF VITA AKAPITO SKILLING TO BE THE SECRETARY OF THE DEPARTMENT OF HEALTH AND SOCIAL AFFAIRS OF THE FEDERATED STATES OF MICRONESIA NOVEMBER 21, 2007 session were various employees and officials of the Department of Health and Social Affairs.

HEARING WITH THE NOMINEE The nominee appeared, accompanied by her husband, Senator Bob Skilling of the Kosrae State Legislature.
Present from the FSM Congress were Speaker Figir, HESA Chairman Urusemal, Vice-Chairman Phillip, and Senators Halbert, Kansou, Nelson, Neth, Primo, Sitan and Welly.

A representative from the President’s Office, his Chief of Staff, was also in attendance.

The Chief of Staff explained that both the nominee and her husband had been approached by the administration as possible candidates for the position.

The Skillings decided as a family that Dr. Vita Skilling would accept the nomination.
The nominee confirmed that, after discussions with her family, she accepts the nomination without reservation.

The position will require her to live away from her husband and children but she explained that her family is willing to accept this.

In response to a question regarding her experience as a manager, Dr. Skilling explained that, in her current role as a hands-on physician, she manages all aspects of her patients’ health.
She also manages financial aspects of programs she is active in on Kosrae, including the Parent Teacher’s Association, and youth and women’s groups.

However, the nominee conceded that her management experience is on a small scale.

She expressed confidence that, with the assistance of her staff, she would be able to manage at a larger and more complex level.
Regarding her plans on how to improve health services in the FSM, Dr. Skilling highlighted the lack of resources, including equipment, support, inventory and long delays in accessing resources.

She also noted that she is prepared to review the number of staff at the national level and the division of funding between the national government and the states.

Accountability, she said, is key.


When asked a question regarding any weaknesses she perceives currently in the Department, Dr. Skilling said, although she hesitates to criticize, she has noted a persistent lack of communication between the national government and the states, even extending to information -2- STANDING COMMITTEE REPORT NO.

15-53 RE: C.R.

NO.
15-53 RE: C.R.

NO.

15-64/HESA SUBJECT: CONFIRMING THE NOMINATION OF VITA AKAPITO SKILLING TO BE THE SECRETARY OF THE DEPARTMENT OF HEALTH AND SOCIAL AFFAIRS OF THE FEDERATED STATES OF MICRONESIA NOVEMBER 21, 2007 on the approval of grant requests.

Dr. Skilling pointed out that we in the FSM can improve our diets by eating what is available locally, rather than relying on cheap imported foods such as turkey tail.
However, the nominee said she does not support banning the importation of unhealthy foods at this time; rather, she proposes providing information in grocery stores regarding the potential danger to health of certain foods.

At the same time, the reduced importation of turkey tail would inevitably result in reduced consumption.

The nominee expressed the view that the FSM spends too much money on referring patients to foreign medical centres that have greater capacities than our own state hospitals.
A medical centre in the FSM to provide care for our own patients is needed.

Travel to this one FSM centre, in whatever state it may be located, would still represent a cost savings over international medical referrals.

In addition, the money spent would remain in the FSM.
In response to a question regarding medicines available in the FSM and the accuracy of their labeling, Dr. Skilling said the Department of Health and Social Affairs should undertake to verify the drug content of remedies available over the counter.

The FSM also has a need for a laboratory that would test the quality of drug products, among other things.

Such a laboratory, the nominee suggested, would be a first step toward the establishment of a medical referral centre.
Dr. Skilling acknowledged her difficulty in responding to a question regarding her overall vision for the health problems of the FSM.

She referred to her work with the Cancer Council and identified this as one of the most dangerous diseases currently in the FSM, after tuberculosis and diabetes.

Dr. Skilling said that each state must present its health plan and budget proposal, as the national government coordinates the work of the states in the area of health.
She emphasized the need to evaluate the current national health plan and again referred to ongoing problems of communication between the national government and the states.

The nominee stated that the national government should not dictate priorities to the state governments.

In response to a concern regarding the increasing and prohibitive cost -3- STANDING COMMITTEE REPORT NO.

15-53 RE: C.R.

NO.
15-53 RE: C.R.

NO.

15-64/HESA SUBJECT: CONFIRMING THE NOMINATION OF VITA AKAPITO SKILLING TO BE THE SECRETARY OF THE DEPARTMENT OF HEALTH AND SOCIAL AFFAIRS OF THE FEDERATED STATES OF MICRONESIA NOVEMBER 21, 2007 of health insurance, the nominee responded that this is a matter for Congress, rather than the Department of Health and Social Affairs, to address.
In response to a question regarding HIV/AIDS in our islands, Dr. Skilling responded that, although there are currently few cases of HIV, even one case is too many, given the highly communicable nature of the disease.

She noted that we are currently in a position to prevent the spread of HIV/AIDS.
HEARING WITH DEPARTMENTAL STAFF Many employees of the national government and one staff member from the Micronesia Seminar who know or have worked with Dr. Skilling in various capacities were in attendance at the hearing to show their support.

All spoke overwhelmingly in support of her nomination and responded to direct questions from Committee members.

They were united in their testimonies that Dr. Skilling is an exemplary individual and would be a competent and intelligent leader of the Department.
The current Acting Secretary of the Department of Health and Social Affairs, Mr. Marcus Samo, outlined what he sees as the most important characteristics of a competent department secretary: flexibility, determination, the ability to listen and leadership.

The ability to work with the states is also critical.

Dr. Skilling was subsequently described by members of the Department, one after the other, as a person who possesses these qualities, among many others.
Dr. Skilling was described as both well and diversely qualified.

In terms of the FSM states, she knows both Kosrae and Chuuk as home states, and has worked in Pohnpei and, briefly, in Yap.

One witness spoke of growing up in Chuuk with the nominee and of always having a great admiration for, and looking up to, the nominee.

Dr. Skilling was described as always having been one of the brightest and most intelligent students among her peers and as having excelled academically.
The nominee was described as being “on top” of the issues in health today, including national, regional and international.

-4- STANDING COMMITTEE REPORT NO.

15-53 RE: C.R.

NO.
15-53 RE: C.R.

NO.

15-64/HESA SUBJECT: CONFIRMING THE NOMINATION OF VITA AKAPITO SKILLING TO BE THE SECRETARY OF THE DEPARTMENT OF HEALTH AND SOCIAL AFFAIRS OF THE FEDERATED STATES OF MICRONESIA NOVEMBER 21, 2007 Comments were overwhelmingly in favor of the nominee and Department staff expressed a commitment to support her in her responsibilities, if the nominee were to be confirmed.

One person noted that “no one can do everything alone”.
In response to a comment regarding the sense of appointing a practicing physician to an administrative post and the potential for thereby depriving he patients of her care, witnesses noted that hours for doctors in Kosrae have lately been reduced, making this a good time for Dr. Skilling to bring her abilities to the aid of the nation as a whole.
One witness stated the Dr. Skilling can make a great contribution to work on policy and that the Department requires a medical doctor’s knowledge and background in the Secretary position.

Witnesses suggested that comments from the states, perhaps in the form of hearings in the states, would be beneficial.

Your committee notes that requests for written comments on this nomination were sent to the four states.

A response has been received from the State of Kosrae, very supportive of the nominee.
CONCLUSION Based on the above hearings, your committee is satisfied with the qualifications and dedication of the nominee and recommends her with confidence for the position of Secretary of the Department of Health and Social Affairs.
Your committee would like to recommend that, if confirmed, Dr. Skilling work diligently to improve the delivery of health services in the FSM, including training FSM citizens in health care, especially nursing, improving health facilities throughout the nation and particularly on our outer islands and other remote areas, improving the working relationship between the national government and the states in the area of health and promoting the maintenance of good health through improved hygiene, healthy diet, exercise and other means.
Youth development should also be an area of focus, along with the mental health of our islanders.

Your Committee on HESA is in accord with the intent and purpose of C.R.

No.

15-65 and recommends its adoption in the form attached hereto as C.R.

No.

15-65.

-5- STANDING COMMITTEE REPORT NO.

15-53 RE: C.R.

NO.
15-64/HESA SUBJECT: CONFIRMING THE NOMINATION OF VITA AKAPITO SKILLING TO BE THE SECRETARY OF THE DEPARTMENT OF HEALTH AND SOCIAL AFFAIRS OF THE FEDERATED STATES OF MICRONESIA NOVEMBER 21, 2007 Respectfully submitted, /s/ Joseph J. Urusemal Joseph J. Urusemal, chairman /s/ Claude H. Phillip Claude H. Phillip, vice chairman /s/ Dohsis Halbert (sign below) Dohsis Halbert, member /s/ Roosevelt D. Kansou Roosevelt D. Kansou, member /s/ Resio S. Moses Resio S. Moses, member /s/ Setiro Paul Setiro Paul, member Joe N. Suka, member -6-