(a) The chief of service immediately concerned rills out an off-island medical referral form and sends it to the office of the director of health.
(b) The medical referral committee (chiefs of various services) will meet to review each proposed referral case, and after discussing each case, will recommend approval or disapproval according to policies, procedures, and criteria governing this process,
(c) The referral form, and the medical referral committee’s recommendations are given to the director of health with the patient’s medical record for review and decision.
(d) If approved, the referral form is given to the patient coordinator, who:
(1) confirms that the patient meets eligibility requirements;
(2) obtains the patient’s signature (or legal guardian’s signature if the patient is a minor), which obligates the patient to accept the treatment recommended by the physician to whom referred and ascertains that patient understands the document-being signed;
(3) ensures that the patient’s immigration papers (passport and visa) are valid and in possession;
(4) obligates funds for the patient’s travel and off-island medical care;
(5) prepares the travel authorization and obtains the air travel ticket for the patient’s transportation; and
(6) advises an ambulatory patient of the telephone numbers of American Samoa Office-Hawaii and the patient coordinator’s residence and that after checking through U.S. Immigration and Customs in Honolulu to call these numbers in case no one is at the airport to meet him or her.History: Rule 7-80, eff 24 Jun 80, § 3: and Rule 1-86, eff 10 Jun 86, § 2.