Although the administrative staff of the Gov. Juan F. Luis Hospital is familiar with procedures that cut close to the bone, they told the Senate Finance Committee on Thursday that the 15 percent budget cut mandated by Government House goes too deep.
Thomas Robinson, CEO of the hospital, told senators at the Finance Committee’s budget hearing that his revised fiscal year budget of $18.9 million contains only half, or $1.5 million, of Gov. Charles Turnbull’s government-wide directive that departments and agencies cut 15 percent from their spending plans.
To cut deeper, Robinson said, would mean hitting a nerve — personnel. Or even worse, the quality of care the hospital can deliver. He emphasized, however, that in trying to meet Turnbull’s 15 percent target the hospital would not cut the number of physicians or nurses on staff.
"To (cut) the other 7.5 percent, there would have to be severe personnel cuts and we hope to avoid that," Robinson said, adding that his staff will try to drop vacant positions to meet the governor’s mandate.
But if that doesn’t reduce the budget enough, Robinson said, "We’ll have to go back to the budget and make some severe cuts."
Sen. Almando "Rocky" Liburd said he didn’t have a problem if the hospital only achieved half of Turnbull’s 15 percent budget reduction.
"It’s health care," Liburd said. "We can’t cut a bunch of people just because we have a mandate to cut. We have to draw the line somewhere."
In August, the hospital officially became a semi-autonomous agency after the Legislature approved the proposal. The move will allow the hospital to control its own finances, order supplies and conduct hiring and firing of the staff of approximately 600, something that irked Sen. Alicia "Chucky" Hansen.
Hansen was adamant that Robinson, who was recruited from off island and has been on the job since January, not consider cutting the hospital’s non-medical staff.
"You’re not going to hear me praise semi-autonomy," Hansen said. "We’ve placed the fate of our people in your hands and I resent that."
Robinson said that while a variety of staffing problems plague the hospital, the most critical is nursing. He said that recently 16 people have resigned, most of them nurses recruited by off-island hospitals promising more money and less work.
"Our staff in the nursing department has been tight on the floors and it’s produced a lot of strain," Robinson said.
Another source of stress is the number of patients using the emergency room for non-emergency cases, Robinson said. Such visits tax the E.R. staff by requiring overtime, causing the hospital to spend more money.
A proposal in the hospital’s budget aimed at augmenting revenue calls for more aggressive billing for services presently being provided by E.R. physicians. Based on 19,000 E.R. visits, the change could result in additional billing of about $2 million.
Robinson and several senators said that the quality of care at the hospital is improving steadily.
"Our capabilities are actually very, very good," Robinson said. "The reputation by some people in the territory is not deserved."
Sen. Anne Golden said the hospital’s reputation and care could be enhanced more if a proposed joint venture of sorts is completed with a prestigious mainland hospital.
After a lengthy tirade by Hansen concerning the lack of analysis on the budgets the Finance Committee is hearing, committee chairwoman Lorraine Berry said that current hearings are preliminary until Government House completes its government reorganization plan on Sept. 15.
Once the plan is complete and additional information added, she said the committee will reexamine the budget that includes analysis by the Legislature’s Post Audit Division.
