Oct. 7, 2003 – A bill to privatize the operations of two health clinics, transferring them from the Health Department to not-for-profit agencies, had general support but nevertheless ran into difficulty Monday at a Senate Health, Hospitals and Human Services Committee meeting.
The process of transferring the operations of the East End Family Health Center to St. Thomas East End Medical Center Corp. and those of the Frederiksted Health Center/Ingeborg Nesbitt Clinic to Frederiksted Health Care Inc. has been ongoing for about three years.
While most senators appeared in favor of the transfer on Monday, they agreed that details remain to be hammered out.
A major reason for the move is that as not-for-profit agencies, both entities will be able to apply for federal funding not available to local governments. They cited the need for several additions and clarifications in the bill now before the Legislature.
According to a report in Tuesday's Avis newspaper, Maureen Rabsatt-Cullar, executive director of the East End Medical Center Corp. said the Health Department cannot receive federal grants to assist HIV/AIDS patients because they are awarded only to community-based and not-for-profit organizations.
Vivian Ebbesen-Fludd, executive director of Frederiksted Health Care, said the transfer also is needed because of the government's inability to maintain the Frederiksted building which houses the health care center. "We are maintaining things in a facility we do not have a lease for," she said. "For instance, if we maintain an air conditioner and we are told by the government we have to leave, we have to leave the air conditioner there."
The Senate overrode a veto by the governor last year of a proposal to lease the building to the not-for-profit agency for $1 dollar a year, but the lease is yet to be enacted.
The senators agreed on the need for the transfers but were concerned about staffing details and funding. Sen. Lorraine Berry said she was "really surprised for the length of time it is taking for this issue to be resolved."
"It is very obvious," Berry said according to the Avis, "that the only way we will get any more federal funds is by this new arrangement." She said the bill will have her "full approval" after the needed amendments are added.
The St. Thomas East End Medical Center Corp. requested a budget of $760,155 for FY 2004, up by $218,834 from FY 2003. It also requested assistance with the $200,000 annual rent for the East End Clinic space at Tutu Park Mall.
The corporation, which operates the clinic for the government, "does not have a lease or rental agreement with the Tutu Park Mall," Rabsatt-Cullar testified at an Aug. 13 Senate Finance Committee FY 2004 budget hearing. "The lease is between the Department of Health and the mall," she said, and the Health commissioner negotiated the contract, which has three more years to go.
EEMC as a federally qualified health center is required to offer clinical care by physicians and nurses, prenatal services, immunizations, family planning and many other services without consideration for patients' ability to pay. Rabsatt-Cullar said the corporation hopes to apply for a $650,000 grant along with the private corporation operating the Frederiksted Clinic in order to provide primary health care to the homeless.
Rabsatt-Cullar said Monday that the government "has been unable to meet its obligation, and we had to get monies to pay the rent."
Sen. Adlah "Foncie" Donastorg expressed concerns of several senators about how transferring the operations will affect the status of clinic personnel. "The mere idea of passing this bill has to instill some fear in government employees who work at the centers," he said. He advised that each center seek additional funds to balance their budgets besides the federal funds they will receive.
Donastorg has not set a date for the next Finance Committee meeting to again discuss the governor's controversial FY2004 budget, which has been in the hands of the Senate since the governor sent it down Sept. 30. The 2004 Fiscal Year began Oct. 1 and until a budget is adopted, the provisions of the previous year's budget remain in effect.
Both executive directors said the bill needs to define the term "operational aspects" and to spell out employee transfer policies and procurement procedures, among other items.
Ebbesen-Fludd said another plus is that the changeover would allow the agencies to control their own finances. She said it takes six months for the Finance Department to distribute funds, and the resulting delays in vendor payments can lead to additional fees and fines.
Sen. Usie Richards said he opposed excluding the Health Department from involvement in policymaking for the changeover. He said the department is responsible for overseeing and setting policies for all health organizations in the territory.
The bill will now go to the legislative legal counsel's office for incorporation of changes the committee agreed upon Monday.
Mavis Matthew, who as Health commissioner had been invited to testify at the hearing, didn't appear. Matthew submitted her resignation to the governor on Friday. (See "Matthew is no longer Health commissioner".)
Committee members attending the meeting were the chair, Sen. Douglas Canton Jr.; and Sens. Berry, Donastorg, Emmett Hansen II and Richards. The other two members, Sens. Norman Jn Baptiste and Luther Renee, were not present. Also present was Sen. Louis Hill, who is not a member of the committee.
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