July 8, 2004 – Fiscal year 2005 budget hearings before the Senate Finance Committee concentrated on health Wednesday afternoon, with Health Commissioner Darlene Carty defending her budget request and the Board of Nurse Licensure and the East End Clinic of St. Thomas also making their bids.
Carty said the Health Department cannot make do with anything less than the $27.2 million that the governor has proposed. She said the department's total FY 2005 budget of $ 52.8 million — $25.5 million of it projected to come from federal funds — is down by $1.1 million from the FY 2004 budget.
And she said the proposed reduction represents a 38.6 percent decrease from the current Health Revolving Fund appropriation. The revolving fund consists of money the department collects for permits, health violation fines and inspections. Carty said the Office of Management and Budget has projected a decrease in the fund's revenues — from $2.8 million in FY 2004 to $1.7 million for FY2005, she said.
Carty said 51 percent of the Health budget — or $27 million — goes for personnel salaries and benefits. She also said the department is facing a personnel shortage because a significant number of employees have retired or resigned since the beginning of FY 2004. At the moment, 527 of the department's 628 positions are filled and 101 are vacant, she said, but department is in the process of filling 70 percent of the vacancies.
Carty said she received the good news on Wednesday morning that four new ambulances are on the way. She said the Public Finance Authority told her that a check for the vehicles had been sent to the vendor.
A major thorn in the department's side remains the funding in territory for the Medicaid program, she said. Health officials have "repeatedly said that the bottom line is that the local government can't handle this lopsided burden of the Medicaid program, nor can it handle the legislated 50 percent burden of the program determined by the federal government," she said
The disparity between federal Medicaid coverage in the states and the far lower cap on federal funding in the territories is something Delegate Donna M. Christensen has long been addressing in Washington, D.C.
Because of the ongoing shrinkage in local dollars awarded to the program, Carty said, "we will be forced to re-evaluate the program to see how we can further limit or eliminate Medicaid services, which will have severe impact on the health care of the territory."
As important Health Department accomplishments of FY 2004, Carty cited the "substantial" completion of renovations to the Charles Harwood Memorial Complex on St. Croix, which she described as a one-stop health facility, and the opening in February of the Eldra Schulterbrandt Medical Facility on St. Thomas.
Board of Nurse Licensure
Winifred L. Garfield, Nurse Licensure Board executive director, requested a budget of $267,879 — $156,904 for salaries and fringe benefits for the board's four employees and $110,975 for operating expenses — from the Nurse Licensure Revolving Fund.
The senators were very receptive to Garfield's requests, several of them praising her presentation as accurate, detailed and easy to read.
Garfield also presented the board's proposal to provide a temporary solution to the critical shortage of nurses at Schneider Hospital, a subject addressed exhaustively on Wednesday morning by hospital chief executive officer Rodney Miller. (See "Schneider CEO Tells Senators He Needs Their Help".)
St. Thomas East End Clinic
The committee also heard from Maureen Rabsatt-Cullar, East End Clinic executive director, who requested a FY2005 budget of $815,406.
Committee members present for the hearing were Sens. Louis Hill, Shawn-Michael Malone and Luther Renee. As vice chair, Renee conducted the meeting in the absence of the chair, Sen. Adlah "Foncie" Donastorg, who excused himself at the start of the session, citing a personal matter. Sen. Roosevelt David was excused. Sens. Norman Jn Baptiste and Ronald Russell were absent. Also attending were Sens. Liburd and Douglas Canton Jr., who are not members of the committee.
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