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Schneider Hospital Needs More Money to Cover Costs

Aug. 30, 2005 — Representatives from the Schneider Regional Medical Center disputed the FY 2006 budget recommendation on Tuesday, telling senators that at least $3.3 million more would be needed to cover employee salaries alone.
"One of the biggest challenges we face concerns our inability to recruit and hire needed staff," said Rodney E. Miller Sr., the center's president and CEO. "The governor's recommendation of $23.1 million is only enough to cover our present personnel costs. But we're going to need more money to fill our present vacancies, and when our cancer institute is finished, we need to be able to hire capable individuals so that our patients can receive that care they need."
Due to past budget cuts, Miller also said many of the hospital's current staff have been hired on employment contracts outside of the NOPA (Notice of Personnel Action) process in order to reduce certain expenses — including the hospital's reliance on traveling nurses. "But even though we've cut down on these costs by 50 percent, our contract employees still aren't presently receiving any benefits, and we are at risk of losing them if the general fund allotment is not increased," Miller said.
While $26.4 million is the minimum amount needed for the hospital to remain on par with similar mainland facilities, Miller told senators that he had originally made a $31.1 million request so that an appropriation could be made to complete the Charlotte Kimelman Cancer Institute on St. Thomas. Although the Legislature previously appropriated about $10.9 million for the building from tobacco settlement and bond money, Gov. Charles W. Turnbull has allocated no funds for the project this year — the first time it has been put in as a line item by the hospital.
"We currently need another $7 million to finish the institute," Miller said. "We're currently working with the governor to identify other funding sources. However, I'm still confident that we will be able to open the institute by November."
Miller reminded senators that the facility is much needed—especially with an estimated 400 to 500 new cases of cancer within the territory every year. "We have expanded our team of oncology and radiation specialists," he said. "A large part of our team's focus will be on early detection of cancer cases, as the Caribbean has a higher rate of people facing cancer in later stages."
"People are dying too fast, too soon, and we hope this will change with the opening of the institute," Miller said.
Lack of federal funds, federal Medicaid cuts and other "perilous" financial conditions were also described in Miller's plea for a budget expansion. "What makes it hard with this is that since we're considered a 'safety-net' hospital, we have to provide services to those uninsured or indigent," Miller said.
Miller further explained that the territory has a cap on Medicaid funding of $6 million — which is used up in the first quarter of every year. "The cap amounts to $436 in federal funding for our each of the 15,000 Virgin Islanders eligible for Medicaid. The national average is $3,862 per person. Plus, the territory also has one of the highest rates of uninsured persons in the nation, and the burden to provide care for these individuals falls back on us."
Although the hospital generated more than $30 million in revenue last year, losses due to the care of uninsured or indigent persons equaled about $24 million — almost one quarter of the total costs for the center.
To solve some of these problems, Miller told senators that the one of the hospital's goals is to achieve full autonomy to determine "all staffing and operational priorities."
"Full autonomy would give Schneider Regional the ability to hire its own staff without having to rely on a central government hiring process, as well as the ability to manage our own human resources," Miller said. In the meantime, Miller added that he expects the senate to consider the hospital's additional budget request.
"Given the financial condition of the Virgin Islands' government, we don't think it prudent — nor do we expect — to ask to be funded the entire $31.1 million. But we do feel that our expectation is reasonable to have our general fund allotment funded at the minimum level of $26.5 million," Miller said.
Representatives from the Office of Information Technology also presented senators with a $1.1 million request Tuesday. The Bureau of Economic Research will additionally utilize $410,653 from the budget of the Office of the Governor.
An appropriation transfer for the Department of Health was also approved by senators on Tuesday. The transfer, which reprograms $1.3 million within the department's budget, was introduced at last Thursday's budget hearings and will be used primarily for environmental health equipment, such as fogging machines and trucks.
Additionally, payments will be made to take care of outstanding obligations on behalf of the department to Kmart, Seaview Nursing Home, the Water and Power Authority and Innovative Communications Corp. Health Commissioner Darlene A. Carty said this sum will only partially cover the department's debts — approximately $2 million is owed to Kmart alone, with another $500,000 split between WAPA and Innovative.
Present at Tuesday's budget hearings were Sens. Roosevelt C. David, Liston Davis, Juan Figueroa-Serville, Neville James, Norman Jn Baptiste, Terrence "Positive" Nelson, Usie R. Richards, and Celestino A. White Sr.
Sen. Adlah "Foncie" Donastorg was absent.

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