Once the political posturing died down at a hearing of the Senate Finance Committee Wednesday over which legislative committee has jurisdiction over the Frederiksted health clinic, the real issues surfaced: The facility is understaffed and underfunded.
Earlier this week, Health Committee Chairman Douglas Canton Jr. called the Finance hearing on the Ingeborg Nesbitt Clinic in Frederiksted "an unnecessary and unwarranted encroachment" on his committee. He intimated that Finance Committee Chairwoman Alicia "Chucky" Hansen's hearing Wednesday, held under the pretense of potential lost revenue for the Department of Health, was little more than political grandstanding and control.
At the hearing, Canton kept his comments brief, saying he has hearings scheduled later in the month to address concerns at the clinic. Hansen, meanwhile, repeatedly reminded anyone within earshot that she was a key factor in past efforts to expand hours and services at the clinic.
"Nobody would be working today if I didn’t get the clinic and emergency room open," she said.
While the clinic and urgent-care facility are indeed open, operating hours have been scaled back because of funding and staffing shortfalls, said Vivian Ebbesen-Fludd, the Frederiksted Health Center’s executive director. The clinic’s hours were cut at the end of last July from 8 a.m. to 7 p.m. Monday through Friday and Saturday from 8 a.m. to noon, to 8 a.m. to 5 p.m. during the week and closed on Saturdays.
Currently, the urgent-care facility at the clinic is staffed by one registered nurse, when there should be two, Ebbesen-Fludd said. Had the hours not been scaled back, the service would have been affected even more, she said, citing unaffordable overtime and, "more importantly, staff burnout, resulting in additional lack of staffing and ultimately no services."
Part of the reason Hansen called the meeting was to discuss concerns about the clinic’s role while cruise ships are calling on Frederiksted. Each Wednesday, for example, some 4,000 passengers and crew are in town when Carnival Cruise Lines ships call. Every other week, that same number of people is in port until midnight for the Harbour Night street fair. But after 5 p.m., the urgent-care facility is closed.
The promoter of Harbour Night, Hugh Dalton, who says the event brings in $4 million to $5 million annually to the island, said he will soon pitch the street fair idea to other cruise lines in order to entice them to call. But part of that pitch is ensuring that a medical and police presence is nearby.
Health care, he said, "is part of the perception of feeling safe."
"I would certainly like to have health care in downtown Frederiksted as part of marketing my agenda," Dalton said.
But covering the hours past 5 p.m., whether or not a ship is in port, doesn’t come cheap. Ebbesen-Fludd said it would cost about $450,000 a year to staff the urgent-care facility with an additional two to three physicians, two to three nurses and a support staffer.
"We can say to the community what we want to do," Ebbesen-Fludd said. "But if I don’t get actual money . . . I can’t do it. "There are a number of hurdles when we come up with another plan. It comes down to personnel."
Ironically, Ebbesen-Fludd said she has money available for nearly a dozen vacant positions, including sorely needed registered nurses. But efforts to have those positions filled have continued for nearly a year because of a delay in getting personnel requests signed by the governor.
Upon hearing that information, Hansen had the Senate’s post auditor call the Office of Management and Budget to find out why there was such a long delay. The result was a pledge to expedite the Notice of Personnel Action for the positions at the clinic.
Similar issues will likely be raised when clinic and other Health Department officials testify at a Health and Hospitals Committee meeting on Feb. 22 on St. Croix and on Feb. 28 on St. Thomas.
