Aug. 26, 2002 Roy L. Schneider Hospital is bleeding to the tune of $12 million a year in uncompensated care to the indigent and illegal immigrants, but Rodney Miller, new chief executive officer, plans to slow that hemorrhaging down.
In a presentation to a luncheon meeting of the St. Thomas-St. John Chamber of Commerce on Monday, Miller said 43 million Americans are currently uninsured, so the problem of uncompensated care is not exclusive to the Virgin Islands. But, he said, as the only hospital in the district, Schneider Hospital, along with its Myrah Keating Smith Community Health Center on St. John, has an obligation to serve the entire community. Illegal immigrants and indigent people are not the only problem, he said. Uninsured dependents of government workers also end up coming to the emergency room and running up bills they can't or don't pay.
Miller said another part of the problem, which he is addressing with the help of Delegate Donna M. Christensen, is the federal Medicaid cap imposed on the territory. Getting the cap lifted, updating computer systems and improving collections by 20 percent are "key to elevating and expanding our services to the community," he said.
Despite ongoing challenges, the hospital can become a "world class" health care facility, in part because of the distinguished medical specialists who have been drawn to the islands, Miller said.
A big step toward that goal, he said, will be the opening of the hospital's cancer center, slated for groundbreaking this year. He announced that he had just cut a deal with Oncology Solutions, a nationally recognized organization specializing in the development of cancer centers, to work with the hospital administration to "establish the clinical infrastructure for a successful cancer center."
He also said negotiations are ongoing with Dr. Bert Petersen Jr. to spearhead the project. Petersen, a native Virgin Islander, is a New York City surgeon, cancer specialist and medical school professor. He has already begun working to establish academic affiliations "that would result in specialists, residents and interns being based at the center," he said at the 8th annual Bio-Medical Ethics Workshop in November. (See "Cancer center will bring more than care".)
Miller sees the Charlotte Kimelman Cancer Treatment Center, as it will be called, as one big step toward keeping residents on island for their health care. More specialists will help further, he said, adding to revenues. But more important, he added, patients will be able to stay on island, thus alleviating the added stress involved in traveling long distances for care.
Miller said the availability of specialists locally is no longer the problem it used to be. For a community of its size, St. Thomas has an impressive number of highly trained physicians, he said. Infrastructure and technology, which cost money, are the areas that cry out for improvement and funding.
Miller said an investment in the hospital is really "reinvestment." "If you made a one-time investment in the hospital, you would get your ROI [return on investment] immediately." He also said if health care spending stayed on island, "it would change the face of the Roy L. Schneider Hospital overnight."
Among his other goals, Miller said, he hopes to:
Obtain accreditation from the Joint Commission on Accreditation of Healthcare Organizations.
Increase federal grants and private endowments.
Complete a certified audit for Fiscal Year 2002 to insure the hospital's financial solvency.
Complete computer automation to improve billing and accountability.
He also is bent on improving morale both in the hospital and in the community.
He said when he arrived, staff morale was low. Employees "had been made promises, and those promises had been broken," he said. "They had lost hope in the hospital."
Miller said he is "big on promotion from within," but not without merit. "We don't promote just to promote. The ones that go above and beyond will be the ones to get recognition," he said.
Included in his plans to improve the hospital's prestige in the community is cleaning the facility up. He got that project started last weekend, attracting more than 200 volunteers to the hospital to clean, wash and wax floors, and paint.
He said he plans to have the outside of the hospital repainted, too. This also had been a goal, never achieved, of his predecessor, Eugene Woods, who referred to it as "painting away the blues."
Most important, Miller said, "It's my job to build trust" in the community. "I've got to prove that I can provide health care." But, he added, "It's going to take the community, too."
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