July 31, 2003 – Health was a recurring theme at the Senate Finance Committee's budget hearing on Thursday as Roy L. Schneider Hospital, the Health Department and the Board of Nurse Licensure presented their Fiscal Year 2004 requests. First up, however, was Finance Commissioner Bernice Turnbull, who asked for an increase for her department's budget.
"The V.I. government does not have resources to give the Department of Finance additional funds," Turnbull said in testimony that extended over three hours. But she nonetheless requested an appropriation of $10.2 million, up 6.6 percent from the current fiscal year, even though there are reductions in most items.
She said the funding would consist of $7.7 million for the department, $2.1 million for the Indirect Cost Fund and $460,000 from the Government Insurance Fund.
The budget breakdown:
– $4.9 million for personnel, a cutback of .04 percent.
– $205,000 for capital outlays, a drop of 52 percent.
– $1.5 million for fringe benefits, a reduction of 6.3 percent.
– $364,000 for supplies, a cut of 7.2 percent.
– $393,000 for utilities, a drop of 7.4 percent.
– $2.8 million for services and charges, an increase of 35.6 percent.
– $3.9 million for 122 classified positions.
– $944,000 for 25 unclassified positions.
Turnbull noted that as a cost-saving measure, government checks will be printed on St. Croix using a laser-writing technique. She said it will cost about $200,000 to implement the procedure. "You know we have to invest in the system so we can save money," she told the senators.
Sen. Louis Hill asked what the savings would be. Turnbull said it would amount to $500,000 over time. The new system will use regular paper instead of the check stub paper used now and will eliminate the cost of sending checks by seaplane or other means, she said.
Turnbull told the committee that the governor's financial team is continuing to meet weekly to discuss revenue projections, which she said are in continual flux because of what's "happening in the economy."
Schneider Hospital was the first agency heard in the afternoon. Its chief executive officer, Rodney E. Miller Sr., expressed his frustration with the hospital's financial limitations, telling the senators that it's as if "you are actually running an organization with your hands tied behind your back."
His FY 2004 budget request for the hospital and St. John's Myrah Keating Smith Community Health Center is for $27.9 million, up 15 percent from $24.2 million this fiscal year.
Miller said current hospital collections are up 23 percent over Fiscal Year 2002 and that he expects them to total $31.3 million by the end of FY 2002.
"The biggest challenge facing the hospital," Miller said, "is the shortage of adequate staff, particularly nurses." Contracting off-island nurses is draining the hospital's resources, he said, with each nurse costing "average of $110,000 annually," whereas permanent nurses hired locally would cost less than half that.
Miller said Schnieder Hospital will spend more than $6 million this fiscal year for contract nurses.
When he made a recruiting trip to Puerto Rico, he said, 80 nurses there expressed a serious interest in working in the territory. The nurses have degrees from accredited schools, have extensive experience, are licensed in Puerto Rico and work in facilities accredited by the Joint Commission on Accreditation of Healthcare Organizations, he said; however the Board of Nurse Licensure would not approved them.
Later in the afternoon, when two of the 11 members of the licensure board came before the committee to present its budget, Sen. Adlah "Foncie" Donastorg, the committee chair, and Hill asked them about the board's ruling on the nurses from Puerto Rico. "It is in the opinion of the board, and that it really what it rests on," Hill said of the decision.
Winifred Garfield, board executive secretary, said the board rejected the nurses because they have not taken a standardized examination and because they "are licensed to work in that district. They are not registered nurses. We cannot license what they do not have."
Board of Nurse Licensure
The Board of Nurse Licensure is asking for $253,983 for FY 2004, 27 percent more than this year. Of that, $151,408 would come from the General Fund and $102,575, from the Nurse Licensure Revolving Fund.
Donastorg noted an item of $17,075 for travel expenses in the proposed budget. He asked that the board, which has members in both districts, consider cutting costs by holding teleconferenced meetings.
Health Commissioner Mavis Matthew requested an appropriation of $56.8 million, consisting of $27.2 million from the General Fund, $2.9 million from the Health Revolving Fund and a supplemental request of $3.9 million, with the remainder to come from federal funds estimated at $22.8 million.
Matthew said her first goal for FY 2004 is to maintain and increase access to quality health care services by providing comprehensive and coordinated services.
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