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Health Department Needs More of Everything, Including Money

Aug. 18, 2006 – While the Emergency Medical Service may be short staffed, the fact that the emergency medical technicians aren't stationed close enough to reach sick people in a timely manner may be more pressing, EMS Medical Director Dr. Selwyn Mahon said as the Health Department appeared Friday for its budget review before the Legislature's Finance Committee.
"We must be deployed from areas where we can get to you," he said.
He suggested that St. Thomas and St. Croix need a minimum of three locations each, with St. John needing two.
He said that currently St. Thomas and St. Croix each have two stations and St. John has one.
Sen. President Lorraine Berry, who made a brief appearance at the Finance Committee meeting, said she was at a funeral in Frederiksted, St. Croix, when a woman fainted. She said it took at least a half hour for the ambulance to arrive from Juan F. Luis Hospital.
"That's a long distance to travel, especially if there's traffic," she said.
Mahon said the territory currently has a total of 52 EMTs, with six vacant positions. He said one of those positions was for a boat captain to run the Star of Life ambulance boat on St. John.
He said in order to adequately serve the public, EMS needs 28 EMTs each on St. Thomas and St. Croix and 17 for St. John.
Alexander Williams, who serves as EMS coordinator for St. Thomas-St. John, said the department pays $1.5 million in overtime costs to EMTs because EMS lacks sufficient staff.
Health Commissioner Darlene Carty made the case for the department's $66.6 million Fiscal Year 2007 budget request. Of that figure, $32.4 million comes from the General Fund, $2.2 million from the Health Revolving Fund, $31.8 million from federal funds, and $232,000 from the Emergency Medical Services surcharge fund.
She said this was an increase of 6.9 percent over the previous year.
Carty said the Health Department had 678 positions, with 495 of them funded from the general fund. She said 175 were paid for by the federal government and four through the St. John Capital Improvement Fund.
She said 123 of those positions were vacant, many because the department cannot pay the salaries health care professionals demand. She said the problem was particularly acute with positions such as psychiatrists. And she said that social workers can make more at other government departments and agencies.
"Salaries are determined by collective bargaining agreements," Carty said.
She said that the department was working on reclassifying some jobs, but that the process was lengthy.
In matters not related to the budget, some senators put Carty in the hot seat by asking her about the apparent conflict that exists between the Health Department and the Schneider Regional Medical Center.
"There has been a very clear indication of conflict between Health and the hospital," said Sen. Louis P. Hill, Finance Committee chairman.
He said that the courts upheld the Health Department's position on granting a certificate of need to a private medical facility – a matter that caused a huge public tug-of-war between the Health Department and the hospital.
Earlier, Carty told Sen. Roosevelt David, who asked a question about the conflict, that it wasn't a fair question. She inferred that it wasn't the Health Department that was causing the problem.
Hill also called the recent tussle between the Health Department and the hospital over Carty's reluctance to give the hospital its license to operate a "huge debacle." (See "Health Commissioner and Hospital CEO at Odds Over License Procedure").
After he asked Carty if she got the documents she wanted from Schneider Hospital in order to grant the license, she said she had 85 percent of them. However, she said that she got all the documents necessary from Juan F. Luis Hospital regarding its license.
On another Health and hospital issue, Carty said that when the Legislature split off the territory's hospitals from the Health Department, it left the department just about homeless. The Health Department on St. Thomas operates out of the hospital and from other locations around the island. However, Carty said plans are in the works to build the Health Department its own facility.
To help fund increased budget needs, Vashti Liburd-Gumbs, the department's deputy commissioner for fiscal affairs, said that in the next three to four months the Health Department will announce an increased fee schedule for its services to help increase revenues.

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