Executives Update Health, Hospitals and Human Services Committee on JFL Audit and Rebuilding

Gov. Juan F. Luis Hospital and Medical Center on St. Croix, in March 2018. (Source file photo by Bill Kossler)

The Senate committee on Health, Hospitals and Human Services learned some of the reasons progress has been so slow moving into the temporary structure that will serve as the hospital for St. Croix until a new permanent structure is built.

Testifying for the Juan F. Luis Hospital were Christopher Finch, member of the JFL governing board and chairman of the territorial hospital board, Doug Koch, JFL chief executive officer, Darryl Smalls, executive director of the Territorial Hospital Redevelopment Team, and acting Human Resources director, Terry Lynch.

Finch addressed the April Inspector General’s report about discrepancies at the St. Croix hospital and said the audit was requested by the JFL governing board. It covered the period from 2017 to 2019.

Christopher Finch, board chair, addresses the Territorial Hospital board during a virtual meeting in February of 2021.

The audit found the hospital staff did not always follow procedures to solicit competitive bids for items over $25,000 and follow the procurement and approval process. Additionally, five purchases over $100,000 were not approved by a board member.

Finch said that the management and the board have changed since the audit period but emphasized that payment requests over $100,000 are being examined by committees, and district boards, and now there is a procurement meeting prior to approval by the full board. Also, both hospitals have since hired procurement officers, appointed bid evaluation committees and Finch signs all contracts over the $100,000 limit.

According to Finch, the Office of the Inspector General accepted JFL’s remedy to avoid further mistakes. A contract for $650,000 that was approved without a proper signature was the reason for asking for the audit in the first place, he said.

Senators wanted to discuss a management decision that involved wasting $1.4 million to outfit two operating room trailers that were never used after the 2017 hurricanes. Finch admitted he didn’t really know because he wasn’t involved with the hospital at the time. The JFL executives and board members at that time expected the trailers were already outfitted and they didn’t realize the trailers had to be returned, he surmised.

“A lesson was learned. This was perhaps a gift horse that should have been looked in the mouth,” Finch said, adding that the Office of the Inspector General indicated the item was “resolved, but not implemented.”

Some other delays and errors were made because the hospital was not condemned immediately after the hurricanes and expenses were authorized to make repairs instead of waiting to rebuild. Now there is the Hospital Redevelopment Team and a procurement policy, created by the board, to manage all rebuilding projects and avoid making the same mistakes, Finch said.

Then Smalls talked about the redevelopment team that consists of three engineers, a former FEMA disaster recovery specialist, two procurement people and an executive assistant. He gave a short summary of the JFL rebuilding progress. Smalls said the all-important mechanical room to contain emergency generators, the water system, medical air and vacuum system should be completed by August. Once it is finished and functional, demolition of the old hospital will commence. Some delays were caused by the inability to get supplies and rebuilding the ground beneath the mechanical building to support the weight. Smalls estimated JFL North will be activated in the fall of 2022.

The new chief executive officer, Douglas Koch, testified about the status of the hospital and reported the labor and delivery unit remains closed pending an air quality report to re-open.

Staffing problems continue to plague the St. Croix hospital and Koch said the needs for nursing staff are based on the 62 in-patient beds in addition to the emergency room, operating room, and the outpatient dialysis unit. JFL North has a similar staffing plan and is based on industry and regulator indicators for each service, he said. Currently, JFL has almost half of the number of registered nurses needed and is using staff from Pafford Staffing to fill vacancies.

“Our recruitment plan includes ongoing recruitment for permanent critical hires, implementing workforce development initiatives that grow local talent and utilizing agency staff to fill critical vacancies,” Koch said.

To gauge employee morale and ask about their needs, Koch met with 70 staff members for an eight-hour discussion recently. He said in-house staff development, such as educational programs and cross-training, is important to keeping staff and keeping them happy.

Senators had a variety of questions for hospital officials. The $1.4 million trailer error was questioned by several who wanted to know if there were repercussions. Finch said he knew of one termination but didn’t know of any consequences for other errors.

Senators Kenneth Gittens and Kurt Vialet asked about COVID-19 pay for emergency responders who have worked through the pandemic. Although there seems to be a $70,000 cap to qualify, Terry Lynch, acting Human Resources manager, said she has submitted all employees for the compensation.

Regarding finances, Koch told Sen. Javan James that current vendors have been paid on time but there are older invoices that have not been compensated fully.

Committee Chair Sen. Novelle Francis commended JFL for asking for the audit and accepting the Inspector General’s recommendations. He asked Finch what has been changed to deal with any future losses such as the $1.4 million spent on the operating room trailers. A procurement procedure was put into place three years ago and the board finance committee reviews vendor files, he answered.

“We’re praying for you to deliver JFL North to the people of St. Croix. What can we do, as legislators, to get it up and running?” asked Francis.

Attending the session were Sens. Francis, Gittens, James, Vialet, Janelle Sarauw, Samuel Carrion, Alma Francis Heyliger and Marvin Blyden.