The government of the Virgin Islands, by law, is mandated to cover unpaid medical care at the territory’s hospitals, but each year, the margin gets narrower or exceeds the appropriation.
Last month, the Gov. Juan Luis Hospital and Schneider Regional Medical Center presented their budget proposals to the 35th Legislature for fiscal year 2024 and talked about how they have used their funding to try to make ends meet.
On Wednesday, the chief executive officers shared their presentations with the V.I. Government Hospital and Health Facilities Corporation Territorial Board.
Tina Comissiong, CEO at SRMC, presented a budget of $105.7 million that included the Senate’s allotment of $31 million. By law, the purpose of the Senate allocation is to cover uncompensated care, which Comissiong projected to be $27 million in FY 2024. The local Medicaid match should be $3.1 million, she added, which pushes the hospital’s budget to the limit.
The CEO told the Senate that SRMC’s bi-weekly payroll is $2.1 million and that salaries and wages for next year are budgeted at $52.3 million with $19.6 million in fringe benefits. Salaries and fringes comprise around 68 percent of the total operating budget.
“Then we spoke about our efforts to improve our financial position, specifically about increasing our revenue. We described the success we’ve had over this fiscal year at improving our actual collections and the work that we’re doing within revenue cycles to collect more than we already do.”
The reduction methods were also shared with the board members by Comissiong. Costs should drop by hiring full-time workers rather than using contract labor at the cost of $11.4 million annually. She said SRMC will continue to need contract labor and reduced her FY 2024 budget to a little over $9 million for so-called travelers.
Doug Koch, CEO of Juan Luis, said they presented a balanced budget of $88,116,899, including the presumed governmental allotment of $26.75 million. The 2023 uncompensated care at the St. Croix hospital could be as much as $35.9 million, leaving a $7.1 million shortfall.
Salaries for 2023 are projected to be $35,644,028 million with fringe benefits of $25,487,113, according to Koch.
Also, in an attempt to reduce costs, Koch displayed a graphic showing the dramatic reduction in accounts payable from more than $55 million in 2019 to $17 million in 2023.
Koch also presented the impact that so-called boarders — patients who have completed their recovery but have nowhere to go — had on JFL in May 2023. The cost of caring for eight boarders and the loss of revenue was $1.1 million. Koch took into account the actual cost of providing food, care, and other supplies to those occupying the beds and the income lost.
Interagency debts to JFL that affect the bottom line have grown to more than $1.25 million since 2021. The highest debts are owed by the Bureau of Corrections and the Labor Department.
“We continue to work with these agencies to clean these up. It’s working well as we continue to see a downward trend,” he said.
Also, during the meeting, Daryl Smalls, director of the hospital redevelopment team, updated the members about demolition and rebuilding on each island.
Currently, the Charlotte Kimmelman Cancer Institute is the major project underway and demolition has been completed. There might be a construction contractor for the board approval by the next meeting, Smalls said.
Delays have occurred for the Myra Keating Smith Community Health Center because it was approved for a full rebuild rather than a renovation.
The St. Croix administration building has been delayed by the need to reroute a water line from around the CMU to the street.
Smalls said the team is preparing a bid invitation for the old JFL and a solicitation will be out by Nov. 1.
During the meeting, medical appointments for both hospitals were appointed and renewed. The board also approved a revised bad-debt policy.
After an executive session, Chairman Christopher Finch said the board voted to lease office space for the redevelopment team close to the upcoming demolition of the Kimmelman and SRMC facilities on St. Thomas.
