ST. THOMAS – The Committee on Budget, Appropriations, and Finance, under the leadership of Senator Donna A. Frett-Gregory met in the Earle B. Ottley Legislative Hall. Lawmakers received testimony on the proposed Fiscal Year 2025 Executive Budget for the Schneider Regional Medical Center and the St. Thomas East End Medical Center Corporation.  

Tina Commissiong, Esq., Chief Executive Officer of the Schneider Regional Medical Center delivered a recommended budget of $32.75 Million. However, Commissiong stated that the GVI appropriation should be $46.3 Million. As per law, the Government of the Virgin Islands appropriation must cover the local Medicaid match. Under the Federal/State Medicaid Program, the local government must cover its share of payments to the Hospital for approved services provided to Medicaid beneficiaries. The Federal Government pays 83% of approved claims and the Local Government must match 17%. It must also cover uncompensated care. Also, Commissiong stated that the local Medicaid match for FY 2024 is projected to be about $4.4 Million by year’s end. For Fiscal Year 2025, the local Medicaid match is expected to be approximately $2.3 million. This number is lower as approximately 16,000 people are losing Medicaid coverage before Fiscal Year 2025. Furthermore, SRMC is on track to provide at least $32 Million in uncompensated care in FY 2024. SRMC is expected to provide $44 Million in uncompensated care. It is expected that more people will show up to the hospital as self-pay who cannot pay their hospital bill which would increase the uncompensated care for Fiscal Year 2025. 

Salaries and wages expenses for SRMC for FY 2025 are budgeted at $55 Million. Fringe Benefits are budgeted at $19.6 Million. Biweekly payroll is $2.6 Million. There are 569 full time employees at SRMC, which includes 114 full time registered nurses and 37 full time physicians. There are also 21 part-time employees and 49 per-diem employees. Materials and supplies total $12.2 million. Other services and charges, which include freight, professional services, and temporary staffing agency expenses are budgeted at $16.7 million. The use of 13 locum physicians costs SRMC approximately $7 Million annually. Utility costs are budgeted at $6.4 Million. The disposal of medical waste costs the facility $500,000 annually. Repairs and maintenance costs are budgeted at $1.8 million, which were said to be insufficient for the repairs needed to the facility. Commissiong voiced concern that the Roy L. Schneider Hospital, originally built in 1982, was aging and although some areas were updated, others had not received any update since it was originally constructed. Additionally, the temporary structure built at the Myrah Keating Smith Clinic on St. John was not intended to be a permanent solution and that repairs were needed until the permanent facility is built. These facilities will be rebuilt. The facility has been challenged with a long-standing high accounts payable, which is currently $30 Million. One of the largest payables is to the GERS, which is $5.7 Million. SRMC currently does not owe any employee withholdings to GERS. SRMS also has a large payable to the DOP for CIGNA Insurance Premiums at $4.6 Million. SRMC serves more than 15,000 patients annually and performs more than 1,500 outpatient surgeries and procedures annually. Reducing expenses has been critical for the facility. An average of $15,000 per payroll has been saved due to an initiative that began in December 2023 that looked at overtime expenses. An anticipated savings of $300,000 is expected by the end of FY 2024. Temporary labor spending has decreased from $15.3 Million in FY 2023 to $10.4 Million in FY 2024.  

Tess G. Richards, M.D., Interim Executive Director of the St. Thomas East End Medical Center Corporation delivered its proposed FY 2025 Budget of $7,770,108. STEEMC is requesting $3,266,424 from the General Fund. Personnel costs cover 70 employees, budgeted at $4,643,541. Employee benefits total $1,125,266. Contract and professional services are budgeted at $196,000 and $427,600, respectively totaling $623,600. Supplies is budgeted at $189,200. Travel and continuing education is budgeted at $20,000.  Rental of spaces, land and off-site storage is budgeted at $600,000, Communications at $36,000, Utilities (water and electricity) at $132,000, repairs and maintenance at $100,000, other services at $150,500, which includes recruitment, which is budgeted at $60,000. Recruitment costs include engaging a recruitment agency, posting classified and journal advertisements, candidate interviews and telephone listings. Advertising and events are budgeted at $30,000. Insurance is budgeted at $60,000. Projected program income is budgeted at $3,000,000. $1,464,580 is expected from the 330 Federal Grant.  

Expenses were cut by about $250,000 in the past year. The physical footprint in the Tutu Park Mall was reduced, which also reduced the rent by about $40,000 per month. Payroll was reduced by $2.5 Million. STEEMCC also negotiated out of a land lease. Three more providers (2 internal medicine, and one pediatric) were added. Two full time dentists, a dermatologist, and two primary care providers were added to the staff. STEEMCC is required to provide care to everyone, regardless of ability to pay. Often, some patients do not pay their bills, and some cannot pay their bills. Some are also seen at discounted rates. STEEMCC treated 1,939 self-pay patients in 2023, which was an increase from 1,662 patients in 2022. Self-pay charges totaled $2,281,191. STEEMCC collected $191,429. The balance of $1,880,461 is uncompensated care. Richards stated that there has already been an increase in self-pay from 24% in 2022 to 29.5% in 2023, when patients who qualified for medical assistance during the COVID-19 pandemic no longer qualified for medical assistance. This number is expected to increase due to recent changes in Medicaid enrollment. In 2023, STEEMCC served 6,623 total patients with 17,814 visits.  

Senators present at today’s committee hearing included Donna A. Frett-Gregory, Novelle E. Francis, Jr., Marvin A. Blyden, Angel L. Bolques, Jr., Samuel Carriόn, Dwayne M. DeGraff, Ray Fonseca, and Milton E. Potter. 

The Division of Public Affairs is committed to providing the community with accurate information on proceedings at the Legislature of the Virgin Islands. Visit legvi.org. 

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