Operations At Juan Luis Hospital Declined By 50 Percent Following Hurricane Maria, Officials Say

ST. CROIX — It has been no secret that both of the territory’s hospitals suffered massive losses following the devastating storms of 2017. During a Finance Department budget hearing on Monday, officials from the Juan F. Luis Hospital and Medical Center (J.F.L.) spoke of the challenges the hospital faced and continues to following Hurricane Maria, including the new reality of a depleted staff as 80 employees have been made redundant since the storm; the hospital’s outpatient dialysis service was completely lost, and its operating room was reduced to only emergencies.

That’s according to J.F.L.’s latest CEO Wanda Reuben, who testified under oath during Monday’s budget hearing. She said the hospital’s emergency room, its medical-surgical units, its progressive care units and intensive care units were also severely damaged. “J.F.L.’s census fell by more than 50 percent,” Ms. Reuben said. She reinforced her answer when asked for a percentage on the decrease of operations at the hospital by Senator Kurt Vialet.

To help mitigate the hospital’s dwindled cashflow, some $22 million of community disaster loan (C.D.L.) funding has been approved, but Ms. Reuben said to date J.F.L. has received only $13 million.

Wanda Reuben, center, JFL’s new CEO, responds to question posed during a town hall meeting held at the hospital in November 2017. (Ernice Gilbert, VIC)

The hospital has also been struggling to pay its debts. As of July, it owed $69 million, including $19 million to the Virgin Islands Bureau of Internal Revenue, $13.7 million to the Virgin Islands Water and Power Authority, and $10.8 million to the Government Employees’ Retirement System.

The government has never met its full responsibility of ensuring that the hospitals are adequately funded with particular attention to uncompensated care. Wanda Reuben, JFL CEO.

Ms. Reuben spoke of Governor Kenneth Mapp’s plan to demolish and rebuild new hospitals in both districts, and her approval of the governor’s intentions. During a recent press conference at Government House on St. Croix, the territory’s leader teased what he deemed a solution for the current situation of the hospitals, but he did not elaborate.

Even amid the hardship, however, Ms. Reuben struck an upbeat tone during her testimony, telling lawmakers that the hospital will overcome its current struggles. “Whether it is limited financial resources for operational and capital expenditures, newly formed leadership team, collective bargaining agreements that limit the ability of the organization to offer competitive salaries for clinical positions, or limited procurement capabilities based on geographic location, these can and will be overcome,” she said. “The JFLH staff, while faced with resources constraints, continues to be committed to provide the highest quality of care to our patients.”

Ms. Reuben also spoke of a monumental problem that continues to weigh on the hospital’s bottom line: uncompensated care. She said the government appropriation to the hospital in 2016 and 2017 were $28,325,834 and $24,007,736 respectively. For the same time period, uncompensated care at J.F.L was $31,005,791 in 2016 and $32,353,673 in 2017. Ms. Reuben said while the hospital remains grateful for the support it receives from the G.V.I. annually, “the government has never met its full responsibility of ensuring that the hospitals are adequately funded with particular attention to uncompensated care.”

J.F.L.’s operating budget for 2019 is $69,790,029.18, less than half of which will come from the government. The breakdown is as follows: $24,712,127.13 for personnel services, $18,961,496.34 for fringe benefits, $9,372,468.63 for supplies, $2,275,499.08 for utility services, and $14,468,437.72 for other services and charges.

Also giving testimony Monday were officials from the Waste Management Authority, which sought a 2019 budget of $29.6 million. The budget is a combination of the government’s general fund, Antilitter & Beautification Fund, Sewage Fund, St. John CIP Fund, Tourism Advertising Revolving Fund and Miscellaneous General Fund. The total cost of expenditures incurred by W.M.A. to close landfills from 2013-2016 is $14,667,549. Total obligated funds for project worksheets from FEMA is $9.37 million.

Property and Procurement Commissioner Lloyd Bough, Jr. was on hand on Monday to testify on the behalf of the department he leads. D.P.P.’s requested 2019 budget is $15.8 million: $$3,896,870 from the Business Commercial Properties Revolving Fund, $181,151 from the Indirect Cost Fund, $971,000 from local non-appropriated funds and $10,775,452 from the general fund.