The Juan F. Luis Hospital and Medical Center. Photo Credit: ERNICE GILBERT, V.I. CONSORTIUM
Just over two weeks after he initially floated the idea of a state of emergency in the territory over healthcare, Senator Ray Fonseca has written formally to Governor Albert Bryan Jr. requesting such a declaration.
In an open letter to the governor, dated January 31, Mr. Fonseca outlined 11 actions he says can be taken during a hospital-related state of emergency to put the territory's public healthcare facilities on more solid footing. These include renegotiating insurance agreements, mandating zero co-payments for members of the government's health plans, renegotiating reimbursement rates to ensure territorial hospitals receive higher reimbursements than other healthcare facilities, and providing emergency support to the East End Medical Center.
The senator also wants the governor to utilize emergency funding to hire staff, replace non-functional equipment, and pay down outstanding invoices from vendors. Under his plan, the governor would also be prioritizing healthcare facility reconstruction projects as well as those for residential senior facilities, with the latter action aimed at addressing the issue of “boarders” in the territory's hospitals. The last of the lawmaker's 11-step plan would be to fund the Virgin Islands Diabetes Center for Excellence, to the tune of $1.5 million.
“We need to get our hospitals back in a situation where our residents would want to go to them,” said Sen. Fonseca when reached for comment. “And when they go to them, they would have the staffing and equipment and the basic supplies to provide the services.”
While acknowledging that not all of his 11 action items necessarily required the governor's emergency powers to achieve, the chair of the Senate Committee on Health, Hospitals and Human Services nevertheless argued that outside the emergency declaration, “some of them you just cannot do, such as speeding up the procuring of the constructions, hiring these additional staff, making these adjustments to the insurance, the out of pocket expenditures.”
Fonseca told the Consortium that the public is behind him on this issue. “Since I brought this to the public's attention, it's like I've opened up an ant's nest,” he said. Noting that he has received numerous calls from vendors telling him that they are owed significant sums, Fonseca suggested that “the hospitals are like WAPA, where they owe more money than they can pay.” Therefore, like WAPA, he argued, hospitals need emergency intervention from the executive branch to stabilize their operations.
“That way, you can dip into the budget stabilization fund to pay certain vendors…you can dip into the general fund to pay for other things…you can go and get a single contractor and negotiate,” he said.
Completing his 11-step action plan would ensure that territorial hospitals become the facilities of choice for Virgin Islanders, establishing a positive feedback loop where hospital revenues rise as more and more residents remain on island for routine care rather than traveling to healthcare facilities on the mainland. Currently, he argued, “they are buying a plane ticket and staying up in a hotel and having a colonoscopy there in these other places for two main reasons: they have a lack of confidence [in local hospitals], and the other reason is that they have a larger out of pocket expense [in local hospitals].”
Responding to Governor Bryan's suggestion that private management firms takeover the running of the territory's hospitals, Fonseca asserted “that's not the solution. The solution is providing the resources that we're going to need.” He indicated that the issue would be explored further in an upcoming Senate committee meeting.
