St. Thomas East End Medical Clinic and Frederiksted Health Care's Ingeborg Nesbitt Clinic are seeing increasing numbers of patients, spurring both to expand, even as the percentage of insured, paying patients is decreasing, the clinics' managements told senators during budget hearings Tuesday.
FHC has seen a steady increase in patient visits over the past half decade, with 9,250 patients in 2007; 14,744 in 2010; and 16,795 patients projected for the current year, Chief Executive Officer Masserae Sprauve Webster told the Senate Finance Committee.
Exacerbating the trend, in February the clinic began offering dentistry, and since then, the Health Department closed its dental services, making the clinic the sole provider of affordable dental care on St. Croix, Webster said.
As a result, "FHC's dental services are scheduled two months out and we presently have a waiting list of over 560 patients," she said.
To help meet this increased demand, the clinic is looking to expand in Christiansted, by setting up a rental suite of four dental chairs in Christiansted at a projected cost of $1.1 million, which they hope to have ready for patients in October.
As more patients began flowing to the clinic, it also saw uninsured patients increase from 23 percent to 26 percent of all patients, she said.
"With the closing of Hovensa and the subsequent loss of jobs that supported the oil refinery, we at FHC have had to say goodbye to several of our patients. On the other hand, we have seen a small surge in patients who no longer have insurance," Webster said.
But Medicaid, Medicare and private insurance payments have remained flat or decreased, putting a strain on finances. For that reason, Frederiksted Health Care is asking for a General Fund budget appropriation for Fiscal Year 2013 of $2.6 million – more than half a million dollars in excess of the Office of Management and Budget recommendation of $2 million. And a million dollars more than the 2012 appropriation of $1.5 million.
Of that requested figure, $1.7 million is for wages and salaries; $484,000 is for associated benefits; $250,000 is for utilities; and $50,000 is for "other services and charges."
Along with its General Fund request, FHC anticipates another $1.3 million in federal funds and $840,000 in program income, for a total FY13 budget of $4.2 million.
"If you don't get the extra money you are asking for, how will you manage?" Sen. Patrick Simeon Sprauve asked.
"We will continue as we are," Webster said, adding later, “But we are concerned for the community.”
Meanwhile St. Thomas East End Medical Center Corp. has seen its patient visits increase nearly four-fold in four years, from 4,247 in 2009 to the 15,880 projected for the current year, according to testimony from Moleto Smith Jr., chairman of the STEEMCC Board of Directors.
To serve the increased demand, the medical center recently completed an expansion more than doubling the footprint to about 7,600 square feet, thanks to federal stimulus funds. The expansion increased the number of exam rooms from five to 14, and dental suites from two to three, Smith said.
St. Thomas East End Medical Center is requesting a General Fund appropriation of $1.7 million for FY13 – the same amount recommended by the Office of Management and Budget. That sum represents an increase of $579,000 from the FY12 appropriation.
The clinic anticipates another $2.5 million in income from fees for services, and $676,000 in federal grant funds, for a total operating budget of $4.9 million.
Salaries are budgeted at $2.2 million, with associated benefits costing another $640,000. Contracts and consultants, including lab services, information system operations and other contracted services, total $1.3 million. Supplies are budgeted at $162,000. The catch-all category of "other services and charges" is budgeted at $1.1 million. Of that, travel and continuing education is $52,000; another $25,000 is budgeted to purchase a vehicle. Phone, internet, paging and answering service expenses are budgeted at $40,000. Facilities rental is $240,000.
No votes were taken at the information gathering hearing.