March 9, 2004 Statistics flew fast and furious on the Senate floor Monday as individuals testified both for and against granting a Certificate of Need to a proposed ambulatory surgical center in St. Thomas. Monday's testimony was given during a meeting of the Health, Hospitals and Human Services Committee, chaired by Sen. Douglas E. Canton Jr. Although the members of the Legislature have no role in granting the Certificate of Need, Canton indicated he held the day-long hearing to enlighten the public.
According to St. Thomas attorney David Bornn, who's representing the nine local doctors proposing the center, all that's at stake is 2.04 percent of Roy L. Schneider Hospital's outpatient revenue.
"That's what this fight is all about," Bornn said, who estimated the hospital's outpatient revenue at $1.28 million.
As expected, Schneider Hospital CEO Rodney E. Miller Sr. sees it differently. "The effect of an approval [of the certificate] will be devastating," he said.
Miller said that 53 percent of the hospital's procedures are done on an outpatient basis and added that outpatient procedures are a profit center that offsets losses in other areas.
He listed loss of revenue and surgeons and nurses as reasons why the Health Department should deny the Certificate of Need to the group.
In order for the surgical center to become a reality, the nine physicians need to secure a Certificate of Need from the Health Department. The matter is now wending its way through the bureaucratic process.
Both sides have already been heard extensively in the media and at various meetings held by community organizations.
Canton started the meeting by asking Acting Health Commissioner Darlene Carty to explain the process for obtaining a Certificate of Need. She then explained that the department gives such certificates when there is an unmet need.
Bornn said that physicians at the surgery center will provide services not available at the hospital, ticking off a list that included eyelid reduction, collagen injections, laser eye surgery and face lifts.
Dr. Ruth Watson, who is medical director at Roy Schneider Hospital, said those services were available at the hospital.
She complained that the nine physicians never expressed their concerns about doing such procedures at the hospital.
Watson said the hospital has "excess capacity," meaning it has rooms and times available for physicians to do more procedures than are currently being done.
The nine physicians proposing the center are Dr. Byron W. Biscoe, Dr. Jeffrey Chase, Dr. Catherine Kean, Dr. Sonia Taylor-Griffith, Dr. Horace Griffith, Dr. Derrick Jones, Dr. Francesco Isolani, Dr. Michael Savage, and Dr. Adam Shapiro.
Dr. Anne Treasure, who is the outgoing president of the V.I. Medical Society, said that a poll of 33 physicians in St. Thomas and St. Croix showed they all opposed the surgery center.
Biscoe said he envisioned the center would attract tourists wanting outpatient medical procedures. "This is our recovery room," said Biscoe, showing a slide of Magens Bay.
Bornn said that patients would pay less for procedures at the surgical center and noted a survey showing that nationally, the cost at an outpatient center ran 46 percent cheaper.
However, Watson and others pointed out that only those with good insurance would use the ambulatory facility. The hospital would be stuck caring for those with no insurance, Medicare patients and the indigent.
Dr. Alfred O. Heath, who several times during the previous decades was health commissioner, said that it cost the hospital $900,000 to care for a gunshot wound victim who had no where else to go. And, he said the hospital paid $250,000 to a Miami hospital for care of a premature baby. Heath argued that without the profit center of outpatient surgery, the hospital would be financially devastated.
Later in the afternoon, RLSH Chief of Surgery Dr. Frank Odlum added that "what the V.I. health care system needs is not an ambulatory surgical center but more support for its hospital."
In other committee action, the members considered Bill No. 25-0069, legislation that would transfer the operational aspects of the East End Family Health Center and the Frederiksted Health Center/Ingeborg Nesbitt Clinic to the St. Thomas East End Medical Center Corporation and Frederiksted Health Care, Inc. The committee members approved the measure, which will be forwarded to the Rules Committee for further action.
Senators present at the hearing included Douglas Canton Jr., Lorraine Berry, Luther Renee, Emmett Hansen, Usie Richards, David Jones, Ronald Russell, and Carlton Dowe.
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