Mental health care is an urgent need in the territory and, if money becomes available in these tight budgetary times, it needs the funding, Health Commissioner Darice Plaskett told the Senate Finance Committee during budget hearings Tuesday.
"Care for the mentally ill is a great challenge in the territory," Plaskett testified. “There are many gaps in the system and limited available resources.”
The inpatient psychiatric unit at Gov. Juan F. Luis Hospital has been closed for two years and successful clubhouse programs have been shut down, compounding the challenge, Plaskett said. Health spent $4.2 million on mental health and substance abuse services in Fiscal Year 2013, of which $1.4 million was for adult residential off-island care, she testified.
Health has given the Office of Management and Budget a proposal to establish a mental health case management program and to reestablish the mental health clubhouse programs, "in the event new revenues are available," Plaskett said.
Mental health services are available at the Charles Harwood Complex, Frederiksted Clinic, Barbel Plaza and Morris de Castro Clinic. A total of 2,509 clients were served in FY13, with 341 at Charles Harwood; 235 at Frederiksted Health Center; 1,694 at Barbel Plaza; and 239 at Morris Castro clinic, according to Plaskett’s testimony.
In 2009 the V.I. government entered into a consent decree to develop a five-year strategic plan to improve the mental health and substance abuse care system. Last year Athena Consultant was contracted to develop the five-year strategic plan, which is scheduled to be completed by the end of July.
Plaskett presented the department’s budget request of $48.8 million. Of that total, $20 million is to come from the General Fund; $6.2 million from the Miscellaneous Fund; $2.6 million from the Health Revolving Fund comprised of fees for services; $881,000 from other nonappropriated funds from casino taxes and federal funding through the Indirect Cost Fund; and $19.2 million, or 39 percent, in federal funds.
The General Fund appropriation will cover $11.7 million in wages and salaries and $4.6 million in employer Medicare, Social Security and pension contributions. Utilities are budgeted at $788,000 from the General Fund – unchanged from last year.
Out of the Miscellaneous Fund allocation, $2 million is for the Frederiksted Health Center; $1.7 million for St. Thomas East End Medical Center; $1.2 million for outstanding mental health care and other obligations; $569,000 for V.I. Perinatal Inc.; $274,000 for the Nurse Licensure Board; $225,000 for the Ryan White Title IV program; $180,000 for HIV medication and $75,000 for ambulance boat maintenance.
Federal funds will pay $6.2 million for wage and salaries; $2.5 million for employer benefit contributions; $6.3 million in supplies; $2.7 million in other services and charges; $1.2 million for local indirect costs of federal programs; and $18,000 for utilities.
Later the Public Finance Authority’s executive director, Angel Dawson, gave the committee an overview of the Virgin Islands’ public debt and the authority’s operations in the current fiscal year, but he did not present a proposed budget. The PFA is an autonomous public corporation that aids the Virgin Islands government in meeting its fiscal obligations and raising capital for essential public projects, but its operation is not funded through the General Fund.
The PFA budget is appropriated through contributions from the Internal Revenue Matching Fund and from the authority’s project/administration fund, comprised solely of fees collected upon the closing of bond financings.
The PFA will finalize its budget in August, covering PFA office expenses, transportation, payroll, property and casualty insurance. Dawson said the FY14 operating budget was $6.2 million, a $900,000 reduction from the year before.
The federal Revised Organic Act limits the V.I. government’s general obligation debt to a ceiling of 10 percent of the assessed value of taxable property in the territory, which Dawson said was about $924.9 million as of July 1.
Currently the government’s general obligation debt stands at $753.5 million, which includes a Water and Power Authority guaranty loan of $10.3 million.
The territory also has $1 billion in bond debt secured by rum revenues through the Internal Revenue Matching Fund, plus another $283.8 million in special bonds for Diageo and Cruzan Rum, where the government has limited liability and the loans are secured only by new revenues that arise out of the capital projects paid for by the bonds.
Debt service on the combined total bond debt of $2.1 billion comes to $179.4 million a year. Bond ratings remain steady, Dawson said.
All committee members were present. Noncommittee members Sens. Kenneth Gittens and Tregenza Roach were also present.