Health commissioner: Budget cuts result in no open positions, despite staffing shortage

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ST. THOMAS - V.I. Health Department Commissioner Darice Plaskett fielded questions from senators for about six hours Tuesday as she defended the department's total $48.8 million Fiscal Year 2015 budget before the Senate Finance Committee.

Among the topics for discussion was the Emergency Medical Services division, the cancer registry, services for the mentally ill, HIV/AIDS programs and many other issues.

The department's total operating budget, as recommended by the governor, is $48,832,269. Of that amount, $26.2 million comes from the General Fund.

The budget breaks down as follows:

- General Fund operating budget - $20,034,274.

- Miscellaneous section - $6,167,430.

- Health Revolving fund - $2,554,707.

- Local funds - $881,417.

- Federal funds - $19,194,441.

The $6.1 million from the miscellaneous section of the executive budget consists of earmarks to other agencies and programs that fall under the Health Department for budgetary purposes but are passed along. The miscellaneous appropriation will fund the Frederiksted Health Center; the St. Thomas East End Medical Center; V.I. Perinatal Inc.; the Nurse Licensure board; ambulance boat maintenance; HIV prescription and other programs; and mental health and other obligations.

Staffing cuts

Budget cuts in the current fiscal year have forced the Health Department to eliminate all vacant positions funded by the General Fund, according to Plaskett.

Despite the need for additional staff - particularly in the EMS division - no money is available for hiring, she said.

Similar reductions took place in FY 2013 as well, Plaskett said.

In the event new revenue becomes available, Plaskett said she sent a list of critical positions that need to be funded and filled to the Office of Management and Budget.

"The staffing needs for the areas where significant overtime is generated to maintain appropriate coverage, such as EMS and the Eldra Schulterbrandt Facility, are included," Plaskett said. "Additionally, a proposal for the establishment of a Mental Health Case Management Program and to re-establish the Mental Health Clubhouse Programs was also transmitted to OMB."

The proposed FY 2015 budget will fund salaries and benefits for 274 positions.

For federally funded positions, the department has about seven unfilled vacancies, Plaskett said.

The department spent about $646,271 in overtime in FY 2013 and from October to April of FY 2014 has already spent $490,694, according to Plaskett.

EMS deficiencies

In a line of questioning by Sen. Judi Buckley, it came out that while EMS employees have been trained they have not been promoted because the funding is not available to pay them a higher salary. The territorial director, David Sweeney, is paid to be the district coordinator but performs the territorial director position "pro bono," he said.

Sweeney said the St. Croix supervisor position has been filled by an employee in an acting capacity, but she has been acting for about a year and a half without getting any additional compensation.

Buckley said she did not understand how there is funding to pay half a million dollars in overtime, but no funding exists to provide salary increases so people can be promoted.

"Does that make sense to anyone here?" she asked.

Plaskett said it is not that simple to move money around, but Buckley pointed out that the department got a lump sum budget and that should not be an issue.

"When we go into the budget mark-up, I think I know which line we should look at line-iteming," Buckley said.

Ambulance issues

Senators also asked about ambulances, which often have been a problem for the department.

Plaskett said that she needs to replace two ambulances, one in each district and that it would cost about $450,000.

Sweeney said while two vehicles are more than 10 years old and need to be retired, all seven should be replaced and kept as a back-up fleet.

Sweeney told senators that each district currently has an ambulance in the shop, leaving only three working ambulances on St. Thomas and two on St. Croix.

An issue with getting ambulances repaired on St. Croix will soon be resolved, according to Plaskett. The department is required to get three quotes before selecting a mechanic, but only two diesel mechanics are working on the island, Sweeney said.

Plaskett said the department is entering into a contract with one of the mechanics for service of the St. Croix ambulances so that in the future vehicles can be brought in, fixed and released back into service in a timely manner.

- Contact reporter Aldeth Lewin at 714-9111 or email

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