New Hospital approv...
 

New Hospital approved for STX  


singlefin
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As per: The Source 5/24

The Federal Emergency Management Agency will cover the cost of replacing the Gov. Juan F. Luis Memorial Hospital on St. Croix, which sustained severe damage the hurricanes of September 2017, Gov. Albert Bryan Jr. announced in a statement released Friday by Government House.

FEMA has reviewed the proposed replacement of Governor Juan F. Luis Hospital and found the actual replacement cost is eligible, as the estimated repair cost exceeds 50 percent of the estimated replacement cost, the news release said.

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Jumbie
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This is  fantastic news & looks good on paper. However given the track record of the USVI being given Federal $$ over the years for specific projects, this news should be viewed with skepticism.

Time after time after Federal $$ app’d for USVI , the project never is completed because of lack of money; it disappeared somewhere. 

Take for example, post Hurricane Hugo in 1989 when the gov’t was given Federal funds to bury the electrical grid. Only a small part of the system  was buried. Where did the rest of the $$ go? Anyone care to guess? 

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Scubadoo
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Let's hope the Feds are a little smarter now and provide more oversight so funds are not dispersed until work completed.

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Gator's Mom
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Posted by: Scubadoo

Let's hope the Feds are a little smarter now and provide more oversight so funds are not dispersed until work completed.

And where do you suppose the upfront money would come from if FEMA were to pay for disbursement only on building the new hospital? Are there construction companies ready to foot $80 million to the government? We know the VI government doesn't have the cash or credit.

Also, the VI landscape is far too steep, rocky and remote to put all the power grid underground - physically impossible. Further, there would not be enough money EVER to accomplish that. I would like to see documentation that there was a FEMA funded plan to underground the entire electric system after Hugo.  

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Scubadoo
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Posted by: Gator's Mom
Posted by: Scubadoo

Let's hope the Feds are a little smarter now and provide more oversight so funds are not dispersed until work completed.

And where do you suppose the upfront money would come from if FEMA were to pay for disbursement only on building the new hospital? Are there construction companies ready to foot $80 million to the government? We know the VI government doesn't have the cash or credit.

The same as any other bank financed construction loan which pays out drafts as work is completed to plan and inspected.

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Gator's Mom
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Posted by: Scubadoo
Posted by: Gator's Mom
Posted by: Scubadoo

Let's hope the Feds are a little smarter now and provide more oversight so funds are not dispersed until work completed.

And where do you suppose the upfront money would come from if FEMA were to pay for disbursement only on building the new hospital? Are there construction companies ready to foot $80 million to the government? We know the VI government doesn't have the cash or credit.

The same as any other bank financed construction loan which pays out drafts as work is completed to plan and inspected.

Who would provide the collateral for the bank financed construction loan? 

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Scubadoo
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Posted by: Gator's Mom
Posted by: Scubadoo
Posted by: Gator's Mom
Posted by: Scubadoo

Let's hope the Feds are a little smarter now and provide more oversight so funds are not dispersed until work completed.

And where do you suppose the upfront money would come from if FEMA were to pay for disbursement only on building the new hospital? Are there construction companies ready to foot $80 million to the government? We know the VI government doesn't have the cash or credit.

The same as any other bank financed construction loan which pays out drafts as work is completed to plan and inspected.

Who would provide the collateral for the bank financed construction loan? 

There's no bank involved if FEMA is funding.

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Jumbie
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Posted by: Gator's Mom
Posted by: Scubadoo

Let's hope the Feds are a little smarter now and provide more oversight so funds are not dispersed until work completed.

And where do you suppose the upfront money would come from if FEMA were to pay for disbursement only on building the new 

Also, the VI landscape is far too steep, rocky and remote to put all the power grid underground - physically impossible. Further, there would not be enough money EVER to accomplish that. I would like to see documentation that there was a FEMA funded plan to underground the entire electric system after Hugo.

They had more than enough $$ to bury electric lines along some of the main roads.  It was there but was squandered elsewhere.

WAPA buried line to the hospital & to some places in Christiansted, so it could have been done on selected  main roads like the road to east end,  along Melvin Evans. & on south shore road for example. This would have greatly reduced the amount of above ground poles exposed. 

 

 

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singlefin
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If private health insurance could be brought into the territory, along with the construction of a new hospital, that would be two major nuts taken care of.

Finding a private health insurance option for the VI was Lieutenant Governor Potter’s #1 priority. Did the man accomplish anything?

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vicanuck
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Don't get too excited. Most of us will be long gone by the time a new hospital is built.

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East Ender
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Are they going to put it in the same footprint as Juan Luis? Or is there a new and better spot for it?

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singlefin
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As per The Consortium:

“This announcement is welcomed news for the residents of St. Croix and also the hardworking men and women of the Governor Juan F. Luis Hospital,” said the the territory’s leader. “JFL is a critical part of our territory’s healthcare system, and we are working to ensure we rebuild it to meet the healthcare needs of our residents. We now have an opportunity to build a facility that is more comfortable for the staff and patients, more energy efficient and resilient enough to withstand the rigors of our changing climate.”

The governor said, however, while the replacement of JFL is “a step in the right direction, a new structure will not solve the longstanding issues challenging the territory’s ability to provide quality affordable healthcare to its residents.”

While in Washington recently, Mr. Bryan spoke to some of those issues, namely the disparities with Medicare and Medicaid reimbursements to the territory in his testimony before the Senate Committee on Energy and Natural Resources Feb. 26.

“Healthcare funding in the Virgin Islands was under great stress even before the two hurricanes. Under Medicaid, the arbitrarily low FMAP rate and the correspondingly high local matching requirement have imposed severe and unsustainable financial demands on the territory,” he said.

The governor said Tuesday that “ensuring access to quality affordable healthcare is one our administration’s key priorities,” and a that “the administration will aggressively continue working with our federal partners in the recovery and rebuilding effort on behalf of the people of the territory.”

The Government of the Virgin Islands will undertake the project in collaboration with the Juan F. Luis Hospital, according to the release. FEMA and the GVI are currently developing a fixed cost estimate for the succeeding medical facility.

JFL will continue to utilize the modular units already installed on site to treat patients on St. Croix while the new structure is erected.

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Fishbait
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A lot of the rebuilding funds seem to require that either the VI government lay out money and get reimbursed or else chip in a percentage, such as 10%.  That little hitch plus what seems to be a continuing problem to submit correct paperwork, on time; seems to always get in the way of the huge cash amounts promised. 

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Gator's Mom
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Posted by: Fishbait

A lot of the rebuilding funds seem to require that either the VI government lay out money and get reimbursed or else chip in a percentage, such as 10%.  That little hitch plus what seems to be a continuing problem to submit correct paperwork, on time; seems to always get in the way of the huge cash amounts promised. 

Managing federal grants and grant funded projects of any scope and scale is not for the weak or timid. 

For sure it's a cash availability problem - but not necessarily a "correct paperwork" problem - that limits the VI government from spending down reimbursement grants completely. Though, the financial paperwork that is submitted for reimbursement payments can be enormously detailed and difficult to get right in the best of circumstances. 

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singlefin
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I find it hard to believe a consultant/legal advisor from the states can’t be brought in to deal with the “enormously detailed and difficult” paperwork. 

Priorities are the problem.

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Gator's Mom
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Don't know if this is happening …. but sometimes a grantee like the VI government projects a project budget to be higher than what actually occurs. Generally, institutions/governments don't bid out work until the grant is secured. They have a good idea but err on the high side. So projects can be completed with unspent grant money remaining - and remember money can only be spent on exactly what you told the grantor it would be spent on.  Balance must be returned to the grantor unless the amount is immaterial - then you have to request permission to keep it.

One of the most painful things is to not ask for enough money and end up with an incomplete project and no where else to get funding …..

Institutions with big grant funded enterprise have vast teams of accounting/finance people managing the everyday work on grants of all sizes.  I'm not sure consultants/attorneys would be cost effective. Anyway, the work requires someone that grinds on it all day every day for as long as it takes.

Someone writes the grant narrative, someone else prepares the budget, then someone else approves and then someone else submits the grant. Once awarded a bookkeeper has to set up an account for the project and manage purchase orders and make sure invoices are detailed enough to meet grant guidelines.

THEN at least quarterly someone else packages all the invoices along with a detailed financial report to send to the grantor. An interim narrative report is then sent to the grantor by another person.

Then the grantor's financial staff and project management team takes apart the interim report materials submitted to assure money was spent exactly as it was supported to be spent based on the originally submitted project budget. If anything is off - or questioned - the grantee has to refile the report.

Then repeat as often as necessary.

Electronic submission and reporting doesn't make it any easier …. because each grantor has a separate system and requirements.

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Gator's Mom
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Posted by: Gator's Mom

Don't know if this is happening …. but sometimes a grantee like the VI government projects a project budget to be higher than what actually occurs. Generally, institutions/governments don't bid out work until the grant is secured. They have a good idea but err on the high side. So projects can be completed with unspent grant money remaining - and remember money can only be spent on exactly what you told the grantor it would be spent on.  Balance must be returned to the grantor unless the amount is immaterial - then you have to request permission to keep it.

One of the most painful things is to not ask for enough money and end up with an incomplete project and no where else to get funding …..

Institutions with big grant funded enterprise have vast teams of accounting/finance people managing the everyday work on grants of all sizes.  I'm not sure consultants/attorneys would be cost effective. Anyway, the work requires someone that grinds on it all day every day for as long as it takes.

Someone writes the grant narrative, someone else prepares the budget, then someone else approves and then someone else submits the grant. Once awarded a bookkeeper has to set up an account for the project and manage purchase orders and make sure invoices are detailed enough to meet grant guidelines.

THEN at least quarterly someone else packages all the invoices along with a detailed financial report to send to the grantor. An interim narrative report is then sent to the grantor by another person.

Then the grantor's financial staff and project management team takes apart the interim report materials submitted to assure money was spent exactly as it was supported to be spent based on the originally submitted project budget. If anything is off - or questioned - the grantee has to refile the report.

Then repeat as often as necessary.

Electronic submission and reporting doesn't make it any easier …. because each grantor has a separate system and requirements.

I left off about 20-30 steps that include involving politicians, lawyers and other big shots for each grant. And of course vendors and having to get multiple bids ….

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singlefin
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Cost effective? 

Roll the fees for accounting/finance and legal logistics into the cost of each government funded project. How can this not be part of the package? How is this not a priority? 

This system has been set up by the Federal government. They’re aware of the people needed for oversite, reporting, submissions, etc. You can’t tell me there aren’t people willing, able, and ready to move down here to work for a piece of this pie.

If things don’t change, we will foolishly loose the bulk of this money.

 

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Gator's Mom
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Posted by: singlefin

Cost effective? 

Roll the fees for accounting/finance and legal logistics into the cost of each government funded project. How can this not be part of the package? How is this not a priority? 

This system has been set up by the Federal government. They’re aware of the people needed for oversite, reporting, submissions, etc. You can’t tell me there aren’t people willing, able, and ready to move down here to work for a piece of this pie.

If things don’t change, we will foolishly loose the bulk of this money.

 

Actually overhead/indirect costs don't necessarily roll into the cost of the grant. Sometimes you're allowed to charge an overhead/indirect cost percentage (sometimes 50% or more of the value of the project) on top of the grant value. Other times overhead is included in the total grant budget. The calculations are different and each grant opportunity is different. I would think FEMA allows overhead to be charged on top of the project budget amount - but don't know for sure.

To manage large federal grants you need a checks and balance system - with those managing the project checked by financial staff that aren't involved in day-to-day project operations.  Having the scale of resources to manage the huge sums that have come to the VI would be thwarting for organizations much larger than the VI. 

The VI government's pay scale will definitely keep most folks away, These are high demand, well-paid and extremely secure positions in government and universities on the mainland. 

Aside from original preparation of grant submissions, this work is better suited for employees than consultants.

 

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