Another budget, another funding plea for University Hospital, Newark
Taken from NJ Spotlight News
March 20, 2024
Last year, University Hospital president Edward Jimenez focused on the numbers when testifying before New Jersey lawmakers tasked with crafting the annual state budget.
This year, Jimenez opted to paint a picture in very human terms of the needs at the Newark facility, the state’s only public hospital and the primary teaching site for multiple Rutgers University health programs.
The hospital is planning for a massive renovation of its campus estimated to cost at least $1.8 billion, but there is no dedicated funding for the project in Gov. Phil Murphy’s proposed $56 billion spending plan.
“I think we just want what everyone else has,” Jimenez told members of the Senate Budget and Appropriations Committee Tuesday during its first public hearing on the governor’s budget proposal.
“A hospital that doesn’t leak,” Jimenez said. “A hospital that doesn’t break. A hospital that is befitting of the world-class talent of the Rutgers New Jersey Medical School physicians, dentists, nurses and staff.”
Ruiz ‘not even looking for bells and whistles’
State Sen. Teresa Ruiz (D-Essex), the Legislature’s Democratic leader, noted that University Hospital, the state-designated regional trauma center for north Jersey, also provides more free health care than any other acute care facility in New Jersey.
“We’re not even looking for bells and whistles,” she said. “We’re looking for a place so that the next time I go to visit there isn’t a hose attached to the ceiling, into a garbage can, to deal with a leak that just cropped up that morning.”
Murphy’s spending proposal would increase funding slightly for clinical education programs at University Hospital and fund operations at the same level as in years past, according to the draft budget. It would provide an additional $40 million for ongoing facility improvements — up from zero last year — but $21 million less than requested. University Hospital also asked for $100 million to begin work on the reconstruction, but Murphy included nothing extra for this initiative.
Jimenez later told NJ Spotlight News that the $100 million “would keep the project moving.” Without it, he said work will need to be further broken down into annual installments. So far, University has raised about $260 million toward the project. Borrowing money is an option, Jimenez said, but one he’d rather avoid, since the hospital’s poor credit rating could result in an interest rate as high as 8.5%. And with limited revenue, any debt is a challenge to pay off, he added.
Major rebuilding is years away
Major construction is still several years away, but Jimenez said investments have already been made to upgrade aspects of the emergency department and trauma center, improvements that will be incorporated into a renovated facility. Staff members are also moving out of the “temporary” trailers installed in 1968, which will eventually be demolished to build a new medical office building and garage.
In addition to the power outages and floods that Jimenez said are regular occurrences, University Hospital needs to modernize an outdated facility that a consultant to the New Jersey Economic Development Authority determined “functionally obsolete” last year.
All rooms house two, and sometimes three, patients — lacking privacy and making infection control more challenging. And the air-conditioning system requires manual activation each season, a process that is time-consuming and can lead to burst pipes, Jimenez said.
“I’d love to have a state-of-the-art facility,” he said. “I’d also love my emergency room to have more walls than curtains [separating the patients].”
The emergency room was designed to accommodate about 50,000 patients annually and now treats nearly twice that number each year.
Trouble getting to the finish line
In his testimony Tuesday, Jimenez praised the Murphy administration and state legislators for providing the resources they have in the past, including $35 million added as part of last-minute budget negotiations last year. “But we can’t get over the finish line without [additional] funding,” he said.
Murphy’s budget proposal for fiscal year 2025, which lawmakers will debate over the coming months before voting on a final spending plan by July 1, includes roughly $45 million for operations at University Hospital, the same as last year. It also provides $84.8 million for clinical education, an increase of nearly $25 million from last year, but far below the $205.8 million requested for this work.
Debbie White, president of the largest health care union in the state and consistent advocate for University Hospital, told NJ Spotlight News on Tuesday that the state has “failed in its mission to fully fund” its only public acute care hospital. The union, HPAE, is urging lawmakers to include at least $206 million for University Hospital in the new budget, including $100 million for capital construction.
“Not only does University Hospital need investment in a brand-new campus but also to survive in the interim,” White said in a statement. “The proposed budget is woefully inadequate on both fronts… The state owes it to the city of Newark, the residents of Essex County, and all the people this great hospital serves.”
Jimenez also stressed in an interview after the committee hearing the importance of maintaining the Newark Accords, an agreement drafted with the community in the wake of the 1967 uprising that guaranteed residents access to quality health care.
‘Substandard’ facility
“If we … believe the Newark Accords have meaning and merit, then each day that passes [without additional resources] we have a facility that is not living up to those promises,” he told NJ Spotlight News. “No one can draw a conclusion that we are honoring the spirit of the Newark Accords.”
Even if you ignore the historic agreement, he said it raises the question: “How does the state’s only public hospital have a facility that is substandard to the rest of the state.”
University Hospital has seen support in the past from local lawmakers like Ruiz, state Assemblywoman Eliana Pintor Marin (D-Essex), who chairs the Assembly Budget Committee, and Assemblywoman Nancy Muñoz (R-Union), a nurse with strong family connections to the hospital. The emergency department is named after her late husband, former Assemblyman Eric Munoz, who was a trauma surgeon there.
Jimenez cited the support but said it has proved more challenging to build support among lawmakers from other parts of the state, something that could be necessary to boost funding.
“The more we move from Essex County,” he said, “the harder it is to get your head around [the hospital’s needs].”
Despite these structural obstacles, Jimenez told NJ Spotlight News that he is impressed by the dedication and creativity of the doctors, nurses and other staff at University Hospital. When 40,000 gallons of water burst from pipes recently, flooding the main pharmacy, he said pharmacists organized for medications to be coordinated at two other sites — an outpatient pharmacy and another at the hospital’s cancer center — and brought in runners to make sure the medications were delivered in the sprawling hospital complex.
“How you make up for substantial facilities issues is by having the most amazing faculty and staff,” Jimenez said.