ST. THOMAS, VI - The Committee on Budget, Appropriations, and Finance, led by Senator Novelle E. Francis, Jr. met in the Earle B. Ottley Legislative Hall. Lawmakers received testimony regarding proposed Fiscal Year 2027 budgets from the VI Board of Nurse Licensure, St. Thomas East End Medical Center Corporation, and Frederiksted Health Care, Inc. 

Ms. Carmen Vanterpool-Romney, Territorial Executive Director of The Virgin Islands Board of Nurse Licensure, presented its Fiscal Year 2027 operations and strategic updates before outlining a total budget demand of $856,373 funded entirely through general fund allocations. The funding directly supports eight full-time personnel slots via $486,000 in base salaries and $247,736 in fringe benefits, leaving $122,637 to supplies and professional services. To maximize operational logistics, the Board maintains seven active service and real property contracts across St. Thomas and St. Croix, with plans to finalize two new climate control contracts in the incoming fiscal year. 

As of May 29, 2026, the Board generated $89,530 in specialized regulatory revenues, driven heavily by $62,910 in Registered Nurse transactions alongside localized fees from Advanced Practice Registered Nurses, Licensed Practical Nurses, and Certified Nursing Assistants. During the current tracking cycle, teams managed 1,661 active and 19 inactive professional licenses. Comprehensive annual processing volumes featured 48 initial exam credentials, 1,227 structural renewals, 316 cross-jurisdictional endorsements, and 70 inactive nursing reinstatements. 

Key administrative achievements include submitting a revised 1982 Nurse Practice Act for legislative action  and drafting an updated regulatory manual to govern modern workforce development strategies. The Board also plans to expand their physical infrastructure to house a new computer-adaptive Certified Nursing Assistant testing center on St. Croix, complemented by parallel remodeling initiatives at the St. Thomas facility. Community and educational advancements were highlighted by localized nursing recognition initiatives, professional file digitization via Med-Cred Plus, and a joint $4,000 nursing scholarship program launched alongside AeroMD. 

Several operational obstacles continue to restrict license processinng, notably a pending continuing education tracking contract with CE Broker and integration limits with the Bureau of Information Technology that prevent online payment processing. Financial modeling continues for the multi-year Nurse Licensure Compact implementation, which requires $6,000 in annual dues and carries a projected structural volatility risk of $12,000 in baseline renewal attrition.   In  Fiscal Year 2027, the Board's strategic targets focus on expanding compliance monitoring visits, establishing national criminal background check channels, and launching an inaugural territory-wide Nursing Summit. 

Tess G. Richards, MD, Executive Director of the St. Thomas East End Medical Center Cooperation, is requesting a $2,700,000 government allotment to support its total $8,026,172 operating budget. The request marks a major turnaround from 2023 when the Center faced near-closure with a $2.65 million deficit. Workforce restructuring downsized operations from 103 to 48 employees while doubling the ratio of revenue-generating clinical staff. This yielded a $772,000 surplus in FY 2025 and a $240,607 surplus in FY 2026, establishing a baseline of positive financial performance. The current fiscal trajectory remains strong, with the Center collecting $1.773 million in revenue against $1.698 million in expenses during the first three months of its current cycle, positioning it for a projected $300,000 year-end net income. Financial mitigation also resolved severe legacy liabilities, including settling outstanding rent debts at Tutu Park Mall and reducing an outstanding IRS payroll tax obligation from $1.4 million down to $299,000 through sustained compliance. Total accounts payable dropped by nearly 67 percent in less than seven months, plunging from $2.714 million to $890,000 to improve the utility's balance sheet and standing with financial institutions. 

Clinical volume remains high, delivering over 22,000 visits to more than 5,100 patients annually, with 98 percent of the service demographic living below the federal poverty line. To secure long-term revenue stability and counter the recent departure of two high-volume specialists, STEEMCC onboarded three new providers across Family Medicine, Obstetrics, and Pediatrics. The balance of patient revenue to grant funding stands at a 40-to-60 ratio, affected heavily by a 12.1 percent drop in local Medical Assistance Program enrollment that simultaneously expanded the center's non-reimbursable self-pay patient base to 41.5 percent of total traffic. 

The requested $2.7 million government allotment will directly fund rising uncompensated care mandates and satisfy a $600,000 annual local Medicaid match requirement to secure uninterrupted healthcare access. Internal program reforms continue to advance self-sufficiency, including scaling an optimized drug program to generate $150,000 annually and launching an in-house laboratory that eliminated a $40,000 monthly vendor contract. Broader community outreach remains active through local health expositions and mobile wellness clinics, headlined by the successful revival of the Relay for Life tradition which united hundreds of participants to raise $77,000 for territorial cancer care. 

Chief Executive Officer, Masserae Sprauve Webster, of the Frederiksted Health Care is requesting a general fund appropriation of $3,592,728. The baseline budget request allocates $2,091,111 for personnel services and $43,689 for fringe benefits, with the remaining balances dedicated to capital outlays, public utilities, and external services to preserve daily operations. 

The organization's patient demographics emphasize a dramatic rise in economic vulnerability, with 98 percent of the 9,000 unduplicated individuals treated in 2025 earning incomes at or below 200 percent of the federal poverty level. Furthermore, FHC’s uninsured patient rate doubled from 14 percent in 2022 to 28 percent in 2025, forcing the network to accept a large amount of uncompensated care. Total uncompensated costs reached over $9 million in 2025 and are projected to hit $9.4 million by the close of 2026 before climbing to $10 million in Fiscal Year 2027. This financial burden includes a self-funded $200,000 annual specialized outreach initiative that provides integrated medical care, syringe exchanges, and hygiene support for the island's unhoused population without any local or federal grant subsidies. 

To bridge critical service gaps across central St. Croix, FHC requested an additional, one-time legislative allotment of $300,000 to complete the expansion of its Mid-Island Health Center at Sion Farm. The funding will finalize the construction of a new dental clinic, expanding the center's total island-wide capacity to 16 operatories and eliminating long travel times for residents in surrounding neighborhoods like Peter’s Rest and Sunny Isles. FHC has already secured a $150,000 federal Ryan White grant to offset the project's $320,000 dental equipment costs and will absorb the remaining $170,000 equipment balance internally, positioning the site to deliver critical preventive oral healthcare. Webster also issued an urgent call for the Legislature to provide direct funding to fully implement the territory's delayed Health Information Exchange. While FHC and St. Thomas East End Medical Center successfully linked their electronic health records to the platform via Crisp Shared Services, broader territory-wide integration remains stalled due to a lack of local funding and severe cyber breaches at local hospitals. Highlighting the territory's lag behind other insular areas like Guam and American Samoa, Webster emphasized that a functional HIE is vital to eliminate duplicate testing, prevent adverse medication events, and establish an integrated regional healthcare system. 

Senators present at today’s committee hearing were Novelle E. Francis Jr., Marvin A. Blyden, Angel L. Bolques, Jr., Dwayne M. DeGraff, Ray Fonseca, Marise C. James, and Kurt A. Vialet. 

The Division of Public Affairs is committed to providing the community with accurate information on legislative proceedings and other events at the Legislature of the Virgin Islands. Visit legvi.org.   

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