Published: Jun 8, 2023

ST. THOMAS – The Committee on Health and Hospitals, and Human Services chaired by Senator Ray Fonseca convened in a meeting at the Capitol Building. Officials from the Health Industry briefed lawmakers on the status of operations. The Virgin Islands Department of Health (DOH), the St. Thomas East End Medical Center Corporation (STEEMCC), and the Virgin Islands Board of Nurse Licensure (VIBNL) were among the invited testifiers. Representatives from the Office of Collective Bargaining, MASA Global, and Skymed also provided updates. 

The principal duty of the Virgin Islands Department of Health is to serve as a state regulatory agency as well as the Territory’s public health agency. In addition to delivering health services to the population, Justa Encarnacion, Commissioner of the Virgin Islands Department of Health, stated that the DOH’s goal is to implement public health initiatives that include health promotion and prevention. Some of the essential components include educating the public on the importance of good health and effective methods for managing chronic conditions. DOH’s goal is for the Virgin Islands to be a healthy society with lower healthcare expenses due to public health efforts. Encarnacion stated that the DOH Office of the Commissioner, in partnership with several bureaus, supervises twenty-six initiatives. In addition, the department oversees hospitals during a proclaimed emergency or disaster as the lead agency for Emergency Services Function 8 (ESF-8). 

Separately, Joss Springette Esq. Chief Negotiator, Office of Collective Bargaining shared an update. Collectively the nursing unions represent nurses with varying degrees of experience who work for the Department of Health and in hospitals Territory-wide. The RNLU represents registered nurses in positions of leadership. Their previous CBA expired on September 30, 2020, and is now extended on a day-to-day basis while discussions continue. VISNA is an organization that represents non-supervisory registered nurses, according to Springette. Negotiations are slated to begin in July 2023.  

Meanwhile, The Virgin Islands Board of Nurse Licensure Chairperson Tanicia Penn expressed the challenges facing the board. Penn indicated that because VIBNL lacks training facilities, testing is delayed and there is a backlog of nursing assistant exams. Two VIBNL employees, the Executive Director and Administrative Specialist, give exams in the absence of an external proctor. Penn also mentioned that it’s challenging to offer regularly scheduled exams for CNAs due to the lack of recognized standardized testing locations. Lastly, the board must find a location that complies with national criteria for testing, including faculty requirements, lockable storage, parking accessibility, a separate exam room from the check-in area, and technical requirements like hardware operating systems, among others. Senator Donna Frett Gregory stated that the challenges facing the Healthcare Industry plagued the Territory for years and must be resolved.  

The Virgin Islands Healthcare Foundation Medical Director Tasnim Khan, MD provided recommendations from the Dialysis Patient Advocacy Group to mitigate ongoing issues faced by patients. Khan advocated for additional generators, backup water systems, and staff. Furthermore, renal care including peritoneal dialysis and transplantation, access to preventative programs, and building a solid secure facility for patients are also among the recommended changes. Senator Fonseca stated that we must work diligently to resolve the dialysis crisis in the Territory. As a result of the 2017 hurricanes, it is reported that dialysis patients were relocated from the Territory to the mainland to receive treatment for one year; at an estimated cost of $40 million to the federal government. It is important that efficient medical services for dialysis patients are provided in the Virgin Islands.  

Steven Mayers, Chief Financial Officer of St. Thomas East End Medical Center, stated that the STEEMC is in financial distress. Patient revenues fell from $6.6 million in 2019 to $3.7 million in fiscal year 2022. However, some of the funding was recovered because of grants from the COVID-19 pandemic and endemic. Contractual provider costs are around $4 million in terms of non-payroll expenses such as operational costs. Senator Fonseca enquired about STEEMCC’s monthly rent. Mayer said that it is $70,000 per month. Collectively, policymakers voiced dissatisfaction with STEEMCC’s financial difficulties. Senator Kenneth L. Gittens stated this government does not have a money problem but a money management problem.  

The following senators attended the meeting: Ray Fonseca, Novelle E. Francis, Jr., Marvin A. Blyden, Donna Frett-Gregory, Javan E. James, Kenneth L. Gittens, Marise C. James, and Milton E. Potter.  


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