ST. THOMAS – The 35th Legislature of the Virgin Islands, led by Senate President Novelle E. Francis, Jr., convened into Regular Legislative Session at the Earle B. Ottley Legislative Hall. Lawmakers first convened into the Committee of the Whole to receive testimony on the departure of Pafford Medical Services from the territory and its impact on healthcare services.
Justa Encarnacion, Commissioner of the Virgin Islands of Health delivered the Department’s transition plan for ongoing operations at the Eldra Schulterbrandt Long Term Care Facility, the Mobile Integrated Health Unit, and the Maternal Child Health Clinic and the Family Planning program. Encarnacion stated that the team at the Department remains committed to successfully transitioning and placing the necessary personnel to ensure continued service. Pafford originally deployed to the territory to St. Croix after the passage of Hurricane Maria in 2017. It returned to St. Croix in 2019 to reinforce Emergency Medical Services in the territory. The federal emergency related to the global pandemic ended in 2023, as well as federal funding attached to it. The department has since been working to transfer some of Pafford’s staff to the Department of Health. The department has been working to recruit locally and internationally. However, there has been a global shortage of clinical staff. Before the departure of Pafford, the Department contracted 10 staff members from Pafford Medical Services.
Encarnacion detailed steps the Department is taking as it transitions away from reliance on Pafford Medical Services. Two registered nurses from the Core Behavioral Health Services will be providing additional nursing care to the Eldra Schulterbrandt Long Term Care Facility. General funds were also secured allowing the department to extend employment offers within the department to one registered nurse and two licensed practical nurses. One LPN began on July 15, 2024, and another RN and LPN are scheduled to begin on August 26, 2024. Clinical staff was identified for the Mobile Integrated Healthcare Unit that will support the unit until funding is available. A nurse previously contracted by Pafford signed on with the Dept. of Health as a volunteer to assist with clinical rounds. The agency has requested personnel savings to support the hiring of 4 MIH members, which includes one nurse practitioner, one registered nurse, and one paramedic EMT. The department also extended an offer of employment to an obstetrician/gynecologist. A qualified certified medical assistant will assist with patient care until an RN is hired for that role at Maternal Child Health. The most recent payment was sent to Pafford on March 7, 2024, for $50,485,28. The remaining balance is $1,785,724.99. The Department cannot meet its payment schedule due to other obligations such as off-island care for behavioral health patients. According to Act 8729, which appropriates $700,000 to the Caribbean Kidney Center, the most recent payment was made on July 19, 2024, of $90,523,25. The outstanding balance is $1,060,181.90 for clinical services and $78,000 to satisfy the federal math. The projected cost to maintain dialysis services until January 31, 2025, is $973,325,20, totaling $2,111,507.10. Encarnacion stated that while she recognized the concern that the departure of Pafford had, she assured the community that the Department of Health is fully committed to addressing gaps in service.
Christopher Finch, Chairman of the Virgin Islands Government Hospital and Health Facilities Corporation detailed the expenses for construction, equipment, and start-up cost for medications, supplies, and staffing for the hospitals to expand capacity with the anticipated increase in dialysis patients. In St. Thomas, all outpatient dialysis care is provided by the Schneider Regional Medical Center and the Caribbean Kidney Center. St. John patients must travel to St. John. SRMC provided dialysis care to 74 patients through a clinic within the hospital. CKC has a clinic building near SRMC that serves 55 patients. Patients typically receive care 3 times a week for 3-4 hours at a time. An expansion of the RLSH dialysis capacity was added in a space near the present dialysis clinic, which can add an additional 12 patient stations to accommodate CKC patients. Through diverting funds from other needed purposes, SRMC purchased a water treatment system, machines, and chairs for a new patient station. Almost all dialysis patients care is covered by Medicare. SRMC has so far spent $978,009.21 on construction and equipment purchases using its allotment of PFA and ARPA funds that were designated for other purposes. SRMC is projecting that the cost to treat and additional 55 dialysis patients will cost $188,540 for the cost of medications for the first four months, patient supplies at $155,980, and contract professional staffing at $1,047,200.
In St. Croix, JFL currently provides dialysis care to 42 patients in a trailer located in the old hospital parking lot. CKC provides dialysis to 60 patients in its Gallows Bay Location. The Juan F Luis hospital has a long-term solution to build a FEMA funded outpatient, off-site dialysis clinic. The cost of buildout and equipment and several years of lease would be covered by FEMA PW for this purpose. Finch stated that the mobile trailer that patients currently receive dialysis care in is prone to hurricane damage. A short-term solution is for St. Croix to cover dialysis care at JFL, but it is problematic due to water supply and fire suppression challenges. Additionally, a new non-profit entity, which has received ARPA funding is projected to open in October 2024 and could take CKC’s patients. The Hospital Redevelopment Team acquired a FEMA PW for a new dialysis clinic and has been preparing to get a clinic ready to open. FEMA funds would be used to purchase the new equipment, pay for space buildout, and lease costs until the new hospital is built. JFL has spent $230,000 on equipment purchases using its own funds that were designated for other uses. JFL projects that $150,000 is needed to solve water supply and fire suppression challenges. JFL projects that the cost to treat an additional 60 patients would be $205,680, for the first four months of medication, patient supplies at $170,160 and contract and hired staffing at $1,000,000. It is expected that after this period, the facility would have CMS Certification and would be able to bill Medicare and other 3rd party payers. Total requested funding is $1,755,840. Finch emphasized that neither hospital has enough funds to take on the initial cost on their own.
Concerning Pafford, Senate President Francis stated, “We have had a good working relationship with Pafford. It is unfortunate that they find themselves at a quagmire where they have to fight to get their payments.”
The Legislature then returned to Legislative Session, where lawmakers voted to override the following Governor’s vetoes:
- Bill No. 35- 0229, An Act honoring and commending the Eighth elected Governor of the Virgin Islands, Kenneth Ezra Mapp for his years of service to the people of the Virgin Islands and naming Route 75 on the island of St. Croix from Bassin Triangle intersection at Route 70, Estate Richmond and ending at Krausse’s Lagune the “Gov. Kenneth E. Mapp Highway”; appropriating $45,000 from the General Fund of the Treasury of the Government of the Virgin Islands to the Department of Public Works to implement the mandates of this Act, to bestow the Virgin Islands Medal of Honor on Kenneth Ezra Mapp and for other related purposes, was overridden. The measure was proposed by Senators Franklin Johnson, Donna Frett-Gregory, Milton Potter, Samuel Carrion, Javan E. James Sr., Kenneth L. Gittens, Marise C. James, and Ray Fonseca.
- Bill No. 35-0269, An Act amending Title 2 Virgin Islands Code, Chapter 1 by adding a section 13 providing a penalty for the commission of perjury in proceedings before the Legislature of the Virgin Islands. The measure was proposed by Senators Kenneth L. Gittens, Marvin A. Blyden and Novelle E. Francis, Jr.
Additionally, lawmakers voted to approve the following bills:
- Bill No. 35-0274, An Act appropriating $1,933,461 from the General Fund of the Treasury of the Government of the Virgin Islands to the Roy L. Schneider Hospital and Medical Center. The measure was proposed by Senator Ray Fonseca.
- Bill No. 35-0275, An Act appropriating the sum of $910,000 from the General Fund to the Department of Health to be disbursed to the Caribbean Kidney Center to assist with the funding of the salaries of dialysis nurses and the staff members. The measure was proposed by Senators Ray Fonseca, Kenneth L. Gittens, and Diane T. Capehart
- Bill No. 35-0276, An Act providing an appropriation from the General Fund of the Treasury of the Government of the Virgin Islands to the Governor Juan F. Luis Hospital and Medical Center to assist in purchasing dialysis machines and chairs, a reverse osmosis water system, medication, supplies and to fund staff salaries. The measure was proposed by Senators Ray Fonseca and Kenneth L. Gittens.
Senators present at today’s Committee of the Whole and Legislative Session were Novelle E. Francis, Jr., Marvin A. Blyden, Angel L. Bolques, Jr., Samuel Carrión, Diane T. Capehart, Dwayne M. DeGraff, Ray Fonseca, Alma Francis Heyliger, Kenneth L. Gittens, Marise C. James, Javan E. James, Sr., Franklin D. Johnson, and Carla J. Joseph.
The Division of Public Affairs is committed to providing the community with accurate information on proceedings at the Legislature of the Virgin Islands. Visit legvi.org.
####
