ST. CROIX–The Committee on Health, Hospitals, and Human Services chaired by Senator Nereida Rivera-O’Reilly met Monday in the Frits E. Lawaetz Legislative Conference Room, St. Croix where testimonies were given on several pieces of proposed legislations.
Bill No.32-0038 proposed by Senator Jean Forde seeks to amend the Virgin Islands Code and to provide for the acceptance of the Real ID as a valid form of identification and to allow senior citizens to receive a discount on public buses, car registration, transportation services operating under a government grant of exclusive franchise and on any mode of public passenger transportation service subject to the jurisdiction of the public commission as well as for tuition reduction at the University of the Virgin Islands.
In his testimony, Anthony Olive, Director of the Bureau of Motor Vehicles along with Ethlyn Dewindt, MIS Administrator and Mireille Sankatsing-Smith, Systems Manager said that they are in the process of implementing the “Real ID,” and after having further discussion with their software developers, a slight modification can be done to the software which would allow them to do exactly what the intent of Bill No.32-0038 implies.
Troy De Chabert-Schuster, Director, AARP Virgin Islands, said his organization supports the Bill. He added that the proposed legislation is trying to limit the burden on seniors who want to take advantage of Government discounts. These discounts are substantial and are only bestowed upon individuals who happen to have their Senior Discount Card issued by Human Services with them at the time they seek the discount.
Other testifiers who supported Bill No.32-0038 were Debra Christopher, President, St. Croix Government Retirees, Inc., and Janet Turnbull-Krigger, Assistant Commissioner, Human Services. The Bill was voted out of the committee with a favorable recommendation to the Rules and Judiciary Committee for further consideration.
Bill No. 32-0084 sponsored by Senator Rivera-O’Reilly amended the Virgin Code and extended the period the court may order the commitment of a person to the Department of Health from a period of not more than five days to a period up to 30 days for the purposes of a diagnostic examination.
Bill No 32-0085 also sponsored by Senator Rivera-O’ Reilly amended the Virgin Islands Code relating to mental health emergency commitments by extending the time period a person may be detained for treatment.
In his testimony on both Bill No.32-0084 and Bill No.32-0085 Joseph Ponteen, Chief Deputy Attorney General said the Department supports both measures; however, they still recommend that the committee standards be changed. According to him, a state cannot involuntarily hold an individual for longer than is necessary and for longer than what in statutorily allowed.
Ponteen pointed to the standard that a judge would consider. He said if the standards and criteria for commitment were slightly relaxed, then the judge would have more leeway in deciding whether or not the individual should be committed for the extended periods of time that are suggested in these proposed measures.
Michelle S. Davis, Commissioner of Health also speaking on both proposed measures said in regard to Bill No.32-0084, that after holding a person 30 days as the Bill suggest, this legislation does not address the outcomes of an individual struggling with a mental or substance abuse disorder requiring repeat visits for crisis mental health stabilization. She pointed out that the Juan F. Luis Hospital and Medical Center does not currently have an acute care unit for mental health patients or a behavioral health unit.
In respect to Bill No. 32-0085 she said the Department is in general support of mandating stabilization care, evaluation and treatment. They also support the maximum “emergency commitment” stay of 10-days. According to her, it is their firm beliefs that while some people may require a shorter timeframe for returning to a stabilized baseline of mental functionality, there are other individuals who may require a longer stay for stabilization.
“Mental problem is a serious matter in the territory and it is my responsibility to do something about it,” said Senator Rivera-O’Reilly.
Bill No.32-0079 also sponsored by Senator Rivera-O’Reilly seeks to amend the Virgin Islands Code relating to application for certificates of need to establish by statute initial and renewal application fees; mandating a report from the Commissioner of Health with recommendations for changes to the certificate of need process; and providing for a one-year suspension on issuances of Certificate of Need (CON).
Dr. Bernard Wheatley, Chief Executive Officer, Schneider Regional Medical Center (SRMC) pointed to two significant factors in regards to CON as proposed in Bill No.32-0079.
According to him, SRMC’s financial challenges are complex and competition from outpatient surgical centers and private health care facilities are one part of the picture. He added that one; CON laws if properly implemented and enforced can help to measure and define need, control costs, protect lower-cost centers from taking the highest-paying customers away from hospitals, and require that lower-cost centers provide charity care.
Secondly, added Dr. Wheatley, regardless of any changes to CON laws in the Virgin Islands, it is going to be very difficult for SRMC to increase its percentage of commercial business without significant investment in its infrastructure, resolution of its vender payment issues, and investment in staffing and marketing. Accordingly, if SRMC increases its percentage of commercial business, it will improve its operating margin which could reduce the level of funding required annually from the local government.
The Commissioner of Health Dr. Davis said the CON application fees have not changed since its original implication. The current application is $200 for service provision or $400 for facility development. She pointed out that while she support an increase, mandating a flat fee increase from the current fees to $2,000 may present an undue burden for some CON participants.
According to Dr. Davis, she would support efforts that would help determine a reasonable fee increase of a CON application fee based on the proposed services, facility type and overall projects costs. She added that she would also support efforts that would help determine a reasonable increase fee that factors in all patient variables.
Committee members voted in favor of both Bill No.32-0084 and Bill No.0085 and sent them to the Rules and Judiciary Committee for further consideration. Bill No.32-0079 was held in Committee subject to the call of the Chair.
Bill No.32-0048 sponsored by Senator Rivera-O’Reilly requires the board of the Juan E. Luis Hospital to solicit proposals for the selection of a third-party management or health care system to manage the hospital by May 30, 2017.
Aracelis Bermudez-Walcott said as the Board Chair of JFLH, she has reservation about public private partnership for the management operations of the hospital. There are many factors to consider. As the only hospital on the island, such a public private partnership must be vetted closely by all stakeholders to ensure that the benefits gained from this relationship will improve the confidence of the community in the hospital, support our physicians, build the existing workforce and provide additional services rather than limiting access to care.
Richard Evangelista, Acting Chief Executive Officer, JFLH said in his testimony, that at this time, hiring a management company is not the best way to spend the limited fiscal resources available to the Government of the Virgin Islands. Instead, he recommended collaboratively reviewing the three-year capital spending plan and earmarking the funds to make desperately needed capital improvements. He recommended the constructing of two new hospitals, one on St. Croix and one on St. Thomas.
Tracy Stewart Sanders, Continuum Care Hospice said that with the consideration of a third-party management relation, we have an opportunity to be afforded the introduction and adoption of Evidenced Based Practices and Best Practices.
Keith Moore of Barry University Physician Assistant, St. Croix said in his testimony, the proposed legislation has the potential to bring a fresh look to St. Croix health care in an efficient manner that considers all the major stakeholders in the health care system.
AARP State Director, De Chabert-Schuster said JFLH is currently in a state of crisis and while leadership is committed, there is a lack of experience in steering the hospital out of its crisis. According to him, when a hospital is in crisis, we need to look outside of our current executive team to bring in support and management that will assist in stabilizing the organization.
The Bill was held in the Committee subject to the call of the Chair.
Committee members at Monday’s meeting were Chairman Senator Nereida Rivera-O’Reilly, Kurt A. Vialet, Marvin A. Blyden, Dwayne DeGraff, Novelle E. Francis, Jr., Sammuel Sanes, and Janette Millin Young. Non-Committee member was Senator Brian Smith.