Stomatological operating microscope. By. GETTY IMAGES
Frederiksted Health Care clinic is looking to expand its role in dental care to better assist hundreds of underprivileged families in St. Croix who cannot otherwise afford private treatment.
A new dental clinic at the Lena Schulterbrandt Health Center is in its final stages and will offer implants and dentures along with regular services like cleaning and filling.
At a Committee on Finance hearing last Tuesday, Masserae Sprauve Webster, CEO of Frederiksted Health Care testified that dental needs continue to be a major concern for the clinic.
“We provided almost 900 emergency dental visits in 2021 and patients typically arrive for care with extensive dental disease,” she shared, noting that the challenge is the significant number of people needing care particularly after their dental health has deteriorated.
Frederiksted Health Care serves patients in Frederiksted, Christiansted, and Kingshill and is the only public facility that offers dental services, catering to an estimated 16,000 people each year.
Ms. Webster said that the current facilities simply do not have the capacity to serve all these residents. "You're talking about 36,000 visits a year with less than 20 chairs," she made known.
“We don’t have freedom of choice with our Medicaid system so someone who is on Medicaid does not have the freedom to walk into a private office and receive services. They have to acquire services at a public facility,” she explained.
The Lena Schulterbrandt Health Center location, which is on schedule to open this summer, will include three fully equipped dental operatories and a panoramic X-ray machine, bringing much needed care to that portion of the island.
The community health center will also upgrade its dental clinic at Ingeborg Nesbitt and would have added a new dental operatory by the end of the year, bringing total number of dental operatories in St. Croix to three.
In addition, Ms. Webster said that 88 percent of the clinic’s patience are Afro-Caribbean/African American people — a high number of whom present with chronic diseases such as hypertension, diabetes and asthma that require complex treatment plans.
“In 2021, FHC provided care to 9,485 unduplicated individuals in 35,195 encounters. Ninety-three percent of these patients had income below the 100 percent of federal poverty guidelines. For a single individual, this was less than $13,000 per year – about $1,100 a month to cover food and housing and clothes and transportation and medicine and so on.”
Within its patient population, there were several subpopulations of individuals who Ms. Webster termed as being “even more vulnerable,” including 84 individuals who are being treated for HIV/AIDS and 121 individuals who are chronically homeless.
Some of these patients, she shared, have not sought medical care since the start of the Covid-19 pandemic, and the clinic is concerned that they may be very sick. “In the past two years we’ve lost 2,000 patients that we believe just have not come out for care. Due to Covid a lot of people got caught up with everything else except their health care. We’ve been diligently trying to contact these patients and bring them back into care.”
The vast majority of patients at the Frederiksted Health Care are underserved by the traditional health care system. The center gives discounts to individuals with income at or below $25,000 a year based on their ability to pay for care.
A needs assessment conducted by the clinic revealed that there are over 12,000 low-income individuals without access to primary services on St. Croix. Most of them, Ms. Webster said, reside of the eastern end of the island. She believes the lack of access to transportation prevents people from visiting the health facility.
She added that no part of St Croix is immune to poverty. "According to the Health Resources and Services Administration, more than 60 percent of individuals on the western end of St. Croix live below 200 percent of federal poverty guidelines and more than 50 percent of individuals on the eastern end of St. Croix live below 200 percent of federal poverty guidelines," she testified.
The research also revealed that life expectancy for both men and women in the Virgin Islands is lower than on the mainland. Based on the CEO’s testimony, life expectancy is 2.3 years lower than in the United States for women and 6.6 years lower than in the United States for men. The leading causes are chronic disease which can be positively impacted by primary care such as heart disease and diabetes as well as conditions which have better outcomes with early detection and prevention such as prostate cancer, colorectal cancer, and lung cancer.
