The Frederiksted Health Center is asking lawmakers for $3,582,728 in fiscal year 2027 support as uncompensated care continues to climb, with the facility projecting that the cost of services provided without reimbursement could reach $10 million in FY2027.
Masserae Sprauve Webster, the center’s chief executive officer, told the Committee on Budget, Appropriations, and Finance on Monday that the requested funding would cover “the local share of the Medicaid match as well as for the uncompensated care we provide…”
In 2025, uncompensated care at FHC totaled more than $9 million. The figure is expected to increase to $9.4 million by the end of FY2026, then rise to $10 million in FY2027.
The increase comes as the center continues to serve a large low-income and uninsured patient population. In 2025, FHC provided care to “over 9,000 unduplicated individuals in 2025, 98% of whom have income at or below 200% of the poverty level.” According to Ms. Sprauve Webster, the percentage of uninsured patients “has doubled from 14% in 2022 to 28% in 2025,” forcing the center to “absorb a growing volume of uncompensated care each year.”
“If that continues, eventually it's going to eat into your program income,” Senator Ray Fonseca noted.
FHC’s uncompensated care burden has also grown as the center provides medical, dental and behavioral health services to St. Croix’s unhoused population. The center also manages a syringe exchange program “which helps to stop the spread of communicable diseases among intravenous drug users,” Ms. Sprauve Webster said. Both programs are self-funded at a combined cost of $200,000 annually.
Ms. Sprauve Webster also addressed non-financial barriers to healthcare access, including transportation. Senator Novelle Francis, who chairs the committee, asked her to submit the estimated cost of a minivan.
“I think that there may be some funding that I could convince my colleagues that we could provide, " he said.
The center is also asking for a separate, one-time allotment of $300,000 to “support the completion of the dental clinic at Mid Island.”
Dental services are currently unavailable at that location, one of three managed by FHC. Ms. Sprauve Webster said the new clinic will include five operatories, making dental services “accessible to communities in the surrounding areas of Sion Farm, Peter’s Rest, Anna’s Hope, and Sunny Isles.”
Dental equipment for the new site is expected to cost $320,000. FHC has received a $150,000 grant through the Ryan White Program and will pay the remaining $120,000 itself. The $300,000 requested from the Legislature would cover the “renovation and build-out of the dental clinic.”
Senator Fonseca said he “definitely” supports the request.
FHC is also preparing to renovate its Ingeborg Nesbitt building after much of its administrative staff was relocated to the new Administration and Outreach building at the North Shore location. Ms. Sprauve Webster said the renovations would allow the center to “expand clinical services, increase primary care, and behavioral health services.”
The planned renovations include an in-house pharmacy intended to “foster seamless collaboration between our medical providers and pharmacists, ultimately enhancing patient care and health results,” the CEO testified.
The center also plans to replace the building’s “aging” air conditioning system. Ms. Sprauve Webster warned that “this project will be costly” and “will require a multi-pronged funding strategy.” FHC intends to apply for federal grants and pursue other “innovative approaches,” but she said the center will “also seek additional financial support from the Government of the Virgin Islands.” The total cost is estimated at just over $500,000.
Ms. Sprauve Webster also called on the Legislature to provide resources needed to sustain a certified Health Information Exchange. Although an HIE was launched with Crisp Medical Services, she said it was “mostly funded by Medicaid and partially by the Office of Health Information Technology.”
Locally, however, the financial commitment has not materialized. “There has been no major funding for the HIE from this body,” she stated.
Ms. Sprauve Webster said progress was “dwarfed” by cyber attacks on the hospital and “federal Medicaid cuts.” As a result, after “five years of investments and hard work,” the Virgin Islands still lacks a functioning system.
The CEO described implementation as “unacceptably slow” and said “our territory lags far behind the rest of the United States and other territories, including Guam and American Samoa.” She urged the Legislature to “recognize the immense value of this system, provide the required funding, expedite the development process, and ensure its earliest possible implementation.”
Senator Francis promised to investigate how the Legislature could “support that.”
Wrapping up the day’s hearing, Senator Kurt Vialet praised the center’s financial management.
“You have been very consistent in the way that you spend your money and the way that you account for your money, so I don't have an issue with funding Frederiksted Health Center,” he said.
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