Health Commissioner Justa Encarnacion. By. V.I. LEGISLATURE
The V.I. Department of Health said Friday it is taking steps to successfully transition staff and services to DOH since Pafford’s announcement that it will leave the U.S. Virgin Islands due to millions of dollars in outstanding payments. Health Commissioner Justa Encarnacion testified as such before the 35th Legislature, alongside Christopher Finch from the V.I Government Health and Hospitals Corporation.
Pafford’s departure is impacting several key units within the DOH, said Ms. Encarnacion, including the Mobile Integrated Health Unit, the Maternal Child Health Clinic, the Family Planning Program and the Eldra Schulterbrandt Long-Term Care Facility. The government’s failure to pay Pafford Medical Services has potentially jeopardized the ease of accessing these services for several community members.
“The Department has attempted to meet our payment schedule. However, due to other obligations, such as the off-island care for behavioral health patients, we’re unable to do so,” said Ms. Encarnacion, repeating the explanation given during DOH’s budget hearing. The department currently owes Pafford $1,628,206.29. Additionally, the V.I. Fire and Emergency Medical Services owes the entity $3,508,061.30.
DOH is aware that Pafford’s departure may “understandably cause some concern,” but the commissioner affirmed that “the Department of Health is fully committed to addressing any gaps in our services.” According to Ms. Encarnacion, DOH is in the middle of a transition phase, including transferring some Pafford staff to the DOH. That process began when the global Covid-19 pandemic officially came to a close, bringing with it an end to federal funds that were used to pay Pafford. DOH also wants to hire new medical staff, but local and national recruitment efforts have been difficult. “It's important to recognize that there is a global shortage of clinical staff which presents additional challenges.”
In the interim, the commissioner said DOH is making do with the resources currently available. At the Schulterbrandt facility, “two registered nurses from our core behavioral health services team will be providing additional nursing care.” New work schedules have been developed to address residents’ needs. DOH has also secured funding that will allow it to “extend employment offers within the department to one registered nurse and two licensed practical nurses,” the health commissioner told lawmakers.
An area of major concern for several legislators, including Senator Diane Capehart, was the fate of the Mobile Integrated Health Unit. The unit, which was largely staffed by Pafford healthcare professionals, offered preventative care to many Virgin Islanders and reduced the burden on hospitals. “The agency has also taken strategic steps to plan the transition of the Pafford team until the funding is available to support the MIH Act,” Ms. Encarnacion reported. Ninety-four Virgin Islanders receive care through that program.
Jacqueline Greenwich Payne, the MIH unit director, has identified clinical staff and community health workers to provide support to the patients enrolled in the program, the commissioner said. One nurse practitioner employed via Pafford has agreed to volunteer her services with the Department of Health. To further supplement the loss of Pafford staff, DOH has “requested personal savings to support the hiring of four MIH team members” with the necessary documentation submitted to the Office of Management and Budget on August 9.
As for the Family Planning Program, DOH successfully extended an employment invitation to the obstetrician/gynaecologist previously provided by Pafford. The individual in question is a local professional. “The physician has expressed a firm commitment to serving us as part of the V.I. Department of Health Maternal Child Health Program,” shared Ms. Encarnacion. Pafford had also supported the program with a registered nurse. Now, DOH has “assigned a qualified, certified medical assistant to the Family Planning Division to assist the physician with patient care until an RN is hired for that role.”
The transition is characterized by reassigning existing DOH staff and working diligently to attract new clinical workers, Ms. Encarnacion summarized.
Pafford’s departure has exposed major gaps in the territory’s healthcare services that the service provider has filled for nearly 7 years. Nonetheless, the commissioner ensured that “we've been able to cover very well,” after Senator Samuel Carrion raised concerns over the void left by Pafford.
Whether or not DOH can pay its debts to Pafford soon, it seems unlikely that the GVI will contract their services once again. “It's very costly to have Pafford here within the territory,” Ms. Encarnacion told Senator Alma Francis-Heyliger. “Whether or not staff would like to stay, the question is can we afford them.” For individual Pafford employees who are willing to transition over to the DOH, Ms. Encarnacion shared that Pafford has “been very humble in indicating that if there are any individuals that want to transfer over to the GVI, they would not bind them by contract.”
Friday’s discussion within the Committee of the Whole focused on appropriating funding for the the hospitals and other health care facilities, with little mentioned regarding securing funding to pay down the GVI’s debt to Pafford. Recent efforts by DOH to submit supplemental requests to pay the entity were not approved. “We were hoping to get that funding source through the general fund, but that did not occur,” said Ms. Encarnacion.
VIFEMS, which plays a critical role in delivering emergency healthcare, has also been heavily impacted by Pafford’s departure. VIFEMS will lose 2 ambulances in the St. Thomas/St. John district, and eight paramedics territory-wide. “It's a strain on us right now, but they are capable and they're willing to take care of this community,” said VIFEMS director Antonio Stevens. “We’re sorry that we're in this situation that we find ourselves in. It's unfortunate, but we just have to be able to be supportive of each other and get it done.”
