On March 31, 2020, AARP in The Virgin Islands penned a letter to Governor Albert Bryan urging him to minimize restrictions to the healthcare workforce during this national crisis.
AARP continues to advocate for targeted solutions to address access to healthcare, especially during the COVID-19 pandemic. This letter offers policy changes that support the expansion of practice capacity for healthcare professionals to include; waiving restrictions to out-of-state providers and practitioners, access to telehealth technologies, and temporary suspension of scope of practice requirements for Advance Practitioners. These recommendations play a vital role in ensuring that all Virgin Islanders have access to healthcare during this public health crisis. AARP VI urges you to contact your elected officials and demand immediate action.
The letter was copied to; Commissioner of Health, Justa Encarnacion, Commissioner of Human Services, Kimberly Causey-Gomez and members of the 33rd Legislature –
President Francis, Senator Blyden, Senator DeGraff, Senator Frett-Gregory, Senator Barnes, Senator DeGazon, Senator James, Senator Hodge, Jr., Senator Vialet, Senator Steven Payne, Senator Thomas, Senator Sarauw, Senator Gittens, Senator Benta, and Senator Jackson.
Dear Honorable Governor Bryan:
AARP in The Virgin Islands, and on behalf of our 22,000 members and all older Virgin Islanders, is writing to encourage the Virgin Islands to take immediate policy steps to extend the capacity of our islands’ healthcare workforce in response to the COVID-19 pandemic. According to the Centers for Disease Control and Prevention (CDC), older people and people with underlying health conditions, like heart disease, lung disease and diabetes, are about twice as likely to develop serious outcomes from COVID-19 versus younger, healthier people. In the face of this outbreak, AARP is providing information and resources to help older people and those caring for them protect themselves from the virus and prevent it spreading to others. In addition to the many steps the state has already taken to contain the outbreak, we believe more can and needs to be done to extend the capacity of healthcare professionals and first responders who are on the front lines of this effort.
On March 24, the U.S. Department of Health and Human Services (HHS) sent a letter to governors across the country asking states to take immediate action in eight specific policy areas to better support providers and more efficiently distribute scarce provider services during this time of widespread emergency. The recommended actions include temporarily waiving board restrictions that prevent licensed out-of-state health providers from practicing in Virgin Islands, waiving restrictions that prevent more widespread use of telehealth technologies, suspending scope of practice requirements that prevent healthcare professionals from practicing to the full extent of their education and training such as supervision or collaboration requirements for nurse practitioners and other professionals, and modifying laws to allow for signature-less deliveries of pharmaceuticals.
We greatly appreciate the important actions your administration has already taken to minimize barriers to care during this time, we urge you to consider and, as appropriate under the Virgin Islands code, take prompt action on the series of recommended actions delineated in the March 24th letter.
In particular, we urge you to adopt:
Provider Licensure Exceptions: Allowing health professionals licensed or certified in other states to practice their professions in Virgin Islands expands provider availability for in-person services and reduces barriers to the use of telehealth services. As recommended in the HHS letter, this provision would allow licensure exceptions during the emergency period and waive any licensing fees to encourage practice across the nation.
Waivers of Scope of Practice Requirements: During a pandemic, advance practice registered nurses (APRNs) can be critical front line health professionals -- approving tests, signing death certificates, etc. As suggested by HHS, the state should temporarily suspend supervision or collaboration requirements, expand allowable provider activities for certain healthcare professionals, such as APRNs, Registered Nurses, Physician Assistants and others, and remove all restrictions on where these types of professionals can furnish care. States should also encourage their State Boards of Medicine, Nursing, and other health professions to put in place an enforcement moratorium, for the length of the public health emergency, for scope of practice violations to ensure all practitioners can deliver needed care during the crisis. This moratorium on scope of practice violations should apply to all services for which providers are licensed. Temporarily removing this red tape will allow consumers direct access to practice and care from APRNs and other clinicians at a time they need it the most.
Telemedicine Modality and Practice Standard Waivers: To the extent permissible, the state should waive telehealth statutes and regulations not necessary for the applicable standard of care to establish a patient-provider relationship, diagnose, and deliver treatment recommendations utilizing telehealth technologies. Greater availability of telehealth services would increase access to health providers, including specialists, facilitate the sharing of clinical information for evaluation, and improve remote patient monitoring, particularly during times of public health emergencies. Such technology would help bring care to the patient, rather than having the patient travel and put themselves and others at risk for possible exposure.
Signature-less Pharmaceutical Deliveries: During this time of recommended social distancing, the state should modify any laws or regulations to allow for signature-less deliveries of pharmaceuticals, which can help prevent contact between recipients and delivery personnel.
In addition to the recommended actions in the HHS letter, AARP in The Virgin Islands encourages the Administration to take other actions through Executive Order or other means to ensure that nurses are able to quickly and efficiently join the healthcare workforce at this crucial time.
AARP in The Virgin Islands greatly appreciates the efforts to ensure the health and safety of Virgin Islanders during this challenging time. Thank you for your attention to this issue. We stand ready to help in any way that we can.
Troy A. de Chabert-Schuster, State Director
Corinne Plaskett, Volunteer State President