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Health Commissioner Justa Encarnacion Photo Credit: V.I. LEGISLATURE
The V.I. Department of Health's budget hearing Wednesday opened discussions on several critical public health concerns, including behavioral health, gun violence, communicable diseases, and health inspections, while also reviewing the department's performance in terms of service delivery, employee training, and maternal child health services.
Health Commissioner Justa Encarnacion defended the department's Fiscal Year 2024 budget request of $26.8 million, responding to pressing questions from lawmakers, who also praised the commissioner for the department's yeoman service to the community.
Ms. Encarnacion presented a budget request of $26.8 million from the territory's general fund. Combined with federal funding at a similar level, revolving funds of just under $2 million, and non-appropriated funds of just over $3 million, DOH's total budget comes up to over $58 million to provide public health services to the residents of the Virgin Islands, especially through health promotion and preventive initiatives.
The commissioner praised the efforts of the department’s over 350 employees for their efforts towards service delivery, and highlighted the department's commitment to training, reporting an average of 10 training opportunities per month offered to the team.
Behavioral health was the subject of intense discussion between health officials and lawmakers. During her testimony, Ms. Encarnacion noted that a standardized assessment of high school students found that a 37 percent occurrence of little interest or pleasure in doing things, 24 percent feeling of depression, and a 2 percent suicidal risk. Senator Diane Capeheart expressed concern about the increase in behavioral issues and suicide among young people. In response, Ms. Encarnacion emphasized the importance of awareness and education, stating, "Everyone has to be more aware of what's happening."
She noted that DOH has been actively reaching out to schools and implementing suicide prevention campaigns. Ms. Encarnacion also cited the successful hosting of children's mental health summits, the organization of community events like the father versus son basketball games, and mental health concert events which aim "to increase positive interaction." She also mentioned the planning for a mental health court district training and the progress in the development of two behavioral health facilities.
However, the commissioner indicated that while infrastructure was a priority, it was not the highest in the efforts to improve behavioral health.. Instead, she emphasized prevention and awareness, with a specific focus on suicide prevention, as their main priorities. Gun violence was also identified by Ms. Encarnacion as a serious public health emergency, and she described inter-departmental efforts attempting to tackle that thorny issue.
The communicable diseases division, the commissioner told lawmakers, is concerned about the 39 percent drop in people tested for HIV, STIs and TB when compared to the same time last year. Despite this, the division has maintained their 90 percent success rate in linking a patient to care within days of confirming a diagnosis in 90 percent of cases.
Another concern for legislators was the significant decline in impromptu visit by health inspectors. Senator Marvin Blyden expressed concern over the sharp decrease in health permits and increased health cards issued, to which Encarnacion responded with the examples of large public events as factors influencing these numbers.
However, Senator Donna Frett-Gregory, budget committee chair, returned the line of questioning to the issue of a lax inspection system. Noting that Mr. Blyden himself had recently suffered from a bout of suspect food poisoning, Ms. Frett-Gregory pointed to the fact that food safety was a challenge in the region. She asked for a clear explanation as to why inspections were not being conducted on the same level, noting the 75 percent reduction in inspections compared to last year. This time, the commissioner pointed to changes in the department's inspection strategies and admitted that staffing was a challenge.
Senator Kenneth Gittens wanted to explore the possibility of appropriate signage from health officials placed in various eating establishments. Department of Health representatives admitted a deficiency in this area and promised to work on it.
An apparent decrease in maternal child health services was due to a lack of healthcare infrastructure, particularly on St. Croix, along with a shortage of pediatricians. Notwithstanding this challenge, Senator Marise James highlighted the territory’s low maternal mortality rate, and the possibility of advertising this face to boost medical tourism in the USVI.
On the laboratory front, the territory's public health laboratory successfully renewed the certificate of need for high complexity testing. The average time for receiving test results is now under 24 hours, an improvement from the past where tests may have had to be sent off Island.
The health commissioner concluded by stating that the department "is committed to reducing health risks, increasing access to quality health care provided in a culturally sensitive equitable manner, and enforcing health standards."
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