A virtual town hall at 5:30 p.m. Thursday will give residents a chance to ask questions about the government’s Healthier Horizons initiative, a package of public health measures that Gov. Albert Bryan Jr. said Monday will increase residents’ access to affordable health care and modernize the delivery of mental and behavioral health services and the sharing of medical health records.
In his weekly news briefing, Bryan said all of the initiatives are in some phase of development and implementation, with some close to being submitted to the Legislature and others just waiting approval. Some have also been informed by the territory’s response to the ongoing public health crisis, which Bryan said Monday has exposed critical needs in the areas of telehealth and telemedicine, among other things.
“This package displays the progressive thinking necessary to transform our health care system given our limited resources,” Bryan said. He also described many of the efforts as “revolutionary” in their approach, which can help guide the system for “many years to come.”
Mental health and the lack of available services within the territory has been a bone of contention for decades, and Bryan said that the public has seen its “traumatic results” as the numbers of suicides, murders and homeless cases continue to increase. Recent hurricanes and the ongoing pandemic have exacerbated the situation, and Bryan said even the uptick in gun violence over the past few months can be linked to intellectual and behavioral health disorders.
“It’s the same students acting out as juveniles that are now finding themselves locked into a life of incarceration and unfortunately a grisly end, lying in pools of blood on our streets,” he said.
Bryan said a comprehensive Behavioral Health and Developmental Disabilities Act was submitted on Jan. 13 to address the needs of adults and children experiencing everything from behavioral health issues to alcoholism and drug dependency while also updating “antiquated laws” to provide doctors and other practitioners with the “clarity and tools they need to better service these populations.”
The roles of the Health, Police and Human Services departments, along with Bureau of Corrections in working with patients and clients, are also defined, and a self-imposed mandate for the establishment of a behavioral health treatment facility included. Bryan said in setting up such a facility, it is also necessary to clarify the rights of patients during voluntary and emergency treatment.
Modernizing the delivery of health care services, and the sharing of records, is also important, Bryan said as he explained the steps the administration is taking to set up a health information exchange and build a proposed Telehealth Act.
The exchange would be funded by a $14.9 million award of federal funds to benefit Medicaid recipients and promote the use of certified electronic health record technology by providers. It would also allow access to and the sharing of a patient’s medical information and give a complete view of their health record to reduce the risk of errors, duplicate treatment and repeat admissions, he said. A request for proposals for vendors who can build such a system for the territory will soon be released, Bryan added.
Meanwhile, with telehealth – or virtual – medical services becoming more popular, Bryan said the second proposed bill would allow video conferencing and other technology to be used for remote treatment and enable insurers to cover those services.
“We are working to bring care closer to you and closer to your pocketbook,” he said.
A draft of the telehealth bill has been completed and the logistics of licensing and other requirements are being worked out.
With limited medical staff on island, Bryan said he is also exploring the territory’s ability to set up interstate compacts, which would allow physical therapists, nurses and emergency medical services personnel from off island to practice or work within the territory without going through a complicated licensing process. While details are being ironed out with the local licensure boards, Bryan said that lessons learned from the pandemic about how limited medical resources can be quickly overwhelmed and are “wholly inadequate” during times of emergency helped drive the initiative.
Meanwhile, a proposal that helps to facilitate “association health plans,” will give more uninsured workers access to health care, by allowing small businesses and the self-employed to join together and apply for insurance as if they would in a big company. Both districts’ Chambers of Commerce have been contacted to consider organizing an effort to make such plans available for their members and Bryan said that at least three private insurance companies on island are willing to offer their help.
A comprehensive community health assessment that would help inform much of this work is in the final stages of completion with the overall completion date targeted for December, he added.
Bryan also announced a V.I. Healthy Housing Initiative, in partnership with local stakeholders and the Corporation for Supportive Housing, to assess housing and healthcare services in areas of behavioral health, youth rehabilitation, supportive housing and elder care. A charrette is scheduled for the end of 2020 and Phase 3 of the three-phase initiative is scheduled to begin in the spring of 2021 with the goal of putting into place an overhauled housing and healthcare system in the territory, Bryan said.
Finally, the comprehensive series of initiatives would not be complete without the rebuilding of local medical facilities, and Bryan said the Office of Disaster Recovery is waiting on proposals for architectural and engineering services for the permanent repair and design of the territory’s hospitals, Charlotte Kimelman Cancer Institute and the Myrah Keating Smith Community Health Center.
All four proposals are due on July 17, he said.
The governor also urged senators to take action on a revised medicinal cannabis bill, which they began discussing on the floor on Friday. While medicinal cannabis is legal in the territory, Bryan said without this bill, there is no structure in place to govern the industry itself and one is needed in order to generate tax revenues and fund it.
“If a decision is made to not proceed, we are prepared to implement the current law as it exists, but we need to decide before the Cannabis Board moves ahead with policies that would be changed by the proposal,” he said.
More information on the Healthier Horizons package is online here.