From Service Provider to Administrator, It’s All About Health for Encarnacion

Justa Encarnacion, a registered nurse and health administrator, is commissioner-designee for V.I. Department of Health. Photo by Jahnesta Ritter, DOH

Whenever anyone asked the little girl playing in Frederiksted what she wanted to be when she grew up, she was ready with her answer.

“I always said ‘a nurse’,”  Justa Encarnacion said, adding that a keen interest in health care has been a part of her “from the time I was three or four years old.”

In an interview with the Source Wednesday, Encarnacion traced her career from the first spark of interest to her recent appointment by Gov. Albert Bryan as the commissioner-designee for the Virgin Islands Health Department.

By the time she was in high school, Encarnacion said she was spending her summers as a volunteer at St. Croix’s only hospital, then the Charles Harwood Hospital.

She earned her associate’s degree in nursing from what is now UVI (the University of the Virgin Islands) but what was then CVI. (“People who graduated from the College of the Virgin Islands are proud of that,” she said. “It was always a good school.”)  She went on to earn a bachelor’s degree at Barry University in Miami. Later, she earned a master’s in business and health care management online from the University of Phoenix.

In her nursing practice, Encarnacion specialized in pediatric care. She worked awhile in Cleveland, Ohio, then returned to St. Croix where she put her administrative talents to work; Encarnacion has worked at UVI, at the Juan Luis Hospital and in private practice.

In a long list of accomplishments, she includes hosting a UVI-led youth symposium focusing on women’s health issues, working as a nurse recruiter for the hospital, spearheading a middle management survey on health care, leading a peer health education team and taking on various management positions at the Luis hospital where she worked from 2003 to 2016. Typically, the projects have been joint efforts, partnering with various health-related government agencies and private sector entities.

“In order to be successful, you have to build a good team,” Encarnacion said – a mantra she is carrying with her into the Health Department.

Her new position requires a major shift in focus – from in-patient care to public health service, she said.

“One of the major issues (for DOH) is connection,” Encarnacion said. It’s essential for Health to reach out to other government departments.

“I’ve already started to do that,” she said, describing how she has approached other Cabinet appointees to look for areas of mutual interest among their mandates.

On a more formal level, she said the department is working on two major administrative projects. With a grant from the federal Center for Disease Control, and cooperation from the territory’s hospitals and clinics, it will draft a Territorial Health Plan.

At the same time, it is pushing to complete a Human Services sponsored project started several years ago that aims to create a Health Information Exchange, an electronic database of patient information that is available to appropriate public and private healthcare providers in the territory.

“We’re bringing everyone back to the table” to implement the Health Information Exchange, Encarnacion said.

Health issues facing the community are many and varied; Encarnacion listed among the top priorities “behavioral health” (mental health) and HIV/AIDS.

The Virgin Islands is “high on the scales” for per capita rates of HIV infection, she noted.

“It’s no longer a death sentence,” she said. “It’s very manageable.” Attention should be on prevention, detection, treatment and transmission, and the territory’s clinics as well as its education system should be involved, she added.

“We improve our chances if we collaborate,” she said.

The department continues to monitor for signs of environmental health issues such as dengue fever and the zika virus, she said, but currently there is no cause for concern. The last time any cases of zika were confirmed in the territory was more than a year ago, in January 2018, and there were just two at that time.

As for chronic diseases plaguing V.I. residents, “diabetes is top of the list,” she said, adding that there continues to be a high rate of heart disease, which connects with diabetes, as well as hypertension, high cholesterol and renal disease. Obesity, which is also prevalent, is a risk factor for all of the conditions.

Before DOH can mount a very viable campaign on any of these fronts, it will need to address its own form of malnourishment: the department is suffering from a severe lack of personnel, reportedly exacerbated by the exodus of many health professionals following the September 2017 hurricanes.

Encarnacion backed away from releasing specific figures, as did her office in follow up communications.  But she and Jahnesta Ritter, DOH spokeswoman, both cited the vacancies as a problem they are anxious to solve.

The department website features a large “We’re hiring” announcement. Among the positions it lists as open are HIV director, mental health director and federal grants manager. There are 22 separate jobs listed, and some of them – such as “staff nurses” – likely represent numerous vacancies within the category.

“We are working diligently to fill those vacancies,” Encarnacion said. “A lot of Virgin Islanders are away” and “we are not able to compete with salaries” they earn stateside. Still she is hopeful.

When people return to the Virgin Islands, it isn’t money that draws them back, she said.  Rather, people return for family.

For staffing and for other issues, Encarnacion sees a will and determination as more important than funding.

“Yes, we need money,” she said. “But we have to want to do it.”

The first thing she’d like to do is improve intake services, establish a one-stop service for people in the health care system and maintain satellite centers for those who need them because “access to care is critical.”