Lawmakers Criticize Health Officials Over Mental Health, Federal Grants

Director of Health Justa Encarnacion takes questions from the Senate Finance Committee. (Photo by Barry Leerdam for the USVI Legislature)
Director of Health Justa Encarnacion takes questions from the Senate Finance Committee. (Photo by Barry Leerdam for the USVI Legislature)

Lawmakers expressed dissatisfaction Monday over the Department of Health’s handling of the mental health crisis in the territory and some at-risk federal grants aimed at shoring up the Virgin Islands’ behavioral health support system, saying that the Senate unfairly gets the blame.

“We are blamed and they say the senators are not doing anything, the senators are stealing, the senators and their big salaries, and we are working our tail off day and night … trying to figure this thing out and making sure we’re sending the money to the right places,” said Sen. Allison Degazon (D-STX).

“Every time someone passes the Wendy’s area and you see that lady laying down, it’s a reminder to the constituents that senators aren’t doing anything when we have in fact put the money out there where it needs to be,” Degazon told Health Department officials.

On Monday, officials from the Department of Health, led by Health Commissioner Justa Encarnacion, testified before the Senate Committee on Health, Hospitals and Human Services on St. Croix on the status of department’s programs.

Encarnacion laid out the territory’s behavioral health services plan in three phases, with the first one, the reopening of the Charles Harwood Complex Clubhouse as a social interaction center, not scheduled until the end of August.

This means work on the much-awaited Anna’s Hope treatment facility, funded by $2 million in reprogrammed funds through Bill No. 32-0247, is also scheduled further back. The plan’s second phase involves retrofitting the Anna’s Hope facility, a one-story masonry building encompassing about 5,000 square feet that would accommodate 12 patients. The retrofit will take $765,000 out of the $2-million appropriation.

Phase three, meanwhile, will see the buildout and establishment of a project management office for the Anna’s Hope treatment facility using Community Development Block Grant-Disaster Recovery funds. The long-term residential care facility will provide 24/7 care for people diagnosed with behavioral health challenges or mental health disorders. Outpatient services will also be made available through the facility.

On Monday, senators said work on Health Department programs such as behavioral health is slow, even taking into account that the Bryan administration is still in the last stretch of its transitional phase.

“I’m always talking about continuity of government. We don’t have to see the same faces to continue a program, but what’s disheartening and disappointing is when we see the same phases and we still hear a bunch of excuses,” said Sen. Kenneth Gittens (D-STX).

Lawmakers also reacted to officials’ report that the department will temporarily lose the Ryan White B Supplemental Grant, which distributes medication through two local pharmacies.

According to Encarnacion, the Health Department did not meet the spending limit for the Ryan White Supplemental Grant, which supplements the Ryan White Title II grant. While the department will not lose the money awarded under the grant, it also cannot reapply for the grant for the upcoming fiscal year. When asked if this means medication will not be distributed because of the loss of the Ryan White Supplemental Grant for the next fiscal year, grant writer Eleanor Johannes said no.

“They buy medication in bulk, so when the total funding that they did spend is run out through that contract, the Ryan White Title II program kicks in,” Johannes said.

According to Encarnacion, some of the main reasons for unspent funds include staffing vacancies and unexecuted contracts. The Health Department’s Office of Federal Grants Management oversees 75 grants, she said. For Fiscal Year 2020, their total federal budget is $48.6 million, up significantly from the previous year’s, which stood at $33.7 million.

The department’s Behavioral Health division alone currently has some $2.8 million in grants from the Substance Abuse and Mental Health Services Administration.

Encarnacion said their newly hired director of behavioral health, Vernita Bicette, is working closely with each program manager to ensure that they deliver grant requirements on time.

“When [the Department of Health] has unobligated funding, the program directors have the option to request a carryover of funds,” Encarnacion said. “ This would allow the service to go on with the funding that was not spent. The goal is to reduce and eventually eliminate unobligated funding.”

The Health Department is also engaging new software to streamline the monitoring and exchange of vital statistics data, Encarnacion said. The State and Territorial Exchange of Vital Events Electronic Records, or STEVE, a web-based messaging application that allows the Office of Vital Records to electronically exchange data such as births and deaths, was implemented in May. Next month, the department will roll out the Electronic Verification of Vital Events, or EVVE, a web-based verification application that federal, state and local agencies can use to immediately confirm the existence of a record.

“Currently, there are records that date back to the early 1900s,” Encarnacion said. “While every effort is made to handle these documents delicately, they are subject to deterioration. Since Hurricanes Irma and Maria in 2017, the records were further compromised by mold.”

Health officials also reported progress as a result of the Hurricane Recovery Crises Cooperative Agreement, a Centers for Disease Control-funded program to support public health response, recovery and expenses directly related to the 2017 hurricanes. A total of $22.6 million was awarded to the Department of Health and partner organizations for projects targeting chronic diseases, communicable diseases, environmental health, emergency preparedness and immunizations. The program has so far proven to be a salve to the staffing shortage, according to Encarnacion.

“Over 30 individuals have been hired through the cooperative agreement and approximately 12 additional personnel will be hired within the next six months,” Encarnacion said.

During Monday’s hearing, lawmakers also unanimously approved Sen. Alicia Barnes (D-STX) Bill No.33-0086, which would require all restaurants and establishments that sell food to post signs that show how to administer first aid for choking. The bill was sent to the Rules and Judiciary Committee for review.

Present during Monday’s hearing were Committee Chairman Sen. Oakland Benta (D-STX), Janelle Sarauw (I-STT), Donna Frett-Gregory (D-STT), Marvin Blyden (D-STT), Kurt Vialet (D-STX) and Gittens.