Health officials have until Jan. 14, 2024, to find a way to guarantee continuous dialysis treatment for kidney patients on St. Croix. The chair of the Health, Hospitals and Human Services Committee expressed confidence on Monday that there was “no possibility” of any healthcare service interruptions up ahead.
The January date marks the end of a 90-day preliminary injunction issued Oct. 16 by Superior Court Judge Yvette Ross-Edwards. The injunction was issued to keep a private dialysis service provider from closing their business prematurely. A Memorandum and Opinion published Oct. 31 put the injunction, issued from the bench, in writing.
There are currently 219 kidney patients in the V.I. receiving full-time dialysis care, according to one government official. Those suffering from end-stage renal failure risk serious illness or death if dialysis treatments are withheld. If not for the services provided through the Caribbean Kidney Center, the territory’s two hospitals would have more patients to treat than their resources could manage.
Under the current agreement, the kidney center also benefits by getting government help with the center’s staffing shortages. The 35th Legislature heard testimony from Caribbean Kidney Center owner Dr. Walter Gardiner earlier this year. Gardiner said the cost of hiring travel nurses during the COVID-19 pandemic rose significantly, leaving the center with a deficit. The Senate responded by supplying a $700,000 supplement.
Health Commissioner Justa Encarnacion also made an arrangement with Pafford Emergency Medical Services to relieve the kidney center’s personnel shortage.
But according to details contained in the opinion signed by Ross-Edwards, Gardiner grew frustrated with the pace of talks with Health over taking over the business. At that time, he said the Caribbean Kidney Center would close its doors as of Oct. 5 at 5 p.m.
On Oct. 7, Health officials petitioned for and won a temporary restraining order preventing the kidney center from terminating end-stage dialysis service. An evidentiary hearing was held Oct. 16, allowing both sides to state their case.
By hearing’s end, the judge replaced the TRO with a 90-day injunction “… based upon the findings that the government had meritorious claims, irreparable harm would be suffered by the Government as parens patriae, were status quo not maintained, and the public interest and irreparable harm outweighed the minimal harm to the Defendants,” the judge said.
Under the principle of parens patriae, the government can act on behalf of citizens who could not otherwise defend themselves. The very young, the old, and disabled people are among those fitting this category in the eyes of the law.
One of the violations alleged by the government — and later determined in court — was that the kidney center ignored a requirement set by the Centers for Medicare and Medicaid Services. Under CMS rules, patients receiving care at the center would have had to receive individual notices that the center was about to close.
On Monday, Sen. Ray Fonseca, chairman of the committee, said he believed negotiations between the government and Gardiner would find favorable terms before the injunction expired.
“They are in the final stages of negotiation,” Fonseca said. “There is no possibility that there would be any kidney emergencies in the territory. I am reasonably confident because I have been talking to both sides.”
