A senate committee added $2 million in on-paper appropriations to buy vans for drug treatment, to a bill appropriating another $3 million to build and operate a mental health facility on St. Croix. The appropriations are all from sources that may not be able to support the spending, for projects whose costs bear no relation to the amount of the appropriation, calling into question whether they will lead to the hoped-for results.
The bill, (BILL NO 32-0247) sponsored by Sens. Novelle Francis (D-STX), Nereida Rivera-O’Reilly (D-STX) Kurt Vialet (D-STX) and Janelle Sarauw (I-STT), nominally appropriates $2 million to renovate a derelict facility in Estate Anna’s Hope into a mental health facility and $1 million to develop an outpatient mental and behavioral health treatment program. It was first heard in committee in August, without testimony.
Francis urged the Rules and Judiciary to approve the appropriation, emphasizing the urgent need for mental health care on St. Croix, especially since the 2012 closure of the behavioral health unit at Gov. Juan F. Luis Hospital.
“This bill would restore humanity and compassion to how we treat our mentally ill,” Francis said, introducing the measure to the Rules and Judiciary Committee on Thursday. Often, the severely mentally ill end up in St. Croix’s Golden Grove prison, for lack of a better alternative, he said, a point backed up by several other testifiers.
“I will continue to say Golden Grove is not the place for the individuals so we really need to find a way to redress their situation,” Francis said.
All the testifiers, including Deputy Commissioner Of Public Health Services Dr. Nicole Craigwell-Syms; Acting JFL Chief Executive Officer Dyma Williams, National Alliance on Mental Illness St. Croix Vice President Aminah Saleem and others, uniformly agreed on the urgent need for more mental health funding and for a dedicated facility.
Less clear was whether the funding described would accomplish the goals, or if renovating the abandoned building was the best option.
A close look at the funding sources strongly suggests neither the $3 million for a mental health clinic, nor the $2 million additional appropriation for mobile mental health units, is really available.
Craigwell-Syms spoke in support, saying the Health Department was working on planning to staff the facility and hoped the remaining nine acres of undeveloped land on the site could eventually be used for additional facilities. As for whether the funding, if available, is enough, Craigwell-Syms said it would “assist greatly in helping DOH get the ball rolling.”
Williams said space is being set aside in post-hurricane temporary modular hospital buildings to house a behavioral health unit. But she emphasized this was not a full solution to St. Croix’s needs. Williams outlined an array of mental and behavioral health needs, including a critical need for outpatient substance abuse treatment and a facility to segregate those adjudicated criminally insane or potentially dangerous from regular hospital patients and from other mental and behavioral health patients.
But she questioned the viability of the plan for Anna’s Hope.
“(N)ot all facilities can be retrofitted to meet the needs of those clients, particularly the one that has been currently identified such as the Anna’s Hope facility,” Williams said.
“Retro fitting an aged space, with old electrical wiring, plumbing, roofing and infrastructure often may compromise the space allocations needs, life safety requirements (such as fire suppression, egress) overlooks industry best practice/standards and ultimately maybe be more costly than building from foundation up,” she said.
Francis agreed a new facility would be better.
“However I think time is really against us and we need to do something in the interim,” Francis said.
The legislation for the Anna’s Hope construction has two nominal sources of funding: $1 million is “re-appropriated” from a 2014 piece of legislation (Act 7697) that appropriated $1 million from “(a)ny refund from CIGNA to the Government of the Virgin Islands for overpayment” for the Gov. Juan F. Luis Hospital to restore its acute care inpatient psychiatric unit, shut in 2012 due to lack of funding.
It is not clear this 2014 funding exists. The 2015, 2016, 2017, 2018 and 2019 V.I. Government executive budgets make no mention of millions of dollars in refunds from CIGNA, nor have millions of dollars in refunds been mentioned in the several legislative hearings on last-minute renewals of the government’s policies with CIGNA. Additionally, the V.I. government has been facing severe budget shortfalls for the past several years, with two consecutive administrations repeatedly taking emergency budget measures over the intervening years. The government has large outstanding debts.
Another $2 million is from funding in the 2016 budget from the St. Croix Capital Improvement Fund to to build “a new Herbert Grigg Home for the Aged.”
Grigg Home was severely damaged in 2017’s storms. Craigwell-Syms said Thursday she did not want to take the funding if Grigg Home needed it. But Gov. Kenneth Mapp indicated in May that fund is tapped out, when the Legislature appropriated $4 million from that same fund for dredging and other projects.
“The St. Croix Capital Improvement Fund is tapped for many projects,” Mapp said in his letter to the Senate notifying it of his actions. He approved the measure anyway, saying he expected to instead be able to fund the dredging with U.S. Department of Housing and Urban Development Community Development Block Grant disaster funding.
In September, the Legislature appropriated $2 million from the current year’s federal excise tax remittances to that fund, which might change the situation. The fund’s current balance and pre-existing appropriations were not discussed during Thursday’s hearing or when the bill was discussed in an earlier hearing. No budgetary officials testified.
After dismissing the testifiers, the committee amended the bill to appropriate another $2 million to buy two “mobile wellness” vans tasked to perform psychiatric screenings, “outpatient treatment of substance abuse,” and other services. There was no testimony on whether vans were useful for outpatient substance abuse treatment or the other functions envisioned nor on the cost of buying and using such vans.
This funding too does not appear certain. $ 1 million for a St. Croix van would be appropriated from the St. Croix Capital Improvement Fund, which, as noted above, may or may not have sufficient funds. The other $1 million, for a St. Thomas-St. John van, is supposed to come from a fund called the Community Facilities Trust Account, which gets 3 percent of gross federal alcohol excise taxes remitted to the territory.
The amendment says to use the funds, irregardless of the provisions of section 7.1 of Act 7012, which is the legislation approving the contract between the V.I. government and Diageo for funding the construction of the Diageo refinery on St. Croix. But the law has no section 7.1. Instead, the Community Facilities Trust Account is established in section 7.1 of the contract between the Government of the Virgin Islands and Diageo.
The contract. which also includes provisions providing direct cash subsidies to Diageo and provisions requiring V.I. officials to actively fight any changes to those subsidies, is subject to contract law and not revisable by the Legislature. Diageo would have to agree to any revisions, after a negotiation process involving the executive branch of the V.I. government. [Diageo Act and Contract]
The contract says the fund is to be “administered by the V.I. Public Finance Authority … for the development, operations and maintenance of community and/or sports facilities or urban redevelopment projects on St. Croix and similar facilities and projects on St. Thomas or St. John, which projects shall be recommended by the Governor and approved by the Legislature.”
The governor could potentially recommend the mobile health vans but has not done so to date.
The bill also would change references in V.I. law to mental illness to refer instead to “behavioral health” and changes the name and composition of the Citizen’s Council on Mental Health and Drug Dependency. That council has existed sporadically since its legislative creation in 1977. Testimony from a 2007 hearing credits Health Commissioner Julia Sheen with “reestablishing” the council. Testimony during Thursday’s hearing suggested it is not currently functioning. Craigwell-Syms said the “Department of Health advocates for the establishment and existence of such a commission.”
Voting to send the bill, as amended, to the Senate floor for a final vote were: Francis, Sarauw, Sens. Positive Nelson (ICM-STX) and Sammuel Sanes (D-STX). Sens. Jean Forde (D-STT, Janette Millin Young (D-STT) and Myron Jackson (D-STT) were absent., having left before the vote to catch return flights to St. Thomas.