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Schneider Regional Medical Center Faces $24 Million in Unsettled Bills, Calls for Prompt Aid



Schneider Regional Medical Center (SRMC), a beacon of health services in the Virgin Islands, is wrestling with financial strain amid burgeoning unpaid patient bills. As conveyed by Tina Commissiong, the CEO, during her Senate Committee appearance, these challenges threaten the very financial backbone of the establishment.

The figures presented by Ms. Commissiong were daunting. For the 2024 fiscal year, SRMC plans for a budget of $105.7 million. Of this, they anticipate net patient revenues will constitute $72.3 million. Notably, the institution manages to self-fund almost 70% of its operating costs. She also called for a $31 million allocation from the territorial general fund, which will serve primarily to offset uncompensated care expenses and match local Medicaid needs.

However, the fiscal scenario becomes bleak when looking at the figures for uncompensated care. Senators were taken aback to learn that these expenses might soar past $24 million this fiscal year. To provide perspective, in FY 2023, SRMC has billed an excess of $14.7 million for self-paying patients, managing to retrieve a mere 4% of this amount.

One of SRMC’s more formidable challenges is the steep gap between Medicare and Medicaid reimbursement rates and the actual costs incurred. Ms. Commissiong threw light on a striking fact: SRMC provides roughly 80% of its care either entirely free or at significantly reduced prices. This places immense financial stress on the center’s resources.

Reacting to Committee Chair Senator Donna Frett-Gregory’s concerns on the poor settlement rate of bills by self-paying patients post-care, Ms. Commissiong enumerated potential solutions. These included revamping Medicare and Medicaid reimbursement structures, broadening the local insurance net, and advocating for uncapped federal Medicaid resources.

On the operational side, SRMC has been relentless in its drive to augment revenue, optimize collections, and curtail overheads. The CEO shared an encouraging metric: a 17% spike in cash collections, topping at a commendable $5.7 million in May 2023. They’ve also launched innovative payment methods, introducing online payment options and SMS bill alerts.

In terms of expanding their medical expertise, SRMC eyes fields such as psychiatry, cardiology, dermatology, and gastroenterology. Parallelly, to keep expenditures in check, they’re moving away from pricier contractual workers to more permanent staffing solutions. They’re also rerouting some long-term care funds to address prior uncompensated care.

An additional point of concern brought to the fore by Ms. Commissiong is the lack of capital for deferred maintenance of their aging facility. The recommended yearly investment stands at $3.9 million, a figure corroborated by Darryl Smalls of the Territorial Hospital Redevelopment Team. The team is veering towards a more comprehensive revamp rather than piecemeal renovations.

A priority for SRMC is to instill confidence in local residents. The center aims to harness a portion of the $30 million insurance fund that typically exits the territory. However, apprehensions were voiced, with Senator Marvin Blyden sharing less-than-ideal personal experiences at SRMC, prompting Senator Frett-Gregory to push for stringent quality checks.

On an optimistic note, Ms. Commissiong spotlighted SRMC’s accomplishments, from maintaining a flawless two-year accreditation after rigorous Joint Commission audits to garnering high praise from the Centers for Medicare and Medicaid Services, especially for their hemodialysis wing.

Moving forward technologically, SRMC is on the cusp of rolling out a patient portal and a virtual nursing platform. This new system, currently 82% ready, forecasts a yearly collection boost of about $2.5 million. Nonetheless, they still need an additional $3.5 million to see it through, along with auxiliary data backup measures.

Ms. Commissiong concluded with a clarion call for swift fiscal support from the Virgin Islands government. Emphasizing the center’s dedication to quality healthcare for an aging, underinsured populace, she remarked, “The hospital’s financial backing is not just a need; it’s imperative to uphold the health and well-being of our community.”

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Virgin Islands Health Department Alerts Public to Dengue Fever Amid Regional Outbreak



Amid concerns over a dengue fever outbreak in Puerto Rico, the Virgin Islands Department of Health is urging residents to be vigilant in recognizing and responding to the symptoms of this mosquito-borne disease. The call to action follows the confirmation of three cases of dengue fever within the territory, sparking fears of a potential increase in cases.

Health Commissioner Justa Encarnacion emphasized the critical need for public education on the similarities and differences between the symptoms of dengue fever and COVID-19. With both diseases presenting similar early symptoms, Encarnacion underscored the importance of early detection and appropriate medical consultation.

“Dengue and COVID-19 share early signs, but understanding and distinguishing the unique symptoms of dengue is crucial for timely and effective treatment,” Encarnacion stated. She outlined the typical symptoms of dengue fever as fever, nausea, vomiting, rash, and pains in the eye, muscles, joints, or bones. These symptoms generally last from two to seven days, with most people recovering within a week.

The Health Commissioner provided guidance on managing dengue symptoms, advising against the use of aspirin or ibuprofen and recommending acetaminophen instead. She stressed the importance of seeking medical advice and undergoing a blood test if symptoms appear.

The Aedes aegypti mosquito, which is most active at dawn and dusk, is identified as the primary carrier of the dengue virus. In light of the outbreak, residents are advised to eliminate standing water around their homes and use EPA-approved repellents to prevent mosquito bites and breeding.

The Center for Disease Control (CDC) has warned that severe dengue can develop in about 5% of cases, posing a higher risk to infants, pregnant women, and individuals who have previously contracted dengue. Symptoms of severe dengue, including abdominal pain, persistent vomiting, and bleeding from the nose or gums, require immediate medical attention.

This advisory comes as Puerto Rico declares a state of emergency following a record 549 cases of dengue reported this year. The Virgin Islands Department of Health remains proactive in its efforts to prevent a similar surge in cases, advocating for community awareness and adherence to prevention measures.

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The Complex Challenge of Diabetes Management in the USVI: Insights from Health Professionals



In the US Virgin Islands, the battle against diabetes presents unique challenges, underscored by the local response to treatment options like Semaglutide, known commercially as Wegovy and Ozempic. These medications, which are increasingly popular for their weight loss side effects, have not seen widespread adoption in the territory, according to healthcare professionals.

Semaglutide, a weekly injectable medication for type 2 diabetes, enhances insulin production and lowers blood sugar. It’s also taken orally by prediabetic individuals to delay the onset of diabetes. Despite its benefits and growing fame—bolstered by celebrity endorsements like Oprah, who referred to it as a “maintenance tool”—the drug’s reception in the USVI has been lukewarm.

During a recent legislative discussion on diabetes management, Senator Marise James questioned the extent of Semaglutide’s use in the territory. Carlos Castillo, a nurse practitioner at the V.I. Diabetes Center of Excellence, revealed a surprising trend: many Virgin Islanders resist the weight loss that accompanies the medication. Castillo shared that while Semaglutide could lead to a 4-6% reduction in body weight, many locals prefer not to use it for fear of losing weight.

Another significant hurdle is the medication’s cost. Without insurance coverage, the price can soar to $1,200 monthly, making it inaccessible for some. This issue of affordability, alongside cultural attitudes towards weight and medication, contributes to the drug’s limited use.

The phenomenon of preferring natural remedies over prescribed medication and the reluctance to lose weight reflect broader cultural attitudes towards health, as noted by Julia Sheen, the executive director of the Virgin Islands Diabetes Center of Excellence. Sheen stressed, however, that not all Virgin Islanders share this sentiment. The Center’s efforts in education, outreach, and diabetes management classes aim to promote healthier lifestyles and understanding of the link between weight control and diabetes management.

Despite the challenges, the commitment of the Virgin Islands Diabetes Center of Excellence to combat diabetes through comprehensive education and support programs remains unwavering. Their work illustrates the importance of tailored health interventions that respect cultural values while striving to improve outcomes for those living with diabetes in the territory.

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Addressing the Diabetes Epidemic in the USVI: A Call for Urgent Action



At a recent meeting convened by the Committee on Health, Hospitals, and Human Services, the growing epidemic of diabetes within the U.S. Virgin Islands was thrust into the spotlight, revealing a critical need for immediate public health interventions. Julia Sheen, the executive director of the Virgin Islands Diabetes Center of Excellence (VIDCOE), delivered alarming statistics, positioning diabetes as the sixth leading cause of death in the territory, with over 12,000 residents currently afflicted.

Sheen highlighted lifestyle factors such as insufficient exercise and poor dietary habits as key contributors to the territory’s diabetes rates. Although women are predominantly represented in these statistics, Sheen suggests this may mask an underreporting issue among men. A notable gap in data concerning diabetic children in the USVI prompted questions from Senator Diane Capehart, to which Sheen admitted the absence of comprehensive data on youth, emphasizing a significant blind spot in the territory’s public health strategy.

The absence of specific data notwithstanding, Sheen underscored the urgent need for targeted educational programs aimed at children, particularly those overweight or obese, to curb the onset of diabetes. In support of this preventive approach, Senator Milton Potter relayed a citizen’s proposal for screening all fourth graders for prediabetic conditions, subject to parental consent and available funding.

The discussion also turned to the scarcity of public facilities conducive to exercise, a crucial preventive measure against diabetes. Senator Kenneth Gittens critiqued the reliance on private sector support for creating walkable spaces, instead advocating for government-led initiatives to improve and maintain public recreational facilities. He lamented the demolition of Arthur A Richards Junior High School, which had provided a range of recreational resources to the community, and emphasized the importance of accessible, well-maintained sidewalks to support a healthy lifestyle.

The committee unanimously recognized the need for a collaborative approach to combating diabetes, involving multiple government departments, including Education and Human Services. The financial strain of diabetes management, costing the territory approximately $120 million annually, underscores the urgency of these interventions. This collective resolve marks a pivotal step toward addressing the diabetes crisis in the USVI, aiming to safeguard the health and wellbeing of its citizens through comprehensive public health strategies and infrastructure improvements.

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