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Strategic Preparations for Dialysis Care Amid Caribbean Kidney Center’s Impending Closure

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In a proactive response to the expected closure of the Caribbean Kidney Center (CKC), the VI Government Hospital and Health Facilities Corporation Territorial Board recently approved several crucial measures to enhance the Schneider Regional Medical Center (SRMC)’s capacity to manage an expected surge in dialysis patients.

Board Chair Christopher Finch emphasized the urgent need for upgraded equipment, stating that the existing apparatus at CKC would soon be inadequate. The board’s focus, he remarked, was on ensuring the availability of state-of-the-art equipment for patient care.

The board’s initial action involved approving the procurement of a state-of-the-art reverse osmosis system from Renal Dynamics LLC. This system, which purifies and disinfects water for dialysis, represents an investment of $291,231, encompassing installation and freight charges to Miami. Department of Health Commissioner Justa Encarnacion lauded this system as the gold standard for dialysis care, highlighting its critical role in ensuring patient safety.

Additionally, the board greenlit the purchase of 15 hemodialysis machines, also from Renal Dynamics LLC, at a total cost of $290,025, inclusive of freight to Miami. SRMC’s CEO, Tina Commissiong, explained that these machines are identical to those currently used at SRMC, ensuring consistency in care and supply chain efficiency. These machines will cater to the approximately 50-55 CKC patients transitioning to SRMC.

To complement the dialysis machines, the board also sanctioned the acquisition of 15 hemodialysis chairs from Champion Manufacturing Inc., with a budget cap of $34,065, inclusive of shipping to Miami.

Addressing staffing needs, the board approved hiring additional dialysis technicians and registered nurses. A 6-month professional service agreement with ProLink Healthcare LLC was authorized, capping at $1.5 million, to facilitate a safe and efficient transition for CKC’s patients. Commissiong highlighted the necessity of temporary, experienced contract labor to manage this transition smoothly.

The funding for these expansions is anticipated to be sourced from a reprogramming of American Rescue Plan Act funds, pending approval from the Office of Management and Budget. While alternative funding sources may be considered later, Finch noted the re-allocation of ARPA funds as the most expedient solution for SRMC’s immediate financial needs.

Earlier, senators had allocated $700,000 from the territory’s general fund to CKC, intended to forestall its closure by hiring essential staff. Despite initial hesitations about using taxpayer money for a private entity, the senators prioritized uninterrupted access to vital dialysis services for Virgin Islanders. This funding, however, was rapidly utilized for services provided by Pafford Medical Services, expected to be depleted by September 30.

As of July, discussions regarding the acquisition of CKC by hospitals had hit a standstill, primarily due to delays in government appraisals. The current status of these negotiations remains uncertain.

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Governor Bryan Pushes for Urgent Legislation to Address Medicaid Fund Shortfall

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Governor Albert Bryan announced on Monday that the territory has exhausted its funds for the local Medicaid match, prompting Government House to submit draft legislation to the Senate seeking an additional $3 million for this purpose.

Despite the fiscal shortfall, Governor Bryan views the situation as a sign of increased healthcare access. “We’re having so many people access care,” he stated, highlighting that during the pandemic, nearly 40,000 individuals utilized Medicaid for services including braces, dental care, and various medical appointments. Furthermore, eased referral requirements have facilitated access to specialty care. “Before, you had to go to East End or Frederiksted Health Center for a referral; now, a regular doctor can refer you,” Bryan explained.

These expanded services and simplified processes have rapidly depleted the Medicaid matching funds. However, Governor Bryan does not foresee this as a recurring issue, predicting stabilization next year. He noted that the V.I. Department of Human Services has already reduced some services, which has led to a decrease in Medicaid enrollment.

The proposed $3 million allocation remains critical for Virgin Islanders. Governor Bryan emphasized its importance, pointing to the recent U.S. Department of Defense Innovative Readiness Training (IRT) Program health fair, where medics served over 2,500 people seeking no-cost healthcare services. Although 6,000 people applied, many were turned away due to limited resources. The governor stressed that healthcare costs for uninsured residents ultimately fall on the territory, whether through Medicaid or hospital services.

The effort to secure adequate Medicaid funding is ongoing. In 2019, Congresswoman Stacey Plaskett successfully obtained an additional $252 million for the territory in a fiscal year 2020 spending bill, raising the federal match from 55% to 83%. This increased match rate, initially set to expire in 2021, has been made permanent, ensuring the territory receives the highest possible Medicaid match in the U.S.

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Measles Outbreaks Prompt Vaccination Drive in U.S. Virgin Islands

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As measles outbreaks rise across the United States and the Caribbean, U.S. Virgin Islands Health Commissioner Justa Encarnacion is urging parents to prioritize their children’s vaccination schedules.

Commissioner Encarnacion voiced her concerns this week about the alarmingly low vaccination rates among children in the territory, emphasizing the imminent threat of measles. “We are very concerned about the low childhood vaccine rate in the Territory, especially with measles threatening the US,” she said. Currently, only 60 percent of USVI children are vaccinated, a situation worsened by an increasing number of parents seeking vaccination exemptions.

The urgency is underscored by the latest data from the Centers for Disease Control, which reports weekly on measles outbreaks. As of June 6, 2024, there have been 151 measles cases across 22 jurisdictions, including Arizona, California, Florida, and New York, with over half resulting in hospitalizations.

The infectiousness of measles is a significant concern for the V.I. Department of Health. “While 151 may seem like a low number, it is alarming because one person can infect nine to ten others,” Encarnacion explained. She also highlighted the risk of the disease spreading to the USVI and neighboring regions, noting that the Turks and Caicos Islands reported their first measles cases since 1991 this past May.

In response, the Department of Health launched the “Be Wise, Immunize” campaign earlier this year. This initiative aims to educate parents about the vital importance of vaccinations, stressing that immunization is the best defense against diseases like measles both in childhood and later in life.

The primary defense against measles is the measles, mumps, and rubella (MMR) vaccine, which provides long-lasting protection against all strains of the virus. Measles can lead to severe health complications, particularly in children under five, including pneumonia and encephalitis.

Measles is highly contagious, spreading through the air via coughs or sneezes from infected individuals. It remains active in the air or on surfaces for up to two hours. Symptoms typically appear seven to 14 days after exposure and include high fever, cough, runny nose, red watery eyes, and a characteristic rash.

Although declared eliminated in the United States in 2000, measles continues to persist globally and is often brought into the U.S. by unvaccinated travelers.

The VI Department of Health is urging parents to ensure their children are vaccinated and provides resources for scheduling immunization appointments at www.doh.vi.gov/immunization.

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Douglas Koch to Lead Kearney Regional Medical Center in Nebraska

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Just a day after announcing his resignation from the Juan F. Luis Hospital (JFL) on St. Croix, CEO Douglas Koch has been named the new CEO of Kearney Regional Medical Center in Nebraska. He will assume his new role on August 5, according to a report from KSNB Local 4.

In his resignation letter, Mr. Koch cited a desire to return to the Midwest to be closer to his family. His departure has been a significant loss for local health officials, with JFL Board Chair Chris Finch expressing disappointment. Mr. Finch, who also chairs the Territorial Hospital Board of Directors, highlighted Mr. Koch’s exemplary service, noting that he had recently received an excellent personnel evaluation from board members.

Koch’s new role in Nebraska is eagerly anticipated by his future colleagues. John Woodrich, Executive Vice President and Chief Operating Officer of Bryan Health, which owns Kearney Regional, praised Koch’s midwestern roots, education, and extensive operational experience as ideal for the position. “Doug’s commitment to community health and his leadership skills will be a tremendous asset to Kearney Regional Medical Center,” said Woodrich.

Before his tenure in the U.S. Virgin Islands, Koch held leadership positions in South Dakota, Wisconsin, and Illinois. At Kearney Regional, he will oversee the expansion of inpatient facilities and the construction of a cancer center, similar to his work with JFL’s transition to a temporary modular structure. Woodrich emphasized Koch’s ability to help communities thrive, stating, “He will be an outstanding leader for Kearney Regional Medical Center.”

As Mr. Koch prepares to embark on his new journey, JFL officials now face the task of finding a new CEO to lead the hospital forward.

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