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Finance Committee Approves Infant Mortality Reduction Effort

Jan. 21, 2005 – The Senate Finance Committee, during its first meeting Friday, unanimously approved a federal grant application for the St. Thomas East End Medical Center Corporation to assist in the reduction of the infant mortality rate in the St. Thomas-St. John district.
Maureen Rabsatt-Cullar, medical center executive director, told committee members the infant mortality rate for the St. Thomas-St. John district for the period 1999 to 2001 is 22.53 deaths per 1,000 live births.
"This is five times the national average of 4.5 deaths per 1,000 live births," Cullar said.
Cullar said the federal government called her clinic and encouraged her to apply for the grant because of the high infant mortality rate.
The four-year "Eliminating Disparities in Prenatal Health" grant would help reduce the district's infant mortality rate, Cullar said.
The grant was successfully administered on St. Croix by the Village-V.I. Partners in Recovery from 2000 to 2004, she said.
"At the time of award, the infant mortality rate in St. Croix – October 1999 – was 11.6 per 1,000 live births," Cullar said. "As of Dec. 31, 2004, the rate decreased to 1.56 deaths per 1,000 live births."
Under questioning by Sen. Liston Davis, Cullar said the statistics do not include undocumented aliens.
"Some 10 to 15 years ago, the infant mortality rate was decreased," Sen. Usie Richards, chairman of the Committee on Health, Hospitals and Human Services, said. "Now in this day and age with improved health care, our infant mortality rate has increased. At least that is what the numbers are saying."
The grant, if approved by the Maternal and Child Health Bureau, Health Resources Services Administration, will be awarded in the amount of $750,000 annually for four years.
Clement Magras, associate director of the Office of Management and Budget, told the committee the goals of medical center are to reduce barriers to care for pregnant women, reduce the number of babies born with low birth weights and increase the number of women who breast-feed in the St. Thomas-St. John district.
Grant funds would also be used to educate women of childbearing age and for outreach programs to housing communities, schools and businesses, as well.
"Services will be provided regardless of one's ability to pay, which will significantly reduce barriers and disparities," Magras said.
Currently 50 percent of the medical center's patients are uninsured and charged on a "sliding fee scale," Cullar told the committee.
Under the grant program, the medical center is required to hire eight employees. Cullar said it would hire only six individuals and use two current staff members.
Sen. Usie Richards asked what would happen to the employees after the grant period expired. Cullar said the medical center would try to keep them as part of the staff.
Richards said it was the "custom" in the territory to, "at the end of the grant period, come back to the local government and ask for these grant employees to be kept on."
Cullar told Richards the goal of the program is to become self-sustaining.
Sen. Roosevelt David asked Cullar to what extent poverty impacts the infant mortality rate.
"Poverty impacts their nutritional health, their ability to receive adequate healthcare," Cullar said of pregnant women.
Cullar said the center will work along with the Women, Infant, Children Program and the Department of Health to successfully implement the project.
"I am certainly pleased with the project your agency is undertaking," Committee Chairman Sen. Norman Jn Baptiste told Cullar. "However, I am concerned whether you will be able to meet your goals and fulfill your obligations."
Cullar assured him the health center would, because the grant comes with program guidelines and the Maternal and Child Health Bureau offers assistance based on the progress reports submitted by grant recipients.
Sen. Pedro "Pete" Encarnacion commented that while the infant mortality rate has increased, teen-age pregnancy has decreased.
Dr. Marilyn Nutter, center medical director, said this was due in part to the efforts of Family Planning, which counseled 4,000 teenagers in 2004 alone.
Sen. Craig Barshinger asked how St. John residents would benefit from the program.
"We will do outreach in that area, as well," Cullar responded. She added the grant would help the medical center to provide transportation vouchers to St. John residents, and the center could arrange pick-up at the Red Hook Dock.
According to Cullar, the grant application was sent out on Dec. 28. A local legislative body's approval was required, however, to be approved by the federal government.
Attending the meeting were committee members Sens. Jn Baptiste, David, Richards, Neville James, Juan Figueroa-Serville and Terrence "Positive" Nelson. Sen. Adlah "Foncie" Donastorg was excused. Other senators present at the hearing were Barshinger, Davis, Encarnacion, Louis Hill and Celestino A. White, Sr.

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