The Virgin Islands Healthcare Reform Implementation Task Force has done its work and will disband, Lt. Gov. Gregory Francis told the group meeting last week at Government House on St. Croix.
The panel, which learned at the meeting about plans to expand the Medicaid program to serve greater numbers of Virgin Islanders, was told, was formed in 2010 to guide the territory’s implementation of the Affordable Care Act, according to a news release Sunday from Government House.
“We have fulfilled our primary objective of implementing the Affordable Care Act and meaningful healthcare related reforms to improve the delivery of services to all Virgin Islands” said Francis, who has chaired the task force since its inception.
He reaffirmed the territory’s continued commitment to health reform, which will now be led by targeted work groups. He also thanked all of the appointed members and the various ad hoc representatives that assisted in conducting due diligence on all health reform items that were brought to the table for discussion.
According to Taetia Phillips-Dorsett, policy advisor to Go. John deJongh Jr., the territory’s focus on healthcare reform made it a leader among its territorial counterparts.
“The Virgin Islands is not often ahead of the pack,” she said. “In advancing healthcare reform, we found ourselves considered leaders by other territories who were guided by our efforts.”
The task force conducted an extensive study to determine the feasibility of an insurance exchange, shepherded the implementation of an application portal and the coordinated development of the Medicaid Management Information System.
During the meeting, DHS Commissioner Christopher Finch presented plans for the second wave of Medicaid expansion. Earlier this year, the Virgin Islands opted to pursue Medicaid expansion instead of a health insurance exchange to allow greater numbers of uninsured residents gain access to healthcare services. The first wave of Medicaid expansion to SNAP eligible pregnant women and children began in August. According to Finch, approximately 3,600 new applicants were projected to enroll.
Despite an extensive media and direct mail campaign to reach this Medicaid eligible population, the turnout has been short of that number, Finch said. In response, DHS began phoning eligible applicants during September and will continue this effort for the next 30 to 60 days, he said.
Phase 2 of Medicaid expansion, which is scheduled to begin Jan. 1, is targeted to enroll children, seniors, disabled residents and former foster children ages 18 to 26.
DHS is considering two options, increasing income limits or using a percentage of the Federal Poverty Level, depending on which would enable service to larger groups of people. Finch said his department will continue to model various scenarios to determine which offers the greatest opportunities to serve the Virgin Islands community.
Cost is also a consideration in Medicaid expansion, he added, although the DHS is committed to serving as many residents as possible.
“Our rationale is that a family of three working full time should have health care,” Finch said. “At the end of the day, we look at what we can afford and try to cover the most persons from our uninsured but potentially Medicaid eligible pool. The strategy is to cover as many persons using funding from a federal source and any savings to the general fund allotment can then be used for development of practical insurance coverage alternatives for persons who are not eligible for federal Medicaid."
Task force members also discussed longterm care, which has been an ongoing concern since the task force was created in 2010 to implement the applicable provisions of the Affordable Care Act. Representatives from the Juan F. Luis Hospital shared the costs associated with boarder patients, who are often not covered by Medicare during their extended hospital stays.
Finch and task force members discussed options for certification and expanding the Herbert Grigg home and alternatively, developing a program similar to the federally run Program of All-Inclusive Care for the Elderly. This program allows the participant to receive comprehensive care at home rather than in a nursing home. Earlier review of this program has found it to be very costly for states to implement and requires a large investment of local funds. Finch indicated that repurposing a portion of the $24.9 million in exchange subsidies originally allocated to the USVI by the federal government could constitute good use of the funding, but this would depend on whether or not the federal government deems a “PACE-like” program as a form of Medicaid Expansion under the Affordable Care Act.
Government House’s Sunday news release did not state which day last week the St. Croix meeting took place.
