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December 17, 2003
Darlene Carty, Commissioner of Health designee, reviewed the recently issued Virgin Islands Office of Inspector General's (OIG) Investigative Report on the Disappearance of HIV Test Specimens. The report provided several constructive recommendations for the improvement of the HIV Program, with the goal of preventing the recurrence of the events. Ms. Carty thanks the Office of Inspector General for the professional conduct of the investigation and subsequent thorough report.
Having been appointed to the position of Commissioner subsequent to the events that are the subject of the Investigative Report, the Commissioner-Designee felt it important to thoroughly review the report and to consult with pertinent departmental personnel prior to issuing this public statement.
The Commissioner-Designee notes that many of the findings and recommendations for improvement, are similar to those developed by the Department of Health and the Centers for Disease Control. Both agencies conducted assessments shortly after the incident.
Realizing from its inception the serious nature of the matter, the department, prior to the issuance of the OIG report, implemented several recommendations considered critical to preventing a recurrence of the loss of HIV test specimens. The Commissioner-Designee states that of particular importance is the development and implementation of new policies and procedures addressing testing in general, and in particular, chain-of-custody protocols for the handling of HIV test specimens and results.
Ms. Carty reports that the newly developed policies and procedures were transmitted to the CDC for review, and have been implemented for use in the program. Additionally, the Commissioner designee states that development of standardized written protocols, systems and procedures for other areas of the HIV clinic, as recommended by the CDC and the OIG is currently in progress, and are specifically designed to ensure that the program components work in a cohesive manner.
Given that the OIG and CDC reports point to management deficiencies and staff vacancies being in part at the basis of the events, according to Ms. Carty, the program has implemented several of the related recommendations contained in those reports. A Project Coordinator for the St. Thomas/St. John program has recently been hired. Additionally, the Territorial Director, previously a contract position, recently became NOPA'd. The Commissioner-designee stresses that this particular development is important as it now allows the Territorial Director to supervise NOPA'd as well as contract employees within the program without running afoul of union rules that prohibit such supervision. Additionally, there are newly hired employees in the St. Thomas/St. John district including a nurse practitioner, case manager, and outreach worker. These and other prospective new employees shall contribute to the more efficient administering of the services offered by the program. Further, the conducting of regularly scheduled supervisory and staff meetings have recently been instituted. The Commissioner-designee also observes that while the OIG report "is inconclusive with respect to why and how the tests actually became missing", it refers to a hostile/aggressive working environment being pervasive within the HIV Program as a contributing factor in the test specimens being missing. To address this aspect, Ms. Carty reports a comprehensive review of the employees within the agency was performed. The department is confident that those persons in the program are committed to its mission, Ms. Carty said.
The Commissioner-designee, on behalf of the department, would like to again inform the general public that the department will continue to take the measures needed to rebuild the public's confidence with respect to the ability to provide safe and confidential HIV testing.