Michelle Davis, regional health administrator for the U.S. Department of Health and Human Services Region 2, was approved by the V.I. Senate Rules and Judiciary committee as Health commissioner Friday and her name was forwarded to the full Legislature for approval.
The decision came as no surprise to anyone in the chamber.
“Relax, because you’re going to be confirmed,” said Sen. Tregenza Roach, a non-committee member, during the first round of questioning.
Davis is on loan from the U.S. government for two years under the Intergovernmental Personnel Act program. In January, Gov. Kenneth Mapp introduced her as his nominee for Health commissioner. The IPA allows temporary assignment of employees between federal and non-federal entities.
In February, the V.I. Senate changed the law to allow higher salaries for temporary officials on loan from the federal government to match their federal pay without automatically raising salaries of other V.I. officials whose salaries are tied to commissioners’ pay levels.
Davis told senators Friday that her salary is $150,000, currently to be paid in full by the V.I. government unless the governor renegotiates the terms with the federal government to pay a portion.
During Friday’s session on St. Croix, senators expressed their support for Davis but asked questions about how Davis plans to turn around the traditionally low-performing department.
“The department’s not where it needs to be, but it can be,” she said, rating the DOH performance 50 percent of what it should be.
A previous temporary position in Washington D.C. she held had the same challenges and she has already had offers from national organizations to help improve the VIDOH.
Staffing, maintaining vital statistics and a cancer registry, mental health care and hiring and retaining EMT’s have been hurdles for Health over the last few years.
Davis acknowledged that employee morale is low and said her highest priorities are to fill vacancies and provide training.
Funding is available and recruitment is ongoing for positions including a chronic disease manager, a territorial immunization director, a maternal and child health director, a risk management director and a mental health director. An assistant director of vital statistics for St. Croix, a pediatrician, legal counsel, several physicians and a clinical psychologist are also needed.
Needed, but unfunded positions included directors for environmental health and EMS, environmental inspectors, an epidemiologist, a health economist and data entry staff. Davis said there are two environmental inspectors to handle 8,000 food establishments on St. Thomas.
Federal funding was received in 2012 to establish a cancer registry and senators as well as public have been asking when the territory will begin to keep record of cancer cases and victims. Davis said work began in January to build a program but it is not half way towards being operational.
Mental health care has been lacking, especially on St. Croix since the Gov. Juan F. Luis Hospital closed its psychiatric unit in 2013. Davis said a five-year strategic plan has been developed for mental health care, training is underway and the department is recruiting a territorial director.
Senators pointed out the EMS system is so understaffed it has been forced to use police officers to drive ambulances while technicians work on patients. Davis said she will work with the Governor’s Office to realign EMS and Fire Services and improve EMT training, recruitment and retention.
Senators tried not to show skepticism towards the nominee, but the commissioner’s position has been a revolving door for the last decade.
Sen. Nereida “Nellie” Rivera-O’Reilly commented there have been seven or eight Health commissioners during her 10 years in office who stay on the job only seven or eight months.
Sen. Novelle Francis, Jr. said he thinks there have been 10 commissioners in the last 10 years and “mismanagement” has been the result of the department’s instability.
“The Department of Health needs a dose of stability,” he said.
Davis said her two-year stint can be expended for as long as six years, if necessary.
“I plan to be here as long as it takes. The governor can request additional time,” she said.
Davis read 31 pages of testimony Friday that included her background, department successes, areas where improvement is needed and lists of vacancies.
Among its successes, Davis said the response to the Zika virus has included setting up an emergency operations center with CDC staff and a hotline. Almost 600 pregnant women have been tested and prevention kits were distributed.
After some initial research, Davis’s management team has identified deficiencies at the DOH that include lack of training and operating policies and procedures. She added that there are not enough financial, leadership and human resources staff.
Short-term goals include filling vacancies within the department and additional training for employees and Davis said she has the freedom to choose staff to fill the jobs.
“If you don’t have competent individuals conducting the activities you’re supposed to conduct, you can’t apply for resources because you don’t have anyone to use the resources,” Davis said.
After years of hearing Health Department problems, senators had several recommendations:
Rivera-O’Reilly said a performance review form is needed for directors as well as employees and scolded the DOH for not having policies and procedures already in place.
Sen. Janet Millin Young said federal grants should be utilized and not be returned to the government. Davis agreed.
“If you have to send back money, you have to use local money,” Young said.
In response to Davis’s information that several employees have been terminated in the last few months for suspected fraud, Sen. Kenneth Gittens, committee chair, recommended turning in the suspects to the V.I. Police Department.
The motion to approve Davis and send the recommendation to the full body was made by Sen. Jean Forde. Voting in favor were Sens. Gittens, Francis, Rivera-O’Reilly, Forde and Justin Harrigan. Young abstained and Roach is not on the committee.