The Virgin Islands Board of Nurse Licensure told lawmakers it is on a “skeletal budget” and that funding delays and outdated systems are straining efforts to license and regulate nurses.
Testifying before the Senate Budget, Appropriations and Finance Committee, Territorial Executive Director Carmen Vanterpool-Romney and Operations Director Joycelyn McFarlande said funding delays, outdated technology and other administrative hurdles are straining the agency’s operations.
The board regulates registered nurses, licensed practical nurses, advanced practice registered nurses and certified nursing assistants, issuing licenses, processing renewals and handling disciplinary matters.
Vanterpool-Romney described the board as “the primary regulatory authority dedicated to … ensuring that health care professionals within the territory are qualified, competent, and ethically sound.”
The board operates with eight full-time employees. For the current year, it has a General Fund allocation of $856,373 and is seeking continued support in the upcoming fiscal year, in addition to the revenue it collects through licensing and related fees.
McFarlande told senators the board has not received an allotment from the Office of Management and Budget in nearly three months. “The last allotment we received was back in March,” she said. “We still haven’t received anything since April, May, and now we’re in June.”
She said the board’s monthly General Fund allotment is about $73,000. Delayed funding makes it more difficult to pay rent, vendors and other operating expenses on time. The board sometimes postpones one payment to cover another until additional funding arrives, while payroll continues to be processed and later reconciled once funds are posted.
The board also reported outstanding payments to a janitorial vendor dating back several months. McFarlande said the delay stemmed from complications associated with the government’s transition to a new contracting system after the previous contract expired. She said the work has been completed and the board is working through the process to pay the vendor.
According to board statistics, the Virgin Islands now has approximately 400 fewer active nursing licenses than in prior years, with the largest decrease occurring among registered nurses.
McFarlande said hospitals employ the largest share of registered nurses, with additional nurses working in clinics, schools, public health and other health care settings. Vanterpool-Romney noted that the board does not track why nurses leave the territory, change jobs or choose not to renew their licenses. “We do not monitor the reasons why they left,” she said. “We are not labor, so we just issue licenses, regulate them.”
The decline in active licenses also affects the board’s fee-supported revenue. Vanterpool-Romney said the nurse licensure fund generated about $163,000 in fiscal year 2024 and about $180,000 in fiscal year 2025, primarily from registered nurse licensing fees.
Another challenge involves the board’s effort to modernize how it tracks continuing education requirements for nurses. Vanterpool-Romney said the board has spent about three years trying to implement a no-cost electronic tracking system, but the agreement remains stalled in the government approval process.
According to Romney, the contract moved through the Health Department’s procurement office and the Property and Procurement Department before the board was told the vendor’s documents had expired and the package would need to be resubmitted. The system would allow real-time tracking of continuing education credits and reduce paperwork for both nurses and board staff. Until it is approved, staff must continue manually verifying that nurses have completed required coursework.
The board is also working to modernize its payment process. Vanterpool-Romney told senators that licensing fees can currently only be paid by money order, requiring many applicants to visit the office or submit payments by mail. That approach can slow applications and renewals and add extra steps for nurses who are seeking to maintain or obtain a license.
McFarlande said the board has selected a vendor and is working with the Bureau of Information Technology to establish an online payment system that would allow nurses to pay fees electronically through the board’s website and link those payments to the government’s existing financial system.
Lawmakers also heard updates on efforts to implement FBI background checks and prepare for participation in the Nurse Licensure Compact, which would allow qualified nurses to practice across participating states under a single multistate license.
Vanterpool-Romney said the board has obtained an identifier number to work with the Virgin Islands Police Department and the Health Department on criminal background checks, but a memorandum of understanding and other procedural details still need to be finalized.
Vanterpool-Romney said the board is also seeking approval for additional testing opportunities in the territory. A new facility on St. Croix, leased for about $1,600 per month, will be used for nursing assistant examinations, with 21 candidates currently approved for testing.
She said the board has previously relied on borrowed classroom space for some exams, and discussions are ongoing with national testing authorities about establishing a local NCLEX (the nursing licensing exam) site on St. Croix so candidates would not need to travel to St. Thomas or off-island.
Committee Chair Sen. Novelle E. Francis Jr. said lawmakers have seen “marked and significant improvement” at the Board of Nurse Licensure and thanked Vanterpool-Romney and her staff for their work, while noting that the automation and technology upgrades the board is pursuing are changes he wants to see across the government.
