Dec. 11, 2007 — In a Senate committee meeting Tuesday, Sen. Norman Jn Baptiste pushed the public Gov. Juan F. Luis Hospital and the private V.I. Kidney Center to get a kidney dialysis clinic open in Frederiksted post haste.
Officials from both facilities said their institutions are expanding and improving services, but demographic trends point to an incoming tide of kidney disease and dialysis needs that demand greatly expanded dialysis capacity. The discussion came during a meeting in Frederiksted of the Health, Hospitals and Human Services Committee.
"We will have twice the population of patients needing dialysis in the next five years," said Dr. Ramesh B. Lakhram, chairman of the hospital's kidney treatment section. The need is expected to grow particularly fast on St. Croix's West End, he said, while the hospital and the Kidney Center — the two current dialysis locations — are mid-isle and east of Christiansted, respectively.
Dr. Walter Gardiner, founder and medical director of the Kidney Center, said he has plans to open such a center and has obtained a certificate of need from the Health Department. Certificates of need, originally mandated by the federal government, are required before opening any medical facility to avoid redundant services resulting in wasted money and insolvent medical institutions.
The hospital also has a plan to establish a dialysis clinic in Frederiksted and hopes to cooperate with Gardiner, said Gregory Calliste, the hospital's chief operating officer.
"He has the certificate of need, and to get another will be almost impossible," Calliste said.
Baptiste pressed Gardiner for a time frame.
"My experts tell me by this time next year we will be fully operational," Gardiner said.
Baptiste asked Calliste to speak with Gardiner about a joint venture and to prepare two or more proposals, with a determination of what level and form of government assistance might be needed.
"I don't want to be coming back here two or three years from now to talk about certificates of need and why there was no performance," Baptiste said. "Whoever can provide dialysis in the shortest period of time, that is what I will support. … Feel free to give me a call any time so we can talk about what we need to do to get this done. That is the governor's mantra: 'Together we can,' and I believe that."
The committee also heard testimony and took action on two bills. It held back for revision the Elder and Dependent Abuse Prevention Act of 2007, which aims to tighten up investigating, reporting and punishing fraud, physical abuse and other maltreatment of the elderly and those who need help to care for themselves. And it voted in favor of sending a bill updating medical licensing procedures and regulations, the V.I. Medical Practice Act, on for consideration by the Rules and Judiciary Committee.
"This bill represents a long-overdue revision and expansion of territorial law governing the care of our elders and disabled adults," said Elliott Davis, the territorial solicitor general. Davis then ticked off a list of concerns about the specific provisions of the bill, asking that it be systematically rewritten.
Human Services Commissioner Chris Finch said his department would like the bill to amend, rather than replace, existing law. Why amend rather than replace? asked Sen. Neville James.
"To keep useful features of the existing law," Finch replied.
The most pressing problems facing elderly people in the territory are a shortage of long-term-care beds, combined with the high cost of long-term care and low incomes of the territory's senior population, agreed Finch, Calliste and Dr. Jorge A. Galiber, the hospital's director of patient care.
"I say without exaggeration that I hear weekly from a member of the community that needs long-term care," Finch said. "I say 'weekly,' but members of my staff are hearing people ask for help daily."
Voting to hold the bill for further revision were Sens. Baptiste, James, Usie Richards and James Weber II. Absent were Sens. Shawn-Michael Malone, Basil Ottley and Carmen Wesselhoft.
Testifiers had fewer quibbles with the Medical Practices Act.
"Current law is quite old," said Frank A. Odlum, chairman of the V.I. Board of Medical Examiners. "Most of it was probably written in the '60s, with some modification since. … Hopefully the current bill will give us more detailed guidelines so we can function like a medical board should."
Weber questioned a provision in the bill requiring that physicians live in the Virgin Islands at least six months before receiving a license to practice in the territory. The provision is also in the existing law, Odlum said. Asked whether it should be removed, he said he would like to take the question back to the Board of Medical Examiners.
"When we discussed removing that, other board members wanted to keep it in place," he said. "There are some privileges we like to keep to ourselves, do we not?" Weber asked.
"In the time I've been on the board, that has never held anyone out," Odlum responded. "Everyone was there because of need, which is an exception."
"Then we should get rid of it," Weber said. "The need is exactly what we are getting."
Odlum said later that some shorter waiting period was advisable to take care of paperwork and weed out applicants who are not serious or intend to work only a month or two, then leave.
Voting to send the bill on out of committee were Baptiste, James, Richards and Weber. The Committee on Rules and Judiciary will take up the bill now, and will decide whether to send it on for a vote by the full Senate.
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