VI CONSORTIUM
USVI Lawmakers on Monday received an update on the adverse impact the Covid-19 pandemic has had on the senior and other vulnerable populations in the USVI. One of the grim realties is the abandonment of seniors by families at the Juan F. Luis Hospital, according to Dyma Williams, interim CEO at JFL, who said the U.S. Virgin Islands is experiencing an eldercare crisis.
Other testifiers included Dept. of Health Commissioner Justa Encarnacion, Dept. of Human Services Commissioner Kimberley Causey-Gomez and AARP for the VI State Director Troy deChabert-Schuster.
Since the Covid-19 pandemic started impacting the territory in March, the senior population and those with pre-existing health conditions were deemed the most vulnerable. Nursing homes in the territory have been severely affected by the virus. As of Monday, Covid-19 had claimed the lives of 19 Virgin Islanders, with four of them being seniors who lived at the Queen Louise Home for the Aged. There are 20 nursing home facilities in the territory, and D.O.H. as of Monday had performed tests on 247 seniors at those facilities.
The number of cases and deaths in nursing homes have become an area of concern for many in the community. In the territory, three nursing homes have been impacted the virus: Queen Louise, Lucinda Millin, and Herbert Grigg, according to D.H.S. To manage the virus’s spread, bed capacities at both Queen Louise and Herbert Grigg have been dramatically reduced, said D.H.S., from 40 beds to 25 at Herbert Grigg and from 29 to 17 at Queen Louise.
Ms. Encarnacion told the committee that the pandemic presents many challenges and requires interventions that affect all community sectors in the entire territory. “Community intervention and Covid mitigation efforts in the USVI is particularly challenged by several factors: high poverty rate, a high percentage of our population over 65, the status of our hospitals, limited healthcare capacity, and workforce shortages,” she said.
For example, Ms. Williams stated that JFL is the only acute hospital facility on St. Croix. However, the hospital is not a licensed senior care nor a skilled nursing facility. “At the beginning of the pandemic, JFL had to transfer up to ten seniors to off-island facilities. The transfer occurred because the territory has no skilled senior living facilities which can care for the needs of these vulnerable seniors around the clock,” said Ms. Williams. The transfer came at a cost of $150 a day per individual or a total cost of $4,650 per patient for a 31-day month.
While JFL continues to do what it can to keep St. Croix’s senior population safe, Ms. William said, “The hospital is not a safe place to manage our seniors, many of whom have pre-existing conditions.” Ms. Williams highlighted that due to the lack of skilled nursing homes or available beds at senior home facilities, many seniors who have been discharged from JFL have been abandoned at the hospital by their families. She also stated that the territory has an eldercare crisis.
The JFL interim CEO said family and community members have listed multiple reasons why the seniors were not able to return home. At the top of the list is the lack of capacity to care for the seniors if they were to return home. These families lack the financial means to cover medication, food, home care, and other expenses. Because of this, the elders remain at JFL. “This displacement of our elders serves as a great disservice to them when they should be surrounded by family, friends, and loved ones when they need the support the most,” said Ms. Williams.
Presently, there are no skilled nursing facilities within the USVI. Sea View, located on St. Thomas, was a skilled nursing facility but it has since lost accreditation. “Skilled nursing facilities are something we desperately need in the territory as our population ages,” said Ms. Causey-Gomez.
Compounded by the pandemic, many of these nursing homes face shortages of staff to care for senior residents properly. When Senator Javan James Sr. asked D.H.S. what financial resources would the department need to get through Covid-19, Ms. Gomez said, “We are severely short staffed when it comes to nursing care in the territory, especially at our homes for the aged.”
Mr. de Chabert-Schuster, the AARP VI state director, gave some advice to D.H.S. on how to ensure that staffing levels are and remain adequate at its facilities. Among the ideas were incentives to attract and retain staff, and the development of a contingency plan to respond to instances of low staffing levels to care for residents properly.
Like every other state in the continental U.S., response to Covid-19 was hindered by the lack of available testing and personal protective equipment. Due to this, nursing home populations were at an elevated risk of being affected by the virus. Ms. Encarnacion said, “A strong infection prevention and control program is critical to protect both residents and healthcare personnel.”
When Senator Dwayne Degraff asked how often staff were tested at the nursing homes, he was taken aback by the answer. “Staff gets tested every two weeks, and residents will only be tested if they leave the facilities for procedures and then come back,” said Ms. Encarnacion. Mr. Degraff expressed to Ms. Encarnacion that two weeks is too long. “We are talking about the seniors, a very vulnerable population. The staff should be tested every day because they leave and come back,” he said.
Senator Myron Jackson inquired if testing had begun earlier in the nursing homes if the facilities would have been able to prevent the spread of the virus better.
Ms. Gomez stated that unlike the Herbert Grigg facility, which has separate rooms for their residents, Queen Louise is a congregated care facility, which made it hard to reduce the spread of the virus between residents. “We have done some partitions, but right now, we are working closely with V.I.D.O.H. to ensure we don’t have a negative pressure room at either facility,” said Ms. Gomez. D.H.S. ensured the public that the department is working on a plan on how to manage and isolate residents who may test positive at Queen Louise. Mr. Jackson recommended that D.H.S. renovate the second floor of Queen Louise so that the nursing home could be better equipped to combat the virus.
Ms. Gomez reminded lawmakers that interventions and efforts to control and prevent the transmission of Covid-19 are fluid and continue to change from day to day. She revealed that as of Monday there was one asymptomatic resident and one asymptomatic staff member, both of whom tested positive for the virus last week at Queen Louise Home. All other residents of both homes for the aged were in stable condition and doing well as of Monday, she said.