Lt. Governor Gregory Francis chairs a recent meeting of the Healthcare Reform Implementation Task Force at Government House, St Croix
ST CROIX, USVI -- The US Virgin Islands’ Healthcare Reform Implementation Task Force last week learned of the Department of Human Services intentions to expand the parameters of the Medicaid program in order to serve greater numbers of US Virgin Islanders.
DHS Commissioner Christopher Finch, presented plans for the second wave of Medicaid expansion at a meeting of the task force held last week at Government House on St Croix. The meeting was chaired by Lieutenant Governor Gregory Francis, who is also the territory’s Commissioner of Insurance.
Earlier this year, the USVI opted to pursue Medicaid expansion instead of a health insurance exchange, as a means of enabling greater numbers of uninsured residents’ access to healthcare services. The first wave of Medicaid expansion to SNAP eligible pregnant women and children began in August of this year.
According to Finch, approximately 3,600 new applicants were projected to enroll. Finch reported that, despite an extensive media and direct mail campaign to reach this Medicaid eligible population, the turnout has been short of the department’s expectations. He indicated that the DHS has already begun to directly contact eligible applicants by phone during the month of September and will continue this effort for the next 30-60 days, in hopes of enrolling greater numbers of Virgin Islanders.
Phase 2 of Medicaid expansion, which is scheduled to begin on January 1, 2014, is targeted to enroll children, seniors, disabled residents and former foster children ages 18-26. Presently, the DHS is considering which option -- increasing income limits or using a percentage of the Federal Poverty Level – would enable service to larger groups of people.
Finch indicated his department will continue to model various scenarios to determine which offers the greatest opportunities to serve the US Virgin Islands community. He cautioned that cost is also a considering factor in Medicaid expansion, although the DHS is committed to serving as many residents as possible.
“Our rationale is that a family of three working full time should have health care,” Finch noted.
“At the end of the day, we look at what we can afford and try to cover the most persons from our uninsured but potentially Medicaid eligible pool. The strategy is to cover as many persons using funding from a federal source and any savings to the general fund allotment can then be used for development of practical insurance coverage alternatives for persons who are not eligible for federal Medicaid,” Finch said.
Task force members also discussed the issue of long-term care, which has been an ongoing concern since the task force was created in 2010 to implement the applicable provisions of the Affordable Care Act.
Representatives from the Governor Juan F. Luis Hospital shared the costs associated with boarder patients, who are often not covered by Medicare during their extended hospital stay. Finch and task force members discussed various ways to best address the territory’s long-term care challenges, which include options for certification and expanding the Herbert Grigg home and alternatively, developing a program similar to the federally run Program of All-Inclusive Care for the Elderly (PACE).
This program allows the participant to receive comprehensive care at home rather than in a nursing home. Earlier review of this program has found it to be very costly for States to implement and requires a large investment of local funds. Finch indicated that repurposing a portion of the $24.9 million in exchange subsidies originally allocated to the USVI by the federal government could constitute good use of the funding, but this would depend on whether or not the federal government deems a “PACE-like” program as a form of Medicaid Expansion under the Affordable Care Act.
Francis, who has chaired the task force since its inception, announced its disbanding.
“We have fulfilled our primary objective of implementing the Affordable Care Act and meaningful healthcare related reforms to improve the delivery of services to all Virgin Islands,” Francis stated.
He reaffirmed the territory’s continued commitment to health reform initiatives, which will now be led by targeted work groups. He also thanked all of the appointed members and the various ad hoc representatives that assisted in conducting due diligence on all health reform items that were brought to the table for discussion.
According to policy advisor to the Governor, Taetia Phillips-Dorsett, the territory’s focus on healthcare reform made it a leader among its territorial counterparts.
“The Virgin Islands is not often ahead of the pack,” she stated. “In advancing healthcare reform, we found ourselves considered leaders by other territories who were guided by our efforts.”
The task force conducted an extensive study to determine the feasibility of an insurance exchange, shepherded the implementation of an application portal and the coordinated development of the Medicaid Management Information System (MMIS).