Even if the financing comes through today, the Virgin Islands Healthcare Foundation won’t be able to complete the new dialysis center on St. Croix before hurricane season, according to the medical director. Foundation administrators told the Source Tuesday they want the hundreds of patients, caregivers and future patients to know so they can make other plans.
Frustration and desperation could be heard in their voices as Dr. Tasmin Khan, medical director, Paula Graeber-Tracey, VIHCF administrator, and board secretary Aminah Saleem explained why the September date is so important.
They pointed out that the Juan F. Luis hospital’s portable trailers, installed after the 2017 hurricanes, now provide dialysis treatment for the island’s residents. Khan said the facilities would not withstand a strong thunderstorm. There are roof leaks, the air conditioning is sporadic, and the power goes out frequently.
The new temporary hospital, so-called JFL North, isn’t dependable, Khan said. It is structured of aluminum. Her opinion is that flying debris “would cut through it like butter.”
There are no arrangements for multiple dialysis treatment stations in the temporary hospital, JFL North. Khan said there is only a small space to accommodate one chair for use in the case of acute dialysis. The hospital has the capability to perform dialysis at bedside, but, the nephrologist added there is not enough staff to care for a large number of patients who need to be dialyzed in an emergency.
“The structure that the patients are dialyzing in now, it will take less than a thunderstorm,” she said. “If there is one little storm that tips that trailer over, they’re all going to be evacuated off island.”
According to James Rollins, JFL public information officer, the trailers will be replaced in about six months with a hardened structure and will accommodate at least 40 patients. He added that the temporary hospital has a hurricane Category-5 durability rating.
One of Khan’s patient’s caregivers, who spoke on condition of anonymity, said her husband left the island when he learned he would need dialysis in the near future. Instead of waiting for treatment on the island, he moved in with relatives stateside. She said it’s very expensive and stressful to travel back and forth.
FEMA spent $40 million to evacuate patients before the 2017 hurricanes, she said.
According to Khan, the only other dialysis center on St. Croix is not prepared to take an additional 40 patients in the case of a storm. If something happens to the Kidney Center, all St. Croix patients will have to be evacuated. After the 2017 storms, it took patients as long as two years to return home. Some still have not returned and others died before they could come home.
Furthermore, Dr. Khan said her 42 patients “have dug in their heels” and don’t want to use the other facility. She has another 10-15 patients who will need dialysis in the future — currently, they are controlling the condition with diet and medication, although several have left the island for treatment. In the near future, there will be more need for additional services.
VIHCF was awarded a $416,002 grant in 2020 from the Federal Communications Commission COVID-19 Telehealth Program and in 2021, the 501-c3 organization received $1 million in funds from the American Rescue Plan Act and the Office of the Governor.
Those funds have been expended in designing and constructing the roomy clinic in the Sunny Isle Annex with a dialysis room for 14 patients, four examination rooms, a kitchen and lunch room, offices for medical and administrative staff, storage rooms, and a conference room.
In July 2022, VIHCF requested additional funding from the governor and when he attended an open house at the center in September, they repeated the request. Khan said she, Dr. Jan Tawakol and Saleem told him they needed another $1 million to cover $10,000 monthly rent since March 2022, storage fees, and price increases due to supply chain issues. The construction contract increased from $718,000 to $918,000.
Khan said the governor told them he would follow the project to the end and do whatever it takes.
In December, work stopped and an ARPA request form was submitted for additional funding on Dec. 15. Specifically, money was requested for equipment, installation and up-front operational expenses, including salaries and taxes. Dialysis equipment was originally donated, but due to the construction delays, the donor reneged because the equipment would have to be repaired and re-certified. He didn’t want to take on the expense, so the dialysis chairs must be purchased.
The ARPA request reported 98 percent of the build-out had been completed. Khan and Graeber-Tracey said all reports had been submitted to V.I. Finance Director Jenifer O’Neil when due.
In February, VIHCF received a denial letter from the Office of Management and Budget. They were told “the request doesn’t meet the priorities of ARPA,” despite the governor’s commitment.
When they tried to find out why this request was denied after the first one was granted, Graeber-Tracey and Khan said their emails and phone calls weren’t returned by the OMB.
Saleem was told Monday the governor was aware of the situation and they would get the funding. On Tuesday, a message was received that O’Neil would inspect the facility on Wednesday.
“Even if we got the funds upfront, we might be able to open in August or September, but it is unlikely,” Graeber-Tracey said.
After the inspection Wednesday, Graeber-Tracey said the O’Neil reiterated the dialysis center does not qualify for the $1 million grant. They could possibly qualify for the construction and installation expenses but not staffing and operations.
With the most recent denial, VIHFC will need to find another source of funding. At the very least, they will need to re-apply for the local grant. The dream of opening the facility by September is fading fast.
“If we don’t get the funds and we don’t get the supplies on island, we won’t be able to get the supplies after the hurricane. We must get the supplies as soon as possible,” Khan said. “I promise you, If it’s the last thing I do on this planet, I’m going to get this open.”
Related Link: New Dialysis Facility to Hold Open House in July
