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36th Legislature of the U.S. Virgin Islands Committee on Health, Hospitals & Human Services Wednesday, July 7, 2025 Testimony Tasnim Khan, MD - Medical Director, VIHCF (Virgin Islands Healthcare Foundation Renal Center). Good morning, Honorable Chair Senator Fonseca, honorable members of the 36th Legislature, and all present here and the viewing public. Thank you for inviting me to give testimony on behalf of the Virgin Islands Health Care Foundation (VIHCF) regarding the availability and continuity of dialysis services on St. Croix. The Virgin Islands Healthcare Foundation is a 501 (c) (3) non-profit organization, and we reaffirm our commitment to ensuring uninterrupted access to life-sustaining dialysis care for our community. We have the capacity to accommodate 78 dialysis patients and currently serve 31 patients, six days a week, with two shifts a day. We do not take our service to this community lightly. We understand that we serve our most vulnerable patients, who depend on us to be there for them at all times. We have been gradually bringing on patients, but we are prepared and fully capable of assuming the care of up to 47 additional dialysis patients should the need arise. In the event that we are called upon to absorb 39 patients, we must emphasize that doing so under current staffing conditions would necessitate that we transition into our Emergency Plan, which is : 1. We require full cooperation in obtaining patient records immediately. 2. Add an additional shift for each day 3. Assign our personnel to work 10 to 14-hour shifts to uphold the required standards of care. 4. While we are prepared to act in the interest of patient safety and continuity of care, we would have to immediately reach out to hire displaced dialysis staff from closed or damaged dialysis units and hire additional trained dialysis staff if needed to prevent exhaustion, reduce risk, and preserve high-quality treatment. Importantly, the Virgin Islands Healthcare Foundation is not requesting financial assistance. We have structured our operations to sustain this expansion through revenue derived from patients’ insurance reimbursements, and we are prepared to compensate any additional staff accordingly. However, should the Foundation absorb patients previously served by the Caribbean Kidney Center, we respectfully request that we also be reimbursed by the Medical Assistance Program (MAP) in a manner consistent with the reimbursement arrangements provided to the Caribbean Kidney Center. This parity is essential to ensuring continuity of care for vulnerable patients and sustaining the long-term viability of dialysis services on St. Croix. VHCF Testimony 2 Our foundation started operations in January 2025, following a successful completion of a comprehensive survey conducted on behalf of Medicare. In our short time serving the public, we have already shown our commitment to excellence as noted by many Virgin Islands Government and Federal Government officials who have visited our advanced dialysis unit — a testament to the strength of our team and the integrity of our care model. Our sincere hope is that we can put aside our differences, judgments, and agendas and truly come together as a Virgin Islands community to address this ongoing issue. Let us not be disconnected from our fellow human beings, because we may feel that it is not our suffering. Unless someone lives with dialysis—either personally, as a family member, or as a friend—there is no understanding of the full extent of what is being endured. The VIHCF has worked diligently to establish a permanent dialysis unit on St. Croix, and we remain committed to serving, as we have always stated. We understand that it is essential for patients to have a choice. However, they need options that are reliable and permanent. We are only part of the solution. Thank you for your time and consideration. Respectfully submitted, Aminah Saleem, Board Secretary On behalf of the Virgin Islands Healthcare Foundation