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FREDERIKSTED HEALTH CARE, INC. Our Mission: To provide non-discriminatory, evidence-based, affordable and accessible health care to the community of St. Croix. “Putting The Care Back into Health Care” Website: FHC-INC.NET 1 Physical Address #516 Strand Street, Frederiksted St. Croix, U.S. Virgin Islands 00840 Fax (866) 933-2933 Mailing Address P.O. Box 1198, Frederiksted St. Croix, U.S. Virgin Islands 00841 Tel (340) 772-0260 Committee on Finance June 22, 2026 Budget Testimony FY2027 Frederiksted Health Care, Inc. Good afternoon Honorable Senator Novelle E. Francis Jr., Chair of the Committee on Finance, other Committee members, all other Senators and our listening and viewing audience. I am Masserae Sprauve Webster, Chief Executive Officer of Frederiksted Health Care, Inc. otherwise referred to as FHC. Here with me today is Ms. Jacqueline Rhymer-George, Frederiksted Health Care’s Chief Financial Officer and Ms. Tarah Graham-Hodge, Frederiksted Health Care’s Chief Human Resources Officer and Corporate Compliance Officer. We are here today to testify on behalf of the Board of Directors, Management, Staff and our Patients of Frederiksted Health Care, Inc. Our Mission: To provide non-discriminatory, evidence-based, affordable and accessible health care to the community of St. Croix. “Putting The Care Back into Health Care” Website: FHC-INC.NET 2 We would like to begin with sharing a quote, “Health Care is not valued until sickness comes.” at FHC, we strive daily to provide preventative health care to keep our patients and our community healthy. We accept this invitation as an honor and a responsibility. We thank you for the opportunity to share the successes and challenges that Frederiksted Health Care experiences in our efforts in providing the best quality health care to our community. Frederiksted Health Care is an independent non-profit primary care organization that was created in 2000. Our mission is to provide patient-centered, non-discriminatory, evidence-based, and affordable health care to the community of St. Croix. Our services are comprehensive and integrated. We provide primary care from pre-natal to our senior community. FHC offers obstetrics and gynecology, dental, psychiatric, behavioral health counseling, and enabling services at three service delivery locations across St. Croix. Currently there are no dental services at Mid-Island. However, we are presently remodeling an adjoining suite to add dental at our Mid-Island suite. Our Mission: To provide non-discriminatory, evidence-based, affordable and accessible health care to the community of St. Croix. “Putting The Care Back into Health Care” Website: FHC-INC.NET 3 Our community health center is funded under Section 330 of the Public Health Service Act. Section 330 of the Public Health Service Act is the federal statute that authorizes and funds the Health Center Program. It provides crucial grants to community- based organizations that deliver comprehensive primary care to low-income, uninsured, or medically underserved populations. The Health Center Program requires health centers to be community-based and governed by our patients. FHC’s Board is a consumer led board; which means that at least 51% of our board members are required to receive health care services from Frederiksted Health Care. Consumer participation helps us understand our patients’ needs and ensures patients have a voice in the decision-making of the health center. Our Board members are required to be connected to the local community by either living or working in our service areas. Federally Qualified Health Centers, (FQHC’s) are designed to provide care to everyone and particularly to people who find it difficult to access health care. While the ability to afford health Our Mission: To provide non-discriminatory, evidence-based, affordable and accessible health care to the community of St. Croix. “Putting The Care Back into Health Care” Website: FHC-INC.NET 4 care is a major barrier to care, there are many other significant barriers faced by health center patients. These include transportation, a lack of health care providers in the area where the patient lives, and access to medical services outside of normal business hours. To address the financial barriers, FHC accepts anyone who presents for care regardless of whether they have insurance or the ability to pay. We also provide Sliding Fee Discounts based on family size and income. To address barriers related to transportation access, FHC has three locations across St. Croix. FHC also provides care into the evening hours Monday through Friday until 7p.m. We also provide care on Saturdays and Sundays alleviating the need for the misuse of the emergency room for non-emergent concerns. At FHC, our most important job is to remove barriers to care because health care should be a RIGHT, not a privilege!! In 2024, more than 32.4 million people nationally received health care from the Health Center Program which is nearly 1 in 10 individuals living in the United States. A recent survey of health Our Mission: To provide non-discriminatory, evidence-based, affordable and accessible health care to the community of St. Croix. “Putting The Care Back into Health Care” Website: FHC-INC.NET 5 center patients found that 97% of patients would recommend their health center to family or friends. On St. Croix, Frederiksted Health Care provides services to nearly 1 in 4 residents on the island. Take a moment and imagine that every 4th person that you encounter on St. Croix is receiving services from Frederiksted Health Care. This past year, FHC has been proudly celebrating our 25-year anniversary. We would like to publicly thank our staff for their continued dedication and support over these last 25 years. We thank our Board of Directors for their unwavering commitment. And we thank our patients for trusting us with their health care. Our Mission: To provide non-discriminatory, evidence-based, affordable and accessible health care to the community of St. Croix. “Putting The Care Back into Health Care” Website: FHC-INC.NET 6 During our celebrations, our team has not lost sight of our mission, “To provide non-discriminatory, evidence-based, affordable, and accessible health care to the community of St. Croix” and our shared vision for “A Healthy, Vibrant, Resilient Community.” Frederiksted Health Care’s three locations have maintained our certification as the only designated Patient Centered Medical Homes in the Virgin Islands. We provided care to over 9,000 unduplicated individuals in 2025, 98% of whom have income at or below 200% of the poverty level. Our percentage of uninsured patients has doubled from 14% in 2022 to 28% in 2025. This has forced us to absorb a growing volume of uncompensated care each year. As it relates to uncompensated care, this is particularly true for our unhoused patients for whom we provide medical, dental and behavioral health services, in addition to case management services, food, clothing, and personal hygiene support. Every 2nd Saturday of the month our health center opens exclusively to provide care for the unhoused. Additionally, we run a syringe Our Mission: To provide non-discriminatory, evidence-based, affordable and accessible health care to the community of St. Croix. “Putting The Care Back into Health Care” Website: FHC-INC.NET 7 exchange program which helps to stop the spread of communicable diseases among intravenous drug users. Frederiksted Health Care fully funds these programs at a cost of $200,000.00 per year. We do not receive grant support or any local funding to offset these costs. We re-invest funds from our program income to ensure we can continue to meet our commitment to reducing the spread of HIV/AIDS and serving the unhoused. FHC’s services are comprehensive and integrated. We are committed to offering medical, dental and behavioral health at every location as outlined in our strategic plan. We are presently expanding our Mid-Island Health Center at Sion Farm to offer dental services. With the completion of our new dental suite at Mid Island, later this year, all services will soon be available at all three locations. This will be a significant step forward for our patients who live in the Sion Farm, Peter’s Rest, Strawberry, Barren Spot and surrounding communities who currently must travel to Frederiksted or North Shore for dental care. Our Mission: To provide non-discriminatory, evidence-based, affordable and accessible health care to the community of St. Croix. “Putting The Care Back into Health Care” Website: FHC-INC.NET 8 We also have continued to build upon our “Grow Your Own” approach to staffing and have successfully increased our dental staff. Under this program, Frederiksted Health Care provides qualified staff members with financial assistance to further their education in the health care field. One of our dental assistants completed her training as a dental hygienist and is now a licensed dental hygienist in the Virgin Islands working for Frederiksted Health Care. We could not be prouder to have helped a fellow Virgin Islander reach her dream and to have increased access to preventive dental services on St. Croix. FHC has the only accredited dental residency program in the Virgin Islands which further increases access to dental care for our community. We have expanded our behavioral health services through the addition of two psychiatric nurse practitioners. We are also proud to share that thru our “grow your own program”, we have invested in 2 nurse practitioners who are completing the course work to become psychiatric nurse practitioners. They too will soon join our Behavioral Health team and further expand our behavioral Our Mission: To provide non-discriminatory, evidence-based, affordable and accessible health care to the community of St. Croix. “Putting The Care Back into Health Care” Website: FHC-INC.NET 9 health services. Over the past several years, we have only been able to provide psychiatric services via telehealth on a part-time basis. These additions to staff represent a significant increase in our capacity to provide much-needed psychiatric services on island. Last summer, we completed and dedicated our new Administration and Outreach building at our North Shore location. We take this opportunity to again thank those of you who attended that dedication and shared in our celebration. This building was primarily funded by Frederiksted Health Care with some federal support. This building has allowed us to relocate most of our administrative staff from Ingeborg Nesbitt location. Over the next year, we will be working to obtain funding for renovations to the Ingeborg Nesbitt building to expand our clinical services, increase primary care and behavioral health services. The renovations will include establishing an in-house pharmacy to foster seamless collaboration between our medical providers and pharmacists, ultimately enhancing patient care and health results. Our Mission: To provide non-discriminatory, evidence-based, affordable and accessible health care to the community of St. Croix. “Putting The Care Back into Health Care” Website: FHC-INC.NET 10 The project will also replace our aging air conditioning system; which is nearing the end of its useful life. We anticipate this project will be costly and will require a multi-pronged funding strategy. We are applying for federal grant funding. We are also exploring innovative approaches such as the New Market Tax Credit program; which is designed to drive private investment and economic growth into low-income, distressed communities. We will also seek additional financial support from the Government of the Virgin Islands. We cannot emphasize enough that Frederiksted Health Care remains steadfast in its commitment to ensuring care is available to all members of our community regardless of ability to pay. However, we cannot do this alone. We must stress the importance and value of an integrated health care system in the territory. One issue where we risk losing all progress made is failing to fully launch a certified Health Information Exchange (HIE). Delivering modern healthcare is highly complex, and no single entity can address the scope of needs, found in a community such as ours. Our Mission: To provide non-discriminatory, evidence-based, affordable and accessible health care to the community of St. Croix. “Putting The Care Back into Health Care” Website: FHC-INC.NET 11 A healthy health care system requires a robust system of primary care, specialty care, dental care, behavioral health care, and inpatient care. We are all aware of the struggles of the health care system in the Virgin Islands. However, we must place more attention on the concern related to the ability of the various health organizations to effectively communicate with each other. Over the past 20 years, health care organizations have made significant investments in electronic health record systems; which have revolutionized our ability to fully document our services and to use data to drive quality improvement efforts and improve our patient’s health outcomes. While a Health Information Exchange was launched with Crisp Shared Services, which was mostly funded by Medicaid and partially by the Office of Health Information Technology, a local commitment of financial support to get all healthcare providers effectively connected has not been realized. There has been no major funding for the HIE from this body. Frederiksted Health Center and St. Thomas East End Medical Center Corporation have fully connected our Electronic Medical Our Mission: To provide non-discriminatory, evidence-based, affordable and accessible health care to the community of St. Croix. “Putting The Care Back into Health Care” Website: FHC-INC.NET 12 Record systems to the Health Information Exchange; however we cannot fully reap the benefits as the critical funding needed to connect our hospitals and all other local providers is simply lacking. While the Office of Health IT offered subgrants to encourage Health Information Exchange (HIE) connectivity, this financial support was dwarfed by the harsh realities the territory's hospitals faced, including crippling cyber breaches, costly rebuilding efforts, and federal Medicaid funding cuts. Consequently, after five years of investments and hard work, we are still without a functioning HIE in the Virgin Islands. The Health Information Exchange (HIE) enables organizations to securely share critical medical data on shared patients, replacing isolated silos with fully coordinated care across the entire health system. HIE’s decrease duplicate testing, prevent adverse medication events, and improve patient outcomes. These systems increase efficiency by saving time for healthcare staff and reduces errors due to missing or out-of-date medical information. Our Mission: To provide non-discriminatory, evidence-based, affordable and accessible health care to the community of St. Croix. “Putting The Care Back into Health Care” Website: FHC-INC.NET 13 The implementation of a Health Information Exchange (HIE) system in the U.S. Virgin Islands has been unacceptably slow. As a result, our territory lags far behind the rest of the United States and other territories, including Guam and American Samoa. The federal government has made a significant financial investment in a system for the Virgin Islands. It is past time for us to develop and implement a regional health information system in the Virgin Islands. Frederiksted Health Care, serving as both a key stakeholder and a member of the Health Data Utility Governance Board, remains fully committed to this critical endeavor. We urge the Legislature to recognize the immense value of this system, provide the required funding, expedite the development process, and ensure its earliest possible implementation. As demonstrated, providing our patients with the best care possible is a top priority for Frederiksted Health Care. Therefore, we are requesting FY-2027 funding for the local share of the Medicaid match as well as for the uncompensated care we provide for uninsured and underinsured patients. In 2025, uncompensated Our Mission: To provide non-discriminatory, evidence-based, affordable and accessible health care to the community of St. Croix. “Putting The Care Back into Health Care” Website: FHC-INC.NET 14 care at FHC totaled over $9 million dollars. It is expected that uncompensated care will total $9.4 million at the end of FY 2026 and $10 million in FY 2027. Frederiksted Health Care is hereby requesting annual support from the Legislature in the amount of $3,592,728 million. FY 2027 Budget Request General Fund FY 2027 Request Personnel Services $2,091,111.00 Fringe Benefits $ 43,689.00 Capital Outlays $ 507,928.00 Other Services & Charges $ 200,000.00 Public Utilities $ 250,000.00 Total $3,592,728.00 We are also requesting a one-time allotment of $300,000 to support the completion of the dental clinic at Mid Island. Frederiksted Health Care is the only public dental facility on Our Mission: To provide non-discriminatory, evidence-based, affordable and accessible health care to the community of St. Croix. “Putting The Care Back into Health Care” Website: FHC-INC.NET 15 St.Croix. At our Northshore site, we have 8 operatories. At the Nesbitt site, we have 3 dental operatories. This presently totals 11 operatories for to provide care to the 10,000 patients that FHC provides care to annually. This new site will add 5 operatories to provide services to our community that is in dire need of dental services. Dental services will soon be accessible to communities in the surrounding areas of Sion Farm, Peter’s Rest, Anna’s Hope and Sunny Isles. Maintaining good dental health is far more than just having a bright smile; it is a critical component of your overall systemic health. The mouth serves as the entry point to your digestive and respiratory tracts, and the presence of bacteria there if left uncontrolled can contribute to significant health complications elsewhere in the body. The Oral-Systemic Connection The mouth is home to a vast ecosystem of bacteria. While most of these are harmless or kept in check by regular brushing and flossing, poor oral hygiene can lead to the overgrowth of bacteria, Our Mission: To provide non-discriminatory, evidence-based, affordable and accessible health care to the community of St. Croix. “Putting The Care Back into Health Care” Website: FHC-INC.NET 16 causing oral infections like periodontitis (gum disease). When gums are inflamed or bleeding, it becomes easier for oral bacteria and the inflammation they trigger to enter the bloodstream, potentially affecting other organs. Impact on Overall Health. Research has consistently linked oral health to several chronic conditions. Heart Disease: There is a significant association between periodontitis and an increased risk of cardiovascular issues. Bacteria from the mouth can travel through the bloodstream and potentially contribute to the buildup of plaque in the arteries (atherosclerosis) or cause inflammation in the hearth’s lining (endocarditis).  Diabetes: There is a bi-directional relationship here, people with diabetes are more susceptible to gum disease, which can then make it harder to control blood sugar levels, creating a cycle that worsens both conditions.  Pregnancy Complications: Periodontitis has been linked to premature birth and low weight in some studies. The Our Mission: To provide non-discriminatory, evidence-based, affordable and accessible health care to the community of St. Croix. “Putting The Care Back into Health Care” Website: FHC-INC.NET 17 hormonal changes during pregnancy can also make gums more susceptible to inflammation.  Respiratory Infections: The bacteria in your mouth can be inhaled into the lungs, potentially leading to respiratory issues like pneumonia, particularly in older adults or those with weakened immune systems. Beyond the physical benefits, excellent oral health contributes to better nutrition—as it allows for comfortable chewing – and boosts self-confidence, which plays a vital role in your mental and social well-being. Our dental equipment costs for this new site total $320,000.00. FHC has received a federal grant through the Ryan White program for $150,000.00 to pay for half of the dental equipment for this new site. Frederiksted Health Care will pay the balance of $170,000.00. We are requesting that the Legislature approve a one-time funding allocation of $300,000 to complete the renovation and build-out of the dental clinic. See attached site design. Our Mission: To provide non-discriminatory, evidence-based, affordable and accessible health care to the community of St. Croix. “Putting The Care Back into Health Care” Website: FHC-INC.NET 18 We close today by reminding you of another old proverb: “he who has health has hope, and he who has hope has everything!!” The Board of Directors, Management, Staff and Patients of Frederiksted Health Care ask you to keep this in mind as you deliberate FHC’s FY-2027 budget request. Our investment in health today will allow our community to reach its true potential tomorrow. Thank you for considering our request. Your support is vital to our ongoing mission of serving the community. Ms. Rhymer- George, Ms. Graham-Hodge and I remain poised to answer any questions you may have. Respectfully Submitted, Masserae Sprauve Webster Chief Executive Officer