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36th Legislature of the U.S. Virgin Islands Committee On Disaster Recovery, Infrastructure & Planning Senator Marise C. James, Esq. Chair Testimony Presented By The Honorable Justa Encarnacion, RN, BSN, MBA/HCM Commissioner of Health on The Department of Health's disaster preparedness and hurricane season readiness efforts, including public health emergency planning, disease surveillance, environmental health readiness, continuity of operations, interagency coordination, recovery initiatives, and the Department's responsibilities in support of Emergency Support Functions under the Territorial Emergency Operations Plan. DOH Testimony on Hurricane Preparedness June 30, 2026 Good day, Senator Marise C. James, Esq., Chair of the Committee on Disaster Recovery, 1 Infrastructure and Planning; Senator Milton E. Potter, Vice Chair; distinguished members of the 2 Committee, other senators present, and everyone joining us in person and virtually. 3 I am Justa Encarnacion, Commissioner for the Virgin Islands Department of Health. Joining me 4 today is Dr. Nicole Craigwell-Syms, Assistant Commissioner, and Ms. Aesha Rivers, Director of 5 Public Health Preparedness. Thank you for the opportunity to provide an update on the 6 Department's hurricane preparedness and disaster readiness efforts. 7 Under the Virgin Islands Territorial Emergency Operations Plan (TEOP), the Department of 8 Health serves as the lead agency for Emergency Support Function 8 (ESF-8), public health, 9 which is responsible for coordinating the Territory's public health and medical response before, 10 during, and after disasters. In this role, the Department’s Public Health Preparedness Division 11 works closely with hospitals, emergency medical services, healthcare providers, territorial and 12 federal agencies, and community partners to help ensure that essential healthcare services remain 13 available in times of crisis. 14 During hurricane season and other major emergencies, ESF-8 coordinates medical response 15 efforts, supports healthcare facilities, assists vulnerable populations, and manages critical 16 medical resources. During recovery, we monitor public health threats, help restore public health 17 and healthcare services. This responsibility aligns with FEMA’s National Response Framework 18 which guides how the nation responds to all types of disasters and emergencies. 19 Today, I will focus primarily on our participation in CAPSTONE 2026, the Territory’s annual 20 full-scale hurricane preparedness exercise. Among other functions, the exercise evaluated ESF- 21 8's, public health preparedness, capabilities in the areas of emergency planning, continuity of 22 operations, and interagency coordination. 23 24 CAPSTONE 2026, Exercise Steve, was conducted June 1 through June 5, and simulated a 25 Category 3 hurricane impacting the island of St. John. The exercise validated our emergency 26 coordination with territorial and federal partners, confirmed the operational readiness of ESF 8 27 DOH Testimony on Hurricane Preparedness June 30, 2026 and the Medical Special Needs Shelter, and successfully tested federal patient movement and 1 tracking processes. 2 Just as importantly, it identified several opportunities for improvement, including transportation 3 for non-ambulatory patients, long-term staffing, patient tracking, and finalizing critical 4 operational agreements. These findings are preliminary and will be incorporated into the official 5 After-Action Report and Improvement Plan being developed with VITEMA. 6 Our highest priority is transportation for non-ambulatory, and bariatric patients. These 7 individuals require specialized equipment, additional personnel, and more time to evacuate 8 safely. CAPSTONE demonstrated that once St. John reaches Port Condition X-Ray, when storm 9 force winds are expected within 48 hours, the evacuation window narrows significantly. This 10 creates a logistical challenge of moving our most medically vulnerable residents before weather 11 conditions deteriorate. 12 To address this gap, the Department is expanding transportation capacity by evaluating 13 additional marine resources, validating helicopter landing zones with our federal partners, 14 positioning transportation assets on St. John before port closure, and clearly defining 15 transportation responsibilities within the ESF-8 Annex to the TEOP. Remaining resource needs 16 will be addressed through mutual aid agreements and pre-scripted federal mission requests. 17 The exercise also highlighted the importance of sustaining clinical staffing beyond the first 72 18 hours after a storm. We are seeking to address this through federal staffing support, Emergency 19 Management Assistance Compact (EMAC) resources, and two pre-scripted federal staffing 20 requests coordinated through VITEMA. We will be requesting additional clinical personnel to 21 support both the Medical Special Needs Shelters, the General Population Shelters, and our two 22 hospitals, helping reduce the need for patient transfers before and after a storm. 23 Another key focus is strengthening our medical supply chain. Bulk medical oxygen remains the 24 Territory's most significant supply vulnerability. Schneider Regional Medical Center has on-site 25 oxygen generation, while Governor Juan F. Luis Hospital depends on vendor deliveries that can 26 be disrupted when sea-and-airports close. We are working with our federal partners to identify 27 supply requirements, and to pre-stage resources before a disaster affects the Territory. 28 DOH Testimony on Hurricane Preparedness June 30, 2026 Finally, we continue strengthening fatality management capabilities in partnership with the VI 1 Department of Justice. Refrigerated trailers have been identified across all three districts, and we 2 have requested federal support through a Disaster Mortuary Operational Response Team 3 (DMORT) to augment local capabilities should it become necessary. 4 In summary, CAPSTONE 2026 confirmed that our emergency response framework is strong, our 5 partnerships are effective, and our planning continues to mature. More importantly, the exercise 6 provided a clear roadmap for addressing the remaining gaps before the peak of hurricane season. 7 Every corrective action has an assigned owner, measurable objectives, and a timeline for 8 completion. 9 Following the exercise, the Department of Health also conducted an internal comprehensive 10 Health and Medical Lifeline Readiness Assessment of ESF-8. 11 We concluded that, overall, the Territory's Health and Medical Lifeline is stable and improving. 12 The assessment confirmed many of our strengths while identifying several areas requiring 13 additional attention before the height of the hurricane season. We must continue to strengthen 14 five critical areas: medical care, patient movement, public health and sheltering, fatality 15 management, and medical supply chains. The results of our internal assessment were presented 16 to the Honorable Governor Albert Bryan Jr. and our FEMA Region 2 partners. 17 Our appreciation for the continued support given to us by FEMA through VITEMA is strong. We 18 have also developed a very strong relationship with the Department of Health and Human 19 Services -Administration for Strategic Preparedness and Response (HHS/ASPR) which 20 continues under the current leadership of the Principal Deputy Assistant Secretary, Mr. John 21 Knox. Mr. Knox and his delegation of seven (7) visited the Department of Health on April 27th. 22 Mr. Knox and his team toured Schneider Regional Medical Center and received presentations 23 from our ESF-8 partners, including CEO Darlene Baptiste, VITEMA Director Daryl Jaschen, 24 Human Services Commissioner Averil George, VIFEMS Assistant Director Lisle Evelyn. Mr. 25 Knox also met with Governor Bryan and his team. The recommendations from this visit continue 26 to strengthen both our Hospital Preparedness Program and ESF-8, reflecting the value of our 27 close partnerships with key federal agencies. 28 DOH Testimony on Hurricane Preparedness June 30, 2026 While much of ESF-8 focuses on maintaining medical care during an emergency, the 1 Epidemiology and Environmental Health divisions play a critical role in protecting the public 2 from the health risks that often emerge after a hurricane. Following a storm, the Epidemiology 3 Division is poised to use its disease surveillance tools to identify and respond to communicable, 4 foodborne, waterborne, and vector-borne diseases that may result from flooding, prolonged 5 power outages, or disruptions to essential services. 6 At the same time, the Environmental Health Division is prepared to assess food establishments, 7 shelters, healthcare, and other critical facilities to help ensure they can operate safely. 8 Environmental Health also provides guidance on food safety, safe drinking water, mosquito 9 control, and other environmental hazards that can threaten public health during recovery. 10 Together, these efforts help prevent secondary public health emergencies and support the 11 Territory's safe and healthy recovery. 12 Before I close, I would like to thank the Honorable Governor Albert Bryan Jr. and the Honorable 13 Lieutenant Governor Tregenza A. Roach, Esq., for their leadership and support especially during 14 the times of uncertainty that comes with hurricane season. I want to recognize the 10 staff 15 members that make up the small, yet hardworking team of Public Health Preparedness that was 16 coached by the soon-to-be retired Assistant Commissioner of Health, Rueben Molloy. Over the 17 past few years, you have accepted the “all hazard” challenge and have succeeded at all. Thank 18 you DOH Family - we are all public health service providers ready to respond. 19 Madam Chair and members of the Committee, hurricane preparedness is not measured by what 20 we do when a storm is approaching — it is measured by the work we do every day before one 21 arrives. Through planning, training, exercising, and strengthening our partnerships, we continue 22 to build a more resilient public health and healthcare system for the Virgin Islands. 23 While no emergency plan is ever complete, we are better prepared today than we were yesterday, 24 and tomorrow we will be even stronger. Our commitment is to continually improve our readiness 25 so that when our communities need us most, the Department of Health is ready to respond, 26 protect public health, and help lead the Territory's recovery. 27 Thank you for the opportunity to present this testimony. We appreciate the Committee's 28 continued partnership and support, and we welcome your questions. 29