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GOVERNMENT OF THE VIRGIN ISLANDS OF THE UNITED STATES VIRGIN ISLANDS DEPARTMENT OF HEALTH VI BOARD OF MEDICAL EXAMINERS P.O. BOX 222995 CHRISTIANSTED, VI 00822-2995 BOARDOFMEDEXAMINERS@DOH.VI.GOV October 27, 2025 Honorable Senator Ray Fonseca 36th Legislature of the U.S. Virgin Islands Capitol Building, P.O. Box 1690 Charlotte Amalie, V.I. 0080 RE: VI Board of Medical Examiners Good Day Senator Fonseca, Please find below the testimony requested. I apologize for the delay. Good Day, Honorable Senator Ray Fonseca, Chairman of the Committee on Health, Hospitals, and Human Services; Committee and non-Committee members; and the viewing and listening audience. Thank you for the opportunity to present a formal update on the operations, challenges, and strategic objectives of the Virgin Islands Board of Medical Examiners (Board). I respectfully submit this written testimony for inclusion in the record of today’s proceedings. Pursuant to Title 3, Section 415 of the Virgin Islands Code, the VI Board of Medical Examiners is comprised of seven (7) members—four (4) physicians and three (3) lay members. Of the four (4) physician members, two (2) are appointed from the St. Thomas/St. John District and two (2) from the St. Croix District. The remaining three (3) lay members are appointed one (1) each from St Thomas, St Croix, and St John. All but 2 Board members are serving in a holdover capacity, as their terms expired in 2023, pending reappointment or replacement by the Honorable Governor. There are currently two (2) public member vacancies: one member representing St. Thomas and another representing St. John. The day-to-day operations of the Board are administered by the Office of Professional Licensure and Health Planning (PLHP), which employs three (3) full-time staff members and is also responsible for the management and oversight of eight (8) additional professional boards operating under the Department of Health. Like many boards locally and nationwide, the VI Board of Medical Examiners (Board) faces a mix of successes, challenges, and evolving needs in today’s healthcare landscape. The Board remains committed to its mission of protecting the public and providing regulatory oversight for safe medical practice by licensed Physicians and Physician Assistants in the territory. I would like to start by outlining our key accomplishments, then address the challenges we’ve encountered, and conclude with an overview of our current needs. ACCOMPLISHMENTS: The Board’s website (VIMedicalBoard.org) was created and is fully operational. It includes a directory of all currently licensed physicians and physician assistants. All Board members were provided government email addresses through the Bureau of Information Technology to reduce risks associated with recordkeeping, confidentiality, legal compliance, security breaches, and spam. Furthermore, all Board meetings are now conducted via Microsoft Teams, which offers a secure and reliable platform for conducting official business while providing access to a range of useful technological tools. VIBME collaborates with numerous inter/intra-agencies to ensure compliance with best practices and industry standards. These agencies include the American Medical Association, American Osteopathic Association, National Commission on Certification of Physician Assistants, Federation of State Medical Boards, Drug Enforcement Administration, Department of Licensing, Bureau of Information Technology, Office of Primary Care, and Department of Justice. CHALLENGES: The Board is interested in creating and participating in community outreach activities targeting providers and the public. These efforts would promote transparency and increase public awareness of current issues and emerging standards. Initiatives such as a newsletter for licensees and the broader community would be valuable, but would require additional staff support. Collaboration within the broader healthcare sector is ongoing, but could be better as we share common challenges and can network to share best solutions. faster patient access to medicines, increased efficiency for regulatory authorities through shared work, and reduced barriers to trade and investment by aligning regulations. Collaboration across multiple regulatory boards can enhance communication, improve efficiency, strengthen decision-making, and reduce the costs of duplicative efforts. The principal difficulty lies in convening all stakeholders at the same time and staffing resources. Act 8456 allows the Medical Board to provide quorum for smaller boards unable to meet, ensuring continued operations such as licensure. The Board successfully fulfilled this role for the Boards of Physical Therapy, Optometrical Examiners, and Podiatry. While VIBME is not a subject-matter expert, it secured quorum and maintained service continuity. Consideration could be given to consolidating smaller boards into a single larger board to streamline processes and standardize governance. VIBME continues collaboration with the Virgin Islands Police Department to satisfy the Federal Bureau of Investigation (FBI) Public Law requirements necessary for obtaining an Originating Agency Identifier (ORI) number. Securing the ORI is the first step toward fulfilling the mandate that all initial licensees undergo an FBI criminal background check. Securing an ORI number is also essential as the Board is trying to join the Interstate Medical Licensure Compact, which offers a voluntary, expedited pathway to licensure for qualified physicians. An interstate compact is a legal agreement among participating states that allows them to work closely together to address issues of mutual concern that cross state borders. There are currently over 25 states participating in the Compact. Having the FBI ORI is a prerequisite for joining the Compact. The FBI has approved the drafted amendment to the language, and we are coordinating with Senator Francis’s office to finalize this process. NEEDS: The Board is appreciative of this opportunity to come before you to provide updates and, more importantly, to collaborate with the legislative body to resolve key challenges that will improve the Board’s function and access to services. Develop a Local Administrative Procedures Act to govern and standardize the operations of all professional boards under the Department of Health’s umbrella. By establishing uniform administrative procedures— covering areas such as investigations, rulemaking, adjudications, complaint processing, and public or due process hearings—all Boards can realize enhanced efficiency, consistency, quality control, legal compliance, transparency, and accountability. The Board is awaiting the review and promulgation of draft rules and regulations submitted to support the Medical Practice Act. Dedicated legal resources are needed. The Board seeks to implement online payment capabilities for its special account for application and license verification fees and fines. This would allow applicants the convenience of paying fees online, eliminating the need for mailing payments and reducing processing delays. In closing, I would like to thank you for the opportunity to share this update on behalf of the Board of Medical Examiners. We take great pride in the progress we’ve made and remain committed to addressing the challenges before us. The Board looks forward to working collaboratively to resolve the matters that fall within your authority and to receiving your guidance and support on those that extend beyond your purview. Thanks again for your time and attention. I am happy to answer any questions or provide additional information as needed.