Senate advances bills to combat medical waste and improve access to specialized health care

The Senate Health, Hospitals and Human Services Committee advanced two bills Friday that are expected to make small but significant changes to the territory’s health care sector.

The first, House Bill 35-0408, was sponsored by Senator Donna FFrett-Gregory and would require the Department of Health and the Department of Planning and Natural Resources to develop and administer a regulated waste management plan medical for the territory.

The U.S. Centers for Disease Control & Prevention maintains that any facility generating “regulated medical waste” should have a regulated medical waste management plan. This is not the case for the territory, despite its two large hospitals and several smaller clinics and medical facilities. “Our territory currently does not have a clear policy other than ‘ship waste off-island,’” noted Senator Frett-Gregory. She considered the legislation “timely” since “we are preparing to rebuild hospitals and medical facilities in the territory”. According to the lawmaker, “we must ensure that facilities are built with medical waste disposal issues in mind.”

The DPNR, although invited to testify on House Bill 35-0408, did not attend Friday’s meeting, but instead submitted a letter that was read into the record. In it, DPNR Commissioner Jean-Pierre Oriole said the agency has “no objection to this” and agrees that waste regulations should be updated to include medical waste. However, the DPNR does not agree with the bill’s instruction to develop a management plan. “The DPNR does not manage medical waste and therefore a management plan is not necessary,” Mr. Oriole wrote.

Frett-Gregory said later in Friday’s session that she was “prepared to make adjustments to the legislation that relate specifically to regulations and not necessarily a plan.” However, she insisted that the regulations be submitted to Parliament within a certain time frame, “as this is very important to the health and safety of the people of the Virgin Islands.”

With little further discussion, the bill was referred to the Committee on Rules and Judiciary, as was House Bill 35-0254, which would establish the Interstate Compact in Audiology and Speech-Language Pathology. The USVI will join 34 other states that have implemented similar legislation.

If signed into law, the Compact will facilitate the interstate practice of audiology and speech-language pathology to improve public access to these services, said Reuben Molloy, deputy commissioner at the Department of Health. He testified to the importance of such an arrangement for children, stroke survivors and other populations in the community. Under the Compact agreement, audiologists and speech-language pathologists licensed and in good standing in a Compact member state or territory will be eligible to practice at other Compact locations, Molloy said.

Compact members will benefit from the Compact privilege, considered equivalent to a license to practice. It is anticipated that the Interstate Compact for Audiology and Speech-Language Pathology will begin granting compact privileges to practice during the summer of 2025. In the meantime, the DOH is “working with developers to create the necessary data system to receive applications, ensure inter-State data communications”. and issue privileges to practice.

As Mr Molloy explained, obtaining a Compact license “relies on the presence of an established regulatory body responsible for the management of the specific profession”. Currently, the Virgin Islands does not have a dedicated board for audiologists and speech-language pathologists. There are two audiologists in St. Thomas/St. Saint-Jean district and one in the Sainte-Croix district. According to Mr. Molloy, “in the absence of a dedicated board, allied health practitioners in the territory are assessed through the Office of Professional Licensing and Health Planning.”

Horace Graham, deputy commissioner at the Department of Licensing and Consumer Affairs, questioned “how will the U.S. Virgin Islands be able to comply with this provision without an existing audiology or speech-language pathology board.” Allaying her concerns and those of several lawmakers about the lack of a council, the bill’s sponsor, Sen. Diane Capehart, announced that companion legislation would soon be introduced to create the same council.

Initially, she said the board would be made up of five members, including four occupational therapists and an assistant, all of whom would be appointed by the governor and approved by the Senate. However, Capehart would later accept the DOH’s suggestion that the board of directors should be representative of all allied professionals who do not currently have a dedicated board of directors. “I think it’s a great idea to make sure everything is taken care of,” she said.

With the gray areas temporarily resolved, lawmakers like Sen. Marise James agreed that the Compact would “increase our access to this type of health care.” She agreed with the Ministry of Health’s proposal, noting that “it would be more effective and efficient than having a council for each health profession.”