Home News Local news LEGAL BATTLE LOOMS OVER MEDICAL COMMISSION

LEGAL BATTLE LOOMS OVER MEDICAL COMMISSION

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Aug. 27, 2003 – An ad hoc committee formed by former Sen. Adelbert Bryan and other St. Croix residents reached consensus on Wednesday night to mount a two-pronged legal challenge to the use of Education Department funding for the operation of a U.S.V.I. Medical School Commission that Gov. Charles W. Turnbull created by executive order earlier this month.
As a result, the Committee for Quality Assurance in the Establishment of Medical Education on St. Croix will start the process of bringing legal action against the governor in court while also working to formulate legislation that would amend the executive order.
The executive order in question is the third of three signed by the governor on Aug. 7. The first two grant charters to private medical schools to be based on St. Croix and in the St. Thomas-St. John district, respectively. The third gives a nine-member commission oversight for any medical schools that might be established in the territory, makes the Education commissioner the panel's chair and specifies that funding for the commission's administration shall come out of the Education Department's annual budget.
At least 30 people attended the meeting Wednesday night at Pier 69 in Frederiksted. Among them were such community activists as Clifford Christian, Hope Gibson, Dr. Olaf Hendricks, Noel Loftus, Mario Moorhead and Humberto O'Neal.
Bryant emphasized that the ad hoc committee is not opposed to the establishment of a medical school on St. Croix. In fact, he said, its members support such a school. But he said the governor has "no authority to reprogram funds without legislative approval."
It's a point he made in a letter sent Monday to Senate President David Jones. He noted that the governor's executive orders "describe two separate institutions functioning in both territory hospitals simultaneously" and that they "further create a commission for the oversight of the schools with funding not appropriated by the Legislature."
The Committee for Quality Assurance, Bryan said, "has grave concerns over the legality and wisdom of these executive orders." And he asked Jones to convene the Committee of the Whole "to address these issues" within the next 72 hours — that is, by Thursday.
The Committee of the Whole already was scheduled to meet Wednesday night on St. Croix and Thursday night on St. Thomas to address other matters. As of Wednesday night Jones had not commented on the matter.
Sen. Emmett Hansen II, also on Monday, wrote to the governor expressing his concerns about the order creating the Medical School Commission and providing for funding from within the Education budget. Hansen said he had been unable to find anything in the Revised Organic Act giving the governor authority "to create a commission without the advice and consent of the Legislature."
Further, Hansen wrote, "I do not believe that the creation of a new level of bureaucracy is in the best interests of the health needs of the Virgin Islands public or the establishment of medical schools in the territory. I believe that rather than instituting artificial barriers to progress, particularly on the island of St. Croix, that steps should be taken to assist in the creation of cottage industries and opportunities such as this medical school."
Bryant said the Committee for Quality Assurance has 15 days from the issuance of the executive orders to take legal action.
The executive orders
On Aug. 15, while Gov. Charles W. Turnbull was off island, a release was distributed from the Office of the Lieutenant Governor stating that "Acting Governor Vargrave Richards attested to Executive Order No. 408-2003 to support Gov. Turnbull's decision to sign charters authorizing the establishment of a school of medicine on the island of St. Croix."
Unbeknownst to most of the territory's residents, Richards in a letter of transmittal to Senate President David Jones — also dated Aug. 15 — provided the Legislature copies of three executive orders, numbered 408, 409 and 410, all signed by the governor and attested to by the lieutenant governor on Aug. 7.
Order No. 408, effective Aug. 8, 2003, grants a charter to the U.S. Virgin Islands College of Medicine, LLC to establish a school of medicine on St. Croix. It states that the privately operated school "will greatly increase the opportunity for graduates of the University of the Virgin Islands to pursue careers in the medical field and will provide substantial economic and social benefits" to the district, the territory and the V.I. health-care system.
It provides for the college to begin operations within 24 months of the issuance of the executive order, and empowers it to establish "component colleges" of medicine, dentistry, veterinary science, public health, biomedical engineering and other disciplines. And it requires that the school obtain preliminary accreditation from the Liaison Committee on Medical Education of the Association of American Medical Colleges within 36 months of beginning operations, and full accreditation within 24 months after that.
It requires that the college deposit at least $15 million in a V.I. bank within 60 days of the order and provide evidence of financial commitment — a minimum $10 million more — within 180 days to developing the school's physical plant, personnel, equipment and supplies.
And it provides for the college to be regulated by the Virgin Islands Medical School Commission and to interface with the University of the Virgin Islands, Juan F. Luis and Roy L. Schneider Hospitals, and the Health Department.
Order No. 409, to become effective Nov. 8, 2003, grants a charter to the Medical Faculty Foundation, LLC, to establish a school of medicine in the St. Thomas-St. John district. It states that the privately operated school will provide the same benefits set forth in Order No. 408.
It, too, provides for start-up within 24 months, empowers the foundation to establish the same sorts of "component colleges" and calls for it to become similarly accredited. And it makes the same provisions regarding the deposit of funds and interfacing with UVI , the hospitals and the Health Department.
Order No. 410 establishes the U.S.V.I. Medical School Commission, "an advisory body established administratively within the Department of Education," to oversee and "ensure compliance" by those entities granted charters for the establishment of a medical school of similar facility. The commission is to determine and monitor compliance, improvement and growth of the territory's medical schools for 12 years from the issuance of their charters.
The commission is to be a nine-member advisory body established within the Education Department comprising the commissioners of Health and Education, the president of the University of the Virgin Islands or a designee, the CEO's of the territory's two hospitals, the governor's chief of staff or a designee, the attorney general or a designee, and the chairs of the V.I. Board of Medical Examiners and the Board of Nurse Licensure or their designees.
The order provides for the Education commissioner to chair the commission and specifies that no action "imposing any obligation on the territory or a medical school shall be binding unless approved by the governor." Similarly, any agreements or arrangements it enters into with any government agencies are subject to approval by the governor.
It gives the Education commissioner the power to grant accreditation and degree-granting authority to such medical schools and also to suspend, revoke or terminate such accreditation and degree-granting authority — provided that such sanctions of greater than 60 days shall be subject to approval by the governor.
It specifies that the Education commissioner shall include in the department's annual budget funding for the administrative expenses of the Medical School Commission and provides for the med
ical schools to pay an annual administrative fee set by the commission.
It states that the order is "operative immediately" and will remain in effect until Dec. 31, 2018, "unless sooner revoked by the governor."
Who and what are behind the schools
The Medical Faculty Foundation, the entity chartered for operation of a medical school in the St. Thomas-St. John district, is being promoted by Bruce Tizes, a physician, lawyer and managing partner of Galt Capital, a St. Thomas investment company.
Tizes has said the foundation's school would be affiliated with some of the nation's leading medical teaching hospitals, including Johns Hopkins, the Cleveland Clinic, Massachusetts General Hospital and Brigham and Women's Hospital in Boston.
The U.S.V.I. College of Medicine, the institution chartered to operate on St. Croix, is affiliated with Touro College, a private Jewish-sponsored institution in New York that operates the Touro University College of Osteopathic Medicine in California's Bay Area. The school awards the doctor of osteopathic medicine degree.
Touro's Web site states that osteopathic medicine "stresses a comprehensive approach to the maintenance of health," with its emphasis on "the neuromusculoskeletal system and the use of palpatory and manipulative skills in diagnosis and treatment of disease states."
St. Croix lawyer Kevin Rames represents the Touro group locally.
Legal precedent cited
Bryan said a precedent applicable in the Medical School Commission situation was established more than two decades ago in a case in which a governor was taken to court because of the re-appropriation of funds.
On Dec. 14, 1981, he said, then-senators John Bell, Milton Frett, Edgar Isles and Bent Lawaetz filed a petition for a declaratory judgment and injunctive relief against then-Gov. Juan Luis; his budget director, Stephanos O'Reilly; his acting Finance commissioner, Claude Christian; his assistant federal programs coordinator, Leo Gardner; and his Finance officer, Rose Gordon.
The action rose out of an executive order issued by Luis which created a new agency to administer funds for federal and territorial anti-poverty programs. District Judge Almeric Christian held that the order was null and void because it conflicted with existing legislation and because the governor could not take funds appropriated to one agency and transfer them to another agency.

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