During Wednesday’s Schneider Regional Medical Center district governing board meeting, updates were provided on ongoing projects regarding medical facilities, financial challenges, and progress within the territory’s health care community.
The Territorial Hospitals Redevelopment Team director, Daryl Smalls, shared updates with the board on the projects for the health facilities. Regarding the Myrah Keating Smith clinic, a contractor has been selected.
“The contract is being negotiated through the Public Finance Authority/Office of Disaster Recovery. We will have a contractor on board shortly, and we will begin the program management of our facilities,” Smalls said.
Smalls added that the contractor is responsible for rebuilding the Smith clinic, the Department of Health Facilities on St. John, and a school for the Education Department. He added that the first thing his team will do is develop a program regarding the services being offered at the clinic.
“Currently, we knew it was originally designed as an emergency room,” Smalls said. “We didn’t function in that capacity, and one of the things we’re going to be looking at is the direction we’re going to be going with Myrah Keating.”
The contract is anticipated to be executed within the next 30 days.
Regarding the construction of the Schneider Regional Medical Center, a contractor has been selected and will be the same contractor constructing the Juan F. Luis Hospital. According to Smalls, one benefit of this is “standardization and optimization across the facilities” from a maintenance and operational standpoint, such as having the same generators, elevators, air conditioning systems, and sterilizers, to support both facilities simultaneously.
The existing structure for SRMC will serve as the temporary hospital and will then be demolished to utilize the space as a parking lot.
“The biggest concerns that we have for all of our projects, and that’s why we go through the program manager phase, is we have a set budget. It’s not as though we can go back to the federal government and say we need another $10 million or $100 million. Our budget is already capped,” Smalls said.
Moreover, Smalls said that a major change order has pushed back the completion date for the Charlotte Kimmelman Cancer Institute. The original completion date was Nov. 11, but it is now set for Nov. 19. The current goal is to get full power in the facility, and after that, the linear accelerator can be installed, which is anticipated for Oct. 1, followed by the installation of the CT simulator on Oct. 15.
“We’re up to about $33, $34 million in construction. Equipment is probably another three to four million. So we’re still within the overall cap of funding for this particular project,” Smalls said.
“I do get a little nervous when I drive by and it still looks like it’s very early in the construction process,” said board Chair Jerry Smith.
Smalls then welcomed Smith to tour the facility to see the progress that has been made.
Additionally, Tina Comissiong, SRMC’s chief executive officer, after acknowledging the recent medical staff retreat on St. Croix and the department’s placement at the Battle of the Agencies, spoke about financial constraints still affecting the facility.
“Things are extremely tight right now. We’ve only received about $600,000 of our August allotment. We’ve not received any of our September allotment, so that makes things very very tough for us,” said Comissiong.
During her own presentation, Kenisha Angol, SRMC’s director of financial services, said that due to allotment delays, “This means the hospital has gone over five weeks without paying vendors,” which places strain on hospital operations.
Financial concerns remain pressing. With limited government funding and delays in reimbursements impacting cash flow, the hospital is edged to pursue revenue cycle enhancements. Comissiong mentioned to the board that First Source is a third-party billing service the hospital is using to increase collections and help with financial management. Coding, billing, and claim follow-ups are some of the things First Source handles.
“One of the most impactful developments has been our engagement with First Source,” Angol added.
“I’m very confident that with that engagement, over the next two to three months, we’re going to start seeing collections get back up to where we had been previously of $5.5 million, you know, $6 million, and in the future going even above that as we’re making really strategic improvements,” Comissiong said.
Additionally, Angol told the board that collections are expected to close the fiscal year at approximately $45 million compared to $55 million last year and that the fiscal year budget for 2026 remains “unchanged” from the 2025 budget, with the exception of a $1.5 million allotment for the Myrah Keating Smith Clinic.
Comissiong also shared that the hospital is working on a chargemaster increase, renewing and improving its outdated payer contract with Cigna, cybersecurity enhancements, and physical system repairs to ensure safety and compliance. The radiology, rehabilitation, and respiratory departments are seeing progress in staffing and equipment, and efforts are underway to expand GI services and outpatient procedures. The CEO also shared that the hospital is up to date on its hurricane preparedness for this season.
“We’re hoping to see a great shift in the care that we provide. Build the community’s trust in the care,” Comissiong said.

Water and Power Authority Chief Executive Karl Knight reported to the utility’s governing board Thursday that power should stabilize for customers on St. Thomas and St. John after several weeks of “flirting with disaster.”
“It’s been a very eventful month of September thus far, and we’re still … just about halfway through the month, so who knows what else the month holds for us,” he said before acknowledging that customers on St. Thomas and St. John have been particularly inconvenienced in recent weeks. “It has been a very difficult patch for us, and underpinning most of those events is essentially a shortage of generation capacity.”
Knight said the authority has been running “thinly” with two generators at the Randolph Harley Power Plant — units 23 and 27 — offline, and the summer’s heightened power demands stretched capacity further.
“Unit 27 had been down for several weeks now,” he said. “We had — earlier this year — briefly got it back online. It gave us some breathing room for about two, maybe three weeks, and then it faltered again for an unrelated issue. We have repaired the fuel pumps and some other matters, and we’ve gotten Unit 27 back online.”
Knight said years of deferred maintenance have caught up to the authority, which is unable to take its legacy units offline for major overhauls.
“And so as we fix one component, some other component becomes due for repairs. And so we’ve had our challenges,” he said. At least one recent issue occurred when one of the utility’s newer Wartsila generators developed a leak in its air delivery system Wednesday. “And so that air leak caused the other unaffected units to also trip offline, because they … share a common air system.”
As a result, the district lost 36 megawatts of generation. Knight said they were able to fix the problem and “breathe a sigh of relief” before thunderstorms roiled the territory.
“What I will say is, lightning is not our friend. Rain is usually not a problem. I know a lot of folks, especially in the social media sphere, their belief is ‘oh that little bit of rain and now you’re out,’” he said. “You know, the two enemies of the electrical system are wind blowing obstructions into the lines and lightning striking the system.”
The weather had less of an impact on St. Croix, where Knight said only three or four feeders were offline at any given time. He attributed those outages to lightning strikes.
Knight’s report came after the board approved a handful of contracts, including a nearly $3.39 million agreement with the Island Roads Corporation for the Blackbeard Hill waterline rehabilitation project. Island Roads Corporation was also awarded a $2.72 million contract for the Mahogany Estate waterline rehabilitation. Board members also approved a $181,297 cost reduction to its contract with J. Benton related to undergrounding work in Hannah’s Rest.
Board Chair Maurice Muia asked WAPA mechanical engineer Matthias Clark how many times the authority has reduced costs for a project.
“To my knowledge,” Clark said, “none that I’ve worked on. So yes, this might be the first — at least for me.”
The board then approved a $293,964 cost reduction to the authority’s contract with J. Benton for undergrounding work along Queen Mary Highway, as well as a $5 million, two-year contract with Falcon USVI for security services at the Randolph Harley and Richmond power plants.