Executive
U.S. Virgin Islands ranks #52 by FQHC patients, with 2 organizations and 6 sites tied to federal grant exposure.
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U.S. Virgin Islands has 2 community health centers across 6 sites serving 15,297 patients — the #52 FQHC state by patients in the national-breadth layer. Its community health centers depend on the federal Community Health Center Fund, authorized only through December 2026.
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The U.S. Virgin Islands' two FQHCs serve over 15,000 patients across the main islands of St. Thomas, St. Croix, and St. John under a Medicaid block-grant financing structure that caps federal contributions below mainland parity. The territory's community health centers are the primary safety-net for a population still recovering from the economic and infrastructure damage of the 2017 hurricane season.
Patient-weighted across the 2 centers with UDS 2024 data.
The U.S. Virgin Islands has reduced NP prescribing scope compared to full-practice states, requiring physician collaboration agreements that limit deployment flexibility in the territory's multi-island geography — a structural barrier to filling primary care gaps on outer islands.
U.S. Virgin Islands operates Medicaid under a federal block-grant cap (not standard FFP); the headline risk is the hard funding ceiling plus reduced federal match and the end of pandemic-era enhanced territory allotments.
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U.S. Virgin Islands ranks #52 by FQHC patients, with 2 organizations and 6 sites tied to federal grant exposure.
Use this as the board agenda frame: exposure, owner, decision date, and the first source to recheck.
42.3% Medicaid/CHIP, 26.4% uninsured, and uninsured share is 26.4%.
Turn the payer mix into scenarios for PPS, 340B, grants, and patient-volume stress.
HRSA organization data while public job-source coverage expands; largest systems and directory links show where hiring capacity may need verification.
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U.S. Virgin Islands combines 15,297 FQHC patients with reduced NP practice context and access pressure from payer mix.
Map the signal to panel access, team-based care, top-of-license planning, and patient-impact follow-up.
the PCA, state policy context, and the December 31, 2026 CHC Fund cliff define the sources to keep current.
Assign one source owner for state policy, one for federal deadlines, and one for billing/audit implications.
U.S. Virgin Islands has 2 FQHC employers in the directory and HRSA organization data while public job-source coverage expands to compare before applying.
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2 primary-sourced findings on U.S. Virgin Islands FQHC policy and financing.Newest item: 2026-06-03
The U.S. Virgin Islands' community health centers operate under a dual pressure: the ongoing infrastructure and workforce challenges from Hurricane Maria/Irma recovery (2017) and the hard federal Medicaid block-grant cap that limits matching funds regardless of enrollment need. Any reduction in the block grant ceiling under federal budget reconciliation would directly reduce FQHC operating budgets with no state general-fund backstop.
The CMS interim final rule implementing H.R. 1's Medicaid community-engagement (80-hours/month work) requirement (CMS-2454-IFC), published in the Federal Register, requires states to implement by January 1, 2027 — but Section 1902(xx) does not apply to the U.S. territories, including the Virgin Islands.
So USVI Medicaid enrollees are not subject to the new work/community-engagement test or the disenrollment churn states will see. For Frederiksted Health Care, Inc. (the territory's FQHC on St. Croix, operating four sites) and the VI Department of Health's community health services, this avoids the coverage losses and administrative burden hitting mainland health centers, helping protect the Medicaid patient base.
The structural pressure on USVI remains its capped Section 1108 allotment rather than eligibility rules.
By patients (HRSA UDS 2024). Tap for the full profile.
| Organization | Patients | Sites | Uninsured | Revenue (990) | Resilience | District |
|---|---|---|---|---|---|---|
| Frederiksted Health Care Inc. Frederiksted | 8,976 | 5 | 21.37% | $21M | Stable | VI-98 |
| St Thomas East End Medical Center Corporation Charlotte Amalie East | 6,321 | 1 | 33.46% | $9M | Watch | VI-98 |
| District | Representative | Sites |
|---|---|---|
| VI-98 | Stacey E. Plaskett | 6 |
U.S. Virgin Islands ranks #52 by FQHC patients and #52 by organization count among the 57 national-breadth jurisdictions. All 2 centers depend on the federal Community Health Center Fund, authorized only through December 31, 2026.
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U.S. Virgin Islands directory
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FQHC data from the HRSA bulk-sites file + UDS 2024 + IRS 990. State policy profile via NACHC/KFF/AANP. Intelligence items cite primary sources. Federal items apply to all states; state items are U.S. Virgin Islands-only. Updated 2026-06-30.