Our partner highlight this month is Patient Assist VI, Inc. (PAVI), a patient advocacy organization that helps people to attain prescription drug medications that would otherwise be unattainable due to income limitations. Their services are offered at no charge to their patients. Since their inception in 2013, PAVI has obtained over $2.8 million worth medications for Virgin Island patients.

We spoke to Angela Beall, Executive Director of the Patient Assist VI.

How and why did Patient Assist VI begin?   

Our founder, Laurel Nuschke, has a pharmaceutical background and was assisting in her husband’s medical practice in St. Thomas. She observed that many people were not compliant with their medications due to a lack of health insurance and the inability to afford both their basic living expenses and their medication. Believing that families should not be forced to decide between paying for their basic needs and their medication, she started PAVI to help remove the financial and logistical barriers so people could become compliant with their medications and live healthier lives.

Let me share a little background on our community. We have a high number of uninsured people because private health insurance is very expensive and residents are not eligible to apply for health coverage in the Health Insurance Marketplace. If a person does not have insurance through their employer or business, it is unlikely that they will have it.

What services do you provide?

We offer patient advocacy services free of charge to individuals in need who are under a doctor’s care. This means working with patients’ physicians to attain necessary prescriptions and finding medications resources - pharmaceutical assistance programs, charitable foundations, drug discount programs, and charitable pricing at a local pharmacy. We meet with patients to determine their eligibility and help them gather necessary forms and signatures. We also help assist filling out an application for the medication since people may not have access to a computer or internet. At times, the process is complicated and time consuming. Although we are a U.S. Territory and all of our patients are U.S. Citizens or U.S. Residents, there are some patient assistance programs that exclude our islands.

How do people hear about PAVI?

Most of our patients are referred to us by their physicians and their staff who know the needs of their patients and our eligibility requirements and processes. The healthcare professionals are important partners and some actually allow us space in their offices to assist their patients. We also are getting a lot more referrals through word of mouth. Someone will be speaking to a relative or their neighbor or fellow church member and mention that they can’t afford their medication.

Can you describe your “typical” patient?

Our patients have been described as “the working poor” who are generally in a sector of the hospitality industry. We also have several retired patients whose only source of income is their monthly social security payment. The average age of our patients is 60, and they are landscapers, restaurant workers, fishermen, charter staff, retail clerks and fast-food workers. They work hard to help our island paradise run, but limited resources make it difficult for them to manage their chronic medical conditions.  Most of our referrals are for patients needing assistance with medications for diabetes, hypertension, high-cholesterol, and asthma. These are crucial for helping people stay at the lowest level of care for their conditions and reduce risk for serious complications (heart attacks, stroke, and amputations). Our staff at PAVI work hard to prevent more serious conditions since many medical complications still require treatment in the U.S.  Sadly, our hospitals are still not fully functional following the 2017 hurricanes, and there is a shortage of specialty physicians.

Angela Beall (far left) worked with partners from St. Thomas Recovery Team and Chelsea Drug Store to procure medication donations for COVID-positive households

How has the COVID-19 pandemic affected the clinic? It has been extremely tough for people. We are still recovering from the 2017 hurricanes; one major resort just reopened in January and two months later had to close again due to the pandemic. Patients who had returned to work in early 2020 and had just had their benefits reinstated after the hurricanes then lost those benefits again due to COVID. Another resort has yet to be rebuilt. This speaks to the level of destruction from the hurricanes and to the fact that we’re on an island so everything has to be imported which takes time and is expensive. Since many of our patients are connected with the hospitality industry, many people don’t have insurance or jobs.


How did your partnership with Rx Outreach begin?

Just a few of our patients received medication from Rx Outreach before the hurricanes. As you may know, in September 2017, two category 5 hurricanes, Irma and Maria, devastated our community with wind gusts up to 178 MPH. These are among the costliest hurricanes on record ($50 and $90 billion in damages). People lost their homes, jobs, and their security. Our infrastructure had been so decimated that buildings had to be completely torn down and before being rebuilt. Following the storms, Patient Assist VI joined the Preferred Clinic program so we could help more people who had lost their jobs and insurance and who were desperate to find free or affordable medication.  We love Rx Outreach because it is so easy to use. The prices are transparent and it saves us time not to have to worry about discount codes, pharmacy cards, or complicated paperwork. Of course, the free shipping is convenient. Our partnership with Rx Outreach is essential to fulfilling our mission and was a lifesaver following the storms.


Are you originally from St. Thomas?  No, I am from Bartlesville, Oklahoma, but my career in nursing and healthcare consulting brought me here six years ago. I started at PAVI as a Patient Advocate in 2018 and became the Executive Director last year.

Thank you for your important work, Angela, and for taking time to speak with me. What are ways that other people can support you and your mission?

We invite people to become a donor and support the patients of the US Virgin Islands. As a non-profit, donations to Patient Assist VI, Inc. (PAVI) are tax deductible.


If they do donate through this link, they will receive quarterly updates on how our organization and our patients are doing.