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TCI Hospital restructures the Emergency Department Triage Process

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#Providenciales, January 10, 2019 – Turks and Caicos – Turks and Caicos Islands Hospital has restructured the process for triage in the Emergency Department to create faster access to medical care for patients and more efficient use of resources.

The restructured approach features a moderate adjustment to the current process whereby a clinician will be a patient’s first point of contact. Walk-in patients will be required to undergo triage prior to visiting the Patient Services desk. The new process is scheduled to commence at Cheshire Hall Medical Centre and Cockburn Town Medical Centre on January 11, 2019 and February 4, 2019, respectively.

Patients will be called by a triage nurse in the order of arrival and clinically assessed. Patient verification and registration will also be conducted during the triage assessment. Each patient is assigned a CTAS triage score, which may range from Level 1 to 5. The Canadian Triage Acuity Scale (CTAS) is a five level scale with Level 1 (Resuscitation) representing the most critical patients and Level 5 (Non urgent) representing the least ill.

Any patient requiring urgent intervention (CTAS 1 and 2) will be accompanied to an assessment room or the Rhesus room and treatment initiated immediately. These patients will be registered during treatment. Other patients will continue to be prioritized and seen by a doctor based on the severity of their condition (CTAS Score). The triage nurse will direct ambulatory patients (CTAS 3) to the Patient Services desk to complete the NHIP-eligibility verification and payment process, and then wait to be seen by an emergency doctor.

Non-urgent patients (CTAS 4 and 5) may be transferred to the Outpatient Department or Ministry of Health Primary Health Care clinic, which is located on the hospital property. The clinical transfer is also dependent upon the type of resources required to treat the condition. As a result, some non-urgent cases may remain in the Emergency Department.

Once the Ministry of Health clinics are closed, all patients will be registered and treated in the Emergency Department or Outpatient Department in accordance with their triage score and a payment (co-pay fee or private fees) shall be applied. Payment also applies to any patient transferred to the hospital’s Outpatient Department.

The Emergency Department at Turks and Caicos Islands Hospital treats cases of various acuity levels, including benign conditions that can be treated by a primary care doctor. Patients are therefore encouraged to consider the seriousness of an illness or injury in advance and determine the most beneficial and appropriate place for care, where possible. Primary care clinics operated by the TCI Government Ministry of Health are primarily free of charge and are open during extended hours.

Medical conditions suitable for treatment at a primary care clinic include common illnesses, such as colds, the flu, earaches, sore throats, migraines, low-grade fevers, prescription refills and limited rashes. Minor injuries, such as sprains, back pain, minor cuts and burns, minor broken bones, or minor eye injuries. Patients are encouraged to visit the Primary Health Clinics directly during their opening hours.

Patients should visit the emergency department for emergency and urgent complaints such as: Trouble breathing; Unresponsive and not breathing; Suddenly not able to speak, see, walk, or move; Suddenly weak or drooping on one side of the body; Sudden confusion; Heavy bleeding; Severe allergic reaction with trouble breathing, swelling, hives; High fever with headache and stiff neck; High fever that does not get better with medicine; Poisoning or overdose of drug or alcohol and Seizure. The symptoms above are not a complete, specific listing, but rather guidelines.

 

Press Release: InterHealth Canada

 

 

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TCI Governor’s Office Reports on Meeting with TCI Officials and the US Congressional Delegation

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Press Release

 

#TurksandCaicos, May 20, 2024 – This morning, Her Excellency the Governor Dileeni Daniel-Selvaratnam and the Honourable Premier Charles Washington Misick received a US Congressional delegation at the Governor’s Office, Providenciales, following a request for a meeting to discuss the recent arrests of US nationals for possession of ammunition offences.

The US delegation raised five cases of US nationals currently before the courts, concern for their well-being and clarification on the legal process. In order to maintain the integrity of the legal process, the Governor confirmed it would not be appropriate to facilitate the delegation’s request to meet with the Chief Justice.

The Governor and the Premier confirmed – as per the constitutional separation of the executive and judicial branches – they cannot intervene nor comment on ongoing legal cases before the courts. They explained that the Turks and Caicos Islands have clear laws prohibiting the possession of firearms and/or ammunition and strict penalties are in place to serve and protect all who reside and visit the Turks and Caicos Islands.

The Hon. Attorney General confirmed possession of firearm and/or ammunition offences carry a mandatory minimum custodial sentence of twelve years plus a fine. Where the court finds there are exceptional circumstances, the sentencing judge does have discretion, under the law, to impose a custodial sentence and a fine that are fair and just in the circumstances of each case rather than impose the mandatory minimum.

Noting that it is for defence counsel to ensure all relevant information is put before the court. The UK Government’s Foreign Commonwealth and Development Office representative who was in attendance at the meeting affirmed that the UK Government cannot comment or intervene in an ongoing legal case and that as a British Overseas Territory, the UK have full confidence in the operation of the courts of the Turks and Caicos Islands.

The Governor and Premier appreciated that the circumstances for US nationals who find themselves in this position can be difficult but were aware that US officials are providing consular support to each of the individuals. They noted that the Turks and Caicos Islands law enforcement agencies apply professional standard operating procedures for processing matters through the legal system and that they will investigate any concerns where it was felt standards were not met.

The Governor and Premier noted the prohibited items of ammunition were not identified at US departure screening; and the responsibility of travellers to ensure their baggage is free of firearms and/or ammunition prior to travel to the Turks and Caicos Islands.

They noted that the National Security Council keeps under review the operational effectiveness of legislative provisions that underpin internal and border security. The meeting concluded with both parties recognising continued Turks and Caicos Islands – United States partnerships to tackle shared threats in the region.

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US CONGRESSIONAL DELEGATION

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#TurksandCaicos, May 20, 2024 – The Governor’s Office can confirm that Her Excellency the Governor Dileeni Daniel-Selvaratnam and the Honourable Premier Charles Washington Misick will this morning receive a US Congressional delegation, who have requested a meeting to discuss the recent arrests of US nationals for possession of ammunition offences.

The US delegation, which arrived yesterday evening, was met by Protocol officials and is due to depart this afternoon.

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Eleven Senators, Three Governors make appeals for Leniency; Five Americans now face 12 Years in Prison

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Deandrea Hamilton                                                                                                                              

Editor

 

#TurksandCaicos, May 20, 2024 – US law makers are going to bat bigtime for their citizens detained in the Turks and Caicos for breach of the firearms ordinance, a congressional delegation arrived on Sunday for talks on an amicable  conclusion in the controversial court matters.

Here for a meeting set to take place today,   the congressional delegation is led by Senator Markwayne Mullin.

Five tourists are facing the 12 year minimum for possession of bullets, they say were inadvertently left in their checked baggage, but they can get a lesser sentence if the judge rules that it is warranted under the ‘Exceptional Circumstances’ clause in the Firearms Ordinance, newly amended and stiffened in 2022.

Eleven U.S. Senators and three State Governors have addressed letters to the TCI government beckoning for leniency in the cases of American citizens charged and detained for breach of Turks and Caicos gun laws which strictly prohibit the possession of unregistered firearms or ammunition; an infraction which carries with it a penalty of 12 years imprisonment.

It became known that at least one governor was communicating with Daleeni Daniel- Selveratnam, Turks and Caicos Governor about the unsettling situation.

J Kevin Stitt, Governor of Oklahoma appeared on television vocalizing his thoughts, calling the mandatory 12 year sentence “absurd.”  His letter for leniency was endorsed by Josh Shapiro, Governor of Pennsylvania and Glenn Youngkin, the Governor of Virginia.

“We humbly ask that your government – in its wisdom – temper justice with mercy and recognize that these made mistakes but had no apparent malicious intent,” states the May 14th letter signed by all three governors.

Twelve days before, Senators had already expressed their dire concern in correspondence dated May 2nd.

Magnetic Media obtained that letter which 11 senators have supported; their dispatch issued to the Attorney General of the Turks and Caicos, Rhondalee Braithwaite-Knowles, KC.

Senators Markwayne Mullin, Oklahoma; Robert P. Casey Jr, Pennsylvania; Mark Warner, Virginia; Tim Kaine, Virginia; James Lankford, Oklahoma; Michael Cloud, Texas; John Fetterman, Pennsylvania; Bob Good, Virginia; Guy Reschenthaler, Pennsylvania; Josh Brecheen, Oklahoma and former presidential contender, Ted Cruz of Texas boldly signed the document, with strong words for the TCIG.

“We do not discount the fact that the authorities in Turks and Caicos take the presence of unspent ammunition cartridges seriously to prioritize the safety of its civilians. However, based on our relationships and understanding of the circumstances of these American citizens, we strongly urge you to exercise leniency when reviewing their cases.”

Both letters point to the current good relationship between the Turks and Caicos and the United States as the reason to have the cases of Michael Lee Evans, 72 of Texas; Bryan Hagerich, Pennsylvania; Tyler Wenrich, 31 of Virginia and Ryan Watson, 40 of Oklahoma come to a reasonable conclusion.

Since Monday May 13, added to the four men and despite the media attention and US State Department warnings, Sharitta Grier, 45 of Orlando, Florida was arrested, sentenced and is now out on bail on near identical charges.

She is the fifth American held in recent months for the discovery of ammunition upon departure of the islands.

Grier, was on Thursday May 16 arraigned for allegedly having two bullets in her baggage; detected as she was exiting the Turks and Caicos following a Mother’s Day getaway with her daughter.  By Friday, bail had been granted to the woman who is still expressing shock at the gravity of the consequences; a dozen years in a Grand Turk prison.

A week earlier, a Thursday May 8, media release by the Turks and Caicos National Security Council informed of the Attorney General’s report to the group, which included the Premier, Minister of Tourism and Governor on the nuances of the legislation, according to a recent Court of Appeal decision.

“The Attorney-General, in respect of the law applicable to the cases against US Nationals on charges relating to the possession of ammunition, confirmed that an Attorney General’s Reference to the Court of Appeal certified that where a court finds there are exceptional circumstances, the sentencing judge has discretion under the law, to impose a custodial sentence and a fine that are fair and just in the circumstances of each case rather than impose the mandatory minimum. The Chief Justice is advancing sentencing guidelines in this respect.”

On Sunday, Senator Mullin of Oklahoma landed in Provo, with him:  “Rep. Reschenthaler of Pennsylvania; Rep. Good of Virginia; Rep. Brecheen of Oklahoma and Rep. Cloud of Texas.  They have a few staff members and an escort of four marines.  They will be in meetings all day. We are hoping for an agreeable resolution today,” explained a source close to the senate.

We’ve also learned that the Governor of Florida, Ron DeSantis may climb aboard this train in the name of reasonable justice after Floridian, Sharitta Shiniee Grier was last week charged.

On social media, Grier has opened up about her arrest.

“Once the police cuffed my leg to a chair and left me in a room by myself I started crying out to the Good Lord, saying I know you are real but I need you to move for me, right now!  I need you to show me a sign that I’m going to be alright.”

Grier explains that before she could wipe away tears, “Mrs. Susan and her husband My Pop Pop” turned up, came to check on her while in police custody and are now lending her moral support.

Court correspondent Wilkie Arthur informed that during Grier’s arraignment, the courtroom was filled with some of the other Americans accused and their families; in her post, she called Ryan (Hagerich) and Bryan (Watson), both men who share a vacation villa as they await verdicts in their bullet possession matters, her ‘brothers.’

“I know it was God who placed them in my life.  They have a heart of gold, just like me and I love them. We are family forever.”

It is this kind of solidarity that the defendants hope will work in their favour as their Representatives have reportedly taken advocacy to a new level; landing at the private airport in Providenciales on Sunday to – in person – make appeals on behalf of the five Americans with the hope of seeing them avoid the lengthy prison term mandated by TCI law.

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