Health and social Services in Puerto Rico before and after Hurricane Maria : predisaster conditions, hurricane damage, and themes for recovery / Anita Chandra, Terry Marsh, Jaime Madrigano, Molly Simmons, Mahshid Abir, Edward W. Chan, Jamie Ryan, Nupur Nanda, Michelle D. Ziegler, Christopher Nelson.

Format:

Book

Author/Creator:

Chandra, Anita, author.

Marsh, Terry, author.

Madrigano, Jaime, author.

Simmons, Molly, author.

Abir, Mahshid, author.

Chan, Edward W., author.

Ryan, Jamie, author.

Nanda, Nupur, author.

Ziegler, Michelle D., author.

Nelson, Christopher D., author.

Contributor:

Rand Corporation. Homeland Security Operational Analysis Center.

Rand Corporation.

United States. Federal Emergency Management Agency.

Series:

Research report (Rand Corporation) ; RR-2603-DHS.

[Research report] ; RR-2603-DHS

Language:

English

Subjects (All):

Public health--Puerto Rico.

Public health.

Hurricane damage.

Social service.

Puerto Rico.

Social service--Puerto Rico.

Hurricane damage--Puerto Rico.

Hurricane Irma, 2017.

Hurricane Maria, 2017.

Public Health.

Medical Subjects:

Public Health.

Puerto Rico.

Physical Description:

xxiv, 191 pages : color map ; 28 cm.

Place of Publication:

[Santa Monica, California] : HSOAC, Homeland Security Operational Analysis Center, 2020.

Summary:

In September 2017, Puerto Rico was struck by two major hurricanes-Irma and Maria-that intensified existing challenges in Puerto Rico's health and social services infrastructure. In the aftermath, the government of Puerto Rico created a long-term recovery plan built on an evidence-based assessment of the damage from the hurricanes and the ongoing needs across Puerto Rico. Development of the recovery plan was supported by the Federal Emergency Management Agency, other federal agencies, local stakeholders, and analysis from the Homeland Security Operational Analysis Center (HSOAC), operated by RAND Corporation under contract with the U.S. Department of Homeland Security. HSOAC research provided the foundation for the 31 courses of action in the recovery plan addressing the health and social services sector. These actions are a mix of social, governmental, fiscal, and economic policies and reforms. This collection of actions presents an opportunity to build a more resilient health and social services infrastructure and regional health care networks to ensure reliable access to services, promote health and well-being, and more efficiently and effectively respond to public health crises and future disasters. The actions span the areas of health care, public health and emergency preparedness, environmental health, mental and behavioral health, and social services. The damage and needs assessment and courses of actions cover four major themes: building system capacity to respond both during disasters and routine times; strengthening the health and social services workforce; strengthening support services for at-need populations; and creating health-promoting communities.

Contents:

1. Introduction

Puerto Rico's Challenge and Opportunity

Methodology

Organization of This Report

2. Puerto Rico's Health and Social Services Sectors Before the Hurricanes

Structure, Governance, and Assets

Key Assets

Key Challenges Facing the Health and Social Services Sector in Puerto Rico Before the Hurricanes

Chapter Recap

3. Damage and Needs Assessment

Health Care Infrastructure Damage

Health Impacts

Disruption of Social Services

Posthurricane Conditions as of March 2018

4. Themes for Recovery and Courses of Action

Health and Social Services Portfolio Development

Recovery Themes

5. Implementation Considerations

Key Data Gaps

Appendix A. Courses of Action

HSS 1 Increase Use of Solar-Powered Generators and Solar Backup Power Sources

HSS 2 Prevent Disease Through a Capacity-Building Healthy Housing Initiative: Targeting Mold, Lead, and Other Stressors

HSS 3 Implement Integrated Waste Management Program and Expand Programs to Increase Recycling Rates

HSS 4 Improve Surveillance of Waterborne Disease

HSS 5 Develop and Implement an Integrated Electronic Reporting System for Vital Records

HSS 6 Reduce Opportunities for Vector-Borne Diseases

HSS 7 Reduce Gap in Medicaid/Medicare Reimbursement Rate

HSS 8 Increase Public Health Laboratory Capacity

HSS 9 Increase Access to Telehealth Options as Telecommunication Supports Become More Robust

HSS 10 Expand Care for Trauma and Chronic Stress

HSS 11 Add Incentives and Other Supports to Increase and Retain Supply of Health Care Providers and Public Health Practitioners

HSS 12 Augment Community Health Centers and Elements for Primary Care and Chronic Disease Prevention and Management

HSS 13 Expand Practice Laws for Health Care Providers

HSS 14 Develop a More Robust and Resilient Data System of Health Costs and Links to Health Outcomes

HSS 15 Advance Uptake of Evidence-Based Practices/Quality of Care for Mental Health

HSS 16 Address Food Insecurity by Ensuring Flexible Nutrition Assistance Programs

HSS 17 Ensure That There Are Nutrition Supports for Populations Disproportionally Affected by the Disaster

HSS 18 Improve Programs to Prevent and Address Abuse of Children and Seniors After a Disaster

HSS 19 Create Flex-Funding for Social Service Centers

HSS 20 Improve Supports for Seniors, Particularly Those Living Alone

HSS 21 Improve Public Awareness of Proper Storage of Insulin Post-Disaster

HSS 22 Move to a More Regionally Integrated Approach to Emergency Planning, Exercising, Response, and Recovery

HSS 23 Review and Improve Systems and Processes for Managing Volunteers and Donated Supplies

HSS 24 Increase the Child Welfare Investigative Workforce

HSS 25 Establish a Collaborative Agreement Between PRDOF and WIC for Infant Formula Storage and Distribution

HSS 26 Review and Improve Systems for Stockpiling and Distributing Supplies and Pharmaceuticals Post-Disaster

HSS 27 Improve Current Epidemiological Surveillance to Better Respond to Natural and Man-Made Disasters

HSS 28 Support the Development of a Suicide Prevention Campaign

HSS 29 Revise Regulations on Food Stockpiling at Child- and Elder-Care Facilities

HSS 30 Review and Improve Plans, Systems, and Processes for Tracking and Responding to Physical and Mental Health Needs of First Responders

HSS 31 Review and Improve Systems for Administration and Finance of Response-Related Activities.

Notes:

"HSOAC, Homeland Security Operational Analysis Center."

Includes bibliographical references (pages 169-191).

See also RAND/RR-2595-DHS, RAND/RR-2597-DHS, RAND/RR-2598-DHS, RAND/RR-2599-DHS, RAND/RR-2600-DHS, RAND/RR-2602-DHS, RAND/RR-2604-DHS, RAND/RR-2605, RAND/RR-2606-DHS, RAND/RR-2607-DHS, RAND/RR-2608-DHS, RAND/RR-2856-DHS, RAND/RR-2858-DHS, RAND/RR-2859-DHS, RAND/RR-2861-DHS, RAND/RR-3040-DHS, RAND/RR-3041-DHS, RAND/RR-3042-DHS.

ISBN:

1977403212

9781977403216

OCLC:

1202435636

Publisher Number:

99986729342