Puerto Rico’s children need recovery funds

Hurricane Maria made landfall and caused horrific damage in Puerto Rico and the U.S. Virgin Islands on Sept. 20, 2017. The historic storm caused widespread destruction to critical infrastructure throughout these islands.

Now, 18 weeks after landfall, many people, including children, still lack access electricity and clean water, among other necessities. The damage has been so great that people are leaving Puerto Rico in record numbers. From Oct. 3, 2017 to Jan. 3, 2018, more than 297,000 individuals have arrived in Florida, according to the Florida Division of Emergency Management.

{mosads}As is the case in most disasters, even once the immediate threat goes away, the public health and environmental health issues persist. This is certainly the case in Puerto Rico. Numerous challenges, such as a lack of clean, reliable, drinking water to the widespread occurrence of mold compound recovery efforts. Adding to these challenges is the significant loss of the health workforce. Of the 15,000 doctors who were on the island when Maria made landfall, only 9,000 remain.

As documented by Child Care Aware of America during a recent visit, the children of Puerto Rico and the U.S. Virgin Islands continue to feel the after effects of Hurricane Maria. On the islands, many are unable to return to child care or school due to a lack of power. While some schools are open, many are only operating for a few hours — they dismiss children in the early afternoon as the buildings become too hot to house them.

For those who have left the islands they are struggling to adapt to a new environment, new friends, a new climate and a new lifestyle. Their sense of comfort and familiarity has been taken away, which can lead to lower educational and developmental outcomes if not properly and quickly addressed.

As of early November, Connecticut had more than 600 schoolchildren from Puerto Rico enroll in school. As of December, Florida school districts have enrolled more than 11,200 displaced students from Puerto Rico and the Virgin Islands.

Suddenly accommodating an influx of children, especially those that have gone through a tragic event, is extremely challenging and special efforts must be made to ensure these children receive care, compassion, and a safe and stable environment.

Given the slow progress of recovery on the islands, decisive legislative action is needed to address these challenges and support those in need.

In October, Congress appropriated $36.5 million for storm relief, however that money also included hurricane recovery support for Texas and Florida as well as wildfire recovery funding for California. More funding is needed to sustain recovery efforts in Puerto Rico and the U.S. Virgin Islands. And, in recent weeks, members of Congress have become increasingly vocal about the need for additional support.

Congress members from Connecticut and Florida, which both have seen a high influx of Puerto Rican residents per capita since the hurricane, have done the following:

• Rep. Rosa DeLauro (D-Conn.) hosted a Congressional Briefing, “Sheltering Babies from the Storm: Infants, Toddlers, and Families in the Hurricanes’ Aftermath.”
• Sen. Chris Murphy (D-Conn.) called for congressional hearings to examine public health and education recovery challenges..
• Representative Darren Soto (D-Fla.) recently announced a regional task force to address the needs of Puerto Rican evacuees in Central Florida.  
• Sens, Bill Nelson (D-Fla.) and Marco Rubio (R-Fla.) have urged the U.S. Department of Health and Human Service to more aggressively respond to the public health and environmental health issues facing Puerto Rico.

Senator Bernie Sanders (I-Vt.) also introduced a bill for $146 billion relief for Puerto Rico. The plan would encourage investment in renewable power, such as solar and wind, and would provide funding for health care, education and transportation.

In December, the House passed HR 4667, making further supplemental appropriations through September for disaster assistance for Hurricanes Harvey, Irma, and Maria, as well as 2017 wildfires.

A total of $81 billion would be provided as aid, with $27.6 billion slated for the Federal Emergency Management Agency (FEMA), an additional $26.1 billion for Community Development Block Grants, and $12.11 billion for the Army Corps of Engineers. The package would also include an additional $650 million to the Administration for Children and Families to support Head Start programs impacted by Hurricanes Harvey, Irma or Maria.

The House-passed bill provided nearly double what was requested by the administration. However, the Senate criticized the funding for Puerto Rico recovery efforts and the bill’s failure to address the impending shortage of Puerto Rico’s Medicaid program. Providing additional funds to Medicaid is not unprecedented following a disaster. After Hurricanes Katrina and Rita, Congress provided additional Medicaid funding to Louisiana and Mississippi.

Nelson criticized the bill’s requirement for Puerto Rico to pay for 10 to 25 percent of recovery dollars, which is a tough sell given the island’s financial status.

Looking ahead, it seems a standalone bill will not be the answer. Under the current climate, Congress will likely attempt to include disaster aid within the larger government funding effort, which must be passed by Jan. 19 to avoid a governmental shutdown.

The National Coalition on Children and Disasters, a coalition of child-serving national organizations, has publicly asked Congress to prioritize children and families without offsets to programs that help low-income children, families and individuals.

The coalition suggests the following legislative actions to better protect children:

• Modify current law so that for-profit child care, early learning facilities and pediatrician offices can be eligible for federal recovery assistance to rebuild.
• Allow for federal assistance to support rebuilding schools and childcare facilities that are designed to withstand the growing intensity and frequency of extreme weather events and escalating flood risks in a changing climate.
• Increase Medicaid block grant funding for Puerto Rico, as well as its Medicaid federal matching rate.
• Provide additional resources and sufficient funding for the Social Services Block Grant and the Community Development Block Grant to assist with repairing and rebuilding child care facilities.
• Provide supplemental funds to Puerto Rico’s Nutrition Assistance Program (NAP) so that all eligible individuals and families can access food assistance.
• Waive match and cost share requirements for Puerto Rico for all rebuilding projects and FEMA assistance programs.

In Puerto Rico the unofficial moto has become “Puerto Rico se levanta,” which roughly translates to Puerto Rico rises. Indeed, Puerto Rico will rise again, however, that long process will require support and commitment from the mainland.

Andrew Roszak, JD, MPA, EMT-P, serves as the senior director for emergency preparedness at Child Care Aware of America. He’s worked at the National Association of County and City Health Officials, MESH Coalition and the Health and Hospital Corporation of Marion County, Indiana. Roszak was also a senior advisor for the U.S. Department of Health and Human Services; on the Budget and HELP Committees of the United States Senate; and at the Illinois Department of Public Health. Find him on Twitter: @AndyRoszak.