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One Year after Hurricanes Irma and Maria, Recovery Has Progressed Slowly in Puerto Rico and the U.S. Virgin Islands and Health Care Challenges Remain, Particularly in Mental Health

One year after Hurricanes Irma and Maria made landfall, recovery has progressed slowly and unevenly in Puerto Rico and the U.S. Virgin Islands. The territories’ health care systems continue to face capacity, infrastructure and financial challenges even as health needs have increased, especially in mental health, according to two new reports from the Kaiser Family Foundation.

The reports, drawing upon interviews with government and health officials from both territories, public documents and data, and an online survey of 21 community health centers, find that providers in both territories have restored access to some services limited by hurricane damage, while other services remain closed. Provider shortages in nursing, certain subspecialties and especially in mental health present challenges in both territories. More than seven in ten (71%) health centers reported an increase in the number of patients they served.  Over eight in ten (86%) health centers reported an uptick in patients with depression and anxiety compared to before the hurricanes, and seven in ten reported that patients were more likely to have suicidal thoughts or attempts and alcohol or other substance use disorders.

Federal financing has been critical, stakeholders say. Territory health officials have used additional Medicaid funds from the February 2018 budget bill to support coverage and increase reimbursement rates, but they worry about the expiration of that financing in September 2019. Health care providers have found support from nongovernmental organizations and philanthropy helpful in moving recovery forward with less bureaucracy. Medicaid funding is the most important source of financing for health centers in both territories.

Hurricane Irma made landfall in the territories on September 6, 2017, while Hurricane Maria brought destruction just two weeks later on September 20th. The new KFF reports are:

The survey of community health centers was conducted by KFF and the Geiger Gibson Program in Community Health Policy at the George Washington University, with support from the RCHN Community Health Foundation. Visit our special topic page to see these and other KFF resources that examine various aspects of recovery efforts in the territories, including our recent public opinion poll Views and Experiences of Puerto Ricans One Year After Hurricane Maria.