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Rural Health
Resources by State: Puerto Rico

Twenty Years of School-Based Health Care Growth and Expansion
Examines the status of school-based health centers (SBHCs) and changes from 1998-2017. Includes data on the number of rural SBHCs over time, telehealth-exclusive SBHCs, sponsorship of SBHCs by Federally Qualified Health Centers (FQHCs), the number in each state, funding sources, populations served, types of healthcare provided, and more.
Author(s): Hayley E. Love, John Schlitt, Samira Soleimanpour, Nirmita Panchal, Caroline Behr
Citation: Health Affairs, 38(5), 755-764
Date: 05/2019
Type: Document
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Medicaid Financing Cliff: Implications for the Health Care Systems in Puerto Rico and USVI
Issue brief providing an overview of the status of healthcare systems and Medicaid programs in Puerto Rico and the U.S. Virgin Islands (USVI) a year and a half after hurricanes hit the islands in September 2017. Focuses on challenges and includes an analysis of the implications for the islands' Medicaid finances, as most of the temporary disaster relief funding is set to expire in September 2019. Features statistics on the two territories' past and projected Medicaid spending.
Author(s): Robin Rudowitz, Cornelia Hall, Barbara Lyons
Date: 05/2019
Type: Document
Sponsoring organization: KFF
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Disaster Exposure and Mental Health Among Puerto Rican Youths After Hurricane Maria
Results of a survey administered to 96,108 public school students between February and June 2018. Features statistics including percentage by educational region of students reporting exposure to stressors that warrant mental health services.
Author(s): Rosaura Orengo-Aguayo, Regan W. Stewart, Michael A. de Arellano
Citation: JAMA Network Open 2(4)
Date: 04/2019
Type: Document
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Medicaid in the Territories: Program Features, Challenges, and Changes
Issue brief examining key issues and trends in the Medicaid program for Puerto Rico, the U.S. Virgin Islands, the Northern Mariana Islands, Guam, and American Samoa, using findings drawn from a budget survey and interviews with Medicaid officials. Focuses on Medicaid financing, eligibility and enrollment, benefits, provider access and delivery systems, and the changes from fiscal years 2017 to 2019. Features statistics including Medicaid and Children's Health Insurance Program enrollment as of July 2016, and Medicaid funding and spending in these territories as of fiscal year 2017.
Author(s): Cornelia Hall, Robin Rudowitz, Kathleen Gifford
Date: 01/2019
Type: Document
Sponsoring organization: KFF
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One Year after the Storms: Recovery and Health Care in Puerto Rico and the U.S. Virgin Islands
Issue brief describing status of the recovery in Puerto Rico and the U.S. Virgin Islands, following the September 2017 hurricanes. Draws on public reports and interviews conducted in July and September 2018 and earlier work focusing on the territories' status 6 months after the storms.
Author(s): Cornelia Hall, Robin Rudowitz, Samantha Artiga, Barbara Lyons
Date: 09/2018
Type: Document
Sponsoring organization: KFF
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Vital Signs: Zika-Associated Birth Defects and Neurodevelopmental Abnormalities Possibly Associated with Congenital Zika Virus Infection — U.S. Territories and Freely Associated States, 2018
Focuses on children one year of age or younger born in the U.S. territories and freely associated states whose mothers had laboratory evidence of confirmed or possible Zika virus infection during pregnancy and who had follow-up care reported. Reports data on Zika-associated birth defects and neurodevelopmental abnormalities possibly associated with congenital Zika virus infection.
Author(s): Marion E. Rice, Romeo R. Galang, Nicole M. Roth, et al.
Citation: MMWR (Morbidity and Mortality Weekly Report), 67(31), 858-867
Date: 08/2018
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Health Care in Puerto Rico and the U.S. Virgin Islands: A Six-Month Check-Up After the Storms (Report)
Overview of the status of recovery after Hurricanes Irma and Maria in September 2017, with emphasis on the condition of healthcare systems. Draws on interviews with key stakeholders and residents, and public reports.
Author(s): Samantha Artiga, Cornelia Hall, Robin Rudowitz
Date: 04/2018
Type: Document
Sponsoring organization: KFF
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Zika in Babies in US Territories
Provides an overview of the Zika infection in pregnancy and its impact on babies. Focuses on babies born in American Samoa, the Federated States of Micronesia, Puerto Rico, the Republic of Marshall Islands, and the U.S. Virgin Islands. Identifies what health departments, healthcare providers, and parents can do.
Additional links: Fact Sheet, Video
Date: 2018
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Puerto Rico's Community Health Centers: Struggling to Recover in the Wake of Hurricane Maria
Highlights the importance of Puerto Rico's 86 mostly rural Federally Qualified Health Centers (FQHCs) and details the challenges they face as they recover from Hurricane Maria. Also provides demographic and health status/coverage information for Puerto Rico's health center patient base.
Author(s): Peter Shin, Jessica Sharac, Rachel Gunsalus, Brad Leifer, Sara Rosenbaum
Date: 11/2017
Type: Document
Sponsoring organizations: Geiger Gibson Program in Community Health, RCHN Community Health Foundation
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Pregnancy Outcomes After Maternal Zika Virus Infection During Pregnancy — U.S. Territories, January 1, 2016-April 25, 2017
Provides data on Zika virus infection in pregnant women and outcomes in their fetuses and infants in the U.S. territories of American Samoa, Puerto Rico, and U.S. Virgin Islands and the U.S. freely associated states of Federated States of Micronesia and Marshall Islands.
Author(s): Carrie K. Shapiro-Mendoza, Marion E. Rice, Romeo R. Galang, et al.
Citation: MMWR (Morbidity and Mortality Weekly Report), 66(23), 615-621
Date: 06/2017
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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