I remember distinctly one of my summer visits to Puerto Rico with my family when I was a teenager. We were sitting at the dining room table having lunch, and in mid-bite, I felt the ground rumble.
I thought it was the subway, forgetting for a moment that I was in Puerto Rico and not New York City. Everyone ran out the door, and as my uncle quickly returned to pull me outside, I saw the terror in his face.
I recall that terror as I think about my family and friends in Puerto Rico now.Still stricken by therecentearthquake and its aftershocks, morethan 8,000 residents are reportedly living in 40 shelters; neighborhoods and a school were destroyed, and thousands are sleeping in tents or inside cars.
For all these reasons, Puerto Ricans are at risk for mental trauma and PTSD.Two years ago, after Hurricane Maria, I witnessed firsthand the devastating impact a natural disaster can have on mental health.
I spent two weeks in Puerto Rico with a team from the Health Department as part of New York Citys hurricane relief missions.I remember the painful stories of children who fearfully clung to their parents when the sky grew cloudy, of Puerto Rican veterans who were reminded of war upon hearing helicopters surveying the damage.
Puerto Ricos connection to New York City is so profound. We will always be ready to support the Island.
Today, New York City First Lady Chirlane McCray announced the City is sending nine mental health experts to Puerto Rico to provide crisis counseling, emotional support, connections to mental health services, and help with coping with stressful events. This is in addition to the staffalready on the ground, which includes health professionals, building inspectors, engineers, and emergency managers to support the cities with the worst damage. Governor Cuomo alsopledgedto send extra mental health experts to Puerto Rico as part of the States emergency response.
But we need consistent support from the federal government. Pressured by Democratic leaderslast week, the Trump administrationdeclaredthat a major disaster exists in Puerto Rico, and finally approved the$8.2 billionalready owed in aid, plus an additional $8.3 billion funding notice. On Monday, Senator Chuck SchumerCharles (Chuck) Ellis SchumerPelosi says it was 'sad' to see McConnell 'humiliate' Chief Justice Roberts while presiding over witness vote Behind the scenes of McConnell's impeachment drama Fox's Chris Wallace: 'Every side is going to come out a winner' on impeachment MORE also rightlycalledfor Health and Human Services to release millions more in aid specifically for mental health providers and outpatient services.
The emergency aid will provide vital support, but temporary assistance is not nearly enough. To address this unprecedented mental health crisis, Puerto Rico needs a stronger Medicaid program.
Approximately 1.4 million low-income Puerto Ricans depend on Medicaid, and it is the largest payer for mental health services in the United States. Medicaidcoversinpatient and outpatient mental health services, counseling, case management, supportive housing, and prescription medications.
A key part of the problem is that Puerto Rico receives only a fixed block grant of funding for Medicaid each year that is grossly inadequate to cover the cost of health care for its enrollees.
Last month, Republican and Democratic members of Congress unveiled a massivebudget deal,which included $12 billion in Medicaid for Puerto Rico over four years enough to cover the Islands expenses. But in a devastating blow, President TrumpDonald John TrumpCoronavirus death toll rises to 304 in China Michael Moore: Clinton comments about Sanders 'divisive,' 'cruel' and 'a lie' Palestinian Authority cuts security ties with US, Israel following Trump peace plan announcement MORE intervened and reportedly demanded it is slashed to $5.7 billion over two years.
With another funding cliff looming in two years under the new agreement, Puerto Rico may continue to lack the certainty it needs to commit to long-term investment in Medicaid. Ultimately Congress should agree on a steady infusion of Medicaid funding for Puerto Rico to be on par with the mainland states.
No matter what the federal government does, New Yorkers will do everything possible tosupport Puerto Rico during this mental health crisis, so those remaining on the Islandeither by choice or lack thereof have the same opportunity and security as we do.
Oxiris Barbot is New York Citys Health commissioner.
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