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ENG timeline - registro de impedidos
CPI PR
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2015
One Step Forward, One Step Back
Source: Record of emails obtained by the CPI through litigation • Graph by Gabriela Carrasquillo Piñeiro
Official launch of emPOWER Program, a platform that provides data on Medicare beneficiaries who are electricity-dependent. The goal is for states, territories, and their allies to use the information to prepare for and respond to natural disasters. In an email, the federal Department of Health and Human Services (HHS) contends that it sent aggregated information on these patients monthly to state and territory officials, including Jessica Cabrera, former director of the Department of Health's Office of Preparedness and Response Coordination.
Hurricane seasons
Feds allege they sent data
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2016
Source: Record of emails obtained by the CPI through litigation • Graph by Gabriela Carrasquillo Piñeiro
One Step Forward, One Step Back
Hurricane seasons
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February 15, 2017
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Shirley Esquilin, then a project manager in the Office of Preparedness and Response Coordination, communicates to a group of DS employees the requirements for obtaining funding from various federal initiatives. One requirement is sharing information about at-risk populations using the emPower platform.
Puerto Rico Department of Health (DOH) obtained funds that required identifying the vulnerable
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20XX - An awesome title here
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90% of the information we assimilate comes to us through sight. Tell stories with graphics!
Source: Record of emails obtained by the CPI through litigation • Graph by Gabriela Carrasquillo Piñeiro
One Step Forward, One Step Back
July 28, 2017
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The DOH conducted a drill to test its hurricane emergency plan and the use of a platform for information sharing during disasters.The exercise report indicates that the WebEOC tool was not ready for use, that most of the agency's Office of Preparedness and Response Coordination employees were new and unfamiliar with the plans, and that coordinators were not knowledgeable about the concepts of special needs populations, such as electricity-dependent.
Hurricane seasons
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2016
Clear sign of lack of preparedness
20XX - An awesome title here
Contextualize your topic with a subtitle
90% of the information we assimilate comes to us through sight. Tell stories with graphics!
Source: Record of emails obtained by the CPI through litigation • Graph by Gabriela Carrasquillo Piñeiro
One Step Forward, One Step Back
September 5, 2017
HHS officials hold a telephone meeting with Alexander Quevedo, chief information officer of the Puerto Rico Department of Health, and Antonio Cisco, former Coordinator of Medical Informatics, in preparation for Hurricane Irma. They talk about identifying people receiving oxygen therapy and bedridden people with the emPOWER platform. That same day, the Administration for Strategic Preparedness and Response, attached to HHS, acquired emPOWER data to identify and mobilize dialysis patients from the U.S. Virgin Islands and transfer them to Puerto Rico after Hurricane Irma. The entity consults and copies messages about this mobilization to Jessica Cabrera, who cooperated with the initiative.
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DOH knew it could use emPOWER Program before hurricanes Irma and Maria to help save lives
20XX - An awesome title here
Contextualize your topic with a subtitle
90% of the information we assimilate comes to us through sight. Tell stories with graphics!
Source: Record of emails obtained by the CPI through litigation • Graph by Gabriela Carrasquillo Piñeiro
One Step Forward, One Step Back
Hurricanes Irma and Maria
September 20, 2017
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Most vulnerable neglected during worst disaster
20XX - An awesome title here
Contextualize your topic with a subtitle
90% of the information we assimilate comes to us through sight. Tell stories with graphics!
Hurricane María caused some 3,000 direct and indirect victims, mainly due to the interruption of electrical services.DOH did not use the emPOWER platform to identify electricity-dependent individuals to provide assistance, HHS told CPI.The report evaluating the local Health Department's actions following Hurricanes Irma and Maria argued that the agency must improve preparedness and establish medical shelters because electricity-dependent individuals began arriving at emergency rooms due to the lack of electricity to connect their equipments. HHS Office of Inspector General subsequently concluded that the DOH “put at risk” the health and safety of Puerto Ricans by not implementing a preparedness protocol, which should have included initiatives to protect the sick, children and elderly, among others.
Source: Record of emails obtained by the CPI through litigation • Graph by Gabriela Carrasquillo Piñeiro
One Step Forward, One Step Back
Hurricanes Irma and Maria
October 18, 2018
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As if it were something she had just learned about, Jessica Cabrera tells her team in an email that she attended a talk in which they urged them to use emPOWER to do analysis and disseminate data to municipalities and coalitions that support the DOH. A month later, the agency requested a meeting with Kristen Finne, director of emPOWER, to explain how to use the tool.
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Amnesia at the DOH
Contextualize your topic with a subtitle
Source: Record of emails obtained by the CPI through litigation • Graph by Gabriela Carrasquillo Piñeiro
One Step Forward, One Step Back
Hurricanes Irma and Maria
March 10, 2019
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Another drill begins to test the DOH's response, in conjunction with other public and private actors, to a category five hurricane that would cause infectious diseases, chemical spills, and radiological accidents. The after-action report of this exercise indicates that agency employees needed more basic information on the special needs population, ignored them during planning, and demonstrated difficulties in orienting other participants in managing these patients. It had been almost a year and a half since the deaths caused by Hurricane María, and almost two years since a drill that pointed out the same deficiencies.
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Hurricane seasons
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Lack of preparation is not addressed
20XX - An awesome title here
Contextualize your topic with a subtitle
90% of the information we assimilate comes to us through sight. Tell stories with graphics!
Source: Record of emails obtained by the CPI through litigation • Graph by Gabriela Carrasquillo Piñeiro
One Step Forward, One Step Back
Hurricanes Irma and Maria
August 26, 2019
Mónica Castellano, a plan specialist in the Office of Preparedness and Response Coordination, asks the director of emPOWER what the process is for obtaining identified information on electricity-dependent patients in the event of an emergency. Two days later, DOH made the first request for such data in the face of the possible arrival of Hurricane Dorian, which moved away from Puerto Rico without causing significant damage.
First request for identified data
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Hurricane seasons
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2024
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2020
2018
3,440
2016
20XX - An awesome title here
Contextualize your topic with a subtitle
90% of the information we assimilate comes to us through sight. Tell stories with graphics!
Source: Record of emails obtained by the CPI through litigation • Graph by Gabriela Carrasquillo Piñeiro
One Step Forward, One Step Back
Storm Karen
Hurricanes Irma and Maria
Earthquake
January 7, 2020
A 6.4 magnitude earthquake affects southwestern Puerto Rico, causing a general power outage. The mayors of Ponce, Guánica, and Yauco, some of the most affected municipalities, state that they did not have lists of their electricity-dependent patients. DOH receives data identified through emPOWER, after federal official Kristen Finne explained that the agency could share it with municipal officials who sign federal medical data exchange agreements. But the local health department did not. It visited only 262 homes, making referrals for government services for half of the patients. That response was limited: there were more than 2,391 electro-dependents in those municipalities in 2020, according to emPOWER. The earthquake after-action report indicates that patients with special needs ended up in makeshift shelters because they did not know where they could receive services.
DOH did not share information
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Hurricane seasons
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2020
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2018
2016
20XX - An awesome title here
Contextualize your topic with a subtitle
90% of the information we assimilate comes to us through sight. Tell stories with graphics!
Storm Karen
Hurricanes Irma and Maria
Earthquake
Source: Record of emails obtained by the CPI through litigation • Graph by Gabriela Carrasquillo Piñeiro
One Step Forward, One Step Back
July 28, 2020
DOH begins acquiring the identified emPOWER data in the face of a potential tropical cyclone. Once again, Kristen Finne confirms to the local health department that it can share the data with municipal officials who join federal data-sharing agreements and receive HIPAA training.
HHS reiterates that the identified data can be shared
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Hurricane seasons
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2020
2018
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2016
20XX - An awesome title here
Contextualize your topic with a subtitle
90% of the information we assimilate comes to us through sight. Tell stories with graphics!
Storm Karen
Hurricanes Irma and Maria
Earthquake
Source: Record of emails obtained by the CPI through litigation • Graph by Gabriela Carrasquillo Piñeiro
One Step Forward, One Step Back
February 16, 2021
Officials from the Office of Preparedness and Response Coordination are developing a work plan to expand the emPOWER database (which does not collect details on all electricity-dependent persons) to include patients receiving health plan services from government and private insurers. This plan calls for municipal emergency management offices to be trained on HIPAA and how to use emPOWER during disasters.
DOH seeks to resolve emPOWER limitations
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2020
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2016
20XX - An awesome title here
Contextualize your topic with a subtitle
90% of the information we assimilate comes to us through sight. Tell stories with graphics!
Storm Karen
Hurricanes Irma and Maria
Earthquake
Source: Record of emails obtained by the CPI through litigation • Graph by Gabriela Carrasquillo Piñeiro
One Step Forward, One Step Back
September 18, 2022
Shirley Esquilín, who became director of the Office of Preparedness and Response Coordination, emailed her agency employees to tell them the agency could not share identified data with municipal officials during the response to Hurricane Fiona. But the DOH's own planning expert, Mónica Castellano, had told her a year earlier that the agency did not have the staff to visit the thousands of electricity-dependent patients in Puerto Rico, so it had to train and share information with municipal emergency management offices so they could collaborate with the response.
Agency clung to retaining information during Fiona
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Hurricane seasons
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7,250
2024
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2020
2018
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2016
20XX - An awesome title here
Contextualize your topic with a subtitle
90% of the information we assimilate comes to us through sight. Tell stories with graphics!
Hurricane Fiona
Storm Karen
Hurricanes Irma and Maria
Earthquake
Source: Record of emails obtained by the CPI through litigation • Graph by Gabriela Carrasquillo Piñeiro
One Step Forward, One Step Back
October 16, 2023
The DOH told the CPI that once it receives emPOWER data with identifiers, it shares it with the Emergency Operations Center of the Bureau of Emergency and Disaster Management, which in turn distributes it to municipal officials who have a role during the response.
DOH 180-degree turnaround
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Hurricane seasons
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2024
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2022
2020
2018
3,440
2016
20XX - An awesome title here
Contextualize your topic with a subtitle
90% of the information we assimilate comes to us through sight. Tell stories with graphics!
Storm Karen
Hurricanes Irma and Maria
Earthquake
Source: Record of emails obtained by the CPI through litigation • Graph by Gabriela Carrasquillo Piñeiro
One Step Forward, One Step Back
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9,280
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August 1, 2024
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Hurricane Fiona
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Almost a year later: “The Department of Health is not authorized by the federal government to share patient-identified data with entities that do not comply with the requirements set forth in the DUA. As we have previously reiterated, individually identifiable patient information is protected by HIPAA,” the agency alleges in a communication sent to the CPI.
DOH retracts when asked if it has shared data with city officials
3,440
Hurricane seasons
2024
2022
2020
2018
2016
20XX - An awesome title here
Contextualize your topic with a subtitle
90% of the information we assimilate comes to us through sight. Tell stories with graphics!