Puerto Rico
- Thread starter Jaw
- Start date
Jaw
It's OVER 5,000!
Ah I remember that article. It was prompted by Hillary's tweet:
[tw]911984783194050560[/tw]
I wanted a more informed opinion than that of a politician or some yahoo who partied their way through Journalism school, so I went looking and found this:
But to look at the larger context of the entire relief operation, I decided to talk to someone whose experience rivals that of General Honore: retired Navy Captain Jerry Hendrix. Now a senior fellow with the Center for a New American Security, Hendrix served for decades both on the high seas and in high-level staff jobs, including with the Chief of Naval Operations' Executive Panel and the Office of the Undersecretary of Defense for Policy's Irregular Warfare Quadrennial Defense Review. Few people know more about military history than Hendrix, who has degrees from Purdue, Harvard, the Naval Postgraduate School and a Ph.D. from Kings College in London. Little wonder that in 2012 was named the service's director of naval history.
I figured a guy with those credentials might fit the criteria I was looking for, but I wasn't sure yet. Would his naval experience be useful here, or at least more useful than that of a career politician or reporter? I read more:
Tobin Harshaw: Jerry, before we get to the immediate issue of Puerto Rico, why don't you give us a brief rundown of your own experience in the Navy with disaster relief.
Jerry Hendrix: Like virtually every sailor of the past century, going back to Theodore Roosevelt’s dispatch of the Great White Fleet to respond to a massive earthquake on the island of Sicily, I had several exposures to humanitarian assistance/disaster relief operations during my career. Perhaps the most instructive was when I served with Tactical Air Control Squadron 11 from 2005 to 2008. During that tour, the squadron provided detachments in response to earthquakes and volcano eruptions, including directing air operations in Kashmir following a 7.1 magnitude earthquake. The devastation made the roads largely impassable to wheeled vehicles and at that altitude the air is so thin that helicopter cannot lift as many supplies with each flight.
Most of the time, our people operated from light amphibious carriers. But we also supplied detachments to the West Coast-based hospital ship USNS Mercy when she got underway in support of the planned Pacific Partnership summer exercise.
He's familiar with humanitarian aid and disaster relief and he has worked with hospital ships? All in a naval setting, to go along with the previously mentioned credentials? Yep, this guy fits the bill, definitely far more informed than a former politician or US News reporter. What does he have to say about the relief effort? What does he think of the Comfort? (here is a tip...you already know)
TH: So, it seems like everybody has blasted Trump administration's response to the Puerto Rico crisis. Has that criticism been fair?
JH: No, I don’t think so. First of all, there was a fair amount of anticipatory action that is not being recognized. Amphibious ships including the light amphibious carriers Kearsarge and Wasp and the amphibious landing ship dock Oak Hill were at sea and dispatched to Puerto Rico ahead of the hurricane’s impact.
These are large ships that have large flight decks to land and dispatch heavy-lift CH-53 helicopters to and from disaster sites. They also have big well-decks -- exposed surfaces that are lower than the fore and aft of the ship -- from which large landing craft can be dispatched to shore carrying over 150 tons of water, food and other supplies on each trip. These are actually the ideal platforms for relief operations owing to their range of assets. The ships, due to their designs to support Marine amphibious landings in war zones, also have hospitals onboard to provide medical treatment on a large scale. That these ships were in the area should be viewed as a huge positive for the administration and the Department of Defense.
TH: On the flip side, others say that sending the hospital ship Comfort was unnecessary -- purely symbolic and possibly counterproductive -- given that the number of hospital beds was not the problem. What's your opinion?
JH: Comfort can add to the solution, but her lack of well-decks and large boats as well as her limited support of helicopter operations means that she has to go alongside a pier to be effective. In the immediate aftermath of a huge storm, pulling into a port that has not been surveyed for underwater obstacles like trees or cables or other refuse is an invitation to either put a hole your ship or foul your propellers or rudders.
That being said, there was a broad misunderstanding of the Comfort’s mission. She is not an “emergency response ship” but rather a hospital ship. She was built to accompany a large military force into a war zone as part of a buildup over time of capabilities to respond to wartime injuries. She is manned by military and civilian mariners as well as active and reserve medical personnel. It takes time to both man and equip her for sea. Given that there was no certainty where the hurricane would hit, it doesn’t make sense to have readied her prior to its impact.
It is revelatory of where the U.S. group mind is now that when the American public thinks about ships like the Comfort and Mercy, they automatically think of them as part of a civilian emergency response force rather than quietly considering the type of potential conflict that would require a hospital ship with 1,000 beds. I can tell you that when I think of those ships, I internally shudder at the thought of the type of conflict they were intended to support.
TH: Your plaudits toward the White House on all this are surprising to say the least. But where does the response still need to improve?
JH: One area in which the Trump administration could possibly lend additional assistance would be looking at a more robust activation of its assets in the Defense Department's Transportation Command to include more heavy-lift and cargo aircraft, as well as Maritime Administration shipping to move the logistics-heavy large infrastructure items on the ocean. Everything from bulldozers to transformers needs to come by ships, and it's been decades since it was really flexed to its full capacity. This would have the dual purpose of revealing any significant weaknesses in the Transportation Command assets and readiness should we need it in a military emergency down the road.
TH: Many critics feel that Florida and Houston had much better preparation before their storms hit this month. What could have been done better in advance in Puerto Rico, and what can be done in the rebuilding process to help minimize damage next time around?
JH: Puerto Rico is an island that suffers from its position in the middle of the Caribbean and its physical separation from the U.S. Its roads were in disrepair and its electrical grid was antiquated prior to the hurricane. The island has also suffered for years from ineffective local government and rising local territorial debt.
The Navy used to operate a large Navy base there, Naval Station Roosevelt Roads. I spent six months on the island in 1993, but when the island’s population protested the presence of the training range at nearby Vieques Island, the Navy shuttered the base, taking $300 million a year out of the Puerto Rican economy. I have no doubt that the federal government will be taking a hard look at large infrastructure investments and I hope that local governments look at building and general construction codes to make future buildings more hurricane survivable.
TH: What has been the most impressive crisis response/disaster relief operation undertaken by the Pentagon in recent decades? The tidal wave and nuclear disaster at Fukushima, Japan? The Indian Ocean typhoon?
JH: Without a doubt the Joint Force response to the 2004-05 earthquake and tsunami was the most massive and well-executed relief operation of my professional career. Virtually the entire U.S. Seventh Fleet under the leadership of Vice Admiral Doug Crowder responded with multiple carrier and amphibious strike groups. Water, food, medicine and other supplies flowed to and from disaster sites all over a vast geographical region. Crews worked for weeks on end to bring aid to people miles from the shoreline. The amount of coordination required was on the scale of a small war, and yet the supplies flowed both efficiently and effectively to where they were needed most.
TH: What other sorts of "soft power" can the Navy and other branches put an emphasis on going beyond reacting to disasters? Things like building roads and health facilities in the developing world?
JH: Exercises like the Pacific Partnership are superb for building good will. Navy SeaBees help to build school buildings and other administrative facilities with local tribal leaders. Wells are dug to provide fresh water and medical teams provide basic measles-mumps-rubella and polio vaccines, greatly decreasing child mortality rates in remote regions. These type of operations provide long-term benefits for the U.S. in regions where radical terrorism can easily take hold.
TH: Obviously, it takes years for military purchases to become reality. Just as we have to plan well in advance for the security threats of tomorrow, what acquisitions priorities should the Pentagon have now to prepare for the natural and human-made disasters of tomorrow?
JH: One of the frustrating comments I recently received was that the Navy should have had the Comfort manned and ready prior to these hurricanes. Given that it has been over a decade since the nation suffered a major hurricane-related disaster, the argument my friend was making suggested that we should man the hospital ships each year during the three-month hurricane season. This would have cost tens of millions of dollars each year at the same time the Navy is shrinking and has less money and time to man, train and equip its combat and regular naval presence force to meet its day-to-day tasks. We have had a ship grounded and three collisions in the western Pacific over the past few months, largely due to the strain we have placed the Navy under.
If people want the Navy to be more ready to respond to natural disasters, then they need a larger Navy that is more flexible and has the funding to train and maintain its ships.
[tw]911984783194050560[/tw]
I wanted a more informed opinion than that of a politician or some yahoo who partied their way through Journalism school, so I went looking and found this:
But to look at the larger context of the entire relief operation, I decided to talk to someone whose experience rivals that of General Honore: retired Navy Captain Jerry Hendrix. Now a senior fellow with the Center for a New American Security, Hendrix served for decades both on the high seas and in high-level staff jobs, including with the Chief of Naval Operations' Executive Panel and the Office of the Undersecretary of Defense for Policy's Irregular Warfare Quadrennial Defense Review. Few people know more about military history than Hendrix, who has degrees from Purdue, Harvard, the Naval Postgraduate School and a Ph.D. from Kings College in London. Little wonder that in 2012 was named the service's director of naval history.
I figured a guy with those credentials might fit the criteria I was looking for, but I wasn't sure yet. Would his naval experience be useful here, or at least more useful than that of a career politician or reporter? I read more:
Tobin Harshaw: Jerry, before we get to the immediate issue of Puerto Rico, why don't you give us a brief rundown of your own experience in the Navy with disaster relief.
Jerry Hendrix: Like virtually every sailor of the past century, going back to Theodore Roosevelt’s dispatch of the Great White Fleet to respond to a massive earthquake on the island of Sicily, I had several exposures to humanitarian assistance/disaster relief operations during my career. Perhaps the most instructive was when I served with Tactical Air Control Squadron 11 from 2005 to 2008. During that tour, the squadron provided detachments in response to earthquakes and volcano eruptions, including directing air operations in Kashmir following a 7.1 magnitude earthquake. The devastation made the roads largely impassable to wheeled vehicles and at that altitude the air is so thin that helicopter cannot lift as many supplies with each flight.
Most of the time, our people operated from light amphibious carriers. But we also supplied detachments to the West Coast-based hospital ship USNS Mercy when she got underway in support of the planned Pacific Partnership summer exercise.
He's familiar with humanitarian aid and disaster relief and he has worked with hospital ships? All in a naval setting, to go along with the previously mentioned credentials? Yep, this guy fits the bill, definitely far more informed than a former politician or US News reporter. What does he have to say about the relief effort? What does he think of the Comfort? (here is a tip...you already know)
TH: So, it seems like everybody has blasted Trump administration's response to the Puerto Rico crisis. Has that criticism been fair?
JH: No, I don’t think so. First of all, there was a fair amount of anticipatory action that is not being recognized. Amphibious ships including the light amphibious carriers Kearsarge and Wasp and the amphibious landing ship dock Oak Hill were at sea and dispatched to Puerto Rico ahead of the hurricane’s impact.
These are large ships that have large flight decks to land and dispatch heavy-lift CH-53 helicopters to and from disaster sites. They also have big well-decks -- exposed surfaces that are lower than the fore and aft of the ship -- from which large landing craft can be dispatched to shore carrying over 150 tons of water, food and other supplies on each trip. These are actually the ideal platforms for relief operations owing to their range of assets. The ships, due to their designs to support Marine amphibious landings in war zones, also have hospitals onboard to provide medical treatment on a large scale. That these ships were in the area should be viewed as a huge positive for the administration and the Department of Defense.
TH: On the flip side, others say that sending the hospital ship Comfort was unnecessary -- purely symbolic and possibly counterproductive -- given that the number of hospital beds was not the problem. What's your opinion?
JH: Comfort can add to the solution, but her lack of well-decks and large boats as well as her limited support of helicopter operations means that she has to go alongside a pier to be effective. In the immediate aftermath of a huge storm, pulling into a port that has not been surveyed for underwater obstacles like trees or cables or other refuse is an invitation to either put a hole your ship or foul your propellers or rudders.
That being said, there was a broad misunderstanding of the Comfort’s mission. She is not an “emergency response ship” but rather a hospital ship. She was built to accompany a large military force into a war zone as part of a buildup over time of capabilities to respond to wartime injuries. She is manned by military and civilian mariners as well as active and reserve medical personnel. It takes time to both man and equip her for sea. Given that there was no certainty where the hurricane would hit, it doesn’t make sense to have readied her prior to its impact.
It is revelatory of where the U.S. group mind is now that when the American public thinks about ships like the Comfort and Mercy, they automatically think of them as part of a civilian emergency response force rather than quietly considering the type of potential conflict that would require a hospital ship with 1,000 beds. I can tell you that when I think of those ships, I internally shudder at the thought of the type of conflict they were intended to support.
TH: Your plaudits toward the White House on all this are surprising to say the least. But where does the response still need to improve?
JH: One area in which the Trump administration could possibly lend additional assistance would be looking at a more robust activation of its assets in the Defense Department's Transportation Command to include more heavy-lift and cargo aircraft, as well as Maritime Administration shipping to move the logistics-heavy large infrastructure items on the ocean. Everything from bulldozers to transformers needs to come by ships, and it's been decades since it was really flexed to its full capacity. This would have the dual purpose of revealing any significant weaknesses in the Transportation Command assets and readiness should we need it in a military emergency down the road.
TH: Many critics feel that Florida and Houston had much better preparation before their storms hit this month. What could have been done better in advance in Puerto Rico, and what can be done in the rebuilding process to help minimize damage next time around?
JH: Puerto Rico is an island that suffers from its position in the middle of the Caribbean and its physical separation from the U.S. Its roads were in disrepair and its electrical grid was antiquated prior to the hurricane. The island has also suffered for years from ineffective local government and rising local territorial debt.
The Navy used to operate a large Navy base there, Naval Station Roosevelt Roads. I spent six months on the island in 1993, but when the island’s population protested the presence of the training range at nearby Vieques Island, the Navy shuttered the base, taking $300 million a year out of the Puerto Rican economy. I have no doubt that the federal government will be taking a hard look at large infrastructure investments and I hope that local governments look at building and general construction codes to make future buildings more hurricane survivable.
TH: What has been the most impressive crisis response/disaster relief operation undertaken by the Pentagon in recent decades? The tidal wave and nuclear disaster at Fukushima, Japan? The Indian Ocean typhoon?
JH: Without a doubt the Joint Force response to the 2004-05 earthquake and tsunami was the most massive and well-executed relief operation of my professional career. Virtually the entire U.S. Seventh Fleet under the leadership of Vice Admiral Doug Crowder responded with multiple carrier and amphibious strike groups. Water, food, medicine and other supplies flowed to and from disaster sites all over a vast geographical region. Crews worked for weeks on end to bring aid to people miles from the shoreline. The amount of coordination required was on the scale of a small war, and yet the supplies flowed both efficiently and effectively to where they were needed most.
TH: What other sorts of "soft power" can the Navy and other branches put an emphasis on going beyond reacting to disasters? Things like building roads and health facilities in the developing world?
JH: Exercises like the Pacific Partnership are superb for building good will. Navy SeaBees help to build school buildings and other administrative facilities with local tribal leaders. Wells are dug to provide fresh water and medical teams provide basic measles-mumps-rubella and polio vaccines, greatly decreasing child mortality rates in remote regions. These type of operations provide long-term benefits for the U.S. in regions where radical terrorism can easily take hold.
TH: Obviously, it takes years for military purchases to become reality. Just as we have to plan well in advance for the security threats of tomorrow, what acquisitions priorities should the Pentagon have now to prepare for the natural and human-made disasters of tomorrow?
JH: One of the frustrating comments I recently received was that the Navy should have had the Comfort manned and ready prior to these hurricanes. Given that it has been over a decade since the nation suffered a major hurricane-related disaster, the argument my friend was making suggested that we should man the hospital ships each year during the three-month hurricane season. This would have cost tens of millions of dollars each year at the same time the Navy is shrinking and has less money and time to man, train and equip its combat and regular naval presence force to meet its day-to-day tasks. We have had a ship grounded and three collisions in the western Pacific over the past few months, largely due to the strain we have placed the Navy under.
If people want the Navy to be more ready to respond to natural disasters, then they need a larger Navy that is more flexible and has the funding to train and maintain its ships.
Jaw
It's OVER 5,000!
The funny part here is this line:
Being immediately before this line:
Jaw
It's OVER 5,000!
That's an interesting take on what has happened here.
Jaw
It's OVER 5,000!
57 since I know your true concern here is the people of Puerto Rico, not politics, I thought you would find this article from October 11th comforting. It seems that our sailors were able to come up with a way to get patients to the hospital ship, even though it was off shore.
http://www.marinelog.com/index.php?...needed-medical-care-to-puerto-rico&Itemid=257
On October 6, however, the hospital suffered a generator failure, which endangered the lives of four critical care patients. Those patients, however, were medevaced to the Mercy-class Military Sealift Command hospital ship USNS Comfort (T-AH 20), underway near the coast of the Arecibo-Manati region of Puerto Rico
The medevac was undertaken by the amphibious assault ship USS Wasp (LHD 1) and USNS Comfort's detachments of Helicopter Sea Combat Squadron (HSC) 22, the "Sea Knights."
"We are a mobile platform that can respond to the greatest area of need or act as a strut to help the Puerto Rican health system," said Capt. Kevin Buckley, commanding officer of the medical treatment facility onboard Comfort. "We are engaged and determined to relieve human suffering."
The hospital ship was able to respond by coordinating with U.S. Health and Human Services and the Puerto Rico Department of Health, who engaged in a Medical Summit onboard Comfort immediately upon the ship's arrival in Puerto Rico.
....
USNS Comfort, with the assistance of Army Black Hawk helicopters, had medevaced critical patients from Ryder Memorial Hospital in Humacao, Puerto Rico two days prior, after its generator also failed.
USNS Comfort has treated 75 patients ranging from six months to 89 years in age and performed numerous procedures such as gastrostomy tube placement, colectomies, sacral-decubitus ulcer debridement, as well as treated for wounds, hernias and pneumonia.
57Brave
Well-known member
who decided to leave it in the harbor ?
I missed the name -- 75 people were treated which is great - but the ship has over a thousand beds and reports are hundred have shown up for care since it was brought to port.
Did i miss the name of who is co coordinating and decided to leave the ship in harbor ?
you have answered every other question short of this is the third hospital ship named Comfort
I missed the name -- 75 people were treated which is great - but the ship has over a thousand beds and reports are hundred have shown up for care since it was brought to port.
Did i miss the name of who is co coordinating and decided to leave the ship in harbor ?
you have answered every other question short of this is the third hospital ship named Comfort
Jaw
It's OVER 5,000!
This article was also interesting, as it addresses your point that the ship is hard to get patients to:
http://www.independent.co.uk/news/w...get-to-help-no-one-knows-latest-a8005346.html
Clinics on the island have been overwhelmed with patients since Hurricane Maria made landfall there, but patients and staff say they’re not sure how to start sending sick people over. The ship, the USNS Comfort, is sitting right off shore with just 13 per cent of its 250 beds in use nearly two weeks after it arrived.
The Comfort was deployed to Puerto Rico as a part of the US federal response to the storm, which devastated the island and left hospitals vulnerable to power outages, limited water supplies, and food shortages.
The Puerto Rico Department of Health gets to decide which patients can get care aboard the Comfort, but referrals have been minimal so far.
Ricardo Rosselló, the governor of the island, told CNN that the issue was not because a lack of infrastructure, or physical means of getting patients to the ship.
“The disconnect or the apparent disconnect was in the communications flow,” Mr Rosselló said. “I asked for a complete revision of that so that we can now start sending more patients over there.”
http://www.independent.co.uk/news/w...get-to-help-no-one-knows-latest-a8005346.html
Clinics on the island have been overwhelmed with patients since Hurricane Maria made landfall there, but patients and staff say they’re not sure how to start sending sick people over. The ship, the USNS Comfort, is sitting right off shore with just 13 per cent of its 250 beds in use nearly two weeks after it arrived.
The Comfort was deployed to Puerto Rico as a part of the US federal response to the storm, which devastated the island and left hospitals vulnerable to power outages, limited water supplies, and food shortages.
The Puerto Rico Department of Health gets to decide which patients can get care aboard the Comfort, but referrals have been minimal so far.
Ricardo Rosselló, the governor of the island, told CNN that the issue was not because a lack of infrastructure, or physical means of getting patients to the ship.
“The disconnect or the apparent disconnect was in the communications flow,” Mr Rosselló said. “I asked for a complete revision of that so that we can now start sending more patients over there.”
Jaw
It's OVER 5,000!
So now we can summarize the last two articles to address your concerns.
The ship, the USNS Comfort, is sitting right off shore with just 13 per cent of its 250 beds in use
The ship is close by with plenty of capacity. That's good news.
The medevac was undertaken by the amphibious assault ship USS Wasp (LHD 1) and USNS Comfort's detachments of Helicopter Sea Combat Squadron (HSC) 22, the "Sea Knights."
The military has the ability to get patients in need to the ship. More good news.
The Puerto Rico Department of Health gets to decide which patients can get care aboard the Comfort, but referrals have been minimal so far.
Ricardo Rosselló, the governor of the island, told CNN that the issue was not because a lack of infrastructure, or physical means of getting patients to the ship.
“The disconnect or the apparent disconnect was in the communications flow,” Mr Rosselló said. “I asked for a complete revision of that so that we can now start sending more patients over there.”
Eeek. More trouble with locals not being able to get out of their own way. Rosello at least is a take charge guy though, and it sounds like he has the problem with the local officials in hand.
The ship, the USNS Comfort, is sitting right off shore with just 13 per cent of its 250 beds in use
The ship is close by with plenty of capacity. That's good news.
The medevac was undertaken by the amphibious assault ship USS Wasp (LHD 1) and USNS Comfort's detachments of Helicopter Sea Combat Squadron (HSC) 22, the "Sea Knights."
The military has the ability to get patients in need to the ship. More good news.
The Puerto Rico Department of Health gets to decide which patients can get care aboard the Comfort, but referrals have been minimal so far.
Ricardo Rosselló, the governor of the island, told CNN that the issue was not because a lack of infrastructure, or physical means of getting patients to the ship.
“The disconnect or the apparent disconnect was in the communications flow,” Mr Rosselló said. “I asked for a complete revision of that so that we can now start sending more patients over there.”
Eeek. More trouble with locals not being able to get out of their own way. Rosello at least is a take charge guy though, and it sounds like he has the problem with the local officials in hand.
57Brave
Well-known member
The Governor of PR is heading up the US response to Hurricane Maria ?
there are 1000 beds. Not 250.
https://en.wikipedia.org/wiki/USNS_Comfort_(T-AH-20)
blaming the victims is tacky.
there are 1000 beds. Not 250.
https://en.wikipedia.org/wiki/USNS_Comfort_(T-AH-20)
blaming the victims is tacky.
57Brave
Well-known member
you are exactly right.
I don't understand why a hospital ship is anchored uselessly off shore for weeks while recovery to a natural disaster is in operation.
And no one can name who made that decision
I don't understand
...........................
we demand more accountability from our sports teams
I don't understand
I don't understand why a hospital ship is anchored uselessly off shore for weeks while recovery to a natural disaster is in operation.
And no one can name who made that decision
I don't understand
...........................
we demand more accountability from our sports teams
I don't understand
Jaw
It's OVER 5,000!
It's hard to say because I haven't seen that in any articles or heard about it from any naval types (which is how I knew about the maintenance inspections in Norfolk).
If it was only a matter of whether or not the entrance channel is safe for the Comfort then that would fall on the ship Captain.
For reference, the Comfort extends about 33 feet beneath the water's surface and is about 900 feet long.
Here is a chart of the port entrance - http://www.charts.noaa.gov/OnLineViewer/25670.shtml
Now think about driving a 900 foot long school bus down that channel where all of those rivers were depositing debris. And knowing that if you wreck you won't be able to help anyone and you will also lose your career and cost taxpayers tens or hundreds of millions of dollars.
On the other hand, the 3 star General in charge of the relief effort may have decided it was better to have Comfort out of the harbor for a myriad of reasons. Coordinating this effort is way beyond my understanding so I can't imagine what many of them would be. Security is a possibility with armed looters in the streets and medical supplies on the ship.
It is also possible that the port itself doesn't want the Comfort taking up prime real docking real estate from ships bringing supplies.
Until something else is proven, I will assume that the 3 star General in charge of the operation could park Comfort wherever he wants.
57Brave
Well-known member
I think Trump has other things on his mind
57Brave
Well-known member
Puerto Rico’s Medicaid funding crisis is deepening, adding yet another issue for Congress to deal with in what is sure to be a hectic December.
Hurricane Maria caused serious damage to Puerto Rico’s health-care system, and none of the federal disaster relief money to date has been earmarked for the Medicaid program.
A $44 billion supplemental payment request from the White House on Friday said the administration was “aware” that Puerto Rico needed Medicaid assistance, but it put the onus on Congress to act.
http://thehill.com/policy/healthcare/360971-congress-faces-growing-health-care-crisis-in-puerto-rico
Hurricane Maria caused serious damage to Puerto Rico’s health-care system, and none of the federal disaster relief money to date has been earmarked for the Medicaid program.
A $44 billion supplemental payment request from the White House on Friday said the administration was “aware” that Puerto Rico needed Medicaid assistance, but it put the onus on Congress to act.
http://thehill.com/policy/healthcare/360971-congress-faces-growing-health-care-crisis-in-puerto-rico