Puerto Rico

The fiscal stability of the Commonwealth’s health insurance program is one of the most significant budgetary challenges facing the Commonwealth, especially if neither the availability of ACA funds is renewed nor the CAP imposed on Medicaid matching funds is removed. In view of the current funding disparity between the Commonwealth with respect to the states, the Commonwealth is intensifying its efforts to promote Congress to renew ACA funding. The Resident Commissioner is also involved in these efforts and recently members of the private and public sector formed the Puerto Rico Healthcare Crisis Coalition. However, it is not possible to predict the likelihood that such efforts will succeed. Thus, the Commonwealth will continue evaluating the fiscal structure of the program taking into consideration the current federal funding depletion estimates. To the extent these efforts are unsuccessful; it is unlikely that the Commonwealth would be able to assume a significantly higher portion of the cost of the health insurance program. If the Commonwealth is unable to reduce these costs, it may be required to adopt some of the emergency measures described above in “RISK FACTORS - The Commonwealth may need to implement administrative and emergency measures in fiscal year 2016 and thereafter, which could include a moratorium on the payment of debt service or debt adjustment.”

www.ijaeb.org Page 6 Although this municipality was not sampled in this study since sampling did not focus on fields, it belongs to the group of municipalities of low elevations (Gobierno de Puerto Rico, Oficina de Gerencia y Presupuesto, n.d.). The high incidence of PRSV on these areas demonstrates the need for better agricultural planning, practices and disease management. Some of the municipalities where collections took place have the highest values for minimum and maximum elevation, as well as for average elevation (Gobierno de Puerto Rico, Oficina de Gerencia y Presupuesto, n.d.). The municipalities in this group that were sampled in our study are Maricao, Lares, Villalba, Cayey, Aibonito, Barranquitas, Orocovis, Utuado and Jayuya. In these areas of mid to higher elevations, the incidence of PRSV is lower (Table 2) and the virus is less likely to occur as demonstrated by the GLM and logistic regression generated (Figure 2; Supplementary Figure 1). Commercial fields of papaya need to be more evenly distributed throughout the island and shift to higher elevations where PRSV is not as present and papaya can still grow (Table 1). A first step to a positive change to our agricultural practices and disease management would be to change the distribution and location of papaya farms in Puerto Rico. That would reduce the agricultural intensification occurring in the South.

institutional reforms, and debt restructuring. While there can be choices as to precisely which taxes or expenditures to raise or cut, there can be little or no choice as to the magnitude of the needed changes. Likewise, structural measures will need to be sufficiently far reaching to put business on notice that a business-friendly Puerto Rico is open for business. And institutional reforms, to enforce budgetary discipline, to provide good and timely

The Caribbean Corridor Strike Force (CCSF) investigates South-American based drug trafficking organizations responsible for the movement of multi-kilograms quantities of narcotics using the Caribbean as a transshipment point for further distribution. In April of 2014, the CCSF dismantled a drug trafficking organization responsible for the importation of cocaine into Puerto Rico and the transportation of drug money to Saint Thomas using Culebra as a transshipment point. In January of 2015, the CCSF dismantled, in coordination with the Colombian Government, an international drug trafficking and money laundering organization, charging 29 individuals. The go- fast vessels that transported drugs departed from Venezuela and used Vieques Island as transshipment point, in route to Puerto Rico and the United States. Wire transfers to Panama, China, Colombia and Peru repatriated illegal proceeds of the business.

One area where efforts are currently focused is the development of information systems and technology resources. The State Prosecutors Office, the State Minors Prosecutors Office, the Courts and the P.R. Police are among the criminal justice system agencies engaged in the development of new systems and technologies. Other agencies are aware of the need to develop or update their systems so as to be more efficient and effective and will be working toward that goal in the next few years. One of these agencies is the Department of Correction and Rehabilitation which must develop new technologies to provide a secure environment in its institutions. The Puerto Rico Criminal Justice Information System is giving support to all agencies in this effort.

Our findings could help guide conservation efforts in southwestern Puerto Rico, particularly those aimed at conserving and facilitating movements of forest-specialist species between the Guánica and Susúa Forest Reserves. Occupancy rates in the forested matrix were similar to those estimated for the forest reserves, which represented forested habitat within a 300-1,500 m band along the perimeter of the forest reserves. The similarities hint at the conservation value of the forest matrix for forest-associated species, even in its current condition of low human density and other land uses (Gould et al. 2007). The specific covariates influencing colonization and extinction rates are also valuable for conservation planning. Patch isolation influenced the colonization rates of Puerto Rican Bullfinches, specifically, the distance to the nearest forest patch with a cover value similar to the average cover value of patches in the forested matrix (DF). The highest patch colonization probabilities were documented when these patches were < 0.5 km away from the survey station. Experimentally translocated Puerto Rican Bullfinches used patches with similar cover while traveling through the urbanized matrix to return to their original capture locations (Chapter 2). This example helped visualize how remaining habitat patches may serve two functions: (1) facilitate patch colonization, enhancing the persistence of avian species within the matrix and (2) permit the passage of species through the matrix, providing vital permeability and enhancing the connectivity of the landscape.

A prospective study was carried out at the University of Puerto Rico Hospital (UPRH) and at the North Carolina Baptist Hospital (NCBH) in order to establish the incidence of ABO hemolyti[r]

Berrios, Rodriguez and Quintero conducted an exploratory study on the risks factors of religious abuse among parishioners of three religious denominations in Puerto Rico: Catholic Church, Presbyterian and Church of God Mission Board, which belongs to the Pentecostal movement [21]. Their study showed significant differences between the groups (F=4.776) at a significance level of 0.010. After performing a post-hoc analysis, it was found that there are significant differences between the Presbyterian and Mission Board churches, as well as between the Catholic and Presbyterian churches. These results conclude that the members of the Catholic and Mission Board churches reported a significantly higher number of factors of religious abuse than members of the Presbyterian church [21]. Indeed, this study helps us to understand the results of the present study of religious fanaticism obtained by the Pentecostal Church, which showed significant differences in their levels of religious fanaticism in comparison with the other denominations.

Water bodies and coastal areas around the world are threat- ened by increases in upstream sediment and nutrient load, which influence drinking water sources, aquatic species, and other ecologic functions and services of streams, lakes, and coastal water bodies (Haycock and Muscutt, 1995; Verho- even et al., 2006). Puerto Rico (PR) faces considerable chal- lenges regarding sustainable land use and current land use effects on adjacent coastal ecosystems and their services. Previous studies in PR have shown that sediment contami- nants have increased 5- to 10-fold since pre-colonial levels, with a 2- to 3-fold increase in the last 40–50 years (Sturm et al., 2012). The increased sediment contamination could orig- inate from anthropogenic activities such as agriculture and urban development, or from natural erosion (Tong and Chen, 2002; Gellis, 1993, 2013). The primary concern regarding increased sediment load to reservoirs is that sediment depo-

its proximity to the mainland, continued control of Puerto Rico was desirable because of the economic opportunities there, and its strategic location for defense of the Panama Canal. So the Puerto Rican people simply went from Spanish rule to American rule in 1898, with no real resistance. They had already been ruled by others for over 400 years, and they welcomed the American invaders as hopefully representing more benevolent rule in the future. Unlike the Cubans or Filipinos, who wanted independence and did not accept United States rule, Puerto Ricans did not seem to have any expectation of independence or self-rule in 1898.

The University obtained a $125 million line of credit with the Government Development Bank for Puerto Rico (“GDB”), a public corporation of the Commonwealth, for working capital purposes. This line of credit was converted into a ten year term loan in October 2011 payable in monthly equal principal payments plus interest starting on October 1, 2013. The term loan is collateralized by the University‘s accounts receivable from the Commonwealth of Puerto Rico and its agencies as well as by the Commonwealth of Puerto Rico income guaranteed appropriations under Act No. 2 of January 20, 1966, as amended. This term loan matures on October 1, 2022 and bears interest per annum equal to prime rate plus 150 basis points, with a floor of 6% (6% at June 30, 2013). The balance outstanding of this term loan amounted to $71,926,858 and $64,999,109 at June 30, 2013 and 2012, respectively. In addition, the University has a $75.0 million non-revolving line of credit facility with GDB to complete certain construction projects of the University’s Program for Permanent Improvements. This line of credit bears interest per annum equal to prime rate plus 150 basis points, with a floor of 6% (6% at June 30, 2013). The balance outstanding of this line of credit amounted to $12,918,266 and $10,248,324 at June 30, 2013 and 2012, respectively. The unused balance of this line of credit amounted to $62.1 million at June 30, 2013. As disclosed in Note 15, this line of credit was amended in January 2014 to extend the maturity date to January 31, 2016.

Benefits to you: These benefits apply only to MasterCard cardholders whose cards are issued by U.S. financial institutions. The United States is defined as the fifty (50) United States, the District of Columbia, American Samoa, Puerto Rico, Guam, and the U.S. Virgin Islands. No person or entity other than the Gold MasterCard cardholder shall have any legal or equitable right, remedy, or claim for benefits, insurance proceeds and damages under or arising out of these programs. These benefits do not apply if your card privileges have been cancelled. However, insurance benefits will still apply for any benefit you were eligible for prior to the date that your account is suspended or cancelled, subject to the terms and conditions of coverage.

corresponding property tax for that year. Municipalities do not have jurisdiction to impose property taxes on property located outside Puerto Rico. Likewise, property in interstate or foreign commerce is not subject to the Puerto Rico property tax. On the other hand, a property tax may be imposed on property located in Puerto Rico prior to being transported in interstate commerce or after the property finally comes to rest in Puerto Rico. If, on the assessment date, the property is under the control of the carrier and is to be shipped outside Puerto Rico, it is in interstate commerce and thus exempt from property tax. However, if the property had been sold to a buyer outside Puerto Rico but was still in the hands of the seller on the assessment date, the property tax liability for the property remains the responsibility of the seller, even if on the next day it is delivered to the carrier for shipment outside Puerto Rico.

Admittedly, other factors are considered during conservation planning processes, including accounting for projected costs and accretion of ecological benefits. We contribute to this process by suggesting that changes in occupancy and abundance are most likely detectable ≥6 years post-restoration. We suggest that, given the rapid growth rates of trees in Puerto Rico (Weaver and Birdsey 1991), detectable ecological changes in restored plantations could be accelerated if the DBH of trees delivered to farmers is slightly greater (i.e., >3 cm). Certainly, our findings could be used to guide the formulation of local and landscape level conservation strategies across intensively cultivated coffee landscapes. Mounting evidence suggests that shade-restored farms can function as a secondary forest, providing compelling support for the use of shade restoration actions in conservation strategies, while supporting the livelihood of local communities in Puerto Rico or wherever coffee is cultivated in the tropics (Perfecto and Vandermeer 2015).

This study presents an analysis of the impact of forest fires in Puerto Rico for the period from 2013-2014. The climatological factors analyzed included precipitation, temperature, relative hu- midity, and wind. Several factors have combined to the increase of these forest fires, among others, a decrease in precipitation during this period, as well as an increase in the human involvement in these fires from approximately 40% occurs in the night period (5:00 pm to 8:00 am), where the weather conditions do not favor the appearance of these phenomena. An increase in fires of 44% occurred in 2013 compared to 2014, causing an economic loss of $13.8 million. Fire also adversely affected the flora and fauna of the island, but this was not evaluated in this paper.

Young women are an important target group in microbicide research, yet little is known about why they participate and stay in microbicide trials. Our study examined motivations for participating in a Phase I microbicide trial among 61 women ages 18 - 24 years in the continental USA and Puerto Rico. We also examined their perspectives on study parti- cipation. Participants underwent a semi-structured in-depth interview in which they were asked about factors that moti- vated enrollment and their experiences while participating. They also completed a Web-based Computer Assisted Self Interview in which they were asked to rate study burden (1 = low to 4 = high). Factors that motivated enrollment were altruism (29%), compensation (17%), a combination of altruism and compensation (37%) and free medical exams (17%). Factors that encouraged participants to stay in the study were study staff (95%), confirmation of good health (41%), and the opportunity to learn about their bodies (17%). Mean ratings of study burden ranged from 1.83 (having to travel to site) to 2.41 (colposcopy), indicating that participants were not highly bothered by visits or procedures. Al- though Phase I trials require invasive procedures, participants were not highly bothered by them and recognized them as necessary. Good relationships with staff and clear information about how procedures contribute to study goals may en- courage participants to remain in trials. Young women may be motivated to enter microbicide trials by stressing the role they will play in discovering better HIV-prevention methods and highlighting the comprehensive preventive exams they will receive.

Disaster warning systems are a form of risk communication that allow national, state, and local actors to prepare for, respond to, and understand disaster risk. The increased use of social media platforms to exchange information around disasters challenges traditional, centralized forms of risk communication. While social media is already used in emergency management to some degree, issues of trust and reliability of information limit the widespread adoption of social media into emergency management practices. This paper offers a case study of the role that social media information plays in Puerto Rico’s hurricane early warning system and highlights the affordances and limitations of decentralized, heterarchical communication forms around disasters for federal, state, and local-level emergency management authorities. The case highlights differences in perception of social media information around disasters by emergency management authorities and by community members both before and after Hurricane Maria in 2017.

Abstract. Identifying spatial pattern in plant populations is a fundamental objective of plant ecology. These underlying patterns can be used to better understand not only interactions among plants, but also interactions with the animals that consume them. In this paper, I used second-order spatial point pattern analyses to identify scales of aggregation or over-dispersion in the distributions of four bird-dispersed tree species (Schefflera morototoni, Dendropanax arboreus, Miconia serrulata, and Guarea guidonia) on a 4.05 ha grid in secondary wet forest in the Cordillera Central of Puerto Rico. In order to link these underlying patterns with interactions with seed-dispersing frugivorous birds, I monitored the fruiting phenology of all individual trees and collected foraging observations, noting the individual plants in which birds foraged during a single fruiting season (Aug.-Nov. 1999). For each tree species, I tested the null hypotheses that (1) fruiting trees were distributed randomly with respect to the population of adult trees, and (2) trees visited by frugivores were randomly distributed with respect to the distribution of fruiting trees. Two tree species fruited and were utilized by frugivores during two of the four months (D. arboreus and M. serrulata). The remaining two species fruited and were utilized by frugivores during the entire study period, and for these I examined spatial patterns during shorter time intervals [monthly (S. morototoni) or bimonthly (G. guidonia)].

Curiously enough, the dissent in this case disagreed with the majority as to the interpretation of a Montana statute related with a terminally ill patient’s right to a dignified death. This could be in tension with a Puerto Rico Supreme Court decision that strengthened the right of patients to refuse medical treatment that would result in death. See Lozada Tirado v. Tirado Flecha, 177 P.R. Dec. 893 (P.R. 2010). See also Patricia Silva Musalem, La Fe ante la Muerte: Perspectivas sobre la eutanasia desde el catoli- cismo, islamismo, hinduismo y juda´ısmo, 5 R EV . C LAVE , R EV . E STUDIOS C R´ITICOS D ER . 151, 162 (2010) (When discussing the right to die and assisted suicide in Puerto Rico, the author only references one U.S. State: Montana).

The rural areas of Adjuntas, Yauco, and Utuado, have until recently been Puerto Rico’s most prominent family-owned coffee growing regions (Monclova Vazquez, 2014). According to the USDA, in 2014 the combined coffee sales from the three rural areas made up 40% of Puerto Rico’s coffee sales while 39% of all coffee farms in Puerto Rico are located in the three areas. I had initially planned to collect data in these three rural areas for the above reasons as well as their close proximity to each other, which would have allowed me to gain a deeper understanding of that particular region. However, once I began my research, I quickly realized that family-owned and agroecological farms are currently not concentrated in a particular area. Additionally, the coffee-growing region of Yauco, as well as about 85% of larger coffee plantations throughout Puerto Rico, have been bought and consolidated under the control of Coca-Cola or its subsidiary called PRCR, LLC that mixes beans from other countries (predominantly Mexico) into the coffee they produce but continues to sell the coffee using multiple, trusted brand names (Denis, 2015; Ferrer, 2015). In the end my research areas were much more dispersed than I had initially anticipated, giving a broader picture of agroecological coffee production on the island, as well as the increasing corporatization of coffee in Puerto Rico. For