Medical Homes in Puerto Rico
This page is designed to keep you informed about events and activities happening in Puerto Rico that will help improve access to medical homes for children with special health care needs (CSHCN).

»Medical Home Initiatives	»Resources
»Related Grant Initiatives	»Educational Initiatives
»Partners in the State	»Screening Initiatives

Medical Home Initiatives
This section provides information on state medical home initiatives/programs. States that are a part of the mentorship network will have a "Promise to the State" which outlines how they will achieve ensuring that all children have a medical home by 2010. This is based on the Healthy People 2010 goals which is a 10 year action plan to achieve and measure success for all CSHCN.

Medical Home Pilot Project

The PR Department of Health, CSHCN Section, will implement a medical home pilot project in the region of Bayamón, PR.  The goals are to increase awareness among participant health providers about the importance of providing services that are ongoing, comprehensive, family-centered, coordinated and compassionate and promote the use of the Ages and Stages Questionnaire for early identification of children with developmental delays and referral for services.  Some identified barriers include pediatrician’s lack of time, lack of appropriate reimbursements, the need to hire care coordinators and family consultants and pediatricians’ notion that medical home is a complicated concept.  Facilitating factors include the collaboration of partners/stakeholders that promote medical home and the revision and updating of the EPSDT guidelines for Puerto Rico.

For more information contact:

Milaida Hernandez, MS
PR Department of Health
CSHCN Section
PO Box 70184
San Juan, PR  00936-8184
Phone: (787) 274-7844
Email:  mihernandez@salud.gov.pr

Related Grant Initiatives
This section provides information on current state grants that are working on medical home initiatives. This includes the grant abstract as well as key contacts for the grant.

No information is currently available for this category.

Partners in the State
This section provides information on who in the state (individuals and agencies) are working together to create medical homes for children.

American Academy of Pediatrics (AAP) Chapter:
Contact President: Lillian Rivera, MD at 787/840-7663 or victoria@pol.net or the Chapter Executive
Director, Marisol Capote, at 787/840-0052 or solcapote@hotmail.com.

American Academy of Pediatrics, PR Chapter
President: Dra. Yvette Piovanetti
Contact person: Dr. Cindy Calderón
calderon.cindy@gmail.com

American Academy of Family Physicians (AAFP) Chapter:
www.aafp.org/cgi-bin/chapterlookup.pl?chapter=pr

Title V Block Grant to States
Title V of the Social Security Act is one of the largest Federal block grant programs. It leads the nation in ensuring the health of all mothers, infants, children, adolescents, and children with special health care needs (CSHCN). Title V is administered by the Maternal and Child Health Bureau (MCHB) as part of the Health Resources and Services Administration, U.S. Department of Health and Human Services.

Title V and Children with Special Health Care Needs
MCHB Objective: Support development and implementation of comprehensive, culturally competent, coordinated systems of care for the estimated 18 million U.S. children who have or are at risk for chronic physical, developmental, behavioral or emotional conditions and who also require health and related services of a type or amount beyond that required by children generally.

Title V CSHCN Program
PR Department of Health
Director: Dr. Naydamar Pérez de Otero
(787) 274-5660
nperez@salud.gov.pr 
Site:  http://www.salud.gov.pr/Programas/ProgramaMadresNinosAdolecentes/Pages/SecciondeServiciosaNinosconNecesidadesEspecialesdeSalud.aspx

MCH Contact:
Maria del C. Rullan, MD
MCH Director
Address: PO Box 70184
San Juan, PR 00936
Phone: 787-274-5680 | Fax: 787-274-5523
Email: mrullan@salud.gov.pr
Internet site: www.salud.gov.pr

CSHCN Contact:
Naydamar Perez de Otero, MD, MPH
CSHCN Director
Address: PO Box 70184
San Juan, PR 00936
Phone: 787-274-5660 | Fax: 787-274-3301
Email: nperez@salud.gov.pr
Internet site: www.salud.gov.pr

Early Hearing Detection & Intervention (EHDI) Contact(s):
State EHDI programs promote universal newborn hearing screening, develop effective tracking and follow-up as a part of the public health system, promote appropriate and timely diagnosis of the hearing loss, prompt enrollment in appropriate Early Intervention, link newborns to a medical home and strive to eliminate geographic and financial barriers to service access.

Name: Naydamar Perez de Otero, MD, MPH
Contact: Phone: 787-274-5660 / 5659 | Fax: 787-274-3301 | Email: nperez@salud.gov.pr

Early Intervention/Part C Coordinator:
The Program for Infants and Toddlers with Disabilities (Part C of IDEA) is a federal grant program that assists states in operating a comprehensive statewide program of early intervention services for infants and toddlers with disabilities, ages birth through age 2 years, and their families.

Name: Naydamar Perez de Otero, Coordinator
Contact: Phone: (787) 274-5659 | Fax: (787) 274-3301 | Email: nperez@salud.gov.pr
Web site: www.salud.gov.pr/Dsh/

Section 619/ Preschool Grants Program of the Individuals with Disabilities Education Act (IDEA). This program provides free appropriate public education (FAPE) for children, ages 3 through 5 years, with disabilities:

Name: Maria Yolanda Vazquez, Director for Early Childhood
Contact: Phone: (787) 759-7228 | Fax: (787) 753-7691
Email: vazquez_mar@gobierno.pr | Web site

State Interagency Coordinating Council (ICC) Chairs:
The ICC advises appropriate agencies on the unmet needs in early childhood special education and early intervention programs for children with disabilities, assists in the development and implementation of policies that constitute a statewide system, and assists all appropriate agencies in achieving full participation, coordination, and cooperation for implementation of statewide system.

Name: Ana Navarro, ICC Chair
Contact: Phone: (787) 759-6546 | Fax: (787) 759-6719

Medical Insurance Administration (ASES)
Contact person: Maritza Espada
mespada@asespr.org

Bayamón Pediatric Center
Director and contact person: Dr. Yvonne Villafañe
villafax@caribe.net

Puerto Rico ECCS (Unidos por la Niñez Temprana)
Contact person: Hidelisa Ríos
(787) 294-0719
hrios@salud.gov.pr

Family Voices
Contact person: Irlanda Ruiz
iraruiz@yahoo.com

Parents of Children with Disabilities Association (APNI)
www.apnipr.org

Resources/Documents
Directory of Community Services http://www.salud.gov.pr/Programas/ProgramaMadresNinosAdolecentes/Pages/DirectServClinicComun.aspx 

Medical Home brochure for families in Spanish

Health Care Transition brochure for youth with special health care needs in Spanish

Educational Initiatives
This section provides information on training initiatives on the medical home. Some states will discuss their outreach projects in relation to physicians, families, and the community.

No information is currently available for this category.

Screening Initiatives
This section provides information on surveillance and screening initiatives in the state.

EPSDT guidelines in Puerto Rico were revised with the technical assistance of MCHB. One of the areas identified as priority in the newly revised guidelines was the early developmental screening with an evidence-based standardized tool. The new guideline now includes the use of the Ages and Stages Questionnaire (ASQ) at ages 9, 18, and 24 months. This newly revised guideline has been of support for the MCH Division in PR to educate and give information to directors of medical insurances about the ASQ, and to train pediatricians, nurses and other health care professionals in the use of this questionnaire with the collaboration of Healthy Start. It is hoped that the percent of children screened at early ages, identified and referred to early intervention will increase with these experiences.  

State Resources on the Internet

Note: The information provided on the state pages was submitted by the state medical home teams.As this is not an exhaustive list, please let us know if you have additions for your state resource page. You can contact us at: medical home@aap.org.

Last Updated April 9, 2009