Ties that bind

Stress of Puerto Rico dev­as­ta­tion hits fam­i­lies

New Haven Register (New Haven, CT) - - FRONT PAGE - By Mary E. O'Leary

“Emo­tion­ally, I am drained. I have al­ways taken care of my dad. Now I’m shuf­fling my own par­ents and his par­ents.” Margarita Ser­rano, a med­i­cal records and in­ter­preter su­per­vi­sor at the Fair Haven Com­mu­nity Health Cen­ter

NEW HAVEN — The phone call from her sis­ter-in-law was alarm­ing.

“If we don’t get them out, they are both going to die,” Margarita Ser­rano was told about the med­i­cal chal­lenges her hus­band’s par­ents in Puerto Rico were fac­ing.

“We went into a panic,” said Ser­rano, a med­i­cal records and in­ter­preter su­per­vi­sor at the Fair Haven Com­mu­nity Health Cen­ter.

She was one of sev­eral work­ers at the cen­ter who talked about the stress of hav­ing el­derly rel­a­tives in Puerto Rico who are run­ning low on nec­es­sary med­i­ca­tions, and the equal stress of wor­ry­ing about cov­er­age for their med­i­cal needs now that some have ar­rived in the United States.

Ser­rano, in a lot of ways, is the clas­sic ex­am­ple of the fe­male care­giver who tends to her el­derly par­ents while con­tin­u­ing to work full-time.

She al­ready takes care of her own father, who also has med­i­cal prob­lems.

Her mother-in-law, who just re­cently ar­rived here from the is­land, has mo­bil­ity is­sues, hav­ing lost a leg to di­a­betes. Her father-in-law has a catheter that needs reg­u­lar tend­ing to pre­vent in­fec­tion.

Things such as trans­port by a med­i­cal van — not an is­sue for pa­tients with in­sur­ance — be­comes a fi­nan­cial worry and can be a se­ri­ous ob­sta­cle as these pa­tients and their fam­i­lies look to make med­i­cal ar­range­ments while their in­sur­ance ques­tions get worked out.

Ser­rano started to cry at one point, as she de­scribed how her mother-in-law feels like a bur­den and is gen­er­ally upset by the

trauma of the dam­age to Puerto Rico and leav­ing her home.

“She is tak­ing it re­ally hard,” Ser­rano said.

She said her rel­a­tive said the land­scape looks like “some­one just took a match and threw it and ev­ery­thing just went up.”

Ser­rano her­self is stressed.

“I’m stand­ing still. I don’t know what to do,” she said of mak­ing an ap­point­ment be­fore get­ting in­sur­ance, which may take 30 to 45 days to go into ef­fect.

Once Med­i­caid is back in place for them, it can also help with items these house­holds will need to make them ac­ces­si­ble to the hand­i­capped.

Dr. Mered­ith Niess said she would hear sto­ries anec­do­tally from staff, about the prob­lems they were fac­ing and the stress they were car­ry­ing as they open their homes to rel­a­tives.

They met as a group re­cently so they could share their con­cerns and look for so­lu­tions to­gether.

One thing they agreed on is that up­beat re­port­ing com­ing from the is­land doesn’t re­flect what they are be­ing told of the con­di­tions.

Fair Haven is home to a large His­panic pop­u­la­tion, many of whom are Puerto Ri­can, while many of the cen­ter staff ei­ther were born there or still have close rel­a­tives on the is­land.

Brenda Ne­gron, who works on pa­tient ac­cess and in med­i­cal records, said half of the roof on her mother’s house is gone, but her bed­room is pro­tected. There still are no lights and she wor­ries about the avail­abil­ity of food and medicine.

The sto­ries of long lines for gas, food, wa­ter and to with­draw money from a bank were ubiq­ui­tous, as was the fear of be­ing mugged if out after dark. Ne­gron said care pack­ages are be­ing van­dal­ized.

Ne­gron said her mother won’t leave her dam­aged home for fear she will miss an op­por­tu­nity to fix it.

“She is be­ing stub­born at the mo­ment,” Ne­gron said, as she and her sis­ters con­tinue to con­vince their par­ents to come to the main­land.

Three weeks since Hur­ri­cane Maria knocked out the elec­tri­cal sys­tem, threat­ened clean wa­ter sys­tems and lev­eled the veg­e­ta­tion, Ne­gron said she has yet to hear from rel­a­tives whose homes were dam­aged by mud­slides.

Other needs that will have to be met in­clude win­ter clothes for the new­com­ers.

Ser­rano has a nar­row bath­room that is not prop­erly equipped and would be ex­pen­sive to re­model.

“Emo­tion­ally, I am drained. I have al­ways taken care of my dad. Now I’m shuf­fling my own par­ents and his par­ents,” she said.

Niess told her and the oth­ers to make an ap­point­ment for the new­com­ers with the clinic as soon as they ar­rive so they can get into the sys­tem.

“That will give them ac­cess to us and our re­sources,” Niess said.

“Ev­ery­thing we see with our staff, we will see at some point with our pa­tients, as well, who will have some of the same bur­dens,” Karen Nemiah, head of mar­ket­ing and devel­op­ment at the cen­ter, said.

This all hap­pens as the state doesn’t have a bud­get and Con­gress has failed to re­new fund­ing for fed­er­ally qual­i­fied health clin­ics.

“It is the per­fect storm,” Nemiah said.

Kelly Rivera, a clin­i­cal pa­tient nav­i­ga­tor, cried as she re­counted how her par­ents lost ev­ery­thing in the hur­ri­cane. They will be ar­riv­ing here next week.

“I haven’t been able to talk to them yet,” Rivera said, given lack of elec­tric­ity and In­ter­net con­nec­tions.

She said her hus­band will fly there to es­cort her 83-year-old father and 69year-old mother, who uses a wheel­chair and suf­fers from de­pres­sion.

Rivera, who has young chil­dren, said she has room for her par­ents.

Dr. Suzanne La­garde, the chief ex­ec­u­tive of­fi­cer of the cen­ter, said she is glad the staff shared their con­cerns, and she as­sured them that all new pa­tients from Puerto Rico will be taken care of.

“We ab­so­lutely welcome them,” La­garde said. “We will take care of them. We will meet their med­i­cal needs. Whether or not they have in­sur­ance, it doesn’t mat­ter.”

She said it also be­came clear that new staff who don’t have ac­cu­mu­lated time off may need to be able to care for ar­riv­ing rel­a­tives.

La­garde said she will pro­pose that for these kinds of cir­cum­stances and for a set num­ber of hours or days, staff should be able to do­nate time off to those who need it. The CEO said she will bring this back to the clinic board.

She also has plans to try to open up com­mu­ni­ca­tion with the health cen­ters in Puerto Rico to even­tu­ally share in­for­ma­tion about pa­tients.

Again, to calm those con­cerned about health care bills and in­sur­ance, she as­sured them that when in­sur­ance is ap­proved, it will be retroac­tive.

“I don’t think we will lose in the process. It doesn’t mat­ter. If it is a med­i­cal is­sue, we will see those pa­tients,” La­garde said.

Arnold Gold / Hearst Con­necti­cut Me­dia

Kelly Rivera, left, talks about her par­ents’ sit­u­a­tion in Anasco, Puerto Rico, at the Fair Haven Com­mu­nity Health Cen­ter Wednesday in New Haven, where she works. At right is Car­men Ca­ma­cho.

Margarita Ser­rano, right, talks about her in-laws from Puerto Rico who have come to live with her after Hur­ri­cane Maria, at the Fair Haven Com­mu­nity Health Cen­ter Wednesday in New Haven. At left is Brenda Ne­gron.

Arnold Gold / Hearst Con­necti­cut Me­dia

Dr. Mered­ith Niess, left, lis­tens to Brenda Ne­gron talk about her mother in San Se­bas­tian, Puerto Rico, and the con­di­tions after the dev­as­ta­tion from Hur­ri­cane Maria, at the Fair Haven Com­mu­nity Health Cen­ter Wednesday in New Haven.

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