Puerto Rico Annie Alonso Amador, Psy.D. ,MSW Myrna L. Quiones, MD - - PowerPoint PPT Presentation

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Puerto Rico Annie Alonso Amador, Psy.D. ,MSW Myrna L. Quiones, MD Institute on Developmental Disabilities PR-UCEDD Great Lakes Collaboration Focus on Autism October 4, 2012 Geography Puerto Rico is the smallest of the Greater Antilles.

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Puerto Rico

Annie Alonso Amador, Psy.D. ,MSW Myrna L. Quiñones, MD Institute on Developmental Disabilities PR-UCEDD Great Lakes Collaboration Focus on Autism October 4, 2012

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Geography

Puerto Rico is the smallest of the Greater Antilles.
Puerto Rico is an archipelago. The main island is

Puerto Rico and two smaller islands which are populated (Vieques and Culebra). There are

ther small keys or islets that are not populated

around the main island. The main Island is mainly

mountains. We have two mountain ranges.
Located between the Caribbean Sea and the

Atlantic Ocean

To the west we have the Dominican Republic
To the south-east we have the Smaller Antilles

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State Plan Highlights

To know how many children with autism we have in Puerto

Rico.

Support a registry of children with autism.
To work with the Administration of Health Insurance of the

Government of Puerto Rico to included autism as a preexisting cover in the “ Mi Salud” Plan.

Advocate for the completion of the bill for the creation of

interagency policy for ASD (Department of Health, Education, Administration of Child Care and Development (ACUDEN), and others).

Continue the development of pre-service and in-service

training for teachers, therapists, and health care providers.

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programs.

Department of Education.

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Accomplishments

Prevalence Study: Report 1/62 children with

autism ( 2011).

Autism Center : Service , Training and
Research. Start services April 2012 as a UCEDD

training site.

Autism Public Policy PR Public Law 220,

September 4, 2012.

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Challenges

Primary care physician training (special health

coverage).

Service providers training about best practices

in diagnosis and intervention.

Services through adulthood.
Access to community based services.
Data collection system.

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Next Steps

Establish a surveillance system.
Implementation of the new public policy bill.
Research about culturally appropriated

intervention practices.

Continue training to service providers.
Continue evaluation of health services

utilization for the population with autism (public and private insurance).

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Demographics

According to the 2010 Census the population of Puerto

Rico is 3,725,789.

An estimated 20.6 % of the population has a disability

and is not institutionalized. (2009)

– Ages 18 or less – 7% – Ages 18-64 - 18.1% – Ages 65+ - 55.2%

Services to the DD population in the central part of the

Island is very limited, compared to the services in the coastal areas, where the main cities are located.

The estimate of people with disabilities in Puerto Rico

is 20% (American Community Survey).

Autism prevalence 1/62. Considering all ages PR have

28,745 persons with autism.

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1.5% 1.7% 1.4% 1.0% 1.8% 2.3% 1.0% 1.9% San Juan

PR Regions and Autism prevalence

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Economics

Traditionally Puerto Rico has been considered the

poorest jurisdiction of the United States

One fourth of the population lives in poverty.
50% of the population is over 65 years old.
Women comprise 52% of the population (US Census

2010)

The poverty level of people with disabilities is higher

than the population without a disability. (2009)

– 41.6% versus 39.3% under the poverty level – 17.2% versus 16.7% on poverty level

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Annual income :families with children with autism

38 29 18 5 8 16

5 10 15 20 25 30 35 40 < 10,000 10,000-19,999 20,000-29,999 30,000-39,999 40,000-49,999 50,000+

PR Autism Prevalence Study 2011

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Statistical Data on Education

Part C serves 5,204 children 0 to 3 yrs.
Department of Education serves 13,952 children 3 to 5 yrs.
Special Education Program serves 126,560 children from 6

to 21 yrs.

49% of people with disabilities do not have a high school

diploma compared to 30 % of the non-disabled population

Only 1,813 students with disabilities graduate from high

school a year (2009)

There are 5,097 qualified special education teachers for the

population of 6 to 21 yrs.

2008-2009: 1,534 Latest report for children with autism

served by Part B in PR .

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IEP: Children with autism

20 80 No Sí

PR Autism Prevalence Study 2011,

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Health

93% of the population with disabilities has some type of health
insurance. 96% of the population without a disability has health
insurance. There are some capitation issues related to medical

referrals to specialists.

Puerto Rico has a Medicaid cap. Funding is approximately 20% of

what a state normally receives according to its population.

We do not have Medicaid waivers. The only state program we have

is very limited and it is administered by the Department of the Family and includes the elderly and only includes part-time day care if the person is bed-ridden.

The government’s health insurance revised the coverage to include

pre-existing conditions specially children with autism.

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Transportation

Accessible public transportation is very

limited, making employment , recreation and in general, quality of life, very difficult to achieve for the population. The only para- transit system that exists is located in the San Juan Metropolitan Area (8 municipalities) with a fleet of 50 accessible buses.

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Next Steps/Future Plans

Dissemination of information about the new

public policy bill and the rights of the population with autism.

Assure private insurance companies are in

compliance with the public policy.

Establishes a surveillance system.

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annie.alonso@upr.edu myrna.quinonez@upr.edu