Program Description

Provides terciary health services in the metropolitan area along with superterciary services to all regions in Puerto Rico. It has 287 beds. This Hospital accepts patients suffering from complicated health conditions that require high levels of specialized medical care. In addition, it serves as a training facility to the different health professionals and promotes clinical research to improve the care of patients. Among the superterciary services this Hospital offers are urological services, lipotropic services, dialysis, trauma center, plasmaphyresis, bone marrow, nuclear medicine, orthopedics, intensive medical-surgical services, neurosurgery, birthing center and nursery.

Objectives

• Improve the quality of the services offered by the Adult University Hospital and guarantee that they are within reach of the medically indigent population.

• Improve the admissions process by decreasing the amount of time the patient spends in the ASEM Emergecy Room, to less than 48 hours.

• Include research and investigation activities in the educational curriculum and in services provided by clinics.

• Stregthen the services of the Bone Marrow Clinic Unit

• Stregthen the services of the Assistance to Patients and Community Relations Office.

• Develop a new information system that integrates with the ASEM Systems.

• Continue refurbishing the Hospital's physical plant to meet current service needs. Continue to repair deteriorated areas and improve the Hospital's functions.

Statistical Data	2010	2011	2012
Admissions	10,027	9,907	9,798
Average stay	7	7	7
Daily Average Census	196	208	211
Days/Patient	72,660	77,146	77,232

The statistical data was provided by the Agency during the budgetary process for fiscal year 2011-2012.

Customers

Patients 16 years of age and older referred by regional, area, municipal and private hospitals.

Human Resources

Authorized and Proposed Positions	2009	2010	2011	2012
Managerial,Technical, Administrative, and Office Staff	115	115	68	62
Other staff	4	5	2	2
Other Safety and Protection Staff	1	1	1	1
Food Services Staff	30	30	27	24
Planning, Budget, Statistics, Auditing, and Finance	108	92	82	78
Maintenance and General Services Staff	46	46	24	24
Families and Community Services Staff	22	15	14	9
Health Services	711	638	635	661
Total, Positions	1,037	942	853	861

The Pediatric Hospital currently has 162 beds. The distribution, up to June 30, 2010 was 55 General Pediatrics, 30 Pediatric Surgery, 25 Neonatal Intensive Care, 10 Pediatric Intensive Care, 15 in Oncology and 3 units on Bone Marrow Transplant. It also inclues 7 Isolation rooms which are distributed as follows: 2 units for general surgery, 2 pediatric units and 3 pediatric intensive care units.

The Hospital also includes an Emergency Room and 4 Surgical Rooms outfitted with instruments and equipment required for all pediatric surgeries. During that same fiscal period, 3,761 surgical procedures were performed. Practically, all pediatric services necessary for the diagnosis and treatment of pediatric medical conditions are offered in this facility. Such services are offered in an environment that has been adapted to the needs and characteristics of the pediatric population. The majority of services are highly specialized. Among the services offered are: intensive care for premature, pediatric retinopathy intensive care, medical genetics, bone marrow transplants, cardiology, hemotology and gastroenterology, endocrinology, neurology and others.

Within the surgical specialty there are innumerable services that require specialized and competent knowledge, skills and personnel to tend to the patient's health problems: general pediatric surgery, opthamology, urology, neurology, orthopedics, EENT (Eye ,Ear, Nose and Throat specialist) and thoracic surgery. Surgeons count with the support of the Department of Anesthesiology of the Medical Sciences campus and the ASEM.

Education and research are an integral parts of the Hospital's capabilities. The most modern and scrutinize medical attention is guaranteed.

Objectives

• Continue to provide terciary and superterciary level services to the entire pediatric population of Puerto Rico and the Caribbean, as established by public policy on health, and in compliance with the standards established by the agencies that regulate and certify health services installations.

• Comply with the licensing regulations for different health installations, hospitals, laboratories, pharmacies and meet the standards of quality that relate to the health services offered to the pediatric population of Puerto Rico and the Caribbean.

• Continue to monitor Infection Control and Safety of Life of patients, employees and visitors.

• Serve as a teaching hospital and contribute to the preparation of professionals in the health field in order to respond more effectively to the health needs of the population.

• Meet the quality standards for services provided by the Clinical Departments.

• Comply with the accreditation requirements as set forth by renowned, competent organizations in order to maintain the required certifications.

Statistical Data	2010	2011	2012
Admissions	4,762	4,544	4,791
Average stay	7	8	8
Beds in use	162	162	163
Daly average census	124	127	130
Days/Patient	45,278	46,636	47,450
Emergency room visits	7,298	7,272	7,500
External clinics visits	14,503	18,099	18,099
Surgical interventions	3,447	3,447	3,447

Customers

Minors up to 17 years old

Human Resources

Authorized and Proposed Positions	2009	2010	2011	2012
Managerial,Technical, Administrative, and Office Staff	208	164	83	69
Other staff	1	4	4	1
Food Services Staff	11	11	11	10
Planning, Budget, Statistics, Auditing, and Finance	69	65	60	63
Education and Recreational Services Professionals	1	1	1	1
Public Relations and Communications	2	2	2	2
Maintenance and General Services Staff	38	38	38	35
Families and Community Services Staff	14	11	11	11
Health Services	425	350	388	388
Total, Positions	769	646	598	580

Program Description

Provide the indigent population access to quality medical services through the financing of medical expenses for persons whose income and/or resources are insufficient. Anyone that applies for the Health Services Insurance Card is eligible according to the category and indigency parameters established at the federal and state levels. It should be noted, that the Department of Health is the state agency designated to administer the Federal Medical Assistance Program (Title XIX of the Social Security Act, which began in Puerto Rico on January 1, 1966, by virtue of Public Law No. 89-97 of July 30, 1965 and Title XIX, also know as Children's Health Insurance Program.

Objectives

• Determine the socioeconomic eligibility of the clients applying for the Medical Assistance Program (PAM, Spanish acronym) and for the Health Care Reform.

• Evaluate and certify within 30 days or less, once the applicant presents all required documentation, and according to the standards and procedures established by the Federal and State Governments.

• Evaluate applicants according to the standards and procedures established by the Federal and State Governments.

• Promote the program through the development of educational offerings that promote self care, therapeautic committment, health maintenance and prevention of illness.

• Continue to aggressively monitor the services to prevent fraud.

• Increase provider satisfaction by paying for health services provided to uncertified beneficiaries or to the uninsured public, in a timely manner.

• Measure the quality of routine services in order to facilitate decision making.

• Advise clientele on its rights and responsibilities.

Customers

Any person with limited or no income, that seeks eligibility for the Commonwealth of Puerto Rico's Medical Health Plan, better known as "Medicaid" or "Health Reform Program."

Human Resources

Authorized and Proposed Positions	2009	2010	2011	2012
Managerial,Technical, Administrative, and Office Staff	460	381	268	253
Judges, Lawyers, and Legal Staff	0	0	1	0
Other Safety and Protection Staff	13	13	13	0
Food Services Staff	1	1	1	1
Planning, Budget, Statistics, Auditing, and Finance	21	21	21	20
Maintenance and General Services Staff	92	92	55	52
Families and Community Services Staff	483	528	513	491
Health Services	162	162	96	96
Total, Positions	1,232	1,198	968	913

Program Description

Implements public policy related to the health sector and directs the agency's programs. It is composed by the following offices: Secretary of Health, Undersecretary, Legal Counsel, Communications, Internal Auditing, Federal Affairs, Special Aides, General Health Council, the Fund for Catastrophic Illnesses Office, and the Office of the Panamerican Health Organization (OPS, Spanish acronym). This last office places Puerto Rico within an international context, as advisor and beneficiary of the experiences of other countries within the perspective of scientific-technological developments and needs within the health area. In addition, it includes the Commission for Suicide Prevention, (Act No. 227 of August 12, 1999, as amended), the Puerto Rico Commission for Food and Nutrition (Act No. 10 de of January 8, 1991) and the Office of Implementation and Monitoring of HIPAA. The latter has the responsibility of overseeing compliance with the HIPAA law by making sure the entities abscribed to the Department of Health tend to and provide follow-up to the administrative simplification phase.

Objectives

• Identify risk factors and suicide warning signs to prevent suicides.

• Audit designated areas based on priority, objectives, materials, risks and available resources.

• Offer advice and training to increase value and improve the Agency's operations.

• Promote ethical conduct via the Ethics Committee.

• Provide adequate training to each auditor, based on their knowledge, personal qualities and education, in the techniques, and skills necessary to carry out their assigned duties.

• Perform the required investigations when the misuse of public funds, theft or vandalism of property occurs.

• Keep the public informed regarding activities developed by the agency and about health matters that affect the Puerto Rican community.

• Advise and notify all operating levels of the Department regarding public communications.

• Provide a solid communication structure that facilitates divulging any information that will assist or provide orientation to the public in an effective and immediate manner.

• Attend, in a timely manner, the immediate needs and complaints of persons that visit the Department of Health seeking orientation and assistance.

• Facilitate the dissemination of educational information on the importance of health and disease prevention.

Customers

The general population

Authorized and Proposed Positions	2009	2010	2011	2012
Managerial,Technical, Administrative, and Office Staff	44	47	40	37
Judges, Lawyers, and Legal Staff	9	9	7	6
Other staff	3	1	0	0
Planning, Budget, Statistics, Auditing, and Finance	10	10	7	7
Public Relations and Communications	1	0	0	0
Maintenance and General Services Staff	3	3	3	4
Families and Community Services Staff	0	0	3	2
Health Services	2	2	0	0
Total, Positions	72	72	60	56

Program Description

The Demographic Registry of Puerto Rico (RDPR, Spanish acronym), is the custodian of vital statistic records that contain the demographic data. It provides a service of the highest quality to guarantee confidentiality, privacy and security for the registration of vital events and issuance of documents. It is also responsible for compiling, through its certificates and documents, social, demographic, epidemiological and medical-clinical data about the Puerto Rican population. This data serves as basis for scienfic research, report generation, decision making and for the implementation of public policy. The Registry includes one central office, 7 regional directorates and 78 local registries as well as 3 special registries.

In the local offices, all births, marriages, deaths and fetal deaths that occur in Puerto Rico are registered. On the other hand, the Registry has responsibilities of an administrative as well as judicial nature, such as: emancipations, legitimizations, adoptions, late registrations by judicial order, annulment of marriages and marriages by proxy.

• Complete the Vital Certificates registration process.

• Propose a bill of amendment to Act No. 24, the Demographic Registry Act.

• Comply with the procedures established by the National Center for Health Services regarding the coding, data entry and review of vital records.

• Register, protect and preserve the population's vital statistics.

• Revise and update existing protocols and procedure guides.

• Comply with Act No. 220 of 1998.

• Train the Registry of Property personnel.

• Perform administrative processes efficiently.

• Establish ties with public and private agencies at the federal and state leves.

• Educate the community regarding the different services offered by the Registry of Property.

Statistical Data	2010	2011	2012
Birth certificates issued	725,542	871,154	872,025
Death certificates issued	93,983	112,540	112,653
Expeditions - other certifications such as negative expeditions, marriage licenses and other	15,777	19,391	19,411
Inscriptions Subtotal	126,032	96,001	96,098
Locations - mechanized clearances	20,255	20,236	20,256
Locations - other transactions	22,676	22,779	22,801
Quality control - control, review and verification transactions	96,343	96,343	96,440
Rare causes and AIDS deaths-processed and verified	318	16	16
Registration Births	45,186	45,186	45,231
Registration Deaths	29,764	29,763	29,793
Registration Marriages	50,479	20,450	20,470
Registration Stillborn	603	602	603
Shipments - permits to transfer corpses	24,237	27,938	27,966
Stillborn death certificates issued	149	129	129
Subtotal certificates issued	933,741	1,112,344	1,113,457
Vital operations - Children recognition	3,340	3,341	3,346
Vital operations - adoptions	236	342	342
Vital operations - divorces received and controlled	14,615	14,614	14,629
Vital operations - emancipations	2,494	2,680	2,683
Vital operations - legitimization of children from other marriages	131	120	120
Vital operations - other adoption transactions, late registrations, marriages by proxy, marriage signature registers, medical legal deaths and others	39,157	28,417	28,447
Vital operations - system corrections	2,545	2,544	2,547
Vital operations Subtotal	50,691	52,058	52,114
Wedding certificates issued	74,053	81,192	81,273

Customers

The entire population of Puerto Rico.

Human Resources

Authorized and Proposed Positions	2009	2010	2011	2012
Managerial,Technical, Administrative, and Office Staff	252	218	66	54
Other staff	85	81	153	136
Other Safety and Protection Staff	3	3	2	2
Planning, Budget, Statistics, Auditing, and Finance	6	6	6	6
Maintenance and General Services Staff	20	19	19	18
Health Services	1	1	0	0
Total, Positions	367	328	246	216

Program Description

Administer the state public health facilities that provide primary, secondary and terciary medical-hospital services in the different medical specialties and sub-specialties. Through this Program, services of the highest quality in hospitalization, emergency and external clinics are made available to the community within the serviced geographical area. This program encompasses the health services offered through the unsold health facilities. This includes the Bayamon Regional Hospital and the following health centers throughout the Island: Naguabo, Las Piedras, Yabucoa, Santa Isabel, Adjuntas, Vieques and the Public Health Unit of Ro Piedras. Emergency rooms operate 24 hours a day in: Aguas Buenas, Barceloneta, Camuy, Castaer, Ciales, Corozal, Culebra, Dorado, Gunica, Guayanilla, Jayuya, Isabela, Lajas, Lares, Maricao, Maunabo,Morovis, Quebradillas, Sabana Grande, Toa Alta, Toa Baja and Trujillo Alto.

• Implement regulation for the licensing of the different health installations such as hospitals, laboratories, drugs and pharmacies; and establish standards of quality for the health services.

• Automate Invoice and Collection process for Health Insurance providers, both prepaid and non-private.

• Increase the funds collected from invoicing and the billing of health insurance providers, both prepaid and non-private.

• Improve the facilities of the Bayamon Hospital, enlarge the capacity of the Operating Room and increase services in order to ease congestion at the Puerto Rico Medical Center.

• Relocate the Culebra Diagnostic Treatment Center (CDT) to a new facility at the old Baxter plant.

• Continue refurbishing of physical plant at the Ramn Ruz Arnau University Hospital and at the Diagnostic Treatment Center (CDT) to meet current service needs.

Customers

The general public, with emphasis on the medically indigent population

Human Resources

Authorized and Proposed Positions	2009	2010	2011	2012
Sciences and Environment staff	1	1	1	1
Managerial,Technical, Administrative, and Office Staff	202	173	128	114
Other staff	5	7	6	0
Other Safety and Protection Staff	13	13	8	8
Food Services Staff	16	16	16	14
Planning, Budget, Statistics, Auditing, and Finance	74	73	61	60
Maintenance and General Services Staff	93	72	48	48
Families and Community Services Staff	15	15	10	7
Health Services	381	363	353	313
Total, Positions	800	733	631	565

Program Description

Serves as an institutional and support tool for the Department of Health's executives to facilitate the decision making process and allow them to meet established goals in an efficient and productive manner. In addition, it counsels the secretary of health in matters pertaining to the health of the population by analyzing the data generated by the Department and identifing predominant health tendecies. Some of the activities that need to be completed in order to meet established goals are: systematize and institutionalize the planning process, formulate short and long term plans, monitor the quality of the services, develop and analyze health related statistics, allow easy access to the patient medical records and information, and determine eligibility to the Puerto Rico's Government Medical Plan.

Objectives

• Assist the Agency's directors in the formulation of public policy and in the establishment of strategic plans that allign with said policy.

• Provide the technical assistance needed to implement the strategic planning process in all Health Department's programs, to identify the needs, priorities and development strategies.

• Manage the process of generating an Integranted Development Plan that includes performance measurement tools and the mechanisms with which to update the plan's contents.

• Analyze the findings or results regarding the state of health, the utilization of medical, dental and hospital services; and other indicators of the Continuous Study on Health.

• Continue with the development and implementation of the Puerto Rico Healthy Community 2010 by providing the necessary technical support and follow up.

• Provide the statistical information that will serve as a frame of reference for making of decisions and the formulation of public policy through the compilation and analysis of statistical health data generated through the different Department of Health agencies and programs, as well as through private institutions that provide health services.

• Facilitate reliable health service information to all users.

• Divulge and disseminate statistical information about the diverse aspects related to public health through the publication of reports on vital statistics, health professionals, health installations as well as special bulletins by psychologists, medical doctors and others.

• Define the indicators and standards that will be used to monitor, evaluate and analyze the quality of health services provided to participants of the health reform, as well as those that use private providers.

• Design questionnaires or evaluation tools for the different types of studies.

• Understand and analyze the results of the studies and the evaluations.

• Evaluate the proposals submitted by the different programs or projects.

• Consolidate the Geographical Information System, its structure, its network of users and database, in order to facilitate the use of this tool within the offices and programs of the Department of Health.

• Increase the levels of information and epidemiological analysis, obtaining geo-spatial information useful in public health studies and analyses.

Statistical Data

The statistical data was provided by the Agency during the budgetary process for fiscal year 2011-2012.

Customers

The Department, Federal Government institutions, other public agencies, private entities, students and the general public.

Human Resources

Authorized and Proposed Positions	2009	2010	2011	2012
Managerial,Technical, Administrative, and Office Staff	23	21	17	16
Other staff	8	7	3	1
Other Safety and Protection Staff	9	0	0	0
Planning, Budget, Statistics, Auditing, and Finance	11	11	11	11
Maintenance and General Services Staff	1	1	1	1
Information Systems	36	28	27	25
Total, Positions	88	68	59	54

Program Description

This program is part of the Department of Agriculture's Federal Food and Consumer Services Program. It provides services to low income pregnant women, infants and children from 1 to 5 years of age who are at nutritional risk. The program includes nutritionists, nurses and doctors that evaluate the participant's medical-nutritional needs to establish the food supplements each should have, according to their risk and dietary needs. The program, provides food stamps that can be redeemed in previously authorized commercial establishments. There are 700 authorized stores throughout Puerto Rico. The foods provided to the participants must meet the nutritional criteria established by the Federal Government, which includes: sources of protein, calcium, iron and vitamins C and A, among others.

• Identify ways to help participants achieve a healthy weight. Offer educational advice that will stress the balance between energy (calories) consumed and the energy consumed through physical activity, according to the recommendations of the Promise for Healthy Weight Foundation, to change and reduce 1.5 trillion calories by fiscal year 2011-2012.

• Implement the Lets Move Initiative in clinics that focus on childrens' weight control.

• Educate parents about the importance of keeping their children at a healthy weight to prevent conditions associated with excess weight and early childhood obesity.

• Offer educational activities according to the established plan for children identified as high risk.

• Continue educating participants about the nutritional aspects and the benefits of consuming low fat milk as part of their daily food intake.

• Educate participants and their guardians on the importance of consuming whole grain cereals or whole wheat products.

• Develop educational strategies specifically aimed at mothers on the importance of consuming cereals or food products made of whole wheat.

• Include clases on consumption of healthy products as part of the Education in Nutrition Plan.

• Continue to educate participants, individually as well as in educational activities, about how to obtain the benefits of Cash Value Vouchers (CVV) and how to make the best use of them at authorized commercial establishments.

• Educate participants on how to select fruits and vegetables with high nutritional value and its importance in reducing the risk of chronic diseases, excess weight and obesity.

• Educate participants on the importance of increasing the intake of Vitamin A and C, Folic Acid, potassium and fiber.

• Recruit and retain trained nutricionists to offer high quality services. The state agency will put into effect all strategies required for this.

• Train nutritionists on the Strengthening and Valuation of Nutritional Assessment process (VENA, Spanish acronym).

• Train nutritionists on new risks criteria and incorporate this criteria into the MIS application.

• Conduct training in the Using Loving Support to Grow and Glow in WIC to provide more information about lactation.

• Process food stamps and cash certificates efficiently.

• Provide Regional Directors the information and tools needed to increase participation.

• Provide orientation to illiterate applicants on how to obtain access to the services provided by the WIC Program with promotional materials with graphic representations.

• Authorize commercial establishments by enforcing the Federal Regulations and State Laws.

• Use a contractor for all purchasing related work.

• Investigate with the Department of Health's Internal Audit Office and the WIC Program's Merchants Administration Office, cases of misuse of instruments of exchange and cash certificates by authorized merchants, participants and program employees.

• Revise the RFMNP agreement in order to incorporate the applicable procedures to allow Roadside Stands and Farmer's Markets to redeem the Cash Value Certificates.

• Continue to verify compliance with the operating responsibilities of the WIC clinics, as they relate to the activities linked to the FMNP.

Statistical Data	2010	2011	2012
Children	413,844	413,844	417,982
Infants	162,786	162,786	164,413
Nursing infants	22,449	22,449	22,673
Post- partum	44,657	44,657	45,103
Pregnant women	96,626	96,626	97,592

The statistical data was provided by the Agency during the budgetary process for fiscal year 2011-2012

Composed of low income pregnant, lactating or post-partum women; as well as infants and children from 1 to 5 years of age, that are at nutritional risk during a critical period of their development, and that qualify according to the criteria of eligibility by income. On average 199,077 cases are seen on a monthy basis.

Human Resources

Authorized and Proposed Positions	2009	2010	2011	2012
Managerial,Technical, Administrative, and Office Staff	417	414	332	312
Judges, Lawyers, and Legal Staff	1	1	0	0
Other staff	1	1	0	0
Planning, Budget, Statistics, Auditing, and Finance	12	12	12	12
Maintenance and General Services Staff	89	89	41	40
Families and Community Services Staff	38	38	55	53
Health Services	222	152	226	241
Total, Positions	780	707	666	658

Program Description

Develops standards; plans and evaluates primary health services through a preventive, comprehensive and holistic focus on the individual within the context of a family group. As of Administrative Order No. 179 of January 15, 2003, a new focus for health services became official. It is founded on the following principles: the prevention of risk factors associated with non-contagious chronic illnesses; restructuring to create effective promotional models in response to public health and aimed at protecting the health and security of the individuals and the communities through vaccination; monitoring epidemiological diseases and the environmental aspects that affect public health. The program revolves around the provision of health maintenance and disease prevention services, with an emphasis on the medically indigent population, specially on high risk groups such as women, children with special health needs, adolescents and the elderly. Through this Program, specialized services are also offered to the handicapped population from 0 to 21 years of age and to victims of sexual assault. In addition, assessment and treatment for patient with HIV and other contagious diseases. Vaccination services are offered as well as diagnostic and intervention services for eligible handicapped infants from birth to 2 years of age as provided by Act No. 51 of June 6, 1966, as amended, to create the Office of the Assistant Secretary of Integrated Educational Services for Handicapped Persons, known as the Special Education Act. It is important to note that this Program also includes the Fund for the Treatment of Non-Fatal Catastrophic Illnesses that offers financial assistance to patients that lack the financial resources, and to their families.

Objectives

• Work with the Ryan White Program, Part B, to identify women and youth with HIV who discontinued their primary medical treatment for HIV at the Centers for the Prevention and Treatment of Communicable Diseases (CPETTs).

• Establish a referral monitoring and tracing system for women, youth, adolescents and children with HIV to facilitate compliance.

• Offer individual education to the population of women with HIV and pediatric clients, to increase knowledge of conditions related to HIV, adherence to the treatment and the adoption of healthy behaviours that will minimize the transmission of HIV.

• Join forces with local/state agencies and community based organizations (CBOs) to organize a minimum of 12 community based activities per year to identify new cases of women and youth with HIV/AIDS.

• Promote self-care in patients with respect to their own medical care, through the establishment of support groups that foster auto-sufficiency of patients/consumers.

• Reduce the incidence of preventable Neural Tube Defects (NTD) for 2012 to 7.5/10,000 of live births.

• Maintain, in a continuous and systematic manner, the auditory testing of all neonatal children in Puerto Rico, before being released from the hospital, or before completing 1 month of age, when born in a locale without auditory testing services.

• Set the foundation that will ensure the continuity of the Esteban Calderon Vaccination Centers so that the population can continue to access these services.

• Facilitate access to vaccination services for all children with private health insurance. Include all private health insurance participants in the Puerto Rico vaccination proposal.

• Provide access to the automated Puerto Rico Immunization Register (PRIR) in the Esteban Calderon Centers.

• Provide vaccination services to adults in the Esteban Caldern centers.

• Provide FDA approved medication through the Aids Drugs Assistance Program (ADAP), to treat HIV/AIDS and cover the costs incurred by the medically indigent (income equal to or less than 200% of the federal poverty level), or of patients that have no medical coverage (public or private) or patients that have limited prescription medicine coverage.

• Medically indigent HIV patients that have private insurance with limited or unlimited (co-payments, co-insured or other deductibles) prescription medicine coverage and need access to antiretroviral medication are covered by ADAP.

• Strengthen clinical human resources and support in the CPTET's through funds from the Ryan White Program, Part B.

• Offer support to contracted community organizations in such a way that payment for services subsidized by the the Ryan White (Program) Part B is made in a quick and efficient manner minimizing the interruption of services.

• Identify and effectively address the limitations in clinical treatment, psychosocial and support services provided to the VIH/AIDS population that receive services at the Centers for Prevention and Treatment of Contagious Diseases, Community Based Organizations, and Agencies and Consortiums financed by the Ryan White Program, Part B.

• Increase the number of patients that receive on going treatment based on referrals from search services.

• Increase the percentage of women from Program Services to at least 30% of the total of women seen.

• Start the recruitment process and hire the professionals needed to evaluate and offer services at the Autism Center.

• Through the coordination of services, have the Center direct its efforts towards evaluation and referral, utilizing programs from the Board of Education, pediatrician's offices and other private level professionals.

• Have the Center focus on discussing multidisciplinary team's cases and on the coordination of new projects driven by evidence-based practices.

Statistical Data	2010	2011	2012
Cancer preventive services	102	102	102
Cases of aids deaths	302	389	322
Cases receiving benefits from the catastrophic illness fund	300	208	188
Issuing cards to seniors	14,281	14,281	14,281
Services to rape victims (counseling, therapy, referrals, education, etc.)	52,000	52,000	52,000
Sexually transmitted diseases diagnosed cases	16,404	19,815	19,815
Special children services	83,598	83,598	83,598
Vaccination - doses administered	3,475,132	3,963,132	3,963,132

The statistical data was provided by the Agency during the budgetary process for fiscal year 2011-2012

Customers

Children, pregnant women, adolescents, the elderly and physically and mentally handicapped persons, as well as patients with Human Immunodeficiency Virus (HIV), Acquired Immunodeficiency Syndrome (AIDS) and sexually transmitted diseases

Human Resources

Authorized and Proposed Positions	2009	2010	2011	2012
Sciences and Environment staff	3	0	0	2
Managerial,Technical, Administrative, and Office Staff	320	280	139	175
Other staff	62	160	162	53
Other Safety and Protection Staff	3	3	2	0
Planning, Budget, Statistics, Auditing, and Finance	96	93	93	98
Maintenance and General Services Staff	68	66	63	62
Families and Community Services Staff	154	129	126	126
Health Services	513	435	436	440
Total, Positions	1,219	1,166	1,021	956

Program Description

Oversees and complies with the sanitation laws and regulations of the Department of Health. Also responsible for public health in the areas of food services, milk safety, drinking water control, zoonosys, animal control, dengue fever control, the cleanliness of the surrounding environments, sanitary engineering and radiological health.

Provides guidance, has an evaluation process and maintains reliable information regarding all of the problems related to environmental health. The system has 3 levels. The central level exercises the functions of technical support, evaluation and training; and formulates the standards and procedures related with the regulation of environmental health. The regional level exercises the administrative duties and provides direction for the system according to the standards and procedures established by the central level. Finally, the local level carries out field operations, which include: inspections, reinspections, taking of samples for chemical, bacteriological and physical analysis, confiscations, embargoes, condemnations, cancels licences, handles complaints, lifting of condemnations, pesticide spraying in communities, sanitation surveys, cleaning campaigns, issuing of permits, endorsements, certifications, granting of extensions of time and investigation of complaints in the programs and service areas, and first response services in the event of emergencies.

Objectives

• Institute a rapid action antivectorial system to control outbreaks of dengue fever in 90% of the sectors identified by the surveillance system.

• Maintain a system of virological vigilance for dengue fever and hemorrhagic dengue fever in coordination with the CDC laboratory and create a multisector commission to institute an integrated action plan.

• Inspect establishments that prepare and serve food to achieve a sanitary compliance index of not less than 90% on a scale of from 0 to 100%.

• Inspect 100% of the school lunchrooms included in the service contract with the School Food Authority.

• Inspect summer camps where the Department of Education offers the Summer Food Program.

• Inspect 100% of the dairies and pasteurization plants on the island and 90% of the samples collected for bacteriological and chemical analysis.

• Inspect food factories, warehouses, bakeries and pastry shops, water bottlers and ice plants.

• Inspect 100% of the food establishments included in the contract with the Food and Drug Administration.

• Register and certify 3,800 X-Ray machines.

• Inspect and certify 100% of the mammography machines used in the mammography screening clinics included in the Food and Drug Administration.

• Investigate 100% of the reported cases of exposure to rabies. Approve regulations to license commercial animal breeders.

• Investigate complaints received regarding violations of the sanitation regulations.

• Investigate 100% of the complaints related to important vectors in public health such as the Dengue Fever mosquito.

• Drinking water systems are 100% compliant with state and federal regulations.

• Complete tasks and activities included in the Potable Water Division's annual workplan as established by the Environmental Protection Agency (EPA).

• Revise all drinking water facility's construction or modification projects as they are submitted for endorsement of contruction or operation.

• Grant loans to finance the construction of the infrastructure for drinking water systems so that they comply with the Safe Drinking Water Act (SDWA).

• Continue to comply with the Amended Transactional Agreement between the Department of Health and the Aqueducts and Sewer Authority, so that the Authority's drinking water complies with state and federal laws and regulations.

• Carry out 8 mass vaccinations against rabies in animals.

• Audit 100% of the subsidies granted by the OECA and execute agreements with the Department of Education for training teachers, as well as continue the training and certification of Animal Control officers.

• Investigate 100% of the reported cases of food poisoning.

Statistical Data	2010	2011	2012
Aqueducts bacteriological samples	3,575	3,575	6,170
Food factory inspection	1,656	1,656	1,368
Inspection of milk facilities	597	597	484
Restaurants and food services inspections	13,466	13,466	13,799
X-ray machine inspection	1,612	1,612	720

The statistical data was provided by the Agency during the budgetary process for fiscal year 2011-2012

Customers

Environmental health services have an impact on the entire population of Puerto Rico. In addition, they also have an impact abroad, as is the case of the production and distribution of food and drugs that are made in, or sent out of the Country.

Human Resources

Authorized and Proposed Positions	2009	2010	2011	2012
Managerial,Technical, Administrative, and Office Staff	73	73	40	35
Other staff	62	58	55	51
Planning, Budget, Statistics, Auditing, and Finance	14	7	8	8
Maintenance and General Services Staff	18	12	9	9
Families and Community Services Staff	1	1	1	0
Health Services	285	258	256	247
Total, Positions	453	409	369	350

Program Description

Plans, issues standards, and expedites licenses to regulate and provide accreditation for health institutions and services. One of its functions is to make certain that all health facilities are established in an orderly manner by ensuring compliance with the laws, regulations and state and federal standards and make sure that all institutions are duly authorized, licensed and certified so that the beneficiaries receive the appropriate quality services. Among its activities is the Certification of Need and Convenience required to establish health facilities in Puerto Rico; the regular inspection of the facilities committed to drug manufacturing and distribution; the regulation of clinical and anatomical laboratory operations, blood banks, plasmapheresis and serumpheresis; the inspection required to certify health facilities participating in the Medicaid, Medicare and the Clinical Laboratory Improvement Amendments (CLIA). The inspection of state, municipal and private ambulances; the inspection and licensing of Tattoo Studios; the maintenance of a Dermographic Artists Registry; authorizes the issuing of Health Certificates by physicians and administers the Patient's Bill of Rights. On the other hand, it investigates complaints related to health services and the Board of Drug Bioequivalents is ascribed to it. The Board's purpose is to educate patients regarding the use, accessibility and benefits of bioequivalent drugs.

• Offer high quality services while recognizing patient's needs and guarantees the access to services for those who request them.

• Maintain a high quality service and anticipate changes to the external environment that may impact the needs and services of the clientele, thus increasing our capacity to respond.

• Offer quality service by maximizing the capacity and potential of the labor force and optimizing the technological and administrative infrastructure, thus obtaining the best from our resources.

• Complete 100% of inspections to health institutions and services, and related establishments, according to applicable regulations. Certify the majority of the facilities and health services.

• Improve employee performance as well as the services offered to clients and increase the number of applications received by health facility.

• Help control the costs of health service industry and insure that services are provided in the areas where they are needed.

• Educate tattoo and body piercing artists regarding sterilization measures. Offer testing for the licensing of Tattoo and Body Piercing Artists. Establish the Tattoo and Body Piercing Artists' Registry.

• Comply with the requirements of the ADA law.

Customers

This Program grants licenses and inspects health installations, establishments, ambulances, products and drugs.

• 72 Hospital
• 5 Extended Care Units
• 6 Health Houses
• 7 Rehabilitation Centers
• 6 Mental Health Centers
• 2 Mental Retardation Medical Installations
• 39 Renal Units
• 28 Ambulatory Surgery Centers
• 15 Emergency Wards
• 1 Public Health Units
• 127 Diagnostic and Treatment Centers
• 2 Psychosocial Rehabilitation Centers
• 47 Home Health Services Programs
• 37 Hospices
• 32 Pharmaceutical Industries
• 736 Medicine Chests
• 877 Clinical Pathology Laboratories, Blood Banks y Medical Offices
• 985 Pharmacies
• 44 Druggist shops
• 35 Sales Agents
• 66 Wholesale Drug Distributors (OTC)
• 184 Retail Drug Distributors (OTC)
• 1,200 State, Municipal and Private Ambulances
• 696 Doctors authorized to issue Health Certificates, Tattoo and Body Piercing Artists
• 278 Certificates of Need and Convenience issued to establish newly created, purchased or remodeled facilities, among others
• 8 Abortion Centers
• 1,447 Biological Products
• 19 Veterinary Installations
• 3 Wholesale Veterinary Drug Distributors
• 105 Retail Veterinary Drug Distributors

Authorized and Proposed Positions	2009	2010	2011	2012
Managerial,Technical, Administrative, and Office Staff	44	44	10	11
Other staff	5	0	26	25
Planning, Budget, Statistics, Auditing, and Finance	5	5	4	4
Maintenance and General Services Staff	5	5	3	3
Health Services	25	20	3	3
Total, Positions	84	74	46	46

Program Description

Advises the Health Secretary regarding the implementation of Act. No. 11 of June 23, 1976, as amended, known as the Puerto Rico's Integrated Health Services Reform Act and the Organic Laws of the Examining Boards of the different Health Professionals. Establishes and develops the administrative mechanisms for the sound operation of the Examining Board and audits the existing laws and regulations that govern them. The Medical Discipline Examining Board has the duty to regulate the practice of medicine in Puerto Rico and the development of medical education programs for students living on the island, but attending foreign medical schools. In addition, oversees and maintains custody of the records of the medical professionals, and reminds these professionals to comply with all registration and continuing education requirements.

• Provide access via the internet so that all health professionals can request licenses, Board exams, to view results of Board exams and statistics, recertifications, continuing education, provider certifications, etc.

• Facilitate the publication of statistical data and guarantee that health services are being offered by qualified professionals.

• Lower rental costs, improve the services offered to health professionals and increase revenues.

• Make available alphabetized, automated registries to facilate locating the files of the professionals that have not enrolled in the Professional Registry.

• Save time and money by eliminating the copying of exam brochures. Eliminate the process of warehousing, safekeeping and disposing of exam brochures, thus reducing the waiting time between exams.

• Compile a list of health professionals that are part of the education and prevention programs by geographical areas.

Statistical Data	2010	2011	2012
Administrative hearings	15	15	71
Board meetings	322	322	388
Continuing education authorized institutions	200	200	160
Exams offered	82	82	77
Investigative hearings	55	55	129
Permanent licenses	5,078	5,078	4,576
Provisional licenses	4,303	4,303	5,295
Registered professionals	65,597	64,974	64,974

The statistical data was information provided by the Agency during the budgetary process for fiscal year 2011-2012

Customers

106,212 health professionals, including pharmacists, doctors, technologists, therapists, 28 examining boards and 53 health professions

Human Resources

Authorized and Proposed Positions	2009	2010	2011	2012
Managerial,Technical, Administrative, and Office Staff	93	70	55	51
Judges, Lawyers, and Legal Staff	2	1	0	2
Other staff	2	1	2	0
Maintenance and General Services Staff	6	5	7	7
Total, Positions	103	77	64	60

Mental Retardation

Program Description

Provide individually focused, habilitation services and clinical treatment, through the Division of Services to Persons with Mental Retardation. The Division currently provides services to a total population of 658 persons between the ages of 15 to 55 years of age. These persons obtain services through the 8 Habilitation Development Centers (CDH, Spanish acronyum), located in the municipalities of Bayamn, Cayey, Aibonito, Aguadilla, Ponce, Vega Baja, Juana Daz and Ro Grande. These centers provide holistic services in the areas of: Psychology, Social Work, Nursing, Occupational Therapy, Service Mediators, Rehabilitation Counselors, Consultation Services, Nutrition/Diet, Dental Clinic (Dentist), Medical Clinic, among others.

The services offered at the Habilitation Development Centers are founded on psycho-educational programming aimed primarily at the development of independent living skills and abilities for the participant's prompt inclusion into the community. The participants benefit from the following independent living skills and abilities: self care and self help, domestic skills, skills and abilities conducive to community adjustment, social-emotional adjustment skills, the use of free time and recreation, functional-education, health and security, workforce preparation skills, job training and job postings with agencies as well as with public and private entities.

In like manner, habilitation services are offered through 4 private institutions (Psycho-pedagological Institute, the Modesto Gotay Foundation, the Shalom Center and the John Crisming Center), community homes and family homes, throughout the island. In the community homes, services are offered to 282 participants.

The program offers support to families with participants in homes by providing a housekeeper. This service is provided 7 days a week. There are currently 57 participants benefitting from this service.

The community homes, classified as community or substitute homes, are contracted by private providers through the Division. These providers must apply for the permits required by law (ARPE Use Permit, Fire Department and Environmental Health). In addition, a public and driver's liability policies are required. These homes are parts of the community, households are required to maintain a family atmosphere and total inclusion of the participant in the community. The provider offers the participant different community activities such as: moives, beaches, bowling, church, recreational activities, and activities planned by the community. Said homes may house 1 to 6 participants and the level of support required depends on the participant's condition. The homes are divided according to gender or according to physical needs.

The strategy of establishing Community Homes complies with the national tendency of non-institutionalization, and with the 5 year deinstitutionalization plan pursuant to the Federal Court case against the Mental Retardation Program (Case #99-1435 (PG), and the Olmsted VLC decisin, 527 U.S. 581).

Objectives

• From an holistic perspective, promote and encourage the inclusion of mentally retarded persons in the community.

• Guarantee the well being and health of every citizen.

• Increase the number of participants so that they may develop different concepts of cognitive, affective and psycho-motor skills.

• Establish community homes and habilitation services to meet the needs of persons with mental retardation that are on a waiting list or that have filed a new application for services.

• Empower individuals and communities to promote excellent health services through self-intersection and self confidence.

Statistical Data	2010	2011	2012
Customers served	712	800	658

Customers

Patients with mental retardation, including: children, adolescents and adults of both sexes, between the ages of 9 and 55 years of age. Services are currently being provided to a population of 658 persons with another 140 persons on a waiting list.

Human Resources

Authorized and Proposed Positions	2009	2010	2011	2012
Managerial,Technical, Administrative, and Office Staff	61	55	36	39
Other staff	25	88	92	15
Other Safety and Protection Staff	9	9	9	9
Food Services Staff	12	12	12	12
Planning, Budget, Statistics, Auditing, and Finance	22	22	22	22
Education and Recreational Services Professionals	58	44	44	44
Maintenance and General Services Staff	94	94	88	79
Families and Community Services Staff	79	57	56	61
Health Services	361	301	300	279
Total, Positions	721	682	659	560

Program Description

Provides managerial and administrative support to the programmatic areas of the Department to facilitate the achievement of its goals. It also collaborates with the formulation of public policy in the managerial and administrative fields as well as contributes to the development of effective strategies. It plans, develops and coordinates the responsibilities, in the administrative aspect, of the Department's central offices, which are: Purchases and Auctions, Finances, General Services, Health Facilities, Facility Lease Agreements, Risk and Security Office, Human Resources Office and Budgeting Office. On the other hand, it coordinates the implementation of the Secretary's management strategies, revises work plans and proposals for contracts, and plans and coordinates the administrative functions of the Department.

Objectives

• Increase Department of Health's revenues.

• Complete the reorganization process as directed by the Governor's Office, The Office of Budget and Management, ORHELA, the Legislative Branch and other regulating agencies.

• Continue the stabilization of the Department's finances, so that each of its components has the resources needed to operate.

• Avoid findings from either the Comptrollers Office or the Office of Internal Auditing.

• Meet report deadlines established by the Office of Management and Budget, Office of the Comptroller and the Department of the Treasury.

• Provide the documents, reports and budgetary information needed by the Secretary of Health and the Assistant Secretary of Administration.

• Create procedures and/or fiscal processes pursuant to the functional use of PS 8.4, aimed at complying with the regulations issued by the Department of the Treasury.

• Decrease the high volume of claims for the reissuance of checks for services rendered and establish measures to review claims and check's expiration dates.

• Handle documents in 10 days or less. Speed up payment to suppliers and decrease the volume of documents.

• Review the application's users list and remove access of users that did not access the application in the last year and of any user who has a conflict of interest.

• Digitalize the Finance Office's filing system to reduce warehousing space, provide greater access and security for fiscal documents.

• Review contract fees; standardize contract expiration dates and terms in order to keep them in effect.

• Prepare and submit the Indirect Costs Proposal 2010-2011 and compile the information for 2011-2012.

• Establish a new system to compile, evaluate and summarize the cost information for state and federal reports.

• Work with accountants and officials of the different secretary's Offices, Programs, Health Institutions, and Providers so that they submit all the purchase and auction related documents in a timely manner.

• Identify all the areas that are pending maintenance work.

• Work with the Office of Health Facilities on an Energy Costs, Fuel and Energy Reduction Plan.

• Make sure contractors submit required documents in a timely manner.

• Evaluate each contract to ensure compliance with the regulations established by the Office of the Governor, Ethics Office, the Treasury Department, the Justice Department, the State Department, ORHELA and the Comptroller's Office.

• Reduce the loss associated with compensation payments made for damages to the property and the services.

• Complete claims for damages to the Department's property and services, as well as claims for service to defective equipment or property.

• Establish policies that comply with the Health and Security in the Workplace regulations.

• Reduce the Agency's operating costs by reducing fines, penalties stemming from OSHA complaints and accidents and injuries to personnel caused by unsafe practices.

• Encourage all management to fully understand the importance of occupational health and safety processes.

• Evaluate working conditions of supervisors and employees to reduce occupational health and safety risks in the workplace.

• Mitigate the effects of Act No. 7 of March, 2009, as amended, on the employees that continue working in the agency.

• Complete the design and construction of various new projects.

• Refurbish Diagnostic and Treatment Centers and 3 Health Institutions.

• Develop a preservation and maintenance program for the facility's mechanical equipment.

Department of Health's Programmatic Units and the general public.

Human Resources

Authorized and Proposed Positions	2009	2010	2011	2012
Managerial,Technical, Administrative, and Office Staff	232	197	121	113
Other staff	2	0	3	2
Other Safety and Protection Staff	2	2	2	2
Planning, Budget, Statistics, Auditing, and Finance	34	28	27	27
Public Relations and Communications	1	1	1	1
Maintenance and General Services Staff	45	34	33	30
Health Services	1	1	1	1
Total, Positions	317	263	188	176

Program Description

Comprised of the Central Administration Unit of the Health Department's Laboratory Institute; the Special Clinical and Sanitary Laboratories at the central level; Health Department Laboratories in Ponce, Mayagez and Arecibo and the Toxicology Laboratory; the Office for Certification of Hygienic Laboratories on the island; and the Proficiency Service for Clinical Laboratories. The Public Health Laboratory at the Central level offers clinical services in general bacteriology, immunology, rabies, tuberculosis and parasitology, certified by the Centers for Disease Control and Prevention (CDC) and directly related to that Center. The Rabies Laboratory is the only such facility for Puerto Rico and the Virgin Islands. The Alcohol Toxicology Laboratory offers its services to the Police, the Court System, the Department of Justice and the Administration for Compensation of Automobile Accidents. The sanitary component of the Public Health Laboratory includes: Potable Water Chemistry and Microbiology, Milk Chemistry and Microbiology and Food Chemistry and Microbiology.

The Office of Sanitary Laboratory Certification was established in 1986, at the request of the Environmental Protection Agency (EPA). This Agency's Certifying Officers (approved and certified by the EPA) certify the drinking water labs of the Acueducts and Sewer Authority (AAA, Spanish acronym) and others laboratories on the island. It also handles the Department of Health's Proficiency Program, which measures the quality of the services offered by Puerto Rico's clinical laboratories, both public and private, by sending unidentified samples regularly to all of clinical laboratories.

Objectives

• Renew accreditation for laboratories that analyze water and milk, milk manufacturing plant supervisors and other factories. Renew accreditation of water sample collectors in Puerto Rico. Complete installation of the new STARLIMS system. Certify the Drinking Water Chemical Laboratory. Recruit two data entry operators.

• Train personnel in diagnostic viral testing and expand the services offered by the State Publich Health Laboratory. Coordinate the analysis of each case referred by the clinic in order to eliminate or confirm rabies as a cause of death in humans.

• Continue the automation process of the Puerto Rico Public Health's STD/HIV Laboratories and their labs in Ponce and Mayaguez. Automate the different Immunolgy clinics. Establish the HIV Genotype Laboratory. Recruit new personnel, a medical technologist and a Laboratory Assistant to increase the range of services, as well as the number of clients, to attract new sources of income.

• Train breathlizer operators so they can be certified by the Secretary of Health. Maintain a system where the analysis perfomed is of high quality. Offer conferences and provide orientation to judges, prosecutors, lawyers and the general public regarding the legal aspects of driving under the influence of alcohol, drugs or controlled substances.

• Reduce the delivery time of laboratory specimens from 3 days to 1. Report direct smears for Acid-Fast Bacillus (AFB) within 24 hours of receipt of the specimen. Identify Tuberculosis cultures in 14 to 21 days. Provide results of drug sensitivity in 21 to 28 days. Conduct a survey to assess provider services in Puerto Rico. Meet with representatives of each laboratory and medical facility to discuss their needs, the types of service offered, the time required for observation in order to obtain results, and establish a work plan. Provide training, meetings, seminars, and establish frequent communication among the participants. Consider automated methodology for the analysis of samples.

• Perform physical, chemical and entomological analysis of the food that is consumed by the public, as well as the cookware and serving utensils, to guarantee quality and hygiene and to protect the public from chemical contaminants that may cause toxicity, death or an increase in chronic diseases or death. Process samples of foods that are processed, bottled or canned, warehoused and marketed in Puerto Rico, as well as items that are the subject of community complaints and food poisoning. All inspections should be completed by the Assistant Secretary of Environmental Health Inspectors. Samples are also received from bakeries, school lunchrooms, penitentiaries, the WIC Program and production exportation certification through the SASA Inspectors.

• Improve data entry through an electronic reader or via the internet. Resend unknown test results for new testing. Update the internet page.

Statistical Data	2010	2011	2012
Certification visits	64	64	50
Clinical laboratories	300,000	300,000	280,000
Environmental laboratories	30,208	32,208	30,000
Forensic Toxicology Lab: Court appearance	900	1,030	1,000
Forensic Toxicology Lab: Machine check	850	869	850
Forensic Toxicology Lab: No sender samples	790	869	800
Forensic toxicology laboratory: samples analyzed	1,323	1,725	900
Proficiencies program; samples submitted	206,165	206,165	180,000
Samplers collector certifications	525	362	329
Samples prepared	190,935	206,165	200,000
Samples submitted	206,165	206,165	180,000
Technical trainings	20	20	20

The statistical data was provided by the Agency during the budgetary process for fiscal year 2011-2012

Customers

The Department of Health, the Department of Justice, the Adminstration for Automovile Accident Compensation (ACAA), the Commission for Traffic Safety, Federal Agencies, all certified laboratories in Puerto Rico, educational entities and professional associations.

Human Resources

Authorized and Proposed Positions	2009	2010	2011	2012
Sciences and Environment staff	12	12	11	16
Managerial,Technical, Administrative, and Office Staff	11	11	6	4
Other staff	3	3	4	0
Planning, Budget, Statistics, Auditing, and Finance	1	1	1	1
Maintenance and General Services Staff	8	8	7	8
Health Services	63	61	62	62
Total, Positions	98	96	91	91

Program Description

Develop standards, plans and evaluates primary health services focused on prevention. It also provides disease prevention services with emphasis on the medically indigent population, specially the high risk groups: women, children, adolescents, children with special needs, the elderly, alzheimer's patients and rape victims. Educates and treats patients with of HIV and AIDS, as well as other contagious diseases, with emphasis on community services.

Objectives

• Establish, as a main strategy, a promotional model of health at all levels (community, corporate and governmental) centered on the following areas: nutrition, physical training, stress management and reduction of chronic diseases.

• Develop at least 16 educational seminars per year that focus on the major prevailing conditions, as reflected on the Department's morbility and mortality index for each region.

• Establish the Inter-sector Coordinating Board for the Promotion of Health and Education ascribed to the Assistant Secretary of Family Health and Integrated Services.

Customers

Residents of marginalized and needy communities in Puerto Rico, specifically those from the special communities and the public housing projects.

Human Resources

Authorized and Proposed Positions	2009	2010	2011	2012
Managerial,Technical, Administrative, and Office Staff	3	3	0	0
Maintenance and General Services Staff	1	1	0	0
Families and Community Services Staff	13	13	0	0
Total, Positions	17	17	0	0

Program Description

Monitors public policy as it relates to the Health Services Card and oversees the medical-hospital services, through private or governmental health installations in each municipality. Guarantees that all persons, without regard to economic condition, have access to health services 24 hours a day.

Objectives

• Evaluate the existing Department installations to determine the needs and use of the physical structure.

• Guarantee the offering of primary, secondary and terciary health services.

• Retain existing public health installations.

• Promote the development of mechanisms that will make possible the auditing of health services in order to guarantee the efficient use of fiscal resources.

• Measure client satisfaction by having beneficiaries evaluate the health services received through the Health Reform.

Customers

The public that qualifies for services through the Health Reform.

Human Resources

Authorized and Proposed Positions	2009	2010	2011	2012
Managerial,Technical, Administrative, and Office Staff	2	2	2	1
Maintenance and General Services Staff	1	1	0	0
Total, Positions	3	3	2	1

FISCAL YEAR 2011-2012 ADOPTED BUDGET

The adopted budget for fiscal 2011-2012 is $875,322,000, $276,659,000 from the Joint Resolution of the General Budget, $13,910,000 from Special Appropriations, $14,839,000 from State Special Funds, $436,854,000 Federal Funds, $96,331,000 from Revenues from Internal Resources and $36,729,000 from the Federal Reinvestment and Economic Stimulus' Program (ARRA).

The Operating Costs reflect a decrease of $30,812,000, compared to the resources assigned for fiscal year 2010-2011. This decrease is due to the measures implemented to reduce and control public spending.

Special Appropriations include, $8,000,000 to comply with Law No. 150 de August 19, 1996, which created the Catastrophic Illness Services Fund; $2,000,000 assigned for Hepatitis C (Act No. 42 of January 3, 2003); $350,000 to comply with formulation of public policy for community with autistic disorders or conditions (Act No. 318 of December 28, 2003); $550,000 to be transferred to the Society for Education and Rehabilitation of Puerto Rico (SER); and $300,000 for the Mercedes Rub Foundation. In addition, $250,000 are included to cover the operating costs of the Coordinating Board (Donations and Transplants Act); $150,000 for the Modesto Gotay Foundation, $100,000 for the Program for the Prevention and Vigilance of Childrens Medical (Act No.259 of August 31, 2000), $30,000 for the Histotechnological Examining Board (Act No. 258 de 31 de August de 2000); $30,000 for the Examining Board of Naturopathy (Act No. 208 of December 30, 1997); $1,000,000 to comply with Act No. 139 of August 19, 2008, known as the Medical Licensing and Discipline Board Law, which rules the practice of medicine in Puerto Rico and is ascribed to the Department of Health; $30,000 to comply with Act No.237 of August 15, 1999, to establish the Alzheimer's Registry, $10,000 to comply with Act No. 254 of September 3, 2003, to regulate the practice of Massage Therapy; $100,000 for the Commission on Food and Nutrition of the Commonwealth (Act No. 10 January 8, 1999); $25,000 to Regulate the Practice of Smoking in Designated Public and Private Places (Act No. 40 of August 3, 1993); $250,000 for Puerto Rico's Renal Council (Joint Resolution No. 204 of August 8, 2006) $500,000 for the Aerial Subsidy of the Municipality of Vieques; $10,000 for the Professional Council Examining Board (Act No. 147 of August 9, 2002), $10,000 to Regulate the Practice of Psychology (Act No. 96 of June 4, 1983) and $40,000 for the Commission for the Implementation of Public Policy for the Prevention of Suicide (Act No. 227 of August 12, 1999), $300,000 for operating costs of the American Cancer Society and $75,000 for the Puerto Rican Cancer League.

The federal programs that provides major funding contributions are: Supplemental Nutrition Program for Women, Infants and Children, Medical Assistance Program, HIV Care Formula Grant, Bioterrorism Hospital Preparedness Program and Maternal and Child Health Services Block Grant. These resources are used to certify medically-indigent health insurance beneficiaries and to provide educational services in food and nutrition to nutritionally at-risk women and children. They also allow support and treatment services to be offered to HIV positive patients; women, infants and children with special needs.

State Special Funds are supported by resources from the Puerto Rico Lottery and the Fund for the Treatment of Remediative Catastrophic Illnesses; funds raised from the issuance of licenses, birth certificates, death certificates, certification of professionals and others. Revenues from Internal Sources are generated through medical insurance biling and collections, paying customers and from services rendered by the Health Services Card at the University Adult Hospital, the University Pediatric Hospital and in other installations. The American Reinvestment and Recovery Act (ARRA), establishes that the Department of Health is eligible to obtain these funds and other, through competitive federal programs. For fiscal year 2011-2010, contributions to the Medicaid, Medicare Platinum Part D and Suplementary Nutrition for Pregnant Women, Infants and Childrens (WIC) Programs will be included.

SUMMARY OF RESOURCES BY PROGRAM

Adult Hospital Administration

Pediatric Hospital Administration

Economic Aid to the Medically Indigent

General Management and Administration

Registering and Issuing of Documents of the Demographical Registry

Health institutions

Health Area Planning, Evaluation, and Statistics

Health Promotion and Protection

Environmental Health Regulation

Regulation and Certification of Health Professionals

Mental Retardation

Health Insurance card