Hospitals, dialysis and elder housing: generator, cistern and 20 days

This is the law written after the country learned, the hard way, what happens when a hospital, a dialysis center or an elder housing complex goes weeks without power and water. It gives the citizen no benefit: it imposes obligations on the facility, and gives someone the power to fine it. That someone is, surprisingly, the municipal emergency management office, not a state agency. So this guide is useful mainly for two things: knowing what you can demand of the facility where your relative is, and knowing which door to knock on if it does not have it.

The law is not applied for: it applies to facilities, not people. Those it names are health facilities, renal dialysis centers, airports, gas stations, nursing homes, elderly housing and children’s and adults’ or elderly homes in Puerto Rico. Article 3 itself clarifies that list is not exhaustive and that the Secretary of Public Safety may add whatever regulatory provisions they deem necessary. In addition, facilities used by the Department of Education and the Department of Housing as shelters must meet the power, fuel, medication and cistern requirements, as applicable.

• That the facility be among those the law covers: health facilities, renal dialysis centers, airports, gas stations, nursing homes, elderly housing, and children’s and adults’ or elderly homes.Verified against the official source
• To claim: you need not be a resident or patient. The law places oversight with the Municipal Emergency Management and Disaster Administration Offices of the municipality where the facility is.Verified against the official source

• The compliance certification the facility must submit to the Municipal Emergency Management and Disaster Administration Office on or before 31 May each year. Ask for it by name: it is the document proving the facility complied that year.
• If the facility cannot store the fuel on site: the reliable proof that it will have the supply for the twenty (20) days, which the law requires it to provide.

1. 1

   Step 1: Check whether the facility is covered

   The law names health facilities, renal dialysis centers, airports, gas stations, nursing homes, elderly housing and children’s and adults’ or elderly homes. It is a broader list than people assume: it covers the corner gas station as much as the hospital. And it is not closed: the text itself says the list is not exhaustive and that the Secretary of Public Safety may add whatever regulatory provisions they deem necessary. There is an additional group: facilities the Department of Education and the Department of Housing use as shelters must meet the power, fuel, medication and cistern requirements, as applicable.

2. 2

   Step 2: Power: the law does not require a generator, it requires electricity

   The text is written by result rather than by equipment, and that is worth knowing before complaining. Every covered facility must have a power source producing enough electricity to continue its operations when the Electric Power Authority’s system is not working. And the law lists how that requirement may be met: through multiple electric generation mechanisms, such as gasoline or diesel generators, solar panels, wind generators and any other the regulation authorizes. That is, an elder housing complex having solar panels instead of a generator is not by itself a breach; what to look at is whether the source produces enough electricity to keep operating.

3. 3

   Step 3: The twenty days of fuel and the five of water

   Two numbers you can ask about directly. Fuel: every covered facility must have supplies sufficient to run the electric generator at least twenty (20) days after a force majeure event; and if it lacks the capacity to hold those supplies on its premises, it must provide reliable proof that it will have the fuel supply for that number of days. That second part matters: "there is no room for that much fuel here" is not an excuse, it is a different obligation — showing the contract or supply commitment. Water: every covered facility must have a water cistern with capacity sufficient to meet its need for at least five (5) days. Note the difference in terms, which is not a drafting error: twenty days of fuel, five days of water.

4. 4

   Step 4: Medications: only for health facilities and dialysis

   This requirement does not apply to every facility and should not be demanded where it does not belong. The text says: health facilities and renal dialysis centers covered by this law must have supplies of medications and essential items sufficient to operate for a term of twenty (20) days after a natural disaster. And it adds who decides which: the medications health facilities must store for these events shall be those set by the Department of Health. Act 88-2018 does not publish that list and neither do we invent it; if you need to know which medications are included, the source is the Department of Health, not this law.

5. 5

   Step 5: 31 May: the date you can ask about

   Of everything this law requires, this is the easiest to check from outside. Every facility covered by this law must certify to the Municipal Emergency Management and Disaster Administration Offices its compliance with this Act’s provisions on or before 31 May each year. It is a fixed annual date, right before hurricane season. If your relative lives in elder housing or a home, or if you are a dialysis patient, you can ask for that certification by name: the current year’s, filed with the municipal emergency management office of the municipality where the facility is.

6. 6

   Step 6: Who fines: the municipality, not the state

   This is the part most people look for in the wrong place. Article 6 says the Municipal Emergency Management and Disaster Administration Offices — OMMEAD — shall be responsible for overseeing compliance with this Act’s provisions and the regulation issued under it, and that OMMEAD shall have the power to impose the fines under Article 5(a). The fines are five thousand dollars ($5,000) daily while the natural or legal person is in non-compliance, up to a maximum of one hundred thousand dollars ($100,000). And non-compliance is also sufficient cause for suspension or revocation of the health facility’s or business’s operating permit, after due process has been provided for an administrative challenge. Revenue from those fines is deposited in a separate municipal account and may only be used for expenses related to compliance oversight and to the municipality’s recovery after a natural disaster, such as solid waste and debris collection, cleanup and improvement works. Municipal legislatures approve the necessary ordinances under the Department of Public Safety’s regulation.

7. 7

   Step 7: What the Department of Public Safety handles

   The DSP does not collect the fines, but it writes the rules. Article 3 charges it with regulating how these facilities will meet the law’s requirements, so they can keep operating during an emergency caused by a natural disaster. The law tells it what that regulation must include: a municipal inventory of the listed facilities, an annual compliance report, a permit revocation procedure and a fine appeal procedure. The Secretary may also issue the regulation jointly with the Permit Management Office. And Article 7 orders the Department of the Family, the Department of Health and the Permit Management Office to include, as a requirement and part of the process for authorizing these facilities’ and businesses’ operation, an orientation on compliance with these operational requirements. What we do not publish: the content of that DSP regulation. The law orders it to exist and says what it must cover; we did not read it and do not describe its terms.

Before the Municipal Emergency Management and Disaster Administration Office (OMMEAD) of the municipality where the facility is. The law gives that office, and not a state agency, both the responsibility to oversee compliance and the power to impose the Article 5(a) fines. The Department of Public Safety is the one that regulates, and its regulation must include the permit revocation procedure and the fine appeal procedure. If the facility is an elderly establishment, there is a second route running in parallel: Act 94-1977 gives the Department of the Family inspection of those establishments, and its Article 6 demands exactly these same things — a five-day cistern, a generator or alternative system, twenty days of fuel, medicine and food — with an Inspection Request form any adult may file. What we do not publish: a directory of the OMMEAD offices, a phone number or a form, because Act 88-2018 does not name them; the office is found by municipality.

• Calling a state agency about a facility with no backup power: oversight and fines sit with the municipality’s OMMEAD.
• Demanding a generator when the law requires a sufficient power source, which admits solar panels and other authorized technologies.
• Accepting "the fuel does not fit here" as an answer: the law then requires reliable proof of the twenty-day supply.
• Demanding the medication supply at a facility that is neither a health facility nor a renal dialysis center.
• Confusing the terms: twenty days of fuel, five days of water.
• Not asking for the 31 May compliance certification, which is the easiest thing to check.
• Believing the law covers only nursing homes: it also names hospitals, dialysis, airports and gas stations.

These are the government pages this guide is based on.

• Departamento de Seguridad Pública de Puerto Rico (DSP)

  DSP

  bvirtualogp.pr.gov

• Puerto Rico Department of Public Safety

  DSP

  www.dsp.pr.gov