AGP Executive Report

Puerto Rico Hospital Sector: Puerto Rico’s hospitals are warning that financing pressure, workforce shortages, demographic shifts, and rapid care changes could reshape access and services islandwide, with leaders calling for clarity on Medicare/Medicaid and new workforce planning. Food Safety Recall: Check your freezer—Frutas y Hortalizas del Sur S.A. expanded an E. coli recall to additional Great Value frozen organic triple berry blend and blueberries, plus Trader Joe’s organic mixed berry blend; the products were distributed in Puerto Rico and may be eaten without cooking. Infectious Disease Watch: Florida is reporting the largest dengue outbreak in decades in the continental U.S., with Tampa-area cases topping 250 and local emergency spraying underway—an alert for mosquito-borne risk planning in the region. Drug Pricing & Policy: A major push to lower prescription drug costs continues, including Medicare/Medicaid pricing experiments and antitrust actions targeting generic drug price manipulation. Travel Health Convenience: TSA launched “Families on the Fly” with dedicated screening lanes at select airports in Puerto Rico for kids 12 and under, aiming to reduce stress during travel.

Drug Pricing Push: A new look at how the Trump administration is trying to lower prescription costs highlights tools like most-favored-nation style deals with drugmakers, Medicare/Medicaid experiments, and other policy moves—plus questions about what will actually deliver savings. Local Hospital Strain: Puerto Rico’s hospital leaders warn that financing pressure, workforce shortages, shifting demographics, and rapid tech changes could reshape care delivery, with Medicare/Medicaid decisions in Puerto Rico and Washington looming large. Dengue Alert: Florida’s dengue outbreak is surging past 250 locally acquired cases, with Tampa-area counties spraying around the clock; the report notes Puerto Rico typically sees far higher dengue burdens than any U.S. state. Food Safety: A frozen-berry recall tied to an E. coli outbreak has expanded again, including Great Value and Trader Joe’s products shipped to Puerto Rico—urging people to check freezers. Workforce & Training: A dietetics career spotlight emphasizes how registered dietitian nutritionists work across hospitals, clinics, and community settings, including diabetes nutrition support. Travel Convenience: TSA’s “Families on the Fly” adds family lanes at select airports in Puerto Rico and the U.S., but only for children ages 12 and under.

Food Safety Alert: A Chilean supplier expanded its frozen berry recall tied to an E. coli outbreak, adding more lots of Great Value Organic Triple Berry Blend and Great Value Organic Blueberries plus Trader Joe’s Organic Mixed Berry Blend; CDC says 17 people were sickened in Florida and Georgia, with six hospitalizations and no deaths reported—Puerto Rico is included, so check freezers and don’t eat affected packages. Public Health: Florida’s dengue outbreak is now the largest in decades in the continental U.S., with 250+ locally acquired cases and local emergencies as mosquito control ramps up; Puerto Rico continues to face higher dengue burdens than U.S. states. Medication Costs & Access: Iowa joined a coalition seeking court approval of a $400M settlement with Sandoz and Fougera over alleged generic drug price manipulation, with Puerto Rico also listed among participating territories. Care Workforce & Training: A dietetics Q&A highlights how pediatric nutrition support can lead to becoming a registered dietitian nutritionist, pointing to hospital and clinic roles and specialty pathways. Local Health Infrastructure: A new Vieques Health Center was inaugurated by Gov. Jenniffer González-Colón and HHS Secretary Robert F. Kennedy Jr., aiming to restore essential services.

Food Safety Recall: Chile-based Frutas y Hortalizas del Sur S.A. expanded its frozen organic berry recall tied to an E. coli outbreak that sickened 17 people and hospitalized six in Florida and Georgia. The update adds more lots of Great Value Organic Triple Berry Blend and Great Value Organic Blueberries, plus Trader Joe’s Organic Mixed Berry Blend, with distribution including Puerto Rico. What to do: Check freezers for affected UPCs/lot codes and don’t eat the products; discard or return for a refund. Public Health Watch: Florida’s dengue outbreak is reported as the largest in decades in the continental U.S., with local emergencies and mosquito spraying underway—an issue Puerto Rico has long faced at higher levels than many states. Healthcare Policy: Aetna announced 2027 Medicare Advantage plan details, highlighting $0 copays for key services and expanded chronic-care support. Access & Costs: Separate reporting flags Puerto Rico’s high student loan default rate, underscoring how debt pressures can shape health and life decisions.

Mental Health & Community Care: Emma L. Bowen Community Service Center announced first sponsors for its 40th Anniversary Gala at Carnegie Hall, highlighting support for mental health, addiction treatment, and food pantry services for thousands of New Yorkers. Food Safety: A CDC report says marine toxins like scombroid toxin and ciguatoxin keep driving most noninfectious foodborne outbreaks in the U.S., with many cases tied to fish storage and tropical reef algae. Medicare Drug Costs: CMS finalized the GLOBE model to link some Medicare Part B drug rebates to prices in other wealthy countries, but with smaller savings than first proposed. Public Health Funding: The Trump administration is shifting HIV-prevention funding away from community groups toward state and local health departments, raising concerns about access to testing and PrEP in places like Puerto Rico. Healthcare Access: Orlando Health opened a new primary care practice in Viera to reduce appointment wait times, underscoring ongoing primary-care shortages. Local Wellness & Travel Tech: Discover Puerto Rico is rolling out AI agents to match travelers and meeting planners with vetted island businesses.

Drug Pricing & Consumer Relief: A coalition of 43 states and territories, including Puerto Rico, is seeking court approval for a $400 million settlement with Sandoz and Fougera over alleged generic-drug price-fixing and reduced competition, with eligible consumers encouraged to file claims for compensation. Medicare Drug Policy: CMS finalized the GLOBE model, starting Jan. 1, 2027, which ties some Medicare Part B drug rebates to international prices, but with smaller savings than first proposed. Public Health Funding Shift: Nearly 100 community HIV-prevention groups lost federal grants as funding is redirected toward state and local health departments, raising concerns about access to testing and PrEP. Infectious Disease Watch: The Philippines reported about 11,965 leptospirosis cases this year after monsoon flooding, while Puerto Rico’s dengue comparison data shows lower rates than many Americas territories. Violence Prevention Data: A CDC report counted 72,093 violent deaths in 2023, with suicides the majority and firearms involved in 58.6%, underscoring the need for earlier risk detection and support.

Generic Drug Costs: Michigan AG Dana Nessel urges consumers to check eligibility and file claims tied to a multistate settlement over inflated generic drug prices after preliminary court approval of the distribution plan. Public Health & Safety: CDC says 2026 backyard poultry Salmonella outbreaks are over, with a final toll of 1,253 illnesses, 256 hospitalizations, and 2 deaths across 46 states and Puerto Rico—plus warnings that backyard birds can still carry germs. Transplant Care: New research finds only 60% of liver transplant recipients are vaccinated against hepatitis B, leaving many at risk for severe complications. Mental Health for Veterans: VA announces FY27 suicide prevention grants (SSG Fox SPGP), including community programs that help Veterans and families reduce isolation and improve well-being. Local Healthcare Workforce: Puerto Rico continues facing a pediatrician shortage as doctors age and leave. Community Health Access: VA-funded Fisher House opens at VA Hudson Valley to support families during inpatient mental health and rehab care. Child Safety (PR): Fort Buchanan Fire & Emergency Services expands child passenger safety support after two inspectors complete a technician course for car seat education and inspections.

Hepatitis B Vaccination Gap: A Baylor-led study in Clinical Infectious Diseases found only 60% of liver transplant recipients are vaccinated against hepatitis B, leaving thousands at risk for severe complications. Food Safety Alert: The FDA assigned a Class I risk level to a Salata Salad Kitchen Jalapeño Avocado Dressing recall after possible Salmonella contamination. Backyard Poultry Salmonella Ends: The CDC declared 2026 backyard-flock Salmonella outbreaks over, with a final toll of 1,253 illnesses, 256 hospitalizations, and 2 deaths (including Puerto Rico). Care Access & Coverage: Illinois warns that new federal Medicaid eligibility rules starting Oct. 1 could disrupt coverage for thousands of immigrants, while emergency coverage may still apply for some. Local Health Support: Fort Buchanan Fire & Emergency Services expanded child passenger safety services after inspectors completed a technician course. Research Funding: NIH awarded $11.09M over five years to a South Dakota clinical research partnership—training and community-linked studies aimed at improving prevention and care. Veterans Mental Health: VA announced FY27 suicide prevention grants, including community programs in Puerto Rico, to reduce isolation and improve well-being.

FDA Recall Alert: Salata Salad Kitchen Jalapeño Avocado Dressing was pulled in Georgia, North Carolina, and Texas after the FDA assigned it a Class I (highest-risk) recall for possible Salmonella contamination, covering 1,724 cases with multiple 2026 expiration dates. Local Care Access: Puerto Rico is facing a pediatrician shortage as licensed pediatricians decline (about 650–700), with many concentrated in the metro area and many graduates leaving for subspecialties. Mental Health Support: VA announced FY27 Staff Sergeant Parker Gordon Fox suicide prevention grants, highlighting community-based wellness and suicide prevention services for Veterans, including Puerto Rico-linked stories of isolation easing through local programs. Hospital & Emergency Readiness: Mennonite Health System is expanding its Aibonito hospital with a $51.8M project to add medical space and strengthen capacity for future emergencies. Medicaid Drug Policy: CMS’s GENEROUS model will tie certain Medicaid drug payments to lower prices abroad, with Puerto Rico among the jurisdictions that applied to join. Child Safety: Fort Buchanan Fire & Emergency Services expanded child passenger safety services after inspectors completed a technician course to help families with car seat education and inspections. Health Fraud Watch: FinCEN flagged about $17.5B in suspicious activity tied to suspected healthcare fraud, with home health and hospice among recurring provider types.

Pediatric Care Crisis: Puerto Rico is facing a growing pediatrician shortage as licensed pediatricians decline and many retire, with shortages reported in central, eastern, and parts of the metro area. Hospital Sustainability: Hospital El Maestro’s new board says it has a detailed recovery plan after FEMA flagged eligibility issues tied to Public Assistance funds, aiming to keep the reopening on track. Disaster Recovery Funding: FEMA approved more than $71M for Puerto Rico, including nearly $43M in Public Assistance and over $28M in Hazard Mitigation to repair infrastructure and reduce future risk. Mountain Region Expansion: Mennonite Health System will expand its Aibonito hospital with a new three-story facility, adding about 47,000 sq. ft. of medical space supported largely by federal CDBG-MIT funds. Public Health & Mosquitoes: Aedes aegypti mosquitoes are confirmed in Southern California, raising dengue and yellow fever concerns—an update that underscores the broader mosquito-borne risk Puerto Rico already faces. Healthcare Fraud Watch: FinCEN flagged about $17.5B in suspected healthcare fraud-related activity nationwide, with home health and other provider types repeatedly showing up as concern areas. Clean Water Access: Multipure’s Pure Foundation is promoting free water filtration systems and lifelong filter replacements for eligible nonprofits and vulnerable families, highlighting clean drinking water as a health priority. School Meals: A federal bill would permanently raise school meal reimbursement rates, with Puerto Rico already receiving higher rates to reflect local food and shipping costs. Wellness Travel Trend: Marriott’s study finds travelers across Puerto Rico and the region increasingly prioritize mental well-being and simplicity when planning vacations.

Healthcare Fraud Watch: FinCEN says it flagged about $17.5B in suspicious activity tied to suspected healthcare fraud, with home health providers and hospice/behavioral health among recurring targets. Local Health & Access: FEMA approved $71M+ for Puerto Rico disaster recovery and mitigation, including pier and bridge repairs plus upgrades to public facilities. Cardiovascular Health: A new AHA statement reports cardiovascular disease is now the leading cause of death among Hispanic adults, driven by earlier and higher rates of obesity, diabetes, and high blood pressure—key context for Puerto Rico’s aging population. Disease Risk & Prevention: In Southern California, officials confirmed Aedes aegypti mosquitoes, warning of potential spread of dengue and yellow fever—a reminder to stay alert as invasive mosquitoes expand. Wellness Tourism in PR: A U.S. Forest Service/Cornell project highlights “low volume, high value” sustainable tourism ideas around El Yunque, including adventure, ecotourism, education, and wellness experiences. Drug Pricing Claims: Multiple state AGs urge consumers to file for compensation tied to settlements over inflated generic drug prices.

Cardiovascular Care & Drugs: Sun Pharma and LIB Therapeutics struck a global licensing deal for lerodalcibep (Lyrokaul), a once-monthly PCSK9 inhibitor now approved in the EU—aimed at LDL-C lowering for high-risk patients. Women’s Health: AbbVie reported positive phase 3 results for atogepant in menstrual migraine prevention, with fewer migraine days vs placebo and no new safety concerns. Hispanic Health Watch: A new American Heart Association statement says cardiovascular disease has overtaken cancer as the top cause of death among Hispanic adults in the U.S., tied to earlier and uneven risk-factor recognition and care access. Local Relevance (Puerto Rico link): Aedes aegypti mosquitoes are surging in Southern California, raising dengue and yellow fever concerns—CDC notes the species is also found in Puerto Rico. Diabetes Update: The FDA approved Lilly’s once-weekly basal insulin Onswik (insulin efsitora alfa-gobe) for adults with type 2 diabetes, adding a new weekly option. Puerto Rico Spotlight: NIST updated progress on its investigations into the Champlain Towers South collapse and Hurricane Maria’s impacts on Puerto Rico.

Vieques Healthcare Access: Gov. Jenniffer González-Colón and HHS Sec. Robert F. Kennedy Jr. inaugurated the new Vieques Health Center (Susana Centeno Hospital), a $85.5M project restoring hospital-level services after Hurricane Maria, including $48.3M in FEMA funds. Medical Supply & Jobs: Puerto Rico’s Customed Inc. will invest $12M in Fajardo to expand sterilization capacity for medical products, adding 35 jobs and more specialized infrastructure. Public Health & Climate Risk: Scientists warn Puerto Rico should prepare for extreme heat through at least next fall as El Niño intensifies, with possible environmental and public health impacts. Food Safety Recall: Berlin Seeds recalled 950 pounds of alfalfa sprouting seed tied to a multistate E. coli and Salmonella outbreak; the recall covers consumer sales in 44 states and includes home sprouters. Behavioral Health Lifeline: America’s VetDogs and Hofstra University launched the first collegiate Puppy With a Purpose partnership, pairing service-dog training with campus mental health support. Community Health Infrastructure: Puerto Rico Act 185-2026 amends summary labor claims procedures, a legal change that may affect healthcare workers’ ability to recover litigation costs.

Puerto Rico Health Access: Gov. Jenniffer González-Colón and HHS Secretary Robert F. Kennedy Jr. inaugurated the new Vieques Health Center (Susana Centeno Hospital), a $85.5M project restoring hospital-level care after Hurricane Maria, including $48.3M in FEMA funds. Climate & Public Health: El Niño forecasts are pointing to extreme heat for Puerto Rico through at least next fall, raising concerns for health and environmental impacts. Local Health Industry Jobs: Puerto Rican medical products firm Customed Inc. will invest $12M in Fajardo to expand sterilization capacity, adding 35 jobs and boosting the island’s medical device supply chain. Disaster Medical Response: Direct Relief is tracking Hurricane Nolo’s impacts across the Pacific and sending emergency medicines and medical packs to help Hawaiʻi health providers and first responders prepare for flooding risks. Caregiving & Recovery Stories: A Puerto Rican woman’s family and community support highlight long-term recovery after severe illness, while a separate veteran wheelchair games story underscores how rehab and sports can rebuild mobility and confidence. Health Policy Watch: The Senate Finance Committee advanced HHS deputy secretary nominee Chris Klomp, a role tied to how families experience vaccines and drug pricing decisions.

Vieques Healthcare Access: Gov. Jenniffer González-Colón and HHS Secretary Robert F. Kennedy Jr. inaugurated the new Vieques Health Center at Susana Centeno Hospital, a $85.5M project (FEMA + local funds) that restores hospital-level care for nearly 8,000 residents after Hurricane Maria forced years of travel to the main island. Medical Supply Expansion: Puerto Rican firm Customed Inc. will invest $12M in Fajardo to expand sterilization capacity for medical products, adding 35 jobs and boosting the local supply chain for device manufacturers. Medicaid Drug Pricing: CMS says all states plus Puerto Rico applied to join the GENEROUS Model for Medicaid outpatient drug pricing, with participation agreements due by Sept. 30—potentially changing net costs and coverage criteria for some medications. Local Health & Safety: Puerto Rico Act 185-2026 amends the Summary Labor Claims Procedure to allow prevailing employees to recover litigation costs, keeping compressed timelines intact. Public Health Watch: Florida counties declared emergencies amid a “wildly unusual” dengue surge, including at least one reported death.

Puerto Rico Health & Industry: Customed Inc. says it will invest $12 million in Fajardo to expand medical-product sterilization capacity, adding 35 jobs and boosting supply-chain support for device manufacturers. Local Health Policy: Puerto Rico’s Act 185-2026 updates the Summary Labor Claims procedure, letting prevailing employees recover litigation costs while keeping the fast-track timelines. Medicaid Drug Access: CMS’s GENERous Model is now open to all 50 states, DC, and Puerto Rico, aiming to lower Medicaid outpatient drug net prices via supplemental rebates and standardized coverage criteria. Environmental Health & Compliance: EPA reached an expedited settlement with Kroger Specialty Pharmacy 5-60 in San Juan, citing hazardous waste paperwork violations tied to missing an EPA ID number; the penalty is $1,250. Care in Motion: A crew member aboard Allure of the Seas was airlifted after severe chronic abdominal pain while the ship was northwest of Puerto Rico.