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Nearly two months after Hurricane Maria ravaged Puerto Rico, recovery efforts are still struggling to prove effective — and long-term endeavors may prove themselves just as elusive.

But one California congressman who's visited the island has some ideas on how to address the lack of clarity across the board.

Rep. Raul Ruiz (D-Calif.), who is also a physician, told Independent Journal Review that he's prepared a plan that decentralizes FEMA command centers in Puerto Rico to best address needs at a hyper-local level. To Ruiz, the current model — which places the FEMA command station in a convention center in San Juan — alienates those in municipalities with little to no access to the capital.

“What we need to do is we need to decentralize those conversations and that coordination from San Juan and create command posts out in the field in the municipalities where there is no electricity,” he said. “Because the dynamics of not having electricity and inadequate electricity, when you do have it and the challenges of being homeless is dynamic.”

Dr. Ruiz witnessed the developing needs on the ground in a community clinic in Canóvanas, where a FEMA generator installed by the Army Corps of Engineers failed, rendering the clinic useless. He noted that before the generator was installed, the clinic had scant but partial power. Now, they were in complete darkness. Clinic operators had no clear plan for how and when — or even if — their electricity would be restored.

Basic needs — clean water, electricity, shelter — allude the citizens of Puerto Rico. The lack of sustained recovery efforts could be a death sentence for many of the Americans who are holding on for dear life.

For 51 people, the hesitation to help has already cost too much.

“It appears that for whatever reason, the death toll is much higher than what has been reported,” San Juan Mayor Carmen Yulín Cruz told CNN's Jake Tapper.

Citing a report released by the Puerto Rican government in October, Yulín Cruz speculated that some of the deaths classified as “natural causes” may have instead been a result of Hurricane Maria. Yulín Cruz offered that hospital deaths caused by power outages should be counted in the official death toll rather than as “natural causes.”

“I'd like to say recovery would be done in two or three years, but it is almost impossible [to articulate an exact plan],” a FEMA official said, speaking to IJR on the condition of anonymity.

They noted that the length of recovery in every disaster tends to vary “upon the unique circumstances of the particular event” but did not provide further specifics on the current situation in Puerto Rico.

Ruiz, however, believes that the lack of electricity on the island is a metaphor for larger structural issues facing the island nation.

“They were literally in the dark ... in that they didn't know what the plan was for their repair,” Ruiz said. “They didn't know when the Army Corps of Engineers were gonna come back and fix it. And they didn't have a phone number to call to even ask where they were in the queuing for repairs.”

Hurricane Maria first touched down in the Caribbean in mid-September, leveling a majority of the major islands and leaving little standing in its wake. The hurricane caused mass panic and devastation, especially in Puerto Rico, an island rocked by four consecutive storms: Harvey, Irma, Jose, and Maria.

According to another FEMA official, while there is no exact timeline, there have been initiatives to provide some sort of sustained relief to Puerto Ricans who are unable to return to their homes. Just last week, FEMA and the local government made available Transitional Sheltering Assistance (TSA), which allows “eligible applicants to shelter in a hotel or motel, for a limited period of time, as a bridge to intermediate and longer-term housing.”

However, a difficult caveat exists: in order to be eligible for TSA, an individual must be registered with FEMA disaster assistance — a process that can only be completed online or over the phone. With no, or scant, access to electricity, many may see this aid as intangible at best.

Consequently, an official at the U.S. Department of Housing and Urban Development claimed that initial Community Development Block Grant Disaster Recovery Program (CDBG-DR) funding for Maria falls short in comparison to other deadly storms.

“After these three most recent hurricanes, Congress has appropriated $7.4 billion,” the official stated. “Now, just to give you a sense of context, Hurricane Katrina was on the magnitude of $16.7 billion.”

The official, who spoke on background, explained that HUD allocates funds based on an in-house metric called “unmet need,” which measures holes in aid and attempts to fill them. Though lack of up-to-date information — an issue that seems to echo through multiple departments — resonates loudly at HUD.

“We have just barely any data from what the unmet needs are in Puerto Rico,” the HUD official said. “Now, it's pretty clear that the unmet needs in Puerto Rico are going to be pretty severe.”

Waiting to address unmet housing needs has presented some challenge for the department, especially when it comes to those who may not want to leave.

“If it's just an intermittent electrical issue, do we keep them there?” the official said. “If it's going to be months before electricity can be restored to an apartment building, do people stay in the dark for several months?”

Ruiz cited additional conversations he had with officials from FEMA, HHS, disaster medical assistance teams, and non-governmental organizations who, Ruiz claims, cited communication issues and general lack of information as a major hindrance to aid.

In a Miami Herald op-ed on Oct 30, Lieutenant Governor and Secretary of State of Puerto Rico Luis G. Rivera-Marín claimed that “the vast majority of Americans in Puerto Rico are grateful and optimistic about the future.”

Ruiz, for his part, is not as confident: “When you see people who are hungry and you see people who are struggling to find clean water for their baby's formula, then they're not happy [about how relief efforts are progressing].”

He believes that multiple command posts will allow different agencies to uniquely and collaboratively address the issues of each neighborhood as needs change day to day. Ruiz believes that comprehensive aide to the island is urgent and must become a priority for the Trump administration.

“We can do better and we should do better — and we need to do better right now,” he said. “There is unnecessary deaths and suffering that is our nation's responsibility to prevent and come to their aid.”

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