September 29, 2017 The Honorable William B. Brock Long Administrator Federal Emergency Management Agency 500 C Street, SW Washington, D.C.

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AAP Headquarters 141 Northwest Point Blvd Elk Grove Village, IL 60007-1019 Phone: 847/434-4000 Fax: 847/434-8000 E-mail: kidsdocs@aap.

1 AAP Headquarters 141 Northwest Point Blvd Elk Grove Village, IL Phone: 847/ Fax: 847/ Reply to Department of Federal Affairs Homer Building, Suite 400 N th St NW Washington, DC Phone: 202/ Fax: 202/ kids1st@aap.org Executive Committee President Fernando Stein, MD, FAAP President-Elect Colleen A. Kraft, MD, FAAP Immediate Past President Benard P. Dreyer, MD, FAAP CEO/Executive Vice President Karen Remley, MD, FAAP Board of Directors District I Wendy S. Davis, MD, FAAP Burlington, VT District II Warren M. Seigel, MD, FAAP Brooklyn, NY District III David I. Bromberg, MD, FAAP Frederick, MD District IV Jane Meschan Foy, MD, FAAP Winston-Salem, NC District V Richard H. Tuck, MD, FAAP Zanesville, OH District VI Pam K. Shaw, MD, FAAP Kansas City, KS District VII Anthony D. Johnson, MD, FAAP Little Rock, AR District VIII Kyle Yasuda, MD, FAAP Seattle, WA District IX Stuart A. Cohen, MD, FAAP San Diego, CA District X Sara H. Goza, MD, FAAP Fayetteville, GA September 29, 2017 The Honorable William B. Brock Long Administrator Federal Emergency Management Agency 500 C Street, SW Washington, D.C Dear Administrator Long: On behalf of the American Academy of Pediatrics (AAP), a non-profit professional organization of 66,000 primary care pediatricians, pediatric medical subspecialists, and pediatric surgical specialists dedicated to the health, safety, and well-being of infants, children, adolescents, and young adults, I write to urge you in the strongest possible terms to provide all needed relief, supplies, medication, and other support to Puerto Rico and the U.S. Virgin Islands in the wake of Hurricanes Irma and María. The hurricanes have caused a humanitarian crisis of unprecedented scale, one that we fear will disproportionately harm vulnerable infants, children and their families. The AAP stands ready to partner with federal agencies such as FEMA to provide support to our fellow citizens. The situation for American citizens in Puerto Rico and the U.S. Virgin Islands is dire. In Puerto Rico, 3.5 million American citizens are without power, water, or communications technology. Roughly 100,000 American citizens of the U.S. Virgin Islands are living under similar dire circumstances. Many have lost their homes and businesses due to the storms. Even basic health care supplies are in short supply. The AAP is in close contact with our Puerto Rico Chapter leaders who report the need for first aid items to help children in shelters with non-urgent conditions. A list of the most needed first aid items for children in shelters is attached. Providing these items in sufficient quantities could help minimize hospital visits and avoid overcrowding in the pediatric emergency rooms. Also attached to this letter is correspondence we have been made aware of from the Hospital Pediátrico Universitario seeking medical supplies for their hospital. Please let us know if we can provide you pediatric subject matter experts including such contacts in Puerto Rico and the U.S. Virgin Islands. The AAP joins with all Americans in expressing our sympathy for and commitment to our fellow citizens. Our hearts are with the children and families of Puerto Rico and the U.S. Virgin Islands. We urge you to act now to provide emergency supplies, relief, and aid and stand ready to assist you in those efforts. Sincerely, Fernando Stein, MD, FAAP President

2 First aid items for children in shelters Diapers Wipes Hand sanitizers Alcohol pads Gauzes Band- Aids Betadine swabs Bacitracin or mupirocin oitments Topical antifungals Topical antibacterials Antibiotic ophthalmic drops and/or ointments Tooth paste and brush Otic drops (antibiotics) Zofran PO Zantac PO Infants formulas Specialized Infants formula Baby foods Pedyalite Diaper rash ointments Milk of Magnesia Miralax Lice Killers Normal saline ampules Aero chambers Decadron Prelone Amoxil/ Augmentin Scalpel #11 Clindamycin liquid Benadryl elixir and ointment Hydrocortisone topic 2% EMLA cream Nystatin Suture kids or removal Tape

Most of the businesses were forced to close their doors and many lost some or their entire inventory in the aftermath of the storm.

3 It has been nearly a week since the destructive winds and rains of Hurricane María made landfall in Puerto Rico. There are 3.5 million American citizens in the island without power, water and limited communication. Many lost their homes and suffered crippling losses from the storm. Most of the businesses were forced to close their doors and many lost some or their entire inventory in the aftermath of the storm. The total cost to the local economy is still being calculated and many experts suspect that the total impact will run into the billions of dollars. The University Pediatric Hospital suffered major losses. It is a tertiary facility with its own emergency room, pediatric neonatal and intensive care units, general pediatric wards, oncology ward, bone marrow transplant unit, outpatient clinics and dialysis unit. It is the referral center for the whole island, the Caribbean and the U.S. Virgin Islands. The hospital is part of the Puerto Rico Medical Center (PRMC), which provides access to other facilities including the University of Puerto Rico Medical Sciences Campus, Cancer Center and the Puerto Rico Clinical and Translational Research Center. Other clinical sites include: the University Hospital, the University of Puerto Rico Hospital at Carolina, the San Juan City Hospital, the Cardiovascular Center and multiple private offices in the community. As of now, the University Pediatric Hospital in San Juan is in need of life-saving items and medical supplies (see attachment). We are asking for your help. Currently they have power therefore, they are able to store medications. The contact person is the Director of Emergency Room Jahzel Gonzalez Pagan, M.D. They will appreciate anything we could provide them. While we are waiting on government and federal government support we need your help to cover the present medical needs of the Island. We thank you in advanced for your support! Your donation is greatly appreciated and will be used at the University Pediatric Hospital. You can either donate online or sent the medical items directly to the hospital. Hospital Address Hospital Pediatrico Universitario Centro Medico de Puerto Rico Salon A Primer Piso Barrio Monacillos San Juan, Puerto Rico, Donation link o.org Our patients and our Island thank you for your support.

Crisis Management: One Size Does Not Fit All. Todd Jenkins Sr. Loss Prevention Security Specialist Cracker Barrel Old Country Store, Inc.

Crisis Management: One Size Does Not Fit All Todd Jenkins Sr. Loss Prevention Security Specialist Cracker Barrel Old Country Store, Inc. Cracker Barrel Introduction Company Overview 70k + employees 600