Sept. 20 (UPI) -- Hurricane Maria made landfall in Puerto Rico one year ago Thursday, leaving an impact that's still being felt on the island.
Maria arrived as a Category 4 storm just after 6 a.m. on Sept. 20, 2017, in Yabucoa on Puerto Rico's eastern coast -- with winds up to 155 mph, bringing the most severe weather conditions the island has faced in nearly 100 years.
Maria was responsible for a significant loss of life as dozens were killed by the initial impact and thousands more in the aftermath, although the total number has been disputed.
All of Puerto Rico's 3.5 million Americans were left without power and it wasn't fully restored until nearly a year later. The storm also left a path of destruction, causing $90 billion worth of damage and forcing many to rebuild or leave the island entirely.
Government officials have had difficulty pinning down the exact number of deaths that can be attributed to the storm, with estimates ranging from 65 to more than 4,000, according to various studies.
That total was nearly twice as high as the government's previous toll of 1,427, which came after death registry statistics showed that many more people died in the last four months of 2017 than the same time the previous year.
The highest estimate came from a Harvard University study released in May that said at least 4,645 people were killed, most resulting from delayed medical care.
About 14.3 deaths occurred per 1,000 people from Sept. 20 through Dec. 31, a 62 percent increase in mortality rate, the Harvard study found.
President Donald Trump this month disputed the higher death count, claiming Democrats inflated the numbers to make him look bad.
"3000 people did not die in the two hurricanes that hit Puerto Rico. When I left the Island, AFTER the storm had hit, they had anywhere from 6 to 18 deaths. As time went by it did not go up by much," Trump wrote on Twitter.
On Sunday, Federal Emergency Management Agency administrator Brock Long questioned the relevance of the death toll studies and described the numbers as "all over the place."
"I don't know why the studies were done," he said. "What we've got to do is figure out why people die, from direct deaths, which is the wind, the water, and the waves, you know, buildings collapsing, which is probably where the 65 number came from."
Last month, nearly a year after Hurricane Maria caused a total blackout on the island, the Puerto Rico Electric Power Authority announced power had been fully restored to its customers.
The utility shared a photo of "Charlie, Jazmín and children from Ponce," which PREPA said were the last of its 1.47 million customers left without power.
"According to our reports, all of our clients that were without service since Maria now have electricity," PREPA spokesman Geraldo Quiñones told CNN.
Even after the power was fully restored, the utility said it still has much work left to do to ensure the island's electricity system is improved amid another hurricane season.
PREPA spent $3.2 billion to erect about 52,000 new electrical poles and string 6,000 miles of wire in the rush to restore power after the hurricane, but now must redo up to a quarter of the work to ensure the system is secure, the utility's new chief executive José Ortiz, told the New York Times in August.
"There are many patches -- too many patches -- developed just to bring power to the people," Ortiz said. "Now we have to redo that thing."
PREPA has faced a turbulent shift in leadership and structure since the hurricane, after its former executive director, Ricardo Ramos, resigned in November after testifying to the Senate Energy and Natural Resource Committee about the decision to grant a $300 million contract to Whitefish Energy Holdings to restore power.
Federal officials criticized the hiring of the Montana firm, which was new and had just two employees at the time it was granted the contract, as documents revealed PREPA disregarded its own lawyers' advice when it agreed to hire them.
In January, Gov. Ricardo Rossello announced the government planned to privatize PREPA's assets in a process he said would begin with legislation to establish a legal framework and could take as long as 18 months.
"The Puerto Rico Electric Power Authority does not work and cannot continue to operate like this," Rosello said at the time. "With that PREPA, we cannot face the risks of living in an area of high vulnerability to catastrophic events."
Many Puerto Ricans on and off the island have still yet to reclaim a semblance of their way of life before the storm.
In all, Maria caused about $90 billion worth of damage in Puerto Rico and completely destroyed most wooden structures on the islands of Vieques and Culebra, according to the National Hurricane Center's final report.
FEMA denied nearly half of the applications for individual assistance from hundreds of thousands of Puerto Ricans, as many lacked property titles required to meet the agency's criteria for eligibility, NBC News reported.
The Puerto Rico Builders Association estimated that 55 percent of Puerto Rico's infrastructure -- including 700,000 houses and commercial buildings -- was built informally.
In July, the U.S. Department of Housing and Urban Development approved $1.5 billion through the Community Development Block Grant-Disaster Recovery Program to fund programs focused on restoring homes and businesses.
HUD also granted Puerto Rico $18.5 billion to rebuild homes before the next hurricane season.
Puerto Rico also faced a mass exodus in the wake of the storm, as thousands moved to Florida, New York, Texas and Pennsylvania.
In June, Puerto Rican Republican Rep. Jenniffer González-Colón introduced the Puerto Rico Admission Act of 2018, seeking to make Puerto Rico the 51st U.S. state by 2021.
Puerto Ricans voted overwhelmingly in favor of turning the U.S. territory into a state in a referendum last year and some have become more adamant about the idea since the storm, hoping statehood could lead to increased aid from the federal government.
Puerto Ricans are also able to vote in U.S. elections immediately upon arriving in the mainland and University of Central Florida political science professor Aubrey Jewett told UPI in June that even by the most modest estimates, the number of Puerto Ricans who moved to the United States after the storm could sway midterm elections and elect politicians with pro-Puerto Rico policies.