San Juan, Puerto Rico(CNN) Sammy Rolon is living in a makeshift clinic set up at a school. He has cerebral palsy and epilepsy and is bedridden. He's waiting for surgery that was scheduled before Hurricane Maria smashed into Puerto Rico. Now, he can't even get the oxygen he needs.
There is help available for the 18-year-old -- right offshore. A floating state-of-the-art hospital, the USNS Comfort, could provide critical care, his doctor says.
But nobody knows how to get him there. And Sammy is not alone.
Clinics that are overwhelmed with patients and staff say they don't even know how to begin sending cases to the ship. Doctors say there's a rumor that patients have to be admitted to a central hospital before they can be transferred to the Comfort.
Only 33 of the 250 beds on the Comfort -- 13% -- are being used, nearly two weeks after the ship arrived.
According to the Federal Emergency Management Agency, the official protocol is for patients in need to go to their nearest medical facility. If that facility is unable to provide care, a doctor there should contact the medical coordinating center in San Juan.
Someone there will then determine whether a patient needs to be transferred to a hospital on the island and which one. In some cases, a determination will be made to transfer a patient to the US Army Combat Support Hospital in Humacao, which has 44 beds and has been operational since Sunday.
The remaining option is for patients to be transferred to the Comfort.
"Only patients with critical needs requiring specialized care will be transferred to USNS Comfort," said Coast Guard Lt. David Connor in an email. He is working at the FEMA Joint Information Center in San Juan.
"Over 100 patients have been treated to date, conducting logistics and medical support operations in Arecibo and Aguadilla," according to briefing issued by FEMA on Tuesday.
The hospital ship was deployed as part of the federal response to the storm and its aftermath that has left 3.4 million Americans facing power and communications outages, water and food shortages and at risk for worsening health conditions.
The USS Comfort is waiting; the process laid out by FEMA for patients does not seem clear to local health-care providers.
Puerto Rico's Department of Health has to decide which patients can get care aboard the ship. And referrals have been minimal.
CNN asked Gov. Ricardo Rosselló why so many are in need of help and yet a ship with operating rooms and intensive care units sits nearly empty.
"The disconnect or the apparent disconnect was in the communications flow," Rosselló said.
He acknowledged that the system must get better.
"I asked for a complete revision of that so that we can now start sending more patients over there," Rosselló said.
For doctors and medics in hospitals and makeshift clinics, time is of the essence. It is difficult for them to watch patients suffer, and not be able to provide answers or direction about whether the USNS Comfort is an option.
Dr. Jorge Rosado, who oversees Sammy's care at the clinic and works at San Jorge Children's Hospital, says the young man is a prime example.
"He can become acutely ill if he continues to be (at the school)," he said. "It's very frustrating. I know they have the capacity; they have the medical staff; they have the supplies. ... To hear there's only 33 patients in such a big mobile hospital -- it's tough."
Capt. Kevin Robinson, the Comfort's mission commander, says help is waiting.
"I know that we have capacity. I know that we have the capability to help. What the situation on the ground is ... that's not in my lane to make a decision," he said. "Every time that we've been tasked by (Puerto Rico's) medical operation center to respond or bring a patient on, we have responded."
For Sammy's father, Jose Cruz, the waiting for a plan is heartbreaking.
"I feel horrible," he says. "Because I can't help him."