Hurricane Dorian Information and Resources

NCHA is closely monitoring Hurricane Dorian, and is on standby as a connector to state/federal resources and for information to help our member hospitals and health systems during this storm.

See the green links below for helpful resources.

Be sure to follow @nchospitals on Twitter as we will be sharing messages from throughout the state and tagging them with #DorianNC.

 

Important Information from the NC Department of Health and Human Services

Sept. 6, 2019 Memo from the NC Department of Health and Human Services

 

Patient Care Resources

Patient Placement Procedures from NC Office of Emergency Management
Produced by the Healthcare Preparedness Program at the NC Office of Emergency Medical Services in case a large number of patients need to be transferred/evacuated in anticipation of Hurricane Dorian. Based on the patient placement procedure, if a hospital needs patients evacuated they should complete the attached spreadsheet (NC Hospital Disaster Pt Transfer Form) and send to their Healthcare Preparedness Coalition (HPC). Once the HPC has vetted the list, please email it to Kimberly Clement at kimberly.clement@dhhs.nc.gov. The Duke Patient Transfer Center has been asked coordinate this effort for with all the various hospital systems across the state. They will reach out and determine where patients can be placed and they advise the State to make sure transport resources have been identified. OEMS will then communicate back to the HPCs. Direct questions to Kimberly Clement, Program Manager, Healthcare Preparedness Program at 919-855-3936 or 919-210-1463.

 

State Medical Support Shelters
The state of North Carolina has set up a State Medical Support Shelter (SMSS) operational and ready to take or already taking patients. Please read the SMSS Placement Guidance Sept 2019 (1) for patient placement in a SMSS site. Patients should NOT go to this shelter until they have been given some approval from the SMSS site. Hospitals are asked to use the attached spreadsheet to request patient placement in the SMSS.  Send ANY email related to patient placement at the Medical Support Shelters to OEMSSEOC@dhhs.nc.gov to ensure one point of contact at the state level. The state is using the attached SMSS guidelines to determine if placement in an SMSS is appropriate. Click here to see a complete list of shelters.

 

NCHA Mutual Aid Agreement
The NCHA Mutual Aid Agreement (MAA) is a voluntary written arrangement among signatory hospitals to promote effective utilization of hospital resources in the event of disaster.


Staffing and Supplies

Rapid Response Staffing Available Through Qualivis
When a natural disaster strikes, demand can quickly overwhelm your team pre and post storm. Qualivis offers easy access to a nationwide network to simplify and speed the search process, so that you can focus on providing patient care. There is no cost to sign up for this service. Attached is information on Qualivis’ Rapid Response Staffing program and how to initiate the process. Please contact your Account Specialist or Sherry Kolb at or 803-744-3515. Details are online here.

 

NCHA Emergency Staffing Support Plan
NCHA has developed a staffing support plan that coordinates communication and streamlines a systematic mechanism in which NC Healthcare Association (NCHA), the NC Medical Society (NCMS) and the NC Nurses Association (NCNA) can receive requests and offers for staff and coordinate staff positioning for hospitals in need. Please see the NCHA Emergency Staffing Support Plan and contact NCHA about staffing needs at esc@ncha.org. Attached is NCHA’s Staffing Request Form and the form for hospitals providing staff help. NCHA will be coordinating these requests with the NC Office of Emergency Management. Note: Due to possible road closures and safety concerns, transportation by staff to affected areas may need to be coordinated with local OEMS and NC Department of Transportation.

NCHA Strategic Partners Monitoring Supply Needs
NCHA Strategic Partners through its supplier Vizient is here to help with food (through US Foods), medical supplies (Owens & Minor) and more. Hospitals working through Premier for supplies have similar pre and post disaster plans. Please contact Jody Fleming at jfleming@ncha.org or 919-677-4130 with your urgent supply needs.

Vizient GPO Updates (no login required): https://www.vizientinc.com/our-solutions/supply-chain-solutions

Vizient Customers (requires login) Supply Disruption Info: https://www.vizientinc.com/Our-solutions/Supply-Chain-Solutions/Member-Programs/Clinical-Contract-Support-Resources/CCSR-Disaster-Preparedness

CDC Food, Water, Sanitation Useful Disaster Information: https://www.cdc.gov/disasters/foodwater/index.html

 

Nursing Licensure Verification
The North Carolina Board of Nursing allows out-of-state nurses to practice during a disaster in an established healthcare system or facility, provided the nurse has a valid, unencumbered license in another state. Licensure information can be verified easily through “Nursys QuickConfirm License Verification.” Contact general@ncbon.com for additional information if you’re a licensed out-of-state nurse interested in helping or an employer that needs help.

 

NCMB Emergency Licensure Policy
The NC Medical Board (NCMB) has an emergency policy in place that allows physicians, PAs and certain other medical professionals not currently licensed in North Carolina to practice in the state during a declared state of emergency.

 

Behavioral Health Professionals (Temporary Waiver)
Governor Cooper has signed a temporary wavier permitting  psychologists, licensed clinical social workers, professional counselors and certified substance abuse counselors with out-of-state licenses to practice in North Carolina.

 

Mobile Communications Rapid-Response Teams
Major mobile carriers have rapid-response teams and plans in place to deploy emergency equipment including portable generators, fuel trucks, Cell On Wheels (COWs), Cells on Light Trucks (CoLTS), fuel and diesel trucks and other vehicles.

 

Water Resources
Bulk Water Delivery Services  – Davis Water Service in Randleman NC (1-800-234-8845) and Alamance Triton Water in Burlington (336-228-0900).

 

Restoration Resources
NCHA has compiled a list of restoration service providers referred by members and other partners. View or download the list here: Restoration Services 2019

 

Volunteers Needed
If you are a health or mental health professional interested in volunteering in impacted areas, the Red Cross is seeking volunteers.


Regulatory Updates

North Carolina Hospital Regulations allow for a temporary increase in bed capacity of up to 10% during a natural disaster. Hospitals seeking to increase capacity under this rule should submit a request to Azzie.Conley@dhhs.nc.gov  Note there should be no delays as there is no longer a required review by the DHSR Construction Section.

Newly Declared Section 1135 waiver
These waivers and modifications will become effective at 4:00 P.M. Eastern Standard Time on September 6, 2019, but will have retroactive effect to September 1, 2019, in the State of North Carolina.
https://www.cms.gov/About-CMS/Agency-Information/Emergency/EPRO/Current-Emergencies/Current-Emergencies-page.htmlhttps://www.phe.gov/emergency/news/healthactions/section1135/Pages/nc-dorian-4sept19.aspx

CMS powerpoint on 1135  Waiver & the Preparedness Rule
https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertEmergPrep/Downloads/CMS-Presentation-1135-Waivers.pdf

Public health emergency declarations and 1135 Waiver 
https://www.phe.gov/emergency/news/healthactions/phe/Pages/default.aspx

List of Emergency Policies and Procedures that Can Be Done Without 1135 Waiver
Attached from the Centers for Medicare and Medicaid Services is a list of emergency policies and procedures that can be done without an 1135 waiver. More emergency preparedness guidance, including Conditions of Participation/Coverge is online here.

Waiver Information

A request for authorization to operate under an 1135 waiver can be sent to CMS’ Atlanta Office (ROATLHSQ@cms.hhs.gov) to ensure proper payment. Once you send the email you will be contacted back by the regional office.  Adrianne Saunders is the individual that is responsible for this out of our regional office and handles these requests.

Links below from past Hurricanes may have helpful information.

 1135 Waiver At A Glance Guidance

What Information to Provide for an 1135 Waiver

Request for Blanket Waivers(provided by Texas Hospital Association)


State of North Carolina Resources

North Carolina’s Hurricane Dorian Site
The NC Department of Public Safety’s official site for the Hurricane. It includes evacuation orders, shelter locations, road conditions and more. Check back for updates.

NC Department of Health and Human Services Hurricane Dorian Site
In conjunction with other state agencies, DHHS is monitoring Hurricane Dorian and the storm’s effects on North Carolina and the people that DHHS serves.  This information will continue to be updated before, during and after the storm.

NC Office of Rural Health (ORH)- 2019 Natural Disaster Support Survey
In partnership with the NC Community Health Center Association, NC Association of Free and Charitable Clinics, NC Association of Local Health Directors, NC Healthcare Association, and the NC School-Based Health Center Alliance, ORH is trying to gather information about your needs and available services.  This information will be shared daily with the team at NC DHHS to assist in storm preparation and reparation.  It will also be shared daily with the aforementioned groups to create a collective response across the entire partnership.  Please complete the survey link below to help us better understand your needs at this time.  As previously stated, your responses will assist ORH as we share information with our partner organizations and NC DHHS before and during the storm.  The link will allow you to complete the brief survey on your mobile device or on a computer. Please complete this survey as many times as necessary to account for ongoing impact: https://ncruralhealth.az1.qualtrics.com/jfe/form/SV_1ELTl3aUjUwB4tD

Temporary Medicaid Access Flexibilities
DHHS has received federal authority to make it easier for beneficiaries to access services and for health care providers to deliver care. This includes receiving or providing care in a temporary shelter, transfers to another nursing home facility, and more. Visit the Medicaid Hurricane Dorian webpage for details.

List of Shelters
For families concerned about sheltering those with autism or in need of calming rooms, contact the Red Cross disability advisor at 720-618-3513 for help identifying a shelter near you that could provide support.

North Carolina Emergency Management
The NC Department of Public Safety’s Emergency Management Site links you to emergency communications resources, disaster recovery, homeland security and more.

Ready NC
Download the ReadyNC app for latest traffic, shelters, flood gauge info, evacuations and more.

Healthcare Preparedness Coalition
Links to the State Medical Assistance Teams (SMAT) in North Carolina that coordinate efforts between the North Carolina Office of EMS (NCOEMS), North Carolina Regional Advisory Committees (RACs), NC hospitals, local, county, and other state agencies which ultimately enhance North Carolina’s State Medical Response System (SMRS).

North Carolina 2-1-1
Community health and human services resources and services, and real-time support and communications during emergencies and disasters.

Duke Energy
Latest update on power outages and outage status.

RxOpen
Rx Open helps patients find nearby open pharmacies in areas impacted by disaster.

Early Food Benefits for WIC Participants
Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participants in storm-affected counties who were scheduled to receive their benefits should have had those benefits automatically added to their eWIC card by their local WIC agency. WIC participants can confirm that benefits have been added by calling the eWIC customer service line at 844-230-0813 or by accessing their account at www.mybnft.com. This automatic renewal will continue through the weekend in storm-affected counties.


Federal Resources

ASPR TRACIE
The US HHS Office of the Assistant Secretary for Preparedness and Response (ASPR) Technical Resources, Assistance Center, and Information Exchange (TRACIE) is your gateway to healthcare emergency preparedness information. Whether you work for a hospital, are part of a healthcare coalition, or are a healthcare provider, emergency manager, or public health practitioner, ASPR TRACIE can help you learn more about disaster, medical, healthcare, and public health preparedness.

ASPR TRACIE’s Hurricane Resources Page
These resources can help our stakeholders prepare for, respond to, and recover from hurricanes and flooding. Also see this ASPR US Public Health Emergency site.

Fact Sheet on EMTALA and Disasters
The federal Health and Human Services Office of the Assistant Secretary for Preparedness and Response has issued a fact sheet addressing frequently asked questions about the Emergency Medical Treatment and Labor Act (EMTALA) and disasters. The fact sheet includes updated information on addressing patient surge without an EMTALA waiver, as well as links to other resources and additional information.


Additional Reference Information

Hospital Disaster Preparedness Self-Assessment Tool
The Hospital Disaster Preparedness Self-Assessment Tool, prepared by the American College of Emergency Physicians (ACEP), was developed to assist hospitals in revising and updating existing disaster plans or in the development of new plans.

Disaster Planning Checklist for Chief Financial Officers of Healthcare Organizations
The Healthcare Financial Management Association has put together a helpful Disaster Planning Checklist for Chief Financial Officers of Healthcare Organizations. Some of the items and activities listed may not fall directly within the responsibility of the financial leaders of a facility, but have financial implications that must be considered during the planning process.

SAMHSA Disaster Toolkit
Free disaster toolkit created by the Substance Abuse and Mental Health Services (SAMHSA) for disaster recovery workers and dealing with workplace stress.

CDC Coping with a Disaster or Traumatic Event
The Centers for Disease Control and Prevention has resources for coping with a disaster or traumatic event.

Responders – Tips for Taking Care of Yourself
The CDC also has tips and resources specific to emergency responders for resiliency and coping during a disaster.

APA Coping after Disaster, Trauma
The American Psychiatric Association has very digestible and lay-friendly resources to help after a disaster or trauma.

Lessons Learned from Hurricane Harvey
The Texas Hospital Association released a special report (click link to download) analyzing Texas hospitals’ disaster response before, during and after Hurricane Harvey, including findings and recommendations for future preparation strategies.

Lessons learned from Hurricane Sandy
Prepared by the American College of Emergency Physicians


Past Resources

2018 FEMA Reimbursement Process Webinar Recording

Mr. Jody Moore and Mr. Don Campbell of Crisis Focus conducted a webinar on September 28, 2018 providing participants with an introduction and overview of the Federal Emergency Management Agency (FEMA) Public Assistance Grant Process. The recorded webinar is still available.

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