Hurricane Helene Updates

• Baxter International supply chain updates -Baxter International, which manufactures 60% of the country's supply of IV solutions, previously announced Sept. 29 its temporary closure as a result of damage from Hurricane Helene. In a letter to customers, Baxter stated it is implementing allocations on certain products. The Food and Drug Administration (FDA) said it is working with Baxter and other federal agencies to increase supply and reduce the risk of new shortages. FDA is also working with Baxter to confirm the amount of product recently released for distribution or may be available to wholesalers. For additional information and the latest updates from Baxter, please see Baxter’s Hurricane Updates webpage and this letter from ASPR.

  • Contact FDA if experiencing IV fluid bag shortage – Facilities experiencing issues sourcing IV fluid bags can inform the federal Food & Drug Administration (FDA) of this issue by emailing deviceshortages@fda.hhs.gov.

  • HHS Fact Sheet on Increasing Access and Supply of IV Fluids

  • WHO (World Health Organization) suggested management of dehydration secondary to diarrheal illness

  • 2023 American Society of Anesthesiologists Practice Guidelines for Preoperative Fasting: Carbohydrate-containing Clear Liquids with or without Protein, Chewing Gum, and Pediatric Fasting Duration—A Modular Update of the 2017 American Society of Anesthesia

  • Vizient adult and pediatric IV push medication reference

  • CDC health advisory on IV solutions – The Centers for Disease Control and Prevention (CDC) has issued a health advisory on the supply disruption of peritoneal dialysis and intravenous solutions due to the Baxter plant closure in North Carolina following Hurricane Helene. The advisory summarizes recommendations from the Food and Drug Administration; the Administration for Strategic Preparedness and Response Technical Resources, Assistance Center, and Information Exchange; the American Society of Health-System Pharmacists; the American Society of Nephrology; and the American Society of Pediatric Nephrology, among others, about addressing supply disruptions to PD and IV solutions.
  • Hospitals do not need an Emergency Use Authorization (EUA) to compound. Hospitals can reach out to compounding@fda.hhs.gov if they have questions.
    • FDA landing page: Hurricane Helene: Baxter's manufacturing recovery in North Carolina | FDA
    • Letter to health care leaders from HHS that went out this morning: Letter to Health Care Leaders and Stakeholders on Impacts of Hurricane Helene from Secretary Becerra | HHS.gov

• Internet availability: Spectrum is offering free Wi-Fi access points in affected areas.

• Salvation Army mobile feeding units are providing free meals and drinks in states affected by the hurricane.

• Updates from Georgia State Agencies:
  • Pharmacy Board emergency refill policy – The Georgia Board of Pharmacy has indicated that its emergency refill policy provides for the refill of certain medications for up to 30 days for persons in the areas covered by the State of Emergency declared by Gov. Kemp and/or the hurricane warnings issued by the National Weather Service for Hurricane Milton.
  • Out-of-state nurses can assist during Hurricane Helene State of Emergency - In response to the current State of Emergency for Hurricane Helene, the Georgia Board of Nursing has voted to implement its Policy 1.14, which allows out-of-state licensed practical nurses (LPNs) and registered nurses (RNs) with unencumbered licenses to work in Georgia health care facilities during the emergency if:
    • • The out-of-state nurse is supervised by an RN licensed in Georgia.
      • The health care facility verifies the out-of-state nurse’s license.
      • The health care facility provides the Board with the out-of-state nurse’s name and license number within 15 days of initial credentialing verification through www.nursys.com or the out-of-state board that licensed that nurse.
  • Supreme Court of Georgia issues order declaring statewide judicial emergency - Due to the widespread impacts of Helene, the Supreme Court of Georgia has issued an order declaring a statewide judicial emergency and extending certain deadlines in ongoing court proceedings due to the effects of tropical storm Helene. The Court has suspended, tolled, extended, and otherwise granted relief from certain deadlines. Those extensions apply only in cases where the filer can certify that the impacts of Helene resulted in the inability to take required action.

  • OCI Hurricane Helene directive to end – The Georgia Office of the Commissioner of Insurance and Safety Fire (OCI) has decided to end its directive prohibiting insurers across all lines from canceling policies for certain affected policy holders for nonpayment of premiums. This directive will end Oct. 31.

  • 988 disaster response resources – 988 Georgia has created a disaster response webpage that contains mental health resources and tips for individuals responding to a disaster.
  • DOR Extends Tax Relief to Victims of Hurricane Helene - The Department of Revenue announced on Oct. 3, that certain return and payment deadlines for taxpayers have been extended to May 1, 2025, following the aftermath of Hurricane Helene. 
  • The Georgia Department of Human Services announced the SNAP customers affected by the hurricane can request replacement benefits.
  • The Georgia Emergency Management and Homeland Security Association (GEMA/HS) keeps an updated list of sheltering and feeding locations, as well as points of distribution for pickup of essential items. 
  • Medical Board to allow out-of-state providers to care for displaced patients – Gov. Kemp has approved the Georgia Composite Medical Board’s emergency rule that will allow the Board to issue emergency temporary permits to out-of-state providers so they can provide in-person or virtual care to their out-of-state patients who are temporarily in Georgia because of the recent hurricanes. The out-of-state providers must have an established physician-patient relationship with these displaced patients and the patients must be from the providers’ home state. The emergency rule will be effective for up to 120 days after Georgia’s state of emergency expires and any emergency temporary permits issued pursuant to this emergency rule will be valid for 120 days. Learn more.

• Federal Updates
  • Federal disaster declaration expanded –The federal disaster declaration for Georgia continues to be reviewed and has recently been expanded to include additional counties. The declaration makes federal funding available to affected business and individuals in the covered counties.
  • Waivers and flexibilities for providers – Following the U.S. Department of Health and Human Services’ (HHS’s) declaration of a public health emergency (PHE) in Georgia in response to Hurricane Helene, retroactive to Sept. 24, the Centers for Medicare & Medicaid Services (CMS) has issued waivers and flexibilities for providers in addition to the blanket 1135 waivers that HHS already issued. If facilities need additional waivers, they can submit requests to CMS.
    
  • CMS has waived the 3-day hospital stay requirement to be eligible for skilled nursing facility (SNF) services
  • 1135 Quick Start Guides
    • 1135 Waiver
    • Public Health Emergency (PHE) Inquiry
  • CMS Training Videos
    • 1135 Waiver/Flexibility Requests
    • PHE-Related Inquiry Requests
    • Standard Waiver List
    • Medicare Fee-For-Service - Emergency-related policies and procedures that may be implemented without 1135 waivers
  • SAMHSA’s Disaster Distress Helpline
  • Commissioner of Insurance and Safety Fire Directive (10/11/24)
  • ASPR Emergency Prescription Assistance Program (EPAP)

• Hospital Statements and Press Releases:
  • Archbold
  • Carl Vinson VA Medical Center
  • Grady Health System

• Payer Updates
  • Amerigroup Hurricane Helene Updates
  • Anthem Hurricane Helene Updates
  • CVS Aetna Hurricane Helene updates
  • Georgia Medicaid/PeachCare for Kids provider communication regarding Hurricane Helene - 9/26/2024
  • United Healthcare Hurricane Helene Updates

• Specialty Care
  • Dialysis patients - Any dialysis patient can contact the Fresenius Emergency Hotline 1-800-626-1297, open 24/7, to locate the nearest open clinic.

  • CMS is helping people obtain and maintain access to critical life-saving services by activating the Kidney Community Emergency Response (KCER) program and working with End-Stage Renal Disease (ESRD) Network 6 (Georgia) and Network 7 (Florida), which is responsible under a contract with CMS for assessing the status of dialysis facilities in potentially impacted areas of the impacted states. This includes assessing impacts related to generators, alternate water supplies, providing education and materials for patients, and more. The ESRD Networks are also assisting people to received dialysis services in the location to which they evacuated. CMS, through the ESRD Networks, has also advised people to keep an emergency supply kit on hand in a waterproof bag, containing important personal, medical, and insurance information; contact information for their dialysis facility; the ESRD Network hotline number; and contact information of those with whom they may stay or for out-of-state contacts. They have also been instructed to have on hand supplies to follow a three-day emergency diet. The ESRD Network 6 (Georgia) toll-free hotline is 1-800- 524-7139. Additional information is available on the KCER website at: kcercoalition.com/

  • The American Kidney Fund has a financial assistance program ($250) in place for Georgia counties impacted by the hurricane. Dialysis and recent kidney transplant patients who need emergency financial help should contact a social worker at their dialysis or transplant clinic for information on applying for aid or apply directly at gms.KidneyFund.org.

  Hurricane Response Hub Website

Disaster Epidemiology Work Group

This group will focus on projects related to epidemiology training and tabletop exercise guidance; post-event needs assessment; exposure-response and investigation; and integration of data sources into dashboard for disaster response.

Incident Management Work Group

This group will focus on projects related to the management of hurricane incidents, including the development of statewide capabilities and capacities tools and maps, as well as trainings about patient hand-off and receiving processes, and the Incident Management Team support processes.

Strategic Communications Work Group

This group will focus on projects related to crisis and emergency risk communications and web-based emergency operations centers.

Surge Management Work Group

This group will focus on projects related to shelter operations, patient tracking and evacuation protocol.