As the catastrophe in Western North Carolina further unfolds, U.S. Health and Human Services (HHS) has declared its eighth hurricane related Public Health Emergency (PHE) since July 12.
In conjunction with the PHE, the Centers for Medicare and Medicaid Services (CMS) took action October 2 to accelerate payments and advance payments to fee-for-service healthcare providers and suppliers affected. The benefits, however, will depend on whether they meet certain criteria.
Providers and suppliers with delinquent amounts due under Medicare, on payment holds, or under investigation for fraud, waste, or abuse-related issues, for example, would be excluded, according to CMS. Furthermore, they must have unique National Provider Identifier (NPI) and Medicare ID Provider Transaction Access Number (PTAN) combinations.
Nevertheless, CMS’s payment action may come as welcome news to hospitals, health clinics, and clinical laboratories serving the disaster area where health risks could be rising following Helene.
Downgraded from a hurricane, Helene hit Asheville, NC, and nearby areas starting September 27 as a tropical storm.
Health Care Situational Assessment Teams have been deployed to assess the storm’s impacts to hospitals, nursing homes, dialysis centers, and other healthcare facilities, the American Hospital System said. Among the facilities impacted was Baxter International's North Cove plant in Marion, NC, which manufactures 60% of the country's supply of IV solutions, producing 1.5 million bags per day.
Baxter took actions before the storm, according to details on the company’s website.
“These include actively managing inventory and implementing a protective allocation process by product line to help support supply continuity and equitable product distribution,” Baxter said. “The company will leverage Baxter's global manufacturing network to help mitigate potential supply impact as it continues efforts to fully restore North Cove's manufacturing operations.”
However, hospitals around the country are beginning to conserve IV fluids now that one week has passed, according to NBC News. The full extent of disruptions to healthcare operations, medical laboratory testing, and supplies, as well as infection control practices, may continue to be felt in the coming days.
Quest Diagnostics reported via its website today that Helene was "severely impacting its operations across the Southeast." Clinical laboratories in the Asheville area reported being closed and open, for example, Keystone Laboratories.
"Despite the devastating impact of Hurricane Helene on Western North Carolina, Keystone Laboratories will remain fully operational," stated a notice on the lab's website.
Prior to the storm, the North Carolina State Laboratory of Public Health (NCSLPH) hoped to keep newborn screening online, working with its overnight courier, United Parcel Service (UPS), to identify disruptions in specimen transport services, according to the North Carolina Medical Society.
Atrium Health deployed a mobile MED-1 hospital, according to WBTV news in Charlotte, NC. Atrium is part of the Charlotte-Mecklenburg Hospital Authority but serves parts of four Southeastern states.
The work of healthcare situational assessment teams so far includes surge support in medical tents in Buncombe County and Mitchell County, as well as state medical support shelters in Catawba and Polk County, the Administration for Strategic Preparedness and Response (ASPR) said October 2.
However, the situation is dire, Jennifer Horney, PhD, professor of epidemiology and core faculty of the Disaster Research Center at University of Delaware, told LabPulse.
“The extent of the damage to facilities is tremendous with many still, a week out, operating without water or electricity, with some pretty dramatic evacuations needing to occur,” Horney said.
“It’s just so complex. The other side of this, too, is workers,” she continued. “Some workers have been stuck in their hospitals … some people have been stuck away from the hospital and unable to come in and relieve them, and so we know after disasters that there are some factors that really exacerbate burnout and mental health outcomes.
“A lot of attention has been paid to Asheville,” Horney said. “Asheville is the regional healthcare center, the only Level 1 trauma center in that western North Carolina region. The prioritization of getting them back up and running as a regional center is really critical. They are advising people who are [pregnant and] close to term or postpartum to evacuate because they can’t guarantee infection control and basic parameters of care delivery.”
Even though this is a huge storm, there is still surge capacity that is available to come, unlike during the COVID-19 pandemic, Horney explained.
The problem is, “we don’t have surge capacity built into any of our systems,” she said. “Everything is a just-in-time system at this point. Any time there is a disaster, it’s going to put pressure on those logistics systems, on employment and staffing, and all kinds of things just because we don’t have surge capacity built in any longer.”
Jennifer Horney, PhD, professor of epidemiology and core faculty of the Disaster Research Center at University of Delaware, on what has been learned of disaster recovery. Helene will be unique due to water supply disruption and competing priorities.
