FHA Alert: Hurricane Ian Advisory

09/28/2022 4:00:00AM

Total Available Beds: 12,582
Available bed percent: 20.6%
Percent of hospitals reporting: 95.20%
Percent of nursing homes reporting: 98.56%
Hospitals evacuating: 15
Affected patients: 256

Storm Information

The Florida Hospital Association (FHA) is monitoring Hurricane Ian’s progress as it begins to impact Florida and our hospital community. Key messages are below:

As of 5:00 pm, ET, the latest update indicates that Ian is restrengthening over the southeastern Gulf of Mexico.
Life-threatening storm surge is increasingly likely along the Florida west coast where a storm surge warning is in effect, with the highest risk from Naples to the Sarasota region.
Hurricane-force winds are expected in the hurricane warning area in southwest and west-central Florida beginning Wednesday morning with tropical storm conditions expected overnight.
Heavy rainfall will affect most of the Florida Peninsula for the next several days, spreading to the rest of the Southeast U.S. by Thursday and Friday, likely causing flash, urban, and small stream flooding.
Considerable flooding is expected with widespread, prolonged moderate to major river flooding expected across central Florida.

Complete weather information related to Hurricane Ian is available from the National Hurricane Center. Local advisories and information are available from the National Weather Service.

FHA ACTIONS

FHA holds first Hurricane Briefing

FHA hosted a statewide call this afternoon with nearly 400 hospital representatives and featured several state officials including State Meteorologist Amy Godsey, FDOH Surgeon General Dr. Joseph Ladapo, Commander Aaron Otis, AHCA Secretary Martsiller, and Deputy Secretary Kim Smoak. The focus of remarks was largely on emergency preparedness, local coordination, and patient safety.

Utility representatives from TECO and Duke Energy shared how their companies have prepared for the storm by mobilizing line workers and damage assessors. Both companies reassured that they are standing ready to assist with disaster recovery.

Several FHA-member hospital and health system leaders with facilities in the anticipated path of Hurricane Ian shared their plans for preparation and crisis control. FHA also introduced its statewide data dashboard; AHCA requested hospitals submit updates by 10 a.m. daily at the Health Facility Reporting System (HFRS).

FHA Submits Letter to OIR Urging Office to Exercise Authority

Additionally, today, FHA submitted a letter to David Altmaier, Commissioner of the Office of Insurance Regulation urging him to exercise the office’s authority with Florida’s insurance providers to require the waiver of certain coverage policies during the remainder of the Hurricane Ian disaster.

Specifically, FHA is asking that OIR requires health insurance plans licensed by their office to implement the following practices during the relevant disaster period:

Insurance providers should waive all prior authorization requirements for covered services.
Insurance providers should furnish any services necessary to maintain a beneficiary’s safety and health regardless of policy limits.
We appreciate the reminder of the provisions of 252.358, re: early prescription refills.
Insurance providers should waive penalties and restrictions, and not deny payment, for out-of-network care obtained during the disaster period.
Insurance providers should work with affected consumers to provide flexibility around the timing of premium payments to help affected consumers maintain coverage.
Plans should authorize payment for needed medical equipment and supplies regardless of when supplies were most recently provided.
FHA will keep you informed with any updates to this request. Read the full letter here.

FEDERAL ACTIONS

HHS Secretary Becerra declares Public Health Emergency for Florida in response to Hurricane Ian HHS

Secretary Becerra declared a public health emergency for Florida under section 319 of the Public Health Service Act retroactive to September 23, 2022.

Additionally, Secretary Becerra authorized 1135 Waivers under the Social Security Act, giving the HHS Centers for Medicare & Medicaid Services (CMS) beneficiaries and their healthcare providers and suppliers greater flexibility in meeting emergency health needs in disasters.

Read the full press release here.

STATE ACTIONS

Florida Division of Emergency Management (FDEM)

The State Emergency Operations Center is fully activated to a Level 1. The State Emergency Operations Center is staffed by Division of Emergency Management personnel and all Emergency Support Functions. The FHA is staffing the State Emergency Operations Center and working with state officials to respond to identified needs.

A list of Essential Elements of Information (e.g., evacuation orders, local states of emergency, shelter information, school closures, etc.) are provided daily by County Emergency Management Agencies. Shelter information is also available as preparedness activities continue. See the Florida Evacuation Orders Map online.

There are no requests for assistance or resources to FDEM from hospitals at this time.

Florida Agency for Health Care Administration (AHCA)

Today, AHCA issued the Florida Medicaid Health Care Alert Hurricane Ian -- Key Medicaid Information for Fee-For-Service and Managed Care Providers alert. The Agency’s directive is intended to ensure reimbursement for critical Medicaid services that are provided in good faith to eligible recipients who reside in the counties impacted by Hurricane Ian.

The Agency will waive all prior authorization requirements for critical Medicaid services beginning September 27, 2022, until further notice.

Early prescription refill edits have been lifted for all maintenance medications (this does not apply to controlled substances).

If a recipient requires critical Medicaid services beyond limits stated in policy in order to maintain safety and health, providers can furnish the service.

All Preadmission Screening and Resident Review (PASRR) processes are postponed until further notice by the Agency.

Retroactively performed screenings or resident reviews must document the reason for delay in the completion of PASRR requirements.

The PASRR process is waived for recipients who are evacuated due to an evacuation order or power outage and are admitted and discharged during the storm.

Additional information for providers is located on the Agency website, http://www.ahca.myflorida.com/: click the Hurricane banner at the top of the page for more information. Governor Ron DeSantis’ emergency executive orders, including impacted counties, is located online at: https://www.flgov.com/2022-executive-orders Additionally, AHCA has prepared a webpage with resources and information for providers during Hurricane Ian. There you can find links on updating Health Facility Reporting System (HFRS), Executive orders and regulatory information. The site will be updated through the storm.

Visit AHCA’s Hurricane Ian Information webpage at https://ahca.myflorida.com/mchq/emergency_activities/IAN_2022.shtml.

Florida Department of Health (FDOH)

The State Surgeon General issued a letter to Local Law Enforcement Partners advising that a business performing a critical role in providing healthcare delivery services is authorized to travel outside of established curfews during Hurricane Ian in order to deliver critical medical supplies, pharmaceuticals, and/or health care delivery services to medical facilities. Read and download the full letter here.

OTHER ACTIONS

Health Services Advisory Group Dialysis Patient Assistance Hotlines

The Health Services Advisory Group has issued the Dialysis Patient Assistance Hotlines. The Conditions for Coverage for End Stage Renal Disease facilities require that dialysis facilities provide patients with:

Instructions on how to contact their facility during an emergency.
An alternate emergency phone number in case the facility phone is not answered and/or the facility is not functioning during a disaster.
Directions on what to do if they are not able to get to their regular dialysis treatment, including dietary precautions and seeking treatment promptly in the event that a natural or man-made disaster results in the closure of their facility.

If a patient is unable to reach someone from their facility, they (or a support person or healthcare provider) can use the following patient hotlines, starting with their dialysis company’s hotline first, to obtain an appointment for dialysis treatment.

Dialysis Company	Patient Hotline Phone Number
American Renal Associates (ARA)	978.232.4099
DaVita (DVA)	800.400.8331
Dialysis Center Inc. (DCI)	866.424.1990
Fresenius Medical Care (FMC)	800.626.1297
US Renal Care (USRC)	866.671.8772
National Renal Care (NRC)	562.421.2690

If a patient is unable to obtain placement for treatment via the company hotline phone number above, they can contact ESRD Network 7 at 800.826.3773

Visit fha.org/emergency-management.html for up-to-date information.

Please contact John Wilgis at (850) 524-2037 for more information and assistance.