NACHC continues to monitor the latest developments regarding hurricanes Harvey, Irma and Maria. This page will be updated as more information becomes available. NACHC also maintains resources related to emergency preparedness and continuity of operations.
NACHC is collecting information from health centers, health center controlled networks and primary care associations interested in providing support to health centers impacted by Hurricane Maria. Information collected will be shared with Asociación de Salud Primaria de Puerto Rico (PCA). Please fill out this online form if your organization is interested in providing support. Contact Jason Patnosh with any questions.
Report: Puerto Rico’s Community Health Centers, Which Serve 1 in 10 Residents, Essential to Hurricane Recovery
A new report by the Geiger Gibson/RCHN Community Health Foundation Research Collaborative at George Washington University’s Milken Institute School of Public Health details how the island’s 20 federally funded health centers are helping residents cope with urgent and emerging health care needs, at a time when communication is limited and access to electricity and clean water remains scarce.
Expected Migration of Residents of Puerto Rico to High Population Centers on U.S. Mainland (10/04/17)
Severe hurricane damage in Puerto Rico is prompting questions from many communities from the U.S. mainland with high Puerto Rican populations. This may accelerate patterns of northern migration from Puerto Rico, which has seen ten percent of the population leave the island over the last decade. Currently, New York City, Philadelphia, and Chicago have the highest numbers of Puerto Rican residents. As of 2010, there were 723,621 Puerto Rican residents in New York, making them the city’s largest Hispanic group. Florida takes the claim for the state with the largest Puerto Rican population overall, with over 1 million Puerto Rican residents. Finally, Holyoke, Massachusetts has the highest Puerto Rican population as a percent of the total population in the U.S. Accommodation and resettlement will take huge investments from local, state, and federal agencies. Several examples that have risen in the news recently are below:
- NPR’s Morning Edition recently highlighted Holyoke, Massachusetts, where broad resettlement efforts highlight how deeply displacement goes, and the lasting impact the hurricane is having on financial and social futures. Most of Holyoke’s incoming students, for example, may be classified as homeless, and/or arriving with no school or immunization records. The district, in accordance with federal guidelines, will enroll them, and provide money for school uniforms, lunches, and food to take home. It is too early to say how many residents from Puerto Rico may arrive in this one town.
- In New York, Governor Andrew Cuomo announced the deployment of critical medical supplies and is readying personnel for deployment, while in New York City communities are doing all they can to house the displaced. The Community Health Care Association of New York State (CHCANYS) has been active in the preparations, along with many of the health centers.
- In Florida, Governor Rick Scott has declared a state of emergency for the state to respond to the potential migration of residents from the island. The Florida Association of Community Health Centers (FACHC) is working with other partners throughout the state. In Miami, Borinquen Medical Center is part of a coalition of groups, including the Salvation Army and Catholic Charities, that have set up at Miami International Airport to assist residents as they arrive from the island.
If health centers, HCCNs, and/or PCAs are hearing of conversations happening in their state and/or through the health centers please share them with Jason Patnosh (firstname.lastname@example.org). NACHC anticipates these questions will start to come up at various levels.
BPHC – Temporary Privileging of Clinical Providers by Federal Tort Claims Act (FTCA) Deemed Health Centers in Response to Certain Declared Emergency Situations (September 26, 2017)
This Program Assistance Letter clarifies the credentialing and privileging documentation required to support temporary privileging of clinical providers by health centers in response to certain declared emergency situations for purposes of deemed Public Health Service employment with associated FTCA protections under section 224 of the Public Health Service Act PHSA.
Hurricane Maria Update & Resources (September 22, 2017)
As many know the information and updates coming out of Puerto Rico and the U.S. Virgin Islands has been very limited. NACHC has been in touch with the Primary Care Association in Puerto Rico as they attempt to reach all health centers across the island. Currently 100% of the island is without power and cell reception is only present for about 5-10% of the island. NACHC found using the WhatsApp texting app was the best way to communicate.
President Trump has made a Puerto Rico disaster declaration and U.S. Department of Health and Human Services (HHS) Secretary Tom Price, MD, declared a public health emergency in Puerto Rico and the U.S. Virgin Islands due to Hurricane Maria. This allows resources to be made immediately available to the island. News reports indicate that airports will begin opening to relief shipments on September 22.
HRSA/Bureau of Primary Health Care (BPHC) Update
BPHC staff is tracking impact data on delivery sites affected by the storm. BPHC project officers (POs) or other BPHC staff will be in touch with health centers to gather information about operational status and answer questions related to grants or scopes of project. BPHC is encouraging health centers to proactively provide information and contact their PO with any updates as soon as they are able. BPHC has said that they will be as flexible as possible knowing that health center staff are responding to their own challenges.
- Health centers may request a change in scope of project to add a temporary site(s) in response to emergency events through a streamlined process outlined in Program Assistance Letter (PAL 2014-05): Updated Process for Requesting a Change in Scope to Add Temporary Sites in Response to Emergency Events
- Following a Public Health Emergency Declaration by the HHS Secretary, HRSA allows eligible entities in affected states to immediately enroll for the 340B Drug Program. To enroll, contact the 340B Prime Vendor Program: email@example.com or 1-888-340-2787.
- The Federal Tort Claims Act Health Center Policy Manual provides additional guidance related to emergencies in Section F: FTCA Coverage When Responding to Emergency Events
If you have questions about FTCA coverage, contact the BPHC Helpline online or by phone: 877-974-BPHC (2742) from 8:30 a.m. to 5:30 p.m., Mondays through Fridays (except federal holidays). For specific questions related to your health center grant or scope of project, please contact your project officer. Also see the BPHC webpage for updates.
Additional Resources for Hurricane Relief
- Direct Relief is providing ongoing support to those affected by Hurricane Maria, and to community health centers specifically.
- Americares is responding in Puerto Rico and supporting community health centers as well.
- Visit FEMA’s website for additional updates and information on hurricane relief. FEMA also opened a 24-hour helpline for Puerto Rico residents.
- The American Red Cross Safe and Well website is a free public reunification tool that allows individuals and organizations to register and post messages to indicate that they are safe, or to search for loved ones. The site is always available and open to the public and available in Spanish. Registrations and searches can be done directly on the website. Messages exist in both Spanish and English. To speak with someone at the American Red Cross concerning a missing friend or relative, please contact 1-800 REDCROSS OR 1-800-733-2767, choose option 1.
NACHC will provide updates on how you can help health centers in Puerto Rico and the U.S. Virgin Islands as that information becomes more available. Please contact Jason Patnosh at firstname.lastname@example.org or 301/347-0400 if you have any questions.
Updates from Hurricanes Harvey and Irma
FEMA-Hurricane Recovery Resources for Health Centers From Capital Link (September 18, 2017)
This resource, developed by HRSA National Cooperative Agreement partner Capital Link, provides guidance to health centers looking to obtain Federal Emergency Management Agency (FEMA) funding for facilities damaged or destroyed due to Hurricane Harvey. Capital Link developed an additional resource providing guidance to health centers impacted by hurricanes Irma and Maria.
Hurricane Irma—Clinical Guidance for Carbon Monoxide (CO) Poisoning – CDC Health Advisory (September 12, 2017)
The purpose of this CDC advisory is to remind clinicians evaluating persons affected by the storm to maintain a high index of suspicion for CO poisoning.
Tetanus in Areas Affected by a Hurricane: Risk, Prevention, and Management Guidelines for Clinicians – CDC Clinician Outreach and Communication Activity (September 12, 2017)
This bulletin, issued by CDC’s COCA Now, provides guidance on protection against Tetanus for those working in flood clean-up.
BPHC Bulletin: Hurricane Irma – Health Center Resources (September 8, 2017)
This bulletin, issued by the Bureau of Primary Health Care (BPHC) provides key guidance documents for health centers preparing for and responding to Hurricane Irma.
HHS Secretary Price Declares Public Health Emergency in Florida due to Hurricane Irma (September 8, 2017)
U.S. Department of Health and Human Services (HHS) Secretary Tom Price, MD, declared a public health emergency in Florida as Hurricane Irma continues to track toward the Florida peninsula.
Resources for Health Centers Responding to Hurricane Harvey – Bureau of Primary Health Care (BPHC) Bulletin (September 1, 2017)
This bulletin, issued by BPHC, includes guidance documents to support health centers’ response to Hurricane Harvey.
This website, developed by the U.S. Department of Health and Human Services, provides guidance to health care providers attending to the medical needs of adults and children with HIV displaced from disaster areas who have not yet secured HIV care in the areas where they have relocated.
Disaster Assistance for Hurricane Harvey – FEMA eBrief (August 31, 2017)
This ebrief, issued by FEMA, includes instructions for how to apply for Hurricane Harvey disaster assistance, safe and effective ways to donate or volunteer, and other resources.
Hurricane Harvey Website – U.S. Department of Health and Human Services, Assistant Secretary for Preparedness and Response (ASPIR)
If the hurricane has impacted your area, listen to state and local officials as well as your local news. Take some time to touch base with family, friends and neighbors to find out who you can count on and who is counting on you. If local officials tell you to evacuate, listen! It could save your life. These resources can help you make some last-minute plans, start important conversations, connect with state and local officials online, and learn about considerations for evacuating.
The U.S. Department of Health and Human Services (HHS) issued a list of its latest actions in response to Hurricane Harvey.
“Preparing for Hurricane Harvey” – BPHC Bulletin (August 25, 2017)
This list, compiled by BPHC, provides basic tips for advance preparation by patients and staff. It includes a telephone/text crisis hotline as well as links to Spanish language materials.