In response to Hurricane Florence, Health and Human Services (HHS) Secretary Alex Azar has declared a public health emergency in North Carolina, South Carolina, and Virginia.
The Centers for Medicare & Medicaid Services (CMS) issued blanket waivers for Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) requirements for the affected states. These waivers are retroactive to Sept. 7 in North Carolina and Sept. 8 in South Carolina and Virginia. The agency also issued state-specific Section 1812(f) and Section 1135 waivers.
Additionally, the agency is offering a special enrollment period for Medicare beneficiaries and for select individuals seeking health plans through the federal health insurance marketplace who were affected by the hurricane. The agency also activated the Kidney Community Emergency Response program to provide dialysis services and has suspended requirements for Medicare beneficiaries seeking replacement medical equipment and supplies.
CMS has released a disaster response toolkit for state Medicaid agencies, and the HHS Office of Civil Rights has released guidance on applying federal civil rights laws in an emergency and how privacy laws apply in an emergency.
CDC Issues Clinical Guidance for Carbon Monoxide Poisoning
Meanwhile, the Centers for Disease Control & Prevention (CDC) urges clinicians to remain vigilant for carbon monoxide (CO) poisoning among patients from areas affected by Hurricane Florence.
Improper use of alternate power sources, such as gasoline generators and propane or charcoal grills, during power outages might lead to CO buildups inside buildings, garages, and campers. While symptoms can vary, patients exposed to CO might experience a tension headache, dizziness, drowsiness, chest pain, altered mental status, and flu-like symptoms without a fever.
When CO poisoning is suspected, CDC encourages clinicians to perform carboxyhemoglobin (COHgb) testing using a multiple wavelength spectrophometer and evaluate COHgb levels in light of the patient’s exposure history. An elevated COHgb level of 2 percent or higher for nonsmokers and 9 percent or higher for smokers supports a diagnosis of CO poisoning.
Clinicians should administer 100 percent oxygen until the patient is symptom-free or until a CO poisoning diagnosis has been ruled out, and consult with a toxicologist or Poison Control Center to consider hyperbaric oxygen therapy. Clinicians should notify emergency medical services to investigate the CO source and advise patients about proper use of generators and other alternative power sources.
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