HRSA Health Services and Research Administration FAQ
QuestionTopics
- General
- Coverage
- Resources
- Resource
- Federal Tort Claims Act (FTCA) Covera
- Funding/Use of Grant Dollar
- 340B Drug Pricing Program
- Mobile Medical Units
- Clinical
- Grants Management
- Supplies
- Medicare, Medicaid, and SCHIP
- Personnel
- Capital Needs
- Reporting/Uniform Data System
General
Where can I find resources about getting FEMA assistance for damaged or destroyed facilities?
Capital Link has contracted with HRSA to work with grantees in the Hurricane affected region and have created a resource for obtaining FEMA assistance. "Obtaining FEMA Funding for Temporary Relocation, Repair and Replacement of Damaged or Destroyed Facilities" can be found at ftp://ftp.hrsa.gov/bphc/pdf/comment/Getting_FEMA_Public_Assistance.pdf (10/14/05)
Are there resources to assist health care providers in accessing medical information for Hurricane survivors?
Yes, KatrinaHealth.org is a secure, online service giving authorized healthcare providers access to medication and dosage information for evacuees from Hurricane Katrina. The site will allow authorized physicians and pharmacies to renew critical medications, coordinate care, and avoid potential medication errors, when renewing or prescribing new medications. KatrinaHealth.org was established through the efforts of medical software companies; pharmacy benefit managers; chain pharmacies; local, state, and federal agencies; and a national foundation. (10/14/05)
UPDATED: I am a grantee providing medical treatment to evacuees who are not eligible for Medicaid in a state operating under an emergency section 1115 Medicaid demonstration. Is there additional funding available to treat these evacuees?
Alabama, Arkansas, Georgia, Mississippi, Tennessee and Texas have uncompensated care pools as part of their approved emergency section 1115 Medicaid demonstrations. An uncompensated care pool was created in these states to reimburse providers that incur uncompensated care costs for medically necessary services and supplies for evacuees who do not have other coverage for such services and supplies through insurance from August 24, 2005 through January 31, 2006. Detailed information on approved demonstrations can be found on the Centers for Medicare & Medicaid Services website at http://www.cms.hhs.gov/katrina (10/14/05)
Are other states submitting emergency section 1115 Medicaid demonstrations to the Centers for Medicare & Medicaid Services (CMS) similar to Texas?
Detailed information on states having approved emergency section 1115 Medicaid demonstrations can be found on the CMS website at http://www.cms.hhs.gov/katrina (10/14/05)
Can grantees in a state not operating under an emergency section 1115 Medicaid demonstration that are seeing patients from Louisiana displaced by the Hurricane bill Louisiana Medicaid if the patient has a Louisiana Medicaid card? What if the patient was not previously on Medicaid in Louisiana?
Grantees can contact the Louisiana Medicaid Office at the following numbers to determine eligibility and billing information: Provider Relations (billing assistance or press 0 for rep) - 1-800-473-2783, Provider Enrollment - 1-800-473-2783 or 1-225-237-3370, Providers to confirm Louisiana eligibility -1-800-776-6323, and the public (potential or current recipients) - 1-800-834-3333. (10/14/05)
UPDATED: Is financial assistance available for grantees to hire additional staff or reimburse present staff volunteering to care for individuals displaced from Hurricane Katrina?
No, HRSA does not currently have additional funding available for grantees to hire additional staff or reimburse present staff volunteering. (9/28/05)
Will deadlines be extended for non-competitive grant funding?
Extension requests for non-competitive grant funding should be submitted to the HRSA Grants Management Office (GMO) with the BPHC Project Officer copied in the request. The request must be submitted prior to the published application deadline which corresponds with the grantees budget end date. Janice Gordon is the existing GMO contact and may be reached at (301) 443-2385 or JGordon@hrsa.gov . After September 30^th , GMO requests must be sent to Pam Hilton. Ms. Hilton may be reached at 301.594.4248 or PHilton@hrsa.gov . Responses regarding either approvals or denials will be sent directly to the grantee with a copy to the Project Officer. (9/28/05)
For clinicians interested in volunteering with the Red Cross, where can they find information about Red Cross’s medical malpractice protection policy?
The Red Cross has a general liability policy that also includes medical malpractice. Volunteers must be acting on behalf of the Red Cross and under the direct supervision of the Red Cross. Volunteers should contact their local Red Cross chapter (www.redcross.org/where/chapts.asp) for detailed information on medical malpractice liability. (9/28/05)
UPDATED: Are health center providers covered under FTCA if they are providing services to disaster victims at non-health center sites?
For purposes of medical response to Hurricanes Katrina and Rita, emergency response activities, including services to non-health center patients and services at temporary locations, will be considered part of a health center’s scope of project as long as services provided at non-health center sites are on a temporary basis, services provided by health center staff are within the approved scope of project, and all activities of health center staff are conducted on behalf of the health center. In addition, the center must communicate with HRSA, in writing, within 15 days (or as soon as practicable) of beginning the emergency response activities. Please see PIN 2005-19 for more detail on FTCA coverage and the hurricane response. (9/28/05)
UPDATED: For those grantees affected by Hurricane Katrina, will the deadlines for competitive grant funding be extended? Can Primary Care Associations in Hurricane affected States receive an additional extension?
Applicants located in counties or parishes in Alabama, Louisiana, and Mississippi that have been designated by either FEMA or the state Governor as "designated counties" for the purposes of disaster assistance are automatically granted a deadline extension for competitive funding opportunities until November 30, 2005 at 5:00 PM ET. Other applicants, including Primary Care Associations, who believe they have been adversely affected by Katrina and will be unable to complete and submit a timely application should send a request for an extension to Gail Lipton at glipton@hrsa.gov . These requests, which will be handled on an individual basis, should include the guidance number, the location of the applicant, and specific information which indicates why the agency is unable to meet the published deadline. Note that applications will need to be submitted on paper to the HRSA Grants Application Center address indicated in the guidance; electronic applications past the initial deadline will not be accepted. (9/26/05)
For those grantees affected by Hurricane Rita, will the deadlines for competitive grant funding be extended?
Applicants who believe they have been adversely affected by Hurricane Rita and will be unable to complete and submit a timely application should send a request for an extension to Gail Lipton at glipton@hrsa.gov . These requests, which will be handled on an individual basis, should include the guidance number, the location of the applicant, and specific information which indicates why the agency is unable to meet the published deadline. (9/26/05)
Can the recent PIN (2005-19) on FTCA coverage related to Hurricane Katrina be extrapolated to encompass all natural and man-made disasters?
No, the recent PIN (2005-19) was meant to address FTCA coverage issues related to Hurricane Katrina and has been extended to include Hurricane Rita. (9/26/05)
I am a grantee who has seen evacuees from Hurricane Katrina and Hurricane Rita. Should I track the evacuees and expenses from services separately for both Hurricanes?
Yes, grantees should track patients and expenses from Hurricane Katrina and Hurricane Rita separately. (9/26/05)
Where can grantees refer evacuees who are cancer patients for information on getting needed services?
Evacuees should contact the National Cancer Institute’s (NCI) Cancer Information Service (CIS) at 1-800-4-CANCER (1-800-422-6237). CIS provides cancer-related information, including referrals to possible support services, to patients and providers affected by the hurricanes. This information is also provided on the NCI’s web site at http://www.cancer.gov/hurricane-response-efforts (9/23/05)
Does the recent PIN (2005-19) on FTCA coverage related to Hurricane Katrina apply to Hurricane Rita?
Yes, Hurricane Rita has resulted in a declaration of a federal emergency. (9/23/05)
Can funding for health centers from states affected by Hurricane Katrina who will be awarded a New Access Point in December be expedited?
Yes, the Department of Health and Human Services announced Friday, September 9, that the award of grants to establish 26 new health center sites in areas impacted by Hurricane Katrina will be made in September rather than December. . Approximately $2.3 million in fiscal year 2005 funds to these sites will get health care resources up and running quickly in disaster areas and neighboring states treating evacuees from the storm-ravaged Gulf Coast. For a list of recipients, please go to www.hhs.gov/news/press/2005pres/20050909a.html (9/12/05)
Where can out-of-state providers get information on getting enrollment numbers for the Louisiana Medicaid Program?
Providers can go www.lamedicaid.com/provweb1/default.htm to download a basic enrollment packet that contains information that providers will need to enroll temporarily in the Louisiana Medicaid Program for purposes of serving Medicaid eligible Louisiana residents out-of-state. Providers can also call 225-237-3370 or 225-237-6370 to receive a packet. (9/12/05)
Is there funding available to reimburse health centers who provide volunteers to treat Hurricane victims and continue to pay their salaries?
At this time, HRSA does not have additional funding available to reimburse health centers that have staff volunteering to care for victims of Hurricane Katrina. Health centers that provide volunteers and continue to pay salaries do so at their own costs. HRSA recognizes that some health centers are providing volunteers at their own cost and appreciates their efforts. (9/12/05)
Are there resources available to assist in crisis counseling for Hurricane victims?
The Substance Abuse and Mental Health Services Administration (SAMHSA) has a toll-free hotline for people in crisis in the aftermath of Hurricane Katrina. The toll free number is 1-800-273- TALK (1-800-273-8255). People who are in emotional distress or suicidal can call at any time from anywhere in the nation to talk to a trained worker who will listen to and assist callers in getting the mental health help they need. People will be provided with immediate access to local resources, referrals, and expertise. (9/12/05)
Who do Hurricane victims contact if they are not receiving their Social Security benefits?
Victims should contact the Social Security Agency’s main toll-free number at 1-800-772-1213. The United States Postal Service has suspended mail service in some areas damaged by Hurricane Katrina. Victims can contact the toll free number or visit their web site at www.ssa.gov/emergency/ to find out where they can pick up their monthly payment. (9/12/05)
Coverage
Are health center providers covered under FTCA if they are providing services to disaster victims at non-health center sites?
The Bureau of Primary Health Care issued Program Information Notice (PIN) 2005-19, Federal Tort Claims Act Coverage for Deemed Consolidated Health Center Program Grantees Responding to Hurricane Katrina. Please check the HRSA web site to download and view the PIN at www.hrsa.gov(9/6/2005)
If grantees use volunteers to provide services during a natural disaster, are these volunteers covered under FTCA?
The Bureau of Primary Health Care issued Program Information Notice (PIN) 2005-19, Federal Tort Claims Act Coverage for Deemed Consolidated Health Center Program Grantees Responding to Hurricane Katrina. Please check the HRSA web site to download and view the PIN at www.hrsa.gov (9/6/2005)
Questions (9/5/05 - 9/23/05)
Resources
Where can grantees find information about HRSA’s response to Hurricane Katrina?
The HRSA web site lists information for grantees including linkages to hospitals, health centers, and HIV/AIDS providers in the affected areas. The web site also links to additional Federal resources related to disaster efforts. This information is available at www.hrsa.gov (9/6/2005)
Is there guidance available to help communities reopen former hospitals to care for survivors of Hurricane Katrina?
Yes, the Agency for Healthcare Research and Quality has published a report and toolkit to help communities reopen former hospitals to care for survivors. The toolkit includes lists of supplies and medications needed by stable medical/surgical patients, checklists to assess facility readiness, staffing needs and levels, and patient transport readiness. The toolkit is available at http://www.ahrq.gov/research/shuttered/(9/6/2005)
Who do I contact at the WIC program for additional supplies?
Grantees should contact their state WIC Agency. A list with contact information is available at www.fns.usda.gov/wic/Contacts/statealpha.HTM Grantees may also want to link up with their state Maternal and Child Health and Children with Special Health Care Needs Directors. A list of these individuals can be found on the HRSA web site at http://mchb.hrsa.gov/programs/default.htm (9/6/2005)
Where can grantees find additional information for mobile populations Spanish speaking individuals affected by Hurricane Katrina?
The Migrant Clinicians Network has a list of resources for mobile populations and Spanish speaking individuals on their web site. The information is available at http://www.migrantclinician.org/news/hurricane_updates.php Federal Tort Claims Act (FTCA)
Does FEMA have a Public Assistance program to help in rebuilding and repairing sites with Hurricane damage?
Yes, FEMA’s Public Assistance program reimburses public and private non-profit organizations, such as health centers. The Federal share of assistance is up to 75% of the eligible cost. Grantees may access the program at http://www.fema.gov/ In order to receive assistance, organizations should attend a State-sponsored Applicants’ Briefing. (9/13/05)
Where can grantees and individuals go to find out additional information about caring for victims left homeless by Hurricane Katrina?
The National Health Care for the Homeless Council lists Frequently Asked Questions on their web site with information on caring for newly homeless individuals, donation of medical supplies to health centers, and volunteer opportunities. Their web site is www.nhchc.org/aboutkatrina.html Additional information is also available at the Federal Interagency Council on Homelessness web site, http://www.ich.gov/(9/12/2005)
What information about HIPAA should grantees be aware of related to serving Hurricane victims?
The Office of Civil Rights in the Department of Health and Human Services has issued two bulletins, "Hurricane Katrina Bulletin: Disclosing Protected Health Information in Emergency Situations" and "Hurricane Katrina Bulletin #2: Compliance Guidance and Enforcement Statement" about HIPAA regulations in emergency situations. The bulletins can be downloaded from http://www.hhs.gov/ocr/hipaa/ (9/12/2005)
Who should Hurricane victims in Texas contact to find housing and medical resources?
Victims in Texas are encouraged to dial 2-1-1 which links them to medical and housing resources. (9/12/05)
Are there resources available to assist in crisis counseling for Hurricane victims?
The Substance Abuse and Mental Health Services Administration (SAMHSA) has a toll-free hotline for people in crisis in the aftermath of Hurricane Katrina. The toll free number is 1-800-273-TALK (1-800-273-8255). People who are in emotional distress or suicidal can call at any time from anywhere in the nation to talk to a trained worker who will listen to and assist callers in getting the mental health help they need. People will be provided with immediate access to local resources, referrals, and expertise. (9/12/05)
Who do Hurricane victims contact if they are not receiving their Social Security benefits?
Victims should contact the Social Security Agency’s main toll-free number at 1-800-772-1213. The United States Postal Service has suspended mail service in some areas damaged by Hurricane Katrina. Victims can contact the toll free number or visit www.ssa.gov/emergency/ to find out where they can pick up their monthly payment. (9/12/05)
Where can grantees find information about HRSA’s response to Hurricane Katrina?
The HRSA web site lists information for grantees including linkages to hospitals, health centers, and HIV/AIDS providers in the affected areas. The web site also links to additional Federal resources related to disaster efforts. This information is available at www.hrsa.gov (9/6/2005)
Is there guidance available to help communities reopen former hospitals to care for survivors of Hurricane Katrina?
Yes, the Agency for Healthcare Research and Quality has published a report and toolkit to help communities reopen former hospitals to care for survivors. The toolkit includes lists of supplies and medications needed by stable medical/surgical patients, checklists to assess facility readiness, staffing needs and levels, and patient transport readiness. The toolkit is available at http://www.ahrq.gov/research/shuttered/ (9/6/2005)
Who do I contact at the WIC program for additional supplies?
Grantees should contact their state WIC Agency. A list with contact information is available at www.fns.usda.gov/wic/Contacts/statealpha.HTM Grantees may also want to link up with their state Maternal and Child Health and Children with Special Health Care Needs Directors. A list of these individuals can be found on the HRSA web site at http://mchb.hrsa.gov/programs/default.htm(9/6/2005)
Where can grantees find additional information for mobile populations and Spanish speaking individuals affected by Hurricane Katrina?
The Migrant Clinicians Network has a list of resources for mobile populations and Spanish speaking individuals on their web site. The information is available at http://www.migrantclinician.org/news/hurricane_updates.php (9/7/05
Federal Tort Claims Act (FTCA) Coverage
A physician from a deemed Louisiana health center goes to work at a deemed health center in Houston. Is the physician covered under the FTCA?
Volunteers who are not Intermittent Federal Employees cannot cross state borders and be covered under FTCA under 42 USC 233(g). Employees who wish to cross state borders and volunteer to provide care at a heath center that has been affected by a hurricane can apply for coverage under the Federal Tort Claims Act (FTCA) as Intermittent Federal Employees using the Health Center to Health Center Volunteer process. A description of this process is available on the HRSA web site in the Hurricane Katrina Relief and Recovery Frequently Asked Questions. Please click on the question on "FTCA coverage for health center staff across State lines" for a description of the process. Volunteers must meet the licensure requirements in the affected state. The health center sending volunteers must identify a health center in need of assistance, and the sending and receiving health centers should agree on the volunteers to be sent before a request is initiated. (9/22/05)
Would a grantee who receives volunteers be covered under FTCA even though the volunteer may not be covered under FTCA or other malpractice insurance?
Provided that the activity at issue is within the scope of the section 330 grant, the health center receiving the volunteer would be covered under FTCA under 42 USC 233(g). The volunteer, if he/she has been deployed as an intermittent federal employee would be covered under another FTCA authority set forth under 42 USC 233(a). It is also possible that the volunteer would qualify for immunity under state immunity statutes or regulations or under federal provisions related to the National Disaster Medical System (section 2811 of the Public Health Service Act). If the volunteer has not been deployed as an intermittent federal employee, he/she would not qualify as an individual for FTCA coverage under 42 USC 233(g). (9/15/05)
Is a health center covered under the Federal Tort Claims Act (FTCA) for the acts of a National Health Service Corp (NHSC) staff person?
NHSC clinicians who work at deemed health centers have FTCA coverage if they meet the health center FTCA coverage requirements. NHSC members who are Federal employees have FTCA coverage whether they work at Federal or non-Federal facilities including health centers. (9/15/05)
Why are individuals hired but not paid by the Federal government to provide care for Hurricane victims (intermittent federal employees) covered under FTCA but volunteers of health centers are not covered?
Intermittent federal employees would be covered by 28 U.S.C.1346(b) and 28 U.S.C. 2672 as direct federal employees. Health centers have narrower coverage that is available to them under title 42 U.S.C. 233(g), which only provides Federal Tort Claims Act coverage to the center, its officers, governing board members, employees, and certain contractors. This list of covered groups does not include volunteers of health centers. Congress has been considering legislation that would extend FTCA coverage to volunteers at health centers. (9/12/05)
Are health center providers covered under FTCA if they are providing services to disaster victims at non-health center sites?
The Bureau of Primary Health Care issued Program Information Notice (PIN) 2005-19, Federal Tort Claims Act Coverage for Deemed Consolidated Health Center Program Grantees Responding to Hurricane Katrina. Please check the HRSA web site to download and view the PIN at www.hrsa.gov(9/6/2005)
Funding/Use of Grant Dollars
Will grantees be able to receive supplemental funding to treat individuals affected by Hurricane Katrina?
HRSA continues to work with the Department of Health and Human Services to identify the current and future needs of grantees treating individuals affected by the Hurricane. It is important for grantees to document and track the number of Hurricane patients treated, where the patient came from, what services were provided, and the costs associated with those services. In addition, grantees can use current HRSA funding to provide care to individuals affected by the Hurricane. (9/8/2005)
Will HRSA fund applications that were not selected for funding in the most recent New Access Point funding cycle from states affected by the Hurricane?
At this time, HRSA is not considering funding any applications that were not selected in the most recent New Access Point cycle to receive a grant. (9/8/2005)
Is financial assistance available for grantees to hire additional staff or reimburse present staff volunteering to care for individuals displaced from Hurricane Katrina?
No, HRSA does not currently have additional funding available for grantees to hire additional staff or reimburse present staff volunteering. Grantees can use current HRSA funding for these purposes. (9/8/05)
Will HRSA provide funding to cover costs for temporary buildings, office space, and mobile office units if a grantee site was destroyed or damaged?
Grantees should their state Emergency Management Agency (EMA). If the state EMA is not operational, grantees should contact the Federal Emergency Management Agency (FEMA). (9/8/05)
Can entities funded under Section 330(h) of the Public Health Service Act use grant dollars to provide care to individuals who have become homeless from a natural disaster?
The relevant statute (section 330 of the Public Health Service Act) does not limit eligibility for services based on the cause of an individual’s homelessness. Therefore, individuals whose homes have been destroyed by a natural disaster can be viewed as homeless. (9/7/2005)
Can organizations treating Hurricane victims who are not FQHC Look-Alikes receive an emergency FQHC Look-Alike designation?
No, organizations must submit an FQHC Look-Alike application and meet all the requirements set out in Section 330 of the Public Health Service Act. HRSA will work with organizations in affected areas to expedite the application process. The FQHC Look-Alike application is available in Program Information Notice (PIN) 2003-21 and 2005-17 on the HRSA web site at http://bphc.hrsa.gov/pinspals/default.htm (9/7/2005)
May health centers charge fees for services rendered to hurricane evacuees?
Health centers are encouraged to consider all sources of payment, such as Medicaid, prior to charging individuals. Health centers may charge fees for services rendered to hurricane evacuees who have an ability to pay, provided that such fees comply with existing statutory and regulatory requirements. Under existing regulations for health centers funded under Section 330 of the Public Health Service Act, health centers are required to maintain a sliding fee schedule for their patients. Health centers are required to waive patient co-payments under the fee schedule for patients below the poverty line, except for nominal co-payments when consistent with project goals, and in every case must assure that services are not denied due to the patient’s inability to pay. Given the extenuating circumstances of Hurricane Katrina and the evacuees, health centers are encouraged to utilize the maximum flexibility when determining income and other assets for purposes of applying the sliding fee schedule. (9/22/05)
Can funding for health centers from states affected by Hurricane Katrina who will be awarded a New Access Point in December be expedited?
Yes, the Department of Health and Human Services announced Friday, September 9, that the award of grants to establish 26 new health center sites in areas impacted by Hurricane Katrina will be made in September rather than December. Approximately $2.3 million in fiscal year 2005 funds to these sites will get health care resources up and running quickly in disaster areas and neighboring states treating evacuees from the storm-ravaged Gulf Coast. For a list of recipients, please go to www.hhs.gov/news/press/2005pres/20050909a.html(9/12/05)
Is there funding available to reimburse health centers who provide volunteers to treat Hurricane victims and continue to pay their salaries?
At this time, HRSA does not have additional funding available to reimburse health centers that have staff volunteering to care for victims of Hurricane Katrina. Health centers that provide volunteers and continue to pay salaries do so at their own costs. HRSA recognizes that some health centers are providing volunteers at their own cost and appreciates their efforts. (9/12/05)
Will grantees be able to receive supplemental funding to treat individuals affected by Hurricane Katrina?
HRSA continues to work with the Department of Health and Human Services to identify the current and future needs of grantees treating individuals affected by the Hurricane. It is important for grantees to document and track the number of Hurricane patients treated, where the patient came from, what services were provided, and the costs associated with those services. In addition, grantees can use current HRSA funding to provide care to individuals affected by the Hurricane. (9/8/2005)
Will HRSA fund applications that were not selected for funding in the most recent New Access Point funding cycle from states affected by the Hurricane?
At this time, HRSA is not considering funding any applications that were not selected in the most recent New Access Point cycle to receive a grant. (9/8/2005)
Is financial assistance available for grantees to hire additional staff or reimburse present staff volunteering to care for individuals displaced from Hurricane Katrina?
No, HRSA does not currently have additional funding available for grantees to hire additional staff or reimburse present staff volunteering. (9/8/05)
Will HRSA provide funding to cover costs for temporary buildings, office space, and mobile office units if a grantee site was destroyed or damaged?
Grantees should contact their state Emergency Management Agency (EMA). If the state EMA is not operational, grantees should contact the Federal Emergency Management Agency (FEMA) with these requests. (9/8/05)
Can entities funded under Section 330(h) of the Public Health Service Act use grant dollars to provide care to individuals who have become homeless from a natural disaster?
The relevant statute (section 330 of the Public Health Service Act) does not limit eligibility for services based on the cause of an individual’s homelessness. Therefore, individuals whose homes have been destroyed by a natural disaster can be viewed as homeless. (9/7/2005)
Can organizations treating Hurricane victims who are not FQHC Look-Alikes receive an emergency FQHC Look-Alike designation?
No, organizations must submit an FQHC Look-Alike application and meet all the requirements set out in Section 330 of the Public Health Service Act. HRSA will work with organizations in affected areas to expedite the application process. The FQHC Look-Alike application is available in Program Information Notice (PIN) 2003-21 and 2005-17 on the HRSA web site at http://bphc.hrsa.gov/pinspals/default.htm (9/7/2005)
340B Drug Pricing Program
Can 340B drugs be used to fill/refill prescriptions for non-health center patients who are victims of Hurricane Katrina?
Yes, provided that the individual is a patient (as defined by the 340B program) of the covered entity. First, the services provided must be within the scope of grant or other eligibility (this is not a requirement for Disproportionate Share Hospitals). Second, the covered entity must maintain health records of care provided to the individual. Finally, the individual must receive services from a health care professional who is employed by the covered entity, under contract with the covered entity, or has another arrangement with the covered entity such that responsibility for the care remains with the covered entity. (9/6/2005)
Do health records for non-health center patients filling prescriptions with 340B drugs have to meet the usual health record practice standards for purposes of the 340B program?
In a declared emergency, an abbreviated health record is adequate for purposes of the 340B program. However, the record must identify the patient, record the medical evaluation (including any testing, diagnosis or clinical impressions) and the treatment provided or prescribed. In cases where patients have no identification, insurance cards, etc., self reporting of identity, condition, and history is adequate. (9/6/2005)
Are entities able to refill prescriptions for hurricane victims unknown to them with 340B drugs without medical staff intervention?
No. Prescriptions cannot be refilled using 340B drugs without the personal involvement of medical or health professionals with prescribing authority who are employed by, are under contract with, or maintain another arrangement with the covered entity. In the event of a declared emergency, where volunteer health professionals may be used, emergency paperwork should be generated to make the relationship between the provider and the covered entity clear and to make clear the covered entity’s responsibility for providing care. This document should recognize the emergency nature of the situation, the relationship of the volunteer(s) to the clinic, and should be kept on file by the covered entity. (9/6/2005)
Because of the current emergency, 340B covered entities may have set up temporary sites at locations other than those listed on the 340B website. May a wholesaler or drug manufacturer ship 340B covered drugs to these temporary sites that are not listed on the Office of Pharmacy Affairs (OPA) web site?
The flexibility of all of the drug manufacturers and wholesalers in meeting the needs of the 340B covered entities during this emergency is appreciated. A manufacturer or wholesaler who has verified the participation of an organization on the 340B website may ship drugs ordered by the covered entity even if the shipping address may be different than what is shown on the 340B website. The temporary address for a covered entity should be communicated to the OPA in writing by the covered entity, if possible, within 30 days after the move. To the extent that temporary addresses can be verified in a timely manner, they will be posted on the OPA web site. If the temporary address becomes the new permanent address for the covered entity, the covered entity should notify OPA. (9/22/05)
Can 340B drugs be used to fill/refill prescriptions for non-health center patients who are victims of Hurricane Katrina?
Yes, provided that the individual is a patient (as defined by the 340B program) of the covered entity. First, the services provided must be within the scope of grant or other eligibility (this is not a requirement for Disproportionate Share Hospitals). Second, the covered entity must maintain health records of care provided to the individual. Finally, the individual must receive services from a health care professional who is employed by the covered entity, under contract with the covered entity, or has another arrangement with the covered entity such that responsibility for the care remains with the covered entity. (9/6/2005)
Do health records for non-health center patients filling prescriptions with 340B drugs have to meet the usual health record practice standards for purposes of the 340B program?
In a declared emergency, an abbreviated health record is adequate for purposes of the 340B program. However, the record must identify the patient, record the medical evaluation (including any testing, diagnosis or clinical impressions) and the treatment provided or prescribed. In cases where patients have no identification, insurance cards, etc., self reporting of identity, condition, and history is adequate. (9/6/2005)
Are entities able to refill prescriptions for hurricane victims unknown to them with 340B drugs without medical staff intervention?
No. Prescriptions cannot be refilled using 340B drugs without the personal involvement of medical or health professionals with prescribing authority who are employed by, are under contract with, or maintain another arrangement with the covered entity. In the event of a declared emergency, where volunteer health professionals may be used, emergency paperwork should be generated to make the relationship between the provider and the covered entity clear and to make clear the covered entity’s responsibility for providing care. This document should recognize the emergency nature of the situation, the relationship of the volunteer(s) to the clinic, and should be kept on file by the covered entity. (9/6/2005)
Mobile Medical Units
My organization wants to send a mobile medical unit. What do I do?
HRSA encourages grantees to contact their state Emergency Management Agency to volunteer Mobile Medical Units. Volunteers accompanying mobile health units and crossing state borders must become Intermittent Federal Employees to maintain coverage under the Federal Tort Claims Act. Volunteers can follow the Health Center to Health Center Volunteer Request Process to become Intermittent Federal Employees. Information on this is available at http://www.hrsa.gov/katrina/ (9/22/05)
Clinical
How should grantees report communicable diseases?
Grantees should report communicable diseases to their state and local health department. If your state or local health department is not operational, please contact the Centers for Disease Control and Prevention at 1-800-CDC-INFO.
How should grantees report communicable diseases?
Grantees should report communicable diseases to their state and local health department. If your state or local health department is not operational, please contact the Centers for Disease Control and Prevention at 1-800-CDC-INFO. (9/8/05)
Grants Management
For those grantees affected by Hurricane Katrina, will the deadlines for competitive grant funding be extended?
Applicants located in counties or parishes in Alabama, Louisiana, and Mississippi that have been designated by either FEMA or the state Governor as "designated counties" for the purposes of disaster assistance are automatically granted a deadline extension for competitive funding opportunities until November 30, 2005 at 5:00 PM ET. Other applicants who believe they have been adversely affected by Katrina and will be unable to complete and submit a timely application should send a request for an extension to Gail Lipton at glipton@hrsa.gov. These requests, which will be handled on an individual basis, should include the guidance number, the location of the applicant, and specific information which indicates why the agency is unable to meet the published deadline. Note that applications will need to be submitted on paper to the HRSA Grants Application Center address indicated in the guidance; electronic applications past the initial deadline will not be accepted. (9/6/2005)
Do grantees have to submit a change in scope for extended hours of operation due to treating victims of Hurricane Katrina?
No, a change of scope does not need to be submitted. (9/6/2005) Supplies
Are there restrictions on grantees to receive medical supplies, pharmaceuticals, and gifts/donations during an emergency or natural disaster?
No, as long as the purpose is to provide immediate and needed relief to victims, and there is no condition of sending future Federal business to the donor.
How do grantees access the Strategic National Stockpile (SNS) of drugs?
Grantees should contact their SNS coordinator in their state Emergency Management Agency (EMA). Please contact Tom Tubesing/Stephanie Dulin in Louisiana at 225-763-5735, Liz O’Mara in Mississippi at 601-576-7178, Judy Henry in Texas at (512) 458-7219, or Allyson Brown in Alabama at (404) 687-6648. (9/7/2005)
Who should grantees contact to request additional medical supplies?
Grantees should contact their county/parish Emergency Management Agency (EMA). If the local EMA is not operational, grantees should contact their State EMA. Please visit the HRSA web site at www.hrsa.gov for additional information and links to State EMAs. (9/6/2005)
Who should grantees contact to request a generator?
Grantees should contact their county/parish Emergency Management Agency (EMA). If the local EMA is not operational, grantees should contact their State EMA. Please visit the HRSA web site at www.hrsa.gov for additional information and links to State EMAs. (9/6/2005
For those grantees affected by Hurricane Katrina, will the deadlines for competitive grant funding be extended?
Applicants located in counties or parishes in Alabama, Louisiana, and Mississippi that have been designated by either FEMA or the state Governor as "designated counties" for the purposes of disaster assistance are automatically granted a deadline extension for competitive funding opportunities until November 30, 2005 at 5:00 PM ET. Other applicants who believe they have been adversely affected by Katrina and will be unable to complete and submit a timely application should send a request for an extension to Gail Lipton at glipton@hrsa.gov . These requests, which will be handled on an individual basis, should include the guidance number, the location of the applicant, and specific information which indicates why the agency is unable to meet the published deadline. Note that applications will need to be submitted on paper to the HRSA Grants Application Center address indicated in the guidance; electronic applications past the initial deadline will not be accepted. (9/6/2005)
Do grantees have to submit a change in scope for extended hours of operation due to treating victims of Hurricane Katrina?
No, a change of scope does not need to be submitted. (9/6/2005)
Supplies
What is the Strategic National Stockpile (SNS)?
The Strategic National Stockpile (SNS) is the national repository of pharmaceuticals and medical supplies including antibiotics, chemical antidotes, antitoxins, life-support medications, IV administration supplies, airway maintenance supplies and medical/surgical items. The SNS is designed to supplement and re-supply state and local public health agencies in the event of a national emergency within the United States or its territories. The SNS is administered through the Centers for Disease Control and Prevention. (9/12/05)
Are there restrictions on grantees to receive medical supplies, pharmaceuticals, and gifts/donations during an emergency or natural disaster?
No, as long as the purpose is to provide immediate and needed relief to victims, and there is no condition of sending future Federal business to the donor. (9/12/05)
How do grantees access the Strategic National Stockpile (SNS) of drugs?
Grantees should contact their SNS coordinator in their state Emergency Management Agency (EMA). Please contact Tom Tubesing/Stephanie Dulin in Louisiana at 225-763-5735, Liz O’Mara in Mississippi at 601-576-7178, Judy Henry in Texas at (512) 458-7219, or Allyson Brown in Alabama at (404) 687-6648. (9/7/2005)
Who should grantees contact to request additional medical supplies?
Grantees should contact their county/parish Emergency Management Agency (EMA). If the local EMA is not operational, grantees should contact their State EMA. Please visit the HRSA web site at www.hrsa.gov for additional information and links to State EMAs. (9/6/2005)
Who should grantees contact to request a generator?
Grantees should contact their county/parish Emergency Management Agency (EMA). If the local EMA is not operational, grantees should contact their State EMA. Please visit the HRSA web site at www.hrsa.gov <http://www.hrsa.gov/> for additional information and links to State EMAs. (9/6/2005)
Medicare, Medicaid, and SCHIP
Will grantees have access to medical records and data from the Louisiana Medicaid office?
Yes, you can contact the Louisiana Medicaid office at the following numbers: Provider Relations (billing assistance or press 0 for rep) - 1-800-473-2783, Provider Enrollment - 1-800- 473-2783 or 1-225-237-3370, Providers to confirm Louisiana eligibility -1-800-776-6323, and the public (potential or current recipients) - 1-800-834-3333. (9/8/05)
Can grantees in other states that are seeing patients from Louisiana displaced by the Hurricane bill Louisiana Medicaid if the patient has a Louisiana Medicaid card? What if the patient was not previously on Medicaid in Louisiana?
HRSA is working with the Centers for Medicare and Medicaid Services to resolve issues related to billing and eligibility. Please select "Notify me by e-mail if this Answer is Updated" on the HRSA web site Frequently Asked Questions to stay informed if more information should become available. (9/8/05)
Have there been changes in the Medicare, Medicaid, and SCHIP programs as a response to the Hurricane?
Yes, the Secretary of the Department of Health and Human Services (DHHS) has issued a statement waiving some provisions of those programs related to licensing, HIPAA privacy regulations, and conditions for participating in the programs. A list of these provisions can be found at http://www.hhs.gov/emergency/ssawaiver.html (9/6/2005)
Has the Centers for Medicare and Medicaid Services (CMS) made temporary provisions for the Medicare, Medicaid, and SCHIP programs?
Yes, CMS has acted to assure that these programs will flex to accommodate the emergency health needs of beneficiaries and providers in Hurricane Katrina devastated states. A list of the temporary changes to these programs are listed on the CMS web site at www.cms.hhs.gov Some individual states may be waiving additional requirements, such as residency. Individuals are encouraged to contact their state Medicaid office to find additional information. (9/6/2005) Personnel
Are additional personnel available to meet the increasing demand for providers and other health care professionals?
Grantees with immediate personnel needs should contact their Project Officer (PO) and indicate the type of provider, expected duration of service, and a brief justification of why a provider is needed. The PO will then forward this information to HRSA to determine Federal personnel available. Grantees may also want to contact the American Red Cross or the state Emergency System for Advance Registration of Volunteer Health Professionals if applicable. (9/8/2005)
Can the Health Professional Shortage Area (HPSA) requirement be waived for individuals participating in the J-1 Visa program and the National Health Service Corps?
No, there is no applicable statutory or regulatory authority to waive the HPSA requirement for individuals participating in the J-1 Visa program and individuals satisfying National Health Service Corps service obligations. (9/8/05)
Can areas that have seen an increase in their underserved population due to Hurricane Katrina be designated as emergency Health Professional Shortage Areas?
No, there is no applicable statutory or regulatory authority to provide emergency HPSAs. HRSA will work with communities to expedite the application process for new HPSA designations or updating scores for current HPSAs in affected states.
Are States providing temporary licensures for physicians coming from other States to treat Hurricane Katrina disaster victims?
Some states may be offering temporary licenses for physicians who are licensed to practice in another state but have been asked to treat Hurricane Katrina victims. Please contact the State Medical Board for more information on states who are participating in this type of program. Texas is offering temporary licensures for providers coming from Louisiana to treat patients in Texas. Physicians must complete and submit a form to the Texas Medical Board to receive a temporary license. The form is available at www.tsbme.state.tx.us/katrina_emergency.htm (9/6/2005
I am a grantee who is treating evacuees in Texas who are not eligible for Medicaid. What resources are available to treat these evacuees?
An uncompensated care pool to help compensate physicians, hospitals, and other health care providers who provide needed medical treatment to evacuees who do not currently have health insurance and are ineligible for Medicaid or SCHIP has also been created. Please visit the Texas Health and Human Services http://www.hhs.state.tx.us/ for more information. (9/22/05)
Are other States submitting emergency Section 115 waivers to the Centers of Medicare and Medicaid Services (CMS) similar to Texas?
Some states may be working with CMS to submit an emergency Section 1115 waiver. Currently, Texas is the only state with an approved waiver. Individuals should contact their State Medicaid Office for more information. (9/22/05)
Are Federally Qualified Health Centers (FQHC) in Texas able to bill for services provided by activated reservist groups or volunteers through the Office of the Surgeon General?
Although it is not clear whether the FQHC can bill for these services, the Texas Medical Board suggests that a physician at each FQHC apply to supervise the incoming physicians for Visiting Physician Temporary Licenses. The Visiting Physician Temporary Licenses information can be found at http://www.tsbme.state.tx.us/katrina_emergency.htm . (9/15/05)
What additional steps has The Centers for Medicare & Medicaid Services (CMS) taken to assist Hurricane victims?
CMS has adopted a series of emergency policy changes to accommodate the needs of thousands of displaced Medicaid and SCHIP beneficiaries. Special evacuee status will be granted to all those who fled states because of Hurricane Katrina. This designation will allow those persons to apply for the full range of federal benefits administered by the states without having to produce the normal forms of documentation to verify eligibility. Accordingly, CMS is working with affected states to develop a new Medicaid and SCHIP application template, through which states may be granted emergency section 1115 demonstrations to provide temporary eligibility for all eligibility groups. Using this new program, evacuees displaced because of the storm will be able to quickly enroll in Medicaid or the State Children’s Health Insurance Program (SCHIP) in the state to which they have been evacuated. Applications will be accepted retroactively from August 24, 2005. (9/12/05)
Will grantees have access to medical records and data from the Louisiana Medicaid office?
Yes, you can contact the Louisiana Medicaid office at the following numbers: Provider Relations (billing assistance or press 0 for rep) - 1-800-473-2783, Provider Enrollment - 1-800-473-2783 or 1-225-237-3370, Providers to confirm Louisiana eligibility -1-800-776-6323, and the public (potential or current recipients) - 1-800-834-3333. (9/8/05)
Can grantees in other states that are seeing patients from Louisiana displaced by the Hurricane bill Louisiana Medicaid if the patient has a Louisiana Medicaid card? What if the patient was not previously on Medicaid in Louisiana?
HRSA is working with the Centers for Medicare and Medicaid Services to resolve issues related to billing and eligibility. Please select "Notify me by e-mail if this Answer is Updated" on the HRSA web site Frequently Asked Questions to stay informed if more information should become available. (9/8/05)
Have there been changes in the Medicare, Medicaid, and SCHIP programs as a response to the Hurricane?
Yes, the Secretary of the Department of Health and Human Services (DHHS) has issued a statement waiving some provisions of those programs related to licensing, HIPAA privacy regulations, and conditions for participating in the programs. A list of these provisions can be found at http://www.hhs.gov/emergency/ssawaiver.html (9/6/2005)
Has the Centers for Medicare and Medicaid Services (CMS) made temporary provisions for the Medicare, Medicaid, and SCHIP programs?
Yes, CMS has acted to assure that these programs will flex to accommodate the emergency health needs of beneficiaries and providers in Hurricane Katrina devastated states. A list of the temporary changes to these programs are listed on the CMS web site at www.cms.hhs.gov. Some individual states may be waiving additional requirements, such as residency. Individuals are encouraged to contact their state Medicaid office to find additional information. (9/6/2005)
Personnel
Can health center volunteers, who temporarily become Intermittent Federal Employees (IFE), still receive compensation from the health center while they are an IFE?
Yes, health center employees who become intermittent federal employees under the volunteer program during this disaster relief program can continue to receive compensation from the health center. (9/22/05)
Are additional personnel available to meet the increasing demand for providers and other health care professionals?
Grantees with immediate personnel needs should contact their State Emergency Management Agency (EMA) or Emergency Operations Center (EOC). Please copy the Project Officer (PO) on any personnel requests submitted to the EMA or EOC. Grantees may also want to contact the American Red Cross or the state Emergency System for Advance Registration of Volunteer Health Professionals if applicable. (9/22/05)
Do out-of-state physicians coming to Texas who are activated reservist groups or volunteers through the Office of the Surgeon General have to be licensed through the Texas Medical Board (TMB)?
No, these individuals are exempt from licensure. If you have additional questions regarding licensure, please contact the TMB at 1-800-248-4062 (Texas only), 512-305-7030 (outside of Texas), or verifcic@tsbme.state.tx.us . (9/15/05)
Can National Health Service Corps (NHSC) providers serve in the medical reserve corps?
No, NHSC providers must be serving in an NHSC approved site in a Health Professional Shortage Area (HPSA) in order to receive service credit. The Medical Reserve Corps is not able to guarantee that NHSC providers would be placed in an approved site in a HPSA. (9/12/05)
Can the Health Professional Shortage Area (HPSA) requirement be waived for individuals participating in the J-1 Visa program and the National Health Service Corps?
No, there is no applicable statutory or regulatory authority to waive the HPSA requirement for individuals participating in the J-1 Visa program and individuals satisfying National Health Service Corps service obligations. (9/8/05)
Can areas that have seen an increase in their underserved population due to Hurricane Katrina be designated as emergency Health Professional Shortage Areas?
No, there is no applicable statutory or regulatory authority to provide emergency HPSAs. HRSA will work with communities to expedite the application process for new HPSA designations or updating scores for current HPSAs in affected states. (9/8/05)
Are States providing temporary licensures for physicians coming from other States to treat Hurricane Katrina disaster victims?
Some states may be offering temporary licenses for physicians who are licensed to practice in another state but have been asked to treat Hurricane Katrina victims. Please contact the State Medical Board for more information on states who are participating in this type of program. Texas is offering temporary licensures for providers coming from Louisiana to treat patients in Texas. Physicians must complete and submit a form to the Texas Medical Board to receive a temporary license. The form is available at www.tsbme.state.tx.us/katrina_emergency.htm (9/6/2005)
Capital Needs
Will HRSA provide assistance in rebuilding and repairing health centers damages by Hurricane Katrina?
Health Centers with facility improvement needs are encouraged to contact Capital Link, a BPHC contractor for facility development technical assistance. The director of Capital Link is Ms. Allison Coleman, and she can be reached at 617-422-0350. In addition, the BPHC offers a facility loan guarantee program that provides credit enhancement for facility project loans made by local lenders to Health Centers. Additional information on Capital Link and the BPHC Loan Guarantee Program can be obtained by contacting Ms. Marie Legaspi in the BPHC Division of State and Community Assistance at 301-594-4488. (9/8/05)
Will HRSA provide assistance in rebuilding and repairing health centers damaged by Hurricane Katrina?
HRSA currently does not have any additional funding for rebuilding and repairing health centers damaged by the Hurricane. Grantees are encouraged to contact FEMA’s Public Assistance program (www.fema.gov ) for assistance. In addition, the Bureau of Primary Health Care offers a facility loan guarantee program that provides credit enhancement for facility project loans made by local lenders to health centers. Additional information on the BPHC Loan Guarantee Program can be obtained by contacting Ms. Marie Legaspi in the BPHC Division of State and Community Assistance at 301-594-4488. (9/22/05)
Reporting/Uniform Data System
How should individuals who became homeless from a natural disaster be counted in UDS ?
If the evacuee has not previously been seen by the grantee, they should be counted as a new user/patient regardless of whether they are seen at a permanent or temporary site. (9/15/05)
If a grantee is volunteering staff at another grantee’s location, how should the encounters be reported for UDS?
The grantee site, whether permanent or temporary, where the encounters took place should report for UDS. Volunteers cannot report encounters generated at another location as their encounters for UDS purposes. (9/15/05)
