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Healthcare Ready Hurricane Ian Situation Report #6

High Level Situation Summary Highlights Emergency Declarations and Measures Critical Infrastructure Impacts Access and Reentry Healthcare Response Updates and Needs Public Health Impacts Supply Chain Resource Staging Emergency Prescription Refills Evacuations and Curfews Sheltering
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Hurricane Ian Situation Report #6

This report provides an assessment of the impacts to healthcare and public health due to Hurricane Ian.

Note: Green text indicates new or updated content in this report compared to the previous report.

Healthcare Ready's Posture

Healthcare Ready is ENGAGED for the response to Hurricane Ian. We are closely tracking potential impacts to healthcare infrastructure and supply chain, and will share information frequently via situation reports and Twitter, Facebook, and LinkedIn. Our pharmacy operating status map Rx Open will be updated daily for pharmacies in Florida, Georgia, South Carolina, North Carolina, and Puerto Rico. Healthcare Ready’s Team is on the ground in Florida to support public-private coordination requests.

High-Level Situation Summary

Power and water outages are the main risk and current impact to healthcare operations following Hurricane Ian’s initial landfall in Florida on 9/28, and in South Carolina on 9/30. In Florida, Lee County has sustained significant impacts from sustained power and water outages, forcing several hospitals, nursing facilities, and other facilities to evacuate hundreds of patients. Field hospitals and response needs have been situated in response; however, there is potential of long-term implications to electrical infrastructure. FEMA and other emergency management agencies are responding with resources to restore utilities in those areas, and meanwhile points of distribution and NGOs are providing bottled water to residents in some of the affected areas.
 
Residents and utilities customers in some areas affected by water outages are being asked to conserve water until further notice. While damage assessments continue, pharmacies, clinics, hospitals, and dialysis centers in most areas have started to resume operations. Individuals with medical needs who typically rely on access to water and power at home (to reconstitute medicines, or to operate medical equipment, etc.) face disproportionate harms with prolonged lack of access to water and power. Transportation impacts, including damage to connections (causeways, bridges) to several barrier island communities (Sanibel Island, Pine Island), have resulted in those communities being cut off to road travel

Power outages in South Carolina have decreased greatly since their peak, which may suggest more limited damages overall. Coastal South Carolina is the most impacted area in the state, with a handful of facilities reporting damages. Central North Carolina and central Virginia also saw some impacts. Georgia has largely been unaffected by the storm.  

Highlights

  • About 13% of Florida’s population is uninsured. Emergency Prescription Assistance Program (EPAP) is the federal program that provides medication coverage for uninsured patients, but the program has not yet been activated. The uninsured population under age 65 in areas impacted by Ian is especially high:
    • Lee County: 19.3%
    • Collier County: 17.9%
    • Charlotte County: 16.9%
    • Hendry County: 27.6%
  • More than 100 FEMA Disaster Survivor Assistance Team staff have been deployed to help survivors apply for assistance and identify immediate and emerging threats.
  • About 5,000 Florida National Guard members and 2,000 National Guard members from other states are activated to help with the response.
  • Information on Points of distribution (POD) for food, water, ice, etc. have been posted.
  • As of 1:00pm EDT on 10/2, nearly 817,000 Florida customers have power outages. This is a decrease of about 383,000 outages since 10/1.
    • As of 1:00pm EDT 10/2, nearly 2,000 customers are without power in South Carolina, while nearly 18,000 customers are without power in North Carolina. As of 1:00pm EDT 10/2, more than 7,000 customers are without power in Virginia, In Georgia, power is mostly restored (360 remain without power), we will stop reporting on power impacts to Georgia.
  • Fuel sites in Port Charlotte, Cape Coral and North Fort Myers, Florida have severely limited operations. Wait times for gas has been reported to be longer than six hours in some areas.
  • As of 10/1, the state of Florida is providing additional resources (water and diesel) to Lee County in order to power water supply to nearby hospitals.
  • The SR-78 / Pine Island at Matlacha Draw Bridge, which connects Pine Island to Ft. Myers, remains closed as of 10/2. Coast Guard evacuation is planned for Pine Island today, Sunday 10/2. Evacuation will happen during daylight hours
  • Many Florida residents have begun to return home from shelters, reducing the population in shelters from around 10,000 on 10/1 to just over 3,600 on 10/2.
  • All but one major Florida airport have reopened. Southwest Florida International Airport (RSW) remains closed, but is expected to reopen on 10/5.

Assessment of Healthcare and Logistics Impacts

Emergency Declarations and Measures

Critical Infrastructure Impacts

  • Power
    • Florida
      • As of 1:00pm EDT on 10/2, nearly 817,000 Florida customers have power outages. This is a decrease of about 383,000 outages since 10/1. Outages are concentrated from the West to the East of central Florida, with the greatest outage rates in Lee County and surrounding counties, where between 30-70% of customers are out. Additionally, over 20% of Volusia County remains without power.
      • Florida Power and Light Company (FPL), Duke Energy, and Tampa Electric Company are three of the largest providers in the Tampa area. These companies, and other energy companies, are reporting major outages and are working to repair damage.
    • South Carolina
    • North Carolina
      • As of 1:00pm EDT 10/2, nearly 18,000 customers are without power in North Carolina – a significant improvement from the day prior (200k). Outages are concentrated in the center of the state.
    • Virginia
      • As of 1:00pm EDT 10/2, more than 7,000 customers are without power in Virginia – a significant improvement from the day prior (60k).
    • Georgia
      • As of 1:00pm EDT 10/2, with power mostly restored (360 remain without power), we will stop reporting on power impacts to Georgia

    Fuel 

    • Fuel sites in Port Charlotte, Cape Coral and North Fort Myers, Florida have severely limited operations. Wait times for gas has been reported to be longer than six hours in some areas.
    • Those looking for fuel and gas are encouraged to use Gas Buddy, to search for open stations and providers using crowdsourced information.
    • As of 9/30, 11% of Florida’s gas stations are without fuel or are not operational due to impact of the hurricane.
    • The Interior Department’s Bureau of Safety and Environmental Enforcement has suspended around 190,000 barrels of oil production (equal to around 2% of total US oil production) in the Gulf of Mexico as Ian headed to Tampa and Florida.
    • As of 9/28, Chevron Corp removed staff from two offshore Gulf of Mexico platforms, however Occidental Petroleum Corp (OXY.N) and Hess Corp (HES.N) have taken precautions ahead of the storm’s arrival and are implementing storm procedures. This may impact fuel resources getting sent to other areas of the country and could impact medical and other types of manufacturing. 

    Water

    • As of 10/2, parts of 24 counties are still under boil water advisories. Residents are encouraged to reach out to local utility or county emergency contacts for the most up-to-date information.
      • As of 10/1, 42 drinking water treatment plants are non-operational; 45 plants partially operational; 700 fully operational; 98 (+51) boiled water notices are in effect
    • As of 10/1, the state of Florida is providing additional resources (water and diesel) to Lee County in order to power water supply to nearby hospitals.
    • The U.S. Army Corps of Engineers (USACE) are meeting with county officials, noting that work crews are using water trucks to pressurize critical facilities to locate and repair leaks.

    Communications 

    • Florida
      • As of 12pm EDT 10/2, FCC reports: 5.5% of cell sites are down. 11 (-0) cell sites are down due to damage, 173 (-98) are due to transport, and 260 (-209) are due to power outages. 356 cell sites are running on back-up power.
      • All 911 calls are being answered but some Public Safety Answering Point (PSAP) are being rerouted due to power outages.
      • As of 10/2, 1 TV station is reported as being out of service, 12 FM stations are reported as being out of service, and 4 AM stations are reported as being out of service.
      • The (FCC) may grant Special Temporary Authority (STA) to permit immediate or temporary operation of certain radio facilities during emergencies or other urgent conditions, as well as waivers to support emergency communications and service restoration.
        • International Bureau grants verbal special Temporary Authority (STA)  for two weeks to repair of antennas and other facilities. The purpose of this STA is to allow the provider to operate with facilities that are not covered by their current authorization while they are fixing facilities caused by Hurricane Ian.
        • Public Safety and Homeland Security Bureau issue a verbal waiver for Florida public safety officials to use 700 – 800 MHz interoperability channels.
        • Wireless Telecommunications Bureau grants the American Radio Relay League (ARRL) an emergency request for a temporary waiver of Section 97.307(f) of the Commission’s Rules.
        • Wireless Telecommunications Bureau and the Public Safety and Homeland Security Bureau extend licensing and regulatory deadlines for 30 days following President Biden’s declaration of emergency for the State of Florida.
        • Wireless Telecommunications Bureau grants an emergency waiver of sections 96.67(c)(2) and (3) of the Commission’s rules governing the Citizen’s Broadband Radio Service to Federated Wireless, CommScope, Inc., and Google LLC.
        • Wireless Telecommunications Bureau and Public Safety and Homeland Security Bureau Extend Filing and Regulatory Deadlines in Additional Areas (SC and GA) Affected by Hurricane Ian.
      • Comcast has opened Xfinity WiFi hotspots in Central, North, Southwest, and Panhandle of Florida for Xfinity customers, and non-customers, to remain in contact during and after the storm.
      • AT&T has waived talk, text, and data overage charges for Postpaid and Prepaid customers with billing addresses in the Florida zip codes (828) through October 28, 2022, to facilitate customer access to communications before, during, and after major events.

    Transportation

    • Road Closures and Travel Updates
      • Florida
        • The SR-78 / Pine Island at Matlacha Draw Bridge, which connects Pine Island to Ft. Myers, remains closed as of 10/2. Coast Guard evacuation is planned for Pine Island today, Sunday 10/2. Evacuation will happen during daylight hours. Residents are asked to make their way to Pine Island Fire Department, 5700 Pine Island Rd NW, Bokeelia, where they will be taken by truck to Yucatan Waterfront on Pine Island Road. From there, evacuees will be taken across Matlacha Pass to D & D Bait and Tackle 3922 Pine Island Road NW, where LeeTran buses will take them to a shelter.
        • Ride-hailing app Uber is offering discounted or free rides to or from state-approved evacuation shelters. Use code IANRELIEF.  
        • Florida 511 has real-time traffic conditions and incident information.
        • There are dozens of road closures across central Florida from coastal Fort Myers/Cape Coral area northeast to Daytona Beach. Closures are concentrated in Fort Myers, Port Charlotte, Orlando, and Daytona Beach.
        • Hurricane Ian destroyed a section of the Sanibel Causeway connecting Sanibel Island and Captiva to mainland Florida, cutting off the only access to the barrier island where roughly 6,300 residents reside. The Sanibel Causeway bridge remains closed as of 10/2. With the bridge compromised, Sanibel-Captiva rescues can only be conducted by water or air.
      • South Carolina
        • The South Carolina Department of Transportation provides live updates on South Carolina 511. Users can view alerts from the National Weather Service as well as evacuation resources.
        • Several news outlets are reporting road closures due to flooding, including areas of downtown Charleston, West Ashley, Summerville, North Charleston, Georgetown, James Island, and Johns Island.
      • North Carolina
      • Georgia
        • The Georgia Department of Transportation provides live updates on Georgia 511.
    • Airports
      • Florida
        • According to the Federal Aviation Administration’s airport status map, airports are largely operational in Florida. Daytona Beach International (DAB) has reopened as of 10/1.
          • Southwest Florida International Airport (RSW) in Fort Myers is the remaining major airport closure as of 10/2. RSW will remain closed until further notice pending water and power restoration. The airport continues to serve emergency personnel and humanitarian flights. The FAA states RSW is expected to reopen on 10/7.
          • North Perry Airport (HWO) in Hollywood Broward County reopened on 9/29 after temporarily closing due to tornado damage.
      • Other states
        • All major airports in North Carolina and South Carolina are open as of 10/1.
    • Port status
    • Rail
      • Freight activities have slowed (increasing delays) or temporarily ceased operations in Florida.
      • As of 10/2, FEMA reports that four (was nine) railways are not operating normally with numerous Amtrak and Northern schedule cancellations and changes.
      • As of 10/2, SunRail service remains suspended but plans to resume service on 10/3 with a modified schedule.

Access and Reentry

  • No updates since 9/30.
  • Florida
    • Florida’s access and re-entry plans and policies are managed by local officials, working closely with Florida’s Division of Emergency Management. During a disaster, private sector companies should coordinate with the Division of Emergency Management, in addition to local health departments and local emergency managers to assess whether they are authorized to enter an impacted area, only after it has been deemed safe enough to do so.
    • Individuals who wish to enter the disaster area must have the following on hand:
      • Valid government-issued ID (driver’s license, passport)Proof of employment (employer credentials, document on company letterhead)
      • Demonstrated need to enter the area (work order, inventory list, employer authorization)
      • Note, DHS CISA’s Access Coordination Letter is not an acceptable document to enter any disaster areas in Florida.
  • North Carolina
    • North Carolina requires pre-registration of vendors who provide critical services and goods before they attempt to enter disaster areas. These vendors must apply for a Certificate of Post Disaster Re-entry to be able to enter areas impacted by disasters. Information on applying for this certificate can be found at this North Carolina Business Emergency Operations Center site. Final decisions about entry/re-entry are still under the authority of local governments.
  • South Carolina
    • South Carolina requires business to register for post-disaster reentry certification before they attempt to enter impacted areas. Business can register for the program with the SC Emergency Management Division and SC Department of Commerce. Final decisions about entry/re-entry are still under the authority of local governments.

Healthcare Response Updates and Needs

  • Healthcare Facilities
    • As of 10/2 FEMA reports 138 (-7) healthcare facilities impacted by Ian.
    • As of 10/2, in Lee County, there is only one facility is reporting below normal water pressure, and Cape Coral Hospital has a water-tanker truck supplementing waterline.
      • DMAT was deployed to Gulf Coast Medical Center to set up supplemental emergency care.
    • As of 10/2 NCH Downtown Baker Hospital and all other NCH emergency departments are now open; the NCH Physician Group Practices and Wellness Centers are scheduled to reopen Monday, October 3.
    • As of 9/30, Tampa General Hospital’s emergency room is open and caring for patients. TGH Brandon Healthplex are all open except for Outpatient surgery center and services.
    • Other closures and evacuations:
      • HCA Florida Pasadena reopened on 9/30 after evacuating on 9/26. 
      • HCA Florida South Tampa Hospital and HCA Florida West Tampa Hospital also reported evacuations.
      • On 9/29, Sarasota Memorial Hospital in North Point closed its emergency room. However, as of 9/30, Sarasota Memorial Healthcare System has reopened their urgent care centers.
      • On 9/28, Kindred Hospital Bay Area – Tampa and Kindred Hospital Bay Area – St. Petersburg announced they safely evacuated all patients to other facilities.
      • On 9/28, Windmoor Healthcare of Clearwater reported it safely evacuated patients and staff.
      • As of 9/27, Encompass Health Rehabilitation Hospital of Cape Coral has evacuated all patients and staff to another Encompass Health area hospital.
      • HCA Florida Fawcett Hospital in Port Charlotte was severely damaged during the hurricane, patients in the ICU were affected by flood waters entering their rooms.
      • Advent Health locations in Central Florida remain closed and hospice care facilities have paused home visits and admissions. Elective surgeries are postponed. AdventHealth North Pinellas also evacuated patients.
    • As of 10/2, all hospitals operated by BayCare remain open. In Polk County, outpatient wound care at Bartow Medical Center and Winter Haven Hospital are closed.
    • The Agency for Health Care Administration for the State of Florida is collecting health facility status. All licensees providing residential or inpatient services are asked to update status via the Health Facility Reporting System.
    • As of 10/2 Walmart Health centers in Tampa and Orlando are offering complimentary sick or injury exams. Make appointments at walmarthealth.com or walk-in. Health and Wellness Service Locations
      • Kissimmee, FL Store 2881, 904 B Cypress Pkwy, Kissimmee, FL
      • Walmart Health is open Mon. – Fri. from 7:30am – 7:30pm; Sat. from 9am – 5pm; Sun. telehealth only*
      • Sanford, FL Store 857, 3647 S Orlando Dr, Sanford, FL
      • Walmart Health is open Mon. – Fri. from 7:30am – 7:30pm; Sat. from 9am – 5pm; Sun. telehealth only*
      • Wesley Chapel, FL, Store 3418, 28516 State Road 54, Wesley Chapel, FL
      • Walmart Health is open Mon. – Fri. from 7:30am – 7:30pm; Sat. from 9am – 5pm; Sun. telehealth only*
      • Brandon, FL, Store 2387, 11108 Causeway Blvd, Brandon, FL
      • Walmart Health is open Mon. – Fri. from 7:30am – 7:30pm; Sat. from 9am – 5pm; Sun. telehealth only*
  • Emergency Medical Services
  • Pharmacy
    • Rx Open is activated for Georgia, Florida, South Carolina, and North Carolina. It was last updated on 10/2 at 2:00pm EDT and is showing 321 pharmacy closures across the impacted states.
    • Please see the table outlining pharmacy statuses per state: 
    • Due to adjusted pharmacy hours on weekends, it is difficult to correctly calculate which counties have more than 50% of pharmacies as operational. This can be seen in the chart above with an unusually high number of “Pharmacies not Participating.” See our previous situation report for a list of counties to track pharmacy operations in.
    • As of 10/2, OptumRx provided guidance to customers for rerouting existing prescription deliveries to new addresses. 
    • Pharmacy deliveries via Express Scripts may arrive late.
  • Dialysis
    • No changes since 10/1.
    • As of 10/1, many dialysis facilities impacted by Ian have reopened, though closures remain in Florida. Most closed facilities plan to reopen by Monday, 10/3.
    • In Florida, several facilities are on generator power and/or connected to water tankers. Damage has been reported at some facilities, but overall damage is minimal.
    • See Kidney Community Emergency Response (KCER’s) Hurricane Ian webpage to share information with the dialysis community. The page includes patient helpline numbers and contacts for End Stage Renal Disease Networks supporting Florida:

Public Health Impacts

  • Infectious illnesses
    • With people entering shelters due to the hurricane, there is a higher potential for COVID-19 and other infectious and vector borne diseases to spread without the appropriate precautions and protective measures.
    • As of 10/2, CDC reports 11,825 total COVID cases, 256 new hospital admissions, and 53 deaths in the past seven days in Florida.
    • As of 10/2, there are 2,529 monkeypox cases in Florida.
  • Mental health
    • The Hurricane Ian disaster recovery hotline is available for mental health needs, disability services, military and veteran assistance, etc.
    • Individuals may call or text 211 to be connected with help for physical and mental health needs and assistance in the aftermath of Hurricane Ian.
    • The SAMSHA Disaster Distress Helpline, 1-800-985-5990, is open 24/7 to provide immediate crisis counseling for people who are experiencing emotional distress. The Helpline is toll-free, multilingual, and confidential and is available to all residents in the United States and its territories. Individuals may call or text 1-800-985-5990 to connect with a trained crisis counselor.
      • Royal Park Hospital Patients experiencing behavioral health crisis are encouraged to call the National Suicide and Crisis hotline at 988.

Supply Chain

  • Manufacturing
    • Manufacturers in Florida have not reported any major impacts. There are no expected impacts to Georgia, South Carolina, and North Carolina supply chain.
  • Distribution
    • As of 10/2, UPS is reporting potential delays for 59 zip codes within South Carolina, and 81 in Florida.
    • As of 10/1, FedEx is reporting temporarily suspended service in 115 zip codes across Florida, with additional impacts ground and freight deliveries parts of Florida, South Carolina, North Carolina, and Georgia.
    • As of 9/30, US Postal Service indicates potential service disruptions to at least 13 locations in Florida.
    • Localized healthcare supply chain disruptions are likely, however damage to distribution centers has been minor.
    • As of 9/30, retailers, such as Amazon.com Inc., have about 10 fulfillment centers in Florida and have paused operations at these sites. Walmart Inc. (WMT.N) and Sam Club have closed at least 100 stores and Target Corp (TGT.N) temporarily closed stores. Costco Wholesale Corp closed 9 stores in Florida.
    • Many of the medical product distributors as well as third party logistics providers have operations and/or distribution centers in Florida. We will be closely tracking any impacts to facilities or centers to determine any downstream supply chain impacts.

Resource Staging

  • General resource staging
    • As of 10/2, FEMA and state search and rescue operations continue in Florida with a priority on hospitals, healthcare facilities, and barrier island communities. More than 100 FEMA Disaster Survivor Assistance Team staff are working in the hardest hit communities to help survivors apply for assistance and identify immediate and emerging threats.
    • In Florida, approximately 5,000 Florida National Guard members and 2,000 National Guard members from other states are activated to help with the response.
    • As of Sunday, FEMA had nearly 10,000 staff deployed to support open and active presidentially declared disasters. This includes more than 2,400 supporting Ian response efforts.
    • As of 9/29, FEMA teams have delivered 1.1 million meals and 1.5 million liters of water to impacted areas. More supplies are expected to follow once conditions are deemed safe for transport. FEMA is currently procuring an additional 6 million liters of water and 5.5. million meals.
      • As of 9/28, FEMA has been preparing and staging supplies in strategic locations in Alabama and Florida. One location is Maxwell Airforce Base in Alabama. Supplies being staged at Maxwell Airforce Base include four Mobile Communications Operation Vehicles, 3.5 million liters of water and 3.6 million meals. Supplies in Alabama include more than a million liters of water, more than 480,000 meals and more than 7,200 cots.
    • As of 9/29, US Department of Health and Human Services deployed a National Disaster Medical System (DMAT) of 38 personnel to Miami and two other teams to Robins Air Force Base in Georgia. Additionally, two health and medical task forces and four pharmacists were deployed to Atlanta. Additional DMAT teams are on standby if needed.
  • Florida
    • Points of Distribution (POD) began distributing food, water, and ice in Lee and Charlotte Counties.
      • In Lee County, the following PODs are open from 8am to 5pm daily. Updates will be posted to www.leegov.com, twitter @Lee County Government, and at www.facebook.com/leecountyflbocc.
        • Old Bonita Library, 26876 Pine Ave., Bonita Springs
        • Kelly Road Soccer Complex, 10750 Kelly Road, Fort Myers
        • Cape Coral Sports Complex, 1410 Sports Blvd., Cape Coral
        • Cape Coral Leonard Street, 4820 Leonard St., Cape Coral
        • Estero High School Ballfield Park, 9100 Williams Road, Estero
        • North Fort Myers Recreation Center, 2000 N. Recreation Park Way, North Fort Myers
        • Fleamasters Fleamarket, 4135 Dr. Martin Luther King Jr. Blvd., Fort Myers
        • Veterans Park Recreation Center, 55 Homestead Road S., Lehigh Acres
      • Highlands County has two PODs open and will be setting up two more.
        • Lake Placid Save A Lot parking lot, 70 Plaza Ave: Food, water and ice.  To get there, turn onto CR 621 East from U.S. 27. Then Follow posted directions and flagmen through the POD, then exit on US 27.
        • South Florida State College in Avon Park, 600 W. College Drive: Food, water and ice. It opened at noon. Drivers should Take U.S. 27 to College Drive. Follow the messages and flagmen through the POD, then exit onto College Drive.
    • Florida Department of Emergency Management (FDEM) has six active fuel depots and is staging an additional four fuel depots today throughout Central and Southwest Florida to ensure first responders have the fuel they need to conduct search and rescue operations.
    • FDEM is deploying several hundred shelter support staff to address staffing needs in counties that have opened their Special Needs hurricane shelters. Currently, more than 200 public shelters are open and available to impacted residents, with more than 50 of these being Special Needs Shelters.
    • FDEM has received more than 2,000 resource requests for Hurricane Ian and fulfilled. Over 1,700 of these requests are currently being processed and are either en route or being mobilized. This includes the coordination of resources such as: trucks of food and water, generators, and water pumps.
    • FDEM is deploying the following resources for distribution to impacted areas:
      • More than 4,000 gallons of diesel to Lee County to power water plants that provide water to nearby hospitals.
      • Drone teams to assess flooded areas.
      • 500 traffic barrels to Charlotte County to safely modify traffic patterns.
      • More than 400 bottles of oxygen to Charlotte County.
      • 255 ambulances.
      • 200 trucks of food, water, and ice.
      • 200 large generators.
      • 2 full service mechanical shops.
      • 500,000 tarps.
      • 375 kits for parents of infants and toddlers with critical supplies that will last for 10 days each.
      • Four mobile triage units to Miami-Dade County.
      • Five truckloads of blankets and five truckloads of cots to support displaced residents.
      • FDEM is currently coordinating the provision of meals for first responders staged in Orange County.
    • FDEM has over 3.5 million meals and over 1.8 million gallons of bottled water in preparation for distribution to impacted areas.
    • FDEM is in constant communication with all 67 county emergency management offices and state agencies to coordinate protective actions and needed resources ahead of potential storm impacts.
    • FDEM has activated the State Assistance Information Line (SAIL) to provide an additional resource for Floridians to receive up-to-date information regarding Hurricane Ian. Residents and visitors can call this toll-free hotline at 1-800-342-3557.
    • As of 9/29, Florida Emergency Operation Center (EOC) is fully activated.
      • Incident Management Teams are in Tallahassee, Miami, and Atlanta. Mobile Emergency Response Support teams are present in Tallahassee and Orlando, with support teams located in Alabama and Georgia.
      • More than 2,000 personnel are supporting the response throughout the Southeast with more than 3,200 reservist personnel and more than 7,500 Surge Capacity Force members standing by for deployment. FEMA is establishing a personnel mobilization center to expedite deployments when critical.
    • South Carolina
      • As of 9/30, the South Carolina EOC is fully activated.
    • North Carolina
      • The North Carolina State EOC has transitioned to virtual operations. All Regional Coordinating Centers (RCCs) have demobilized. Utility partners are continuing to restore power in areas impacted by the storm. A FEMA Federal Coordinating Officer (FCO) remains on site at the SEOC to assist. 

Emergency Prescription Refills

  • Florida
    • About 13% of Florida’s population is uninsured. Emergency Prescription Assistance Program (EPAP) is the federal program that provides medication coverage for uninsured patients, but the program has not yet been activated. The uninsured population under age 65 in areas impacted by Ian is especially high:
      • Lee County: 19.3%
      • Collier County: 17.9%
      • Charlotte County: 16.9%
      • Hendry County: 27.6%
    • As of 9/24, early prescription refills are permitted under State of Emergency. All health insurers, managed care organizations, and other entities licensed by the Office of Insurance Regulation and provide prescription medication coverage as part of a policy or contract will waive time restrictions on prescription medication refills.
    • Overarching Florida disaster regulation states that you can obtain a 30-day refill of your prescription medication – even if you have just refilled it – if you reside in a county that:
      • Is under a hurricane warning issued by the National Weather Service;
      • Is under a state of emergency executive order declared by the Governor; or
      • Has activated its emergency operations center/emergency management plan.
    • Opioids are considered a controlled substance, and therefore excluded from emergency prescription refill laws.
    • Centers for Medicare & Medicaid Services (CMS) implemented 1812 Waiver and 1135 Waiver in response to the Public Health Emergency (PHE) declaration. These waivers and modifications are intended to ensure individual pharmaceutical and medical needs are met during emergency and disaster situations.
    • As of 9/29, individuals that live in one of the 67 impacted counties who have Blue Cross Blue Shield of Florida (Florida Blue and Truli) memberships can access early prescription refills for maintenance medications through 10/24/2022.
      • People impacted can receive a 30-day supply.
      • Teledoc, the virtual healthcare system is available for $0 cost to those impacted by Hurricane Ian.
      • This hotline number, 855-225-5032, will help to reach doctors 24/7 through this network for basic care and prescriptions and prescription refills that are not controlled substances.
    • As of 9/29, Humana Healthy Horizons™ in Florida will provide special accommodations for prescription access until the PHE declaration has ended, and or, 30 days has passed since the initial event.
    • As of 9/28, Cigna has lifted certain medical and benefit pharmacy restrictions.
    • As of 9/28, Molina Healthcare of Florida is suspending all prior authorization requirements for prescription refills until the state of emergency is lifted.
  • North Carolina
    • In the event of a disaster, if a prescriber is unable to provide medical services, Board Rule .1815 states that a pharmacist can issue up to a 90-day supply emergency refill.
  • South Carolina
    • According to South Carolina Law, if a pharmacist is unable to reach a prescriber for refill authorization of a non-controlled substance, under certain circumstances they are permitted to issue an emergency refill of up to a 14-day supply once within a 12-month period.

Evacuations and Curfews

  • Strikethrough indicates removal from evacuation category or warning.
    • As of 10/2, the following Florida counties have issued mandatory evacuation orders: Charlotte County, Citrus County, Clay County, Collier County, Flagler County, Hillsborough County Lee County, Levy County, Pasco County, St. Johns County, Pinellas County, and Sarasota County.
    • As of 10/2, the following Florida Counties have issued voluntary evacuation orders: Clay County, Franklin County, Gilchrist County, Glades County, Highlands County, Manatee County, Nassau County, Osceola County, Polk County, Putnam County, Orange County, Seminole County, Sumter County, Taylor County, and Volusia County.
  • As of 2:00pm on 10/2 Lee County’s evacuation and curfew have not been lifted.
  • As of 10/2, a curfew is still in effect for Charlotte County including the city of Punta Gorda from 9pm to 6am.
  • As of 10/2, Collier County and the city of Naples have a curfew from 12am to 6am until 10/3.
  • As of 10/2, North Carolina does not have any evacuation orders or curfews.
  • As of 10/2, South Carolina has not issued any evacuation orders or curfews.

Sheltering

  • The FEMA Daily Ops Brief from 10/2 reports 44 open shelters with 3,607 residents. This is a major decrease overall compared to 10/1 (10,054).
  • As of 10/2, Florida Disaster Maps shows there are 18 open shelters and 7 Special Needs Shelters in the state.
  • Full list and map of shelters, including special needs shelters, open in Florida can be found on the Florida SERT site.
  • List of open American Red Cross shelters can be found here.
  • Florida SERT and Florida Tourism Department have partnered with Expedia to launch an emergency accommodations page. Expedia has reached out to accommodation partners and encouraged them to waive cancellation fees and pet restrictions for evacuees.  

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