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Graphic: HurricaneHurricane Katrina: Health Resources for Recovery Efforts

Centers for Medicare and Medicaid Services

 

HHS Waivers in Response to Hurricane Katrina 

In an effort to ensure the continuity of health care services for the victims of Hurricane Katrina, CMS has developed a new section 1115 demonstration initiative. Under this program, States may apply to be part of a unique cooperative demonstration that allows coverage of evacuees from the affected geographic areas of Louisiana, Mississippi, Alabama, and Florida in which a Natural Disaster has been declared. Under this demonstration, effective retroactively to August 24, 2005, evacuees who have been displaced from his or her home as a result of Hurricane Katrina will be provided the opportunity to enroll to receive services under the Medicaid or SCHIP programs in whatever State they now reside. States may provide a period of temporary eligibility for up to 5 months. Evacuees will apply through a simplified application within the Host State through January 31, 2006.

Among the Medicaid and SCHIP changes available through the special Section 1115 demonstration initiative will be:

  1. Waiver of the normal document requirements verifying their Medicaid or SCHIP status in their home states or any information relating to household income or employment;
  2. Provision of temporary eligibility to applicants who are already enrollees in their home state. During the period of presumptive eligibility, the host state is required to verify circumstances of eligibility to the extent possible;
  3. Evacuees may apply using a simplified application in the host state.
  4. Host states, at a minimum, will provide their own Medicaid and SCHIP benefit packages to the evacuees;
  5. Host states must extend the expedited application process to evacuees who may be newly eligible because of new economic circumstances created by the hurricane (i.e. loss of job and income that may have made them ineligible prior to the storm.)
  6. Host states will submit their estimated expenditures to CMS as a component of their usual cost reporting for determining federal payments.

New Section 1115 Demonstration initiative, developed to ensure continuity of health care services for the victims of Hurricane Katrina (PDF 203KB)

Approved Katrina 1115 Waiver Documents

CMS has worked 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.

Application Template - Medicaid and SCHIP Coverage for Evacuees of Hurricane Katrina

 

Section 1135 of the Social Security Act allows the Secretary of Health and Human Services to waive or modify certain Medicare, Medicaid, or State Children's Health Insurance Program requirements in order to protect the public health and welfare in times of national crisis. On Wednesday August 31, 2005 Secretary Levitt notified the Congress that he was invoking this authority, as a consequence of Hurricane Katrina, in order to protect the health and welfare of the public in areas impacted by this crisis. CMS is taking action consistent with this authority to ensure that the people in these areas receive all necessary health care services.

Signed Waiver Under Section 1135 of the Social Security Act, 9/4/2005

Stark 1135 Waiver, 9/29/05

 

Medicaid Enrollment

In addition to these initial actions, the Secretary announced that those individuals granted special evacuee status would be permited to access benefits through the Medicaid, and Temporary Assistance for Needy Families and Head Start programs via a simplified enrollment process. State enrollment teams are already set up in many shelters, and many have 1-800 numbers people can call. Any evacuee can go to the nearest state or local benefits offices to get information and get enrolled. Evacuees staying in a home or church that has access to the Internet, or who can visit a nearby public library with Internet access, can also enroll by going to http://www.govbenefits.gov/.

 

HIPAA Privacy and Disclosures in Emergency Situations

Persons who are displaced and in need of health care as a result of a severe disaster – such as Hurricane Katrina – need ready access to health care and the means of contacting family and caregivers. We provide this bulletin to emphasize how the HIPAA Privacy Rule allows patient information to be shared to assist in disaster relief efforts, and to assist patients in receiving the care they need.

Providers and health plans covered by the HIPAA Privacy Rule can share patient information in all the following ways:

  1. TREATMENT. Health care providers can share patient information as necessary to provide treatment.

    • Treatment includes

      • sharing information with other providers (including hospitals and clinics),
      • referring patients for treatment (including linking patients with available providers in areas where the patients have relocated), and
      • coordinating patient care with others (such as emergency relief workers or others that can help in finding patients appropriate health services).

    • Providers can also share patient information to the extent necessary to seek payment for these health care services.

  2. NOTIFICATION. Health care providers can share patient information as necessary to identify, locate and notify family members, guardians, or anyone else responsible for the individual’s care of the individual’s location, general condition, or death.

    • The health care provider should get verbal permission from individuals, when possible; but, if the individual is incapacitated or not available, providers may share information for these purposes if, in their professional judgment, doing so is in the patient’s best interest.

    • Thus, when necessary, the hospital may notify the police, the press, or the public at large to the extent necessary to help locate, identify or otherwise

      • notify family members and others as to the location and general condition of their loved ones.

      • In addition, when a health care provider is sharing information with disaster relief organizations that, like the American Red Cross, are authorized by law or by their charters to assist in disaster relief efforts, it is unnecessary to obtain a patient’s permission to share the information if doing so would interfere with the organization’s ability to respond to the emergency.

  3. IMMINENT DANGER. Providers can share patient information with anyone as necessary to prevent or lessen a serious and imminent threat to the health and safety of a person or the public -- consistent with applicable law and the provider’s standards of ethical conduct.

  4. FACILITY DIRECTORY. Health care facilities maintaining a directory of patients can tell people who call or ask about individuals whether the individual is at the facility, their location in the facility, and general condition.

Of course, the HIPAA Privacy Rule does not apply to disclosures if they are not made by entities covered by the Privacy Rule. Thus, for instance, the HIPAA Privacy Rule does not restrict the American Red Cross from sharing patient information.

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