Hurricane Helene Aftermath InformationOn September 27-28, North Carolina saw high winds and flood waters, created by the remnants of Hurricane Helene, rush through western North Carolina communities. In the wake of the storm, search and rescue personnel are still working tirelessly. Emergency management services are working to restore communication channels, power, and provide access to drinkable water. The North Carolina Association of Pharmacists encourages you to keep the families, businesses, and communities impacted by the storm in your thoughts and prayers as relief efforts continue to take shape. Many are asking how they can help those in need. As of Monday, September 30th, emergency management services are asking people to refrain from traveling into the area. The North Carolina Association of Pharmacists is working hand-in-hand with the North Carolina Board of Pharmacy and Emergency Management Services to help provide information and coordinate pharmacy relief efforts when it is safe for outside support to go into the area. Emergency Management ServicesIf you are aware of community members that are in need of assistance, please connect them to the following resources: Pharmacy Needs In Hurricane Helene Impacted Areas Pharmacies that have a need can email NCAP staffer, Rhonda Davis, at [email protected] and provide your name, pharmacy name, what you need, and provide your contact information. NCAP will then post your request here and use our communication channels to spread the word. Individuals who can assist are to contact the requester, directly.
Latest UpdateOctober 10th 9:00 AM Governor Cooper and NC DHHS have provided updated information that includes fewer than 81,000 power outages remain, and 80% of AT&T and Verizon outages have been repaired. FEMA has approved approximately 126,000 individual assistance applications with more than $60 million in aid paid out. The state has confirmed 88 storm-related deaths. There are approximately 2,600 people staying in hotels through FEMA's transitional sheltering assistance program. We are still in the beginning of what will be a very long recovery. FEMA has 900 staff members on the ground in western NC assisting with the Helene response. FEMA will continue to have a strong presence in western North Carolina, although teams that specialize in search & rescue have mobilized to help with immediate aftermath of Hurricane Milton's in Florida. FEMA and the NC Emergency Management have each set up webpages to address rumors and misinformation that are confusing and impacting people on the ground. More than 460 roads have reopened, but more than 600 remain closed. There are 5,800 sites that have sustained damage, including 500 bridges and 600 culverts. DOT estimates approximately 100 bridges will need to be replaced. DOT states "nonessential traffic is hindering our efforts" to get the roads assessed and reopened. The DOT asks that traffic stay away from the area and when travel is necessary use alternate routes by checking the Drive NC website. October 7 8:00AM People in 23 Western North Carolina counties impacted by Hurricane Helene who are enrolled in Food and Nutrition Services now have access to replacement benefits on their Electronic Benefit Transfer (EBT) cards. The United States Department of Agriculture approved North Carolina to allow current FNS participants in the 23 counties to receive 70% of their total monthly September benefit back on their EBT card. The benefit replacement is automatic and does not require action from the FNS participant. This impacts more than 200,000 people in North Carolina and more than $24 million in replacement benefits. More information click here.
NC Legislators Return to Raleigh to Pass Hurricane Helene Relief Legislation The General Assembly of North Carolina enacted “The Disaster Recovery Act of 2024” due to the impact of Hurricane Helene. Hurricane Helene caused widespread heavy rainfall, record flooding, and significant loss of human life and property in North Carolina.In accordance with G.S. 166A-19.20 ( c)(2) the statewide declaration of emergency issued by the Governor in Executive Order No. 315, has extended the state of emergency until March 1, 2025. Visit this link to read the entire bill.
Providing Medications During This Emergency Disaster FEMA Approves 20 Counties in Western NC for Emergency Prescription Assistance Program As of Friday, October 4th, FEMA has activated the Emergency Prescription Assistance Program (EPAP) in 20 counties in Western NC, which allows for prescription coverage (30-day supply) for uninsured patients for a limited time. Click here for information about the program. Prescriptions can be refilled every 30 days for as long as EPAP is active. If you work for a pharmacy in the disaster area, first to check to see if your pharmacy is already enrolled. List of enrolled pharmacies. Patients and pharmacies must be enrolled to participate in EPAP. Pharmacies must also be registered with Express Scripts to process claims. If you are not already registered, visit the Express Scripts website to register.
21 NCAC 46 .1815 EMERGENCY PRESCRIPTION REFILL DUE TO INTERRUPTION OF MEDICAL SERVICESBoard Rule .1815 authorizes pharmacists to provide a one-time emergency refill of up to a 90-day supply when the pharmacist is unable to obtain refill authorization from the prescriber due to the prescriber’s inability to provide medical services to the patient. This authority was specifically created for times of emergency like those in western North Carolina. Pharmacists are encouraged to use it to assist patients in affected counties.DEA APPROVES USE OF BOARD RULE .1815 TO CREATE AND DISPENSE EMERGENCY REFILLS OF SCHEDULE 3, 4, AND 5 CONTROLLED SUBSTANCES.The DEA has issued an exception letter allowing Rule .1815 to be used to create and dispense emergency refills of Schedule 3, 4, and 5 substances (found here). This exception is in effect for 30 days (until November 3, 2024), though DEA states that it will consider a further extension if emergency conditions continue to exist at that time. Board staff thanks DEA Agent Stevie Ikner and DEA Assistant Administrator Tom Prevoznik for their quick response to this patient need.*REMINDER* CONTROLLED SUBSTANCE PRESCRIPTION FORMATS.The North Carolina STOP Act requires that prescriptions for “targeted controlled substances” to be transmitted electronically unless an exception applies. One exception is “technical failure or other circumstance preventing electronic transmission.” For obvious reasons, transmission or receipt of electronic prescriptions in Helene-affected counties is likely to be problematic. Accordingly, the STOP Act’s electronic transmission provisions are not a reason to decline filling a controlled substance prescription issued for a legitimate medical purpose in the ordinary course of medical practice. More STOP Act information is found here.*REMINDER* VERBAL SCHEDULE 2 PRESCRIPTIONS IN EMERGENCIES.Pharmacists are reminded that, in the case of an “emergency situation,” federal law (21 CFR 1306.11(d)) allows a pharmacist to dispense a Schedule II controlled substance upon receiving oral authorization from the prescriber, provided that: (1) the amount is limited to that adequate to treat the patient during the emergency period; (2) the prescription is immediately reduced to writing by the pharmacist; (3) if the prescriber is not known to the pharmacist, the pharmacist makes a reasonable effort to determine the oral authorization came from a DEA-registered prescriber; and (4) within 7 days, the prescriber causes a written prescription to be delivered to the dispensing pharmacist.
BOARD AND DRUG CONTROL UNIT STAFF PROVIDE REASSURANCE ON PHOTO IDENTIFICATION REQUIREMENTS FOR DISPENSING CERTAIN CONTROLLED SUBSTANCES TO HELENE-AFFECTED PATIENTS.
North Carolina law requires production of a photo identification prior to dispensing Schedule II controlled substances, and certain Schedule III controlled substances. More information on that requirement here. Board staff have conferred with staff at NCDHHS Drug Control Unit about this requirement in Helene-affected areas and for Helene-affected patients. If a patient impacted by Helene presents with a prescription that ordinarily requires identification, do the best you can. If the patient is known to you or has any form of identification, that’s acceptable. If the patient is not known to you and has no type of identification (which is likely to be the case for some folks displaced by Helene), use your best professional judgment. If, in the exercise of that judgment (which should include checking the CSRS if possible), the prescription is clinically appropriate and the patient (or person picking up for the patient) is the appropriate recipient, dispense without concern over identification.
Pharmacist Volunteers Needed To Support Hurricane Helene ReliefFrom NCDHHS Division of Public Health, Public Health Preparedness and Response Branch: Our partners in the NC Office of Emergency Medical Services (OEMS) are looking for pharmacists to assist with medical response operations in Western NC related to Hurricane Helene. We really need your help! If you are interested is assisting, please use this form to sign up. Deployment for at least 3 consecutive days is preferred. Please use the comments section to provide details about your availability. If you have questions, please send an email to [email protected].State of Emergency DeclaredGovernor Roy Cooper declared a State of Emergency ahead of Hurricane Helene due to severe weather impacts that could threaten life and property across North Carolina. The NC Department of Insurance reminds health benefit plans of compliance requirements for operations under a state of emergency for purposes of obtaining extra prescriptions during a state of emergency or disaster. Pharmacists and pharmacies are reminded that the Board of Pharmacy has exercised its authority under G.S. 90-85.25(a) to waive certain requirements of the North Carolina Pharmacy Practice Act to facilitate the provision of patient care during a declared emergency. The Board’s emergency waiver is now in effect. That waiver allows pharmacists and nationally-certified technicians who hold a license in good standing in another state to practice in North Carolina to assist during the period of the declared emergency. The waiver also authorizes relocations of pharmacies as needed to provide continuity of care. Certain notifications to the Board are required. Now is the time to review the waiver and begin taking action to implement plans to ensure continuity of patient care. The referenced notification email address – [email protected] – is open. North Carolina Granted Federal Major Disaster DeclarationPresident Biden has granted Governor Roy Cooper’s request for a Federal Major Disaster Declaration for Tropical Storm Helene providing immediate federal help for 25 North Carolina counties and the Eastern Band of Cherokee Indians. The declaration means that FEMA will be able to speed additional help to the state, and provide Individual Assistance to people living in those counties, as well as Public Assistance to reimburse local governments, state agencies, and non-profits or other eligible organizations for funds spent repairing facilities and infrastructure. Applying for FEMA Disaster Assistance FEMA may be able to help with disaster-caused needs for homeowners and renters in the impacted counties included in the federal disaster declaration. There are several ways to apply: Go online to DisasterAssistance.gov, use the FEMA App or call 800-621-3362 from 7 a.m. to 11 p.m. ET daily. The telephone line is open every day and help is available in most languages. If you use a relay service, such as Video Relay Service (VRS), captioned telephone or other service, give FEMA your number for that service. Open Pharmacies In The Impacted AreaThe counties in the federal disaster declaration include Alexander, Alleghany, Ashe, Avery, Buncombe, Burke, Caldwell, Catawba, Clay, Cleveland, Gaston, Haywood, Henderson, Jackson, Lincoln, Macon, Madison, McDowell, Mitchell, Polk, Rutherford, Transylvania, Watauga, Wilkes, and Yancey Counties as well as the Eastern Band of Cherokee Indians. We know that many pharmacies are greatly impacted by the storm. Our thoughts and prayers are with the pharmacy personnel who are working to restore operations. The Board of Pharmacy has asked that if you operate a pharmacy in the area impacted by the Hurricane Helene disaster that you let the Board of Pharmacy know if you are currently open and able to serve patients.
Resources for Medicare BeneficiariesThe CMS Regional Office has also shared this information during this challenging time. If a Medicare beneficiary has specific service concerns, they may call CMS at 800-MEDICARE (800-633-4227) or reach out to us via email at [email protected]. CMS understands that Medicare beneficiaries may have questions about accessing their coverage if displaced and during emergencies. Please refer to the updated document: Getting Care & Drugs in a Disaster or Emergency. It is also available in Spanish: Cómo obtener atención médica y medicamentos en una situación de desastre o emergencia. NC Medicaid Information Update on NC Medicaid Temporary Flexibilities Due to Hurricane Helene New sections added from the previous bulletin are:
Updates will be provided as they become available. Disaster Relief Applications for Health Care Professionals Not Currently Enrolled as an NC Medicaid ProviderThe NC Department of Health and Human Services is committed to ensuring continued access to care for NC Medicaid beneficiaries, as well as reimbursement to qualified providers for services rendered, in good faith, throughout the period of impacts from Hurricane Helene, committed to ensuring continued access to care for NC Medicaid beneficiaries, as well as reimbursement to qualified providers for services rendered, in good faith, throughout the period of impacts from Hurricane Helene, retroactively from Sept. 25, 2024, through Oct. 15, 2024, (unless otherwise communicated by DHHS).
Health care professionals who will be rendering services to NC Medicaid beneficiaries due to Hurricane Helene can complete and submit an application through the NCTracks Provider Portal. Please refer to the disaster provider enrollment job aid Disaster Relief Provider Enrollment Application Job Aid (PRV703) located under Quick Links on the NCTracks Provider Enrollment home page for necessary instructions to complete the temporary disaster provider enrollment application. Be sure to review the job aid before starting to complete the application, as several preliminary steps are necessary. Providers must indicate the application is for Disaster Relief by answering “Yes” to the Disaster Relief enrollment question on the Basic Information page of the application. Resources From National AssociationsIf your pharmacy experiences any damage due to this natural disaster, the NCPA Foundation Disaster Relief Fund can help with costs for repairs. Impacted pharmacy owners can apply for a disaster relief grant visit here. Please contact Stephanie Vichness ([email protected]) at NCPA with any questions. North Carolina Disaster Relief FundDonate to help North Carolinians with recovery from Hurricane Helene. You can donate at http://nc.gov/donate. American Red Cross Visit redcross.org/donate or send a check donation form and check to: American Red Cross, PO Box 37839, Boone, IA 50037-0839 or text “REDCROSS” to 90999 to donate to American Red Cross Disaster Relief or call 1-800-HELP NOW (1-800-435-7669). You can find more information about how to help, including blood donations and being a volunteer, online at redcross.org. The Community Foundation of Western North Carolina Visit https://cfwnc.fcsuite.com/erp/donate/create/fund?funit_id=1332 to make a donation. Charities Helping Animals in Western NC After Hurricane Helene Best Way To Help Financial contributions to recognized disaster relief organizations are the fastest most flexible and most effective method of donating. Organizations on the ground know what items and quantities are needed. They buy in bulk with discounts and when possible they buy from local businesses helping make donations go further and support local economic recovery. Though it may seem helpful, FEMA says used clothing is never needed and recommends connecting with organizations about what may be needed before contributing supplies. At this time, the North Carolina Department of Public Safety is discouraging anyone from sending physical donations or volunteers to western NC. The best way to help is through financial donations to vetted disaster relief organizations and to sign up to volunteer with OEMS (see section above).
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