When disaster strikes, hospitals and health care systems stand ready to provide emergency and critical care services for any patient that comes through their doors. Emergency declarations afford hospitals regulatory flexibility and access to supplemental funding they need to continue providing care in the most extreme circumstances. But accessing and maximizing these opportunities is rarely simple.
COVID-19 has spread to at least 177 countries, killing hundreds of thousands and sickening millions in a matter of months. In January, the World Health Organization declared COVID-19 a pandemic. By March, the World Health Organization declared COVID-19 a pandemic and both the U.S. and Texas had declared states of emergency. A state of emergency allows for more flexibility in health care systems, but navigating these flexibilities can lead to confusion for hospitals and caregivers.
To help wade through any confusion, hospitals are relying on experts in disaster preparedness and recovery. Tidal Basin is a consulting group that specializes in disaster response for various industries, including health care. “We work in both the preparedness and recovery space, but right now, we are working almost completely in the disaster recovery space,” said Kristopher Prickett, director of healthcare services at Tidal Basin.
Learning from Hurricanes
Texans are no strangers to recovering from disasters. Just two years ago, Hurricane Harvey ravaged hundreds of miles of coastline. The first Category 4 hurricane to hit the U.S. in 13 years, Harvey killed 90 people and caused $200 billion in damages. Harvey allowed hospitals to draw a roadmap to better prepare for the next storm. This time, the next storm was not another hurricane, but instead a global pandemic.
“Even though this is a completely novel event, to both the Federal Emergency Management Agency and hospitals, the platform that is in place that you would use for a hurricane or other natural disaster were able to be changed to work in a pandemic,” said Pricket.
The most significant difference, though, according to Pricket, is that hurricanes and other natural disasters have finite timeframes in which they occur. This pandemic is enduring. There is no way of knowing how long this will last and how long our hospitals and economy will be recovering. “The process of responding and recovering after this pandemic will last much longer than what we see with a natural disaster, but we still build the process on the same foundation,” he said.
Hurricane Harvey also helped hospitals be able to anticipate the types of waivers they would see during this disaster. “We learned a lot during Harvey on the process on how to do this kind of disaster response,” said Cesar Lopez, J.D., associate general counsel at the Texas Hospital Association. “That event highlighted what the pressure points for hospitals are during disasters and what specific waivers we could anticipate.”
THA moved quickly to work on waivers that are pertinent to the current situation. THA is continuously working with state and federal leaders to waive specific regulatory requirements so that Texas hospitals can prioritize high quality, safe care during the declared state and federal disaster.
Cutting Through Red Tape
COVID-19 has had a significant financial impact on the state’s economy, and hospitals experience that strain too. Texas hospitals postponed all non-essential surgeries and procedures to conserve limited supplies of personal protective equipment and increase bed capacity. Tidal Basin is helping hospitals navigate complex governmental processes to ensure that they get the maximum reimbursement possible under FEMA regulations. “We’re helping hospitals recover expenses they had related to COVID-19,” Pricket said.
Once COVID-19 was declared a national emergency, public assistance funding from FEMA became available to state and local governments and specific private non-profit organizations. FEMA says that their public assistance program “supports communities in recovering from disasters by providing them with grant assistance for debris removal, life-saving emergency protective measures and restoring public infrastructure.”
According to the American Hospital Association, certain hospitals can apply for FEMA reimbursement for emergency protective measures taken to respond to COVID-19. In addition to the FEMA reimbursements, there is also the CARES Act, which Pricket says is equally as important.
The CARES Act, signed into law on March 27, provides $100 billion in emergency relief payments for providers in need.
Tidal Basin says hospitals must make sure they are tracking all their costs during this time, even if they haven’t seen a surge of COVID-19 patients yet. Doing this will allow for easier filing for financial help from FEMA and other state and federal government programs.
As far as waivers go, Lopez says that during a disaster, hospitals should be looking at regulations on the state and federal levels that they know they won’t be able to comply with during a state of disaster while the facility is entirely focused on providing needed care to the community. “If there is something out there that a hospital thinks they might need a waiver for, we are happy to help them either work through the issue or request a waiver,” he said.
In the wake of COVID-19 THA immediately requested several waivers based on experiences managing waivers in previous disasters. As the situation evolved, THA worked with hospitals to understand and apply for additional needed COVID-specific flexibilities.
Tidal Basin, hospitals and other organizations are working hard to respond to and recover from this novel event. However, they’re also working to make sure they have the best practices in place if this situation were to happen again.
So far, Don Forse, state director at Tidal Basin, says that something they’ve learned is that hospitals need to have a robust continuity plan in place that considers pandemic response on the non-medical side of things – such as supply chain management.
Hospitals across the nation are facing PPE shortages due to the supply chain issues related to COVID-19. Having supply chain continuity in place may not have helped this situation, but Tidal Basin has pinpointed a few things that hospitals can do to help with the lack of PPE.
“We’ve done our best working with state and federal authorities to help expedite the process of restocking PPE, but we haven’t had much luck there,” said Prickett. “What we have been able to do is advise hospitals on alternative actions they can take.”
Tidal Basin has seen creativity and resourcefulness in the hospitals they are assisting. One hospital in South Carolina even bought a machine to produce its own N-95 masks. Other hospitals have started using 3D printers, often borrowed for local colleges and universities, to create PPE. The Food and Drug Administration and the Centers for Disease Control and Prevention have approved the use of 3D printed masks in a medical setting during this outbreak.
“Every event gives the opportunity to learn and put into place new best practices for that type of occurrence. We learned things from Ebola that are influencing our current response, and we will learn from COVID-19 once it’s all said and done. There will be things that we can put into place that will be helpful in the unfortunate event of another pandemic,” said Forse.
There are indeed many lessons that have been learned, and many more to learn. One thing is clear, we are all in this together.
This sponsored section is underwritten by THA Member Solutions. Tidal Basin has been endorsed by the Texas Hospital Association since 2020. For more information, visit