Resources

Federal, State Updates in Response to LA Fires

This page provides the latest information on federal and state actions regarding the Los Angeles fires. The resources and information about official actions can help your hospital respond to the fires and continue to treat patients.

If you have any questions, contact Trina Gonzalez, Vice President, Policy at tgonzalez@calhospital.org.

Federal

  • Blanket Waivers from CMS – Includes wavier of the SNF 3-day acute care stay requirement, other space/environment, medical staff, and telehealth waivers. Hospitals do not need to make requests to CMS to avail themselves to blanket waivers
  • Noridian Response to California Wildfire PHE – Includes instructions for use of mandatory disaster modifiers for Medicare claims impacted by PHE and provider enrollment relief
  • Public Health Emergency – Declaration to Aid California Health Care Response
  • Medicare waivers/flexibilities – CMS has established a portal for facilities to apply for 1135 waivers of certain Medicare Conditions of Participation and certification, as well as flexibilities that help ensure patient access to care during a disaster. A sample request would be a waiver of the skilled nursing facility three-day prior hospitalization requirements.
  • Waivers of Sanctions under the Physician Self-Referral Law during Emergencies
  • Limited Waiver of HIPAA Sanctions and Penalties During a Declared Emergency: 2025 Public Health Emergency for California in Response to Wildfires and Straight-Line Winds
  • State

  • Department of Health Care Services (DHCS) – DHCS has set up a site dedicated to the LA fires for Medi-Cal enrollees, plans, and providers. Facility flexibilities and other waivers from DHCS will be continuously updated on this site.
  • EMSA has released instructions on the approval process and procedures for health care facilities
  • DMHC Resource Guide – This includes language from the guidance DMHC sent last week and phone numbers and website links for the plans that are operating in the affected area.
  • Health Plans – All Plan Letter: Enrollees’ Continued Access to Health Care
  • Pharmacy – Waiver of standard practices, waiver of staffing ratio provisions, waiver related to remote processing, waiver related to the delivery of provisions
  • First Executive Order – CHA summary and guidance on governor’s first executive order
  • Managed Care Organization Tax

    On Nov. 5, California voters overwhelmingly approved Proposition (Prop) 35, making an existing tax on managed care organizations (MCO) permanent under state law — and directing most of the revenues toward expanding access to care for Medi-Cal patients through improved provider reimbursement. Now, work by the state, hospitals, and others to determine how these funds […]

    Thank You To Our CHPAC 2024 Donors

    Diane Abbett, California Healthcare Insurance Company, Inc. T Abraham, Hospital Council – Northern & Central California Amy Adome, MD, MPH, Sharp HealthCare Steve Aleman, Prime Healthcare Services Dimitrios Alexiou, FACHE, Hospital Association of San Diego & Imperial Counties Mark Allen, Marian Regional Medical Center Jared Amerson, Providence Saint John’s Health Center Sue Andersen, Marian Regional […]

    Hospital Fee Program 9 (2024)

    With each Hospital Fee Program renewal, DHCS retrieves the requisite hospital data and updates the fee and payment model as directed under the authorizing legislation found under state law (specifically, the Medi-Cal Hospital Reimbursement Improvement Act of 2013 codified at Welfare and Institutions Code sections 14169.50 through 14169.76).

    Baxter Announces Expiration Dating Extensions for Certain Products Related to IV Solutions Disruption

    As part of its efforts to mitigate the disruption to the supply of IV solutions after Hurricane Helene temporarily closed its North Cove, N.C., manufacturing plant, Baxter today said that it is now authorized by the Food and Drug Administration (FDA) to extend the use date of some products to provide a 24-month expiration from the manufacture date without relabeling the products. In a letter to customers today, Baxter said the extended expiration date is based on Baxter’s submission to the FDA including container closure integrity data, container functional performance data, and an analysis of product weight loss profiles for those certain product codes.

    HHS, Baxter Announce Additional Mitigation Efforts to Increase Access, Supply of IV Fluids

    The Department of Health and Human Services (HHS) and Baxter officials have announced additional actions to increase access and supply of IV solutions in response to the effects of Hurricane Helene on Baxter’s manufacturing facility in North Carolina. HHS’ mitigation efforts include increasing international and domestic supply chains. HHS Secretary Xavier Becerra joined other Administration leaders and officials from Baxter this afternoon for a call with stakeholders to provide updates on the IV solutions supply disruptions.

    CHA Releases Resource Web Page for Nationwide IV Fluid Shortage

    What’s happening: As hospitals and other health care providers nationally grapple with the shortage of IV fluids following the temporary closure of Baxter International’s manufacturing plant in Marion, N.C., CHA has compiled federal, state, and local resources to assist hospitals. 

    What else to know: Hurricane Helene hit the southeast in early October, causing widespread damage, including the temporary closure of Baxter’s plant — which, pre-Hurricane, manufactured 60% of the nation’s supply of IV solutions, producing 1.5 million bags per day.  

    IV Solution Shortage Resources

    CHA has compiled the following federal, state, and local resources to assist hospitals in navigating the current IV solution shortage:

    State

  • California Board of Pharmacy | Temporary Provisions for Compounding Certain Parenteral Drug Products | October 16, 2024
  • California Department of Public Health | All-Facilities Letter 24-24: Intravenous (IV) Solution Shortage due to Hurricane Helene | October 9, 2024
  • Federal

  • U.S. Department of Health and Human Services | Fact Sheet: HHS Continues Taking Action to Increase Access and Supply of IV Fluids Following Hurricane Helene | October 18, 2024
  • Centers for Disease Control and Prevention | Health Advisory 518: Disruptions in Availability of Peritoneal Dialysis and Intravenous Solutions from Baxter International Facility in North Carolina | October 12, 2024
  • U.S. Department of Health and Human Services | Fact Sheet: Biden-Harris Administration Takes Action to Ensure Americans Can Access Medical Supplies Following Hurricanes Helene and Milton | October 11, 2024
  • U.S. Department of Health and Human Services | Letter to Health Care Leaders and Stakeholders on Impacts of Hurricane Helene from Secretary Becerra | October 9, 2024
  • American Hospital Association | Letter to Biden Administration Urging Action to Address IV Solution Supply Shortage | October 7, 2024
  • American Hospital Association | Special Bulletin: HHS, Baxter Announce Additional Mitigation Efforts to Increase Access, Supply of IV Fluids | October 18, 2024
  • American Hospital Association | Special Bulletin: Baxter Provides Updates on Efforts to Increase Access to and Supply of IV Solutions | October 24, 2024
  • American Hospital Association | Special Bulletin: Baxter Announces Expiration Dating Extensions for Certain Products Related to IV Solutions Disruption | October 28, 2024
  • Clinical Guidance

  • Food & Drug Administration | Temporary Policies for Compounding Certain Parenteral Drug Products | October 11, 2024
  • Baxter | Recommendations for Management and Conservation Measures & List of Impacted Supplies
  • Vizient | Product Disruption Brief | October 10, 2024
  • Vizient | Adult/Pediatric IV Push Medication Reference | October 7, 2024
  • American Society of Health System Pharmacists | Fluid Shortages – Suggestions for Management and Conservation | October 4, 2024
  • Healthcare Ready | Situation Overview | October 3, 2024
  • Baxter | Product Allocation Letter | October 1, 2024
  • American Society of Health System Pharmacists | Guidelines on Managing Drug Product Shortages
  • Situational Updates

  • American Hospital Association | 8 of 10 Baxter manufacturing lines restarted | December 20, 2024
  • Baxter | Hurricane Helene Updates | Last updated December 19, 2024
  • American Hospital Association | Baxter restores additional IV solutions production lines | December 10, 2024
  • American Hospital Association | Shortage of Empty IV Bags Expected to Last Through March | December 4, 2024
  • American Hospital Association | Increased Allocations for Certain IV Products | December 2, 2024
  • Baxter | Expiration Dating Extension to 24 Months | November 8, 2024
  • Food & Drug Administration | Hurricane Helene: Baxter’s manufacturing recovery in North Carolina | Last updated November 8, 2024
  • American Hospital Association | Updates on IV Fluid Supplies After Helene Forces Closure of Baxter Manufacturing Plant | Last updated October, 28, 2024
  • Healthcare Ready | 2024 Baxter Plant Alert Hub | September 30, 2024
  • Healthcare Ready | 2024 Hurricane Helene Alert Hub | September 25, 2024