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10/6/2005  DMEPOS Suppliers Affected by the Recent Hurricanes 
   
  CMS has released procedures to assist those DMEPOS suppliers located in areas that have been determined by the Governor to be disaster areas.

Requests to change a “Physical”, “Mail To” or “Pay To” address or telephone number:

• Can be accepted by fax, but not by phone

• Can be on company letterhead – prefer to be submitted on the CMS 855S, if possible

• Should be signed by the authorized or delegated official

• Should include the Legal Business Name, Tax Identification Number/Social Security Number and signature of the authorized or delegated official
DMEPOS suppliers who are unable to locate the authorized or delegated official may still submit a change request, but the NSC analyst will request additional information to verify the validity of the submittal. If the NSC is unable to verify the validity of the information submitted, the request will not be processed.

Please note once the situation has stabilized, the NSC will contact those suppliers who submitted a request by fax and request the information be submitted on the CMS 855S form.

For suppliers who have documentation already in process, the NSC will attempt to contact these suppliers. Enrollment documentation that can be processed, will be completed. However, if the NSC determines the documentation cannot be processed at the time, the NSC will request the documentation be resubmitted at a later date. Once received, the NSC will make every effort to expedite the processing of this documentation.

Further, for suppliers located in disaster areas, the NSC:

• Will hold reenrollments scheduled to be mailed

• Will not inactivate supplier numbers for reenrollments already mailed or currently in process

• Will not inactivate or set an alert code for returned mail (DNF)

• Will also work with suppliers on a case-by-case basis to assist in resolving enrollment issues

To receive updates on hurricane procedures and for other information regarding enrollment, please sign up for both the CMS and NSC listserv. 
   
   
10/5/2005  The OIG will audit for fraud and abuse in the wake of Hurricane Katrina  
   
  It`s no surprise to those involved in the compliance field: The wake of Hurricane Katrina has created an enormous opportunity for fraud, waste, and abuse.

Joseph E. Vengrin, deputy inspector general for audit services and Michael E. Little, deputy inspector general for investigations for the Department of Health & Human Services (HHS) spoke about this potential when they testified before members of the House Energy and Commerce Committee on Sept. 28.

During their testimony, Vengrin and Little outlined the OIG`s plan for mitigating potential fraud and abuse. They spelled out that HHS has relaxed many system controls to allow victims access to benefits without the usual documentation requirements.

To monitor these areas for fraud and abuse, the OIG is developing special work plans to focus fraud-detection audits. The OIG further plans to investigate more than 20 reports of healthcare providers abandoning patients or engaging in activities resulting in patient deaths.

OIG agents have already been to affected areas to provide emergency assistance to providers impacted by the hurricane. OIG agents assisted in evacuation efforts and provided security assessments for several healthcare facilities.


Go to: http://oig.hhs.gov/testimony/docs/2005/KatrinaEnergy&Commerce.pdf to read "Testimony of Joseph E. Vengrin, Deputy Inspector General for Audit Services and Michael E. Little, Deputy Inspector General for Investigations Department of Health and Human Services," from Sept. 28, 2005.

 
   
   
9/29/2005  National Modifier and Condition Code To Be Used To Identify Disaster Related Claims 
   
  Reference: Related Change Request (CR) #: 4106 Medlearn Matters Number: MM4106
Related CR Release Date: September 23, 2005/Related CR Transmittal #: 181

Effective Date: August 21, 2005

Implementation Date: October 3, 2005, but no later than October 31, 2005

Provider Types Affected: Physicians, suppliers, and providers billing Medicare contractors (carriers, including Durable Medical Equipment Regional Carriers (DMERCs) and/or Fiscal Intermediaries (FIs), including Regional Home Health Intermediaries) for services rendered to beneficiaries affected by Hurricane Katrina.

Provider Action Needed

This article is based on Change Request (CR) 4106, which establishes a new condition code and modifier for providers to use to indicate claims for Hurricane Katrina and other disaster victims.

To accommodate the emergency health care needs of beneficiaries and providers affected by Hurricane Katrina and any future disasters, the Centers for Medicare & Medicaid Services (CMS) has created the following new condition code and modifier, effective for dates of service on and after August 21, 2005. The new condition code is “DR (Disaster related)” and the new modifier is “CR (Catastrophe/Disaster Related).”

Background

CMS has acted to ensure that the programs will be flexible in order to accommodate the emergency health care needs of beneficiaries and medical providers in the states devastated by Hurricane Katrina. Many of the programs’ normal operating procedures have been relaxed to speed the provision of health care services to the elderly, children, and persons with disabilities who depend on the services.

Because of hurricane damage to local health care facilities, many beneficiaries have been evacuated to neighboring states where receiving hospitals and nursing homes have no access to patients’:
• Health care records;
• Current health status; or
• Verification of status as Medicare or Medicaid beneficiaries.

Note: CMS is assuring facilities and medical providers receiving Medicare beneficiaries affected by Hurricane Katrina, that the normal requirements for documentation will be waived and the presumption of eligibility should be made.

Health care providers that furnish medical services in good faith, but who cannot comply with normal program requirements because of Hurricane Katrina, will be:

• Paid for services provided; and
• Exempt from sanctions for noncompliance (unless it is discovered that fraud or abuse occurred).

New Condition Code and Modifier

To facilitate claims processing and track services and items provided to victims of Hurricane Katrina and any future disasters, CMS has established a new condition code and modifier for providers to use on disaster related claims. The new condition code and modifier are for use by providers submitting claims for beneficiaries who are Katrina disaster patients in any part of the country and are effective for dates of service on and after August 21, 2005. The new codes are the following:

• The new condition code is DR - Disaster Related
• The new modifier is CR - Catastrophe/Disaster Related

For physicians or suppliers billing their local carrier or DMERC, only the modifier (CR) should be reported and not the condition code. A condition code is used in FI billing.

For institutional billing, either the condition code or modifier may be reported. The condition code would identify claims that are impacted or may be impacted by specific payor policies related to a national or regional disaster. The modifier would indicate a specific Part B service that may be impacted by policy related to the disaster.

CR4106 instructs Medicare contractors to recognize the new condition code and modifier on October 3, 2005, if possible, but no later than October 31, 2005.

In addition to this Medlearn Matters Article, CMS regional offices will help facilitate contractor outreach regarding provider education on the use of the new modifier and condition code.

Implementation

The targeted implementation date is October 3, 2005, but no later than October 31, 2005.

Additional Information

For complete details, please see the official instruction issued to your carrier/DMERC/intermediary regarding this change. That instruction may be viewed at on the CMS web site. From that web page, look for CR4106 in the CR NUM column on the right, and click on the file for that CR. If you have any questions, please contact your carrier/DMERC/intermediary at their toll-free number, which may be found at on the CMS web site.
 
   
   
9/29/2005  The Emergency Health Care Relief Act of 2005 
   
  The Emergency Health Care Relief Act of 2005

"a somewhat controversial bill that would assist survivors with Medicaid support from states afflicted by recent hurricanes."

Senators earlier this week blocked a floor vote on the bill, which has an estimated price tag of $8.7 billion over five years. It was unveiled earlier this month by Finance Committee leaders Sens. Charles Grassley (R-IA) and Max Baucus (D-MT).

Beyond offering emergency Medicaid assistance, the bill includes temporary 100% matching payments for the cost of care for hurricane survivors from Louisiana, Mississippi and parts of Alabama who have been relocated. It also cancels for all states the federal matching rate reduction scheduled for fiscal year 2006.

HHS Secretary Mike Leavitt said in a letter Tuesday to Senate leaders from both parties that the bill designed to provide temporary Medicaid benefits for survivors of Hurricane Katrina should not be approved. The Bush administration`s strategy of negotiating waivers with state Medicaid programs "largely precludes the need for the activities" proposed in the bill, Leavitt wrote. He added, a ³new program is unnecessary."

Supporters of the bill, include the National Governors Association, American Red Cross, American Hospital Association, and the National Conference of State Legislatures.

==== (from Kaiser Network)==========

The Latest Reports in Health Policy | CBO Estimates Impact of Hurricane Relief Bill on Revenues, Spending
[Sep 26, 2005]
"S 1716, Emergency Health Care Relief Act of 2005," Congressional Budget Office: CBO estimated the effect on direct spending and revenues of S 1716, which would provide public assistance to Hurricane Katrina survivors in part by modifying Medicaid eligibility rules and payment formulas and by establishing a fund to pay for health services and health insurance. According to CBO, the bill would increase direct spending by $7.5 billion in 2006 and by $8.9 billion over the 2006-2010 and 2006-2015 periods. The bill would not have an effect on federal revenues in 2006, but would increase revenues by $12 million over the 2006-2010 period and by $15 million over the 2006-2015 period (CBO, "S 1716, Emergency Health Care Relief Act of 2005," 9/22).

------------
URL of report: http://www.cbo.gov/ftpdocs/66xx/doc6659/s1716-Katr.pdf  
   
   
9/26/2005  Equipment Distribution Program (LATAN) 
   
  People with disabilities and older people in Louisiana were forced to leave wheelchairs, hospital beds, walkers, canes, communication devices, and other types of medical equipment and assistive technology when they evacuated from the path of Hurricane Katrina. Others find themselves in need of such devices due to illness and injury resulting from the storm.

The Louisiana Assistive Technology Access Network (LATAN), in partnership with New Horizons Independent Living Center, Southwest Louisiana Independence Center, Come and Help, and other organizations in the state, are operating an Equipment Distribution Program to receive donated equipment and distribute it to the individuals who need the devices.

Equipment Donations

LATAN is currently accepting requests from Hurricane Katrina evacuees for equipment needs. We can not provide specialized equipment but will try to provide suitable temporary equipment to be used until the appropriate equipment can be obtained.

To donate equipment, please contact Clara Pourciau at cpourciau@latan.org or 225.925.9500 or Mitch Iddins at middins@nhilc.org or 318.671.8131, ext 113.

To review equipment left behind at Louis Armstrong International Airport click here: http://www.latan.org/katrina/katrinaEquipment.html

 
   
   
9/16/2005  MEDICAID: Bill Would Extend Coverage to Hurricane Survivors 
   
  Senate Finance Committee Chair Chuck Grassley (R-Iowa) and ranking member Sen. Max Baucus (DMont.)on Wednesday introduced a compromise, bipartisan measure that would temporarily extend Medicaid coverage to survivors of Hurricane Katrina, CongressDaily reports (Rovner/Heil,CongressDaily, 9/15).

The bill, estimated to cost $5 billion to $7 billion, would have the federal
government for five months pay 100% of Medicaid costs for survivors from Louisiana, Mississippi and parts of Alabama who have relocated to other states, with the option of extending the coverage for an additional five months. In addition, the federal government would pay 100% of Medicaid costs through the end of 2006 for all beneficiaries in Louisiana, Mississippi and counties in Alabama that have been designated as disaster areas (CQ Today, 9/15).

Other states would be assured that their federal Medicaid matching rates would not decline next year (CongressDaily, 9/15). Survivors with annual incomes below the federal poverty level would be eligible for the coverage. Pregnant women and children from families with annual incomes up to 200% of the federal poverty level also would be eligible for Medicaid (CQ Today, 9/15).

The bill also would eliminate any asset tests and would measure income moving forward, CongressDaily reports (CongressDaily, 9/15). Further, the bill would establish a fund to help hurricane survivors with private health insurance pay their premiums and change Medicare and Medicaid laws so that survivors do not face penalties for missed application deadlines (CQ Today, 9/15).

In addition, the bill would eliminate co-payments and deductibles for hospital services for elderly Medicare beneficiaries displaced by the storm (Rogers, Wall Street Journal, 9/15).

The bill would not delay the launch of the Medicare prescription drug benefit for dual eligibles, as was requested by
Democrats. Dual eligibles` prescription drug coverage will be transitioned from Medicaid to Medicare starting on Jan. 1, 2006, as planned. However, HHS would be required to submit by Oct. 7 a written plan for how it will accomplish the transition for beneficiaries in states and counties affected by Hurricane Katrina.

Reaction

"This package will give desperately needed relief," Grassley said, adding, "It offers immediate health coverage for every individual in need" (CongressDaily, 9/15). Grassley said, "We have to prevent more hardship, and we feel this bill will respond to those hardships" (CQ Today, 9/15).

Baucus said, "The most effective and efficient health care system is Medicaid. We don`t have to invent a whole new program" (CongressDaily, 9/15).

According to CQ Today, the bill has the support of Senate Majority Leader Bill Frist (R-Tenn.), and Senate Minority Leader Harry Reid (D-Nev.) issued a statement backing the measure (CQ Today, 9/15). The bill is expected to pass the Senate, but its prospects "are much less clear in the House, where leaders have been discussing a much less far-reaching package," CongressDaily reports (CongressDaily, 9/15).

 
   
   
9/15/2005  CMS Actions to Help Beneficiaries, Providers in Katrina Stricken Areas 
   
  The Centers for Medicare & Medicaid Services has acted to assure that the Medicare, Medicaid and State Children’s Health Insurance Programs will flex to accommodate the emergency health care needs of beneficiaries and medical providers in the Hurricane Katrina devastated states.

Many of the programs’ normal operating procedures will be relaxed to speed provision of health care services to the elderly, children and persons with disabilities who depend upon them.

Because of hurricane damage to local health care facilities, many beneficiaries have been evacuated to neighboring states where receiving hospitals and nursing homes have no health care records, information on current health status or even verification of the person’s status as a Medicare or Medicaid beneficiary. CMS is assuring those facilities that in this circumstance the normal burden of documentation will be waived and that the presumption of eligibility should be made.

Federal Medicaid officials are also working closely with state Medicaid agencies to coordinate resolution of interstate payment agreements for recipients who are served outside their home states.

The agency will also offer the following relief immediately:

  • Health care providers that furnish medical services in good faith, but who cannot comply with normal program requirements because of Hurricane Katrina, will be paid for services provided and will be exempt from sanctions for noncompliance, unless it is discovered that fraud or abuse occurred.
  • Crisis services provided to Medicare and Medicaid patients who have been transferred to facilities not certified to participate in the programs will be paid.
  • Programs will reimburse facilities for providing dialysis to patients with kidney failure in alternative settings.
  • Medicare contractors may pay the costs of ambulance transfers of patients being evacuated from one health care facility to another.
  • Normal prior authorization and out-of-network requirements will also be waived for enrollees of Medicare, Medicaid or SCHIP managed care plans.
  • Normal licensing requirements for doctors, nurses and other health care professionals who cross state lines to provide emergency care in stricken areas will be waived as long as the provider is licensed in their home state.
  • Certain HIPAA privacy requirements will be waived so that health care providers can talk to family members about a patient’s condition even if that patient is unable to grant that permission to the provider.
  • Hospitals and other facilities can be flexible in billing for beds that have been dedicated to other uses, for example, if a psychiatric unit bed is used for an acute care patient admitted during the crisis.
  • Hospital emergency rooms will not be held liable under the Emergency Medical Treatment and Labor Act (EMTALA) for transferring patients to other facilities for assessment, if the original facility is in the area where a public health emergency has been declared.


More information about CMS emergency relief activities, including a detailed explanation of billing and payment policy revisions, and phone numbers for the state medical assistance offices can be found can be found at www.cms.hhs.gov. Frequently asked questions and their answers on the site will be updated daily by 2pm. 
   
   
9/15/2005  HHS Releases Website and Toll-Free Number for Deployment by Health Care Professionals 
   
  The Department of Health and Human Services has established a website (https://volunteer.hhs.gov) and toll-free number (1-866-KAT MEDI) to help identify health care professionals and relief personnel to assist in Hurricane Katrina relief efforts.

“The desire of America’s health care professionals to use their skills to help Hurricane Katrina’s victims has been inspiring, ” Secretary Mike Leavitt said. “This website and toll free number are important tools to become part of this network of goodness that is taking place.”

Multidisciplinary healthcare professionals and relief personnel with expertise in the following areas are encouraged to visit the website and register to volunteer for appointment by HHS:


  • Administration/Finance Officers

  • Nursing Assistants/Nursing Support Technicians

  • Chaplain/Social Worker

  • Nursing Staff Directors

  • Clinical Physicians

  • Patient Transporters/Volunteers

  • Dentists

  • Pharmacists

  • Dieticians

  • Psychologists

  • Epidemiologists

  • Physician`s Assistants or Nurse Practitioners

  • Environmental Health

  • Physician Chiefs of Staff

  • Epidemiologists

  • Respiratory Therapists

  • Facility Managers

  • RNs

  • Housekeepers

  • Safety Officers

  • IT/Communications Officers

  • Security Officers

  • LPNs

  • Social Workers

  • Medical Clerks

  • Supply Managers

  • Mental Health Workers

  • Veterinarians


Please be advised that individuals must be healthy enough to function under field conditions. This may include all or some of the following:

12-hour shifts
Austere conditions (possibly no showers, housing in tents)
No air conditioning
Long periods of standing
Sleep accommodations on bedroll
Military ready to eat meals

These workers will be non-paid temporary Federal employees, and will therefore be eligible for coverage under the Federal Tort Claims Act for liability coverage and Workman’s Compensation when functioning as HHS employees. Although there will not be any salary, travel and per diem will be paid.

Individuals with no healthcare background can find information on volunteering USAFreedomCorps.gov or by calling 1-877-USA-CORPS. 
   
   
9/15/2005  SENATOR KERRY PLANS SECOND HUMANITARIAN AID FLIGHT 
   
  Roger Fisk, Senior Aide for Senator Kerry, informed NEMED today that they are planning a second flight to the Gulf coast region that will leave this Monday (September 19th). According to Fisk, [On last week’s flight], “We got 24 tons of materials down to Lafayette and Baton Rouge.” NEMED is aware of donations from Byram Healthcare and Invacare Supply Group.

THANK YOU!

But there’s more work to do. Roger told Karyn Estrella, NEMED Executive Director, that when they were on the ground, they were hearing about the need for medical supplies. Senator Kerry is asking NEMED members for donations of the following items (if you make a donation, please inform the NEMED office):

Woundcare
Colostomy supplies
Feeding tube supplies
Diapers - all sizes
Gloves
Diabetic strips/glucose monitors
Nebulizers
Scrubs

These items will be delivered directly to relief shelters for immediate use.

Collections will occur Saturday, September 17, 2005
from noon to 5 pm at these two locations.

Bentley College
175 Forest Street, Waltham, Massachusetts
www.bentley.edu
Please use Forest Street entrance

Northeastern University, Main Campus
360 Huntington Ave., Boston, MA
Hurricane Relief Collection Center: Camden
Parking Lot, (follow signs off Columbus Avenue)
www.northeastern.edu


If you would like to do a bulk shipment (like a pallet or a couple pallets) please contact Roger Fisk or Roger Lau at 617-565-8519 for info for the Fedex facility at Logan to have it delivered there, thus removing the drop-off step. 
   
   
9/15/2005  Katrina swells ranks of unemployed  
   
  WASHINGTON (Reuters) - The number of Americans filing new claims for jobless aid shot up by 71,000 last week, the biggest jump in nearly 10 years, as workers displaced by Hurricane Katrina sought to join the benefit rolls, the government said on Thursday.

The rise in first-time claims for state unemployment aid, among the first economic data to capture the human toll of the devastating storm, brought initial filings in the week ended September 10 to 398,000, the highest level in two years.

The Labor Department estimated that 68,000 of those claims were related to Katrina, which slammed into the U.S. Gulf Coast on August 29. However, it cautioned that it was unable to process the huge surge in claims that were filed as state workers waded into evacuee shelters to log applications.

"Due to the unprecedented volume of claims filed in the affected areas and due to the unconventional methods used in filing, the numbers that are reported do not truly reflect the number of claims filed," a department analyst said.

He said the department could not offer a "ballpark" figure on how many claims had been collected but not yet captured in the department`s report. "We are expecting an upward revision in the following week," he said.

Forecasts on Wall Street had centered on a guess that initial claims would rise to 350,000 from the 319,000 initially reported for the prior week. However, Hurricane Katrina led to a wide dispersion of projections -- from a low of 320,000 to a high of 800,000.

The increase in initial claims was the largest for any week since January 1996, when blizzards blanketed the East Coast.

The big jump pushed a four-week moving average of claims up by 19,750 to 340,750, the highest level in nearly a year. Economists usually track the less-volatile moving average to get a better sense of underlying job-market trends.

The number of workers who continued to file for benefits after an initial week of aid rose by 20,000 to 2.59 million. But that number is certain to swell as workers displaced by Katrina join the rolls.

States provide unemployment benefits for up to 26 weeks, but lawmakers are already mulling a federal program to extend aid for an additional 13 weeks in the wake of the storm. Congress passed similar extensions amid the jobless recovery from the 2001 recession.
 
   
   
9/15/2005  CMS - Department of Health & Human Services - Centers for Medicare & Medicaid Services 
   
  See Medicare Q & A for Disasters 
   
   
9/15/2005  President Approves Emergency Funding for Reception States 
   
  Federal disaster aid is now available to affected counties to in states hosting evacuees from Hurricane Katrina. "We`ve been overwhelmed by the generosity of the people of the United States and those opening their hearts and arms and hometowns to evacuees," said Michael D. Brown, Under Secretary of Homeland Security for Emergency Preparedness and Response. "Our goal is to ensure those directly affected by Hurricane Katrina have safe, sanitary shelter during this first step on their road to recovery." FEMA funds will be available to counties in the following reception states:

Arkansas
Colorado
Florida
Georgia
Oklahoma
North Carolina
Tennessee
Texas
Utah
West Virginia 
   
   
9/14/2005  HHS to Coordinate Katrina HME Donations 
   
  Two weeks after Hurricane Katrina ravaged portions of the nation`s southern shore, the home care community is still reaching out to help the storm`s victims by donating time, money and services. Numerous manufacturers and providers have launched company relief efforts offering immediate shipment of equipment and supplies.

But many who have tried to donate HME are having trouble getting it to those in need. With some areas now quarantined, power lines still down, roads impassable and communications spotty along the Gulf Coast--plus a scarcity of trucks, drivers and fuel--logistics, shipping sites and storage are proving to be additional problems.

"People who are making donations don`t know what to do with the equipment. The Red Cross, which is overwhelmed with requests meeting basic needs, won`t take it. People are being turned away," said Mike Hamilton, executive director of the Alabama Durable Medical Equipment Association (ADMEA). "We don`t have any way to match the donations to the needs and then get it down there. Nobody has the transportation or fuel available. It`s very frustrating."

The American Association for Homecare also said members have reported difficulties delivering equipment to patients in the region, primarily because of gas shortages and police lines. According to association spokesman Michael Reinemer, some officials don`t understand that someone bringing equipment or oxygen "should be treated as a first responder, such as a firefighter."

To help coordinate needs, donations and provide a way for the equipment to be delivered, the Department of Health and Human Services announced on Friday that all requests for help or offers to donate should be e-mailed to katrinalogistics@hhs.gov rather than other organizations.

The industry also is scrambling to serve victims who have evacuated across state lines--and sometimes DMERC boundaries.

To date, HHS Secretary Mike Leavitt has declared a public health emergency in Alabama, Florida, Louisiana, Mississippi and Texas, and federal funding has been approved for 10 other reception states: Arkansas, Colorado, Florida, Georgia, Oklahoma, North Carolina, Tennessee, Texas, Utah and West Virginia. President Bush has announced special evacuee status for all who fled their home states because of the hurricane. This designation will allow evacuees to apply for a full range of federal benefits administered by the states, including Medicaid and the State Children`s Health Insurance Program (SCHIP). Federal officials are also working to resolve interstate payment agreements for the programs.

Because many evacuees` medical records are unavailable, CMS announced last week that it is relaxing regulations for health care providers supplying medical services to Katrina victims. Earlier, Gary Karr, CMS director of media affairs, told reporters at a hospital Open Door forum that the agency`s position is to "treat first, ask billing questions later."

Immediate relief from HHS and CMS includes the following:

  • Health care providers who furnish services in "good faith" but cannot comply with certain requirements, such as documentation, will be exempt from sanctions for noncompliance standards, unless it is discovered that fraud or abuse has occurred.

  • Providers covered by Health Insurance Portability and Accountability Act (HIPAA) privacy rules can share patient information as necessary to provide treatment, to identify, locate and notify a patient`s family members or guardians, even if the patient is unable to give permission or information to the provider.

  • To speed enrollment in Medicaid or SCHIP, states serving hurricane evacuees will be granted emergency section 1115 waivers to provide temporary eligibility. Applications for Medicaid coverage for evacuees will be accepted retroactively from Aug. 24.

  • Providers who get requests to provide DME or supplies to a Medicare beneficiary who has been forced to evacuate due to the hurricane can call (866) 270-4909 to learn about materials in the Common Working File. Providers must supply the beneficiary`s name, old addresses, date of birth and a list of requested items. If the information matches the data on file, the provider should be able to get the beneficiary`s HIC number and verify that a valid CMN exists. (According to ADMEA`s Hamilton, some Alabama providers have reported that no information will be shared unless the beneficiary is also on the call.)

  • If there is a request for items that were not furnished before the storm, Medicare providers are advised to treat it like any new order--and to beware of scammers.

  • File Medicare claims for hurricane victims on a paper form, (the old HCFA-1500), clearly marked "DISASTER." For deliveries to any temporary residence, use the Place of Service code 04 (homeless shelter). Providers may file such claims without having the required paperwork in advance, but must plan on eventually obtaining essentially the same proof of medical necessity that is required under normal circumstances for the products delivered.

  • Medicare payment for disaster-related claims will be made in approximately 28 days. Providers may see a delay in processing if the victim has relocated to a new DMERC region.

  • Also on Friday, CMS announced it is now allowing Hurricane Katrina evacuees who left Medicare capped rental items behind to begin new rental episodes for replacement equipment.

  • Additional information on Medicare and Medicaid changes affecting evacuees is available at http://www.cms.hhs.gov/Katrina and is updated daily at 2 p.m. EDT.


    • State association leaders in the affected areas have said that they are still unsure of the number of providers--or their patients--who have been displaced because of the storm. "We still have many folks who we haven`t heard from," said Hamilton. "It`s been spooky."

    TO REQUEST OR DONATE MEDICAL EQUIPMENT
    katrinalogistics@hhs.gov

    TO MAKE A CHARITABLE DONATION
    American Red Cross
    (800) HELP-NOW (435-7669)
    www.redcross.org
    Home Care Donation Site: https://secure2.convio.net/arc/site/Donation?ACTION=SHOW_DONATION_OPTIONS&CAMPAIGN_ID=1783
    To find missing loved ones: (877) LOVED-1S (568-3317)

    Salvation Army
    (800) SAL-ARMY (725-2769)
    www.salvationarmyusa.org

    United Way
    (800) 272-4630
    http://national.unitedway.org

    TO VOLUNTEER
    (866) KAT MEDI
    The Department of Health and Human Services (volunteers with health care experience)
    https://volunteer.hhs.gov

    USA Freedom Corps. (volunteers with no health care background)
    (877) USA-CORPS
    www.USAFreedomCorps.gov

    FOR GOVERNMENT INFORMATION
    Centers for Medicare and Medicaid Services (CMS)
    For detailed information and notices, visit www.cms.hhs.gov/Katrina.
    Hurricane Katrina Q&A: www.cms.hhs.gov/hki

    Palmetto GBA/Region C DMERC
    Voice Response Unit: (866) 238-9650
    CSR: (866) 270-4909 (call to find a CMN on file)
    www.palmettogba.com

    The VGM Group
    www.vgm.com
    www.hmehu     
   
   
9/14/2005  Oxygen claims 
   
  Palmetto will process and pay oxygen concentrator claims without orders or CMNs, provided that all normally necessary paperwork is obtained as quickly as possible. We are seeking information on possible exceptions to Pharmacy Board rules affecting oxygen refills, and until we hear differently, must still recommend getting current orders from a local physician.

Palmetto is also considering an exception to the rules affecting capped rental items. Regardless of the timing, such items are the property of the supplier and will not be replaced, as they should be covered by the supplier`s insurance, but items furnished to storm refugees while they are in temporary housing may be covered under the rule that applies to temporary replacements furnished while repairs are made to beneficiary-owned equipment. We will let you know as soon as we get any additional information.  
   
   
9/9/2005  Congress postpones cuts to Medicaid program  
   
  WASHINGTON (Reuters Health) -

In the wake of Hurricane Katrina, lawmakers in Washington have shelved -- at least temporarily -- plans to reduce spending on the massive Medicaid health program for the poor.

The cuts of $10 billion were to be part of broader budget deficit-reduction legislation due September 16. But U.S. House Speaker Dennis Hastert told reporters that lawmakers` first priority is dealing with the immediate aftermath of the monster storm that has displaced hundreds of thousands of Americans in the states of Louisiana, Mississippi, and Alabama.

As a result, he said, "there has to be some type of delay" in drafting the budget legislation.

House leaders say they have pushed back the September 16 deadline by two weeks. The Senate was expected to announce a similar delay later on Wednesday.

But there is another reason for the delay besides the need to provide immediate relief to hurricane victims --even some Republican lawmakers say it would be bad public relations to cut Medicaid when so many poor people were disproportionately, and visibly on national television, affected by the hurricane.

"This is not the time to take on Medicaid, nor other entitlements for the poor," said Republican Sen. Gordon Smith (news, bio, voting record) of Oregon, a member of the Senate committee charged with making the cuts.

Indeed, a letter signed by Smith and fellow Finance Committee Republican Olympia Snowe of Maine suggests that the committee does not even have enough votes for the changes, since all the panel`s Democrats have already voiced their opposition.

The letter sent late Tuesday to Senate Finance Chairman Charles Grassley of Iowa asked him to postpone "indefinitely" cuts to Medicaid and other programs for the poor that the panel oversees.

"At a time when millions are displaced and seeking federal and state assistance, we believe it is inappropriate to move forward on that portion of a legislative package that would cut programs like Medicaid, Food Stamps, WIC (a food program for pregnant women and children), housing and education," the letter said.

Other Republicans, however, said that while the federal government may well end up spending more on Medicaid to help the hurricane victims, it is important to proceed with the budget legislation as well. Said House Budget Committee Chairman Jim Nussle, Republican of Iowa, "We`re not cutting Medicaid. We`re reforming government."

 
   
   
9/9/2005  Senator Mary Landrieu request for emergency items  
   
  Senator Kerry has received a request from Senator Mary Landrieu of Louisiana for emergency items in the wake of Hurricane Katrina. We are in the process of arranging a plane to deliver items from Boston to Louisiana on Sunday September 11.

Massport has set aside Hangar 10 as a drop-off location at Hanscom Airport.

They are specifically asking if any of our members can provide SURGICAL GLOVES AND MASKS.

Other specific needs include: MRE’s, canned goods, non-perishable food items, baby supplies, mosquito repellants, bleach and other cleaning
supplies, cases of bottled water, toiletries, individually boxed juice, individually wrapped snacks, rubber and heavy duty work gloves, dust masks, plastic utensils, and paper plates.

Senator Kerry, as well as Senator Landrieu and her constituents, would deeply appreciate any donation your organization can make to this effort.

Drop-Off Information for Kerry Relief Flight to Louisiana

Sunday, September 11, 2005

The Drop-off location is Hangar 10 at Hanscom Airfield.

Directions: Take I-95/Route 128 to Exit 30B (Route 2A West exit.) After approximately 1.5 miles, turn right at the blinking light. Get into the left lane, bear left at the fork. After the STOP sign, continue straight ahead and over a small hill. Follow the signs to Hanscom Field and the Civilian Terminal area.

The parking lot is on the left side of the road. Delivery drivers need to call Hanscom Operations at least one hour before arrival to get clearance to enter the airfield. That number is 617-212-6592.

The Kerry staffer on the ground is Will Johnson, cell 617-872-4714.

 
   
   
9/9/2005  New Capped Rental Episode Available for Evacuees 
   
  The GAMES association has just learned that CMS decided to allow Hurricane Katrina refugees who left capped rental items behind to begin new rental episodes for replacement equipment! Additional information on changes affecting evacuees is available at http://www.cms.hhs.gov/katrina and is updated daily at 2:00 PM EDT.

The availability of information on eligibility and CMN status is not as forthcoming as we were given to understand, with members reporting that no information would be shared unless the beneficiary was on the line. To learn as much as you can about the materials in the Common Working File, get the beneficiary on a three-way call to 866-270-4909. You will need the beneficiary`s old and new addresses, and their date of birth, at a minimum, if the HIC number is not available. Despite reports that HIPAA issues would not be allowed to prevent sharing sufficient information to facilitate getting services to evacuees, reports indicate that not everyone has gotten the word. Please report your experiences, so we can continue to work on any needed improvements.

Remember, you must file claims for hurricane victims on a paper form, (the old HCFA-1500), clearly marked DISASTER. For deliveries to any temporary residence, use the Place of Service code 04 (homeless shelter). You may file such claims without having the normally-required paperwork in advance, but you must plan on eventually obtaining essentially the same proof of medical necessity that is required for the products delivered.
 
   
   
9/8/2005  Hiring: Important I-9 Update 
   
  In the aftermath of Hurricane Katrina and with the many people who have been transported away from the areas of greatest storm devastation, many are trying to find work in Texas to North Carolina and Virginia or wherever they are now residing.

You might be wondering, "How can I hire these people if they don`t have the identification that I need for the I-9 Forms?"

Homeland Security provided the answer: The initial waiver is for 45 days beginning September 6, DHS will evaluate this again at the end of the 45 day period, and your staff will advise you somewhere around October 21, as to the agency`s view of the situation at that time.

Here is the link for the Homeland Security Press release:

http://www.dhs.gov/dhspublic/interapp/press_release/press_release_0735.xml

Press Releases


Notice Regarding I-9 Documentation Requirements for Hiring Hurricane Victims

For Immediate Release
Office of the Press Secretary
Contact: 202-282-8010
September 6, 2005

The Department of Homeland Security (DHS) announced today that it will not sanction employers for hiring victims of Hurricane Katrina who, at this time, are unable to provide documentation normally required under Section 274A of the Immigration and Nationality Act. DHS will not bring sanction actions against employers for hiring individuals evacuated or displaced as a result of Hurricane Katrina otherwise eligible for employment but who currently lack personal documents.

U.S. employers are responsible for completing and retaining Employment Eligibility Verification (I-9) Forms for individuals they hire for employment. This form requires employers to verify employment eligibility and establish identity through original documents presented by the employee. For victims of Hurricane Katrina, many individuals lack these documents as a result of being evacuated from their homes, loss or damage to personal items and records, and ongoing displacement in shelters and temporary housing. Additionally, as a result of the widespread damage and destruction to government facilities in the area affected by the hurricane it can be expected that many victims will be unable to apply and receive new documents in the period of time required by the employment verification rules.

Therefore, the Department of Homeland Security will refrain from initiating employer sanction enforcement actions for the next 45 days for civil violations, under Section 274A of the Immigration and Nationality Act, with regard to individuals who are currently unable to provide identity and eligibility documents as a result of the hurricane. Employers will still need to complete the Employment Eligibility Verification (I-9) Form as much as possible but should note at this time that the documentation normally required is not available due to the events involving Hurricane Katrina. At the end of 45 days, the Department of Homeland Security will review this policy and make further recommendations.

--------------------

Mark Higley
The VGM Group
800-642-6065

 
   
   
9/8/2005  Wisconsin donation information 
   
  I just got word that Green Bay Community Church is working with another church in Baton Rouge to provide supplies, equipment, etc. Schneider Transport has donated the semi truck and the transport of these items. The first trailer will be leaving by the end of next week. At this point they say that it might be too soon for certain items to have them arrive any sooner. Anyway, if anyone is interested in donating items (most needed are wheelchairs), please drop off at the Green Bay Community Church, 600 Cardinal Lane, Green Bay, WI, or call Sue Witburroh at 920-865-6564 (home) or 920-655-3343 (cell), or let me know.



Michael R. Tracey
HME Manager
Bay Pharmacy
Sturgeon Bay, WI 54235
(920) 746-2977 ext 136
 
   
   
9/7/2005  Problems with Red Cross, others accepting HME for donation 
   
  Anyone interested in helping to get equipment to the Gulf? I have tried fro the past week to send equipment south and no one will take it. The local Red Cross chapter had a trailer here on Friday for donations and we drooped off 4 hospital beds, 5 wheelchairs, 4 walkers, 4 pairs of crutches and misc. supplies and we got all of it back yesterday. They said they wouldn`t take that bulky stuff down there and that it wasn`t needed. I know that the stuff is needed, we just need figure out how to get it down there. Anyone have any ideas?



Michael R. Tracey
HME Manager
Bay Pharmacy
Sturgeon Bay, WI 54235
(920) 746-2977 ext 136


(or call or email Mark Higley at VGM at 800.642.6065/mark.higley@vgm.com)

=========

(update): Hi Everyone, I would be willing to drive our box truck (17 ft.) down to deliver whatever we want to send. Thanks, Bill Stelzer [bill@gbhme.com]


 
   
   
9/7/2005  Hurricane Katrina: Respironics Responds 
   
 
Hurricane Katrina is one of the biggest and most devastating natural disasters to hit the United States in recent history. The impact of the storm has left a path of destruction that is difficult to comprehend. During this challenging time, it is important for us to come together as individuals, as a community, and as a nation to help those less fortunate.

Respironics feels compelled to contribute to those in need. As you learned, we are working with our associates in that region to assist with temporary housing, transportation, and any other needs as they arise. We are thankful that they are safe, but understand that it will take a while for them to rebuild their homes and their lives.

On a larger scale, the Company is taking several measures to assist with relief efforts. First, on behalf of all of our associates, Respironics has made a donation to the American Red Cross. Second, we are donating our products throughout the impacted areas. We have already provided oxygen concentrators and pulse oximeters to a triage center at Louisiana State University, and plan to send PLV Continuums, CPAP and BiPAP units, additional concentrators and oximeters, and nebulizers to aid victims requiring medical support. Additionally, we are currently awaiting confirmation from the Federal Emergency Management Agency (FEMA) regarding a shipment of 100 nebulizers for use by individuals sheltered in the Houston Astro Dome. Be assured that we will continue to supply products to victims of the disaster through our distributors and federal agencies as they are needed.

Please keep our Respironics associates and their families, as well as all the people displaced by Hurricane Katrina, in your thoughts. I will keep you posted regarding any additional information related to this issue as it becomes available.

Thank you.


Sincerely,

John L. Miclot
 
   
   
9/7/2005  Hospice Home Care, Inc. Provides For Hurricane Victims in Arkansas  
   
  Many of the evacuees were not in good health before Hurricane Katrina hit, and Arkansas` Hospice Centers have been on standby waiting to receive terminally ill patients from Louisiana.
Hospice Home Care, Inc., a Little Rock based compay serving 33 counties in Arkansas, has received advance approval from Governor Huckabee to open a Conway, AR facility to care for these patients. Hospice Centers across the state also said that they are in a critical need of volunteers to help transport Louisiana patients to waiting beds.

"Transportation is the problem from what I`ve understood, and what I`ve seen it is a logistical nightmare," says, Tyler West, of Hospice Home Care, Inc.

If you can assist in transporting terminally ill patients you can call Hospice Home Care at 501-666-9697.

 
   
   
9/7/2005  State Leaders Call - Friday September 9 at 2PM! 
   
  To All,

We would like to have a special State Leaders Call to focus on the issues that the homecare community is facing in the Gulf Region and how we may be able to help with the efforts. The call will take place on Friday September 9 at 2PM! The call in phone number is 888-872-2038 and the pass code is 6677, additional information to follow by tomorrow afternoon. We look forward to speaking with all
those who can attend.

Best Regards,

Tucker Ophof
American Association for Homecare
625 Slaters Lane, Suite 200
Alexandria, VA 20134
Phone: 703-535-1882
TuckerO@aahomecare.org
FAX: 703-836-6730
 
   
   
9/7/2005  Discussion Board Request 
   
  Mark,

Why not have a labor pool of people that worked in the HME business down in the hurricane area and are no longer working due to the destruction and loss of jobs. Could you form a labor bulletin board of job postings?

It could be an employer looking for trained labor for the office or delivery tech. etc. The second part could be a posting of job skills and experience, looking for a job.

This way, if an employer was looking to fill a position or help with a temp. type job, the two parties could get together. Possibly the employer that was looking for a trained person could also be helpful in finding the person and their family a place to stay. If the family was being taken care of locally, it would give the bread winner a job to go to and have some income.

VGM and its dealer network may be able to help. I know that I would post a job opening with your service or would go to your site and see what type of labor pool was available before I went out to the local community and had to try to find and train a new employee.

Please give me your thoughts.

Regards,

Wayne Knewasser
Premier Home Care Inc.
Louisville, KY


-------------------------------------
(Note - please see updates on the discussion board at http://ubb.vgm.com/cgi-bin/ultimatebb.cgi  
   
   
9/7/2005  Important Reminder for HME Medicare Billing Claims 
   
  In servicing beneficiaries that have been impacted by Hurricane Katrina, HME suppliers are facing dilemmas regarding beneficiaries that have relocated from affected areas and are now contacting new suppliers for their supplies and/or durable medical equipment.

Not only do the new physicians and suppliers not know these beneficiaries, but they cannot get in touch with the original suppliers and physicians to obtain such information as certificates of medical necessity (CMNs), detailed written orders, etc.

HME Suppliers are reminded to exhaust all avenues to obtain medical documentation as outlined by the local coverage determination of the item being billed. If required documentation cannot be obtained, suppliers can dispense the item(s), submit a claim for the item, and obtain the necessary documentation at a later date. Please note that this procedure should ONLY be followed when servicing beneficiaries that have been impacted by Hurricane Katrina.

HME Suppliers should submit these claims hardcopy, and should indicate at the top of the claim in bold letters, "Disaster Claim" and include a statement regarding the nature of the disaster, i.e, "Hurricane Katrina".
 
   
   
9/6/2005  HHS Releases Website and Toll Free Number for Deployment by Health Care Professionals 
   
  The Department of Health and Human Services has established a website (<https://volunteer.hhs.gov>) and toll-free number (1-866-KAT MEDI) to help identify health care professionals and relief personnel to assist in Hurricane Katrina relief efforts

The desire of America`s health care professionals to use their skills to help Hurricane Katrina`s victims has been inspiring,” Secretary Mike Leavitt said. "This website and toll free number are important tools to become part of this network of goodness that is taking place

Multidisciplinary healthcare professionals and relief personnel with expertise in the following areas are encouraged to visit the website and register to volunteer for appointment by HHS

  • Administration/Finance Officers Morticians

  • Chaplain Mortuary Assistants*

  • Clinical Physicians Nursing Assistants/Nursing Support Technicians

  • Coroners* Nursing Staff Directors

  • Dental Forensics* Paramedics*

  • Dentists Patient Transporters/Volunteers

  • Dieticians Pharmacists

  • EMT* Psychologists

  • Environmental Health Physician`s Assistants or Nurse Practitioners

  • Epidemiologists Physician Chiefs of Staff

  • Facility Managers Radiologic Technicians*

  • Housekeepers Respiratory Therapists

  • IT/Communications Officers RNs

  • Laboratory Technicians* Safety Officers

  • LPNs Security Officers

  • Medical Clerks Social Workers

  • Medical Examiners* Supply Managers

  • Mental Health Workers Veterinarians

*These categories added as of September 5, 2005.

Please be advised that individuals must be healthy enough to function under field conditions.
This may include all or some of the following:
  • 12 hour shifts

  • Austere conditions (possibly no showers, housing in tents)

  • No air conditioning

  • Long periods of standing

  • Sleep accommodations on bed roll

  • Military ready to eat meals

  • Portable toilets

These workers will be non-paid temporary Federal employees, and will therefore be eligible for coverage under the Federal Tort Claims Act for liability coverage and Workman’s Compensation when functioning as HHS employees. Although there will not be any salary, travel and per diem will be paid.

Volunteers with no healthcare background can find information on volunteering at www.USAFreedomCorps.gov or by calling 1-877-USA-CORPS.
Note: All HHS press releases, fact sheets and other press materials are available at www.hhs.gov/news. 
   
   
9/6/2005  HOME HEALTH ASSOCIATIONS OPEN RECOVERY CENTER AND FUND  
   
 
The home health associations in three states have created the Hurricane Katrina Homecare Recovery Fund and an associated recovery center in New Iberia, Louisiana.

The associations of Louisiana (HCLA), Mississippi (MAHC), and the Home Care Association of Alabama have collaborated to open the recovery account and center, both aimed at assisting homecare employees and their agencies. Donations should be tax deductible, as the 501-C3 organization is being associated with the Foundation for Homecare and Hospice. Thanks to the NAHC for making that possible.

The Hurricane Katrina Homecare Recovery Fund will be directed by homecare providers impacted by Katrina from Louisiana, Mississippi, and Alabama, an attorney, and two CPAs. Funds can be electronically transferred to the account by contacting the HomeCare Association of Louisiana at 800/283-4252. Arrangements are being made for donations to be made via credit card. Checks to the account can be made to the Hurricane Katrina Homecare Recovery Fund and mailed to:

Hurricane Katrina Homecare Recovery Fund
223 East Main St.
New Iberia, LA. 70560

Hurricane Katrina Homecare Recovery Center: The 2000 sq. foot office, 110 miles west of New Orleans, will provide work space at no cost to displaced homecare agencies to maintain and reconstitute their businesses electronically. Along with necessary office furniture, equipment, computers, high speed internet access, phone lines, a receptionist, etc., the Center will host visits for Palmetto GBA assistance and possible CMS visits.

Public health and disaster response specific to home health, will be provided to agencies by RBC Limited of New York. RBC is the recognized as the nation`s expert in homecare disaster response.
Friends from around the country have offered to send items needed to furnish the office.

Donations of office equipment, furniture, computers, and other necessities should be orchestrated through the HomeCare Association of Louisiana at 800/283-4252.

Julie Foley, RN, CHCE, a New Orleans resident, was hired to serve as the executive director of the Hurricane Katrina Homecare Recovery Center. Foley, a Certified Home and Hospice Care Executive, is assistant administrator of Ochsner Home Health Corporation, and is on loan to the Center while she is temporarily displaced from New Orleans. Foley will facilitate the processing of donations of office equipment, furniture, and other resources needed for the Center. She will also assist with communications related to services provided for her fellow homecare providers from areas impacted by Katrina. Julie and her children are temporarily living with family friends in Youngsville. Her husband John is a Captain with the New Orleans Fire Department and is still stationed in New Orleans assisting with evacuation and fire issues in the city.
 
   
   
9/6/2005  LA Pharmacy Supplies and DME Equipment Donations 
   
  LA Pharmacy Supplies and Durable Medical Equipment Donations


If you have Pharmacy Supplies and Durable Medical Equipment (DME) to donate, please contact:

La. State Board of Pharmacy
5615 Corporate Blvd. Suite 8-E
Baton Rouge, La. 70808
Steve Collins
Phone: (225) 925-6496
Cell: (225) 202-6820

email: scollins@labp.com

 
   
   
9/6/2005  Message From Louis Feuer 
   
  This message is from Louis Feuer, Customer Service and Sales & Marketing consultant, and long time friend of VGM and our members....

I just finished reading all of the member posts on the web site. So many touching stories and so much generosity from members and from VGM.

We will not solve this tragedy alone but with working together and helping members and the industry connect you have taken a big step on behalf of many desperate people!

I smiled when I read about all the providers willing to work together. If only we were doing that as much in good times, each company would have probably shown tremendous growth in their business.

We have been such a generous industry for so long, but I am afraid almost no one knew about it! Being a former customer, I realize and continue to be reminded of the great deeds of my clients. VGM needs to continue to highlight the generosity of its own good work and that of your members during this difficult times for so many of our colleagues and customers.

Louis

Louis Feuer, MA, MSW, President
Dynamic Seminars & Consulting, Inc.
www.DynamicSeminars.com
or Louis@DynamicSeminars.com - 954-435-8182

 
   
   
9/6/2005  Birmingham medical supply donations  
   
  ADMEA member Lee Conn reports that the American Red Cross has opened at least one center where medical supplies and equipment will be accepted, at The Summit, on Highway 280 at I-459 in Birmingham.

After refusing merchandise donations intitially, accepting only cash, it appears that transportation may be available for equipment.

Call your local Red Cross office for information.

The information about a collection point in MS that we published earlier was intended for use in shipping merchandise you wished to donate...we did not intend to suggest that anyone deliver to that point on your own vehicles.
 
   
   
9/6/2005  Update From VGM Member A & A Home Health Equipment re Greenville, MS Donations  
   
  As many readers know, on September 1, VGM distributed nationwide requests for donations of HME and supplies for the benefit of hurricane victims.

Our request for Greenville, Mississippi VGM member A&A Home Health Equipment was further distributed by many state and regional medical equipment associations and other industry entities and especially effective.

Here is an update and reply from A&A:

------------------------------------
9/2/05

Dear Mark,

Thank you for your desire to help. Let me brief you on what I know. In Greenville, we are the largest functioning city in the state. We have a large community effort to attempt to meet the mass # of people that are in need. We have a Warehouse owner that has donated 80,000 sq.ft of air-conditioned space for us to store products. We also have a trucking company that has volunteered to transport all items to the coast and surrounding areas. The surrounding areas that are being affected are unbelievable. Our staff that lives up to 180 miles from the coast is experiencing power outage, no fuel, limited food. This thing is unfathomable.

The coordinators of this effort in Greenville are keeping in touch with the Red Cross. We are providing them with a list of the inventory as it arrives. We are poised and ready to go with whatever they ask.

We are also looking for ways to get the product to the people in need. We are looking for ways to get through and are willing to send products with volunteers from our churches and comm. Service agencies to distribute. The huge problem right now is getting through.

As people flee from the most damaged areas, we are getting requests for all types of items for wheelchairs, glucose monitors and strips, diapers, food, clothing, pillows, blankets, cleaning supplies, etc.

The list of items needed is infinite. These people have nothing. The needs will be great and the duration for need may be months.

I cannot tell you at this point what specific needs are more crucial than others. Send what you can. Nothing you send will be