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THIS MESSAGE INTENDED FOR WIDEST DISTRIBUTION
September 20, 2018
HPH Sector Members,  

ASPR CIP and the HPH Sector continues to monitor healthcare and public health critical infrastructure impacts from Florence throughout the east coast. 

While little to no additional precipitation is forecasted for North or South Carolina through the weekend potentials for flooding remains high and poses continues threats to the areas. 
The HPH Sector 2018 Hurricane Response Dashboard continues to provide resources to assist our partners and stakeholders in their preparedness and response efforts.  Additionally, the FEMA National Business Emergency Operations Center (NBEOC) is maintaining situational awareness and engagement for the private sector through their Atlantic Dashboard. 
Daily conference calls are being hosted by the NBEOC. For more information, email NBEOC@fema.dhs.gov. Please note the dial-in number has changed. 
Time: 3:00 - 4:00 p.m. ET
Dial-in: 1-888-789-0244
Passcode: 9132924
If you have any reports of impacts or disruptions to healthcare and public health critical infrastructure, or have any requests for information or resources, email ASPR CIP at CIP@hhs.gov. 

Table of Contents
•	Road Closure Status Resources
•	Healthcare Recovery Systems Guide
•	State Updates
•	Virtual Resources

Road Closure Status Resources
Below are links to resources for tracking the status of road accessibility: 
•	 In North Carolina, approximately 1,100 roads closed due to flooding; to include closures on I-95 and I-40; road conditions expected to deteriorate over the next few days. A complete guide to North Carolina road closures is available via NCDOT. 
•	In South Carolina: All lanes of I-95 open; subject to change based on condition; multiple additional road closures to include portions of: US-501, US-76, SC-9.
•	SCDOT has developed a complete guide to South Carolina road closures and a map that gives specific county and interstate road conditions.  
•	Specific road conditions in Virginia may be determined by calling 511 or at www.511Virginia.org. 
•	USACE's Trafficability Dashboard provides real time road status information (Internet Explorer recommended)  
•	Route Information Hotlines: NC: 1-877-368-4968; SC: 1-855-467-2368

Healthcare Recovery Systems Guide
As response efforts turn to recovery, please consult this ASPR-developed Healthcare Systems Recovery Guide. The document identifies common post-disaster recovery planning issues, proposes courses of action to assist long-term recovery and future response, and identifies relevant support resources. If you have any recovery-related questions or updates, email ASPR Recovery at disaster.recovery@hhs.gov. 

State Updates
Stay updated to states directly and indirectly impacted by Hurricane Florence through the FEMA website with links to all state and territorial emergency management agencies.
WEST VIRGINIA - Division of Homeland Security and Emergency Management
•	A blanket Special Hauling Authorization has been approved for Vehicles and Loads Delivering Relief Supplies (overweight and oversized loads).
VIRGINIA - Department of Emergency Management
•	The Stafford Act Emergency Declaration of September 10, 2018 and State of Emergency remain in effect. 
•	All ports are open for operations but cannot return to full operations until environmental conditions allow and port assessments are completed.
•	Fuel blend waivers are in effect for Southern Virginia through September 30th. 
NORTH CAROLINA - Department of Public Safety 
•	The President issued a major disaster declaration, including Individual and Public Assistance, for North Carolina (DR-4393).
•	Ports of Wilmington and Morehead City open with restrictions .
•	All airports are open. 
•	National Urban Search and Rescue System actively engaged in rescue operations in support of state and local officials in coordination with Federal partners.  completed 802 evacuations, 185 rescues, 91 assistances, 5,183 shelter in place checks, and 518 animal evacuations to date 
•	Dam breaches: 4 confirmed, 4 unconfirmed; Levee breach: 1 confirmed; Dam overtoppings: 3 confirmed, 0 unconfirmed; Dam facilities with varying degrees of protective measures: 22
•	 9 river gauges currently in major flood stage 
•	Curfews in effect across 11 counties and 10 municipalities.
•	Healthcare facility update: North Carolina hospitals are all off generator with rapidly improving situation among nursing homes and dialysis facilities. 39 hospitals are in the affected area; 2 closed, 4 operating emergency departments only, all other hospitals open. 
SOUTH CAROLINA -  Emergency Management Division
•	The President issued a major disaster declaration, including Public Assistance, for South Carolina (DR-4394).
•	 National Urban Search and Rescue System completed 38 evacuations, 1 rescue, 6 assistances, 7 shelter in place checks, and 9 animal evacuations to date 
•	Dam breaches: 14 confirmed, 2 unconfirmed; Dam overtoppings: 8 confirmed, 2 unconfirmed; Dam facilities with varying degrees of protective measures: 6 
•	6 river gauges currently in major flood stage
•	Curfews in effect across 4 counties and 1 municipality 
•	Healthcare facility update: All South Carolina hospitals are open and accepting patients; nursing homes are generally stable; and all dialysis centers have re-opened. 

Virtual Resources
Tips for Retaining and Caring for Staff After a Disaster
A compilation of general promising practices—categorized by immediate and short-term needs—for facility executives to consider when trying to retain and care for staff after a disaster.
Hurricane Resources
Check out ASPR TRACIE’s Select Hurricane Related Resources (UPDATED) page for helpful resources in preparing for hurricanes and their aftermath (flooding, utility outages, etc.). Additional resources available through the TRACIE platform include Recovery Planning, Utility Failure Collection, After the Flood: Mold-Specific Resources, Considerations for Oxygen Therapy in Disasters, Durable Medical Equipment in Disasters, Exchange Issue 6: Evacuating Healthcare Facilities, Hurricane Resources at Your Fingertips,  Major Hurricanes: Potential Public Health and Medical Implications, Post-Disaster Lessons Learned: Dialysis Patient Management, Tips for Retaining and Caring for Staff after a Disaster, resources for healthcare facility continuity of operations plans and internal flood response plans (plans, templates, and guidelines), and SME perspectives on Essential Elements of Information (EEI) that healthcare coalitions can use in exercises or real world events.
Resources from the Field
•	This Emergency Management Healthcare Environment Checklist from The Joint Commission can help facilities with identifying fully functioning systems and processes to ensure full patient care delivery after an incident. This checklist is featured in the APSR TRACIE Healthcare Coalition Recovery Plan Template. 
•	If you are experiencing any challenges or have questions on 1135 waivers, you can contact your regional CMS office for assistance. Additional information is available through  ASPR TRACIE  or on CMS.gov and 1135 Waivers at a Glance.
•	 The South Carolina Department of Health and Environmental Control (SC DHEC) has activated their CareLine at 1-855-472-3432 to help connect people impacted by the storm with various health care services, including prenatal care, transportation to medical appointments, and Medicaid. More information can be found at: https://www.scdhec.gov/health/family-planning/family-planning-services/get-help-finding-services.   
•	Healthcare Ready continues their activation for Hurricane Florence response. They have opened Rx Open for east coast states to track the open and closure status of pharmacies. Sign up for alerts at the Healthcare Ready website.  
•	The FEMA Hurricane Incident Journal provides a view into relevant spatial decision-making support used by FEMA leadership and through the FEMA GeoPlatform. This information is also available to the general public.  
•	Power Resilience Emergency Response Checklist: Developed by HPH SCC member Powered for Patients. 
•	The National Voluntary Organizations Active in Disaster (NVOAD) offers guidance on best practices for volunteering and donating. Consult the North Carolina VOAD and the South Carolina VOAD sites for more information. 
Twitter
•	Humanity Road – Includes a summary of evacuation centers and alerts.  
•	FEMA - Up to date notifications of storm impacts and on island activities
•	FEMA Happening Now - Additional up to date notifications of storm impacts and on island activities
•	Hawaii Emergency Management Agency
Facebook
•	NOAA NWS National Hurricane Center
YouTube
•	Hurricane Preparedness – What You Should Know