UPDATE Aug.29 2:45 ET
The following is an update from Hurricane Irene-affected dialysis providers and ESRD Networks involved in a Kidney Community Emergency Response call on Aug. 29.
This information was gleaned from attendees and not requested or provided by KCER or CMS.
Networks
ESRD Network 1 of New England (Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island and Vermont) reported that its physical office is still not open. Its staff is working remotely and can only access their email but they have no other access to their server. Network 9/10 is providing backup assistance by contacting providers and offering technical support. The toll free line is being directed to Network 9/10.
All dialysis units are operating. Two units in Connecticut are without phone and Internet service, but they are open. Despite widescale flooding in Vermont, all units are open.
ESRD Network 2 of New York reported that there have been four storm related deaths but none were ESRD patients. The state is dealing with huge flooding and trasportation issues, but most of the New York City subways are now open again. One million people in New York are still witoiut power, as of the call time. More than half of new York's dialysis facilities are independent, so the Network staff has divided them up and they hope to have contacted all of them by the end of the day on Monday. So far, they report most are operational.
ESRD Network 3 of New Jersey, Puerto Rico and the U.S. Virgin Islands reported that its office is unaffected by the storm.Two facilites in New Jersey and one on Delaware are flooded and might be closed for weeks. Two more facilities are fine but cannot be reached because of transportation and flooding issues. Three Fresenius units are down.
ESRD Network 4 of Pennsylvania and Delaware reported that its office is fully operational. All facilities have power and some had interrupted service, but all are open now.
ESRD Network 5 of Virginia, West Virginia, Maryland, District of Columbia reported that it is fully operational. Phone lines were down but are up now. Six facilities closed primarily due to power outages, no flooding or structural damage, and all patients have been redirected.
ESRD Network 6 of North Carolina, South Carolina, and Georgia reported that a lot of the areas is without power. All dialysis centers are open. The few dialysis patients who live on Hatteras Island off the North Carolina coast, which is currently cut off from the main land, had evacuated inland prior to the storm.
Dialysis providers
Fresenius reported that between 6 and 10am 65 patient calls, all checking on the status of clinics. Four clinics are not opearating , and they hope three of them should open by the afternoon. One was flooded but they said they hope it will be open son.
DaVita reported that eight facilities are running on generator power and
12 are closed due to no power.
Dialysis Clinic Inc. reported that one Long Island clinic closed due to power loss. All patients are dialyzing at adjacent hospital. Portable generators should open clinic tomorrow.
DSI reported all facilities are open.
American Renal Associatesreported that no clinics closed. and four are on generator power.
The Kidney Community Emergency Response Coalition provided an update based on an Aug. 28 call with ESRD Networks, dialysis providers, and kidney organizations.
Although in a weakened state, Irene continues to produce dangerous storm surge, flooding, heavy rainfall, and gusty winds. Initial reports indicate that approximately four million homes and business remain without power from the Carolinas up to the Northeast. In the wake of the storm, damage assessments are still ongoing and could take days as flooding, downed trees, and other debris hamper local, state, and federal efforts. As of this briefing, the Red Cross has mobilized 200 emergency response vehicles to assist in recovery efforts and with food distribution. In addition, 4,500 National Guard members have been activated and are supporting response and recovery efforts in 13 states. Information on the impact of Irene continues to change from hour to hour. KCER will hold another Hurricane Irene Response and Recovery Status Call at 1:30 pm Et on Monday, Aug. 29.
Network Reports
Network 1 of New England (Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island and Vermont) reported its primary office being without power and it has contacted a back-up Network to assist with fielding forwarded calls and other needs. As of the KCER meeting time, the Network reported that no information had been received from providers regarding closures. The Network representatives said that 29 towns in Connecticut have been evacuated and that 20 shelters in Massachusetts are open and functioning. Estimates of those without power in the region are 170,000 thought the number continues to change. Mass transit remains unopened for many locations in the region, as officials continue to survey damages.
The Network plans to conduct an environmental scan of providers and patients needs tomorrow and report finding at 1:30 p.m. call. The Network reports the server and router are not working and top priority to restore. Danielle Daily is currently serving as Network contact via either phone or e-mail access.)
ESRD Network 2 of New York reported damage assessments are ongoing in impacted areas. New York City Transit remains down and information on when transportation services will be restored is still be determine by city officials. Many subway tunnels have sustained flooding and widespread power outages were reported in Brooklyn, Queens, and Westchester among other boroughs and areas in the region. The Network sent an informative triage letter to shelters in the service region, intended to help shelter staff locate dialysis patients needing care. The streets surrounding the Network office remain flooded and hope was that the building would be accessible later Sunday evening or Monday. The Network reported having an alternative plan to implement if office is unable to reopen by start of business on Monday.
Network 3 of New Jersey, Puerto Rico and the US Virgin Islands reported receiving substantial rainfall between 8-10 inches from Irene which resulted in creek and street flooding in many areas. Currently, an estimated 600,000 residences and businesses are without power. Network office was unable to be reached due to swollen creek beds in the area, but anticipation is that subsiding flood levels will allow access by Sunday afternoon. Network will be in touch with facilities, and expects several closures taking place on Monday. The Network will provide additional updates at during community status call on Monday.
Network 4 of Pennsylvania and Delaware reported approximately 300,000 residences and business were without power due to toppled power lines. The Network indicated it was still in the process of determining facility status, but will be following up and expects to have additional updates by tomorrow. In response to inquiry, Fresenius representative, Jide Salako shared that one facility in Delaware was potentially offline. Additionally, Mr. Salako confirmed that once available, a listing of all Fresenius facilities within impacted states unable to reopen will be e-mailed to Seth Holloway for further dissemination to CMS officials.
Network 5 of Virginia, West Virginia, Maryland, District of Columbia was not represented on the call. Back-up Network 14 shared that approximately 75% of Virginia’s population is without electricity. Network 5 was in the process of conducting a needs and impact assessment and may be able to report findings in the morning or by the next status call. Back-up Network 14 will take steps to check for Network 5 staff contact numbers for additional information.
Network 6 of North Carolina, South Carolina, and Georgia reported that Irene has passed the area and that currently some 300,000 residences and business remain without power; down from over 1 million as of yesterday. Prior to storm few facilities were planning to operate Sunday and had taken steps to prepare patients in advance. The Network will be conducting additional follow-up with facilities on Monday to further determine operability and status. Additionally, the Network shared that some facilities are operating on generator power.
Providers
Fresenius reported having received calls from 12 patients looking for information on the open/closed status of their clinics for Monday. If a clinic was found to not be operational alternative arrangements were made with patient for treatment at another clinic. In addition, provider representatives reported finding some minor leaks at a few facilities and that actions were being taken to fix any such issues. It is anticipated that some facilities will not be open by tomorrow, but additional information will be available by the next meeting call, as facility assessments are anticipated for completion by tonight. Any new information will be made available at the community call held at 1:30 p.m. EST tomorrow afternoon.
DaVita reported that three clinics in North Carolina and one in Virginia are currently without power. The representative also shared information that a few facilities have sustained minor damage, which will be repaired and should not impede patient access to treatment.
DCI reported no calls to its emergency hotline. Assessment of facilities is ongoing and additional information will be available by tomorrow’s meeting.
DSI reported New Jersey facilities have access to power and that overall facilities have held up well. Facility assessments will continue into tomorrow and will be shared during the next community meeting.
Kidney Organizations and Associations
ANNA shared that five clinical practitioners have thus far indicated a willingness to assist with storm related recovery and relief needs. Additional volunteer interest is also beginning to occur.
NKF reported that many staff are in evacuated areas and that efforts to reestablish contact are ongoing. Organization has a meeting scheduled for Monday morning to communicate with staff and determine next steps.
KCER will hold another Hurricane Irene Response and Recovery Status Call at 1:30 pm Et on Monday, Aug. 29.