Hurricane Irma - Disaster Response Resources

Flood-Damaged Medical Records

Many healthcare facilities and physician offices will be trying to recover and restore water-damaged paper and electronic records over the next weeks and months in the aftermath of Hurricane Irma. Before investigating potential damage to medical records:

• Make sure the PHI storage location is safe to enter.
• Call your general liability/property insurer for directions and recommendations.
• Execute business associate agreements with any vendor hired to help recover PHI.

Paper Records

The best thing for wet records is to handle them as little as possible and keep them from molding. Mold starts to grow quickly — within two to three days — so it is important to take action as soon as possible. In the meanwhile:

• Reduce the temperature and humidity and increase the circulation in the record storage area.
• If a professional document drying company cannot be contacted within 48 hours, place the records in a freezer.
  
  • Start with the wettest documents.
  • Do not open or clean the records.
  • Pack records tightly to avoid movement during transport.
  • Do not thaw the records without obtaining professional advice.

Document Drying/Restoration Resources

• AAFP: Recovering Flood-Damaged Records
• Conservation Center: Freezing and Drying of Book, Paper and Photographic Materials
• National Archives: Emergency Salvage of Flood Damaged Family Papers 

Document Drying/Restoration Vendors

There are many national and Florida document drying and restoration services. The Florida Department of State Division of Library and Information Services has collected an extensive list of disaster recovery vendors.

FLOOD-DAMAGED ELECTRONIC DRIVES & DEVICES

The National Archives and Records Administration and DriveSavers Data recovery make the following recommendations for managing water-damaged hard drives and devices:

• Don’t panic. Data can be recovered from water damaged drives and devices; however, the more quickly work can start on the data recovery, the greater the likelihood of success.
• Do not attempt to turn the drive/device on, which can make things worse.
• Do not rinse drives/devices in clean water.
• Send the drive/device to a data recovery service. If the device is battery-powered, remove the batteries before shipping. Leftover charge in the battery can increase corrosion.
  
  
  • Pack drives/devices well in boxes twice their size so they do not move or come in contact with other devices during shipping.
  • If the device/drive is wet, place it in a sealed container to maintain moisture. This keeps the components from further corroding.
  • If the device/drive has already been dried, do not put extra water in the sealed container.
  • Do not put your device/device into a drying agent such as rice or cat litter.
  • Handle the device as little as possible.

DriveSavers is one of many national data recovery companies. According to the DriveSavers website, free recovery service is available for victims of Hurricane Irma. Because exposure to water and air cause corrosion on electronic circuitry, Irma victims must contact DriveSavers and ship their device no later than September 30, 2017. There is a limit of one device per business or household. Customers needing additional recoveries, and those with multi-disk devices such as RAID, NAS and SAN devices, are eligible for a 50 percent discount off the regular service fees.

For more information, visit the company’s website at www.drivesaversdatarecovery.com.

Flood-Damaged Electronic Drives and Devices Resources

• DriveSavers Disaster Preparedness Data Safety Tips
• National Archives: Electronic Media – Hard Drives
• DriveSavers Data Recovery: Data Safety Advice for Hurricane Victims

Medical Information Privacy

While the HIPAA Privacy Rule is not suspended during a public health or other emergency, the Secretary of HHS has declared a public health emergency in Florida and exercised the authority to waive sanctions and penalties for certain HIPAA violations. The details are further discussed in the following documents:

• HHS: Release of Limited HIPAA Waiver During Irma
• AHIMA: Complying with the Privacy Rule during a Disaster Part 1
• AHIMA: Complying with the Privacy Rule during a Disaster Part 2

Flood Water Removal

There are numbers of vendors all over Florida that remove flood water from business properties. Contact your general liability insurer in case it has a preferred contractor.

Reconstructing the Medical Record

If you cannot salvage the medical records or otherwise reconstruct them via electronic data recovery you should recreate them to the best of your ability. Approach the various other entities that are storing your patients’ PHI in their own databases and record-keeping systems. For example, pharmacies, consultants, prior treating physicians, third party insurers, transcription services and hospitals most likely have PHI they can provide. The following strategies can facilitate the reconstruction process:

• Inform patients in writing of their PHI destruction.
  • Include the date and circumstances.
  • Describe attempts to reconstruct their records.
  • Send the patient a history form.
  • Invite the patient to contact you to provide additional information.
  • Keep a copy of the patient record in the patient’s new file.
• Date the reconstructed record with the current date.
• Identify the record as reconstructed PHI so there is no question as to whether the record is reconstructed or original.
• Contact third party insurers as soon as possible to determine whether they require attestation forms.
• Notify the Florida Board of Medicine of the approximate number of records that were lost or destroyed in Hurricane Irma and what actions have been taken in your restoration and reconstruction effort.
  
  

Documentation of the Destruction

Document the PHI record/data damage your recovery efforts, including:

• Describe the event (date, severity, duration, etc.).
• Describe the loss of PHI.
  • Construct a log of damaged or destroyed records.
• Include photograph/video records of the damage and copies of property insurance claims documentation.
• Describe efforts to reconstruct PHI.
• Enter a description of the event and reconstruction efforts into reconstructed patient records that includes what has happened specifically in that patient’s case, e.g., that a letter was sent with a health history form, that conversations took place with the patient/family in efforts to reconstruct the record, etc.

If affected PHI is requested, include documentation of PHI damage and recovery efforts with your response to the PHI request. 

Department of Health and Human Services Centers for Medicare and Medicaid Services (CMS) Waivers

The President declared a state of emergency for Florida and the HHS Secretary declared a Public Health Emergency for Florida, which allows for CMS programmatic waivers based on Section 1135 of the Social Security Act.  The Public Health Declaration and the Social Security Act waiver for Florida are effective as of 4:00 on September 9, 2017.

• Waiver or Modification of Requirements under Section 1135 of the Social Security Act
• Findings Concerning Section 1812(f) of the Social Security Act for Florida (relates to skilled nursing facilities)
• CMS: CERT Process for Handling a Provider’s Allegation of Medical Record Destruction 
• CMS: Policy for Handling Lost or Destroyed Documentation
  
  

The information provided on this website is intended as risk management advice. It does not constitute a legal opinion, nor is it a substitute for legal advice. Legal inquiries about topics covered on this website should be directed to an attorney.

Reference herein to any specific product, process, service, or entity does not necessarily constitute or imply the endorsement, recommendation, or favoring by the NORCAL Group of companies.

General Information Resources for FLORDIA Physicians

• Hurricane Season Public Health Preparedness, Response, and Recovery Guidance for Health Care Providers, Response and Recovery Workers, and Affected Communities
  
  
• Hurricane Resources at Your Fingertips
  
  
• State of Florida Division of Emergency Management
  
  
• State of Florida Division of Emergency Management disaster planning
  
  
• Florida Virtual Business Emergency Operations Center Resources for Businesses
  
  
• Florida Private Sector Hotline: 850-815-4925
  (The hotline is available for business inquiries about the storm, preparedness information and post-impact information.)
  
  
• Florida Special Needs Directory
  (for patients that will need special assistance during Hurricane Irma)
  
  
• Public Health Emergency Resources for Professionals
  
  
• FEMA: Hurricane Irma
  
  
• DHS Ready Check Hurricane Readiness Checklist
  
  
• Florida Health Information Exchange
  (If patients are seeking healthcare outside of their usual region or network of physicians, health information exchanges (HIEs) may provide access to a patient’s information at the point of care.)
  
  
• Interactive Map of Open Pharmacies in the areas affected by Hurricane Irma
  
  
• CDC Post-Hurricane Safety Advice for Healthcare Professionals