On October 24, 2017, the House Energy and Commerce Subcommittee on Oversight and Investigations held a hearing to examine HHS public health preparedness for and response to the 2017 hurricane season. The hearing addressed federal response, impact on patients, and impact on supply of critical medical products. Dr. Michael Burgess (R-TX) and Dr. Raul Ruiz (D-CA), members of the Oversight and Investigations Subcommittee, have each visited Puerto Rico to assess the public health situation. The Energy and Commerce Committee plans to hold a series of hearings on emergency preparedness, as it has jurisdiction over a wide range of response issues in addition to public health, including rebuilding the electric grid, addressing environmental cleanup, and restoring telecommunications.

The subcommittee heard testimony from the following witnesses:

• The Honorable Scott Gottlieb, M.D. - Commissioner, Food And Drug Administration (FDA)
• Ms. Kimberly Brandt - Principal Deputy Administrator for Operations at CMS
• The Honorable Robert Kadlec, M.D. - Assistant Secretary for Preparedness and Response (ASPR), HHS
• Rear Admiral Upper Half Stephen Redd, M.D. - Director of the Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention (CDC)

Witnesses outlined the extensive emergency response from the nearly simultaneous Category 4 and 5 hurricanes that hit the U.S. mainland and its territories. They outlined how HHS agencies, in coordination with the Federal Emergency Management Agency and the Department of Homeland Security, were able to identify and ensure treatment for Medicare and Medicaid beneficiaries who rely upon life-maintaining services such as dialysis and home-health services. In Puerto Rico, CMS was able to track the operational status of dialysis facilities and ensure sufficient fuel, water, and supplies were delivered to provide treatment for the nearly 6,000 patients on the island.

FDA Commissioner Gottlieb focused his testimony on the impact of Hurricane Maria on Puerto Rico, which has a number of facilities that manufacture medical products. According to Commissioner Gottlieb, more than 50 medical device manufacturing plants on the island produce more than 1,000 different kinds of devices, and 50 of these types of medical devices are both critically important to patient care and are only manufactured in Puerto Rico.   Commissioner Gottlieb commended the 90,000 medical product industry employees on the island who have worked to ensure operations continued, even as their own families were displaced.

Energy and Commerce Committee Chairman Greg Walden (D-OR) noted that on October 20, bipartisan Committee leaders sent a letter to the owner of the Rehabilitation Center at Hollywood Hills, Florida, where 14 elderly residents died after the facility’s air conditioning failed, following Hurricane Irma. Congressman Gus Bilirakis (R-FL) focused his questions on hospital preparedness programs, including the nursing home incident in Hollywood Hills. Ms. Brandt testified that this Rehabilitation Center has been terminated from participation in the Medicare and Medicaid programs due to “a complete management failure” that resulted in “several levels of … immediate jeopardy for patients.”  Last fall, CMS updated and improved the requirement that facilities have an emergency preparedness plan, that they train on that plan, and make sure all employees are aware of it. Ms. Brandt testified CMS will begin surveys on November 15, 2017 to evaluate compliance with these requirements.

A link to the hearing and accompanying documents can be found here.