Wildfire Response

The declaration increases access to health care and critical services for those impacted by wildfires. It will speed refills or replacements for medication and medical supplies, reduce paperwork and authorization requirements for providers, allow for alternative care settings and temporarily relax other requirements.

The public health emergency covers the same areas as the federal emergency declaration Washington received on Aug. 4 — Chelan, Ferry, Okanogan, Spokane, Stevens and Yakima counties, as well as the Confederated Tribes and Bands of the Yakama Nation, Confederated Tribes of the Colville Reservation and the Spokane Tribe of Indians.  

The Washington State Department of Health, Department of Social and Health Services and the Health Care Authority have been coordinating closely to help Washingtonians impacted by the wildfires and ensure they can still access essential health care since the wildfires began.

State agencies are also working in coordination with Tribal governments and Tribal health partners to identify and respond to urgent health care needs in tribal communities affected by the wildfires.

The declaration allows agencies to address service disruptions quickly and help health care providers serving individuals enrolled in Medicaid and Medicare in wildfire-impacted communities.

Some of the specific changes it authorizes:

• People who have been displaced can receive home health services in alternative locations like temporary shelters, hotels and places other than their homes.
• Individuals who have lost respiratory or other medication or medical supplies can get replacements much faster.
• Hospitals can set up temporary or alternative care sites or locations to treat patients, including virtual options.
• Care and safety come first and paperwork comes second. Providers and patients will have less paperwork because pre-authorization requirements for medicine or treatment can be paused.

The public health emergency declaration also helps older adults and people with disabilities maintain access to rehabilitation services, skilled nursing and assistance with medication, bathing, dressing and mobility as well as shopping, meal preparation and housekeeping.

In addition, the Department of Health can adjust requirements like facility inspections, credentialing and reporting timelines. This eases the administrative burden on health care providers in fire-affected areas, helping them maintain access while focusing on the people they serve.

Determination that a Public Health Emergency Exists in the State of Washington as a Result of the Consequences of Wildfires | ASPR

Public Health Emergency | Washington Wildfires

As a result of the consequences of wildfires in the State of Washington, on this date and after consultation with public health officials as necessary, I, Robert F. Kennedy, Jr., Secretary of Health and Human Services, pursuant to the authority vested in me under section 319 of the Public Health Service Act, do hereby determine that a public health emergency exists and has existed since August 1, 2026, in the State of Washington.

Waiver or Modification of Requirements Under Section 1135 | Washington Wildfires

August 7, 2026 
 

1. Pursuant to section 1135(b) of the Social Security Act (the Act) (42 U.S.C. § 1320b-5), I, Robert F. Kennedy, Jr., Secretary of Health and Human Services, hereby waive or modify the following requirements of titles XVIII, XIX, and XXI of the Act and regulations thereunder, and the following requirements of Title XI of the Act, and regulations thereunder, insofar as they relate to Titles XVIII, XIX, and XXI of the Act, but in each case, only to the extent necessary, as determined by the Centers for Medicare & Medicaid Services, to ensure that sufficient health care items and services are available to meet the needs of individuals enrolled in the Medicare, Medicaid, and CHIP programs and to ensure that health care providers that furnish such items and services in good faith, but are unable to comply with one or more of these requirements as a result of the consequences of wildfires, may be reimbursed for such items and services and exempted from sanctions for such noncompliance, absent any determination of fraud or abuse:
   1. Certain conditions of participation, certification requirements, program participation or similar requirements for individual health care providers or types of health care providers, including as applicable, a hospital or other provider of services, a physician or other health care practitioner or professional, a health care facility, or a supplier of health care items or services, and pre-approval requirements.
   2. Requirements that physicians or other health care professionals hold licenses in the State in which they provide services, if they have an equivalent license from another State (and are not affirmatively barred from practice in that State or any State a part of which is included in the emergency area).
   3. Sanctions under section 1867 of the Act (the Emergency Medical Treatment and Labor Act, or EMTALA) for the direction or relocation of  an individual to another location to receive medical screening pursuant to an appropriate state emergency preparedness plan or for the transfer of an individual who has not been stabilized if the transfer is necessitated by the circumstances of the declared federal public health emergency for wildfires.
   4. Sanctions under section 1877(g) of the Act (relating to limitations on physician referral) under such conditions and in such circumstances as the Centers for Medicare & Medicaid Services determines appropriate.
   5. Limitations on payments under section 1851(i) of the Act for health care items and services furnished to individuals enrolled in a Medicare Advantage plan by health care professionals or facilities not included in the plan’s network
2. Pursuant to section 1135(b)(7) of the Act, I hereby waive sanctions and penalties arising from noncompliance with the following provisions of the HIPAA privacy regulations: (a) the requirements to obtain a patient’s agreement to speak with family members or friends or to honor a patient’s request to opt out of the facility directory (as set forth in 45 C.F.R. § 164.510); (b) the requirement to distribute a notice of privacy practices (as set forth in 45 C.F.R. § 164.520); and (c) the patient’s right to request privacy restrictions or confidential communications (as set forth in 45 C.F.R. § 164.522); but in each case, only with respect to hospitals in the designated geographic area that have hospital disaster protocols in operation during the time the waiver is in effect
3. Pursuant to section 1135(b)(5) of the Act, I also hereby modify deadlines and timetables and for the performance of required activities, but only to the extent necessary, as determined by the Centers for Medicare & Medicaid Services, to ensure that sufficient health care items and services are available to meet the needs of individuals enrolled in the Medicare, Medicaid, and CHIP programs and to ensure that health care providers that furnish such items and services in good faith, but are unable to comply with one or more of these requirements as a result of wildfires, may be reimbursed for such items and services and exempted from sanctions for such noncompliance, absent any determination of fraud or abuse.

These waivers and modifications will become effective on August 10, 2026, but will have retroactive effect to August 1, 2026, in the State of Washington, and continue through the period described in section 1135(e) of the Act. Notwithstanding the foregoing, the waivers described in paragraphs 1(c) and 2 above are in effect for a period of time not to exceed 72 hours from implementation of a hospital disaster protocol but not beyond the period described in section 1135(e) of the Act, and such waivers are not effective with respect to any action taken thereunder that discriminates among individuals on the basis of their source of payment or their ability to pay

The waivers and modifications described herein apply in the geographic area covered by the President’s declaration, pursuant to the Robert T. Stafford Disaster Relief and Emergency Assistance Act, of an emergency as a result of wildfires, on August 4, 2026, in the State of Washington; and my August 7, 2026, determination, pursuant to section 319 of the Public Health Service Act, that a public health emergency exists and has existed as a result of the consequences of wildfires since August 1, 2026, in the State of Washington.

In response to the fire activity, HCA has established a Wildfire Response Information page to help Apple Health and PEBB/SEBB clients navigate to any health care resources they may need from the state.

• Supports for Apple Health (Medicaid) Clients
  • HCA has been coordinating with MCOs and in-region providers who are impacted, to determine any opportunities to support communities.

• • HCA has authorized pharmacies to furnish medications and supplies to Apple Health (AH) clients as needed, if any such products have been lost, destroyed, or have become inaccessible due to wildfire conditions. HCA has also communicated with pharmacies to guarantee payment on claims that meet our emergency fill policy.
  • HCA is working with MCOs to waive prior authorization for durable medical equipment and necessary expedited services.
  • All MCOs are reaching out to members and providers in the affected areas to support care coordination needs.
• Tribal Coordination
  • HCA’s Office of Tribal Affairs is actively tracking the impact of fires to Tribes in Colville, Yakima, and Spokane.
  • HCA has reached out to Tribal elected officials and health leadership to ask for any emergent needs that HCA can help with and informing Tribes of updated processes for supporting prescriptions and other care needs.
  • HCA is exploring utilization of grant contract funds to support emergency community needs.
• Behavioral Health Support
  • HCA is actively coordinating with the Spokane Behavioral Health Administrative Services Organization (BH-ASO) to support the local BH crisis system and any challenges they may face.
  • HCA has confirmed that the crisis system is still intact and supporting mobile crisis as calls come in, with the exception of level 2 and 3 evacuation zones.
  • Opioid Treatment Providers near the go-now area are authorizing take home doses for clients.
• Supports for PEBB/SEBB Enrollees
  • Alerts have gone out to consumers and health carrier contractors (Premera, UnitedHealthcare, and Kaiser Permanente) are updating websites with information on how to access care during a wildfire.
  • Regence (UMP administrator) is providing assistance in navigating to appropriate sites of care when hospitals or clinics may be closed as a result of the disaster.  Virtual care services are also a valuable resource and will be offered when appropriate.

• • Importantly, under federal and state balance billing protections, all emergency services are covered at the in-network benefit level, even if the hospital is a non-contracted provider.

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• Questions for HCA can be directed to Evan Klein, Special Assistant, Legislative & Policy, [email protected]

Apple Health Emergency Fill Policy 

In response to the wildfires occurring in Washington, Health Care Authority is authorizing Apple Health (Medicaid) Fee-for-Service pharmacy providers to furnish medications and supplies to clients as needed, if such products have been lost, destroyed, or have become inaccessible due to wildfire conditions.

Pharmacy Quality Assurance Commission state on continuity of care under emergency proclamation

The Pharmacy Quality Assurance Commission is aware of the devastating impacts of the wildfires in the Spokane area. As a reminder, WAC 246-945-332 states: “When the governor issues an emergency proclamation for an event which prevents continuity of health care for persons and animals because their prescribed medications are no longer available to them due to the emergency event, pharmacists and pharmacies may provide emergency prescription supplies for medications during the period of the proclaimed emergency” as provided in WAC 246-945-332.

On August 1, 2026, Governor Ferguson declared a statewide state of emergency due to the wildfires in Washington state and extreme weather conditions. WAC 246-945-332 may be utilized during the declared state of emergency as outlined above.

• If a pharmacy claim rejects for refill-too-soon, pharmacies should resubmit the claim indicating the previous fill was lost, destroyed or inaccessible by entering a value of 5 in the Prior Authorization Type Code NCPDP field (461-EU).
• If the medication requires authorization and the dispensing pharmacists determines there is an urgent need, the pharmacy may dispense as an emergency fill.

Moda/ArrayRX (Pharmacy for UMP) has an alert on their website: ArrayRx UMP

• Members evacuating because of a natural disaster may receive an early prescription refill at a network pharmacy.
• Ardon (specialty drugs) is prepared to handle members affected by the Spokane wildfires on a case-by-case basis to ensure access to needed specialty medications. Ardon will work closely with members to identify available options and help coordinate access to their medication.
• Members will be reimbursed at the network rate when using a non-network pharmacy for emergency fills.
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If you qualified for Low Income Home Energy Assistance Program (LIHEAP) in the current program year and live in one of the impacted counties, these agencies may be able to assist with:

• Energy and utility bills
• Temporary shelter or shelter vouchers
• Transportation, food, and other emergency needs
• Air purifiers in counties covered under the wildfire State of Emergency
• Weatherization and home repairs

If you are in Spokane County, the Spokane Complex Wildfire Response Resources page, which has the option of machine translation, is available.

These are agencies serving wildfire-impacted regions:

Chelan‑Douglas Community Action Council (CDCAC)Serves: Chelan and Douglas Counties
Phone: 509‑662‑6156
Website: cdcac.org 

Northwest Community Action Center
Serves: Yakima County, South
Phone: 509-865-7630
Northwest Community Action Center

North Opportunities Industrialization Center of Washington
Serves: Adams, Grant, Yakima North
Phone: 509-248-6751
Website: oicofwa.org

Okanogan County Community Action Council (OCCAC)
Serves: Okanogan County
Phone: 509‑422‑4041
Website: occac.com

Rural Resources Community Action
Serves: Stevens, Ferry, Lincoln and Pend Oreille Counties
Phone: 509‑685‑6000
Website: RuralResources.org

Spokane Neighborhood Action Partners (SNAP)
Serves: Spokane County
Phone: 509‑456‑7627
Website: SnapWa.org

Commerce recognizes the sovereignty of tribes and their valuable partnership in leading wildfire response, recovery and long-term resilience efforts.

Key contacts

• Office of Tribal Realations: [email protected]
• Tribal Technical Assistance Lead: Bennett Hestmark [email protected]

Tribal resources

• Emergency Rapid Response Grants Program (ERR)
  Application: ERR Grant Funding Request
  Commerce contact: Nicole Patrick, [email protected]
• Tribal Climate Resilience Grant Program
  Commerce contact: Kylie Avery, [email protected] 

Other resources may be available to tribes, please reach out to [email protected] as needed. 

Commerce recognizes the vital contributions of local governments and community organizations in leading wildfire response, recovery, and long-term resilience efforts.

Program and contract managers will connect with grantees to:

• Identify program disruptions
• Provide flexibility on contract requirements where possible

Key contacts:

• Local organizations and other partners: [email protected]
• Current grantees: please contact your contract manager

Available funding: 

Commerce has funding available to tribes, local governments, and nonprofit organizations for wildfire disaster relief and recovery. Support includes:

• Emergency Rapid Response (ERR) Grants ($1+ million)
  • Funds available to restore essential community lifelines like food, water, sewer, power, transportation, communication, and shelter.
  • Eligible applicants: Local and Tribal governments
• Broadband Emergency Funding ($2.1 million available)
  • Repairs or replaces broadband infrastructure damaged by wildfire events.
  • Contact: [email protected]
• Traditional Emergency Funding ($7.1 million available)
  • For repairing or reconstructing essential facilities and infrastructure such as roads, water systems, stormwater, and bridges.
  • Eligible applicants: Local governments (Cities/Towns, Counties, Special Purpose Districts, and Quasi-municipal Organizations only)
  • Eligible systems: Roads/streets, bridges, domestic water, sanitary sewer, stormwater, solid waste/recycling/organics

Contact: [email protected]