Appeal Summary | Appeal Letter | Back
Second Appeal Letter
PA ID# xxx-xxxxx-xx; The Sisters, Servants of Mary, Ministers to the Sick
DSR ID# xxxx; Facility Eligibility
December 26, 2006
Mr. Mark DeBosier
Infrastructure Branch Chief
Governors Office of Homeland Security
and Emergency Preparedness
7667 Independence Boulevard
Baton Rouge, LA 70806
Re: Second Appeal The Sisters, Servants of Mary, Ministers to the Sick, Facility Eligibility,
Dear Mr. DeBosier:
This is in response to your letter dated May 19, 2006, which transmitted the referenced second appeal on behalf of the Sisters, Servants of Mary, Ministers to the Sick (Applicant), a private nonprofit (PNP) organization that provides medical care to the sick and terminally ill at the patients home. The Applicant is appealing the Department of Homeland Securitys Federal Emergency Management Agencys (FEMAs) determination that the Applicant does not own or operate an eligible facility.
Hurricane Katrina damaged the Applicants convent, which also serves as an administrative and support building for the health care services it provides in the community. In denying eligibility, FEMA determined that the Applicant did not own or operate an eligible PNP facility as defined at 44 CFR §206.221(e).
The Applicant submitted its first appeal on December 21, 2005. The Applicant asserted that it provides medical services and FEMAs regulations are inclusive of administrative and support facilities essential to the operation of such medical facilities even if not contiguous per 44 CFR §206.221(e)(5). On January 23, 2006, FEMAs Disaster Recovery Manager (DRM) denied the appeal stating that there is no indication that the Applicant owns or operates a medical facility in which direct patient care is provided as defined in FEMA Policy 9521.3 Private Nonprofit Facility Eligibility
and 44 CFR §206.221(e)(5). The DRM further stated that the Applicants facility could not be considered an eligible administrative or support facility because the Applicant did not operate its own medical entities.
The Applicant submitted its second appeal on May 13, 2006, and reiterates the arguments of the first appeal. The Applicant claims its facility meets the regulatory definition of an eligible PNP medical facility, but also argues that it could be classified as a custodial care facility as defined at 44 CFR §206.221(e)(6).
FEMAs regulation at 44 CFR §206.221(e)(5) defines a medical facility as
any hospital, outpatient facility, rehabilitation facility, or facility for long term care as such terms are defined in Section 645 of the Public Health Service Act (42 U.S.C. 2910) and any similar facility offering diagnosis or treatment of mental or physical injury or disease, including the administrative and support facilities essential to the operation of such medical facilities even if not contiguous. A custodial care facility as defined at 44 CFR §206.221(e)(6) means those buildings, structures, or systems including those for essential administration and support, which are used to provide institutional care for persons who require close supervision and some physical constraints on their daily activities for their self protection, but do not require day-to-day medical care. These definitions link the eligibility of administrative and support facilities to facilities in which medical and custodial care is provided.
Based on a review of the information provided, the facility in question is a convent that provides housing and administrative space in support of the Applicants in home patient care services. The Applicant does not provide medical or custodial care services within this facility or another facility that it owns or operates. Without an associated medical or custodial care facility, as defined above, the administrative support facility is not eligible. Therefore, the Applicants second appeal is denied.
Please inform the Applicant of my decision. My determination constitutes the final decision on this matter as set forth in 44 CFR §206.206.
John R. DAraujo, Jr.
Director of Recovery
cc: William Peterson
FEMA Region VI
Infrastructure Branch Chief
FEMA LA Transitional Recovery Office