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Second Appeal Letter
PA ID# 000-UEGG4-00; Lake-Sumter Emergency Medical Services, Inc.
PW ID# 915, 183,193 & 73; Ambulance staging costs
June 28, 2012
Bryan W. Koon
Florida Division of Emergency Management
2555 Shumard Oak Boulevard
Tallahassee, Florida 32399-2100
Re: Second Appeals – Lake-Sumter Emergency Medical Services, Inc., PA ID 000-UEGG4-00, Ambulance staging costs, FEMA-1539-DR-FL, Project Worksheet (PW) 915; FEMA-1545-DR-FL, PWs 183 and 193; and FEMA-1561-DR-FL, PW 73
Dear Mr. Koon,
This is in response to your May 16, 2011 letter, which transmitted the referenced second appeal on behalf of the Lake-Sumter Emergency Medical Services, Inc. (Applicant). The Applicant is appealing the Department of Homeland Security’s Federal Emergency Management Agency’s (FEMA) denial of labor and equipment costs and is requesting approval of $184,205.
In response to Hurricane Charley (FEMA-1539-DR-FL), Hurricane Frances (FEMA-1545-DR-FL) and Hurricane Jeanne (FEMA-1561-DR-FL) in 2004, the Applicant provided ambulance services to an evacuation shelter and an emergency response center in Lake and Sumter Counties. FEMA prepared and obligated PW 915 under FEMA-1539-DR-FL, PWs 183 and 193 under FEMA-1545-DR-FL, and PW 73 under FEMA-1561-DR-FL for a total of $438,504 to document the Applicant’s overtime labor and equipment usage for emergency protective measures. During a final inspection in December 2009, FEMA discovered that the obligated amount included $178,732 for services that patients and insurance providers had paid the Applicant. FEMA also determined that the overtime labor and equipment usage costs associated with time spent in stand-by status were not eligible. FEMA deobligated $363,693 for the duplicated costs and the ineligible costs associated with force account labor and equipment in stand-by and down-time status that were not directly involved in the performance of emergency protective measures.
The Applicant appealed this determination with three letters dated April 22, 2010 (FEMA-1539-DR-FL), March 22, 2010 (FEMA-1545-DR-FL), and April 19, 2010 (FEMA-1561-DR-FL). In the appeal letters, the Applicant asserted that the labor and equipment were not on standby but were pre-positioned in anticipation of the disaster. It further stated that having staged and ready to respond ambulances and labor is a prudent step in protecting public health and safety. The
FEMA Regional Administrator responded to the Applicant’s appeals with a letter dated September 9, 2010. The Regional Administrator explained that only the personnel and equipment costs for which the Applicant’s documentation demonstrates that the ambulances were utilized in the performance of emergency protective measures are eligible for reimbursement. In addition, the Regional Administrator indicated that the information provided by the Applicant showed that the requested costs included transportation and insurance expenses that were invoiced to patients and insurance providers. Section 312 of the Robert T. Stafford Disaster Relief and Emergency Assistance Act (Stafford Act) precludes FEMA from reimbursing any costs that have been billed to patients or insurance providers, even for bills that are unpaid.
The Grantee forwarded the Applicant’s second appeal to FEMA on May 16, 2011. In the appeal the Applicant contended that FEMA policy failed to clearly articulate the on-duty and downtime guidelines for applicants. It further asserted that FEMA cited policies that were published after the event as the rationale for the eligibility determination on labor costs. The Applicant also claimed that emergency medical personnel and equipment were performing emergency protective measures while on call, and even when they were not engaged in other eligible work. In support of the appeal, the Grantee stated that when the Emergency Medical Technician (EMT) crews were not responding to emergency calls, the crews were engaged in maintaining and inventorying supplies within the ambulance unit, training and upgrading skills, and traveling between various readiness locations.
Pursuant to Title 44 of the Code of Federal Regulations (44 CFR) §206.225(a)(3)(i), Emergency Work, in order to be eligible, the work must “eliminate or lessen immediate threats to li[f]e, public health or safety.” When supporting the evacuation or repatriation of patients at congregate shelters, as a result of the declared incident, the activation, staging and use of ambulances constitute emergency protective measures. The Applicant has submitted additional documentation that demonstrates that personnel and ambulances were directly supporting congregate shelters in the amount of $54,535. The following table summarizes the eligible emergency protective measures associated with congregate shelters. The Applicant supported 16 congregate shelters, staged and used 14 Ambulances in support of the congregate shelters, and accrued 1,802 force account labor hours for 47 personnel in support of these congregate shelters.
Summary table of eligible costs
Force account labor in support of congregate shelters
Force account equipment-Ambulances in support of congregate shelters
However, activities such as training, downtime and inventory of supplies do not qualify as emergency protective measures and the Applicant’s second appeal provides no additional information to demonstrate that these costs represent eligible work.
I have reviewed the information submitted with the appeal and have determined that the Applicant’s costs in the amount of $54,535 for emergency protective measures in support of congregate shelters are eligible. Accordingly, I am partially granting the second appeal. By copy of this letter, I am informing the Regional Administrator of my determination in order for him to implement this decision.
Please inform the Applicant of my decision. This determination is the final decision on this matter pursuant to 44 CFR §206.206, Appeals.
cc: Major P. May
FEMA Region IV