9525.4 Medical Care and Evacuations

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This policy is archived and has been superseded by the policy currently in effect.

  1. Date Published: August 17, 1999

  2. Response and Recovery Policy Number: 9525.4

  3. Title: Medical Care and Evacuations

  4. Purpose: This policy describes the circumstances under which applicants may request reimbursement for extraordinary measures taken to treat or evacuate disaster victims.

  5. Scope and Audience: This policy is applicable to all major disasters and emergencies declared on or after the publication of this policy. It is intended for Federal Emergency Management Agency (FEMA) personnel involved in making eligibility determinations for the Public Assistance Program. The policy addresses:

    1. Eligible medical facilities that have extraordinary costs for providing temporary facilities for emergency medical care to individuals, and

    2. Eligible hospitals and custodial facilities (e.g., nursing home) that need to evacuate individuals with special medical needs to another facility for care.

  6. Background:

    1. When the emergency medical delivery system within the designated disaster area is destroyed or severely compromised, the Federal government may provide emergency medical assistance directly to the area through a mechanism known as Direct Federal Assistance. In these cases, the costs of the emergency medical operation are paid by FEMA or the providing Federal agency.

    2. When medical facilities in a disaster area experience increased patient loads and operating costs, FEMA generally does not reimburse them for increased costs. However, FEMA will fund some emergency costs associated with providing additional facilities for emergency treatment in extraordinarily catastrophic disasters.

    3. In addition, there are emergency situations in which eligible public and private non-profit hospitals and custodial facilities (e.g., nursing homes) are adversely affected by the disaster and cannot provide proper care for their patients. When an evacuation is required, there may be eligible costs incurred by an eligible applicant in the evacuation and transportation of the patients. This policy outlines situations that may warrant reimbursement.

  7. Policy:

    1. Eligible Facilities. Only publicly owned and private non-profit (PNP) facilities are eligible to request compensation. Private for-profit organizations are not eligible applicants for public assistance grant funds for either emergency medical treatment facilities or for evacuations.

    2. Extraordinary Expenses to Provide Medical Care.

      1. Eligible costs must be associated with an eligible applicant providing temporary facilities for treating disaster victims when their existing facilities are overloaded and cannot accommodate the patient load. In most instances eligibility should be related to severe disaster circumstances such as mass casualties and a major threat to the health and safety of the community. Eligible costs may include the following:

        1. Temporary tents or portable buildings for treatment of disaster victims;

        2. Leased equipment for use in the temporary quarters;

        3. Security for the temporary treatment area.

      2. Ineligible costs include the following:

        1. Cost of emergency medical treatment of any kind (including vaccinations);

        2. Cost of follow-on treatment of disaster victims;

        3. Increased administrative and operational cost to the hospital due to increased patient load;

        4. Costs associated with loss of revenue.

Ineligible costs remain ineligible even if covered under mutual aid or other assistance agreements.

  1. Extraordinary Evacuation Expenses. Disasters can so seriously threaten or cause such severe damage to eligible medical and custodial facilities that the patients have to be evacuated and transported to either a temporary facility or an existing facility that has spare capacity. Operating costs in the new facility are the responsibility of the medical or nursing facility, as they would have been in the original facility. However, some costs associated with evacuation and transporting may be eligible.

    1. Eligible costs may include:

      1. Overtime for regular full time employees and extra hires to evacuate and assist in the transport of patients from the damaged facility;

      2. Transportation of the patients.

    2. Ineligible costs include:

      1. Medical staff to accompany the patients being transported.

      2. Medication for assisting the patients in their evacuation.

Ineligible costs remain ineligible even if covered under mutual aid or other assistance agreements.

  1. Supersession: Memorandum from G. Clay Hollister to Ken Hutchinson dated March 28, 1994; Subject: Request for Opinion, Special Needs Shelter Costs.

  2. Authorities: Section 403 and 502 of the Stafford Act; 44CFR 206.225.

  3. Originating Office: Infrastructure Division, Response and Recovery Directorate

  4. Review Date: Two years from date of publication

  5. Signature:

Lacy E. Suiter
Executive Associate Director
Response and Recovery Directorate

  1. Distribution: Regional Directors, Regional and Headquarters R & R Division Directors

Note: In the unlikely event that the purchase of equipment can be justified, salvage value will be taken against the eligible cost.

Last Updated: 
07/24/2014 - 16:00
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