Emergency Work-Medical Transports

Appeal Brief Appeal Letter

Appeal Brief

DisasterFEMA-1551-DR
ApplicantEscambia County
Appeal TypeSecond
PA ID#033-99033-00
PW ID#Project Worksheets 861 and 992
Date Signed2007-08-14T04:00:00
Citation: FEMA-1551-DR-FL, Escambia County, FL, Emergency Work—Medical Transports

Cross-reference: Emergency Work, Medical Transports

Summary: From September 13-25, 2004, following landfall of Hurricane Ivan (FEMA-1551-DR-FL, 09/16/04), Escambia County (Applicant) dispatched ambulance crews staffed with Emergency Medical Technicians and paramedics to perform a variety of duties, including transporting citizens from homes to hospitals and other special needs shelters, and reporting on road conditions and potential law enforcement issues. The County requested $236,156.40 in reimbursement of personnel overtime and equipment costs associated with the deployment of these ambulance crews. FEMA prepared Project Worksheets (PWs) 861 and 992 for these costs, but did not approve funding as they were considered to cover ineligible work and costs associated with standby time, damage assessments, and costs typically covered by patient insurance. The Applicant submitted its first appeal on June 8, 2005. FEMA denied this appeal stating that the work performed did not meet the provisions of Section 403 of the Stafford Act. The Applicant submitted a second appeal on March 23, 2006, and provided detailed information identifying the duration of the transports to hospitals and congregate shelters that were not covered by insurance. Based on the additional information provided, it was determined that personnel overtime and equipment costs in the amount of $31,680.45 ($29,113.25 Federal share) were eligible for reimbursement. These costs represent the eligible costs associated with the citizen transports to hospitals and congregate shelters not covered by insurance proceeds.
Issues: 1. Has the Applicant demonstrated that some costs incurred are eligible for reimbursement under 44 CFR § 206.225?
2. Are the costs for standby time, reporting field conditions, and preparing
ambulances eligible for reimbursement?

Findings: 1. Yes.
2. No.

Rationale: Recovery Policies RP9525.4, Emergency Medical Care and Evacuations, and RP9525.7, Labor Costs – Emergency Work, 44 CFR § 206.225

Appeal Letter

August 14, 2007

Mr. W. Craig Fugate, Director
Division of Emergency Management
Department of Community Affairs, State of Florida
2555 Shumard Oak Blvd
Tallahassee, FL 32399-2100

Re: Second Appeal – Escambia County, FL, PA ID #033-99033-00
Emergency Work—Medical Transports FEMA-1551-DR-FL
Project Worksheets 861 and 992

Dear Mr. Fugate:

This is in response to a letter from your office dated March 23, 2006, transmitting the referenced second appeal on behalf of Escambia County (Applicant). The Applicant is appealing the Department of Homeland Security’s Federal Emergency Management Agency’s (FEMA’s) denial of $236,156.40 for labor and equipment costs related to Emergency Medical Services provided in the wake of Hurricane Ivan.
From September 13-25, 2004, following landfall of Hurricane Ivan, Escambia County dispatched ambulance crews staffed with Emergency Medical Technicians and paramedics to perform a variety of duties, including transporting citizens from homes to hospitals and other special needs shelters, and reporting on road conditions and potential law enforcement issues. The County requested $236,156.40 in reimbursement of personnel overtime and equipment costs associated with the deployment of these ambulance crews.
FEMA prepared Project Worksheets (PWs) 861 and 992 for these costs, but did not approve funding as they were considered to cover ineligible work and costs associated with standby time, damage assessments, and costs typically covered by patient insurance. On June 8, 2005, your office transmitted the Applicant’s first appeal for these costs. In a letter dated July 5, 2005, FEMA denied this appeal stating that the requested costs “cover ineligible work—patient care, possible duplication of benefits through anticipated insurance proceeds, Administrative Allowances of searching for damage and damage assessment, and increased operating expenses involving the ambulance fleet.” The appeal denial also states that no additional documentation was provided to identify insurance or other reimbursement based on the number of response calls, and that the work performed did not meet the provisions of Section 403 of the Stafford Act.
On March 23, 2006, your office transmitted the Applicant’s second appeal for these costs. The second appeal stated that the ambulance crews supported 1,474 citizen transports and


that insurance proceeds were collected to cover only a portion of these costs. FEMA requested additional information from the Applicant to help identify the overtime and equipment costs associated with citizen transports to hospitals and congregate shelters—eligible costs under Recovery Policy 9525.4, Medical Care and Evacuations—that were not covered by insurance.
On December 7, 2006, the Applicant provided detailed information identifying the duration of the transports to hospitals and congregate shelters that were not covered by insurance. Based on the additional information provided, we have determined that personnel overtime and equipment costs in the amount of $31,680.45 ($29,113.25 Federal share) are eligible for reimbursement. These costs represent the eligible costs associated with the citizen transports to hospitals and congregate shelters not covered by insurance proceeds. Please note that this amount represents $6,008.40 for eligible costs incurred during the applicant-selected 72-hour period from 12:01 a.m. September 19, 2004 to 11:59 p.m. September 21, 2004, which is funded at 100 percent Federal cost share; the remaining $23,104.85 Federal cost share represents 90 percent of the total eligible costs of $25,672.05 incurred after the 72-hour period. By copy of letter, I am asking the Regional Administrator of FEMA Region IV to prepare and obligate
$31,680.45 for the eligible work.
The additional information provided by the Applicant does not identify any other costs related to specific items of eligible work. Under Recovery Policy 9525.7, Labor Costs - Emergency Work, the costs of standby time for the ambulance crews are not eligible for reimbursement. Additionally, the overtime and equipment costs associated with the ambulance crews reporting information on field conditions and preparing the ambulances for the transports are not eligible for reimbursement. These actions are not emergency protective measures as defined in 44 CFR § 206.225 (a)(3)(i), which must eliminate or lessen immediate threats to life, public health or safety. Therefore, this portion of the Applicant’s 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.

Sincerely,
/s/
Carlos J. CastilloAssistant Administrator
Disaster Assistance Directorate

cc: Major Phil May
Regional Administrator
FEMA Region IVConcur:
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