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Medical Care Expenses

Appeal Brief Appeal Letter

Appeal Brief

Appeal TypeSecond
PW ID#12
Date Signed2001-01-19T05:00:00
Citation: FEMA-1343-DR-OH, PA 057-UGWJP-00, Greene Memorial Hospital, Inc., PW 12, Medical Care Expenses

Cross-reference: Medical Care, Private Nonprofit Eligibility

Summary: On September 20, 2000, an F-4 tornado struck the city of Xenia, Ohio, resulting in one death and multiple injuries. Approximately 50 homes, four churches and six commercial buildings in the community were destroyed or significantly damaged. The Greene Memorial Hospital, located close to the area of impact, treated 160 patients during a five-hour period following the incident. In order to expedite treatment, hospital staff did not obtain the names of patients or information regarding possible insurance coverage. It incurred $24,016 in costs associated with staff overtime and materials required for medical treatment, as described in Project Worksheet (PW) 12. The regional staff found the PW ineligible on October 30, 2000, based on the Response and Recovery Directorate Policy Number 9525.4. FEMA denied the applicant's first appeal on November 20, 2000, because policy 9525.4 states that the cost of emergency medical treatment of any kind is an ineligible cost. The State submitted a second appeal on behalf of the applicant on December 13, 2000. The Governor's Authorized Representative claims that this FEMA policy is too restrictive and contradicts the intent of Section 403 of the Stafford Act (42 U.S.C.  5170(b)).

Issues: 1) Are the costs of overtime labor and materials associated with providing medical care eligible for public assistance funding?

Findings: 1) No. FEMA policy does not allow for funding the cost of medical treatment of any kind in this type of situation.

Rationale: Response and Recovery Policy Number 9525.4, Medical Care and Evacuations (August 17, 1999)

Appeal Letter

January 19, 2001

Dale W. Shipley
Governor's Authorized Representative
Ohio Emergency Management Agency
2855 West Dublin-Granville Road
Columbus, Ohio 43235-2206

Re: Second Appeal - Greene Memorial Hospital, Inc., Medical Care Expenses, FEMA-1343-DR-OH, PW 12

Dear Mr. Shipley:

This is in response to the referenced second appeal submitted by your office on December 13, 2000. On behalf of the Greene Memorial Hospital (Hospital) you are asking FEMA to reimburse the Hospital for $24,016 in expenses incurred providing medical treatment to tornado victims as a result of FEMA-1343-DR-OH. These costs are described in Project Worksheet (PW) 12.

In the aftermath of the disaster, the hospital treated approximately 160 patients in a five-hour period. The hospital did not obtain the victims' names or insurance information in the interest of providing expedited treatment. In your appeal, you state that the expenses incurred by the hospital for overtime and materials should be eligible in accordance with Section 403 (42 U.S.C.  5170(b)) of the Stafford Act. You claim that the Response and Recovery Directorate Policy Number 9525.4, Medical Care and Evacuation (August 17, 1999), is unnecessarily restrictive in limiting funding to medical facilities that provide temporary facilities for emergency medical care and those hospitals and custodial facilities that must evacuate patients to alternate facilities.

It is FEMA practice that we do not reimburse private nonprofit organizations for increased operating costs associated with providing services, even if these costs are increased by the disaster event. These ineligible costs include labor, material, and equipment costs incurred when providing assistance to disaster victims. This practice is outlined in the Public Assistance Guide (FEMA 322, October 1999), page 33. In addition, policy 9525.4(7)(B)(2) states that the cost of providing emergency medical treatment of any kind, the cost of follow-on treatment of disaster victims, operational and administrative costs associated with increased patient load, and costs associated with the loss of revenue are not eligible for public assistance.

We appreciate the efforts of the Greene Memorial Hospital in treating the victims of this tornado. However, I regret that we cannot reimburse them for the expenses incurred in providing this public service. Therefore, I am denying this appeal.

Please inform the applicant of this determination. My decision constitutes the final decision on this matter as set forth in 44 CFR  206.206.

Lacy E. Suiter
Executive Associate Director
Response and Recovery

cc: Janet M. Odeshoo
Acting Regional Director
FEMA Region V
Last updated February 4, 2020