What Does the Presidential Emergency Declaration Provide for?

In my professional career of being an emergency manager I've never seen an emergency declaration for a health emergency like the one we are facing. You can read the details below, but in all disasters there are issues open to interpretation. The guidance below gives a broad swath for what is covered.

Now is the time: To set up financial capture procedures to be able to claim reimbursement. Most organizations start late and then don't have the documentation to be able to claim cost reimbursement. I figure the date of the event is Friday, March 13, so capture what has been spent already and have a system in place for future expenditures. People, equipment, services, supplies. 

Details below:

Subject: President Trump Directs FEMA Support Under Emergency Dec for COVID-19FW -- PA Program - Cat B Emergency Protective Measures

President Donald J. Trump Directs FEMA Support Under Emergency Declaration for COVID-19

The federal government continues to take aggressive and proactive steps to address the COVID-19 threat as the health and safety of the American people remain a top priority.

Today, President Trump declared a nationwide emergency pursuant to Sec. 501(b) of the Robert T. Stafford Disaster Relief and Emergency Assistance Act, 42 U.S.C. 5121-5207 (the “Stafford Act”).

This increases federal support to the Department of Health and Human Services (HHS) in its role as the lead federal agency for the ongoing COVID-19 pandemic response. As a result of the President’s decisive, unprecedented action, FEMA is directed to assist state, local, tribal, territorial governments and other eligible entities with the health and safety actions they take on behalf of the American public. Today’s declaration does not make direct financial assistance available to individuals.

The emergency declaration does not change measures authorized under other federal statutes and HHS remains the lead federal agency directing the federal response to COVID-19.  FEMA actions will be in support of HHS and in coordination with state, tribal and territorial governments. Eligible emergency protective measures taken at the direction or guidance of public health officials in response to this emergency, and not supported by the authorities of another federal agency, will be reimbursed strictly under the FEMA Public Assistance program.

FEMA assistance will be provided at a 75 percent Federal cost share. Reimbursable activities typically include emergency protective measures such as the activation of State Emergency Operations Centers, National Guard costs, law enforcement and other measures necessary to protect public health and safety.

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HHS directive for the COVID-19 pandemic outbreak.

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Presidential Policy Directive-44: Enhancing Domestic Incident Response designates HHS as the lead federal agency for public health responses utilizing authority established through:

• Pandemic and All Hazards Preparedness Act (PAHPA)
• Public Health Service Act
• National Response Framework (NRF) and associated operational plans.

 The Congress-designated appropriation for this mission is the Public Health Emergency Fund for coordinating and delivering assistance.

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Here are a few documents – FEMA Fact Sheet on Infectious Disease and FEMA Public Assistance (PA) Policy & Procedures Guide (PAPPG).

Here are some excerpts:

11. Infectious Disease Event (document page 72)

The HHS Centers for Disease Control and Prevention (CDC) has primary authority to enable support and assistance to States, Territorial, or Tribal Governments in response to an infectious disease event. FEMA may provide assistance for the rescue, evacuation, and movement of persons; movement of supplies; and care, shelter, and other essential needs of affected human populations. Any assistance provided by FEMA in response to an infectious disease event is done in coordination with the CDC. The Office of Response and Recovery Fact Sheet FP 104­009-001, Infectious Disease Event, provides additional details.

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Who’s Eligible to Apply?

• Cities and Towns
• Counties
• Special Purpose Districts
• State Agencies
• Federally recognized Indian Tribes
• Private Non-Profit (PNP) Organizations

Work Eligibility

• Be disaster related
• Conducted in the designated disaster area
• Be applicant’s legal responsibility
• Not funded by another federal agency

Cost Eligibility

• Reasonable and necessary cost to accomplish eligible work
• Complies with federal, state, and local laws and regulations –FEMA funds creates federal nexus
• Credits - Insurance proceeds, salvage value, purchase discounts – no duplication of benefits
• Project Worksheets (PWs) must be a minimum of $3,300 (FFY-20)

 

Types of Work

Emergency Work

• B -Emergency Protective Measures

Eligible Items –Emergency Work

• Eligible activity must be essential to meeting an immediate threat to life or property during or resulting from the declared event.
• Category B - Overtime for Regular Employees to include overtime benefits.
• All Hours (Regular & Overtime) for Temp Hires and Seasonal Workers (working outside of season) including benefits
• All Equipment Hours – Lower of FEMA or Applicant Rates
• Rental Equipment
• Engineering & Design Services
• Materials –Inventory and/or Purchases
• Contracts

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1. Emergency Protective Measures (Category B) document page 58)

Emergency protective measures conducted before, during, and after an incident are eligible if the measures:

• Eliminate or lessen immediate threats to lives, public health, or safety; OR
• Eliminate or lessen immediate threats of significant additional damage to improved public or private property in a cost-effective manner.¹⁷⁷

FEMA may require certification by Federal, State, Territorial, Tribal, or local government officials that a threat exists, including:

• Identification and evaluation of the threat
• Recommendations of the work necessary to cope with the threat¹⁷⁸

Saving Lives and Protecting Public Health and Safety (document page 57)

The following is a list of emergency protective measures and costs that are eligible. These actions save lives or protect public health or safety. This list is not all-inclusive. Some of these actions are discussed in detail below.

• Transporting and pre-positioning equipment and other resources for response
• Flood fighting
• Emergency Operation Center (EOC)-related costs
• Emergency access
• Supplies and commodities
• Medical care and transport
• Evacuation and sheltering, including that provided by another State or Tribal government
• Child care
• Safety inspections
• Animal carcass removal
• Demolition of structures
• Search and rescue to locate survivors, household pets, and service animals requiring assistance
• Fire fighting
• Security, such as barricades, fencing, or law enforcement
• Use or lease of temporary generators for facilities that provide essential community services
• Dissemination of information to the public to provide warnings and guidance about health and safety hazards using various strategies, such as flyers, public service announcements, or newspaper campaigns
• Searching to locate and recover human remains
• Storage and interment of unidentified human remains
• Mass mortuary services

The following are eligible under limited circumstances based on specific criteria described in each of the referenced sections:

• Expenses related to operating a facility or providing an emergency service (see Chapter 2:VI.B.2)
• Mosquito abatement (see Chapter 2:VI.B.12)
• Repair of residential electrical meters (see Chapter 2:VI.B.13)
• Temporary relocation of essential services, including safe rooms for schools (see Chapter 2:VI.B.17)
• Snow-related activities when specifically authorized in the declaration (see Chapter 2:VI.B.18) ¹⁷⁹  

2. Expenses Related to Operating a Facility or Providing a Service (document page 60-61)

The Applicant may incur additional costs related to operating a facility as a result of the incident because of an increased demand for the services the facility provides.

These additional costs are only eligible if:

• The services are specifically related to eligible emergency actions to save lives or protect
• public health and safety or improved property;
• The costs are for a limited period of time based on the exigency of the circumstances; and
• The Applicant tracks and documents the additional costs.

Potentially eligible increased operating costs include, but are not limited to, costs for:

• Generators at a hospital or police station
• Water testing and treatment supplies in the immediate aftermath of the incident to counter
• a specific threat
• Fuel for increased use of a pumping station
• EOC facility costs (e.g., utilities)

Examples of ineligible operating costs include, but are not limited to, costs for:

• Patient care, except as noted in Chapter 2:VI.B.9
• Administrative activities
• Provision of food, except as noted in Chapter 2:VI.B.5, 7, and 8
• Obtaining electrical power from an alternate source
• Obtaining water from an alternate source
• School make-up days, including contracted costs for bus service for make-up days
• Provision of fuel for school bus service

For PNPs, operating costs are generally not eligible even if the services are emergency services, unless the PNP performs an emergency service at the request of and certified by the legally responsible government entity. In such case, FEMA provides PA funding through that government entity as the eligible Applicant.

5. Emergency Operations Centers (document page 62)

The Applicant may use its EOC to direct and coordinate resources and response activities for a period of time. Response activities conducted at EOCs are eligible provided they are associated with eligible work. Costs associated with operating the EOC are also eligible, including, but not limited to:

• Increased utility costs
• Costs to lease a facility
• Supply costs
• Meal costs, as described in Chapter 2:VI.B.8

7. Supplies and Commodities (document page 63-64)

The purchase of supplies and commodities required for emergency protective measures is eligible.

Costs related to the Applicant purchasing supplies or using its own stock to perform Emergency Work are eligible and reimbursed in accordance with Chapter

2:V.D. Examples include, but are not limited to, safety equipment, personal protective equipment, radios, power tools, sand, and tarps.

Purchasing and packaging life-saving and life-sustaining commodities and providing them to the impacted community are eligible. Examples of such commodities include, but are not limited to, food, water, ice, personal hygiene items, cots, blankets, tarps, plastic sheeting for roof damage, and generators, as well as food and water for household pets and service animals. The cost of delivering these same commodities to unsheltered residents in communities where conditions constitute a level of severity such that these items are not easily accessible for purchase is also eligible. This includes food and water for household pets whose owners are in shelters.

The cost of leasing distribution and storage space for the commodities is also eligible.

8. Meals

Applicants often provide meals for emergency workers. Provision of meals, including beverages and meal supplies, for employees and volunteers engaged in eligible Emergency Work, including those at EOCs, is eligible provided the individuals are not receiving per diem and one of the following circumstances apply:

• Meals are required based on a labor policy or written agreement that meets the requirements of Chapter 2:V.A.1;
• Conditions constitute a level of severity that requires employees to work abnormal, extended work hours without a reasonable amount of time to provide for their own meals; or
• Food or water is not reasonably available for employees to purchase.

FEMA only reimburses the cost of meals that are brought to the work location and purchased in a cost-effective and reasonable manner, such as bulk meals. FEMA does not reimburse costs related to group outings at restaurants or individual meals.¹⁸⁴

9. Medical Care

When the emergency medical delivery system within a declared area is destroyed, severely compromised or overwhelmed, FEMA may fund extraordinary costs associated with operating emergency rooms and with providing temporary facilities for emergency medical care of survivors. Costs associated with emergency medical care should be customary for the emergency medical services provided. Costs are eligible for up to 30 days from the declaration date unless extended by FEMA.

Eligible medical care includes, but is not limited to:

• Triage and medically necessary tests and diagnosis
• Treatment, stabilization, and monitoring
• First-aid assessment and provision of first aid
• A one-time 30-day supply of prescriptions for acute conditions or to replace maintenance prescriptions
• Vaccinations for survivors and emergency workers to prevent outbreaks of infectious and communicable diseases
• Durable medical equipment  Consumable medical supplies
• Temporary facilities, such as tents or portable buildings for treatment of survivors
• Leased or purchased equipment for use in temporary medical care facilities
• Security for temporary medical care facilities
• Use of ambulances for distributing immunizations and setting up mobile medical units

Terminology

Durable medical equipment is reusable medical equipment necessary for the treatment of an illness or injury or to prevent a patient’s further deterioration. The equipment includes, but is not limited to:

• Oxygen equipment
• Wheelchairs
• Walkers
• Hospital beds
• Crutches
• Other medical equipment

Consumable medical supplies are medical supplies that are ingested, injected, or applied or are for one-time use only, including, but not limited to:

• Medical supplies
• Medications
• Diapers
• Adult incontinence briefs
• Bandages

Long-term medical treatment is not eligible. FEMA determines the reasonableness of these costs based on Medicare’s cost-to-charge ratio (a ratio established by Medicare to estimate a medical service provider’s actual costs in relation to its charges).

FEMA does not provide PA funding for these costs if underwritten by private insurance, Medicare, Medicaid, or a pre-existing private payment agreement.185 The Applicant must take reasonable steps to provide documentation on a patient-by-patient basis verifying that insurance coverage or any other source funding including private insurance, Medicaid, or Medicare, has been pursued and does not exist for the costs associated with emergency medical care and emergency medical evacuations.

Ineligible costs include:

• Medical care costs incurred once a survivor is admitted to a medical facility on an inpatient basis
• Costs associated with follow-on treatment of survivors beyond 30 days of the declaration
• Administrative costs associated with the treatment of survivor

10. Evacuation and Sheltering (document page 65-66)

Evacuation and sheltering of survivors are eligible activities. This includes household pets and service and assistance animals, but not exhibition or livestock animals.

 

Terminology

Household pets are domesticated animals that:

• Are traditionally kept in the home for pleasure rather than for commercial purposes
• Can travel in commercial carriers
• Can be housed in temporary facilities
• Examples are dogs, cats, birds, rabbits, rodents, and turtles. Household pets do not include reptiles (except turtles), amphibians, fish, insects, arachnids, farm animals (including horses), or animals kept for racing purposes.

(a) Evacuation Including Accessible Transportation and Emergency Medical Transportation

Transportation of evacuees, household pets, service animals, luggage, and durable medical equipment is eligible. This includes emergency medical transportation. The mode of transportation should be customary and appropriate for the work required. Eligible activities include, but are not limited to:

• Transferring patients from inoperable, compromised, or overwhelmed eligible medical or custodial care facilities to another medical facility or to a shelter.
• Transferring patients back to original medical or custodial care facility, when appropriate.
• Transporting survivors, including shelterees, who require emergency medical care to and from the nearest existing or temporary medical care facility equipped to adequately treat the medical emergency. Transport may include emergency air, sea, or ground ambulance services if necessary.
• Use of equipment such as buses, trucks, or other vehicles (including accessible vehicles) to provide one-time transportation to evacuate survivors and their household pets and service and assistance animals to emergency shelters from pre-established pick-up locations. This includes stand-by time for drivers and contracted equipment while waiting to transport survivors.
• Paratransit transportation services, such as vans, minibuses, and buses, (including accessible vehicles) to transport senior citizens, individuals with disabilities (including mobility disabilities) or access and functional needs, individuals in nursing homes and assisted-living facilities, and homebound individuals impacted by the incident.
• Tracking of evacuees, household pets, service animals, luggage, and durable medical equipment. This includes the use of animal microchips for the purpose of tracking evacuated animals.
• Food and water provided during transport.
• Emergency medical care provided during transport, including emergency medical personnel and supply costs.
• Stabilization of individuals injured during evacuation.
• Costs incurred in advance of an incident necessary to prepare for evacuations in threatened areas. Costs may include mobilization of ambulances and other transport equipment. Contracts for staging ambulance services must be part of the State, Territorial, Tribal, or regional evacuation plan. Costs of staging ambulances are eligible even if the incident does not impact the area normally served by those ambulances. PA funding for activating, staging, and using ambulance services ends when any of the following occurs:
• FEMA, and the State, Territorial, or Tribal Government, determines that the incident did not impact the area where it staged ambulances;
• Evacuation and return of medical patients and individuals with disabilities or access and functional needs is complete; or
• The immediate threat caused by the incident has been eliminated and the demand for services has returned to normal operation levels.

FEMA does not provide PA funding for ambulance services that are covered by private insurance, Medicare, Medicaid, or a pre-existing private payment agreement.¹⁸⁶

(b) Sheltering (document page 65-66)

FEMA provides PA funding to State, Territorial, Tribal, and local government Applicants for costs related to emergency sheltering for survivors. Typically such sheltering occurs in facilities with large open spaces, such as schools, churches, community centers, armories, or other similar facilities. FEMA refers to these shelters as congregate shelters.

 

Transitional Sheltering Assistance Program

FEMA’s Transitional Sheltering Assistance program provides short-term lodging to eligible survivors who, after an evacuation, cannot return to their homes for an extended period of time because their community is either uninhabitable or inaccessible as a result of the incident.

FEMA implements and manages Transitional Sheltering Assistance directly through a contract agent.

 

Generally, FEMA does not provide PA funding for emergency sheltering in non-congregate environments, which are locations where each individual or household has living space that offers some level of privacy (e.g., hotels, motels, casinos, dormitories, retreat camps, etc.). In limited circumstances, such as when congregate shelters are not available or sufficient, FEMA may reimburse costs related to emergency sheltering provided in non-congregate environments. FEMA’s Assistant Administrator for Recovery has the authority to approve this policy exception. The Applicant must submit a request for PA funding for costs related to emergency, non-congregate sheltering and obtain FEMA approval prior to sheltering survivors in non-congregate facilities. At a minimum, the Applicant should include the following information in its request:

• Justification for the necessity of non-congregate sheltering;
• Whether the State or Tribal Government has requested Transitional Sheltering Assistance;
• The type of non-congregate sheltering available and which type the Applicant intends to utilize;
• An analysis of the available options with the associated costs of each option; and
• The time frame requested (i.e., date of activation and length of time).¹⁸⁷

FEMA will limit any approval to that which is reasonable and necessary to address the needs of the event (generally no more than 30 days). FEMA determines the eligible costs based on the

contractual agreement, including reimbursement for repairing damage if it is the Applicant’s legal responsibility based on the agreement. The Applicant must obtain FEMA approval for any time extensions, which should include a detailed justification for the continued need and a revised analysis of options, including the costs for each option.

If FEMA approves the request, the Recipient will need to maintain tracking mechanisms to provide sufficient data and documentation to establish eligibility (including the need for non-congregate sheltering resulting from the disaster, reasonableness, and costs). Sufficient documentation includes:

• The number of non-congregate shelterees:
  • By age groups 0-2, 3-6, 7-12, 13-17, 18-21, 22-65, and 66+;
  • With disabilities or access and functional needs;
  • Registered for assistance from FEMA’s IA Programs; and
  • Referred to State or non-governmental organization programs for assistance.
• Number of household pets, and assistance and service animals sheltered and the type of

shelter provided (e.g., stand alone, co-located, or co-habitational;

• Length of stay per “household unit;” and
• Number of meals and other services provided.

As with any activity, lack of full documentation may result in FEMA determining that some or all of the costs are ineligible.

Eligible costs related to sheltering include, but are not limited to, the items listed below, as necessary based on the type of shelter and the specific needs of the shelterees. If any of the items listed are donated, including labor, the Applicant may offset the non-Federal share of its eligible Emergency Work projects in accordance with Chapter 2:V.L. Sheltering and caring for household pets is only eligible while the pet owner is in an emergency shelter.

Shelter Facility Costs

• Facility lease or rent, including space for food preparation
• Utilities such as power, water, and telephone
  • Minor facility modifications if necessary to make the facility habitable, compliant with the Americans with Disabilities Act (ADA), functional as a child care facility, or functional as an animal shelter
• Restoration to return the facility to its condition prior to use
• Generator costs
• Secure storage space for medical supplies

If an eligible State, Territorial, Tribal, or local government Applicant owns or leases the shelter facility, and a volunteer agency operates the shelter, the facility costs described above are eligible. However, the labor costs for the volunteer agency’s workers are not eligible (except as a donated resource in accordance with the criteria in Chapter 2:V.L).

Shelter Staff Costs

• Medical staff
• Personal assistance service staff
• Veterinary staff
• Public Information Officer
• Social workers
• Food service workers
• Custodial and facilities staff
• National Guard personnel (See Chapter 2:V.J)

Shelter Supplies and Commodities

• Hot and cold meals, snacks, beverages, and related supplies for survivors
• Cooking and serving supplies
• Food, water, and bowls for household pets and service and assistance animals
• Durable medical equipment
• Consumable medical supplies
• Medication for animal decontamination and parasite control
• Infant formula, baby food, and diapers
• Refrigerators, microwaves, and crock pots
• Cots, cribs, linens, blankets, pillows, tables, and chairs
• Crates, cages, leashes, and animal transport carriers
• Personal hygiene kits with items such as shampoo, soap, toothpaste, a toothbrush, towels, and washcloths
• Animal cleaning tables and supplies
• Televisions or radios – one per 50 shelterees
• Basic cable service
• Computers – one per 25 shelterees
• Internet service
• Washers and dryers – one of each per 50 shelterees
• Toys and books
• Shelter Services
• Shelter services are eligible for the time the facility is actively used to shelter survivors.
• Shelter management
• Supervision of paid and volunteer staff
• Cleaning the shelter, linens, and animal crates
• Shelter safety and security

Shelter Services

Shelter services are eligible for the time the facility is actively used to shelter survivors.

• Shelter management
• Supervision of paid and volunteer staff
• Cleaning the shelter, linens, and animal crates
• Shelter safety and security
• Use of equipment, such as ambulances, buses, trucks, or other vehicles, to provide sheltering support
• Phone banks for survivors
• Care for survivors with disabilities or access and functional needs, including the provision of the following personal assistance services:
• Grooming, eating, walking, bathing, toileting, dressing, and undressing
• Movement between a cot and wheelchair (transferring)
• Maintaining health and safety
• Taking medications
• Communicating or accessing programs and services
• Emergency medical and veterinary services for sheltered survivors, household pets, and service and assistance animals, including:

• Emergency and immediate life stabilizing care, including necessary prescriptions (not to exceed 30-day supply)
• Triage, medically necessary tests, diagnosis, treatment, stabilization, and monitoring
• First-aid assessment
• Provision of first aid and health information
• Care for evacuees with chronic conditions
• Administering vaccinations to shelterees and workers for transmissible or contagious diseases, including, but not limited to, tetanus and hepatitis
• Administering vaccinations to household pets, and service and assistance animals, for transmissible or contagious diseases, including, but not limited to, Bordetella (kennel cough)
• Medical waste disposal
• Mental-health care
• Outpatient costs for sheltered survivors requiring emergency life-sustaining treatment not available at the shelter for the period of time that a survivor is housed in a congregate shelter. Eligible outpatient services are limited to:

• Physician services in a hospital outpatient department, urgent care center, or physician’s office;
• Related outpatient hospital services and supplies, including X-rays, laboratory and pathology services, and machine diagnostic tests; and
• Local professional transport services to and from the nearest hospital equipped to adequately treat the emergency.

• Sheltering self-evacuees (self-evacuee transportation costs are not eligible)
• Costs paid to the American Red Cross (ARC) or other Non-Governmental Organizations (NGO) to operate shelters under a written agreement [costs that ARC or other NGOs incur under their own authorities (i.e., independent of any Federal, State, Tribal, or local request) are not eligible for reimbursement]