FEMA Policy #104-21-0004
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2. Temporary and Expanded Medical Facilities.
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FEMA may approve work and costs associated with temporary medical facilities or
expanded medical facilities when necessary in response to the COVID-19 Public Health
Emergency. These facilities may be used to treat COVID-19 patients, non-COVID-19
patients, or both, as necessary. Medical care activities and associated costs related to
treating both COVID-19 and non-COVID-19 patients in a temporary or expanded
medical facility may be eligible.
a. Costs must be reasonable and necessary based on the actual or projected need.
b. Eligible costs for temporary and expanded medical facilities include:
i. All eligible items and stipulations included in Section C.1 Primary
Medical Care Facility, but applicable to both COVID-19 and non-COVID-
19 patients;
ii. Lease, purchase, or construction costs, as reasonable and necessary, of a
temporary facility as well as reasonable alterations to a facility necessary
to provide medical care services;
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iii. Mobilization and demobilization costs associated with setting up and
closing the temporary or expanded medical facility;
iv. Operating costs including equipment, supplies, staffing, wraparound
services (as defined in the Definitions section at the end of this
document), and clinical care not covered by another funding source: ; and
v. Maintenance of a temporary or expanded medical facility in an
operationally ready but unused status available for surge capacity for
COVID-19 readiness and response when necessary to eliminate or lessen
an immediate threat to public health and safety, based on public health
guidance, location of areas expected to be impacted, and local/state
hospital bed/ICU capacity.
c. For contract costs related to establishing and/or operating a temporary or
expanded medical facility, contracts must include a termination for convenience
clause that will be implemented if the site is ultimately not needed, or the needs
are less than projected, as determined by the legally responsible entity.
i. Ongoing and projected needs regarding continuing operations at a
temporary or expanded medical facility should be based on regular
assessments and the Applicant must document the review process to
support its decision making.
ii. The assessments should include adjustments to projected needs based
on guidance from public health officials, caseload trends, and/or other
predictive modeling or methodologies; lead times and associated costs for
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Temporary medical facilities may include Alternate Care Sites or Community Based Testing Sites if eligible work and
costs related to these facilities are incurred by eligible PA Applicants.
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As described in Chapter 2:VI.B.17(e) and (g) of the PAPPG (V3.1).