FEMA finds that the claimed costs for force account equipment usage and purchase of medical care equipment are ineligible for PA. Therefore, this appeal is denied. Appeal Letter Rayana Gonzales Deputy Commissioner for Disaster Recovery Programs New York State Division of Homeland Security and Emergency Services 1220 Washington Ave Building 7A, Floor 4 Albany, New York 12242 Gregory Miglino Jr. President Brookhaven Ambulance Co., Inc. (DBA South Country Ambulance) PO Box 596 Brookhaven, New York 11719 Re: Second Appeal – Brookhaven Ambulance Co., Inc. (DBA South Country Ambulance), PA ID: 103-UFVR3-00, FEMA-4480-DR-NY, Grants Manager Projects (GMPs) 674225 and 547942, Immediate Threat Dear Rayana Gonzales and Gregory Miglino Jr.: This is in response to the October 3, 2025 letters from the New York State Division of Homeland Security and Emergency Services, which forwarded the referenced second appeals on behalf of Brookhaven Ambulance Co., Inc. (DBA South Country Ambulance) (Applicant). The Applicant is appealing the U.S. Department of Homeland Security’s Federal Emergency Management Agency’s (FEMA) denial of $4,950,610.48 for force account equipment usage and the purchase of medical care equipment. As explained in the enclosed analysis, I have determined that the claimed costs for force account equipment usage and purchase of medical care equipment are ineligible for Public Assistance. Accordingly, I am denying this appeal. This determination is the final decision on this matter pursuant to 44 C.F.R. § 206.206. Sincerely, /S/ Robert M. Pesapane Director, Public Assistance Enclosure cc: Andrew D’Amora Acting Regional Administrator FEMA Region 2 Appeal Analysis Background The coronavirus (COVID-19) pandemic resulted in a major disaster declaration for New York on March 20, 2020, with an incident period from January 20, 2020, to May 11, 2023. Brookhaven Ambulance Co., Inc. (DBA South Country Ambulance) (Applicant), a private nonprofit emergency medical services (EMS) provider, requested $4,971,634.20 in Public Assistance (PA) funding, which was identified in two separate projects. Grants Manager Project (GMP) 674225 ($4,688,095.56) captured the use of force account equipment (ambulances and a first responder vehicle) to respond to 911 calls from January 20, 2020 to May 31, 2022. GMP 547942 ($283,538.64) captured costs for the purchase of medical care materials, supplies, and equipment, incurred from February 6, 2020 through February 25, 2022. FEMA issued determination memoranda, which denied all costs under GMP 674225 and $263,295.92 for GMP 547942.[1] FEMA found that the Applicant did not demonstrate that the ambulances and vehicle were used to respond to emergencies directly related to COVID-19; and the defibrillators and chest compression machines could not be tied to the performance of eligible emergency protective measures for the declared event, nor were they associated with eligible activities for the safe opening and operation of an eligible facility. [2] First Appeal The Applicant appealed FEMA’s denial of the claimed costs in the two projects.[3] The Applicant asserted that the force account equipment was used for medical transport, stating that, due to COVID-19, the demand for available equipment substantially increased and the medical transport claimed in the project was outside of the normal scope of operations for its EMS organization. The Applicant also stated that it purchased five mechanical chest compression machines and eight defibrillators to help protect the EMS personnel by limiting physical contact between rescuers and patients, asserting this was consistent with FEMA’s policy of providing personal protective equipment (PPE) to first responders. In support of both projects, the Applicant submitted its dispatch call logs, stating that, based on guidelines from Centers for Disease Control and Prevention (CDC), it highlighted every COVID-19 or COVID-19 potential call.[4] The New York State Division of Homeland Security and Emergency Services (Recipient) forwarded the appeals to FEMA, along with letters expressing its support.[5] FEMA sent the Applicant a Request for Information (RFI), asking the Applicant to validate that it was legally responsible to provide EMS services at the time of the disaster, and to provide documentation that showed the specific time the ambulances were used on emergency calls shown in the dispatch call logs. In response to FEMA’s RFI, the Applicant provided documentation to support its legal responsibility to provide EMS services and stated that it was requesting funding for the entire time the ambulances were dispatched during the COVID-19 emergency, including standby time.[6] In a letter dated June 9, 2025, the FEMA Region 2 Regional Administrator denied the claimed costs for force account equipment usage in GMP 674225, finding that the Applicant had not demonstrated that it was legally responsible to provide emergency services, and did not show the specific time ambulances were used for potentially eligible work. For GMP 547942, FEMA denied the claimed costs for purchase of defibrillators and chest compression machines, stating the equipment was not considered PPE under FEMA policies.[7] Second Appeal In letters dated August 8, 2025, the Applicant submitted second appeals for the two projects, reiterating first appeal arguments.[8] Regarding FEMA’s finding that it was not legally responsible to provide emergency services, the Applicant states that its “Ambulance Service Certificates” authorize it to provide EMS services in accordance with the provisions of Article 30 of the New York State Public Health Law. The Applicant states that it used the claimed equipment in both projects for the treatment and transport of COVID-19 patients, which, the Applicant asserts, constitutes eligible medical care under FEMA’s COVID-19 policy. The Applicant also states that it provided PPE to its first responders, which is listed as eligible under FEMA’s COVID-19 policies. The Applicant emphasizes that the dispatch call logs have been highlighted to show every COVID-19 or COVID-19 potential call in which it used the claimed equipment, and states that the ambulances were in use the entire time they were on shift. In letters dated October 3, 2025, the Recipient transmitted the second appeals to FEMA with its support. Discussion FEMA is authorized to provide assistance for emergency protective measures to save lives and protect public health and safety.[9] For emergency protective measures to be eligible, the applicant is responsible for showing the work is required due to an immediate threat resulting from the declared incident.[10] In response to COVID-19, eligible emergency protective measures include the purchase and distribution of face masks and PPE that is directly related to the performance of otherwise eligible work, including the provision of eligible medical care or the safe opening and operation of eligible facilities.[11] PPE refers to items such as N95 and other filtering respirators, surgical masks, gloves, protective eyewear, face shields, and protective clothing (e.g., gowns).[12] FEMA may only provide assistance for PNP organizations that own or operate a medical facility, and provide medical care in response to COVID-19 declared events that is provided in accordance with a COVID-19 specific policy.[13] Eligible medical care activities and associated costs eligible in primary medical care facilities include emergency medical transport related to COVID-19 and the purchase, lease, and delivery of specialized medical equipment necessary to respond to COVID-19.[14] FEMA may provide reimbursement for ownership and operation costs of applicant-owned equipment used to perform eligible work.[15] For GMP 674225, the Applicant requests PA funding for the use of force account equipment (ambulances and first responder vehicle) for medical transport in response to 911 calls. For GMP 547942, the Applicant requests reimbursement for the purchase of defibrillators and chest compression machines, asserting the medical care equipment was used in response to 911 calls, and that the equipment also served as PPE by protecting EMS personnel from potential exposure to COVID-19.[16] For both projects, the Applicant references its dispatch call logs and asserts that it highlighted every COVID-19 or COVID-19 potential call to show the equipment was used for COVID-19-related emergencies. While the Applicant may have used its force account equipment and medical care equipment to respond to COVID-19-related emergencies, the dispatch call logs do not show what portion of the time, if any, the force account equipment was used for EMS calls related to COVID-19. Moreover, the dispatch call logs include a variety of emergencies, and the Applicant does not explain how these emergency calls are related to COVID-19 or how/if the claimed medical care equipment was used.[17] For instance, the highlighted calls include generic descriptions of the call type, such as: back pain, chest pain, respiratory, unknown problem, sick, unconscious/fainting, and cardiac or respiratory arrest.[18] Several highlighted entries include the description “pandemic/epidemic/outbreak,” which could potentially be related to COVID-19, but the Applicant did not provide any further information to validate if the patient had a confirmed or suspected COVID-19 infection or if the patient was transported to a medical care facility.[19] Also, the Applicant claims the entire time when the ambulances were on shift, without any means to determine the specific time spent on a given emergency call that could potentially be related to COVID-19. Not only does the Applicant not tie the claimed force account equipment to the performance of eligible work but even if the Applicant had demonstrated that the equipment was for emergency medical transport related to COVID-19, the Applicant does not own or operate a medical care facility, and responding to COVID-19-related 911 emergency services calls is not eligible work in accordance with this or any other COVID-19 specific policy.[20] Likewise, the Applicant has not shown that the defibrillators and chest compression machines qualify as specialized equipment necessary to respond to COVID-19 or that they were used to perform eligible work in accordance with any COVID-19 policy.[21] Further, the defibrillators and chest compression machines do not meet the PPE definition outlined in the above cited FEMA policies.[22] Conclusion