The Applicant demonstrated that $5,239.00 in requested costs related to public health information and COVID-19 signage is directly tied to the performance of eligible emergency protective measures in response to COVID-19. However, costs for advertising its regular health services and non-COVID-19 signage are ineligible for PA reimbursement. Accordingly, the second appeal is partially granted in the amount of $5,239.00. Appeal Letter SENT VIA EMAIL Kevin Guthrie Director Florida Division of Emergency Management 2555 Shumard Oak Boulevard Tallahassee, Florida 32399-2100 Philip Doyle Chief, Public Safety and Emergency Management Tallahassee Memorial HealthCare, Inc. 1300 Miccosukee Road Tallahassee, Florida 32308 Re: Second Appeal – Tallahassee Memorial HealthCare, Inc., PA ID: 073-UV3QG-00, FEMA-4486-DR-FL, Grants Manager Project (GMP) 678122/ Project Worksheet (PW) 1126, Immediate Threat Dear Kevin Guthrie and Philip Doyle: This is in response to Florida Division of Emergency Management (Recipient) letter dated November 2, 2024, which transmitted the referenced second appeal on behalf of Tallahassee Memorial HealthCare, Inc. (Applicant). The Applicant is appealing the U.S. Department of Homeland Security’s Federal Emergency Management Agency’s (FEMA) denial of funding in the amount of $207,593.00 for dissemination of information under the COVID-19 event. As explained in the enclosed analysis, I have determined that $5,239.00 in requested costs related to public health information and COVID-19 signage is directly tied to the performance of eligible emergency protective measures in response to COVID-19. However, costs for advertising the Applicant’s regular health services and non-COVID-19 signage are ineligible for PA reimbursement. Accordingly, the second appeal is partially granted in the amount of $5,235.55. By copy of this letter, I am requesting the Regional Administrator to take appropriate action to implement this determination. This determination is the final decision on this matter pursuant to 44 C.F.R. § 206.206, Appeals. Sincerely, /S/ Robert Pesapane Director, Public Assistance Enclosure cc: Robert D. Samaan Regional Administrator FEMA Region 4 Appeal Analysis Background The coronavirus (COVID-19) pandemic resulted in a major disaster declaration for the state of Florida on March 25, 2020, with an incident period of January 20, 2020, to May 11, 2023. Tallahassee Memorial Healthcare Inc. (Applicant), a private nonprofit entity that operates a healthcare system, sought Public Assistance (PA) funding for costs associated with its COVID-19 response activities, including $207,589.00 in communication costs for advertising, videos, and signage, incurred from March to December 2020. FEMA prepared Grants Manager Project 678122 to document the Applicant’s total claimed costs. FEMA sent multiple Requests for Information (RFI) to the Applicant about the communication costs.[1] The Applicant provided the following in response:[2] $200,468.00: This cost was related to the “TMH Avoidance Campaign” which used television, radio, and social media to assure the public that it was safe to seek medical treatment at Tallahassee Memorial Hospital because of its COVID-19 safety protocols. The Applicant provided links of the video campaign, showing patients in need of medical services, and promoting its regular non-COVID treatments. $1,400.00: This cost was to produce videos, in which Tallahassee leaders, including state legislators and city and county commissioners, advised the community to follow the direction of health department officials to stop the spread of COVID-19. $600.00: This cost was to advertise a COVID-19 drive-through testing site. $5,125.00: This cost was for printed materials and signage to promote practices that limited the spread of COVID-19 within its properties. Specifically, the signs informed visitors about masking guidance, social distancing, and COVID-19 screening practices. Other signs included messages such as: “Cancer Do Not Enter,” “Magnolia Drop Off,” “Patient Experience,” and “Presurgical Patients Only.” FEMA issued a Determination Memorandum on August 10, 2023, denying the $207,593.00 in communication costs.[3] FEMA found that these costs were not related to emergency protective measures and represented an increased operating cost of providing the Applicant’s routine services in a COVID-19 environment. First Appeal In an October 6, 2023 letter, the Applicant appealed the denied communication costs and stated that they addressed an immediate threat by disseminating public information on COVID-19 health and safety measures, encouraging the public to seek medical treatment during the pandemic, and promoting social distancing and the appropriate use of masks. The Florida Division of Emergency Management (Recipient) transmitted the Applicant’s appeal with a letter of support dated December 5, 2023. The FEMA Region 4 Regional Administrator denied the claimed communication costs on July 23, 2024. FEMA found that the Applicant did not communicate health and safety information or the availability of COVID-19 testing.[4] Second Appeal The Applicant submitted a second appeal on September 18, 2024, requesting $207,593.00 in communication costs, resubmitting the description of the costs, and stating that they were associated with communications of general health and safety information to the public.[5] The Applicant cites previous FEMA second appeal decisions where PA funding was granted for costs associated with public communications of general health and safety information under a COVID‑19 disaster declaration.[6] The Recipient transmitted the Applicant’s second appeal on November 2, 2024, recommending approval. Discussion Eligible emergency work includes emergency protective measures to save lives and protect public health and safety.[7] 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.[8] In response to COVID-19, eligible emergency protective measures may include communication of general health and safety information to the public, medical care in accordance with a COVID-19 specific policy, as well as certain specific, limited measures implemented to facilitate the safe opening and operation of eligible facilities, including signage to support social distancing.[9] Costs must be directly tied to the performance of eligible work and adequately documented.[10] On second appeal, the Applicant demonstrated that its video campaign with local and state government officials provided public health and safety information to stop the spread of COVID-19. Additionally, signage related to advertising a COVID-19 testing site, as well as printed materials and signage to disseminate COVID-19 related information within its properties, is eligible under the COVID-19 policies. In this case, the Applicant provided links to videos and copies of some of its signs along with a chart providing descriptions of other signs’ verbiage. Examples include “must wear a mask properly,” “social distancing elevator signs,” and “social distancing floor decals.” Eligible costs associated with the video campaign, advertising a COVID-19 testing site, and other materials and signage totals $5,239.00. Most of the requested costs, however, are associated with the Applicant’s “TMH Avoidance Campaign,” which the Applicant explains urged members of the public to seek routine and necessary medical treatment at its hospital during COVID-19 and informed the public about the COVID-19 safety protocols it had in place at its facility. Here, the campaign promoted the hospital’s regular medical services and did not provide the public with health and safety information regarding COVID-19. As such, $200,468.00 in associated costs are ineligible.[11] Similarly, certain printed materials and signage are unrelated to COVID-19. For example, two signs read “Cancer Do Not Enter” and “Presurgical Patients Only.” Other signs have vague descriptions (for example, “Mustian Sign Update/Surgery”). These signs do not directly communicate health and safety information or support social distancing in response to COVID-19. Therefore, $1,886.00 in associated costs are ineligible. Conclusion