Temporary Facilities & Operating Costs

When the emergency medical delivery system within a declared area is destroyed, severely compromised, or overwhelmed, FEMA may fund extraordinary costs associated with providing temporary facilities for emergency medical care or expanding existing medical care capacity in response to the declared incident. 

Temporary facilities and expansions may be used to treat COVID-19 patients or non-COVID-19 patients, as appropriate. For COVID-19 declarations where temporary facilities and expansions require additional health care workers, state, tribal, territorial, and local governments may contract with medical providers to provide medical services in these facilities. 

An Alternate Care Site (ACS) is a facility that’s temporarily converted for healthcare use during a public health emergency to reduce the burden on hospitals and established medical facilities. The US Army Corps of Engineers (USACE) and the US Department of Health and Human Services (HHS) compiled materials to support States and municipalities in creating ACSs to support their medical requirements during the COVID-19 pandemic.

Implementation of Alternate Care Sites is a State-led and managed process. While there are some steps listed on ACS Refit Guide in which the Federal Government may be able to provide assistance, States and Municipalities are encouraged to complete them on their own.  The fact that materials and activities are listed on the USACE website does not imply that the Federal Government will be providing any assistance in executing them.  States should tailor all materials based on local requirements.

FEMA may provide assistance and approve funding for an initial 30 days, from the date that the facility is operational, as an immediate need notwithstanding that the services may be covered by another source. If additional time is needed, the Applicant should request FEMA re-assess before the end of the 30 days and FEMA may grant another 30-day extension as warranted. FEMA cannot duplicate funding provided by another source and will reconcile final funding based on any funding provided by another agency or covered by insurance. Applicable requirements for labor and contracting under federal grants apply. For more information on these requirements, see fema.gov/coronavirus and the PAPPG at pp. 63-64.

The need for temporary facilities and operating costs incurred for such facilities is eligible emergency protective measures when directly related to accomplishing specific emergency health and safety tasks if:

a. the services are specifically related to eligible emergency actions to save lives or protect public health and safety

b. the costs are for a limited period based on the exigency of the circumstances, and

c. the applicant tracks and documents the additional costs.

The eligibility is based upon its use for a surge in need and, more importantly, for an immediate threat to lives.

This may include the construction of a temporary facility or leasing an existing structure nonetheless, the decision on which direction hospitals take should be based upon what is prudent and reasonable.

FEMA requires a prudent, well-thought out approach, so it is imperative applicants weigh their options (lease, purchase, etc.) if the activities conducted or to be conducted include the set-up or operation of a temporary facility.  Applicants must complete either submit a separate project application for each facility or submit the information in a master project for each facility. For more information on these requirements, see the FEMA Coronavirus (COVID-19) Pandemic: Eligible Emergency Protective Measures Fact Sheet and the PAPPG at pp. 76-80.

The following information will be required:

What is the name of this temporary facility?

What dates were or will the temporary facility used - Start date: ____________ (MM/DD/YY)  End date:_____________(MM/DD/YY)

What services did or will this temporary facility provide?

☐Emergency medical care

☐Sheltering

☐Other. - Please description

Why was or is this temporary facility needed?

☐Existing facilities were or are forecasted to become overloaded and cannot accommodate the need.

☐Quarantine of COVID-19 affected individuals.

☐Additional space needed to accommodate COVID-19 related response activities.

☐Other. Please describe:

Please indicate how the Applicant did or will establish the temporary facility and attach a cost analysis justifying the selection. Please select all that apply.

☐Rent a facility. Provide a lease agreement.

☐Purchase a facility. Provide documentation to support the purchase price.

☐Construct a new facility.

☐Modify/expand an existing facility.

If purchasing or constructing a new facility, has the Applicant completed its use of this temporary facility?

If the Applicant purchased or constructed a temporary facility, it must return to FEMA the federal share of the equity in the facility. The Applicant must report the equity to FEMA when the approved deadline has expired or when the facility is no longer needed for the authorized purpose, whichever occurs first. For more information on this requirement, see PAPPG at pp. 79-80. Please ensure disposition proceeds are captured and associated questions answered in Schedule B or C as applicable.

Is or will the temporary facility be accessible to and usable by disabled persons, as required by the Americans with Disabilities Act?

☐ Yes, the existing facility is in compliance with the Americans with Disabilities Act and no alterations were or will be required to make the facility ADA-compliant.

☐ Yes, the Applicant has made or will make all required alterations to ensure that the facility is in compliance with the Americans with Disabilities Act.

☐ No. Please describe why compliance is not applicable to this facility:

For additional information on Americans with Disabilities Act, see PAPPG at pp. 95-96.

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