Archives

Assistance with Post-Hurricane Disaster Reimbursement Claim

Situation:

As a direct result of Hurricane Ike, the University of Texas Medical Branch (UTMB), Galveston County’s largest employer, sustained significant damage to over 150 buildings. FEMA’s Office of Corporate Counsel determined that a large emergency repair contract did not adhere to federal procurement rules (44 CFR, Part 13).

Need:

UTMB’s $127.4M disaster reimbursement claim submitted to FEMA was at risk of being denied or substantially reduced. They needed assistance with their post-hurricane disaster reimbursement claim.

Solution:

Hagerty mobilized several accountants with extensive FEMA public assistance experience to conduct a financial and eligibility review. To substantiate UTMB’s claim and ensure reimbursement of all eligible reasonable costs, Hagerty reviewed 170 Category B Project Worksheets, 3300 invoices, and expenses related to overtime, travel, supplies, and materials.

Outcome:

As a result of Hagerty’s work, UTMB’s claim passed a state audit and has not undergone an audit by the DHS Office of Inspector General (OIG). Hagerty concluded 87%, or $111.0M, of UTMB’s $127.4M disaster claim should be reimbursed.

Promote Mission Ready Package Development

Situation:

The Association of State and Territorial Health Officials (ASTHO) and the National Emergency Management Association (NEMA) hired Hagerty, in conjunction with TetraTech, to promote mission ready package (MRP) development for public health and medical resources.

Need:

Mission ready packages are pre-determined response assets that are organized, developed, trained, and exercised prior to an emergency or disaster. To understand what types of MRPs were needed, Hagerty conducted background technical research and compared public health and medical resources from ASTHO and NEMA with those from the Federal Emergency Management Agency (FEMA) and NIMS (National Incident Management System). This comparison identified MRP gaps; a survey subsequently helped identify priority areas for medical and public health MRPs.

Solution:

The Hagerty team identified potential MRPs and worked with a client Advisory Group to select ten MRPs for development within these four areas: fatality management, mobile field medical care, shelter and functional needs support services, and medical surge. The team began building out the MRPs and converting them to EMAC-required templates. They reviewed the MRP templates and developed a companion document to go along with each.

After the review process, the team reached out to key stakeholders for comments. Hagerty staff developed and hosted an educational webinar aimed at state-level Public Health Directors and staff. The webinar explained the MRP template development process, provided and overview of project deliverables, clarified what to expect in the way of additional materials and next steps, and answered questions.

Outcome:

After the webinar, Hagerty distributed the materials (10 MRP templates, forms, companion document) to stakeholders for review. The team collected comments about the MRP process and information about whether a state would be able to request or provide the MRPs in the event of an emergency. The feedback was incorporated into a comment matrix as a supplement for future work; the project ended within the allotted timeframe and was well received by both client groups.

 

 

Business Interruption Claim

Situation:

The Chippewa Cree Tribe’s medical center, the Rocky Boy’s Health Clinic, was severely damaged in 2010 as a result of a flood and landslide. The medical center provided general medical, mental health, pharmacy, optometry, dental, chiropractic, physical therapy, and other professional medical services to the tribe, but was now compromised and unable to deliver care.

Need:

The Tribe needed assistance to prepare a business interruption claim, including comprehensive documentation, to secure the maximum dollar amount possible.

Solution:

Hagerty, working with the CEO and CFO of the Tribe, developed financial documentation for the clinic’s business interruption statement of loss; organized and coordinated documentation for all insured losses; prepared the proof of loss documents required by the insurance contracts; analyzed and evaluated the Federal Emergency Management Agency’s (FEMA) application of the ‘duplication of benefits’ regulations, which were deducted from the Tribe’s project worksheet grant amounts. Additionally, the Hagerty team compared pre- and post-disaster revenues and expenditures for the clinic; interviewed the clinic’s medical staff, executives, and tribal council members; developed models to best determine actual and expected loss of revenue in anticipation of the proof of indemnity. All of this data was organized and turned over to the Tribe to submit as part of their overall statement of loss.

Outcome:

Based on Hagerty’s analysis, the Tribe submitted a business interruption and extra expense claim in excess of $15 million as part of the proof of loss document. This claim was fully one-third of the Tribe’s overall statement of loss. Hagerty also uncovered deduction errors in 15% of the FEMA project worksheets.

Environmental Health Emergency Response Project (ERP)

Situation:

Santa Clara County in California did not have a plan for how to deal with and respond to all aspects of an environmental health emergency.

Need:

Santa Clara County needed three deliverables: a document that would identify and clarify roles, responsibilities, and best practices within the county for dealing with an environmental health emergency; an in-person training based on the new plan; and implementation of a tabletop exercise to test the new plan.

Solution:

Hagerty met with the planning team and subject matter experts in the Santa Clara Department of Environmental Health (DEH). The Hagerty team gathered information about roles and responsibilities, best practices, and normal operations. The team consulted the DEH Continuity of Operations Plan and Operational Area Emergency Operations Plan, as well as the state’s Public Health and Medical Emergency Operations Manual to make sure the proposed recommendations would mesh well with existing plans, policies, and procedures.

Outcome:

The finished Emergency Response Project (ERP) included operating procedures for 10 functional areas, a communications supplement, a profile of local hazards, and a recommended organizational structure based on the National Incident Management System and the Incident Command System.

The second phase of the project had the Hagerty team create and deliver in-person training on the new ERP to stakeholders from DEH, the Public Health Department, the Office of Emergency Services, and the Emergency Medical Services Agency. The team supplemented the in-person training with an on-demand recorded version, suitable for uploading online and extending training opportunities to additional staff.

The final deliverable was to develop and execute a tabletop exercise based on the new ERP. The exercise followed and was fully compliant with the Homeland Security Exercise and Evaluation Program (HSEEP). Hagerty also developed the Situation Manual used during the exercise, led the exercise, and wrote the After Action Report.

 

 

Updating a Volunteer Plan

Situation:

Chicago’s Cook County Department of Public Health (CCDPH) asked Hagerty for assistance with updating and revising CCDPH’s current Volunteer Plan.

Need:

Use the plan as a foundation for future Cook County Medical Reserve Corps (CCMRC) program development.

Solution:

Hagerty updated CCDPH’s current Volunteer Plan in areas pertaining to volunteer retention, training, and coordination of preparedness and response activities; Hagerty also created a handbook for CCMRC Volunteers.

Outcome:

The handbook for CCMRC serves as a foundation for future CCMRC program development.

Quarantine and Isolation Workshops

Situation:

Cook County Department of Public Health (CCDPH) asked Hagerty for assistance with developing internal workshops for quarantine and isolation.

Need:

Identify gaps and solutions in current processes in order to move forward with developing a Quarantine and Isolation Plan.

Solution:

Hagerty conducted a full day workshop with customized materials for internal CCDPH staff, including representatives from Emergency Preparedness, Communicable Disease Control, Legal, Human Resources, Public Information, and Illinois Health and Human Services (IHSS). The workshop focused on a Quarantine and Isolation (Q&I) scenario involving MERS-CoV (Middle East Respiratory Syndrome Coronavirus); it also addressed three Public Health Preparedness Capabilities (PHPC): 3 (Emergency Operations Coordination), 4 (Emergency Public Information and Warning), and 11 (Non-Pharmaceutical Interventions).

Outcome:

The workshop analyzed internal policies and procedures, staff roles and responsibilities, resource/facility utilization, communications, as well as highlighted gaps between units. Following the workshop, Hagerty created an After Action/Analysis Report and conducted meeting to review the findings.

Developing a Threat Response Guide

Situation:

Cook County Department of Public Health (CCDPH) asked Hagerty for assistance developing a threat response guide.

Need:

Supplement current plans and provide guidance to leadership during various scenarios.

Solution:

Based on information gathered from the New York City Department of Health and Mental Hygiene, Hagerty supported CCDPH in the development of three Public Health Threat Response Guides. These guides include a framework for response to the following hazards: (1) Aerosolized Anthrax Attack, (2) Novel Pandemic Influenza, and (3) Inclement Weather.

Outcome:

The guides were used to train the CCDPH Executive Group and staff.