More than , U.S. Representative Andrew Garbarino, chair of the House Committee on Homeland Security, has been investigating significant delays in federal reimbursement to hospitals for expenses incurred during the COVID-19 pandemic. Over to , hospitals across the nation provided critical care, expanded testing capacity, and administered vaccinations, often at substantial financial cost. Despite submitting claims through the Federal Emergency Management Agency (FEMA)’s Public Assistance Program, more than $1 billion remains unpaid to New York health systems alone, according to Representative Garbarino.
The delays are not limited to New York. Nationally, billions of dollars in COVID-19 related disaster reimbursements are outstanding. Garbarino stated he is “still working with” FEMA to obtain requested documentation to fully investigate the situation, having initially requested it in of this year. The funds, intended to offset the financial strain on hospitals during the public health emergency, have yet to be disbursed.
The FEMA Public Assistance Program is designed to provide financial assistance to state, local, tribal, and territorial governments, as well as eligible private nonprofit organizations, for costs related to disaster recovery. In New York State, the program has been crucial in supporting COVID-19 response efforts, including testing, vaccination programs, emergency operations center activation, medical care provision, and the supply of personal protective equipment (PPE). The New York State Financial Plan anticipated a total of $1.46 billion in reimbursements from FEMA over three fiscal years ( – ).
The current delays raise concerns about the efficiency and effectiveness of FEMA’s disaster response capabilities. Recent reports indicate that new rules and bureaucratic hurdles are contributing to broader delays in FEMA grant disbursements, potentially jeopardizing the ability of states to respond effectively to future disasters. This comes after New York was the first state in the nation to receive a Major Disaster Declaration for the COVID-19 pandemic on , making it eligible for FEMA assistance dating back to .
The impact of these delayed reimbursements extends beyond immediate financial concerns for hospitals. These funds are often critical for maintaining operational capacity, investing in infrastructure improvements, and preparing for future public health emergencies. Without timely reimbursement, hospitals may be forced to make difficult decisions regarding staffing levels, service offerings, and capital investments, potentially compromising patient care.
Representative Garbarino, in a letter to Homeland Security Secretary Kristi Noem, emphasized the “severely delinquent” nature of the payments and requested a briefing from FEMA officials. He also requested a comprehensive set of documents and communications related to the reimbursement process, dating back to . His House Homeland Security Committee intends to conduct “oversight” to ensure the payments are processed and disbursed more swiftly.
The process for receiving FEMA funds involves a rigorous review of expenses to ensure eligibility and compliance with federal regulations. New York’s Division of Budget (DOB) works closely with the Division of Homeland Security and Emergency Services (DHSES) and FEMA Region 2 to monitor guidance and identify pandemic-related impacts. The DOB centrally manages the reimbursement request process, conducting eligibility reviews and packaging expenses into project applications for submission to FEMA. Once submitted, FEMA reviews the applications, validates eligibility, and awards funds to the state, which then distributes them according to the state’s financial plan.
While the FEMA Public Assistance Program is intended to provide vital financial support, the current delays highlight the challenges inherent in navigating complex bureaucratic processes during and after a major public health crisis. The outstanding $1 billion owed to New York hospitals, and the billions more nationally, represent a significant financial burden and underscore the need for improved efficiency and transparency in FEMA’s disaster reimbursement procedures. The situation warrants continued scrutiny to ensure that healthcare providers are adequately compensated for their critical role in responding to the COVID-19 pandemic and are prepared for future public health challenges.
