Saturday, July 07, 2012

Personal Assistance Services in Disasters - Frequently Asked Questions

The Post-Katrina Emergency Management Reform Act (PKEMRA) identified an area of need in functional needs support services (FNSS) in general population shelters.  To fill this gap, FEMA developed the Personal Assistance Services (PAS) contract vehicle. This service will be provided upon request by the affected state for survivors in shelters and other congregate sites who have access and functional needs and require PAS in order to maintain the same level of independence as they have at home.

FEMA Mass Care awarded two contracts, one to Dynamic Service Solutions, Inc. (DSSI), and the other to ResCare.  DSSI has 3,000 federally funded health centers in all 50 states, including some US territories, and ResCare has 220 branches in 40 states with 1,200 nursing assistants.  Both agencies provide home health aides. 

Frequently Asked Questions


Q    Why did FEMA award a contract for Personal Assistance Services (PAS)?
A     The Robert T. Stafford Disaster Relief and Emergency Assistance Act (Public Law 93-288), as amended after the hurricane season of 2005, assigned new authorities to FEMA, including the provision of services to individuals with access and functional support needs in congregate facilities.  FEMA awarded the PAS contract to augment the ability of States, tribes, and Territories to help individuals with access and functional needs maintain their health, safety, and independence in congregate facilities after a Presidential declaration.  FEMA has contracts with two personal assistance services providers.


Q    What types of services does the PAS contract provide?
A     The PAS contract provides two levels of support to help individuals with access and functional needs maintain their independence in congregate facilities:
·         Basic personal care, such as grooming, eating, bathing, toileting, dressing and undressing, walking, transferring, and maintaining health and safety. 
·         Higher level of care, including changing dressings on wounds (such as pressure point sores), administering medications / injections (such as insulin), catheterization, and respiratory care (to include mechanical ventilation) when allowed by the State or Territory.


Q    What is the timeframe to deploy PAS staff?
A     A maximum of 50 PAS staff per contractor will deploy a minimum of 24 hours after the task order has been issued and funding has been secured.  Minimum deployment time expands to 48 hours for jurisdictions outside of the continental United States. 


Q    Who is the client for the contract?  Is it the disaster survivor, the State, or the shelter provider (e.g., American Red Cross or local community group)?
A     Eligible applicants are State, tribal, or Territorial governments that request FEMA to provide PAS in congregate facilities after a Presidential declaration.


Q    If there is a need for PAS in an independent or spontaneous shelter, would it be considered an eligible applicant?
A     No, only States, tribes, and Territories are eligible applicants.  The independent or spontaneous shelter provider would need to request support through its office of emergency management for this, or any other, State or Federal resource.


Q    Is PAS covered under Stafford Section 403?  Is there a cost to the State, or is this contract 100% Federally funded? 
A     PAS is provided under Stafford Section 403.  There is a cost-share to the State, tribal, or Territorial government to implement PAS under this contract.   The cost-share is typically 25% of the cost. This contract does not have a readiness component and must be funded from the Disaster Relief Fund.


Q    Would an Emergency Declaration need to be in place prior to activating this contract? Or is there money available to fund the contract when needed?
A     A declaration of emergency or major disaster would be needed for FEMA to implement the contract, as it is funded through the Disaster Relief Fund/Fund Code 6.  Readiness and non-disaster funding have not been allocated to support the contract.


Q    What is the process for requesting PAS support under this contract?
A     The intent of the contract is to augment State, tribal, and/or Territorial PAS staff when shortfalls exist.   The request process follows the usual Action Request Form/40-1 procedure when there is a declaration of major disaster or emergency.  The need for PAS is evaluated and, if validated, the Contracting Officer's Representative (COR) for the PAS Contract works with FEMA Acquisitions to activate the contract.  Although this is a national contract, it can be implemented at the Region or JFO level.


Q    Will there be a potential duplication of benefits, leading to some form of recoupment, if the individual receiving the benefits has private insurance, receives Medicare, Medicaid, or State-provided medical benefits that would normally pay for such services? 
A     Individuals who need PAS cannot wait for the contract to be activated; therefore, if other resources are available, those options will be implemented first.  Not all individuals who need PAS have Medicare, Medicaid, or insurance.  PAS are often provided by family, friends, and volunteers who may have become separated during a disaster or emergency.  As there is a cost-share for this service, States, tribes, and Territories will exhaust other, less costly, options before requesting activation of the contract.


Q    Will individuals who need PAS be required to accept the service?
A     Individuals requiring PAS have the right to choose or reject a PAS provider and cannot be required to use a friend, family member or volunteer simply because this is the most cost-effective option.  All decisions regarding PAS providers will be made with the consent of the individual requesting the service.


Q    Is a cost-benefit analysis required when activating a government contract to perform these functions? 
A     The Stafford Act assigns FEMA responsibility for providing life-sustaining services and support to disaster survivors when there is a Presidential declaration.  As the PAS contract is designed to augment State, tribal, and Territorial resources, it is designed to be implemented when the capabilities of non-Federal resources have been exceeded.  The services performed under the contract enable individuals to maintain their health, safety, and independence in congregate facilities, thereby lessening the burden on the medical system and substantially reducing the overall cost of care.


Q    Who identifies who will receive PAS under the contract?  How is this decision made? 
A     The congregate facility manager, nursing staff, and, in some cases, the shelter critical assessment team, will identify and validate PAS requirements.  The facility manager will forward requests to the County/Parish office of emergency management for action.  If PAS staff cannot be provided at the local level, the office of emergency management will send the request to the State, which will either deploy resources or request FEMA to implement the PAS contract.


Q    Can PAS staff provide assistance to more than one individual? 
A     The answer to this question will depend on the extent of assistance required by an individual.  In some cases, the ratio will need to be one-to-one.  In other cases, PAS staff will be able to assist more than one individual.


Q    Who supervises contracted PAS staff in congregate facilities?
A     Contracted PAS staff report to the congregate facility manager.  In addition, the COR and/or technical monitor(s) for the contract will deploy to the field to ensure that the services provided comply with the requirements of the contract.


Q    What is the minimum number of PAS staff FEMA will deploy under this contract?
A     There is a cost-share to the State, tribe, or Territory to implement the PAS contract, as well as the need to deploy FEMA staff to monitor contractor performance.  Although there is no minimum number of PAS staff that FEMA can deploy under this contract, it would be more cost-effective for the State to deploy State/local resources if fewer than 20 PAS are required when the contract is initially activated.


Q    Are PAS staff deployed under the contract required to meet training, certification, and other requirements?
A     The contractor is required to ensure that all PAS staff are properly licensed, trained, and certified per the local, State, Territorial, and Federal laws and regulations where the congregate facility is located. PAS staff deployed under this contract are required to have successfully passed a background investigation.


Q    When would PAS staff demobilize?
A     As implementation of the PAS contract must be requested by the State, the State also determines when the resource is no longer needed.  Throughout the period that congregate assistance is provided, State and local governments are encouraged to seek State/local resources to meet the needs of individuals with access and functional needs in congregate facilities.  The State is requested to provide 48-hour notice when demobilizing the contract at each site.


Q    Will the services provided under the PAS contract be evaluated?
A     The COR and technical monitor(s) assigned to the contract will evaluate PAS staff performance.  In addition, the contractors are required to submit an after action report to FEMA within 30 days after the period of performance.


Marcie Roth
Director
Office of Disability Integration and Coordination
Department of Homeland Security/ FEMA

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