FEMA Cerro Grande Claims: Payments Properly Processed, but	 
Reporting Could Be Improved (24-DEC-03, GAO-04-129).		 
                                                                 
The Cerro Grande Fire Assistance Act (CGFAA) mandated that GAO	 
annually audit all claim payments made to compensate the victims 
of the Cerro Grande Fire in northern New Mexico. For this third  
report on this topic, GAO determined whether the Federal	 
Emergency Management Agency (FEMA), which is now a part of the	 
Emergency Preparedness and Response Directorate of the Department
of Homeland Security, (1) paid fire claims in accordance with	 
applicable guidance and (2) implemented corrective actions to	 
address prior GAO recommendations, including determining if FEMA 
properly reported claim payments to the Congress.		 
-------------------------Indexing Terms------------------------- 
REPORTNUM:   GAO-04-129 					        
    ACCNO:   A09052						        
  TITLE:     FEMA Cerro Grande Claims: Payments Properly Processed,   
but Reporting Could Be Improved 				 
     DATE:   12/24/2003 
  SUBJECT:   Audit reports					 
	     Auditing standards 				 
	     Claims						 
	     Claims processing					 
	     Damage claims					 
	     Payments						 
	     Reporting requirements				 
	     Policies and procedures				 
	     Cerro Grande (NM)					 

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GAO-04-129

United States General Accounting Office

GAO	Report to the Committee on Appropriations, U.S. Senate, and the

             Committee on Appropriations, House of Representatives

December 2003

FEMA CERRO GRANDE CLAIMS

          Payments Properly Processed, but Reporting Could Be Improved

                                       a

GAO-04-129

Highlights of GAO-04-129, a report to the Committee on Appropriations,
U.S. Senate, and the Committee on Appropriations, House of Representatives

The Cerro Grande Fire Assistance Act (CGFAA) mandated that GAO annually
audit all claim payments made to compensate the victims of the Cerro
Grande Fire in northern New Mexico. For this third report on this topic,
GAO determined whether the Federal Emergency Management Agency (FEMA),
which is now a part of the Emergency Preparedness and Response Directorate
of the Department of Homeland Security, (1) paid fire claims in accordance
with applicable guidance and (2) implemented corrective actions to address
prior GAO recommendations, including determining if FEMA properly reported
claim payments to the Congress.

To help FEMA improve the usefulness of its reports to the Congress, GAO
recommends that the Secretary of Homeland Security require the Emergency
Preparedness and Response Directorate to include summary information on
amounts claimed, approved, and paid and remaining estimated program
liabilities in its annual report to the Congress.

The Department of Homeland Security's Emergency Preparedness and Response
Directorate concurred with our recommendation to include the summary-level
information in its next annual report.

December 2003

FEMA CERRO GRANDE CLAIMS

Payments Properly Processed, but Reporting Could Be Improved

FEMA processed and paid its claims in accordance with its policies and
procedures that were established and in place at the time the claims were
reviewed and processed. For the period from August 29, 2002, to
June 30, 2003, FEMA approved $40 million in claims for payment, including
the initial payment of most of the subrogation claims made by insurance
companies.

In response to GAO's May 2003 report, FEMA established processes to
address GAO's recommendations related to reconciling claimed amounts
approved with actual amounts paid. These processes included comparing
the individual amounts approved for payment to the amounts actually paid
from inception through June 30, 2003, by claim, as well as performing
complete reconciliations of total amounts that were approved and paid for
the same period and as of August 31, 2003. In addition, in our prior
report,
we noted that FEMA improperly reported unreconciled claim amounts
approved for payment as amounts actually paid. In its 2003 annual report,
FEMA properly identified claimed amounts as approved amounts for
payment rather than actual amounts paid in a schedule that was included in
its annual report to the Congress. However, FEMA no longer provided
summary information on amounts claimed, amounts approved, and its
remaining estimated liabilities in its report to the Congress and did not
include any information on claims paid as is required by CGFAA. Without
this information, the report is less useful to the Congress and other
stakeholders.

www.gao.gov/cgi-bin/getrpt?GAO-04-129.

To view the full product, including the scope
and methodology, click on the link above.
For more information, contact
Linda M. Calbom at (202) 512-9508 or
[email protected].

Contents

    Letter                                                                  1 
                                  Results in Brief                          2 
                                     Background                             2 
                               Scope and Methodology                        5 
              Policies and Procedures for Claim Processing Were Followed    7 
               Progress Made in Addressing Prior Recommendations, but    
                            Reporting Could Be Improved                     9 
                                    Conclusions                            11 
                        Recommendation for Executive Action                11 
                                  Agency Comments                          11 

  Appendixes

Appendix I: Comments from the Department of Homeland Security

Table Table 1:	Summary of CGFAA Approved and Estimated Claims to Be Paid
as of September 9, 2003

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A

United States General Accounting Office Washington, D.C. 20548

December 24, 2003

The Honorable Ted Stevens Chairman The Honorable Robert C. Byrd Ranking
Minority Member Committee on Appropriations United States Senate

The Honorable C.W. Bill Young Chairman The Honorable David R. Obey Ranking
Minority Member Committee on Appropriations House of Representatives

On July 13, 2000, the President signed into law the Cerro Grande Fire
Assistance Act (CGFAA).1 CGFAA established the Office of Cerro Grande Fire
Claims (OCGFC) and directed the Federal Emergency Management Agency
(FEMA)2 to expeditiously investigate claims, determine damages, and
compensate the victims of the Cerro Grande fire in northern New Mexico.
CGFAA also requires FEMA to submit an annual report to the Congress by
August 28 that provides information on claims submitted and amounts paid
during the year. CGFAA, as amended,3 requires that we audit all claim
payments made under the act, including subrogation claims4 made by
insurance companies, and report the results of our audit within 120 days
of the issuance of FEMA's annual report. In this our third report under
CGFAA, we determined whether FEMA (1) paid fire claims in accordance with
applicable policies and procedures and (2) implemented corrective actions
to address our prior report's recommendations, including determining if
FEMA properly reported claim payments to the Congress.

1Pub. L. No. 106-246, Div. C, Title I, 114 Stat. 511, 583 (2000).

2As of March 2003, FEMA became part of the Emergency Preparedness and
Response Directorate of the Department of Homeland Security.

3Pub. L. No. 107-73, Title IV, S: 428, 115 Stat. 651, 697 (2001).

4A subrogation claim is the right of one who has paid an obligation that
another should have paid to be indemnified by the other. In this case,
insurance companies and possibly others paid claims that the federal
government is responsible for paying.

Results in Brief	Based on the results of our statistical testing, FEMA
processed and paid its claims in accordance with its policies and
procedures that were established and in place at the time the claims were
reviewed and processed. These procedures included obtaining and reviewing
proper documentation of claims, approvals, and release forms. For the
period from August 29, 2002, through June 30, 2003, FEMA approved $40
million in claims for payment, including the initial payment of
subrogation claims.

FEMA addressed our prior recommendations related to reconciling claimed
amounts approved with actual amounts paid. In response to our May 2003
report,5 FEMA compared the amounts approved for payment to the amounts
actually paid for each claim from inception through June 30, 2003. It also
performed complete reconciliations of total amounts approved and paid
through the same period and as of August 31, 2003. In addition, in our
prior report, we noted that FEMA improperly reported unreconciled claim
amounts approved for payment as amounts actually paid. In its 2003 annual
report, FEMA properly identified claimed amounts as approved amounts for
payment rather than actual amounts paid in a schedule that was included in
its annual report to the Congress. However, FEMA no longer summarized the
amounts claimed, amounts approved, and the remaining program liabilities
in its report to the Congress and did not include any information on
claims paid as is required by CGFAA. Without this information, the report
is less useful to the Congress and other stakeholders.

We are making a recommendation that addresses this reporting issue. In
commenting on a draft of the report, the Director of the Recovery Division
of the Department of Homeland Security's Emergency Preparedness and
Response Directorate agreed with our recommendation to include the
summary-level information in its next annual report.

Background	On May 4, 2000, the National Park Service initiated a
prescribed burn on federal land at Bandelier National Monument, New
Mexico, in an effort to reduce the threat of wildfires in the area. The
plan was to burn up to 900 acres. On May 5, 2000, the prescribed burn
exceeded the capabilities of the

5U.S. General Accounting Office, FEMA Cerro Grande Claims: Payments
Properly Processed, but Reported Payments Somewhat Overstated, GAO-03-623
(Washington, D.C.: May 8, 2003).

National Park Service, spread to other federal and nonfederal land, and
was characterized as a wildfire. On May 13, 2000, the President issued a
major disaster declaration, and subsequently, the Secretary of the
Interior and the National Park Service assumed responsibility for the fire
and the loss of federal, state, local, tribal, and private property. The
fire, known as the Cerro Grande fire, burned approximately 48,000 acres in
four counties and two Indian pueblos, destroyed over 200 residential
structures, and forced the evacuation of more than 18,000 residents.

On July 13, 2000, the President signed CGFAA into law. Under CGFAA, each
claimant is entitled to be compensated by the United States government for
certain injuries and damages that resulted from the Cerro Grande fire.
CGFAA required that FEMA promulgate and publish implementing regulations
for the Cerro Grande program within 45 days of enactment of the law. On
August 28, 2000, FEMA published Disaster Assistance: Cerro Grande Fire
Assistance: Interim Final Rule in the Federal Register (Interim Rule).6
FEMA modified the Interim Rule with a set of implementing policies and
procedures on November 13, 2000. FEMA updated these policies and
procedures in January and March 2001. After reviewing public comments on
the Interim Rule, FEMA finalized and published Disaster Assistance: Cerro
Grande Fire Assistance Final Rule (Final Rule) on March 21, 2001.7

The Congress initially appropriated $455 million to FEMA for the payment
of such claims and $45 million for the administration of the Cerro Grande
program.8 In March 2002, FEMA requested, but did not receive, additional
appropriated funding of $80 million to cover additional claims and
administrative costs. In December 2002, FEMA revised its estimate and
requested additional appropriated funding of $155 million, including $5
million for administrative costs. The revised estimate was based on more
complete claim information since the final date to submit claims had
passed on August 28, 2002. In February 2003, FEMA was appropriated an
additional $90 million, of which up to $5 million may be made available
for

665 Fed. Reg. 52260, 44 C.F.R. Part 295 (2000). 766 Fed. Reg. 15948, 44
C.F.R. Part 295 (2001). 8CGFAA, Sec. 105, 114 Stat. 590.

administrative purposes.9 FEMA stated that only $2 million was used in
fiscal year 2003 for administrative purposes. In October 2003, FEMA
received an additional appropriation of $38.062 million, of which 5
percent may be made available for administrative costs.10 After FEMA
allocated a specific amount for administrative costs, it had a maximum of
$578.6 million available for the payment of claims under CGFAA. During the
audit, FEMA provided revised claim data that reflected the amounts shown
in table 1.

Table 1: Summary of CGFAA Approved and Estimated Claims to Be Paid as of
September 9, 2003

                              Dollars in thousands

  Claim amounts Amounts approved for payment from inception $505,698 Estimated
                            additional liabilities:

                              Pending claims 3,705

                                 Appeals 12,973

                                Mitigation 1,138

                          Projected liabilities 9,339

                 Subrogation claims--approved but unpaid 1,634

                 Subrogation claims--unapproved amounts 53,160

                 Total estimated additional liabilities $81,949

             Total actual and estimated claims to be paid $587,647

Source: FEMA OCGFC.

The claimed amounts that FEMA approved for payment through September 9,
2003, included $51.5 million of approved subrogation claims. Pending
claims included expected payments for individual, business, governmental,
and pueblo claims, and projected liabilities consisted of potential future
appeals, potential arbitrations, and contingency for judicial review.

9Departments of Veterans Affairs and Housing and Urban Development, and
Independent Agencies Appropriations Act, 2003, Pub. L. No. 108-7, Div. K,
Title III, 117 Stat. 474, 516.

10Department of Homeland Security Appropriations Act, 2004, Pub. L. No.
108-90, Title III, 117 Stat. 1137, 1150 (2003).

CGFAA requires that FEMA submit an annual report to the Congress that
provides information about claims submitted under the act. This annual
report is to include the amounts claimed, a description of the nature of
the claims, and the status or disposition of the claims, including the
amounts paid. FEMA's report is to be issued annually by August 28. CGFAA,
as amended, requires that we conduct annual audits on the payment of all
claims made and report the results of the audits to the Congress within
120 days of FEMA's issuance of its annual report. The act also requires
that our report include a review of all subrogation claims for which
insurance companies have been paid. In May 2003, we issued our second
report on the audit of Cerro Grande claim payments made from inception
through August 28, 2002. The report stated that FEMA properly processed
and paid claims but overstated amounts paid in its report to the Congress
and made two recommendations regarding the reconciliation of the approved
and paid amounts in its payment approval and accounting systems.11 FEMA
issued its most recent annual report on August 28, 2003, with claim
amounts approved for payment through June 30, 2003.

  Scope and Methodology

In performing our review, we considered the Standards for Internal Control
in the Federal Government.12 To reaffirm our understanding of the claim
review and payment process established by OCGFC and to follow up on the
changes made to this process since our last report, we interviewed FEMA
officials and analyzed data used in FEMA's annual report to the Congress
and data used by FEMA to determine the estimated claim liability. We also
reviewed the following:

o  the requirements of CGFAA;

o  the final regulations published in the Federal Register;

o  FEMA's policies and procedures manual;

o 	a summary of FEMA's unpaid claim liability estimates as of September 9,
2003;

11GAO-03-623.

12U.S. General Accounting Office, Standards for Internal Control in the
Federal Government, GAO/AIMD-00-21.3.1 (Washington, D.C.: November 1999).

o  FEMA's fiscal year 2002 audited financial statements; and

o 	the fiscal year 2003 approvals, payments, and other documentation
concerning the Cerro Grande program and submitted claims.

Finally, we selected a statistical sample from the population of all
partial and final claimed amounts approved for payment from August 28,
2002, through June 30, 2003, to determine whether FEMA processed,
approved, and paid the Cerro Grande fire claims in accordance with its
applicable policies and procedures.

We selected a dollar unit (statistical) sample of 99 intervals
representing 84 claims totaling $21,000,928 that were approved for payment
from a population of 1,868 reported partial and final claim amounts that
had been approved for payment from August 28, 2002, through June 30, 2003
(FEMA's cutoff date for the annual report to the Congress), to test
specific control activities, such as adequacy of supporting documentation,
evidence of claims manager and approving official review, and actual
payment by FEMA. We obtained and reviewed related supporting documentation
for the approved claim payments that were selected from OCGFC's payment
approval system.

In order to follow up on FEMA's corrective actions to address our prior
year recommendations, as well as determine whether FEMA properly reported
claim payment information to the Congress, we reviewed OCGFC's
reconciliations of claimed amounts that were approved by OCGFC for payment
from its payment approval system and the actual claim payments made by
FEMA's Disaster Finance Center (DFC) and reported in FEMA's accounting
system.

Our work was conducted in Denton, Texas,13 and Washington, D.C., from
September 2003 through October 2003 in accordance with generally accepted
government auditing standards. We requested agency comments on a draft of
this report from the Under Secretary of the Department of Homeland
Security's Emergency Preparedness and Response Directorate or his
designee. The Director of the Recovery Division of the Department of
Homeland Security's Emergency Preparedness and Response

13In December 2002, OCGFC closed its headquarters operations in Santa Fe,
New Mexico, and moved the remaining claims operations to FEMA's National
Processing Center in Denton, Texas.

Directorate provided written comments on our draft, which are reprinted in
appendix I. We discuss the written comments in the "Agency Comments and
Our Evaluation" section of this report.

  Policies and Procedures for Claim Processing Were Followed

Based on the results of our statistical testing, FEMA processed, approved,
and paid its claims in accordance with its guidelines that were
established and in place at the time the claims were reviewed and
processed. FEMA's guidelines for the approval and payment of claims
specify the following steps.

o 	An injured party submits a Notice of Loss (NOL)14 to OCGFC to initiate
the claim payment process.

o 	Upon receipt of the NOL, a claim reviewer contacts the claimant to
discuss the claim, explain the claims process, and determine the best
means to substantiate the loss or damages.

o 	The claim reviewer then assigns a claim number and enters the
information into OCGFC's claim-processing database, the Automated Claim
Information System, and begins the process of verifying the victim's
claim.

o 	Upon completion of its review, the claim reviewer prepares a claim
payment recommendation package, which specifies that a claimant's injuries
or damages occurred as a result of the Cerro Grande fire and that claimed
amounts are eligible for compensation under CGFAA.

o 	The claim reviewer also inputs reserve amounts equal to the total
claimed amounts that he/she expects to be paid into the claimprocessing
database.

o 	A claim supervisor reviews to ensure that a proper investigation of the
claim occurred and that the proper documentation exists, among other
things, and approves each recommendation package.

14The NOL describes in general terms the types of injury, damages, or both
a claimant has incurred as a result of the fire.

o 	Upon approval of the claim payment recommendation package, an Approval
for Payment form is completed and sent to an OCGFC authorizing official
for review and approval.

o 	The Comptroller receives a Schedule of Payments, consisting of amounts
approved for payment, and reviews a sample of requested and approved
payments.

o 	The Comptroller then approves the Schedule of Payments, records the
approved amounts in OCGFC's payment approval system, and sends the
schedules to FEMA's DFC for additional manual processing.

o 	FEMA records all payments in its accounting system, the Integrated
Financial Management Information System, which is not linked to OCGFC's
payment approval system, before funds are disbursed by Treasury.

In addition to the above steps from the claim review process, which is
used for both partial payments15 and final payments, the claim reviewer
prepares a Proof of Loss (POL) form prior to processing a final payment.
This form summarizes all amounts recommended for payment, including those
amounts previously paid through a partial payment. The POL form must be
signed by the claimant subject to the provisions of 18 U.S.C. S:1001,
which establishes criminal penalties for false statements. Once a signed
POL form is received, an OCGFC authorized official sends a Letter of Final
Determination to tell the claimant the total amount of compensation being
offered under CGFAA. Accompanying this letter is a Release and
Certification form that the claimant signs if he or she accepts the OCGFC
compensation determination, thereby releasing the federal government from
any additional claims arising from the Cerro Grande fire.16 Upon receipt
of the signed Release and Certification form, FEMA processes and mails a
claimant's final payment.

15In order to get assistance to fire survivors as soon as possible, CGFAA
allows for claimants to receive partial payments before the start of the
rebuilding process. Partial payments may be based upon actual receipts or
estimates. Final payments are made only after the entire claim review
process is completed.

16Under certain circumstances, claims may be reopened notwithstanding the
submission of a Release and Certification form pursuant to 44 C.F.R. Sec.
295.34 (2002).

Our review of the statistically selected sample of approved claims
determined that the above steps were performed in accordance with FEMA's
established approval and payment process. For the period from August 29,
2002, through June 30, 2003, FEMA approved claims in the amount of $40
million for payment,17 including the partial payment of approved
subrogation claims filed by insurance companies.

  Progress Made in Addressing Prior Recommendations, but Reporting Could Be
  Improved

FEMA addressed our prior recommendations related to reconciling the
reported amounts approved for payment to amounts actually paid. FEMA
reconciled the total amounts approved for payment to the amounts actually
paid as of June 30, 2003, which was the cutoff date for its annual report,
and as of August 31, 2003. FEMA officials stated they would continue to
perform these reconciliations periodically. In reviewing FEMA's annual
report to the Congress required by CGFAA, we found that while improvements
were made in how FEMA represented the detailed claim information in its
report, claim information was no longer summarized in the report, making
it less useful and transparent.

In our May 2003 report, we recommended that FEMA reconcile the amounts
approved for payment in its payment approval system to amounts actually
paid in its accounting system and correct all identified errors in its
payment approval system. We also recommended that FEMA perform monthly
reconciliations of the approved and paid amounts for as long as both
systems are used to track and report paid amounts or request additional
funding.

In response to our recommendations, OCGFC implemented a detailed process
that consisted of compiling the claimed amounts by individual claims from
both the accounting system and the payment approval system and matching
the amounts approved and paid for each claim. It also performed an overall
reconciliation of the total amounts approved and paid through June 30,
2003.

In performing the detailed matching process, OCGFC compared the individual
claim approval data and claim payment data from August 28, 2000, through
February 19, 2003, and performed periodic comparisons of individual claims
from February 20, 2003, to May 31, 2003, and from June 1

17From inception of CGFAA through June 30, 2003, FEMA reported a total of
$462 million in claims approved for payment.

to June 30, 2003. When OCGFC identified differences between amounts
reported as paid by FEMA's accounting system and OCGFC's payment approval
system, it recorded the adjustments and corrections into its payment
approval system to eliminate duplication and made note of data entry
errors, which did not require adjustments. The identified differences
generally consisted of the following:

o 	Duplicate approved amounts that represented a claimed amount that was
approved for payment more than once. For example, in one case OCGFC
approved a final payment of $934,802. Since the claimant appealed, the
amount was not paid. While the claim was being appealed, OCGFC approved a
partial payment of $919,802. Both of these amounts appeared as approved
payments in its payment approval system. After we brought this duplicate
approval to OCGFC's attention during our prior review, it subsequently
removed the original unpaid amount from its system during its claims
comparison process later in fiscal year 2003.

o 	Data entry errors by claim reviewers when entering data into the
payment approval or accounting systems. For example, if an incorrect
identification number was used to process a payment, no comparison could
be made between the approved amount recorded by claim number in the
approval system and the paid amount recorded by claimant's identification
number in the accounting system. To resolve the situation, OCGFC listed
the approved amount as an unmatched item until it located the matching
payment that was recorded to a different identification number.

In addition to these comparisons of individual claim amounts, FEMA's
Financial and Acquisition Management Division (FAMD) performed a complete
reconciliation of the total amounts that were approved for payment and
paid as of June 30, 2003. We reviewed this overall reconciliation of the
total claim amounts approved and paid under CGFAA, from inception through
June 30, 2003, and found that all corrections and adjustments identified
during OCGFC's comparison were made. FAMD also performed a similar
reconciliation of total approved and paid amounts through August 31, 2003,
and stated that it plans to perform this overall reconciliation more
regularly, at least quarterly.

In our prior report, we noted that FEMA improperly reported unreconciled
amounts that were approved for payment in its prior annual reports to the
Congress as amounts actually paid. In its 2003 annual report to the

Congress, FEMA continued to include claimed amounts approved for payment
in a detailed schedule of claim information, but it properly identified
the amounts as such instead of as paid or expended amounts. However,
FEMA's report no longer summarized information on the amounts claimed,
amounts approved, and the estimated liabilities for the remainder of the
program. In addition, FEMA did not include any information on claims paid
as is required under CGFAA. Without this information, FEMA's annual report
is less useful to the Congress and other stakeholders.

Conclusions	FEMA strengthened its internal controls over its claim
approvals and payments by implementing a process to reconcile its detailed
approval information to its payment information. This helps improve the
accuracy of claims information included in its systems and reports to the
Congress. The usefulness and transparency of the report would be further
improved if it included summary claim activity information.

Recommendation for 	We recommend that the Secretary of Homeland Security
direct the Under Secretary of the Emergency Preparedness and Response
Directorate to

Executive Action	include summary-level claim information in its annual
report to the Congress, including amounts claimed, approved, and paid and
remaining estimated program liabilities.

Agency Comments 	FEMA, in a letter from the Director of the Recovery
Division of the Department of Homeland Security's Emergency Preparedness
and Response Directorate, agreed with our recommendation to include
summary-level claim information on amounts claimed, approved, and paid and
remaining estimated program liabilities, if any, in its next annual report
to the Congress. The Department of Homeland Security's comments are
reprinted in appendix I.

We are sending copies of this report to the congressional committees and
subcommittees responsible for issues related to FEMA and the Department of
Homeland Security, the Secretary of the Department of Homeland Security,
the Under Secretary of the Department of Homeland Security's Emergency
Preparedness and Response Directorate, and the Inspector General of the
Department of Homeland Security. Copies will also be made

available to others upon request. In addition, this report is available at
no charge on GAO's Web site at http://www.gao.gov.

If you have any questions about this report, please contact me at (202)
5129508 or Steven Haughton, Assistant Director, at (202) 512-5999. The
other key contributors to this assignment were Christine Fant and Estelle
Tsay.

Linda M. Calbom Director, Financial Management and Assurance

Appendix I

Comments from the Department of Homeland Security

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