Journal articles on the topic 'Federal Insurance Guaranty Agency'

In early 1989, the system of deposit insurance in the United States was in crisis. The Federal Savings and Loan Insurance Corporation (FSLIC), the U.S. government agency that provided deposit insurance for savings and loan (thrift) institutions, had sustained massive losses from the insolvencies of hundreds of thrifts. Tens of billions of dollars of general Treasury revenues will be necessary to make good the losses in the insurance fund, which had previously been financed solely through premiums assessed on thrifts' deposits. The Federal Deposit Insurance Corporation (FDIC), which provides similar insurance for deposits in commercial banks, has sustained much smaller losses but is considered to be in poor enough financial condition that its premium assessments will increase substantially. This article will review the current system of deposit insurance and advocate a set of necessary reforms.

Purpose The purpose of this paper is to scrutinize the structure of the federal crop insurance program and test whether participating private insurers screen insurance buyers better than the federal agency. Design/methodology/approach This paper regresses the claim payout on the risk share of private insurers in insurance pools and other relevant variables. The claim payout should be negatively related with the private insurers’ risk share if private insurers screen insurance buyers better than the federal agency. Findings The payout rates are significantly lower for reinsurance funds with higher risk shares of AIPs, and the relationship between the two variables is not affected much by the aggregate yield (similar relationship in good crop years and bad crop years). Practical implications The federal government could improve the effectiveness and the efficiency of the crop insurance program by restructuring its delivery system. Originality/value The novel contributions of this paper include estimating the economic significance of private insurers’ screening advantage and showing that the economic significance is similar in good crop years and bad crop years.

AbstractThe Pension Benefit Guaranty Corporation's (PBGC) Pension Insurance Modeling System (PIMS) is used to evaluate the financial security and resilience of the national program backstopping private defined benefit plans. The Pension Research Council of the Wharton School at the University of Pennsylvania recently convened a Technical Review Panel of experts to review key inputs, outputs, and model assumptions. Our review was intended to provide a formal evaluation of the technical adequacy of the model by outside experts. The papers herein summarize views of each expert on this project. Key findings are as follows: •The PIMS models are an important and valuable tool in modeling the Pension Benefit Guaranty Corporation's liability risk. To the best of our knowledge, there is no other model that can do a comparable job.•Nevertheless, some improvements could be integrated in the Agency's approach to modeling. Those deserving highest priority attention, in the experts’ view, include incorporating systematic mortality risk (i.e., treat mortality and longevity as stochastic variables); including new asset classes increasingly found in defined benefit plan portfolios (e.g., commercial real estate, private equity funds, infrastructure, hedge funds, and others); developing a more complex model for the term structure of interest rates; and incorporating an option value approach to pricing the insurance provided.•The Agency could also do more to communicate the range of uncertainty and potential for problems associated with the PBGC's financial status. This could include additional information including the conditional value-at-risk, and perhaps an ‘intermediate,’ ‘optimistic’, and ‘pessimistic’ set of projected outcomes, as well as the expected ‘date of exhaustion’ for assets backing pension benefits insured by the PBGC.

Purpose Rent seeking is endemic to the process through which any policy or regulatory initiative is developed in the USA. The purpose of this paper is to show how farm and other interest groups have formed coalitions to benefit themselves at the expense of the federal government by examining the legislative history of the federal crop insurance program. Design/methodology/approach The federal crop insurance legislation and the way in which the USDA Risk Management Agency manages federal crop insurance program are replete with complex and subtle policy initiatives. Using a new theoretical framework, the study examines how, since 1980, three major legislative initiatives – the 1980 Federal Crop Insurance Act, the 1994 Crop Insurance Reform Act and the 2000 Agricultural Risk Protection Act – were designed to jointly benefit farm interest groups and the agricultural insurance industry, largely through increases in government subsidies. Findings Each of the three legislative initiatives examined here included provisions that, when considered individually, benefitted farmers and adversely affected the insurance industry, and vice versa. However, the joint effects of the multiple adjustments included in each of those legislative initiatives generated net benefits for both sets of interest groups. The evidence, therefore, indicates that coalitions formed between the farm and insurance lobbies to obtain policy changes that, when aggregated, benefited both groups, as well as banks with agricultural lending portfolios. However, those benefits came at an increasingly substantial cost to taxpayers through federal government subsidies. Originality/value This is the first analysis of the US federal crop insurance program to examine the issue of coalition formation.

American policymakers and health policy analysts have a love-hate relationship with job-based health insurance. The policy press routinely runs articles about the demise of the current system of voluntary employer-sponsored health insurance coverage. Conservatives argue that it ought to be replaced with individually-purchased insurance, such as tax-favored spending accounts (see Mark Pauly’s article this issue). Liberals assert that government insurance ought to supplant it.Meanwhile, as the debate rages on about the future of employer coverage, states and the federal government pass legislation buttressing and building on the existing employment-based system. Most recently, California has passed an employer mandate requiring employers to cover their workers (and many other states have contemplated similar legislation) and Maine has adopted a universal coverage initiative that includes a voluntary small employer insurance program offered through a state agency (Dirigo Health Care).

The Whittier Narrows earthquake of October 1, 1987 caused significant damage in the Los Angeles urban area. This event provided an opportunity to observe the type and amount of damage sustained by public property and to investigate the funding mechanisms used to repair the damaged facilities. Repair of earthquake damage to public property, which includes public buildings and infrastructure lifelines, is largely funded by state and federal disaster relief payments. Records of the Federal Emergency Management Agency and California Office of Emergency Services were analyzed to determine the value of damage to different classes of infrastructure and public property. Nearly half of the total damage caused by this earthquake occurred to public buildings. The fact that public buildings comprise such a large proportion of the damage is important because these structures were eligible for private earthquake insurance. This factor should be considered in developing a national earthquake insurance program.

In Canada, the financial industry rests upon “four pillars.” These are the securities, insurance, trust, and banking sectors. The first three have been, historically, regulated at the provincial level under the rubric of “property and civil rights,” while the fourth has been federally regulated under section 91(15) of the Constitution Act, 1867. As early as 1935, however, a Royal Commission recommended the establishment of a federal securities agency tasked with overseeing federally incorporated companies. Nothing came of that. In the 1960s and until last year, numerous other studies came up with proposals regarding the establishment of a federal securities regulator. Some proposed a federal regular coexisting with provincial counterparts, while others proposed one single federal regulator. How to get the provinces on board varied depending on the study that was conducted.

PurposeFederal crop insurance programs are the primary risk management programs of the US farm programs. Currently, these programs have been criticized for being disproportionally in favor of the riskier areas. Despite previous researchers having widely speculated its existence, a formal study of the scale, spatial pattern and fiscal impacts of such misrating phenomenon is still missing in the literature.Design/methodology/approachThis paper first purposes an empirically testable definition of misrating, and then detects the scale of the misrating phenomenon by using over two million actuarial records collected by United States Department of Agriculture (USDA's) risk management agency since 1989. Furthermore, multiple spatial statistics methods have been adopted to study the spatial patterns of the misrating statuses. Finally, the paper builds a simple theoretical model to study the potential fiscal impacts of any policy attempts to mitigate the misrating issue.FindingsThe result reveals that roughly 40% of the counties display some degree of misrating. Furthermore, the distribution of misrating displays a significant pattern of positive global spatial autocorrelation, which reflects the existence of regional clusters of premium rate mispricing. Last but not least, the paper concludes that whether an attempt toward fair rating decreases the total program outlay or not relies on the demand elasticity of crop insurance in both overrated and underrated regions.Originality/valueThis paper offers the first attempt to quantify the scale, identify the spatial pattern and evaluate the fiscal impact of the premium misrating in federal crop insurance programs.

North Carolina, a federally facilitated marketplace under the Affordable Care Act (ACA), stumbled in 2013 when opening its health-insurance exchange. Trouble was easy to foresee, as North Carolina had instituted a law barring any state agency from assisting enrollment in health-insurance plans made available through the ACA. Trained workers were needed to help citizens and legal immigrants “navigate” to these plans. Some of these “navigators” could be paid with federal funds, but many others had to work as volunteers. I was one of these volunteer navigators. Much went wrong in training, staffing, and operations, but much still was accomplished. Here I report observations, share assessments, and offer suggestions for similarly complex situations.

The National Flood Insurance Program (NFIP) is administered by the Federal Emergency Management Agency (FEMA) through its Mitigation Division. The NFIP is an insurance, mapping, and land use management program that provides the availability of federally backed flood insurance to home and business owners located in communities that participate in the NFIP. FEMA is currently in the middle of a five-year, billion dollar effort to modernize the Nation's Flood Insurance Rate Maps (FIRMs). FIRMs are an integral part of the NFIP as they provide information used for setting insurance rates and for land use management purposes. As part of the “Map Modernization” effort, FEMA is revamping the Guidelines and Specifications for Flood Hazard Mapping Partners, including guidelines specific to coastal hazards. This major revision to the coastal Guidelines follows nearly 40 years (beginning with the inception of the NFIP in 1968) of improving the assessment and mapping of coastal hazards as new technologies evolve, coastal processes become better understood, and methods for assessing and mapping the risk become more reliable.

Abstract In the United States, the national framework to address flood risk is the 50-year-old National Flood Insurance Program where the government bears the risk and private insurers handle customer policies. The program bundles insurance with flood mapping, floodplain management, and mitigation in the Federal Emergency Management Agency. Despite financial shortfalls and political controversy, evidence shows that public support is sufficient to continue and reform the program. Originally intended to transfer risk from taxpayers to insurance, the program recently required a taxpayer bailout after major hurricane-induced flood losses. Affordability of premiums is a major financial concern, even while premiums are forecast to rise. The flood mapping program is key to risk assessment, but it needs much improvement. The risk pool depends on compliance with floodplain resilience controls, which work better in riverine environments than in coastal zones. There is evidence of increased private sector interest in offering flood insurance. Politics raise questions about whether the needed reforms will succeed, but promising initiatives are to base premiums on risk, emphasize improvements in flood mapping, increase the involvement of private insurers in flood insurance, and increase responsibility of the state and local governments in flood risk resilience.

Flood Insurance Studies (FISs) produced by the Federal Emergency Management Agency (FEMA) per the National Flood Insurance Program (NFIP) regulations and guidelines adopt storm-induced erosion criteria often called the “540 rule”. The methods used in the erosion analysis have been in place since the 1980s. The method requires dunes to be classified as fully eroded, or “removed”, when their cross-sectional reservoir is smaller than 540 square feet. Since the rule’s first application, additional data and recent evidence have become available leading FEMA to identify this approach as an area of the program in need of updating and improvement. Experts involved in conducting coastal hazard analyses for FEMA studies recommend exploring opportunities to improve FEMA guidelines for erosion criterion and revise NFIP regulations and guidance, as needed, to ensure that storm-related erosion hazards are appropriately evaluated and mapped along US coastlines.

From the start of the pandemic, the American public has had inconsistent and often limited access to the COVID-19 data held by their governments. As legal cover for this lack of transparency, state and local officials have frequently invoked one federal law – the Health Insurance Portability and Accountability Act, better known as HIPAA – and its associated regulations. This article examines that trend. It unpacks the key parts of the regulations and explains why, in many cases, they provide no legal basis for agency refusals to disclose coronavirus-related information. The article also offers potential strategies to requesters seeking to pry that data loose.

ABSTRACT This paper examines oil pollution response during disaster situations when the Stafford Act is invoked by the President and the National Response Framework provides funding under ESF-10. The interrelationship between the National Contingency Plan (NCP), created by various pollution statues (Clean Water Act/CWA, Comprehensive Environmental Response, Compensation, and Liability/CERCLA, Oil Pollution Act/OPA) and the National Response Framework (NRF), created to deal with declared disasters under the Stafford Act, is becoming more fractious as time passes and the financial scope of disasters grows. The paradigm that existed when Hurricane Katrina made landfall in 2005 was not in evidence when Hurricanes Isaac and Sandy made landfall in the fall of 2012. The NCP envisions oil and chemical spill response in the context of a single spill, ideally with a known responsible party (RP), who takes action to respond to the spill. That RP is liable for costs and damages resulting from the spill. Action commences when the spill occurs and the Federal On-Scene Coordinator (FOSC) determines that federal action is required. If the federal funds (Oil Spill Liability Trust Fund/OSLTF, CERCLA/SUPERFUND) are used, the federal government seeks cost recovery afterwards. The NRF envisions the federal government acting like a “no-fault insurance” regime, providing federal resources/funds to states when their capabilities are overwhelmed and their citizens require immediate succor. FEMA action commences when the State requests and the President approves aid. The states agree to a cost share – not to exceed 25% of Federal funding. There is no private party liability when actions are complete. The Homeland Security Act established the NRF, and operationally subsumes the NCP under it. However, the Homeland Security Act does not address what fund (Stafford or the pollution funds) will be used when a declared disaster occurs. Furthermore, the Stafford Act structure (State requests, Presidential approvals, Federal Emergency Management Agency Federal Coordinating Officer (FEMA FCO) appointment, area surveys, mission assignments) becomes sclerotic in a large incident when compared to the much more nimble NCP process (spill, FOSC decision, immediate funding). The effect for Coast Guard (CG) and Environmental Protection Agency (EPA) field responders is to lean forward with NCP processes to protect the public. FEMA, faced with dwindling resources, observes this tendency and declines to provide disaster funding when the other federal funds “can be used”. The paper proposes a new paradigm for the “Makris-Suiter” Agreement of 1998 between EPA and FEMA. The opinions stated in this paper are the author's alone, and do not reflect the official policies of the United States Coast Guard.

The article analyzes the development policy, agenda sources, policy formation, implementation, and evaluation process of Nepal. The description of policy agendas, role of the National Planning Commission (PSC) as development policy agency, trend of planned development approach in Nepal its review target achievements and discussion of identified problems of development plans are also the contents of the article. It further explains the explored problems and ideas to solve them in a complete development policy process Nepal. The article examines the level of social justice analyzing whole development policy process of Nepal along with the interpretation of policy agency through the lance of power sharing based on thematic analysis of data. The article has concluded that the current development policy process is centralized, top-down and elite dominated in a old tendency which is not compatible process to federal structure of Nepal. The reformation of this old tendency through inclusive, bottom-up approach and deconstruction of centralization with insurance of multi-dimensional meaningful participation and ownership development to the concerned stakeholders in all levels is the way of solution. The reformation is necessary in both policy agency institutional structure and policy process of development, such as:, agenda setting, situation analysis, alternative selection, policy adoption, and implementation with due monitoring and evaluation process for the bright future of Nepali peoples.

On the evening of October 29, 2012, “Hurricane” Sandy made land- fall on the New York coastline, battering the land with strong winds, torrential rain, and record-breaking storm surges. Homes and commercial structures were destroyed; roads and tunnels were flooded; and more than 23,000 people sought refuge in temporary shelters, with many others facing weeks without power and electricity. At the time, Sandy was heralded as one of the costliest hurricanes in the his- tory of the United States; the second costliest hurricane only to Katrina, which hit New Orleans in 2005. Unfortunately, recent experience with Hurricanes Florence, Maria, Harvey, and Irma suggest that this pattern of devastating superstorms may become the new norm as climate change produces more extreme and unpredictable weather events. In Sandy’s aftermath, as individuals returned to their homes, or what remained of them, and communities began to rebuild, the true cost of the storm became apparent. A year after the storm, the Federal Emergency Management Agency (“FEMA”) estimated that over $1.4 billion in assistance was provided to 182,000 survivors of the dis- aster; another $3.2 billion was provided to state and local governments for debris removal, infrastructure repair, and emergency protective measures. More than $2.4 billion was provided to individuals and businesses in the form of low-interest loans through the Small Business Administration (“SBA”), and millions more were spent on grants de- signed to implement mitigation measures in the future and to provide unemployment assistance to survivors. Before the storm, homeowners paid premiums for flood insurance provided through the National Flood Insurance Program (“NFIP”), and for homeowner’s insurance provided by dozens of private insurers. In the months following the storm, they began to file claims for assistance in rebuilding their homes. While many such claims were re- solved successfully, many homeowners were unhappy with the settlement amounts offered by their insurance carriers and felt compelled to file lawsuits in the surrounding state and federal courts. Many of those lawsuits were filed in the United States District Court for the Eastern District of New York (“EDNY”). This case study describes the EDNY’s specifically crafted, unique approach to handling the mass litigation that ensued from Sandy’s devastation, documents some of the problems that the Court faced during that mass litigation, and describes some of the lessons learned from the Court’s experience.

Rising sea levels and the resultant amplification of flood frequencies and magnitude has the potential to significantly change coastal flood hazards over the coming century. The Federal Emergency Management Agency (FEMA) has recognized the potential future implications of Sea Level Rise (SLR) on coastal hazards and flood insurance. However, at present, FEMA does not incorporate future conditions information in to their regulatory or non-regulatory products in the framework of their National Flood Insurance Program. Many other programs that create products to support risk recognition and resilient planning are based on “bathtub” approaches (for example NOAA’s Sea Level Rise Viewer: https://coast.noaa.gov /digitalcoast/tools/slr). In order to better understand non-linear changes in coastal flood hazards, due to increased water depth and wave heights, or in the surge propagation pathway, FEMA has funded a series of pilot studies. For this study an end-of-the-century SLR condition has been imposed on storm surge simulations in West Florida to gain further understanding into how SLR may modify surge and wave effects, as well as potential techniques for approximating these via efficient approximate methods. Both the detailed nonlinear methods and approximate linear approaches for developing SLR advisory information will be evaluated and compared for this study. A second, mid-century SLR condition was utilized for a shoreline change analysis to evaluate how recession due to SLR may affect coastal flood hazards.

Abstract. Pre-disaster planning and mitigation necessitate detailed spatial information about flood hazards and their associated risks. In the US, the Federal Emergency Management Agency (FEMA) Special Flood Hazard Area (SFHA) provides important information about areas subject to flooding during the 1 % riverine or coastal event. The binary nature of flood hazard maps obscures the distribution of property risk inside of the SFHA and the residual risk outside of the SFHA, which can undermine mitigation efforts. Machine learning techniques provide an alternative approach to estimating flood hazards across large spatial scales at low computational expense. This study presents a pilot study for the Texas Gulf Coast region using random forest classification to predict flood probability across a 30 523 km2 area. Using a record of National Flood Insurance Program (NFIP) claims dating back to 1976 and high-resolution geospatial data, we generate a continuous flood hazard map for 12 US Geological Survey (USGS) eight-digit hydrologic unit code (HUC) watersheds. Results indicate that the random forest model predicts flooding with a high sensitivity (area under the curve, AUC: 0.895), especially compared to the existing FEMA regulatory floodplain. Our model identifies 649 000 structures with at least a 1 % annual chance of flooding, roughly 3 times more than are currently identified by FEMA as flood-prone.

The height above nearest drainage (HAND) model is frequently used to calculate properties of the soil and predict flood inundation extents. HAND is extremely useful due to its lack of reliance on prior data, as only the digital elevation model (DEM) is needed. It is close to optimal, running in linear or linearithmic time in the number of cells depending on the values of the heights. It can predict watersheds and flood extent to a high degree of accuracy. We applied a client-side HAND model on the web to determine extent of flood inundation in several flood prone areas in Iowa, including the city of Cedar Rapids and Ames. We demonstrated that the HAND model was able to achieve inundation maps comparable to advanced hydrodynamic models (i.e., Federal Emergency Management Agency approved flood insurance rate maps) in Iowa, and would be helpful in the absence of detailed hydrological data. The HAND model is applicable in situations where a combination of accuracy and short runtime are needed, for example, in interactive flood mapping and supporting mitigation decisions, where users can add features to the landscape and see the predicted inundation.

Under the ominous title “Rehearsal for State Medicine,” the 17 December 1938 issue of the Saturday Evening Post told its readers about a new health program sponsored by the Farm Security Administration (FSA), a New Deal agency that provided low-interest “rehabilitation loans” to low-income farmers. As an outgrowth of the loan program, the FSA had established cooperative health plans that, for a small annual fee, allowed FSA clients to receive affordable health care. But according to the article's co-authors—Samuel Lubell and Walter Everett—there was much more to the FSA health pro-gram. “What the FSA is doing,” Lubell and Everett claimed, “affords a rare glimpse into what the future might bring.” Their article appeared in the midst of a national debate over health care reform and only months after President Franklin Roosevelt had convened hundreds of doctors, social workers, and public health reformers for a National Health Conference. Charged with the task of making recommendations for a national health program, the conference produced a final report that suggested a range of public policies that might make health care more affordable and accessible. Most controversially, the final report called upon lawmakers to consider creating a program of government-sponsored health insurance. “Though Congress and the nation are debating the prickly issue of state medicine,” Lubell and Everett noted with obvious disapproval, “one Federal agency [the FSA] has jumped the legislative gun and initiated its own program of socialized medicine.” Although they would have rejected the term “socialized medicine,” the architects of the FSA health plans had indeed envisioned a “rehearsal” of sorts.

OBJECTIVES/SPECIFIC AIMS: N/A. METHODS/STUDY POPULATION: Over a million people gained insurance in Los Angeles (LA) County under the Affordable Care Act (ACA). The vast majority gained Medicaid—government sponsored insurance with low-cost sharing. LA County also made significant investments in the safety net including a program called MyHealthLA, which provides primary and tertiary care for the residually uninsured including poor undocumented individuals at specific sites. Despite this insurance expansion, approximately 3 quarters of a million people in the county remain uninsured. Regardless of insurance status, nearly a quarter of LA County residents reported having difficulty obtaining needed medical care, and among those making less than the poverty level, 43% had difficulties. There is still much to understand about barriers to obtaining insurance and accessing healthcare in Los Angeles in the post-ACA era. Our primary objective was to understand how safety net patients are obtaining, maintaining and using their insurance after the ACA. Specifically we hope to understand the barriers and drivers of these three processes. RESULTS/ANTICIPATED RESULTS: We conducted a qualitative study of 34 safety net patients with 3 different insurance types in LA County. We conducted in-person interviews with adult patients (ages 18–64 years), who had either MediCal, MyHealthLA, or were unsinsured. Our interview guide was based on existing literature, a previous qualitative study conducted in Massachusetts and input from experts in the field. We pilot tested our interviews in English and Spanish and then recruited our participants from 3 sites: LAC+USC (a publically funded county hospital), The Wellness Center (a resource center for safety net patients), and White Memorial Medical Center (a private safety net hospital). We approached patients in the ED and urgent care waiting rooms and obtained informed consent for this IRB approved study. We excluded patients who were non-English and non-Spanish speaking or too ill to interview. We recorded interviews, which were then transcribed and translated into English by a contracted agency. We analyzed our interviews using a framework approach, which included a set of a priori codes from the literature as well as emerging codes from patient responses. We will check a sample of our transcripts for coding consistency (aiming for an inter-rater reliability of >80%). DISCUSSION/SIGNIFICANCE OF IMPACT: We recruited a diverse group of patients that were demographically representative of those who gained insurance under the ACA (childless adults making less than 138% of the Federal Poverty Level). Our preliminary results (based on 17 transcripts), suggest that patients, regardless of insurance type have difficulty accessing primary care. We identified seven domains under the broader theme of barriers to accessing primary care: finding a primary care clinic or physician (PCP), getting timely appointments, geography and transportation, continuity of care, using the Emergency Department (ED) or urgent care as a PCP, switching PCPs or clinics, and cost or coverage.

Today, export promotion and support is an integral part of the trade policy of developed countries, where there is a developed system of state support and promotion of national exports, the effectiveness of which has been repeatedly proven in practice. Awareness of the need to form a unified system of state institutions that provide various non-financial and financial services to participants in foreign economic activity is the main result of state support for exports to Russia over the past few years. Thus, the creation of the Russian Agency for export credit and investment insurance was the initial stage of the Russian Government on the way to creating a single integrated system that will ensure and support the development of export activities in Russia both at the national level and at the level of economic sectors, as well as individual industries. At the moment, various government agencies are engaged in export procedures. The ministries of industry and trade are in charge of subsidizing the interest rate on export contracts, as well as issuing licenses for export operations. The Ministry of economic development of Russia commands the activities of trade missions. The Ministry of Finance of Russia provides state guarantees. The Federal customs service monitors customs clearance of foreign trade transactions, and the Ministry of Finance is responsible for providing state guarantees. In addition to financial and insurance support, Russian entrepreneurs-exporters need to support their foreign economic projects in political terms. In this area, intergovernmental commissions are of great importance, which are aimed at solving tax, property, transport problems, as well as expanding investment cooperation.

The Federal Emergency Management Agency (FEMA) is tasked with developing flood insurance rate maps along coastlines and major water bodies within the United States, which includes the U.S. portion of the Great Lakes shoreline. Previous flood studies have developed storm surge and wave models of the Great Lakes (including Lake Huron) in support of FEMA’s efforts; however, an independent technical review of those previous coastal flood studies in Lake Huron revealed technical deficiencies in the methods and tools used to generate the wave conditions needed to support overland mapping. Most paramount of these was the fact that starting wave conditions for one dimensional (1D) transformation from a two-dimensional (2D) model were taken from deep water. Using 1D methods to shoal and refract waves to the coastline for runup and/or overland wave analysis may fail to capture the more complex nature of wave refraction/diffraction that 2D wave models can capture. Further, this method omits the development of the directional wave spectra in the nearshore region. To address this concern, a coupled 2D wave and water level model (ADCIRC+SWAN) was developed to hindcast historical storms that have occurred in Lake Huron. These model results will be used to drive the 1D methods to assess nearshore wave hazards from locations near the surfzone limit.

The article examines the effectiveness of existing measures to prevent insolvency (bankruptcy) of credit institutions, which are provided by the Federal Law “On Insolvency (Bankruptcy)", the directions of their development and problematic aspects. Separate analysis of the effectiveness of the State Corporation “Deposit Insurance Agency" as one of the key participants in the process of preventing bankruptcy of banks and their financial recovery. A statistical analysis has been performed on the number of bankruptcy cases initiated, the procedures performed, and the results of these procedures in recent years. A comparative analysis of the applied methods and procedures is also carried out depending on the goals of the legislator. This discloses the issue of maintaining a balance of interests among participants in the insolvency (bankruptcy) process of credit institutions. The issue of expediency of creation of the Fund of consolidation of the banking sector is raised. Partly examined are its tasks, resources, powers. Features of the prevention of bankruptcy of financial organizations are noted. The current practice of sanation is described, as well as proposals of the Central Bank of the Russian Federation to change it. The issue of the need to improve international regulation and cooperation between the countries in the issues of insolvency (bankruptcy) of banks as a consequence of their enlargement and increasing the importance for the stable functioning of both national and global economies is touched upon.

AbstractIntroduction:Hurricane Harvey (2017) forced the closure of hemodialysis centers across Harris County, Texas (USA) disrupting the provision of dialysis services. This study aims to estimate the percentage of hemodialysis clinics flooded after Harvey, to identify the proportion of such clinics located in high-risk flood zones, and to assess the sensitivity of the Federal Emergency Management Agency (FEMA) Flood Insurance Rate Maps (FIRMs) for estimation of flood risk.Methods:Data on 124 hemodialysis clinics in Harris County were extracted from Medicare.gov and geocoded using ArcGIS Online. The FIRMs were overlaid to identify the flood zone designation of each hemodialysis clinic.Results:Twenty-one percent (26 of 124) of hemodialysis clinics in Harris County flooded after Harvey. Of the flooded clinics, 57.7% were in a high-risk flood zone, 30.8% were within 1km of a high-risk flood zone, and 11.5% were not in or near a high-risk flood zone. The FIRMs had a sensitivity of 58%, misidentifying 42% (11 of 26) of the clinics flooded.Conclusion:Hurricanes are associated with severe disruptions of medical services, including hemodialysis. With one-quarter of Harris County in the 100-year floodplain, projected increases in the frequency and severity of disasters, and inadequate updates of flood zone designation maps, the implementation of new regulations that address the development of hemodialysis facilities in high-risk flood areas should be considered.

Understanding flood probabilities is essential to making sound decisions about flood-risk management. Many people rely on flood probability maps to inform decisions about purchasing flood insurance, buying or selling real-estate, flood-proofing a house, or managing floodplain development. Current flood probability maps typically use flood zones (for example the 1 in 100 or 1 in 500-year flood zones) to communicate flooding probabilities. However, this choice of communication format can miss important details and lead to biased risk assessments. Here we develop, test, and demonstrate the FLOod Probability Interpolation Tool (FLOPIT). FLOPIT interpolates flood probabilities between water surface elevation to produce continuous flood-probability maps. FLOPIT uses water surface elevation inundation maps for at least two return periods and creates Annual Exceedance Probability (AEP) as well as inundation maps for new return levels. Potential advantages of FLOPIT include being open-source, relatively easy to implement, capable of creating inundation maps from agencies other than FEMA, and applicable to locations where FEMA published flood inundation maps but not flood probability. Using publicly available data from the Federal Emergency Management Agency (FEMA) flood risk databases as well as state and national datasets, we produce continuous flood-probability maps at three example locations in the United States: Houston (TX), Muncy (PA), and Selinsgrove (PA). We find that the discrete flood zones generally communicate substantially lower flood probabilities than the continuous estimates.

Arthritis is the disease that kills the fewest but cripples the most. With the aging of the population in the United States and the antiquated DRG reimbursement system for hospital surgical intervention, it is inevitable that the Medicare assistant will bankrupt itself prior to the proposed bankruptcy date of 2026 if changes are not made. It may change would be to insist that the system in Maryland for reimbursement to hospitals for essential joint replacement surgery of the elderly be adapted nationwide. Medicaid expenditures are driven by a variety of factors, including the demand for care, the complexity of medical services provided, medical inflation, and life expectancy. The Medicare program has two separate trust funds – the Hospital Insurance (HI) Trust Fund and the Supplementary Medical Insurance (SMI) Trust Fund. Under the Hospital Insurance Trust, payroll taxes from workers and their employers go towards paying for the Part A benefits for today’s Medicare beneficiaries. In 2019, Medicare provided benefits to over 60 million elderly patients at an estimated cost of $796 billion [1]. While excluding the significant decrease in payroll taxes during the COVID-19 pandemic, the latest 2020 projections calculate Medicare Hospital Trust insolvency by 2026 [2]. The 2020 report declared that funds would be sufficient to pay for only 90 percent of Part A expenses at the time of this writing. Since inception, the Hospital Insurance Trust has never been insolvent, because there are no provisions in the Social Security Act that govern what would happen if insolvency were to occur. Ten of the last twelve years have witnessed expenditure outflows outpacing the Hospital Insurance Trust inflows, resulting in total Medicare spending obligations outpacing the increasing demands on the federal budget, as the number of elderly beneficiaries and the per capita health care costs continue to grow [2]. One of the principal goals of the following study is to determine how elderly patients, who often suffer from acute stages of arthritis and other orthopedic diseases, due in part to wear and tear, can continue to demand surgical intervention, in particular joint replacement surgery. Arthritis has been described as the disease that kills the fewest but cripples the most. With that in mind, the hospital systems ability to absorb the ever increasing number of elderly patients who demand joint replacement surgeries will continue to outstrip supply. The principal author of this study completed his PhD dissertation at the University of Manchester in 1977 by measuring the cost-benefit analysis of the treatment of chronic rheumatoid arthritis in Great Britain. Therefore, the author of this study aims to show the only reasonable method of payment for the imminent immeasurable demand for treatment for the elderly for age related diseases such as joint replacement surgery [3]. A recent Journal of Rheumatology article projects Medicare will finance approximately 2.67 million joint replacement surgeries by 2035, plus an additional 2.35 million joint replacement surgeries by the year 2040 [4]. The author believes that the current nationwide Diagnostic Related Groups (DRGs) system that helps determine how much Medicare pays the hospital for each “product” needs to be phased out as soon as possible. Our research shows that prior to Medicare implementing the DRGs payment system, Maryland proved that their total cost model of state-wide rewards and penalties compensated “efficient and effective” hospitals, providing care as defined by metrics set up by the Health Services Cost Review Commission (HSCRC). The Maryland legislature granted this independent government agency the broad powers to insulate the HSCRC from conflicts of interests, regulatory capture, and political meddling in the long term. In exchange, the HSCRC had the freedom to design a system that must deliver on three areas: cost reduction of hospital services, health improvement for all Maryland residents, and quality of life care improvements. Since inception of the HSCRC, all stakeholders are legally required to comply with robust auditing and data-submission requirements that allow the agency to collect data on the costs, patient volume, and financial condition of all inpatient, hospital-based outpatient, and emergency services in Maryland. This level of transparency allows the agency to set prices for hospital services, and hospitals must obey because it is Maryland law. Because of this methodology, HSCRC-approved average Maryland hospital markups ranged from 18 percent in 1980 to only 22 percent in 2008. During that same period, the average hospital markup nationally skyrocketed from 20 percent in 1980 to more than 187 percent in 2008 [5]. This strong evidence is the primary reason why the HSCRC has continued to receive a federal waiver from the Centers for Medicare and Medicaid Services, which requires both Medicare and Medicaid to pay the HSCRC-approved rates statewide. No discounts are given because of volume, nor any shifting of costs to other payers. There is a mandate: same price for the same service at the same hospital, no exceptions. Adjustments for uncompensated medical care are automatically bundled into the HSCRC-approved rates, as thus, this financial burden is shared by all hospitals in Maryland. This article explores the important milestones taken by the state of Maryland and how the lessons learned are responsible for the impressive results of their program today. This author believes that by applying the Maryland Total Cost of Care Model (Maryland TCOC Model) nationwide will yield financial savings of at least $227 billion by 2035, plus another $280 billion by 2040, exclusively from joint replacement surgeries reimbursed at HSCRC-approved rates and not any other method.

In Germany, support for families includes diverse types of financial and material aid. These different programs are not aligned and coordinated, but rather stand alone alongside each other and are far from being transparent. This article argues that this situation could be remedied by grouping the various family-related support measures within a single family support agency as a parafiscal institution. Here we summarize the basic advantages and disadvantages of parafiscal institutions and evaluate them in the context of family-related support measures. Then we examine the aspect of self-administration, which has taken a prominent role in the debate on parafiscal institutions. The paper concludes by outlining further parameters for the design, financing, and range of services that could be offered by a family parafiscus. However, a detailed discussion of the services offered by a family parafiscus would require systematic evaluation of the overall system. In the medium term, there is substantial evidence that efforts should begin to integrate the family-related support measures provided by the social insurance system with other support measures provided by the federal government in a single family support agency. Zusammenfassung Familienbezogene Leistungen umfassen in Deutschland eine Vielzahl von Sach- und Geldleistungen. Diese Leistungen sind nicht aufeinander abgestimmt, stehen häufig unverbunden nebeneinander und sind wenig transparent. Die Bündelung familienbezogener Maßnahmen bei einer Familienkasse als Parafiskus könnte, so die zentrale Aussage dieses Beitrags, Abhilfe schaffen. Die grundsätzlichen Vor- und Nachteile parafiskalischer Institutionen werden zusammengefasst und es wird diskutiert, wie diese im Kontext familienbezogener Leistungen zu bewerten sind. Daran anschließend wird der Aspekt der Selbstverwaltung beleuchtet, da er in der Debatte um Parafisken einen prominenten Stellenwert einnimmt. Der Beitrag schließt mit der Skizzierung weiterer Ausgestaltungsparameter eines Familienparafiskus, seiner Finanzierung und des Leistungsspektrums. Eine Diskussion um den Leistungskatalog eines Familienparafiskus setzt allerdings eine systematische Evaluierung des Gesamtsystems voraus. Mittelfristig spricht einiges dafür mit einer Integration der familienbezogenen Maßnahmen in der Sozialversicherung und anderer beim Bund angesiedelter familienbezogener Leistungen in eine Familienkasse zu beginnen.

AbstractIn the midwestern United States, intensifying impacts from climate change necessitate adaptation by the agricultural sector. Tree fruit agriculture is uniquely vulnerable to climate change due to the long-lived nature of perennial systems, yet very few studies have addressed how fruit growers perceive climate change and are responding to climate risks. For this study, 16 semistructured interviews were conducted with Michigan tree fruit growers to understand how their climate change beliefs, beliefs about adaptive actions, and climate-related risk perceptions influence adaptation behaviors. While there was a great deal of uncertainty about the anthropogenic nature of climate change, growers generally agreed that unprecedented changes in climate and weather patterns were occurring. Because of a perception of little control over future climate impacts, most growers reactively adapted to climate risks that negatively impacted their orchards by implementing measures such as frost protection, irrigation, pesticides, and crop insurance. This study highlighted that while proactive adaptations such as crop diversification, planting new varieties, and improving soil health will be necessary to increase farm resilience in the future, growers were unable to justify making these changes due to their uncertainty about future climate changes. The findings from this study highlight the need for future outreach efforts by university extension agents, private agricultural advisors, and federal and state agency advisors to provide educational information on the long-term impacts of climate change in order to help growers increase the resilience of their farm in the face of future climate impacts.

This paper examines recovery after major floods in the UK and Germany. It focuses on two areas that were badly hit by flooding: Catcliffe, near Sheffield in the UK, and Passau in Bavaria, Germany. It reports on surveys of residents and businesses in each place and on surveys of national flood experts in both countries. The two events were comparable in terms of impacts, levels of preparedness and government response and show similar patterns of speed and quality of recovery. In Germany, it took about 18 months for 90% or more of residents to get back to normal, while in the UK it took a year longer. This difference may be related to funding; in the UK, over 90% of funding came from household insurance while in Germany over 60% came from federal aid, which may have been quicker. In both countries, the economy had recovered to near normal within 12–18 months. The majority of people surveyed in both countries (74% in Germany and 67% in the UK) believe that their homes and businesses are as just as vulnerable now as they were before the respective floods. However, in the UK, half of the respondents thought their neighbourhood was safer and better prepared compared to only 11% in Germany. This may be because substantial progress has been made in improving protection in the UK in areas flooded in 2007. Both floods were considered to be ‘game-changers’ and resulted in a heightened awareness of flood risk, increased investment in flood defences and an increasing emphasis on citizens taking more responsibility for flood preparedness. However, the Environment Agency in the UK lacks powers to prevent development in flood-prone areas, in Germany there are issues of coordination across large catchments that cross state boundaries and the insurance sector could play a bigger role in ‘building back better’. Many homes and businesses continue to be at risk from major floods and more progress needs to be made in making them more resilient. This article is part of the theme issue ‘Urban flood resilience’.

In 2007, Congress granted the Food and Drug Administration (FDA) new powers to order pharmaceutical companies to conduct drug safety studies and clinical trials in the postmarketing period after drugs are approved. The methodologies include observational studies that examine patients' insurance claims data and clinical records to infer whether drugs are safe in actual clinical practice. Such studies offer a valuable tool for improving drug safety, but they raise ethical and privacy concerns because they would entail widespread use of patients' health information in commercial research by drug manufacturers. This is the first article to explore the ethics of these section 505(o)(3) observational studies, so named after the section of the Food, Drug, and Cosmetic Act that authorizes them.Data access problems threaten to make the FDA's section 505(o)(3) study requirements unenforceable. Under existing federal privacy regulations, it appears highly unlikely that pharmaceutical companies will have reliable access to crucial data resources, such as insurance claims data and healthcare records, to use in these studies. State privacy laws present another potential barrier to data access. If pharmaceutical companies do manage to gain access to the needed data, this will raise serious privacy concerns because section 505(o)(3) observational studies do not appear to be covered by any of the major federal regulations that afford ethical and privacy protections to persons whose data are used in research.If the FDA's program of section 505(o)(3) observational studies fails because of the above problems, this failure will have a number of bad consequences: the public will be exposed to avoidable drug safety risks; taxpayers may be forced to bear the costs of having the FDA conduct drug safety investigations that would have been funded by drug manufacturers if data had been available; and, perhaps most troubling, the FDA may be forced to order postmarketing clinical trials to answer questions that could have been answered using observational studies. Problems with access to data for section 505(o)(3) studies thus could directly imperil human research subjects by forcing a needless over-reliance on risky postmarketing drug safety trials.This Article concludes by describing a promising new legal pathway for resolving these problems. Congress has provided the FDA a new set of powers that if skillfully exercised will allow the agency: (1) to facilitate pharmaceutical companies' appropriate access to data for use in section 505(o)(3) observational studies, (2) to impose strict ethical and privacy protections for persons whose data are used in these studies, and (3) to mobilize private-sector funding to generate much-needed evidence of the safety of FDA-approved drugs.

This paper discusses the value of a community approach to characterizing the coastal storm hazard, e.g., hurricane water levels and wave conditions, through field measurements, data analysis, and modeling. Value is illustrated using experiences and results from recent and ongoing projects. One example is recently completed work by the Interagency Performance Evaluation Task Force (IPET), which was commissioned by the U.S. Army Corps of Engineers. The IPET was charged with gathering the facts regarding performance of the hurricane protection system in Southeast Louisiana in response to Hurricane Katrina. A second example is ongoing work being lead by the Corps to design projects that can greatly reduce the likelihood and consequences of flooding for coastal Louisiana and Mississippi. These investigations are being closely coordinated with work of the Federal Emergency Management Agency to update flood insurance rate maps for the region. Findings and lessons learned are discussed, and challenges in making accurate surge and wave predictions are identified, including: 1) inaccuracy in coastal and estuarine wind fields, 2) specification of a wind drag law in shallow coastal areas, and 3) problems in treating nearshore wave set-up and coupling into surge models. A new Corps research program that is addressing many of these issues, also a community effort, is described as are results from early progress in selected problem areas. The paper presents advantages to developing open-source, community-based computer software for coastal storm wave and surge predictions, and some problems with today's over-reliance on proprietary software.

Seismic performance and loss assessments are required in areas of Insurance, Finance and Public Policy. Providers are Structural Engineers and Risk Management Firms. There are no current procedures to evaluate the epistemic and aleatory uncertainties for such assessments. The essential issue is whether or not there is sufficient reliability in the result to use the result as the basis for risk management decisions and actions. For a single building this may be whether or not a prescribed earthquake performance level is met, life safety or if a portfolio’s vulnerability level is acceptable, whether the. loss for a given time period is less than a stated value. A method based in part on Federal Emergency Management Agency P-695, is developed for evaluating the reliability of performance and/or loss assessments for both individual and portfolios of buildings. Consideration is given to how well the building investigation and corresponding evaluation process have been performed, the qualifications of the person(s) doing the assessment, the thoroughness of the building evaluation, the technical validity of the assessment procedure or model and what computational reliabilities are presented. The method characterizes the uncertainty of each component of the assessment procedure for each building by qualitative determined assignments. The resulting reliability measure is likely to be most useful for determining whether/or not a building has acceptable life safety performance, or if a portfolio has an acceptably low loss risk over a given period of time. In both cases, the reliability must either be sufficient to warrant action, or serve to indicate need for improved assessment.

Abstract Abstract 2488 Poster Board II-465 BACKGROUND. Limited data exist about the national burden of emergency department (ED) care for patients with sickle cell disease (SCD). The proportion of patients being seen in the ED who require hospitalization and factors contributing to the above are poorly understood. We present here analysis of such potential factors from the largest nationally representative ED visit data till date. METHODS. The Nationwide Emergency Department Sample (NEDS) is one of a family of databases and software tools developed as part of the Healthcare Cost and Utilization Project (HCUP), a Federal-State-Industry partnership sponsored by the Agency for Healthcare Research and Quality. The NEDS was constructed using records from both the HCUP State Emergency Department Databases and the State Inpatient Databases. The NEDS is the largest all-payer ED database and contains almost 26 million records for ED visits for over 950 hospitals and approximates a 20-percent stratified sample of U.S. hospital-based ED's thus generating weighted estimates of over 120 million ED visits. The following ICD-9-CM diagnosis codes were used to define SCD related hospitalizations: 28241, 28242, 2825, 28260, 28261, 28262, 28263, 28264, 28268, and 28269 and only ‘primary discharge diagnosis' patients were considered. We analyzed the NEDS data for the year 2006. RESULTS. Approximately three-quarters of the total in-patient admissions for SCD in 2006 came through the emergency department. The total number of patients presenting to the ED with SCD as primary diagnosis was 166,043. Of these visits, 68,420 (41.2%) resulted in admission to the hospital. There was a statistically significant difference (p<0.001) in the proportion of ER visits resulting in hospitalization for the following factors (each studied independently): CONCLUSION. SCD is responsible for a significant burden of ED care in the US. A number of factors including of patient age, insurance status, income, hospital type and location may impact the likelihood of subsequent admission to the hospital. High quality care of uncomplicated pain crises in an ED or day hospital is believed to result in a decrease of avoidable hospitalizations. However, the multiplicity of factors independently associated with likelihood of subsequent hospitalization as demonstrated by these data suggest the need for caution in using the proportion of ED visits resulting in hospitalizations as a surrogate marker of quality of care. Disclosures: No relevant conflicts of interest to declare.

Der neue Schimmelpilzleitfaden des Umweltbundesamtes (UBA) weist darauf hin, dass die Anwesenheit flüchtiger organischer Verbindungen mikrobiellen Ursprungs (microbial volatile organic compounds, MVOC) in der Raumluft ein Indikator für einen verdeckten Schimmelbefall sein kann. Zudem wurde eine Standardmethode für das Messen von MVOC veröffentlicht. Dies war Anlass, die Aussagekraft von MVOC-Messungen unter dem Aspekt von Schimmelpilzbelastungen in Räumen anhand der Messergebnisse aus der Studie „Gesunde Luft in Schulen“ der Unfallkasse Nordrhein-Westfalen (UK NRW) noch einmal kritisch zu hinterfragen. Im Ergebnis wurden in 370 der 381 untersuchten Klassenräumen MVOC nachgewiesen. Eine Korrelation zu den gemessenen Schimmelpilzkonzentrationen im Sedimentationsstaub konnte allerdings nicht festgestellt werden. Auch war keine Korrelation zu den Raumklimaparametern oder der Ausstattung der Räume erkennbar. Die gemessenen (M)VOC werden wohl eher aus Bauprodukten und Einrichtungen emittiert als durch Schimmelpilze erzeugt. &nbsp; Summary The new mould fungi guidance document issued by the German Federal Environment Agency (UBA) states that the presence of microbial volatile organic compounds (MVOCs) in indoor air can be an indicator of hidden mould infestation. A standard method for measuring MVOCs has also been published. This prompted a critical review of the validity of MVOC measurements for determining exposure to mould fungi in rooms. The review was based on results of measurements obtained during the „Healthy air in schools“ study conducted by the German Social Accident Insurance Institution for the public sector in North Rhine-Westphalia (UK NRW). MVOCs were detected in 370 of the 381 classrooms examined. However, a correlation to the measured mould fungi concentrations in the deposited dust was not established, nor were correlations observed to the room climate parameters or the furnishings of the rooms. The (M)VOCs measured are more likely to be emitted from building products and furnishings than to be produced by mould.

Purpose This paper aims to investigate the effect that ownership structure (public vs private) has on the demand for high-quality auditors, specifically in the US banking industry. Design/methodology/approach The authors predict that public banks are more likely to hire a high-quality auditor than private banks and pay a higher audit fee premium for that high-quality auditor (due to higher agency costs, more demand for financial information and higher litigation risk). The authors analyze 2008–2014 banking data from the Federal Reserve using probit and OLS regression analysis to examine if there is a higher probability that public banks choose higher quality auditors and pay higher audit fees when they do so. Findings The results show that private banks are less likely to hire Big 4 auditors and industry-expert auditors than public banks. The authors also find that both private and public banks pay higher audit fees for Big 4 and industry-expert auditors, and that public banks pay a higher premium for Big 4 auditors and industry experts than private banks. Research limitations/implications The findings may not be fully generalizable to other types of firms, as banking is a heavily regulated and complex industry. However, inferences from this study may be generalizable to other similar industries such as insurance or health care. Practical implications The results of this paper imply that public and private banks have differing priorities when hiring their financial statement auditor. This may be of interest to investors and auditing regulators. Social implications The findings of this paper underscore the value of hiring an industry-expert auditor in an industry that is highly complex and regulated. This may be of interest to managers and policymakers. Originality/value Due to data restrictions, the emphasis of prior literature on the banking industry has been on public banks. This study is the first to analyze the differences between public and private banks’ demand for audit services.

Many coastal communities in the US use base flood elevation (BFE) maps for the 100-year return period, specified on Federal Emergency Management Agency (FEMA) Flood Insurance Rate Maps (FIRMs), to design structures and infrastructure. The FIRMs are increasingly known to have serious problems in accurately specifying the risk coastal communities face, as most recently evidenced during hurricanes Harvey and Irma in 2017 and Florence and Michael in 2018. The FIRM BFE maps also do not include the impact of sea level rise, which clearly needs to be considered in the design of coastal structures over the next several decades given recent National Oceanic and Atmospheric Administration (NOAA) sea level rise (SLR) projections. Here, we generate alternative BFE maps (STORMTOOLS Design Elevation (SDE) maps) for coastal waters of Rhode Island (RI) using surge predictions from tropical and extratropical storms of the coupled surge-wave models from the US Army Corp of Engineers, North Atlantic Comprehensive Coast Study (NACCS). Wave predictions are based on application of a steady state, spectral wave model (STWAVE), while impacts of coastal erosion/accretion and changes of geomorphology are modeled using XBeach. The high-resolution application of XBeach to the southern RI shoreline has dramatically increased the ability to represent the details of dune erosion and overtopping and the associated development of surge channels and over-wash fans and the resulting landward impact on inundation and waves. All methods used were consistent with FEMA guidelines for the study area and used FEMA-approved models. Maps were generated for 0, 2 ft (0.6 m), 5 ft (1.5 m), 7 ft (2.1 m), and 10 ft (3.1 m) of sea level rise, reflecting NOAA high estimates at various times for the study area through 2100. Results of the simulations are shown for both the southern RI shoreline (South Coast) and Narragansett Bay, to facilitate communication of projected BFEs to the general public. The maps are hosted on the STORMTOOLS ESRI Hub to facilitate access to the data. They are also now part of the RI Coastal Resources Management Council (CRMC) risk-based permitting system. The user interface allows access to all supporting data including grade elevation, inundation depth, and wave crest heights as well as corresponding FEMA FIRM BFEs and associated zones.

Background Wildfires in California have become more deadly and destructive in recent years, and four of the ten most destructive fires occurred in 2017 and 2018. Through interviews with service providers, this article explores how these recent wildfires have impacted surrounding communities and the role various recovery resources have played in responding to the short- and long-term health and social needs of survivors. Methods Using a purposive sampling methodology, we interviewed 21 health and social service personnel who assisted in wildfire recovery efforts in California in 2017 and 2018. The study participants worked or volunteered in medical facilities, social services agencies and philanthropy/nonprofit organizations located in communities affected by wildfires. Participants were asked about three common, overarching themes that fire-impacted communities navigate post-disaster: health issues, social issues, and response and recovery resources. Inductive coding was used to identify common subthemes. Results The two most frequently discussed social issues during interviews were housing and employment access. Mental and emotional well-being and access to health resources were identified as being the most challenging health concerns that survivors face post-disaster. Participants also identified the following private and public recovery resources that survivors use to attempt to restabilize following the fire: community support, county agencies, the Federal Emergency Management Agency (FEMA,) insurance companies and philanthropic organizations. However, participants noted that the cumulative impacts of these efforts still leave many of their patients and clients without the resources needed to restabilize emotionally, financially and physically. Finally, participants spoke about the community-wide, downstream impacts of wildfires, noting that “survivors” are not only those whose health is immediately compromised by the disaster. Conclusion Given the worsening wildfire seasons in California, we must increase our understanding of both the scope of the health and social issues that survivors navigate following a disaster, as well as the effectiveness and sustainability of recovery resources available to survivors. We must also understand the “ripple effect” that wildfires have on surrounding communalities, impacting housing access, social services, and health care access. More research and support, especially during the current COVID-19 pandemic, is urgently needed to improve our ability to support the health and social needs of wildfire survivors in the future.

Abstract Abstract 169 Background: Patients with sickle cell disease have very high rates of rehospitalization, with rates as high as 40% for young adults. Many institutions have invested significant resources to utilize an inpatient hospitalization as a trigger to alter care and prevent further hospital utilization. While this focus on hospitalizations is important, there has been little attention given to return visits following treat-and-release emergency department (ED) visits. It has been shown that patients with sickle cell disease have high use of acute care resources, including the ED. Given that only half of ED visits by patients with sickle cell disease result in an inpatient stay, it may be possible to use an ED visit as a trigger for improved care rather than waiting for an inpatient hospitalization. We hypothesized that patients with sickle cell disease who were treated and released from the ED would have high rates of return for acute care utilization, both to the ED and the inpatient unit, within 14 days. We further hypothesized that young adults and those with public insurance would have the highest return for acute care utilization rates. Methods: We conducted a retrospective cohort study using 2005 and 2006 State Emergency Department Databases and State Inpatient Databases. The data are from the Healthcare Cost and Utilization Project (HCUP), a Federal-State-Industry partnership sponsored by the Agency for Healthcare Research and Quality. Data for all sickle cell-related ED visits and hospitalizations within the following eight states (AZ, CA, FL, MA, MO, SC, TN, and NY) were extracted for each patient. One-third of patients with sickle cell disease in the United States live within these states. All sickle cell related visits were linked via encrypted person-level identifiers to allow linkage of record level information, thus clustering visits by patient. Each treat-and-release ED visit served as an index visit; all subsequent ED treat-and-release visits and inpatient hospitalizations (whether through the ED or not) were tracked for periods of 7 and 14 days. ED treat-and-release visits within the seven days following a hospital discharge were excluded from being index visits. Results: A total of 12,109 patients with sickle cell disease made 39,775 ED treat-and-release visits during the two-year study period. Of the index ED treat-and-release visits, 4,162 (34.4%) children (ages 1–17 yrs) made 8,636 (21.7%) visits compared to 4,166 (34.4%) 18–30 year olds who made 17,070 (42.8%) ED treat-and-release visits. Overall, 16,731 (42.1%) of the ED treat-and-release visits had either an inpatient hospitalization or another ED treat-and-release visit within 14 days of the index ED visit; 39.7% of those return visits were inpatient hospitalizations meaning that 16.7% of ED treat-and-release visits are followed by an inpatient hospitalization within 14 days. Analyzing the 42.1% return visit rate by age and payer revealed that 49.0% of ED treat-and-release visits by 18 – 30 year old patients resulted in return visits compared to 24.7% of children and 38.6% of 46–64 year olds. 46.5% of ED treat-and-release visits by those with public insurance resulted in a return visit compared to 32.2% of visits by those with private insurance and 35.0% of those who were uninsured. As the timing of return visits might direct the intervention, we also evaluated 7 day return visits. Of the 16,731 return visits within 14 days, 12,561 (75.1%) occurred in the first 7 days; 41.1% of the 7 day return visits were inpatient hospitalizations meaning that 13% of ED treat-and-release visits were followed by an inpatient hospitalization within 7 days. Conclusions: A significant proportion of patients with sickle cell disease return for acute care following an ED treat-and-release visit, with young adults and those with public insurance having the highest rates of return visits. A high percentage of those return visits are hospitalizations. Given these findings, ED treat-and-release visits should serve as a trigger to focus enhanced outpatient comprehensive care on these patients in order to prevent a subsequent inpatient hospitalization and to ultimately improve care for patients with sickle cell disease. Disclosures: No relevant conflicts of interest to declare.

Abstract Introduction Imatinib mesylate (Glivec, Novartis) is the first tyrosine kinase inhibitor (TKI) targeting the BCR-ABL1 fusion protein responsible for the pathogenesis of chronic myeloid leukemia (CML). Low cost generic alternatives to imatinib are an integral part of cost effective healthcare strategies for developing countries. However, the use of generics has been associated with different clinical outcomes. In this study, we compared outcomes of two groups of patients who received Glivec as first-line therapy (Group 1) to patients who received generic imatinib as first-line therapy (Group 2) in Bosnia and Herzegovina. Material and methods This was a multicenter retrospective cohort study of BCR-ABL1 positive CML patients (n = 53) in the Federation of Bosnia and Herzegovina between 1 June 2005 and 31 March 2016. Glivec was used from 01 June 2005 until 30 September 2013, when all patients had to switch to generics, which was mandated by the Federal Solidarity Fund that allocates targeted cancer therapies. The following generic imatinib was available: Anzovip (Zdravlje, Actavis) from 09/2013 to 09/2014, Meaxin (Krka) from 09/2014 to 12/2015, and Plivatinib (Pliva) from 12/2015. Patient data was collected from the database of the Federal Solidarity Fund, a subsidiary of the Federal Health Insurance Agency. Branded and generic imatinib was administered orally at dosage of 400 mg/day. Patients who were switched to nilotinib received orally 400 mg/day. Patients on Glivec included in this study started therapy from 0-6 months from time of diagnosis, while patients who started with generics did not wait for therapy. Patient variables that were collected included age, gender, town, date of diagnosis, date of start of therapy, monthly TKI dosage, adverse side effects, progression, lethal outcome, prognostic factors and diagnostic parameters, including cytogenetics and molecular testing. In September 2013, Glivec stopped being available in Bosnia and all CML patients were switched to generic therapy Anzovip. Median duration of each therapy is given in Table 1. Results We compared patients on Glivec as first-line therapy (Group 1, n=26) to patients on first-line generic imatinib (Group 2, n=27) with the follow-up period of at least three years for each group. When we compare Groups 1 and 2 using intention to treat analysis, Kaplan-Meier estimated rate of overall survival at 24 months of therapy was 88% vs. 68%, respectively (p=0.14), while 69% vs. 70% achieved CCyR (p=0.12), respectively. In Group 1, 27% (7/26) patients switched to nilotinib (treatment failure in 2 patients and side effects in 5 patients), 54% (14/26) patients switched to generics because Glivec was no longer available, and 19% (5/26) patients stopped therapy (2 patients stopped therapy and 3 patients died). Of the 7 patients who switched to nilotinib, 71% (5/7) achieved CCyR, 29% (2/7) achieved MMR and none died. Of 19 patients who stayed on imatinib, 68% (13/19) achieved CCyR, 63% (12/19) achieved MMR and 3/19 (16%) died. Of the 54% (14/26) patients who were switched from branded imatinib to generic imatinib, one patient (7%) lost complete cytogenetic response. Regarding Group 2, 52% (14/27) of patients switched to nilotinib due to treatment failure (n=8) and side effects (n=6), while 48% (13/27) of patients stayed on generics. Of patients who switched to nilotinib, 43% (6/14) achieved CCyR and 15% (2/14) achieved MMR. Of the patients who stayed on generic imatinib, 100% (13/13) achieved CCyR and 85% (11/13) achieved MMR. Conclusion Our results suggest that there was no obvious difference in the treatment efficacy between generic and branded imatinib. At 3 years, there was no significant difference in the overall suvival and achievement of CCyR between first-line Glivec and first-line generic imatinib (p=0.14, and p=0.12, respectively). * Median duration of therapy on generic imatinib Table Table. Disclosures Radich: Bristol-MyersSquibb: Consultancy; Pfizer: Consultancy; ARIAD: Consultancy; TwinStrand: Consultancy; Novartis: Consultancy, Other: laboratory contract.

The cyberattack on the Colonial Pipeline system was impossible to “keep on the lowdown” as industrial attacks of limited scale often are. The shutdown of a 2.5 million B/D system of 5,500 miles of pipeline spanning from the US Gulf Coast to the East Coast does not go unnoticed. And early unconfirmed reports of a ransom payment made to decrypt the seized data intensified the spotlight on the incident. (Continental CEO Joseph Blount confirmed a $4.4-million payment on 19 May.) During what surely was a crisis management nightmare involving not only Colonial but also the US Department of Energy, Department of Transportation, Federal Bureau of Investigation (FBI), Federal Energy Regulatory Commission, Department of Homeland Security (DHS), and the Pipeline and Hazardous Materials Safety Administration (all agencies thanked by Colonial in a 15 May tweet), the information made public has heightened concerns about the security of data and critical infrastructure globally. Foremost is the escalation in the multiple layers of bad actors involved in a single attack. The FBI identified the ransomware-as-a-service (RaaS) DarkSide, which it has been investigating since October 2020. Criminal partners conduct attacks and then share the proceeds with the ransomware developers. The agency released a flash alert about DarkSide on 10 May with indicators of compromise and mitigation measures once infected. “Mitigation measures once infected.” The alert may have come too late for Colonial, whose business network was hit rather than its operational technology (OT) networks that control the pipeline. To contain the damage, it took down its own OT network. An example supporting this action of last resort occurred last year when a ransomware attack on an unidentified natural gas company’s business networks moved into its control systems at a compression facility, halting operations for 2 days, according to a DHS alert. DHS said the company did not have a plan to respond to a cyberattack. A report by FireEye, a cybersecurity firm that confirmed its hiring by Colonial, said since initially surfacing in August 2020, the creators of DarkSide and its partners have infiltrated organizations in more than 15 countries. Affiliates retain a portion of each ransom fee, ranging from 25% for fees less than $500,000 to 10% for fees greater than $5 million. Ransomware operators are masters in extortion and are using new tactics to widen their net of exploitation. In April, the DarkSide operators said in a press release that they were targeting organizations listed on the NASDAQ and other stock markets and were willing to give stock traders advance notice of upcoming attacks to allow them to reap profits when stock prices dropped as a result of the breach, according to FireEye. In another example, an attacker obtained the victim’s cyber insurance policy’s coverage limits and used that knowledge during ransom negotiation, refusing to lower the ransom fee. What this means for organizations is that their boards should assess the full spectrum of risk from prevention to detection as a business risk and have a plan in place to execute when an attack occurs. The investment required may be far less than the increasingly exorbitant ransom fees and the costs associated with the theft or destruction of data and disruption to the business.

Abstract Background: The number of times a patient will seek acute care in the emergency department or require hospitalization for sickle cell related illness has not been described in a population-based manner. Twenty years ago, rates of acute care visits for 3,578 patients who were part of the Cooperative Study of Sickle Cell Disease were reported, eloquently describing patterns of acute care utilization for people followed at select centers. In that study, only 1% of patients had more than six visits per year and 5% of the population (who made three to 10 visits per year) accounted for almost one-third of all visits. The objective of this study is to describe the emergency department and hospital utilization for patients with sickle cell related conditions over a two- year period. This study will be the first to provide a complete assessment of the utilization patterns of patients with sickle cell disease, one that is multi-state, inclusive of all ages, all insurance types, and includes patients that are followed at community, academic and tertiary care centers. Methods: We conducted a retrospective cohort study using 2005 and 2006 State Emergency Department and State Inpatient Databases that include encrypted personlevel identifiers to allow linkage of record level information. The data are from the Healthcare Cost and Utilization Project (HCUP), a Federal-State-Industry partnership sponsored by the Agency for Healthcare Research and Quality. Data for all sickle cell related emergency department visits and hospitalizations within the following seven states (Arizona, California, Florida, Missouri, South Carolina, Tennessee, and New York) were extracted for each patient. To be eligible, a patient had at least one sickle cell specific visit, defined as a visit with a principal diagnosis of sickle cell crisis or a secondary diagnosis of sickle cell disease with a principal diagnosis that was sickle cell related (e.g. pneumonia, stroke, fever). All sickle cell related visits were linked by unique personal identifiers, thus clustering visits by patient and allowing population-based statewide assessments of utilization. An emergency department visit on the same day as an inpatient hospitalization was counted only as an inpatient hospitalization to avoid over counting care-seeking visits. The distribution of acute care visits for each patient (presented as numbers of emergency department visits and hospitalizations over the two-year period) was determined for the entire cohort, then stratified as child versus adult. Results: A total of 24,668 patients with sickle cell disease made 86,535 acute care visits during the two-year study period, 33,520 (38.7%) were emergency department visits and 53,015 (61.3%) were inpatient visits. Of the 24,668 patients, 8,895 (36.1%) were less than 18 years of age; 15,773 were adults. 52.8% of the entire cohort made one visit in the two year period. 1,320 (5.4%) patients had more than 12 visits over the two-year time period; 3,210 (13.0%) made 6–20 visits over two years, and accounted for 31,752 (36.7%) acute care visits. An additional 579 (2.4%) patients had more than 20 visits over two years, accumulating 18,701 (21.6%) acute care visits. Children were less likely to have more than 12 visits over the two years (1.9%) compared to adults aged 18–45 (8.1%) and were also less likely to be in the high utilization group of 6–20 visits over two years (9.9% of children compared to 15.8% of those 18–45 years old). Conclusions: A significant proportion of patients with sickle cell disease seek acute care multiple times in an emergency department setting or through hospitalization. Our population-based study demonstrates an increased proportion of high utilizers compared to previous work, especially among adult patients. Our findings likely reflect the difference in healthcare utilization in the broader community as compared to that within a cooperative study in academic settings. It suggests that some patients, adults in particular, may have limited access to urgent care in a primary care setting and would benefit from better access and more aggressive preventive care. Further work on patterns of and reasons for utilization, especially emergency department care, in this high-utilizer group, would be helpful in targeting and improving overall care for these patients.

1. Introduction This Special Issue (Part 2) expands upon the theme “Building Local Capacity for Long-term Disaster Resilience” presented in Special Issue Part 1 (JDR Volume 5, Number 2, April 2010) by examining the evolving concept of disaster resilience and providing additional reflections upon various aspects of its meaning. Part 1 provided a mixed set of examples of resiliency efforts, ranging from administrative challenges of integrating resilience into recovery to the analysis of hazard mitigation plans directed toward guiding local capability for developing resiliency. Resilience was broadly defined in the opening editorial of Special Issue Part 1 as “the capacity of a community to: 1) survive a major disaster, 2) retain essential structure and functions, and 3) adapt to post-disaster opportunities for transforming community structure and functions to meet new challenges.” In this editorial essay we first explore in Section 2 the history of resilience and then locate it within current academic and policy debates. Section 3 presents summaries of the papers in this issue. 2. Why is Resilience a Contemporary Theme? There is growing scholarly and policy interest in disaster resilience. In recent years, engineers [1], sociologists [2], geographers [3], economists [4], public policy analysts [5, 6], urban planners [7], hazards researchers [8], governments [9], and international organizations [10] have all contributed to the literature about this concept. Some authors view resilience as a mechanism for mitigating disaster impacts, with framework objectives such as resistance, absorption, and restoration [5]. Others, who focus on resiliency indicators, see it as an early warning system to assess community resiliency status [3, 8]. Recently, it has emerged as a component of social risk management that seeks to minimize social welfare loss from catastrophic disasters [6]. Manyena [11] traces scholarly exploration of resilience as an operational concept back at least five decades. Interest in resilience began in the 1940s with studies of children and trauma in the family and in the 1970s in the ecology literature as a useful framework to examine and measure the impact of assault or trauma on a defined eco-system component [12]. This led to modeling resilience measures for a variety of components within a defined ecosystem, leading to the realization that the systems approach to resiliency is attractive as a cross-disciplinary construct. The ecosystem analogy however, has limits when applied to disaster studies in that, historically, all catastrophic events have changed the place in which they occurred and a “return to normalcy” does not occur. This is true for modern urban societies as well as traditional agrarian societies. The adoption of “The Hyogo Framework for Action 2005-2015” (also known as The Hyogo Declaration) provides a global linkage and follows the United Nations 1990s International Decade for Natural Disaster Reduction effort. The 2005 Hyogo Declaration’s definition of resilience is: “The capacity of a system, community or society potentially exposed to hazards to adapt by resisting or changing in order to reach and maintain an acceptable level of functioning and structure.” The proposed measurement of resilience in the Hyogo Declaration is determined by “the degree to which the social system is capable of organizing itself to increase this capacity for learning from past disasters for better future protection and to improve risk reduction measures.” While very broad, this definition contains two key concepts: 1) adaptation, and 2) maintaining acceptable levels of functioning and structure. While adaptation requires certain capacities, maintaining acceptable levels of functioning and structure requires resources, forethought, and normative action. Some of these attributes are now reflected in the 2010 National Disaster Recovery Framework published by the U.S. Federal Emergency Management Agency (FEMA) [13]. With the emergence of this new thinking on resilience related to disasters, it is now a good time to reflect on the concept and assess what has recently been said in the literature. Bruneau et al. [1] offer an engineering sciences definition for community seismic resilience: “The ability of social units (e.g., organizations, communities) to mitigate hazards, contain the effects of disasters when they occur, and carry out recovery activities in ways that minimize social disruption and mitigate the effects of future earthquakes.” Rose [4] writes that resiliency is the ability of a system to recover from a severe shock. He distinguishes two types of resilience: (1) inherent – ability under normal circumstances and (2) adaptive – ability in crisis situations due to ingenuity or extra effort. By opening up resilience to categorization he provides a pathway to establish multi-disciplinary approaches, something that is presently lacking in practice. Rose is most concerned with business disruption which can take extensive periods of time to correct. In order to make resource decisions that lower overall societal costs (economic, social, governmental and physical), Rose calls for the establishment of measurements that function as resource decision allocation guides. This has been done in part through risk transfer tools such as private insurance. However, it has not been well-adopted by governments in deciding how to allocate mitigation resources. We need to ask why the interest in resilience has grown? Manyena [11] argues that the concept of resilience has gained currency without obtaining clarity of understanding, definition, substance, philosophical dimensions, or applicability to disaster management and sustainable development theory and practice. It is evident that the “emergency management model” does not itself provide sufficient guidance for policymakers since it is too command-and-control-oriented and does not adequately address mitigation and recovery. Also, large disasters are increasingly viewed as major disruptions of the economic and social conditions of a country, state/province, or city. Lowering post-disaster costs (human life, property loss, economic advancement and government disruption) is being taken more seriously by government and civil society. The lessening of costs is not something the traditional “preparedness” stage of emergency management has concerned itself with; this is an existing void in meeting the expanding interests of government and civil society. The concept of resilience helps further clarify the relationship between risk and vulnerability. If risk is defined as “the probability of an event or condition occurring [14]#8221; then it can be reduced through physical, social, governmental, or economic means, thereby reducing the likelihood of damage and loss. Nothing can be done to stop an earthquake, volcanic eruption, cyclone, hurricane, or other natural event, but the probability of damage and loss from natural and technological hazards can be addressed through structural and non-structural strategies. Vulnerability is the absence of capacity to resist or absorb a disaster impact. Changes in vulnerability can then be achieved by changes in these capacities. In this regard, Franco and Siembieda describe in this issue how coastal cities in Chile had low resilience and high vulnerability to the tsunami generated by the February 2010 earthquake, whereas modern buildings had high resilience and, therefore, were much less vulnerable to the powerful earthquake. We also see how the framework for policy development can change through differing perspectives. Eisner discusses in this issue how local non-governmental social service agencies are building their resilience capabilities to serve target populations after a disaster occurs, becoming self-renewing social organizations and demonstrating what Leonard and Howett [6] term “social resilience.” All of the contributions to this issue illustrate the lowering of disaster impacts and strengthening of capacity (at the household, community or governmental level) for what Alesch [15] terms “post-event viability” – a term reflecting how well a person, business, community, or government functions after a disaster in addition to what they might do prior to a disaster to lessen its impact. Viability might become the definition of recovery if it can be measured or agreed upon. 3. Contents of This Issue The insights provided by the papers in this issue contribute greater clarity to an understanding of resilience, together with its applicability to disaster management. In these papers we find tools and methods, process strategies, and planning approaches. There are five papers focused on local experiences, three on state (prefecture) experiences, and two on national experiences. The papers in this issue reinforce the concept of resilience as a process, not a product, because it is the sum of many actions. The resiliency outcome is the result of multiple inputs from the level of the individual and, at times, continuing up to the national or international organizational level. Through this exploration we see that the “resiliency” concept accepts that people will come into conflict with natural or anthropogenic hazards. The policy question then becomes how to lower the impact(s) of the conflict through “hard or soft” measures (see the Special Issue Part 1 editorial for a discussion of “hard” vs. “soft” resilience). Local level Go Urakawa and Haruo Hayashi illustrate how post-disaster operations for public utilities can be problematic because many practitioners have no direct experience in such operations, noting that the formats and methods normally used in recovery depend on personal skills and effort. They describe how these problems are addressed by creating manuals on measures for effectively implementing post-disaster operations. They develop a method to extract priority operations using business impact analysis (BIA) and project management based business flow diagrams (BFD). Their article effectively illustrates the practical aspects of strengthening the resiliency of public organizations. Richard Eisner presents the framework used to initiate the development and implementation of a process to create disaster resilience in faith-based and community-based organizations that provide services to vulnerable populations in San Francisco, California. A major project outcome is the Disaster Resilience Standard for Community- and Faith-Based Service Providers. This “standard” has general applicability for use by social service agencies in the public and non-profit sectors. Alejandro Linayo addresses the growing issue of technological risk in cities. He argues for the need to understand an inherent conflict between how we occupy urban space and the technological risks created by hazardous chemicals, radiation, oil and gas, and other hazardous materials storage and movement. The paper points out that information and procedural gaps exist in terms of citizen knowledge (the right to know) and local administrative knowledge (missing expertise). Advances and experience accumulated by the Venezuela Disaster Risk Management Research Center in identifying and integrating technological risk treatment for the city of Merida, Venezuela, are highlighted as a way to move forward. L. Teresa Guevara-Perez presents the case that certain urban zoning requirements in contemporary cities encourage and, in some cases, enforce the use of building configurations that have been long recognized by earthquake engineering as seismically vulnerable. Using Western Europe and the Modernist architectural movement, she develops the historical case for understanding discrepancies between urban zoning regulations and seismic codes that have led to vulnerable modern building configurations, and traces the international dissemination of architectural and urban planning concepts that have generated vulnerability in contemporary cities around the world. Jung Eun Kang, Walter Gillis Peacock, and Rahmawati Husein discuss an assessment protocol for Hazard Mitigation Plans applied to 12 coastal hazard zone plans in the state of Texas in the U.S. The components of these plans are systematically examined in order to highlight their respective strengths and weaknesses. The authors describe an assessment tool, the plan quality score (PQS), composed of seven primary components (vision statement, planning process, fact basis, goals and objectives, inter-organizational coordination, policies & actions, and implementation), as well as a component quality score (CQS). State (Prefecture) level Charles Real presents the Natural Hazard Zonation Policies for Land Use Planning and Development in California in the U.S. California has established state-level policies that utilize knowledge of where natural hazards are more likely to occur to enhance the effectiveness of land use planning as a tool for risk mitigation. Experience in California demonstrates that a combination of education, outreach, and mutually supporting policies that are linked to state-designated natural hazard zones can form an effective framework for enhancing the role of land use planning in reducing future losses from natural disasters. Norio Maki, Keiko Tamura, and Haruo Hayashi present a method for local government stakeholders involved in pre-disaster plan making to describe performance measures through the formulation of desired outcomes. Through a case study approach, Nara and Kyoto Prefectures’ separate experiences demonstrate how to conduct Strategic Earthquake Disaster Reduction Plans and Action Plans that have deep stakeholder buy-in and outcome measurability. Nara’s plan was prepared from 2,015 stakeholder ideas and Kyoto’s plan was prepared from 1,613 stakeholder ideas. Having a quantitative target for individual objectives ensures the measurability of plan progress. Both jurisdictions have undertaken evaluations of plan outcomes. Sandy Meyer, Eugene Henry, Roy E. Wright and Cynthia A. Palmer present the State of Florida in the U.S. and its experience with pre-disaster planning for post-disaster redevelopment. Drawing upon the lessons learned from the impacts of the 2004 and 2005 hurricane seasons, local governments and state leaders in Florida sought to find a way to encourage behavior that would create greater community resiliency in 2006. The paper presents initial efforts to develop a post-disaster redevelopment plan (PDRP), including the experience of a pilot county. National level Bo-Yao Lee provides a national perspective: New Zealand’s approach to emergency management, where all hazard risks are addressed through devolved accountability. This contemporary approach advocates collaboration and coordination, aiming to address all hazard risks through the “4Rs” – reduction, readiness, response, and recovery. Lee presents the impact of the Resource Management Act (1991), the Civil Defence Emergency Management Act (2002), and the Building Act (2004) that comprise the key legislation influencing and promoting integrated management for environment and hazard risk management. Guillermo Franco and William Siembieda provide a field assessment of the February 27, 2010, M8.8 earthquake and tsunami event in Chile. The papers present an initial damage and life-loss review and assessment of seismic building resiliency and the country’s rapid updating of building codes that have undergone continuous improvement over the past 60 years. The country’s land use planning system and its emergency management system are also described. The role of insurance coverage reveals problems in seismic coverage for homeowners. The unique role of the Catholic Church in providing temporary shelter and the central government’s five-point housing recovery plan are presented. A weakness in the government’s emergency management system’s early tsunami response system is noted. Acknowledgements The Editorial Committee extends its sincere appreciation to both the contributors and the JDR staff for their patience and determination in making Part 2 of this special issue possible. Thanks also to the reviewers for their insightful analytic comments and suggestions. Finally, the Committee wishes to again thank Bayete Henderson for his keen and thorough editorial assistance and copy editing support.

AbstractThis study examines possible redistributional effects of the National Flood Insurance Program (NFIP), using a nationwide database of flood insurance policies and claims between 2001 and 2013 from the Federal Emergency Management Agency. Applying methods from the tax and transfer progressivity literature, we use the departure from per capita income proportionality at the zip code level as our measure of progressivity. Our findings indicate that premiums as a percentage of coverage purchased are regressive: premium shares are larger than income shares for lower-income zip codes. Payouts, however, also as a percentage of coverage purchased, are progressive, meaning lower-income zip codes receive a larger portion of claims paid. Overall net premiums (premiums – payouts) divided by coverage are also regressive. Our findings are driven by certain aspects of the current rate structure of the NFIP, as well as how income is related to risk. We discuss potential policies to provide assistance to lower-income households in purchasing flood insurance.