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On the website, it mentions that the program was started and located in Tulane due to actions that occurred post- Katrina in New Orleans. The program began due to "failures in disaster leadership" after Katrina. Tulane University was chosen due to the fact that it has exemplified such resiliency and leadership after Hurricane Katrina and portrays and provides an excellent setting for a program such as this. 

This policy was established in 1965 and set down protocols for the Medicaid program. The medicaid program provides funding for medical and health related services to people who have a limited income. This policy specifically denotes what defines an institution, determining whether or not an institution is IMD and other aspect such as ages, costs and the definition of IMD are also set forth. Ultimately proving to set parameters and expectancies to those people and institutions that find themselves operating within this policy or referencing it.