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Federal Public Health Emergency Law
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This report presents information in the form of "answers" to 37 questions about principal federal laws that shape response to public health emergencies. The information presented in this report is based on the April 28, 2009, teleconference “Federal Public Health
Emergency Law: Implications for State & Local Preparedness and Response”
and was compiled by the Public Health Law Program Centers for Disease Control
The questions and answers are grouped into four
categories: legal authorities, public health emergency procedures, isolation
and quarantine, and workforce issues.
Editor: Emily McCormick, MPH, Prevention Specialist
Associate Editor: Montrece McNeill Ransom, JD, MPH, Senior Public Health
Contributing Editor: Stacie Kershner, JD, ORISE Fellow
CDC Public Health Law Program
The contents of this report have not been formally disseminated by
the Centers for Disease Control and Prevention and should not be construed
to represent any agency determination or policy. The findings and conclusions
in this report are those of the authors and do not necessarily represent
the official position of the Centers for Disease Control and Prevention.
It is important to note that the contents of this document are for informational
purposes only and are not intended to be a substitute for professional legal
or other advice. While every effort has been made to verify the accuracy
of these materials, legal authorities and requirements may vary across jurisdictions,
and laws are often updated and amended. Always seek the advice of an attorney
or other qualified professional with any questions you may have.
1.What authorities does the United States Department of Health
and Human Services have in public health emergencies?
2. What is the Stafford Act and how does it apply to public health
3. What is the purpose and function of the Pandemic and All-Hazards
4. What is the Public Readiness and Emergency Preparedness (PREP)
Act? What are current examples of declarations under the PREP Act?
5. Who is covered by the PREP Act?
6. What actions may the HHS Secretary take under Section 319
of the Public Health Service Act (PHSA) when a public health emergency
has been declared?
7. What other discretionary actions may the Secretary take once
a public health emergency has been declared?
8. What is an 1135 waiver?
9. When the Secretary issues an 1135 waiver, what Medicare, Medicaid,
CHIP, and HIPAA requirements may be temporarily waived or modified?
Glossary of Terms
ASP–Average Sales Price
ASPR–Assistant Secretary for Preparedness and Response
CHIP–Children’s Health Insurance Program
CMS–Centers for Medicare and Medicaid Services
EMTALA–Emergency Medical Treatment and Active Labor Act
ESF–Emergency Support Function
ESAR-VHP–Emergency System for Advanced Registration of Volunteer Health
EUA–Emergency Use Authorization
FEMA–Federal Emergency Management Agency
FFDCA–Federal Food, Drug, and Cosmetic Act
HHS–United States Department of Health and Human Services
HIPAA–Health Insurance Portability and Accountability Act
NDMS–National Disaster Management System
PHSA–Public Health Service Act
PREP Act–Public Readiness and Emergency Preparedness Act
REMS–Risk Evaluation and Mitigation Strategies
SNS–Strategic National Stockpile
SSA–Social Security Act
USERRA–Uniform Services Employment and Re-Employment Rights Act
On April 26, 2009, the Acting Secretary
of the federal Department of Health and Human Services (HHS) issued a
nationwide public health emergency declaration in response to human
infections from influenza A (H1N1) virus. In addition, the World Health
Organization raised the level of influenza pandemic alert to the highest
level on June 11, 2009. The HHS declaration was renewed
by HHS Secretary Kathleen Sebelius on July 24, 2009.
Local and state
health agencies are the first line of preparedness for infectious
disease pandemics and other threats to the health of the public. Their
success hinges on many factors, including, their “legal
preparedness,” that is, their understanding of and capacity to use, laws and legal
authorities that support effective response. Those legal authorities
are complex and involve laws at the federal, state, local, and Tribal
levels. Further, they are found in multiple sectors, including not only
the public health sector but also such sectors as emergency management, health care,
law enforcement, education, and transportation.
Because a number
of federal laws relevant to public health emergencies had been revised in recent years, in the spring of 2009 CDC’s Public Health
Law Program and invited four senior federal attorneys to update
public health practitioners and counsel on current, pertinent federal
laws in a 90-minute teleconference on April 28, 2009. By
coincidence, the teleconference “Federal Public Health Emergency Law:
Implications for State and Local Preparedness and Response” took place
at the beginning of a novel influenza A (H1N1) pandemic. The faculty
highlighted provisions of federal law especially relevant to that new
threat. Following the presentation, members of the large audience –
more than 1,300 public health and other professionals – focused many of
their questions on issues related to the pandemic.
This report –
Frequently Asked Questions about Federal Public Health Emergency Law
– is derived from the April 28 program and the dialogue between the
faculty and participants that followed. The questions and answers are
organized in four categories: legal authorities, public health emergency
procedures, isolation and quarantine issues, and workforce issues.
contents of this report were reviewed by the faculty, it is a
product of the CDC Public Health Law Program and the Program takes
responsibility for any errors it may contain. To view the entire April
28 presentation and access the transcript, please visit
teleconference faculty included:
Sherman, JD, MHS, and Jennifer Ray, JD, MPH, Office of the General
Counsel, U.S. Department of Health and Human Services
- Diane Donley,
JD, Office of Chief Counsel, Federal Emergency Management Agency,
U.S. Department of Homeland Security; and
- Kim Dammers,
JD, Assistant U.S. Attorney, Northern District of Georgia, U.S.
Department of Justice, at the time on detail to CDC.
The CDC Public
Health Law Program is grateful to the faculty and to Brian Kamoie, JD,
MPH, Deputy Assistant Secretary and Director, Office of Policy,
Strategic Planning and Communications, Office of the Assistant Secretary
for Preparedness and Response, HHS, who introduced the program.
The CDC Public
Health Law Program provides many additional resources on public health
emergency legal preparedness accessible in the “CDC Public Health
Emergency Legal Preparedness Clearinghouse” at
Up-to-date information on
legal issues and resources related to infectious disease outbreaks
The training curricula
Public Health Emergency Law 3.0 and Forensic Epidemiology 3.0
The Social Distancing
Law Assessment Template
The Menu of Suggested
Provisions for Public Health Mutual Aid Agreements and companion
Inventory of Mutual Aid Agreements and Related Provision”
A three-part portfolio of
resources for improved coordination across public health, law
enforcement, the judiciary, and the corrections sector, and
The National Action
Agenda for Public Health Legal Preparedness
The Program also
publishes the monthly CDC Public Health Law News, a digest of
developments in public health law and guide to new resources for
improved public health legal preparedness. Subscribe at the
CDC Public Health Law News Web site
Frequently Asked Questions