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Is a Pandemic a Major Disaster?

November 17, 2008

influenzapandemicAlright, I’m gonna get a little crazy today and let you in on a little secret: I know next to nothing about the Stafford Act. But, like everything else that has to do with this blog, I intend to learn as much as I can–in between projects for school.

That is, of course, if the Stafford Act actually applies to public health emergencies. Which, apparently, there is some disagreement about.

Another confession: I’m a huge dork and think that CRS reports are among the most elucidating and enjoyable government documents out there. So imagine my pleasure when I found out that a CRS report (pdf), written by Edward C. Liu, was published in order to address this confusion.

And now to get everyone on the same page. The Stafford Act is the short name for the Stafford Disaster Relief and Emergency Assistance Act. According to Wikipedia:

The Stafford Act is a 1988 amended version of the Disaster Relief Act of 1974 (Public Law 93-288). It created the system in place today by which a Presidential Disaster Declaration of an emergency triggers financial and physical assistance through the Federal Emergency Management Agency (FEMA). The Act gives FEMA the responsibility for coordinating government wide relief efforts. The Federal Response Plan it implements includes the contributions of 28 federal agencies and non governmental organizations, such as the American Red Cross. It is named for Robert Stafford, who helped pass the law.

Congress amended it by passing the Disaster Mitigation Act of 2000 (Public Law 106-390), and again in 2006 with the Pets Evacuation and Transportation Standards Act (Public Law 109-308).

The law can be downloaded from here (pdf).

There are two different declarations that can be made under the Stafford Act: an emergency declaration, and the more famous major disaster declaration. Both provide for emergency funds and actions intended to alleviate the situation that caused the declaration to be made. The main difference between the two is in the scope of what happens and, surprisingly enough, in the definition of what can trigger each type of declaration.

The emergency declaration provides:

authoriz[ation of] technical and advisory assistance to affected state and local governments for certain needs; emergency assistance through federal agencies; clearance of debris; housing assistance; and assistance in the distribution of medicine, food, and other consumable supplies. The total amount of assistance available is also limited in an emergency declaration to $5 million, “unless the President determines that there is a continuing need; Congress must be notified if the $5 million ceiling is breached.”

The major disaster declaration, on the other hand, provides all of this:

authoriz[ation by] the President to offer a variety of federal assistance, although none is specifically required to be provided. The types of general federal assistance available include directing federal agencies to support in assistance efforts, coordinating assistance efforts, providing technical and advisory assistance, and distributing supplies and emergency assistance. Under the major disaster classification, there are also more specific provisions, including repair and restoration of federal facilities, removal of debris, housing assistance, unemployment assistance, emergency grants to assist low-income migrant and seasonal farmworkers, food coupons and distribution, relocation assistance, crisis counseling assistance and training, community disaster loans, emergency communications, and emergency public transportation.

Pretty big difference, huh? But why the step-by-step walkthrough of insanely complex federal law? Because it is Mr. Liu’s contention that pandemic influenza or disease outbreaks may not have sufficient cause to invoke the major disaster declaration of the Stafford Act. Got that?

So, what the hell is going on?

It’s quite simple, really. When the law was written, the definition of the situation that would cause a major disaster declaration is exceptionally narrow:

[A]ny natural catastrophe (including any hurricane, tornado, storm, high water, winddriven water, tidal wave, tsunami, earthquake, volcanic eruption, landslide, mudslide, snowstorm, or drought), or, regardless of cause, any fire, flood, or explosion, in any part of the United States, which in the determination of the President causes damage of sufficient severity and magnitude to warrant major disaster assistance under this chapter to supplement the efforts and available resources of States, local governments, and disaster relief organizations in alleviating the damage, loss, hardship, or suffering caused thereby.

Got it? No mention–anywhere–of anything about disease. While we could say that a disease, such as influenza, is a natural catastrophe, the gist of the definition is of physical events–landslides, earthquakes, explosions, etc. See the disconnect? And it gets worse. This law differs from the original disaster relief legislation, the 1974 Disaster Relief Act, in one significant way:

[A]ny hurricane, tornado, storm, flood, high water, wind-driven water, tidal wave, tsunami, earthquake, volcanic eruption, landslide, mudslide, snowstorm, drought, fire, explosion, or other catastrophe.

They explicitly took out the “or other catastrophe.” They took out the part that deals with non-physical events. They took out the part that deals with disease.

So, does that mean that in a pandemic we probably won’t have access to all of the resources we need?According to one CRS researcher, yep.

What can be done, that same researcher says, in a fashion that I’ve never seen in a CRS report, is simple. Amend the law.

A provision in S. 3721, introduced in the 109th Congress by Senator Collins of Maine, would have added the following to the definition of a major disaster: any act of domestic terrorism or international terrorism (as those terms are defined in section 2331 of title 18, United States Code) [and] any outbreak of infectious disease, or any chemical release, in any part of the United States. 

This provision would have made flu pandemics clearly eligible for major disaster assistance, but it was not enacted. A number of other modifications to the Stafford Act were ultimately added by the Post-Katrina Emergency Management Reform Act of 2006, but no changes to the definition of a major disaster were made by that law.

Hopefully this is something Senator Collins, and others, will address in the next Congress. Given that we know that a pandemic will occur, the delay in changing the law is eating into the one thing that we have less and less of every day: time.

Hat tip to Eric Holdeman.

Photo credit: the fine folks in Missouri

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6 Comments leave one →
  1. December 1, 2008 6:34 pm

    Jimmy – great article. I think it’s safe to say that there aren’t many experts on Stafford. I work with the thing (FEMA) and it drives me nuts. This discussion (Stafford Act declarations in a pandemic) is one I’ve been involved in and I can say that there is every expectation that there would be a Presidential Declaration, which sidesteps some of the Stafford requirements, but like you mention, the simple fix is to amend the Act.

  2. December 2, 2008 6:11 pm

    Joel:

    Thanks for stopping by and giving the thumbs up. Public health law is not seemingly well understood at any level, and I’m aware that some of the Centers for Public Health Preparedness (UPitt especially) are making a real effort to tease out the state-level laws. It’d be nice to have some clarity somewhere.

    Thanks again,
    Jimmy

  3. December 3, 2008 4:27 pm

    Another public health legal / security issue.
    The death of the Walmart employee last Friday has my office talking about security at a POD or clinic in the time of a PH emergency..
    Has there been any discussion regarding the security of the sites that are dispensing to the public? It seems that the locations where a potentially life saving medication is being dispensed could be a place that could easily be over run by a mob.
    Cipro or a HDTV’s, both could easily incite a situation that could turn catastrophic. Law enforcement would likely be at a minimum due to the emergent situation.
    Any thoughts?

  4. December 3, 2008 10:15 pm

    Dutch:

    Those are great questions. When talking about this situation, I always say that the folks at the POD will be giving away “the cure.” Medically, we know that’s not the case, but that’s how it will be seen by the public. And, as you say, people will be more apt to climb over other people for “the cure” than for a sale-priced TV.

    And that’s why it’s crucial that public health planners work hand in hand with the folks at EMA’s and in public safety. Public health cannot do security, simple as that. That’s why the CDC specifically asks about cooperative security planning when they look at mass prophylaxis plans.

    Without significant buy-in from the police, POD plans just don’t work. If you look at the history of POD planning, that’s just the first step. Recently, public health has begun looking into alternative, less manpower intensive ways of mass dispensing. The postal plan requires significantly fewer officers, and more distributed stockpiles (easier to secure, hence the fewer officers). And now there is planning going on to institute what are known as “closed PODs,” which will take the dispensing out of public health’s hands altogether.

    It really is a great question, Dutch. And an area that’s far from solved, and will only be solved with lots of cooperation and hard work–if it can be solved at all.

    Glad to have you stop by,
    Jimmy

  5. February 25, 2009 11:35 pm

    I agree Jimmy that it is something that needs to be addressed. I work in a county Emergency Management office and it has become something that we all need to plan for. I know in our county that it is something that our Public Health officials are always bringing up to make sure we don’t forget to plan for it. It seems that there is not enough support from the top.

    • March 9, 2009 9:59 pm

      Tim:

      Sorry for the delay in replying. You think there’s little support in the EMA world? It’s like that everywhere. The only folks who /really/ get it are the hospitals and the flu-bies (http://www.fluwikie.com).

      Thanks for stopping by and for your comment!

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