Last week, the White House declared the opioid crisis a “public health emergency.” The declaration outlined a number of steps the Administration will take to address the epidemic. The public health emergency declaration, while acknowledging the scope and tragic costs of opioid abuse, falls short of a “national emergency” declaration made under the Stafford Act or National Emergencies Act and was not coupled with any new federal funds.
The declaration of a “public health emergency” is made under Section 319 of the Public Health Services Act (PHSA). The PHSA provides the legal authority for the Department of Health and Human Services (HHS) to respond to public health emergencies. Section 319 authorizes the HHS Secretary to lead a federal public health and medical response to public health emergencies, determine if a public health emergency exists, and assist states in their response activities. A benefit of making a public health emergency declaration is that it allows activation of resources across the federal government, providing for a comprehensive response.
According to the fact sheet released by the White House, the specific steps outlined in the opioid public health declaration include:
- “The action allows for expanded access to telemedicine services, including services involving remote prescribing of medicine commonly used for substance abuse or mental health treatment.
- The action helps overcome bureaucratic delays and inefficiencies in the hiring process, by allowing the Department of Health and Human Services to more quickly make temporary appointments of specialists with the tools and talent needed to respond effectively to our Nation’s ongoing public health emergency.
- The action allows the Department of Labor to issue dislocated worker grants to help workers who have been displaced from the workforce because of the opioid crisis, subject to available funding.
- The action allows for shifting of resources within HIV/AIDS programs to help people eligible for those programs receive substance abuse treatment, which is important given the connection between HIV transmission and substance abuse.”
Congressional Republicans were generally supportive of the declaration. Leaders from the House Energy and Commerce Committee pointed out the work Congress has already done and stated that they are ready to work with the Administration on additional measures. Missing from these and other steps is additional federal funding. The absence of new money drew sharp criticism from some Democrats on Capitol Hill, with Energy Commerce Committee Ranking Member Frank Pallone (D-NJ) and Judiciary Committee Ranking Member John Conyers (D-MI), calling the declaration “meaningless.” Other congressional Democrats have signed onto legislation authorizing over $45 billion of new funds to fight the opioid epidemic.
The near-term impacts of the Administration’s declaration are somewhat unclear. There are several lawsuits filed by states and municipalities against pharmaceutical companies that are likely to continue. If there are no new federal funds – note, current Fiscal Year 2018 appropriations expire December 8th – it could prove difficult for HHS, the Department of Labor, and the Department of Justice to develop and implement new programs. Indeed, this problem could be exacerbated by the fact that that the President’s Opioid Commission is set to release its final recommendations on November 1st which could add a new set of programs. The public health emergency declaration was the latest installment of the public policy story that will play out for months to come. We’ll be watching closely as issues arise.