Public Health Emergency Acts Streamline Texas Disaster Response

The Public Health Emergency declared for Texas by US health authorities this month will cut through bureaucratic hurdles to lifesaving care, but disaster prevention efforts are a more efficient use of federal dollars, scholars of health and environmental law said.

Southeast Texas, including Houston, faced back-to-back disasters earlier this month after Hurricane Beryl was followed closely by a powerful heat wave. The storm left more than one million residents sweltering without electricity or air conditioning as heat indexes surpassed 100 degrees, according to the Department of Health and Human Services.

The sequence of extreme weather was deadly: 15 deaths in Harris County, which includes Houston, had been attributed to Hurricane Beryl as of July 22, local officials said. Seven of those deaths were caused by heat amid power outages due to the storm.

“Often the more serious problems are either the second or the third disaster,” said Robert Verchick, a professor of disaster and climate change law at Loyola University New Orleans and a former Environmental Protection Agency official in the Obama administration. “It’s like a row of dominoes, and not having electricity for a week is a serious public health problem.”

The public health emergency for Texas, declared by the HHS on July 12, followed a major disaster declaration from President Joe Biden that unlocked federal resources to aid recovery efforts.

“The combination of severe heat and limited access to electricity is dangerous, especially for vulnerable populations and those relying on electricity-dependent durable medical equipment and certain healthcare services,” Dawn O’Connell, HHS’ assistant secretary for preparedness and response, said in a statement announcing the agency’s emergency declaration.

Cutting Red Tape

While a major disaster declaration is more “infrastructure oriented,” the public health emergency is focused on “dealing with the people hurt from the storm and dealing with the people hurt from the extreme heat,” said Jean Su, senior attorney and energy justice director at the Center for Biological Diversity.

The emergency declaration is essentially a tool to cut through regulatory red tape that would impede the ability of healthcare providers to respond quickly during a disaster, said Dr. David Lakey, vice chancellor for health affairs and chief medical officer for the University of Texas System.

“There’s a lot of reporting and deadlines and those types of things that get in the way of a hospital being able to respond,” said Lakey, a former commissioner of the state’s health department. “The emergency just takes some of that bureaucratic work off the table for a while for them to be able to concentrate on caring for these individuals.”

Dialysis patients, for example, may have a care provider that’s unable to operate after the hurricane, Lakey said. The emergency declaration would allow them to quickly receive treatment elsewhere, and also to replace supplies they may have lost in the storm, he said.

The emergency declaration unlocks emergency funds and allows HHS to take steps including modifying certain privacy and telemedicine requirements, adjusting Medicare reimbursements, deploying additional personnel, and more.

But Verchick urged officials to invest more resources in preparing for disasters ahead of time, rather than solely reacting once they happen.

“Of course responding to disasters is extremely important, but it’s more important to take actions that prevent the harms to begin with,” he said. “That is money that goes so much further in the prevention stage than it does in the recovery stage.”

Additional efforts to protect against extreme heat would be particularly helpful in predominantly Black and Latino communities, Verchick said. Those places often face disproportionate harm from high temperatures because of policies that have funneled mitigation resources toward wealthier and whiter areas.

The Texas public health emergency is the first such declaration HHS has made this year, though it has twice renewed public health emergencies for wildfire recovery in Hawaii and for the opioid epidemic nationwide. The agency declared five public health emergencies in 2023.