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FWIW, this is the only report which calls this declaration a "National Emergency" rather than a "swine flu emergency", and which gives more than 2 sentences, thus my choice to post.

Obama Declares H1N1 Flu 'National Emergency'

The White House says the declaration allows medical treatment facilities to better handle a surge in flu patients by waiving federal requirements on a case-by-case basis.
Saturday, October 24, 2009

President Obama signed a proclamation declaring the H1N1 influenza a national emergency, giving doctors and medical facilities greater leeway in responding to the flu pandemic.

Obama signed the declaration late Friday, which the White House said allows medical treatment facilities to better handle a surge in flu patients by waiving federal requirements on a case-by-case basis.

"The foundation of our national approach to the H1N1 flu has been preparedness at all levels -- personal, business, and government -- and this proclamation helps that effort by advancing our overall response capability," the White House said in a statement.

The flu has infected millions of Americans and killed nearly 100 children in the U.S. The chief of the Centers for Disease Control and Prevention said Friday that over a thousand people have died as a result, with 46 states reporting widespread H1N1 activity.

"Since the beginning of the pandemic, we've seen more than 1,000 deaths and 20,000 hospitalizations," said Dr. Thomas Frieden, head of the CDC. "We expect it to occur in waves, but we can't predict when those waves will happen."

Sixty million Americans have been vaccinated against the seasonal flu this year, but an additional vaccine against H1N1 has been in short supply. About 120 million doses were expected to be made available by the middle of October, though only 11 million doses have been shipped to health departments for use. ... emergency/

"The world will not be destroyed by those who do evil, but by those who watch them without doing anything." ~ Albert Einstein

Sat Oct 24, 2009 9:14 am
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National Emergency Powers

Federal law provides a variety of powers for the President to use in response to
crisis, exigency, or emergency circumstances threatening the nation. Moreover, they
are not limited to military or war situations. Some of these authorities, deriving from
the Constitution or statutory law, are continuously available to the President with little
or no qualification.

Others—statutory delegations from Congress—exist on a standby
basis and remain dormant until the President formally declares a national
These delegations or grants of power authorize the President to meet the problems of governing effectively in times of crisis. Under the powers delegated by
such statutes, the President may

* seize property,
* organize and control the means of production,
* seize commodities,
* assign military forces abroad,
* institute martial law,
* seize and control all transportation and communication,
* regulate the operation of private enterprise,
* restrict travel,

and, in a variety of ways, control the lives of United States citizens. Furthermore, Congress may modify, rescind, or render dormant such delegated emergency authority. :pig

Definitions of an emergency:

* “an unforeseen combination of circumstances or the resulting state that calls for immediate action.”10

* urgency and relative infrequency of occurrence as well as equivalence to a public calamity resulting from fire, flood, or like disaster not reasonably subject to anticipation.11

* conditions “which have not attained enough of stability or recurrency to admit of
their being dealt with according to rule.”12

* the existence of conditions of varying nature, intensity and duration, which are perceived to threaten life or well-being beyond tolerable limits.”13

* by definition, an emergency requires immediate action, but is, as well, unanticipated :censor and, therefore, as Corwin notes, cannot always be “dealt with according to rule.”

"The world will not be destroyed by those who do evil, but by those who watch them without doing anything." ~ Albert Einstein

Sat Oct 24, 2009 11:04 am
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Obama declares swine flu a national emergency

By PHILIP ELLIOTT, Associated Press Writer Philip Elliott, Associated Press Writer – 6 mins ago

WASHINGTON – President Barack Obama declared the swine flu outbreak a national emergency, giving his health chief the power to let hospitals move emergency rooms offsite to speed treatment and protect noninfected patients.

The declaration, signed Friday night and announced Saturday, comes with the disease more prevalent than ever in the country and production delays undercutting the government's initial, optimistic estimates that as many as 120 million doses of the vaccine could be available by mid-October.

Health authorities say more than 1,000 people in the United States, including almost 100 children, have died from the flu, known as H1N1, and 46 states have widespread flu activity. So far only 11 million doses have gone out to health departments, doctor's offices and other providers, according to the Centers for Disease Control and Prevention officials.

Administration officials said the declaration was a pre-emptive move designed to make decisions easier when they need to be made. Officials said the move was not in response to any single development.

Health and Human Services chief Kathleen Sebelius now has authority to bypass federal rules when opening alternative care sites, such as offsite hospital centers at schools or community centers if hospitals seek permission.

Some hospitals have opened drive-thrus and drive-up tent clinics to screen and treat swine flu patients. The idea is to keep infectious people out of regular emergency rooms and away from other sick patients.

Hospitals could modify patient rules — for example, requiring them to give less information during a hectic time — to quicken access to treatment, with government approval, under the declaration.

It also addresses a financial question for hospitals — reimbursement for treating people at sites not typically approved. For instance, federal rules do not allow hospitals to put up treatment tents more than 200 yard away from the doors; if the tents are 300 yards or more away, typically federal dollars won't go to pay for treatment.

Administration officials said those rules might not make sense while fighting the swine flu, especially if the best piece of pavement is in the middle of a parking lot and some medical centers already are putting in place parts of their emergency plans.

The national emergency declaration was the second of two steps needed to give Sebelius extraordinary powers during a crisis.

On April 26, the administration declared swine flu a public health emergency, allowing the shipment of roughly 12 million doses of flu-fighting medications from a federal stockpile to states in case they eventually needed them. At the time, there were 20 confirmed cases in the U.S. of people recovering easily. There was no vaccine against swine flu, but the CDC had taken the initial step necessary for producing one.

"As a nation, we have prepared at all levels of government, and as individuals and communities, taking unprecedented steps to counter the emerging pandemic," Obama wrote in Saturday's declaration.

He said the pandemic keeps evolving, the rates of illness are rising rapidly in many areas and there's a potential "to overburden health care resources."

The government now hopes to have about 50 million doses of swine flu vaccine out by mid-November and 150 million in December. The flu virus has to be grown in chicken eggs, and the yield hasn't been as high as was initially hoped, officials have said.

"Many millions" of Americans have had swine flu so far, according to an estimate that CDC Director Dr. Thomas Frieden gave Friday. The government doesn't test everyone to confirm swine flu so it doesn't have an exact count. He also said there have been more than 20,000 hospitalizations. ... _swine_flu

"The world will not be destroyed by those who do evil, but by those who watch them without doing anything." ~ Albert Einstein

Sat Oct 24, 2009 11:12 am
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Joined: Fri Oct 16, 2009 5:22 pm
Posts: 46
Easy now, folks. This is going to look funny format-wise as I am cutting from another post I made at PFI:

The 2009 Influenza A(H1N1) Outbreak:
Selected Legal Issues

Kathleen S. Swendiman, Coordinator
Legislative Attorney
Nancy Lee Jones, Coordinator
Legislative Attorney
May 6, 2009
Congressional Research Service


There are a number of emergency measures which may help to contain or ameliorate an infectious
disease outbreak. The Public Health Service Act and the Stafford Act contain authorities that
allow the Secretary of Health and Human Services and the President, respectively, to take certain
actions during emergencies or disasters. While the primary authority for quarantine and isolation
in the United States resides at the state level, the federal government has jurisdiction over
interstate and border quarantine. Border entry and border closing issues may arise in the context
of measures designed to keep individuals who have, or may have, influenza A(H1N1) from
crossing U.S. borders. Aliens with the H1N1 virus can be denied entry, but American citizens
cannot be excluded from the United States solely because of a communicable disease, although
they may be quarantined or isolated at the border for health reasons. Airlines have considerable
discretion to implement travel restrictions relating to the safety and/or security of flights and other
passengers and crew. In addition, the federal government has broad legal authority to regulate and
control the navigable airspace of the United States in dealing with incidents involving
communicable diseases. States have authority to initiate other emergency measures such as
mandatory vaccination orders and certain nonpharmaceutical interventions such as school
closures, which may lessen the spread of an infectious disease. The International Health
Regulations adopted by the World Health Organization in 2005 provide a framework for
international cooperation against infectious disease threats.


The then-Acting HHS Secretary issued a nationwide public health emergency declaration in
response to recent human infections from the influenza A(H1N1) virus on April 26, 2009. Making such a determination enables the Secretary to take three types of actions that can be especially
useful for dealing with an emerging influenza outbreak. First, such a determination authorizes the
Secretary to draw from a special emergency fund.4 Second, it enables the Secretary to implement
an authority in the Federal Food, Drug, and Cosmetic Act—the so-called Emergency Use
Authorization—allowing for the use of unapproved medical treatments and tests, under specified
conditions, if needed during an incident.5 Third, if there is a concurrent declaration pursuant to
the Stafford Act6 or the National Emergencies Act, 7 the Secretary is authorized to waive or
modify a number of administrative requirements, principally involving reimbursement through
the Medicare and Medicaid programs, in order to facilitate the provision of health care items and
services by providers in any geographic area subject to the concurrent declarations.


Specifically, the Secretary may take some or all of the
following actions:
• Waive conditions of participation, certification requirements, program
participation, and pre-approval requirements under Medicare, Medicaid, or the
Children’s Health Insurance Program;9
• Permit health care providers to provide care under Medicare, Medicaid, or the
Children’s Health Insurance Program, even if they are not licensed by the state
with jurisdiction over the emergency area;10
• Waive sanctions under the Emergency Medical Treatment and Active Labor Act
for certain transfers or redirections of patients away from hospital emergency
Waive sanctions for violations of the Stark law, which prohibits certain selfreferrals
by physicians;12
• Extend deadlines and other timetables for required activities;13
• Waive limitations on payments under Medicare Advantage for care and services
provided by out-of-network providers;14 or
• Waive sanctions and penalties for violations of the HIPAA Privacy Rule such as
the use of protected health information for hospital directories, the disclosure of
protected health information to patients’ families and friends, the distribution of
health care providers’ and insurers’ privacy policies to patients, and individuals’
rights to request restrictions, privacy restrictions, or confidential
These waivers and modifications may be retroactively applied by the Secretary to the beginning
of the period during which the concurrent declarations were in effect, and will generally remain in
effect until either of the underlying emergency declarations ends or sixty days have elapsed since
the date on which notice of the waivers or modifications was published


With respect to the current outbreak, the Public Health Emergency Fund is available (but is
currently unfunded)17 and Emergency Use Authorizations have been granted by FDA.18 However,
the Secretary’s waiver and modification authority has not been activated because there is no
concurrent presidential declaration under either the Stafford Act or the National Emergencies Act.9comment: report published in May 2009)


A presidential declaration under the Stafford Act triggers federal emergency authorities that are
independent of the Secretary’s public health emergency authorities. Declarations under the
Stafford Act fall into two categories: emergency declarations and major disaster declarations. As
of this point in time, there have been no Stafford Act declarations pertaining to the current
influenza A(H1N1) virus outbreak.(MAY 2009) A presidential emergency declaration under the Stafford Act
authorizes the President to direct federal agencies to support state and local emergency assistance
activities; coordinate disaster relief provided by federal and non-federal organizations; provide
technical and advisory assistance to state and local governments; provide emergency assistance
through federal agencies; remove debris through grants to state and local governments; provide assistance to individuals and households for temporary housing and uninsured personal needs;
and assist state and local governments in the distribution of medicine, food, and consumables.19
The total amount of assistance available is 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.


Emergency declarations under the Stafford Act in the event of an outbreak of infectious disease
are not unprecedented. In 2000, the detection of West Nile virus in New York and New Jersey
was used as the basis of an emergency declaration under the Stafford Act.21 However, there may
be uncertainty regarding whether a flu pandemic, or any outbreak of infectious disease, would be
eligible for major disaster assistance under the Stafford Act


A major disaster declaration authorizes the President to offer all the assistance authorized under
an emergency declaration, and further authorizes funds for the repair and restoration of federal
facilities, unemployment assistance, emergency grants to assist low-income migrant and seasonal
farm workers, food coupons and distribution,
relocation assistance, crisis counseling assistance
and training, community disaster loans, emergency communications, and emergency public
transportation.23 Additionally, the total amount of assistance provided in a major disaster
declaration is not subject to a ceiling in the same way as under an emergency declaration.


Although there are differences between the types and amounts of assistance that are authorized by
an emergency or major disaster declaration, either declaration would activate the Secretary’s
waiver or modification authority,25 if concurrent with a public health emergency declaration.

Sat Oct 24, 2009 2:05 pm
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Joined: Sun Oct 11, 2009 8:59 am
Posts: 6532
Location: Friendswood, TX
Good on him - about time, IMHO.

This declaration means a whollllllleeee bunch of stuff as Nawty posted above.

It means:

1. Folks WILL be treated regardless of insurance status.

2. Folks WILL be treated without regard to medical records - primarily this means at triage centers. A better way to think of this is to remember the folks treated at the Astrodome after Katrina. It didn't matter that they didn't have their medical records and that there was no access to them, they were treated and they were prescribed medications. Cancer patients were able to continue chemo and radiotherapy.

3. It means triage centers can now be established, if and where needed. I've long told the flubies that this will happen. Folks will be triaged - the sickest with the best chance of life will be treated first, the next level will be those who require hospitalization but no vents/no ICU, third level will be the "walking wounded" so to speak - those who are ill and just require Tamiflu/Relenza, sadly, last will be those who will be given comfort care only - they will be allowed to die with dignity.

4. It means that states can, if necessary, declare a medical emergency and access FEMA/CDC stockpiles of medications, medical supplies, etc. It also means the National Guard can be called in where necessary to protect hospitals, outpatient centers, etc. Not to say that it is martial law - think more along the lines of the National Guard after a hurricane - distributing food, water, and making sure folks are safe at distribution centers. It also enables National Guard medics to be called to active duty to help with vaccinations and/or care of the ill.

5. In my hospital for instance, it means should there be a massive outbreak, TPTB there can lock us down - just like they do for a hurricane.

The test of our progress is not whether we add more to the abundance of those who have much; it is whether we provide enough for those who have too little. - FDR

Sat Oct 24, 2009 3:40 pm
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