At the federal level, the Robert T. Stafford Disaster Relief and Emergency Assistance Act of 1988 (Stafford Act), the National Emergencies Act (NEA), and the Public Health Service Act allow the federal government to declare emergencies under certain circumstances. Under District law, the Public Emergencies Act of 1980, D.C. Official Code §§ 7-2301 to -2308, establishes a program of public emergency preparedness and provides the authority for emergency response. In the District, the Mayor has many of the powers reserved for Governors of states, including the authority to declare an emergency or a public health emergency in certain situations. Such declarations, upon publication, trigger powers that allow the District to address the emergency situation and are precursors to requesting federal aid.
District law authorizes the Mayor to issue two types of emergency declarations: public emergency declarations and public health emergency declarations. A public emergency involves situations arising from disasters, catastrophes, or other emergency circumstances, such as floods, earthquakes, fires, and serious civil disorders, that threaten the health, safety, or welfare of individuals in the District. A public health emergency is an emergency that involves a large number of deaths and/or serious human health disabilities in the District, widespread exposure to an infectious or toxic agent, use, dissemination, or detonation of a weapon of mass destruction, or another type of emergency event that requires the use of volunteer health practitioners. A public health emergency may not be declared unless a public emergency is also declared. In addition, the Mayor is authorized to declare a state of emergency for up to 30 days under the Natural Disaster Consumer Protection Act, D.C. Official Code § 28-4102(b)(1).
The Mayor has established an agency, the District of Columbia Homeland Security and Emergency Management Agency (HSEMA), to ensure that the District is prepared to protect against, plan for, respond to, and recover from, natural and man-made hazards. In addition, the Mayor’s Emergency Preparedness Council (EPC) and the National Capital Region Emergency Preparedness Council (NCREPC) provide assistance and policy recommendations regarding emergency preparedness issues.
The District Response Plan (DRP), created under the Mayor’s authority to establish a public health preparedness plan, unifies and coordinates the efforts of District departments and agencies, as well as non-governmental and voluntary organizations and regional and federal partners, when responding to all hazards. The District of Columbia’s Emergency Operations Center (EOC) is the central location where coordination efforts occur to ensure an effective response.
The Mayor is also authorized to enter into mutual aid agreements in response to emergencies and disasters. The District is a member of the Emergency Management Assistance Compact (EMAC), which provides for mutual assistance between jurisdictions in certain situations and when specified requirements have been met.
4.2 Federal Declarations
4.2.1 The Robert T. Stafford Disaster Relief and Emergency Assistance Act of 1988
The Robert T. Stafford Disaster Relief and Emergency Assistance Act of 1988 (the Stafford Act) is the broadest and most well-known of the federal government’s emergency programs. 42 U.S. Code § 5121 to 5207. The Federal Emergency Management Agency (FEMA) coordinates administration of disaster relief resources and assistance to states and localities. Before FEMA can provide any significant direct funding, however, a presidential declaration must occur.
The Stafford Act authorizes the President to issue two types of declarations: a “major disaster declaration” and an “emergency declaration.” Major disaster declarations authorize a wide range of federal assistance to states, local governments, tribal nations, individuals, households, and certain non-profit organizations to aid recovery from a catastrophic event. Major disaster declarations must be requested by the state governor, mayor, or tribal leader. Emergency declarations, which are issued by the President to protect property, public health, and safety, as well as lessen or avert the threat of a major disaster, authorize a more limited range of federal assistance. In most cases, the governor, mayor, or tribal leader must request the emergency declaration. The President, however, may declare an emergency without first receiving a gubernatorial, mayoral, or tribal leader request if the emergency involves an area of primary federal responsibility, (e.g., federal buildings or army bases).
FEMA issues recommendations to the President based on the severity of the catastrophe or emergency.
Under the Stafford Act, there are three types of disaster assistance programs offered by FEMA:
- Individual Assistance: provides aid to individuals and households
- Public Assistance: provides assistance to state and local governments and certain private non-profit organizations for emergency work and the repair or replacement of disaster-damaged facilities
- Hazard Mitigation Assistance: provides assistance to state and local governments for actions taken to prevent or reduce long-term risk to life and property from natural hazard
More information and a summary of these programs can be found at https://www.fema.gov/disaster-declaration-process.
4.2.2 Public Health Emergency Declarations
Under section 319 of the Public Health Service (PHS) Act, the United States Secretary of Health and Human Services (HHS Secretary) is authorized to declare a public health emergency if the HHS Secretary determines that a public health emergency exists. A public health emergency exists if:
- A disease or disorder presents a public health emergency; or
- A public health emergency, including significant outbreaks of infectious diseases or bioterrorist attacks, otherwise occurs.
A public health emergency declaration is in effect until the HHS Secretary declares that the emergency no longer exists, or after 90 days (whichever occurs first). If the HHS Secretary finds that the public health emergency declaration should remain in effect because of a continuation of the original public health threat or the emergence of new circumstances, the HHS Secretary may renew the declaration for additional 90-day periods. The HHS Secretary has broad authority to “take such action as may be appropriate” and may use funds from the Public Health Emergency Fund to respond to the public health emergency.
4.2.3 The National Emergencies Act
The National Emergencies Act (NEA) allows the President to declare a “national emergency.” The NEA does not provide any specific emergency authority itself; instead, it relies on emergency authorities provided in other federal statutes and triggers statutory authorities as specifically identified in the President’s declaration.
A national emergency may be terminated when the President issues a proclamation or if Congress enacts a joint resolution terminating the national emergency. A national emergency will automatically terminate on the anniversary of the declaration unless renewed by the President.
During the H1N1 pandemic, President Obama signed a declaration under the NEA, which, together with the prior determination by the HHS Secretary of the existence of a public health emergency, allowed healthcare facilities to waive certain regulatory requirements while responding to the pandemic. This declaration can be accessed at https://obamawhitehouse.archives.gov/realitycheck/the-press-office/declaration-a-national-emergency-with-respect-2009-h1n1-influenza-pandemic-0.
4.3 Section 1135 Waivers
When the President declares a disaster or emergency under the Stafford Act or NEA and the HHS Secretary declares a public health emergency under Section 319 of the PHS Act, the HHS Secretary is authorized to take certain actions in addition to their regular authorities under section 1135 of the Social Security Act (SSA). The HHS Secretary may waive or modify certain Medicare, Medicaid, Children’s Health Insurance Program (CHIP), or Health Insurance Portability and Accountability Act (HIPAA) requirements as necessary to ensure that sufficient healthcare items and services are available to meet the needs of individuals in the emergency area during the emergency time period. In addition, the waivers and modifications ensure that providers of such services who act in good faith and are unable to comply with certain statutory requirements are reimbursed and exempted from sanctions for non-compliance (other than acts of fraud or abuse).
An “emergency area” is defined as a geographical area in which an "emergency period" has been declared, during which an emergency or disaster exists that has been declared by the President under the NEA or the Stafford Act; and a Public Health Emergency declared by the Secretary under section 319 of the PHS Act.
For the purposes of 1135 waivers, the term “healthcare provider” refers to any entity that furnishes healthcare items or services (e.g., hospitals, nursing homes) healthcare facilities, or other providers of or supplier of healthcare items or services, a physician, or other healthcare practitioners or professionals.
Examples of 1135 waivers or modifications include:
- Conditions of participation or certification requirements, program participation, or similar requirements for individual healthcare providers or types of healthcare providers;
- Preapproval requirements;
- Requirements that physicians and other healthcare professionals hold licenses in the state in which they provide services if they have a license from another state for purposes of Medicare, Medicaid, and CHIP reimbursement only;
- Sanctions under the Emergency Medical Treatment and Active Labor Act (EMTALA) for redirection or reallocation of an individual to another location to receive a medical screening pursuant to an appropriate state emergency preparedness plan or a state preparedness plan for the transfer of an individual who has not been stabilized if the transfer is necessitated by the circumstances of the declared federal public health emergency. A waiver of EMTALA sanctions is effective only if actions under the waiver do not discriminate on the basis of a patient’s source of payment or ability to pay;
- Sanctions under section 1877(g) (the Physician Self-Referral Law or the Stark Law) relating to limitations on physician referrals;
- Deadlines and time tables for performance of required activities to allowing of such deadlines to be modified;
- Limitations on payments for healthcare items and services to permit Medicare Advantage plan enrollees to use out-of-network providers in an emergency situation; and
- Sanctions and penalties arising from non-compliance with certain HIPAA privacy regulations. The waiver of HIPAA requirements is effective only if actions under the waiver do not discriminate on the basis of a patient’s source of payment or ability to pay.
Section 1135 waivers and modifications may be retroactive to the beginning of the emergency period. Waivers and modifications terminate either upon the termination of the emergency period or 60 days after the waiver or modification is first published (subject to 60-day renewal periods until termination of the emergency). Waivers of EMTALA (other than for a pandemic disease) or HIPAA requirements, however, are effective only for 72 hours after the implementation of a hospital disaster protocol. A waiver of EMTALA sanctions during pandemic disease is effective until the termination of the pandemic-related public health emergency.
The 1135 waiver authority applies only to federal requirements and does not apply to state requirements for licensure or conditions of participation.
Additional information regarding 1135 waivers, including required elements, can be found at https://www.phe.gov/Preparedness/legal/Pages/1135-waivers.aspx.
4.4 The Emergency Medical Treatment and Active Labor Act
EMTALA is a federal law that requires all Medicare-participating hospitals with dedicated emergency departments to provide appropriate medical screening exams to all individuals who come to the emergency department, regardless of ability to pay, to determine if the individual has an emergency medical condition. If an emergency medical condition is found, the hospital must either treat and stabilize the patient to the best of its ability or transfer the patient to another facility that has the capability and capacity to treat the patient. 42 U.S. Code § 1395dd.
Under EMTALA, an “emergency medical condition” is a medical condition manifesting itself by acute symptoms of sufficient severity such that the absence of immediate medical attention could reasonably result in:
- Serious jeopardy to individual, woman, unborn child;
- Serious bodily function impairment;
- Serious bodily organ dysfunction;
- Not enough time to safely transfer a laboring woman before delivery; or
- Transfer may harm the laboring woman or unborn child.
A fact sheet addressing frequently asked questions regarding EMTALA and disasters can be found at https://asprtracie.s3.amazonaws.com/documents/aspr-tracie-fact-sheet-emtala-and-disasters.pdf.
Hospitals have expressed concern regarding their ability to comply with EMTALA requirements during emergencies. In response to these concerns, the Centers for Medicare and Medicaid Services (CMS) published a fact sheet in 2009 during the H1N1 pandemic to clarify options that are permissible under EMTALA. See Centers for Medicare & Medicaid Services, Fact Sheet for Medicaid and CHIP Providers Influenza A (H1N1) Flu.
4.5 Mayoral Authority to Declare Emergencies
The Mayor has the authority to declare a public emergency under D.C. Official Code § 7-2304 and a public health emergency under D.C. Official Code § 7-2304.01. The Mayor is also authorized to declare a state of emergency in order to protect consumers from price gouging after natural disasters under D.C. Official Code § 28-4102(b).
See section 4.6 of the Manual.
4.5.1 Public Emergency
- Emergency Executive Order Declaring a Public Emergency – In certain situations, the Mayor may issue an emergency executive order declaring the existence of a public emergency. D.C. Official Code § 7-2304(a).
- Public Emergency Defined – Public emergency is any disaster, catastrophe, or emergency situation where the health, safety, or welfare of persons in the District is threatened due to actual or imminent consequences within the District of:
- Enemy attack, sabotage, or other hostile action;
- Severe and unanticipated resource shortage;
- Flood, earthquake, or other serious act of nature;
- Serious civil disorder;
- Any serious industrial, nuclear, or transportation accident;
- Explosion, conflagration, or power failure;
- Injurious environmental contamination that threatens or causes damage to life, health, or property; or
- Outbreak of a communicable disease that threatens or causes damage to life, health or property.
- Standard – The Mayor may declare a public emergency if the Mayor has the reasonable apprehension of the existence of a public emergency and determines that the issuance of an order is necessary for the immediate preservation of the public peace, health, safety, or welfare. D.C. Official Code § 7-2304(a).
- Content of Order – The order must state:
The existence, nature, extent, and severity of the public emergency;
The measures necessary to relieve the public emergency;
The specific requirements of the order and the persons upon whom the order is binding; and
The duration of the order.
- Powers – The emergency executive order declaring a public emergency allows the Mayor to do the following:
Expend funds to carry out public emergency service missions and responsibilities;
Implement response plans without regard to normal operating procedures relating to the performance of public works, entering into contracts, incurring obligations, employment of temporary workers, rental of equipment, purchase of supplies and materials, and expenditure of public funds;
Evacuate people to emergency shelters designated by the Mayor;
Disconnect public utilities, such as gas and electric;
Destroy or remove property that is contaminated, is an immediate or imminent danger to persons or property, and can prohibit persons from contacting or approaching such property;
Issue orders or regulations to control, restrict, allocate, or regulate the use, sale, production, and distribution of food, fuel, clothing, and other commodities, materials, goods, services, and resources as required by the District Response Plan (DRP) or by any federal emergency plan;
Direct the reduction or alteration of business hours;
Institute a curfew to keep people off public streets;
Establish public emergency services units as the Mayor deems appropriate;
Expand existing departmental and agency units within District government concerned with public emergency services;
Exercise operational direction over all District government departments and agencies for the duration of the emergency executive order;
Procure supplies and equipment, institute training programs and public information programs, and take all other preparatory steps, including the partial or full mobilization of public emergency services units in advance of an actual disaster to ensure adequately trained and equipped personnel are available during a public emergency;
Request federal disaster assistance, including pre-disaster assistance and certifying the need for federal disaster assistance;
Commit District funds to alleviate damage, loss, hardship, and suffering as a result of the disaster;
Prevent or reduce harmful consequences of the disaster; and
Detain persons who are determined, with probable cause, to be affected with a communicable disease likely to cause death or seriously impair the health of others.
- Duration – An emergency executive order declaring a public emergency issued by the Mayor under D.C. Official Code § 7-2304(a) is effective for no more than 15 calendar days from the day it is signed. If the Mayor determines that the public emergency no longer exists, the Mayor may rescind the order in whole or in part at an earlier date. D.C. Official Code § 7-2306(a).
See Appendix 2.0 for an example of a Public Emergency Declaration Rescission.
- Extension – An emergency executive order declaring a public emergency may be extended for an additional 15-day period if the Mayor submits proposed emergency legislation to the Council of the District of Columbia (D.C. Council) and the D.C. Council enacts such legislation. If extenuating circumstances, such as death, destruction, or other perilous conditions prohibit the convening of at least two-thirds of the members of the D.C. Council for consideration of emergency legislation, the Mayor may decide to extend the emergency executive order up to 15 days after making a reasonable attempt to consult with the remaining members of the D.C. Council. D.C. Official Code § 7-2306(b)-(c).
- Publication of Order – The emergency executive order declaring a public emergency must be published in the District of Columbia Register and in two daily local newspapers, as well as posted in public places in the District as determined by the Mayor, as soon as practicable. D.C. Official Code § 7-2306(d).
- Violation of Emergency Order – An emergency executive order issued by the Mayor may provide for a fine of not more than $1,000 for each violation. D.C. Official Code § 7-2307.
See Appendix 3.0 for a declaration of a public emergency flowchart.
4.5.2 Public Health Emergency
- Emergency Executive Order Declaring a Public Health Emergency – When the Mayor issues an emergency executive order declaring a public emergency, the Mayor may also issue an additional emergency executive order declaring a public health emergency. D.C. Official Code § 7-2304.01(a).
See Appendix 2.0 for an example of a Mayor’s Declaration of a Public Health Emergency.
- Standard – The Mayor may declare a public health emergency if the Mayor has reasonable cause to believe there is an imminent hazard or actual occurrence of any of the following:
- A large number of deaths in the District;
- A large number of serious or long-term human health disabilities in the District;
- Widespread exposure to an infectious or toxic agent that poses a significant risk of substantial future harm to a large number of people in the District;
- Use, dissemination, or detonation of a weapon of mass destruction, as defined by D.C. Official Code § 22-3152(12); or
- Other emergency events that create an acute and immediate need for volunteer health practitioners.
- Content of Order – The order must specify:
- The existence, nature, extent, and severity of the public health emergency;
- The geographic areas subject to the declaration;
- The conditions that have brought about the public health emergency, if known;
- The measures necessary to relieve the public health emergency;
- The specific requirements of the order and the persons upon whom the order is binding; and
- The duration of the order.
- Powers – The emergency executive order declaring a public health emergency may include the following terms:
- Require that healthcare providers licensed in the District reasonably assist and not unreasonably detract from the ability of the District government to successfully respond to and control the public health emergency in accordance with the provisions of the DRP and D.C. Official Code §§ 7-131 to -144;
- Appoint licensed healthcare providers, either from the District or from other jurisdictions, as temporary agents of the District, provided that such appointments are in effect solely for the duration of the public health emergency, without compensation and for the purpose of assisting the District in implementing the provisions of the DRP and D.C. Official Code §§ 7-131 to -144;
- Exempt licensed healthcare providers, either from the District or other jurisdictions, from civil liability for damages for any actions taken within the scope of the provider’s employment or voluntary service to implement the provisions of the DRP and D.C. Official Code §§ 7-131 to -144, (except in instances of gross negligence) for the duration of the public health emergency; and
- Waive any licensing requirements, permits, or fees otherwise required by District law to allow healthcare providers licensed in their home jurisdiction in their fields of expertise to be appointed as temporary agents to respond to the public health emergency.
- Duration – An emergency executive order declaring a public health emergency issued by the Mayor D.C. Official Code § 7-2304.01(a) is effective for no more than 15 calendar days from the day it is signed. If the Mayor determines that the public emergency no longer exists, the Mayor may rescind the order in whole or in part at an earlier date. D.C. Official Code § 7-2306(a).
See Appendix 2.0 for an example of a Public Health Emergency Declaration Rescission.
- Extension – An emergency executive order declaring a public health emergency may be extended for an additional 15-day period if the Mayor submits proposed emergency legislation to the D.C. Council and the D.C. Council adopts such legislation. If extenuating circumstances, such as death, destruction, or other perilous conditions prohibit the convening of at least two-thirds of the members of the D.C. Council for consideration of emergency legislation, the Mayor may decide to extend the emergency executive order by up to 15 days, after making a reasonable attempt to consult with the remaining members of the D.C. Council. D.C. Official Code § 7-2306(b)-(c).
- Publication of Order – The emergency executive order declaring a public health emergency must be published in the District of Columbia Register and in two daily local newspapers, as well as posted in public places in the District as determined by the Mayor by regulation, as soon as practicable given the condition of the emergency. D.C. Official Code § 7-2306(d).
See Appendix 3.0 for a declaration of a public health emergency flowchart.
In the context of a public health emergency, it is foreseeable that a party could seek declaratory relief to determine whether certain information relating to the outbreak or emergency should be disclosed or to determine the appropriateness of a detention facility proposed by the DC Health Director. Moreover, a party might seek a declaratory judgment to revoke a declaration of emergency or public health emergency issued by the Mayor or emergency regulations adopted by the D.C. Council.
Under the District of Columbia Superior Court’s (Superior Court) rules of civil procedure, a party may seek a declaratory judgment to determine present and/or future rights. Super. Ct. Civ. R. 57. Declaratory relief is appropriate if a party needs judicial guidance prior to taking future action rather than adjudicating a party’s past conduct. Granting declaratory relief is within the court’s discretion and is not mandatory. Wilton v. Seven Falls Co., 515 U.S. 277, 288 (1995).
Any party may request a trial by jury on the motion for declaratory judgment. Super. Ct. Civ. R. 38, 39, 57. The party seeking the jury trial must serve the other parties with a written copy of the jury request. The jury request may be made any time after the commencement of the action but not later than 14 days after service of the last pleading. Super. Ct. Civ. R. 38(b). The court may also order a “speedy hearing” on a party’s motion for declaratory judgment. Super. Ct. Civ. R. 57.
4.6 Natural Disaster Consumer Protection Act
4.6.1 State of Emergency
The Natural Disaster Consumer Protection Act provides additional emergency declaration authority to the Mayor to protect consumers from price gouging after natural disasters. Within 48 hours of a natural disaster, the Mayor may declare a state of emergency for not more than 30 days. This declaration must be published in the District of Columbia Register and in two daily newspapers of general circulation as soon as practicable after the declaration. D.C. Official Code § 28-4102(b).
4.6.2 Natural Disaster Defined
Natural disaster is the actual or imminent consequence of any disaster, catastrophe, or emergency, including fire (but not fire caused by human error or arson), flood, earthquake, storm, or other serious act of nature, that threatens the health, safety, and welfare of persons or causes damage to property in the District. D.C. Official Code § 28-4101(1).
4.6.3 Anti-Price Gouging
During a declared emergency, it is unlawful for any person to charge more than the normal average retail price for any merchandise or services sold during the declared emergency. D.C. Official Code § 28-4102(a).
Violators of the Natural Disaster Consumer Protection Act may be fined up to $1,000 and may have their license, permit, or certificate of occupancy revoked, suspended, or limited. D.C. Official Code § 28-4103.
4.7 Emergency Management
4.7.1 District of Columbia Homeland Security and Emergency Management Agency
The Mayor has established the District of Columbia Homeland Security and Emergency Management Agency (HSEMA) to support and coordinate homeland security and emergency management efforts, ensuring that the District's all-hazards emergency operations are prepared to protect against, plan for, respond to, and recover from natural and man-made hazards. D.C. Official Code § 7-2202(a).
A special event is a significant domestic or internal event, occurrence, contest, activity, or meeting that, by virtue of its profile and/or status, represents an attractive target for a terrorist attack. See 32 C.F.R. § 183.3. A national security special event (NSSE) is an event of national significance that, by virtue of its political, economic, social, or religious significance, may be the target of terrorism or other criminal activity. See Id. Examples of special events and NSSEs include presidential inaugurations, major international summits held in the U.S. (typically in the District), major sporting events, and presidential nominating conventions. More information about special events and NSSEs in the District can be found at https://hsema.dc.gov/page/msetg-special-events-calendar.
4.7.2 Mayor's Emergency Preparedness Council
The Mayor is authorized to establish the Mayor’s Emergency Preparedness Council (EPC) to continually re-examine the overall state of emergency and disaster readiness of the District, to provide a consistent network of District agency expertise to make the District a national leader in comprehensive emergency management and homeland security, and to make recommendations on improving District planning for, response to, and recovery from emergency and disaster events as well as emerging threats. Mayor’s Order 2012-82 (June 15, 2012).
4.7.3 National Capital Region Emergency Preparedness Council
The National Capital Region Emergency Preparedness Council (NCREPC) is an advisory body which reports to the Metropolitan Washington Council of Governments (MWCOG) Board of Directors. MWCOG is an independent, nonprofit association that brings area leaders together to address major regional issues in the District, suburban Maryland and Northern Virginia. MWCOG’s membership includes 300 elected officials from 22 local governments, the Maryland and Virginia state legislatures, and the United States Congress. NCREPC derives its authority from a Charter adopted by the MWCOG Board on November 13, 2002.
The NCREPC makes policy recommendations to the MWCOG Board through the Public Safety Policy Committee and makes procedural or other recommendations to the MWCOG Board or, through the MWCOG Board, to various regional agencies with emergency preparedness responsibilities or operational response authority. The NCREPC oversees and implements the Regional Emergency Coordination Plan (RECP); coordinates activities of the various Regional Emergency Support Function (RESF) Working Groups as they develop specific procedures and relationships; oversees the development of plan annexes and establishes such additional plan annexes as may be desirable; and develops training or tests of various components of regional emergency preparedness in conjunction with MWCOG's Chief Administrative Officers Committee (CAO).
For more information on MWCOG and the National Capital Region (NCR), see section 4.10.1 of the Manual.
4.7.4 District of Columbia Emergency Support Function #8 DC Health, Health and Medical Coalition
DC Health, Health and Medical Coalition (DC Health-HMC) serves as a strategic planning committee and advisor to the DC Health Director. As such, it fosters partnerships among government agencies, healthcare providers, and community partners to strengthen the District’s response to emergencies. DC Health-HMC facilitates information, communication and resource sharing and works to maximize the utilization of limited existing resources. It also coordinates training, drills, and exercises between state, local, and federal partners.
4.8 Emergency Planning
4.8.1 District Response Plan and Program
The Mayor has authority to establish a public health preparedness plan and program that utilizes the services of all appropriate District agencies. D.C. Official Code § 7-2302(a). The DRP was created pursuant to this authority to prepare for and respond to emergencies and disasters. The DRP unifies and coordinates the efforts of District departments and agencies, non-governmental and voluntary organizations, and regional and federal partners that may be involved in emergency management and homeland security to protect life and property and ensure public safety.
4.8.2 Emergency Support Function #8 - Health and Medical Services
Emergency Support Function (ESF) #8 – Health and Medical Services provides coordinated District medical assistance and resources to respond to public health and medical care needs following a public emergency. Assistance provided under ESF #8 is directed by the Health Emergency Preparedness and Response Administration (HEPRA) and is supported by several District agencies and private health service providers.
4.8.3 Emergency Support Function #13 - Law Enforcement
ESF #13 – Law Enforcement provides for the safety of citizens and security of property during public emergencies. It prescribes the procedures for the command, control, and coordination of District ESF #13 agencies to conduct emergency operations in the District. It also establishes interagency relationships with the ESF #13 federal law enforcement. In the District, ESF #13 is directed by the Metropolitan Police Department (MPD).
During public emergency operations, ESF #13 manages and coordinates law enforcement activities, and provides personnel and equipment resources to execute response activities in the public safety and security area. Examples of the support provided under ESF #13 include:
Supporting public safety and security operations in the field;
Enhancing situational awareness at operations centers; and
Aiding planning and decision making by the Consequence Management Team (CMT).
4.9 Emergency Operations Center
The Emergency Operations Center (EOC) integrates regional, federal, and local information and communications on a daily basis, and serves as the main operational command and control center for consequence management during an emergency, disaster, special event, and NSSE in the District. During events or incidents that impact the NCR, the EOC ensures information-sharing, coordination and communications with NCR jurisdictions utilizing a variety of communication tools.
The EOC maintains direct contact with NCR jurisdictions and federal counterparts via landlines, hotlines, radio, WebEOC, closed-circuit television (CCTV), and other non-secure systems to ensure constant receipt and dissemination of information.
4.10 Mutual Aid
The Mayor may enter into interstate civil defense compacts with other jurisdictions to provide mutual aid to meet any emergency or disaster from enemy attack or other cause, natural or otherwise. The form of the compact is specified in D.C. Official Code § 7-2209(a).
See section 12.6 of the Manual for information about mutual aid agreements related to mass fatality incidents.
4.10.1 National Capital Region
The NCR was granted authority to establish mutual aid agreements in the NCR with certain liability protection by the Intelligence Reform and Terrorism Prevention Act of 2004, Public Law 108-458, as amended by Senate Report 110-237, S. 1245 (IRTPA). The NCR Mutual Aid Agreement (NCR-MAA) supports all mutual aid generally provided between and among units of NCR jurisdictions, including, but not limited to police, fire, emergency management, public health, and public works.
The NCR consists of 24 jurisdictions within two States and the District of Columbia:
- District of Columbia
- Maryland – Town of Bladensburg, City of Bowie, City of College Park, Charles County, City of Frederick, Frederick County, City of Gaithersburg, City of Greenbelt, City of Hyattsville, City of Laurel, Montgomery County, Prince George's County, City of Rockville, and City of Takoma Park.
- Virginia – City of Alexandria, Arlington County, City of Fairfax, Fairfax County, City of Falls Church, Loudoun County, City of Manassas, City of Manassas Park, and Prince William County.
The MWCOG provides staff support for administrative maintenance of mutual aid agreements in the NCR. Additionally, the MWCOG may assist in coordinating initial requests for mutual aid assistance.
The member jurisdictions of the NCR have entered into a number of agreements for assistance during an emergency or public service event, for example:
- The National Capital Region Mutual Aid Agreement was entered into pursuant to IRTPA between and among the District of Columba, the State of Maryland, the Commonwealth of Virginia, and certain local governments of the National Capital Region, that are MWCOG jurisdictions. According to the NCR-MAA, during an emergency or public service event, assistance will be provided according to the procedures established in one or more operational plans developed and agreed to NCR-MAA members. Parties responding outside of their jurisdiction, and their employees actually providing the assistance, will be under the general control and direction of the appropriate official designated by the jurisdiction requesting aid. This agreement is effective from December 15, 2005 until terminated by all but one of the parties executing the agreement.
- The Metropolitan Washington Council of Governments Fire and Rescue Mutual Aid Operations Plan effectuates provisions of the NCR-MAA, Section 5, and ensures the fullest cooperation among fire prevention and suppression and emergency medical services agencies in the NCR. Fire and Rescue Mutual Aid Operations Plan (MAOP) creates and describes relationships and provides general direction and guidance rather than specifying the operations of responding agencies.
- The National Capital Region Water and Wastewater Mutual Aid Agreement allows a signatory’s authorized official to request mutual aid and assistance from another participating signatory in the event of an emergency, water emergency, or a public service event. They may also request assistance either orally or in writing. Requests for assistance shall be directed to the authorized official of the potential responding signatory. Each signatory must identify one initial authorized official. The procedure for notifying signatories when the authority to act as an authorized individual is given to or withdrawn from an individual is also set forth in the agreement. Nothing in this agreement is intended to interfere with signatory’s ability to request assistance or provide assistance under a state emergency management process, either within the state or out-of-sate as part of the EMAC process.
4.10.2 Emergency Management Assistance Compact
EMAC provides mutual assistance between the member states to manage any declared emergency or disaster in the affected state(s), including those arising from natural disasters, technological hazards, man-made disasters, civil emergency aspects of resources shortages, community disorders, insurgencies, and enemy attacks. See D.C. Official Code § 7-2332.
EMAC was ratified by the United States Congress in 1996 by Public Law 104-321, making it the first national disaster-relief compact to be signed by the United States Congress since the Civil Defense and Disaster Compact of 1950. D.C. Official Code § 7-2332 provides the Mayor with authority to enter into EMAC. All 50 states, the District, Puerto Rico, Guam, and the U.S. Virgin Islands have enacted legislation to enter into EMAC.
EMAC offers assistance during declared states of emergency through the provision of personnel, equipment, and commodities to help disaster relief efforts in other jurisdictions. Once the conditions for providing assistance to a requesting jurisdiction have been set, the terms constitute a legally binding contractual agreement between the jurisdictions, including the responding jurisdiction.
The EMAC legislation helps resolve issues related to liability and costs, and permits reciprocity of credentials, licenses, and certifications. See http://www.emacweb.org for more information.
4.11 National Disaster Medical System
When a disaster overwhelms District resources, health officials may request support from the National Disaster Medical System (NDMS). This request is facilitated by the Assistant Secretary for Preparedness and Response (ASPR) Regional Administrators (RAs) and Regional Emergency Coordinators (RECs). The NDMS provides technical assistance and personnel to augment local health and medical system capacity and response capabilities in the event of disasters and emergencies or as part of a national security special event.
The NDMS is comprised of medical, fatality management, veterinary, and para-professionals. NDMS personnel may be deployed several times per year, and must complete training, attend meetings and drills, respond to requests for information, and maintain appropriate licensure and certifications within their discipline. When NDMS personnel are activated as intermittent federal employees and acting under official orders from NDMS, licensure and certification is recognized in all states. Liability protections are also provided under the Uniformed Services Employment and Reemployment Rights Act (USERRA), the Federal Tort Claims Act (FTCA), and Federal Employees’ Compensation Act (FECA).
More information about the NDMS, can be found at https://www.phe.gov/Preparedness/responders/ndms/Pages/default.aspx.
See section 11.0 of the Manual for more information on licensing and legal protections for volunteers during an emergency.
ASPR can call on a number of NDMS teams, depending on the situation, needs of the community, and the resources overwhelmed. These teams include:
- Trauma and Critical Care Teams (TCCTs): TCCTs provide critical, operative, and emergency care, and advanced trauma life support. TCCTs can provide a deployable advance unit, augmentation to existing medical facilities, and establish a stand-alone field hospital.
- Disaster Medical Assistance Teams (DMATs): DMATs can assist hospitals and medical facilities in serving their patients, support medical sites and shelters, provide mass prophylaxis, and stand ready to serve in case of an emergency or during a special event. DMATs are comprised of clinical, non-clinical, and leadership staff.
- National Veterinary Response Teams (NVRTs): NVRTs provide expert veterinary care to service animals, including security animals. NVRT members include veterinarians, animal health technicians, epidemiologists, safety specialists, logisticians, communications specialists, and other support personnel.
- Victim Information Center (VIC) Team: The VIC team supports local authorities and other NDMS teams in the aftermath of a mass casualty event. The VIC team provides technical assistance and consultation on the collection and management of ante-mortem data, such as pictures, fingerprints, dental x-rays, and other medical records, to help identify the victims. They can also provide subject matter expertise in mass fatality management and victim information procurement, assist in updating the Victim Identification Program (VIP) database, coordinate the release of remains, and serve as a liaison to the victims’ families.
- Disaster Mortuary Operational Response Teams (DMORTs): DMORTs are composed of funeral directors, medical examiners, pathologists, forensic anthropologists, finger print specialists, forensic odontologists, dental assistants, administrative specialists, and security specialists. While DMORTs work under the delegated jurisdictional authority of the local or state Coroner or Medical Examiner, DMORT personnel work under the overall command and control of the United States Department of Health and Human Services (HHS) Emergency Management Group (EMG) and/or the Incident Response Coordination Team (IRCT).
DMORTs can assist a community by:
- Quickly and accurately identifying victims;
- Supporting local mortuary services;
- Reuniting victims with their loved ones in a dignified, respectful manner;
- Helping families, friends, and communities find closure so that they can move forward and begin to heal;
- Tracking and documenting human remains and personal effects;
- Establishing temporary morgue facilities;
- Assisting in the determination of cause and manner of death;
- Collecting ante-mortem data;
- Collecting medical records, dental records, or DNA of victims from next of kin to assist in victim identification;
- Performing postmortem data collection;
- Providing documentation during field retrieval and morgue operations;
- Performing forensic dental pathology and forensic anthropology methods; and
- Processing and re-interment of disinterred remains preparation.
DMORTs may deploy with a Disaster Portable Morgue Unit (DPMU). A DPMU contains a complete morgue and prepackaged equipment and supplies.
Region III DMORT's primary area of coverage includes Delaware, the District, Maryland, Pennsylvania, Virginia, and West Virginia. As of January 2017, the team has approximately 86 members representing all disciplines and support personnel. Region III maintains relationships with the medical examiners' offices in each state and the District, and coroners in Pennsylvania. See dmort3.org.