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Public Health Emergency 101

Updated: Jun 3, 2022

Author: Belle Duguid, Special Populations Community & Partner Liaison, AmeriCorps VISTA at the Legal Council for Health Justice.




We are two years into the COVID-19 pandemic and there is still yet to be a clear end in sight as new variants evolve and cases in the US reach record highs (Coronavirus in the U.S.: Latest Map and Case Count, 2022). On January 31, 2020, Alex Azar, former Secretary of the U.S. Department of Health and Human Services (HHS), first declared COVID-19 a Public Health Emergency (“PHE”), and the federal government has extended it every ninety days since that date. On January 16, 2022, current HHS Secretary Xavier Becerra authorized the PHE’s most recent extension (Becerra, 2022). But what exactly does the declaration of a PHE mean? How does a PHE affect the over three million Medicaid recipients in Illinois (HFS, 2022)? And, how does the PHE impact Medical Legal Partnership (“MLP”) programs throughout the state? This article will provide answers to these questions and more as we delve into Public Health Emergency 101.


 


What is a PHE and what does the declaration mean?

Following the declaration of a PHE, the HHS Secretary is permitted to take certain actions to aid in resolving and addressing the crisis. A PHE can be caused by a range of occurrences, including, but not limited to: natural disasters such as tornadoes, drug-related issues such as the opioid epidemic, and outbreaks of contagious and life-threatening disease such as the COVID-19 pandemic. These events can create public health emergencies because they often result in widespread injury, sickness, and death leading to a strain on the healthcare system, and even threatening public order (World Health Organization, 2016). Strain on the healthcare system is exceedingly prevalent in Illinois as ICUs throughout the state are at roughly 90% capacity. Dr. Kalisha Hill, regional chief medical officer of AMITA Health St. Joseph Medical Center in Joliet and AMITA Health St. Mary’s Hospital in Kankakee, reported that, “some emergency room patients are [having to receive] care in the ER lobby instead of a room” due to lack of available beds (Armentrout & Avery, 2022).


The declaration of a PHE lasts for ninety days, or until the HHS Secretary determines the emergency no longer exists (Public Health Emergency Declaration Q&As, 2019). In the case of COVID-19, the Secretary has been renewing the PHE declaration every ninety days since the emergency was first declared on January 31, 2020.


The HHS Secretary can authorize a range of actions during a PHE, including, but not limited to: deploying the National Disaster Medical System (NDMS) teams and supporting other emergency operations; conducting research regarding treatment, cause, and prevention of the PHE; creating grants and utilizing the Public Health Emergency Fund; providing supplies and services where needed; expanding telehealth; and any other actions deemed appropriate by the Secretary (Public Health Emergency Declaration Q&As, 2019). The American Hospital Association (“AHA”) reinforced the importance of declaring COVID-19 a PHE because the “declarations have proven critical in equipping hospitals and health systems with the tools and resources necessary to manage the recent COVID-19 surges and ensure high-quality care in this unprecedented environment” (AHA, 2022). Thus, declaring a PHE allows local, state, and federal governments to take certain actions that address potential gaps in healthcare and that help to ensure the health and safety of the U.S. population.

 

How does the PHE impact Medicaid enrollment?

The PHE provides a safety net for millions of Medicaid recipients in danger of losing coverage. Since February 2020, more than 11 million people across the US have enrolled in Medicaid, largely due to the Families First Coronavirus Response Act (FFCRA) which was first signed into law on March 18, 2020 (McCausland, 2021). The HHS Secretary’s PHE declaration (in conjunction with an official Presidential declaration of emergency) allows HHS to modify or waive certain public benefits requirements. Currently, pursuant to the PHE, individuals enrolled in Medicaid, Medicare, and the Children’s Health Insurance Program (CHIP) have “expanded access” to healthcare services throughout the emergency (Public Health Emergency Declaration Q&As, 2019) as these programs receive increased funding due to the FFCRA (Buettgens & Green, 2021). "Expanded access” means that any individual who was covered by Medicaid as of March 18, 2020 or later must still be covered through the end of the PHE (Brooks, 2021). As long as the PHE declaration is in effect, states are barred from terminating Medicaid coverage. In Illinois, this means that, per the FFCRA, the IL Department of Human Services (IDHS) will not conduct any Medicaid redeterminations or remove any beneficiaries from the state rolls until the PHE expires (Hou & Eagleson, 2020). IDHS