Distinctions between Federal, State, and Local Authority

In general, the first response will usually be conducted at the level of local and state authority, using local public health and/or public safety resources. Most health emergencies begin at a local level, and show a progressive and sometimes subtle increase in severity, such that it is only when significant numbers of victims are identified that authorities realize that an emergency is occurring. In Texas, a response to such an emergency will occur within the framework of local resources, which vary from region to region and from urban to rural areas. Local health departments may be mobilized, and state authority may be activated. State health codes are generally quite satisfactory in implementing local responses. As the emergency grows, the state emergency response plan may be activated as well. Even in the instance where state and local personnel may be seemingly managing an emergency response, there is reason to secure the assistance of federal resources and authority, especially if waivers of federal law (e.g. Medicare, Medicaid, EMTALA, HIPAA) are needed. This training will distinguish between federal, state, and local authority in response to health emergencies and identify types of emergency assistance that may be available upon request.