Legal Considerations for Emergency Preparedness and Response
Rural communities must account for national, state, tribal, and local statutes and regulations related to public
health emergencies. Federal laws and legal authorities address many topics relevant to public health
emergencies. These include healthcare delivery systems, quarantine and isolation, emergency medical treatment,
public safety, volunteer protection, communicable disease control, transportation management, worker liability
and protection, and personal health information.
The Public Health Emergency Preparedness
Clearinghouse, from the Centers for Disease Control and Prevention (CDC), compiles statutes,
regulations, orders, reports, and legal tools that rural communities can use to clarify their legal preparedness
capacity. This includes the resource Selected Federal
Legal Authorities Pertinent to Public Health Emergencies, updated August 2017, that outlines federal
laws relevant to public health emergencies.
Rural communities must consider legal authorities during the planning, response, and recovery phases.
Governance and legal authorities differ across states and localities. Rural communities must understand the
legal authorities in place that may dictate elements of emergency preparedness planning efforts.
Key planning considerations include:
Healthcare delivery systems – legal authorities that apply to healthcare providers
and institutions during a public health emergency
Staffing adjustments – requirements for adjusting staffing during an emergency, such
as hiring new or temporary staff, reassigning staff, or coordinating volunteers
Credentialing – credentialing agreements with other institutions, jurisdictions, and
states for healthcare workers to work in emergency situations
Volunteers – agreements with volunteer groups that describe management of volunteers
and liability structures and understanding institutional liability for volunteers
Procurement – policies and procedures for procurement of goods and services, based on
state and local procurement practices
Partnerships – legal agreements, such as contracts, mutual aid agreements, or
memoranda of understanding (MOU), that apply to partners, including those in a lead or supporting role, to
Countermeasure dispensing and administration – legal guidelines for handling
controlled substances and medical countermeasures, including registration with the U.S. Drug Enforcement
When working with tribal communities, it is important to leverage existing partnerships with tribal governments.
offers a training course on
building partnerships with tribal governments. Partners should understand cultural practices and
linguistic considerations and respect the autonomy of tribal governance. It is important to consult with tribal
leadership before making decisions that may affect tribal communities. Ensuring active, regular, and meaningful
participation of partners during preparedness planning will ensure an effective response in the event of a
Tribal governments may choose to enter into an intergovernmental agreement with local, state, or federal
governments and agencies to outline expectations in an emergency response. Resource, data, and staff sharing are
some of the things that should be discussed when creating an agreement.
Even at the height of response efforts, organizations involved in the response must be aware of laws and
regulations with which they must comply, as well as those that either provide them with or limit legal
authority. Legal considerations during the response phase include:
Communication – legal guidelines for communicating information and avoiding the
dissemination of protected information
Information exchange – regulations for surveillance information exchange, such as
Resource sharing – mutual aid agreements that establish the legal basis for sharing
of resources across two or more entities, such as between communities, states, and federal agencies, during
Medical surge – legal guidelines and liability considerations to support medical
Nonpharmaceutical interventions (NPIs) – authorities and policies that enable or
limit the implementation of NPIs (such as mask mandates or temporarily closing childcare centers)
Isolation and quarantine – state laws governing isolation and quarantine for
communicable diseases, including authority to impose and enforce orders; personal liability of healthcare
workers and others who are expected to enforce isolation and quarantine orders
Stabilizing treatment for hospital patients – Emergency Medical Treatment and Active
Labor Act (EMTALA) compliance during a public health emergency
Emergency declaration – legal authority within the state or locality to declare a
public health emergency
Casualty Incident Occurs when Duck Boat Sinks in Rural Missouri
In 2018, a duck boat holding 31 passengers capsized in rural Missouri during a severe thunderstorm,
resulting in 17 casualties. Table Rock Lake, where the accident occurred, spans 2 counties. Fire protection
districts from the counties coordinated a response based on previous territorial understanding, and other
organizations also provided support through existing mutual aid agreements.
After a disaster, there are a number of health-harming legal needs that may arise among individuals in the
affected community. These include:
Housing and consumer issues – Examples include evictions, foreclosures, landlord
disputes related to repairs and security deposits, insurance claims and disputes, and scams and price
gouging by contractors and businesses related to home repairs and utilities.
Income and financial issues – Examples include lost documents such as birth
certificates and social security cards, bankruptcy, applications for public benefits, and applications for
federal assistance and loan programs.
Family and educational issues – Examples include issues related to custody and
guardianship, power of attorney, and domestic violence.
Resources to Learn More
FEMA National Tribal Strategy
Offers a roadmap and plan for enhancing coordination between FEMA and federal recognized tribes.
Organization(s): Federal Emergency Management Agency (FEMA)
Preparedness Legal Guidebook
Offers legal guidance to help public health professionals strengthen their administrative preparedness capacity
and establish emergency response activities by encouraging collaborative preparatory work.
Organization(s): National Association of County and City Health Officials (NACCHO)
Public Health Emergency Preparedness
Provides emergency preparedness resources including statutes, regulations, toolkits, handbooks, publications,
trainings, and webinars to help entities clarify and update the legal aspects of their emergency preparedness
and response activities.
Organization(s): Centers for Disease Control and Prevention (CDC)