Trump to declare opioid epidemic a public health emergency

CNN

By: Dan Merica

President Donald Trump, after months of promising to take sweeping action to combat opioids, will use an event at the White House on Thursday to declare the crisis a public health emergency, White House officials tell CNN.

The move is different from the broad order Trump previewed over the last few months. The President, according to these officials, will direct acting Health Secretary Eric Hargan to declare a public health emergency under the Public Health Services Act — which directs federal agencies to provide more grant money to combat the epidemic — not a national emergency through the Stafford Disaster Relief and Emergency Assistance Act.

The difference between the two orders is money and scope. If Trump had used the Stafford Act, the federal government would have been able to tap into funds from the Federal Emergency Management Agency’s Disaster Relief Fund to combat opioids. A senior administration official, however, argued that the designation was not the right fit because the FEMA money is meant for natural disasters, not health emergencies.

Under the Public Health Services Act designation, no additional federal funding will automatically be directed to the crisis, said an official, but federal agencies will be directed to devote more grant money already in their budget to the problem and take “action to overcome bureaucratic delays and inefficiencies in the hiring process,” according to a fact sheet on Trump’s order.

The Trump administration, the official added, will work with Congress to fund the Public Health Emergency fund and to increase federal funding in year-end budget deals currently being negotiated in Congress.
The officials pushed back against the idea that Trump’s order is less sweeping than what he promised.

“Under the Stafford Act, as unfortunately we have seen on multiple occasions over the last several months, the Stafford Act is deigned to respond to mostly natural disasters that are (of a) very short time duration and a specific geographic region,” one official said, adding that the Trump administration believed the order under the Public Health Services Act is “a better use.”

Trump’s order will last 90 days and, according to another official, can be renewed every 90 days until the President believes it is no longer needed.

Since 1999, the number of American overdose deaths involving opioids has quadrupled. From 2000 to 2015, more than 500,000 people died of drug overdoses, and opioids account for the majority of those. Recently released numbers from the Centers for Disease Control and Prevention found that around 64,000 people died from drug overdoses in 2016.

Trump, after campaigning for president in part on fighting the scourge of opioid addiction, has long teased sweeping action.

The President told reporters in August that he would designate the epidemic a “national emergency” but failed to follow through. The lack of action, treatment advocates said, has deprived the fight against the deadly drugs a designation that would offer states and federal agencies more resources and power.

During an impromptu press conference in the White House Rose Garden last week, Trump said that he would officially declare the national emergency when asked why he had not followed through with his initial pledge.

“We are going to have a major announcement, probably next week, on the drug crisis and on the opioid massive problem and I want to get that absolutely right,” Trump said, billing the official declaration as a large step that took time.

And speaking with reporters on the South Lawn of the White House on Wednesday, Trump said he would have a “very big meeting on opioids” on Thursday and will be declaring the opioid epidemic a national emergency “in the very near future.”

The primary difference between the two designations is access to funding.

The designation Trump will announce Thursday does not allow the federal government to tap into FEMA’s Disaster Relief Fund and it is an open question whether Congress will offer more money to fund the Public Health Emergency fund, which Congress has not funded in recent years.

But multiple Obama administration health officials told CNN that they believe using the Public Health Services Act is the more appropriate avenue.

Using FEMA funds to combat the opioid crisis would be “a little bit like asking an engineer to bake a cake,” said Rafael Lemaitre, the former communications director for the White House Drug Policy Office under Obama.

“I do think the public health service act is more appropriate route to take than the Stafford Act designation,” he said. “I worked at FEMA for two years and dealt with multiple disasters. The Stafford Act is not structured to deal with a long term, complicated public health crisis like the opioid crisis.”

Lemaitre added that FEMA’s fund is “already running on fumes because of the three hurricanes” that hit this year.

Tom Coderre, a former senior official under in Obama’s Substance Abuse and Mental Health Services Administration office at HHS, echoed that sentiment.

“One of the things that I think is most beneficial part of having a public health emergency is you really can marshal public support and then you can bring all the resources of the federal government to bear on it, bringing people from all of the agencies to combat the issue,” he said.

Though both Lemaitre and Coderre said this step was important, both argued that it was not a “silver bullet solution to the opioid crisis.” That, they said, would be additional funding from Congress.

“A smarter play here would be for the administration to move beyond this declaration and pass the billions in funding needed to address this crisis. That is how you move the needle on this,” Lemaitre said.

 

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