Airport Public Health Preparedness and Response: Legal Rights, Powers, and Duties (2018)

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21 procedures and adhere to defined protocols, han- dling all ill and potentially ill passengers using the same criteria and procedures. Moreover, govern- ment employees need to demonstrate that they are implementing screening based on facts rather than acting arbitrarily. Because the federal government is likely to be involved in this process, the actions that airport personnel take when holding ill passen- gers must be fair and not overly intrusive.208 Civil Action for Deprivation of Rights (42 U.S.C. § 1983) Airport and airport authority employees acting under the color of state or federal law could poten- tially be subject to a civil rights action based on § 1983, though this is unlikely under existing case law. To state a claim under 42 U.S.C. § 1983, a pas- senger must allege that the airport and its employ- ees deprived the passenger of some right or privilege secured by the Constitution and laws of the United States and acted under the “color of state law.”209 State action most often occurs when the deprivation is effected by a person who is a state actor (individ- ual acts with the state or has received aid from state officials) or for whom the state is responsible. Action taken by private individuals may be “under color of state law” when significant state involvement attaches to the action. Such involvement has been measured through various tests.210 In Wagner v. Met- ropolitan Nashville Airport Authority, the Sixth Cir- cuit Court of Appeals did not find a sufficient nexus to constitute state action where a state entity leased airport space to an airline that employed a company to provide passenger and aircraft security.211 Mere leasing of space to an airport or airport authority did not rise to the level of state action. Moreover, while the airport authority had submitted a security plan to the FAA that included the airline’s security and screening plan, the airport authority did not retain control of the airline’s screening activities, and the actions of the airline’s search and detention of the passenger could not be treated as an action of the airport authority.212 Ultimately, the court held that the passenger could not sufficiently support a § 1983 claim for an allegedly unreasonable and unconstitutional search of the passenger’s baggage. False Imprisonment CBP or local law enforcement would normally be relied upon to detain an ill passenger, but if for any reason airport personnel chose or was directed to improperly detain an ill passenger by intentionally confining him or her without privilege and against consent, then the passenger might have a false impris- onment claim.213 For the airport actor to be liable for false imprisonment, which is a state law claim, the passenger must have been arrested or detained against his or her will without a proper legal author- ity or legal justification.214 However, the ill passenger or potentially infected or infectious passengers most likely will not be able to successfully bring a cause of action for false imprisonment against airport person- nel just for holding them in isolation or quarantine, especially during an emergency situation where limit- ing the spread of a communicable disease would cre- ate a legitimate public health and security concern which would justify detaining the passenger.215 Moreover, quarantine immunity, a qualified immunity that protects public entities and public employees from discretionary acts or omissions relating to quarantine or other similar measures for the prevention or control of communicable diseases, might provide additional protection when state actors detain an ill passenger in New Jersey.216 Responding public actors may be insulated from liability when they act to prevent the spread of com- municable diseases.217 However, airport personnel need to be cognizant that quarantine immunity does not extend to willful or reckless conduct or protect personnel who engage in misconduct.218 Communi- cable disease preparedness plans must continue to recognize the balance between protecting the public and respecting individual civil rights. V. THE CHANGING LEGAL ENVIRONMENT DURING EMERGENCIES A. Emergency Declarations A major function of government is the protection of the community’s health and safety. At the federal 213 restatement (seConD) oF torts § 35 (am. law inst. 1977). 214 Id. § 36. 215 Hickox v. Christie, 205 F. Supp. 3d 579, 603 (D.N.J. 2016). 216 Id. at 604. 217 Id. 218 Id. 208 U.S. Const. amend. V; Hickox, 205 F. Supp. 3d at 579. 209 Wagner v. Metro. Nashville Airport Auth., 772 F.2d 227, 229 (6th Cir. 1985). 210 Tests established include: (1) the public function test, see generally Terry v. Adams, 345 U.S. 461 (1953); Marsh v. Alabama, 326 U.S. 501 (1946); (2) the state compulsion test, see generally Adickes v. S.M. Kress & Co., 398 U.S. 144 (1970); (3) the joint action test, see generally Flagg Brothers Inc. v. Brooks, 436 U.S. 149, 155 (1978); and (4) the nexus test, see generally Jackson v. Metropolitan Edison Co., 419 U.S. 345 (1974); Burton v. Wilmington Parking Authority, 365 U.S. 715 (1961). 211 Wagner, 772 F.2d at 229. 212 Id. at 230.

22 level, various agencies have regulatory powers that enable them to respond in an emergency. Under fed- eral law, an emergency is defined under the Stafford Act as “any occasion or instance for which, in the determination of the President, Federal assistance is needed to supplement State and local efforts and capabilities to save lives and to protect property and public health and safety, or to lessen or avert the threat of a catastrophe in any part of the United States.”219 Laws of various state, tribal, and local governments often contain similar provisions that empower state and local agencies to respond to events that threaten the lives, health, and property of their residents. Emergency declarations can change the legal landscape in terms of an airport’s response and coordination with local hospitals and federal, state, and local health officials. B. Federal Declaration of Emergency Presidential Declaration of Emergency Under the Stafford Act, state and local authori- ties can receive federal assistance through FEMA in a disaster or emergency declared by the President. Assistance in the form of financial, technical, and logistical support may be directed at state and local governments whose response capacities are inade- quate to address a declared emergency.220 To request a presidential declaration and receive assistance, a governor must first implement the state’s emer- gency plan and attest in writing that the state’s resources are inadequate to manage the emer- gency.221 The President can also make a declaration and furnish assistance to save lives and control damage, especially when federal interests are at risk.222 Still, the President is required to consult with the relevant governor(s) if possible.223 Under the National Emergencies Act (NEA), the President can declare a “national emergency” to acti- vate emergency powers in other federal statutes.224 For example, the President’s NEA declaration in response to the 2009 national H1N1 flu pandemic activated a waiver under the Social Security Act based on the HHS Secretary’s authority to declare a PHE.225 A practical consequence was to immunize responders and entities from negligence claims and other viola- tions absent willful misconduct, gross negligence, or recklessness. (For further analysis of potential liabil- ity of airport responders under a federal emergency, see Section VI, Potential Liability and Protections.) Once made, an NEA declaration must be pub- lished in the Federal Register and sent to Con- gress.226 The state of emergency does not go into effect unless the President includes in the declara- tion the statutory authorities the administration will be relying on for its response.227 The House and Senate decide every six months whether to conclude the state of emergency; otherwise it ends on the date listed in the President’s declaration or in the law passed by Congress enabling the declaration. In addition, a joint resolution of Congress or a presi- dential proclamation can be used to end the state of emergency. If no end date is specified, a national emergency expires a year after the President makes a declaration unless it is renewed within the 90-day window leading up to the anniversary.228 Emergency declarations change the legal land- scape in several ways by activating flexible powers that aid in the response to the emergency. Federal funds can be mobilized and certain laws and regula- tions waived. Moreover, a declaration can reduce barriers to the provision of healthcare by emergency responders by altering the regulatory environment. Changes effected that implicate healthcare workers pertain to scope of practice, liability protections, out- of-state licensure, and standards of care.229 PHE Declaration Under Section 319 of the Public Health Service Act, the HHS Secretary can declare a PHE in the event of a major infectious disease outbreak, bioterrorism attack, or any disorder or disease the Secretary deter- mines to be a serious threat to public health.230 The 219 42 U.S.C. § 5122(1) (2017). 220 Ass’n of State and Territorial Health Officials, Fact Sheet, Robert T. Stafford Disaster Relief and Emergency Assistance Act, astho.orG, http://www.astho.org/Programs/ Preparedness /Publ ic -Health-Emergency-Law/ Emergency-Authority-and-Immunity-Toolkit/Robert-T-- Stafford-Disaster-Relief-and-Emergency-Assistance-Act- Fact-Sheet/ (last visited Mar. 12, 2018). 221 Id. 222 Id.; Stafford Act, 42 U.S.C. § 5191(b) (2017). 223 42 U.S.C. § 5191(b) (2017). 224 Ass’n of State and Territorial Health Officials, Fact Sheet, National Emergencies Act, §§ 201, 301, astho.orG [hereinafter Ass’n of State and Territorial Health Officials, National Emergencies Act], http://www.astho.org/Programs/ Preparedness /Publ ic -Health-Emergency-Law/ Emergency-Authority-and-Immunity-Toolkit/National- Emergencies-Act,-Sections-201-and-301-Fact-Sheet/ (last visited Mar. 12, 2018). 225 Proclamation No. 8443, 3 C.F.R. § 8443 (Oct. 23, 2009). 226 50 U.S.C. § 1621(a) (2017). 227 Ass’n of State and Territorial Health Officials, National Emergencies Act, supra note 224. 228 50 U.S.C. § 1622 (2017). 229 James G. Hodge, Jr. et al., The Legal Framework for Meeting Surge Capacity Through the Use of Volunteer Health Professionals During Public Health Emergencies and Other Disasters, 22 J. ContemP. health l. & Pol’y 5 (2006). 230 42 U.S.C. § 247d (2017); U.S. Dep’t of Health and Human Services, PHE Declaration, Phe.Gov, https://www. phe.gov/Preparedness/legal/Pages/phedeclaration.aspx (last reviewed Mar. 12, 2018).

23 Secretary decides whether to make the declaration after consulting the relevant public health officials. In addition, the Secretary must notify Congress of the determination within 48 hours and keep related fed- eral agencies, such as DHS, Federal Bureau of Inves- tigation, and Department of Justice informed. The Secretary can: • Issue federal grants, • Pay expenses incurred from response efforts, • Enter contracts, • Facilitate efforts to address the disease or dis- order triggering the declaration, • Appoint responders through channels exempt from the normal hiring process, and • Temporarily reassign federally-funded person- nel at state, tribal, and local health departments.231 The PHE declaration lasts for the duration of the emergency or for 90 days, subject to renewal based on the same facts that prompted the determination or on new information; the HHS Secretary must let Congress know in writing within 48 hours of the renewal determination.232 To facilitate access to health services in a declared emergency, the HHS Secretary can waive or modify participation and reimbursement requirements for healthcare providers under certain federal programs. The legal requirements include stipulations under Medicare, Medicaid, the State Children’s Health Insurance Program, HIPAA, and the Emergency Medical Treatment and Labor Act. Modified require- ments pertain to professional certification and licen- sure, transfer of injured patients, waiver of prescription and dispensing requirements, extension of deadlines for submission of data or reports, and waivers of sanc- tions for certain violations. However, health care pro- vided must be dispensed in good faith and administered without findings of fraud or abuse. An exemption from standard requirements can be extended for 60 days at a time but expires when the underlying declaration of emergency or disaster comes to an end.233 National Security Threat Determinations The federal government has broad powers under the U.S. Constitution and various statutes to protect against threats to national security.234 Typical responses to these threats were understood to require military and law enforcement measures.235 However, public health issues, such as infectious diseases and environmental degradation, have increasingly been framed as national security concerns due to their implications for the economy, social stability, travel, and mortality.236 Examples of health events that have been recognized as national security issues include outbreaks of the following diseases: human immunodeficiency virus/acquired immuno- deficiency syndrome (HIV/AIDS), severe acute respiratory syndrome (SARS), Middle East respira- tory syndrome (MERS), pandemic influenzas, and multidrug-resistant tuberculosis (MDR-TB).237 In 2013, MERS was declared a national security threat because of its significant potential to affect national security or the health security of U.S. citi- zens living abroad. Such classification authorized the emergency use of in vitro diagnostics for detec- tion of MERS coronavirus (MERS-CoV).238 Also, in 2014, CDC issued a Level 2 Travel Alert for MERS, cautioning travelers in the affected countries to take precautions to prevent the spread of germs, provid- ing technical infection control guidance, and urging healthcare workers worldwide to consider travel history when diagnosing and evaluating patients with respiratory illness.239 Public Readiness and Emergency Preparedness Act Under the Public Readiness and Emergency Pre- paredness (PREP) Act, the HHS Secretary can make a declaration to encourage the development, produc- tion, and administration of certain products to address potential or actual PHEs caused by terror- ist attacks, disease outbreaks, and natural disasters (e.g., pharmaceutical drugs, vaccines, or diagnostic tests). These FDA-regulated products are known as medical countermeasures. The law protects certain entities and individuals from being sued for loss of life, health, property, and income that result from the manufacture, distribution, or administration of medical countermeasures240 (see Section VI, Poten- tial Liability and Protections). 234 James G. Hodge, Jr. et al., Public Health Emergencies as Threats to National Security, 9 J. nat’l seC. l. & Pol’y 81, 84 (2017). 235 Id. at 85. 236 Id. 237 Id. at 86–87. 238 21 U.S.C. § 360bbb-3, § 564. 239 ConG. researCh serv., rl43584, miDDle east resPiratory synDrome (mers): is it a health emerGenCy? (2014), https://fas.org/sgp/crs/mideast/R43584.pdf. 240 42 U.S.C. §§ 247d-6d-247d-6e (2017). 231 U.S. Dep’t of Health and Human Services, PHE Declaration, Phe.Gov, https://www.phe.gov/Preparedness/ legal/Pages/phedeclaration.aspx (last reviewed Mar. 12, 2018). 232 42 U.S.C. § 247d (2017); U.S. Dep’t of Health and Human Services, PHE Declaration, Phe.Gov, https://www. phe.gov/Preparedness/legal/Pages/phedeclaration.aspx (last reviewed Mar. 12, 2018). 233 U.S. Centers for Medicare and Medicaid Services, PHE Declaration: Questions and Answers, available at https://www.cms.gov/Medicare/Provider-Enrollment-and- Certification/SurveyCertEmergPrep/Downloads/PHE- Questions-and-Answers.pdf (last visited Mar. 12, 2018).

24 Pandemic and All-Hazards Preparedness Reauthorization Act The Pandemic and All-Hazards Preparedness Reauthorization Act (PAHPRA)241 was passed by Con- gress in 2013 to advance the nation’s health security. PAHPRA includes several features that enhance national preparedness. The law continues federal funding especially for certain programs initiated under previous legislation (e.g., Strategic National Stockpile and National Disaster Medical System). PAHPRA expands the role of the Assistant Secretary for Preparedness and Response while bolstering pre- paredness efforts for at-risk populations, especially children and persons with disabilities. Certain provi- sions allow greater flexibility for state and local health authorities to deploy federally-funded health workers temporarily during health emergencies. Finally, PAHPRA equips FDA with the authority to support the development of drug-based or medical product countermeasures for chemical, biological, radiological, or nuclear emergencies and infectious diseases, for example, Emergency Use Authorizations.242 National Incident Management System The National Incident Management System (NIMS) is a framework administered by DHS for addressing the full range of potential and actual emergencies likely to occur anywhere in the country. NIMS consists of a collection of doctrines, concepts, terms, and organizational processes designed to facilitate effective collaboration across various fields, at different levels of government, and between pub- lic and private sectors when an emergency arises. Federal agencies use NIMS in their emergency response activities, and state, local, and tribal orga- nizations are required to adopt NIMS as a condition for receiving federal assistance in emergencies. The components of NIMS include preparedness, commu- nications and information management, resource management, command and management, and ongoing management and maintenance.243 National Response Framework The National Response Framework (NRF), for- merly the National Response Plan, is a guide for responding to potential and actual emergencies based on a set of concepts that can be adapted to address incidents anywhere in the country. The con- cepts are drawn from NIMS. The NRF describes principles, roles, structures, and best practices for organizing a coordinated response to a wide spec- trum of emergencies of various scales at local to national levels.244 Federal Food, Drug, and Cosmetic Act To prepare for potential terrorist attacks, acciden- tal releases of hazardous substances, and various dis- eases, the HHS Secretary can make a declaration under the Federal Food, Drug, and Cosmetic Act that permits the use of certain products that have not received FDA approval. The emergencies may be domestic, military, or public health in nature. A decla- ration can also be prompted by DHS’s assessment of a material threat to the nation’s security. Once a dec- laration is made, the FDA Commissioner can issue an Emergency Use Authorization to make available unapproved drug or medical products or allow unap- proved uses of approved drug or medical products to address emergencies. Federal, state, and local author- ities or their representatives can stockpile these products (e.g., prophylaxis drugs, vaccinations, and therapeutics) to prepare for emergencies.245 C. State, Local, and Tribal Emergency Declarations and Responses State and Local Government All states authorize governors to declare a state of emergency, which activates special powers and releases extra resources for addressing the emer- gency. Most declarations are issued under laws aimed at managing “disasters” (e.g., hurricanes or earthquakes) or “general emergencies,” but many states also define PHEs as a distinct class of events warranting declarations that respond specifically to the challenges of tackling threats to public health.246 241 21 U.S.C. § 301 (2017). 242 Network for Public Health Law, Memorandum, Pandemic and All-Hazards Preparedness Reauthorization Act (PAHPRA) of 2013 (2013), https://www.networkforphl. org/_asset/tc6lwo/Western-Region-Memo---PAHPRA.pdf (last visited Mar. 12, 2018). 243 U.S. Dep’t of Homeland Security, Fact Sheet, National Incident Management System (2004), https://www.fema. gov/pdf/emergency/nims/NIMSFactSheet.pdf (last visited Mar. 12, 2018). 244 Id. 245 21 U.S.C. §§ 301-399d (2017). 246 James G. Hodge, Jr. et al., The Legal Framework for Meeting Surge Capacity Through the Use of Volunteer Health Professionals During Public Health Emergencies and Other Disasters, 22 J. ContemP. health l. & Pol’y 5 (2006); Ass’n of State and Territorial Health Officials, Fact Sheet, Emergency Declarations and Authorities, astho.orG [hereinafter Ass’n of State and Territorial Health Officials, Emergency Declarations and Authorities], http://www. astho.org/Programs/Preparedness/Public-Health- Emergency-Law/Emergency-Authority-and-Immunity- Toolkit/Emergency-Declarations-and-Authorities-Fact- Sheet/ (last visited Mar. 12, 2018).

25 States often extend the power to declare emer- gencies to heads of state health departments and related agencies, as well as to directors of emergency management, homeland security, and agriculture. For example, in 2016, the Governor of Florida directed the State Health Officer and Surgeon Gen- eral to declare a PHE for certain counties due to the outbreak of Zika virus.247 The declaration facilitated coordination among airport authorities, city and county commissions, emergency management agen- cies, medical boards, and the tourist development council.248 Depending on the administrative struc- ture of a state, local authorities may also have the legal capacity to declare emergencies and imple- ment appropriate responses. For example, North Carolina empowers the governing bodies of counties and municipalities to declare emergencies.249 A majority of U.S. states have adopted the Model State Emergency Health Powers Act (MSEHPA), which grants public health powers to state and local public health officials to provide effective and prompt responses to public health emergencies, while also recognizing individual rights.250 State emergency declarations typically entail an executive order (or other declaration) by the gover- nor specifying the length of emergency, the geo- graphic or jurisdictional areas covered, the triggering events, and the agencies charged with leading the response.251 A state declaration sets in motion response actions that can include activation of state response plans, emergency operations centers, inci- dent management systems, and mutual aid agree- ments. Additional measures include initiation of powers to mobilize state funds, supplies, equipment, and personnel for the response as well as activation of statutory immunities and liability protections for responders.252 State declarations of emergency can bring about immense changes to a state or local response to a communicable disease outbreak. For example, a state PHE declaration may authorize mandatory examinations of exposed individuals by state or local health officials in the interest of pro- tecting the public’s health.253 While state laws provide for formal emergency declarations, state and local officials also have broad authority that can be exercised to address emergent situations.254 These powers often incorpo- rate authority to investigate disease outbreaks, implement disease control measures (e.g., quarantine), and abate nuisances.255 Such broad powers are sometimes robust enough to address an emergency without a formal state declaration of emergency.256 Therefore, an important aspect of preparedness is identifying the authorities and capabilities avail- able for emergency responses in the absence of a formal declaration.257 Tribal Government Like other governments, tribal authorities have inherent power to protect the public health and welfare of their communities. As such, tribal author- ities can rely on their constitutions, legal codes, or the inherent powers of their governing bodies to declare emergencies resulting from events transpir- ing on their tribal lands.258 Tribal governments can seek assistance for an emergency on tribal lands as part of a request by an affected state. However, changes to the Stafford Act in 2013259 provided tribes the option of directly requesting a presiden- tial declaration and receiving federal assistance without state involvement.260 247 Fla. Exec. Order No. 16-29 (Feb. 3, 2016), https:// www.flgov.com/wp-content/uploads/orders/2016/EO_16- 29.pdf). 248 FloriDa DeP’t oF health, Declaration of Public Health Emergency for Zika (Feb. 4, 2016), http://www. floridahealth.gov/newsroom/2016/02/020416-zika- declaration-public-health-emergency.html. 249 Ass’n of State and Territorial Health Officials, Emergency Declarations and Authorities, supra note 246; Municipal or County Declaration of State of Emergency, N.C. Gen. stat., 166A-19.22 (2012). 250 Lawrence O. Gostin, The Model State Emergency Health Powers Act: Public Health and Civil Liberties in a Time of Terrorism, 13 health matrix 3, 4–5 (2013), http:// scholarlycommons.law.case.edu/healthmatrix/vol13/iss1/4 (last visited Mar. 12, 2018). 251 Ass’n of State and Territorial Health Officials, Emergency Declarations and Authorities, supra note 246. 252 Id. 253 See, e.g., A.R.S. § 36-787 (2017). 254 Ass’n of State and Territorial Health Officials, Emergency Declarations and Authorities, supra note 246. 255 Id. 256 Id. 257 Id. 258 Gregory Sunshine & Aila Hoss, Emergency Declarations and Tribes: Mechanisms Under Tribal and Federal Law, 24 miCh. st. int’l l. rev. 33 (2015). 259 Sandy Recovery Improvement Act of 2013, 42 U.S.C. § 5121 (2017). 260 U.S. Federal Emergency Management Agency, FAQs: Current Process for Tribal Governments to Request a Presidential Declaration, Fema.Gov, https://www.fema. gov/frequently-asked-questions-current-process-tribal- governments-request-presidential-declaration (last visited Mar. 12, 2018).

26 Table 1. Summary of Legally Significant Declarations and Determinations261 If there is a valid… Then… Presidential Declaration of Emergency Access to federal technical, financial, logistical, and other Under the Stafford Act assistance to state and local governments is triggered. The Act [Pub. L. No. 93-288, as amended; directs FEMA to coordinate administration of disaster relief to the 42 U.S.C. §§ 5121–5207] states. The governor of an affected state must first respond to the disaster and execute the state’s emergency plan before requesting that the President declare a major disaster or emergency, and the governor must certify that the magnitude of the emergency exceeds the state’s capability. As of 2013, tribal leaders can also request a Stafford Act declaration from the President. Presidential Declaration of Emergency The declaration of emergency (or contemporaneous or subsequent Under the National Emergencies Act executive orders) will specify the powers or authorities made [50 U.S.C. §§ 1621, 1631] available by virtue of the declaration. For example, the President’s declaration under the NEA for the 2009 H1N1 flu pandemic activated a waiver under the Social Security Act that was based on the HHS Secretary’s authority to declare a PHE. A practical consequence of that was to immunize responders and entities from negligence claims and other noncompliance violations absent willful misconduct, gross negligence, or recklessness. Determination of a PHE by the Secretary of the HHS… • Section 319 of the Public Health From the determination of a PHE flows the ability of the Secretary Service Act: PHEs [42 U.S.C. § 247d] to “take such action as may be appropriate” and to use funds from the PHE Fund (when appropriated). • Section 311 of the Public Health Requires the Secretary to assist states and local authorities in the Service Act: General Grant of Authority prevention and suppression of communicable diseases and to help for Cooperation is activated state and local authorities to enforce quarantine regulations. This [42 U.S.C. § 243] section also authorizes the Secretary to accept state and local authorities’ assistance with enforcement of federal quarantine regulations. Further, this section authorizes the Secretary to develop a PHE management plan and, at the request of a state or local authority, extend temporary assistance regarding PHEs. • Public Health Security and Bioterrorism Requires the Secretary of HHS to “develop and implement” a Preparedness and Response Act of 2002 coordinated strategy in the form of a national preparedness plan. [Pub. L. No. 107-188] Also establishes the position of Assistant Secretary for Preparedness • Pandemic and All-Hazards Preparedness and Response, who is responsible for coordinating the operations Act of 2006 [Pub. L. No. 109-417] of the National Disaster Medical System and other emergency • Pandemic and All–Hazards Preparedness response activities within HHS. The Secretary of HHS has the Reauthorization Act (PAHPRA) of 2013 authority to regulate select agents and toxins and to temporarily [Pub. L. No. 113-5; 42 U.S.C. §§ 247d, exempt individuals or entities from the requirements of these 300hh-1(b)(3)(E), 247d-3a(b)(2)(a)(iii), regulations if necessary to provide for a timely response to a PHE. 247d-6d(i)(7)(iii), 21 U.S.C. § 360bbb-3, Additionally, several provisions for protection of the food and drug et seq.] supply are included. Further, the Secretary may establish and maintain the Emergency System for Advance Registration of Health Professions Volunteers. 261 Centers For Disease Control anD Prevention, Selected Federal Legal Authorities Pertinent to Public Health Emergencies, CDC.Gov, https://www.cdc.gov/phlp/docs/ph-emergencies.pdf (last visited Mar. 12, 2018).