Though the term “disaster” is sometimes thrown around lightly, the feds have very strict guidelines when declaring an emergency. Read on to see the timeline and protocol that ends with the 1135 waiver and certain Medicare allowances. Who: After the President of the United States establishes an emergency under the Stafford Act, the Health & Human Services Secretary declares a PHE. What: The HHS Secretary determines there’s a PHE under Section 319 of the Public Health Service Act (PHSA). When: A Section 319 PHE is good for a duration of 90 days, but it may be shortened by the HHS Secretary if it’s determined an emergency no longer exists. The HHS Secretary can also extend a PHE. Where: The PHE covers only the state and/or local areas referenced in the HHS Secretary’s declaration under Section 319 of the PHSA. Why: The Secretary determines there’s a high risk of disease and disorder due to the emergency or disaster. The hazards must be significant enough to declare the PHE in the first place. And that’s why Under Section 319 of the PHSA, the HHS Secretary then can offer grants, do investigations, support state and local healthcare efforts, and waive certain federal requirements that may be compromised due to the disaster.