---
kind: "section"
citation: "42 C.F.R. § 51d.5"
title: "42"
number: "51d.5"
heading: "How is an emergency determined to exist?"
url: "https://uscodex.org/cfr/42/51d.5"
---

# §51d.5. How is an emergency determined to exist?

- (a) In making a decision as to whether a mental health or substance abuse emergency exists for purposes of section 501(m) of the PHS Act, the Secretary, using discretion, will consider all relevant factors, but at a minimum the following must exist:
  - (1) Existing State, Tribal and local systems for mental health and/or substance abuse services are overwhelmed or unable to meet the existing mental health or substance abuse needs of the local community at issue; and
  - (2) This inability to meet the mental health and/or substance abuse service needs of a local community is the direct consequence of a clear precipitating event. This precipitating event must:
    - (i) **Have a sudden, rapid onset and a definite conclusion, such as—**
      - (A) A natural disaster (including, but not limited to, a hurricane, tornado, storm, flood, earthquake, fire, drought, or other natural catastrophe); or
      - (B) A technological disaster (including, but not limited to, a chemical spill, a major industrial accident, or a transportation accident); or
      - (C) A criminal act with significant casualties (including, but not limited to, a domestic act of terrorism, a hostage situation, or an incident of mass violence including school shootings and riots); and
    - (ii) **Result in significant—**
      - (A) Death,
      - (B) Injury,
      - (C) Exposure to life-threatening circumstances,
      - (D) Hardship,
      - (E) Suffering,
      - (F) Loss of property, or
      - (G) Loss of community infrastructure (e.g., loss of treatment facilities, staff, public transportation and/or utilities, or isolation from services); and
  - (3) No other local, State, Tribal or Federal funding is available to adequately address the specific level of need resulting from the precipitating event and resulting emergency mental health and/or substance abuse service needs of the impacted community.
- (b) In making a determination that a mental health or substance abuse emergency exists, the Secretary will consider the certification and written statements provided in accordance with § [51d.4(a)(1)](/cfr/42/51d.4.md?p=a-1) or [(b)(1)](/cfr/42/51d.4.md?p=b-1), and other information independently available to the Secretary.
- (c) Once the Secretary determines that a mental health or substance abuse emergency exists, the Secretary may exercise discretion to make awards to enable public entities to respond to the emergency, within the limits of funds available.

## Notes

### Authority

Authority: 42 U.S.C. 290aa(o).

### Source

Source: 66 FR 51877, Oct. 11, 2001, unless otherwise noted.