{"data":{"id":"us/42-cfr-51d.5","jurisdiction":"us","citation":"42 CFR 51d.5","heading":"d.5 How is an emergency determined to exist?","body":"(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:\n(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\n(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:\n(i) Have a sudden, rapid onset and a definite conclusion, such as:\n(A) A natural disaster (including, but not limited to, a hurricane, tornado, storm, flood, earthquake, fire, drought, or other natural catastrophe); or\n(B) A technological disaster (including, but not limited to, a chemical spill, a major industrial accident, or a transportation accident); or\n(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\n(ii) Result in significant:\n(A) Death,\n(B) Injury,\n(C) Exposure to life-threatening circumstances,\n(D) Hardship,\n(E) Suffering,\n(F) Loss of property, or\n(G) Loss of community infrastructure (e.g., loss of treatment facilities, staff, public transportation and/or utilities, or isolation from services); and\n(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.\n(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) or (b)(1), and other information independently available to the Secretary.\n(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.","path":["Title 42—Public Health","CHAPTER I—PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES","SUBCHAPTER D—GRANTS","PART 51d—MENTAL HEALTH AND SUBSTANCE ABUSE EMERGENCY RESPONSE PROCEDURES"],"source_url":"https://www.ecfr.gov/api/versioner/v1/full/2026-08-25/title-42.xml","current_through":"2026-08-25","vintage":"","retrieved_at":"2026-08-27T02:26:11Z","sha256":"685fad8531296ef244959701e71d4d7bfbc0c4bb818707e213ff8ca0edebcc55","source_id":"us-cfr","stale":true,"prev":"us/42-cfr-51d.4","next":"us/42-cfr-51d.6"},"notice":"GroundRules: Original legal text. Not legal advice."}