This summer is already delivering record-breaking heat, with heatwaves from Florida to Oregon arriving in May and intensifying across the country in the past week. Temperatures may top those in previous summers when extreme heat killed thousands of people and sent many thousands more to the hospital. Last summer’s heatwaves caused train tracks to buckle and building foundations to crack. Climate change is driving the increasing severity and duration of heatwaves, which are projected to increase over time.
State, local, and tribal governments are the first responders during extreme heatwaves, managing spikes in emergency healthcare needs and providing essential services. In a plea for the federal government to do more to address extreme heat emergencies, a wide coalition of environmental, labor, and health care groups petitioned the Federal Emergency Management Agency (FEMA) this week to update its rules to explicitly name extreme heat as a major disaster eligible for federal emergency response funding. Such a rule would be legally sound and would signal that FEMA is serious about preventing heat-related deaths. However, to successfully unlock FEMA funding for extreme heat emergencies, states and localities need to start tracking the true costs of responding to hazardous heat events. FEMA should assist states and localities in this effort by updating federal guidance on how to account for costs of extreme heat disasters.
The Inequitable Human Health Costs of Extreme Heat Events
Extreme heat kills more Americans than floods, hurricanes, and tornadoes combined. The health impacts of extreme heat are not borne equally: children, infants, pregnant women, the elderly, and the unhoused are more susceptible to heat hazards. Disparities in health outcomes arising from extreme heat also are linked to structural racism. In New York City, for example, Black residents are twice as likely to die from heat-related illnesses than White residents. The actual harms of extreme heat combined with compounding health stressors—such as local air pollution in Black and Brown neighborhoods—are likely worse than previously reported, according to new community-led research by the NYC Environmental Justice Alliance.
Extreme heat is not just deadly, it also is incredibly costly. A recent study by the Center for American Progress estimated that heat-related health care costs in the United States amount to as much as $1 billion each summer. In addition to health care-specific costs, responding to an extreme heatwave places considerable and costly strains on a city’s emergency response capacity. Extreme heat further threatens critical infrastructure, including power grids, and public transit. The full extent of these costs is hard to account for, as they occur across many levels of government.
In anticipation of devastating heat emergencies, many cities are actively expanding their response programs. New York City recently released a proactive safety plan for improving the City’s heatwave response, including opening up more cooling centers and distributing indoor thermometers to the elderly. Phoenix, Arizona, where over 600 people died last summer during a month-long heatwave, is setting up multiple 24-hour cooling centers and training emergency personnel to immerse heatstroke victims in ice baths while en route to the emergency room.
FEMA Has Not Yet Covered State and Local Emergency Response Costs for Deadly Heat
The federal government has launched new efforts to communicate the human health risks of extreme heat. The U.S. Centers for Disease Control and Prevention recently released a helpful Heat and Health Tracker, which provides detailed geographic information on where the most heat illnesses are occurring at the ZIP code level. The National Oceanic and Atmospheric Administration’s National Integrated Heat Health Information System provides specific forecast and heat risk data to communities, to assist with planning and preparedness.
However, despite acknowledging and reporting the acute risks, the federal government historically has not offered much financial support to state, local, and tribal governments for delivering emergency services for vulnerable populations during extreme heat events.
There are some federal grant programs that can be utilized to prevent heat deaths through preparedness and mitigation, but they have not generally been deployed to cover the full range of emergency heat response costs. For example, the Department of Health and Human Services’ Low Income Home Energy Assistance Program (LIHEAP) helps low income households pay for air conditioning, but is limited in scope and allocated on an annual basis, rather than in relation to a particular heat emergency. FEMA’s Building Resilient Infrastructure and Communities (BRIC) grants may cover projects that alter the built environment to lower surface temperatures, but this program has largely focused on flood mitigation and has rarely awarded grants directly targeting extreme heat. As a result, existing federal programs leave a significant gap in support for direct emergency response during extreme heat events.
Federal Law Does Not Restrict FEMA from Covering Extreme Heat Emergency Costs
As it stands now, state, local, and tribal governments serve as the first—and often the sole payers —when deadly heat emergencies strike. However, FEMA potentially could provide support for emergency heat response through the Stafford Act, the federal statute that authorizes disaster response funding. To receive this funding, a governor must request a presidential disaster declaration and demonstrate that the state is responding to a major disaster with a severity and magnitude that overwhelms the state’s capacity. FEMA reviews these applications and makes a recommendation to the President. Despite this broad authority, FEMA has never recommended a disaster declaration for extreme heat.
In the peak of last summer’s heat waves, Arizona Congressman Ruben Gallego introduced legislation that would explicitly include extreme heat in the definition of “major disaster” under the Stafford Act. However, there is a strong argument that FEMA already has the legal authority to approve a major disaster application on the basis of an extreme heatwave, as this week’s rulemaking petition argues.
Under the Stafford Act, a major disaster is “a natural catastrophe (including any hurricane, tornado, storm, high water, winddriven water, tidal wave, tsunami, earthquake, volcanic eruption, landslide, mudslide, snowstorm, or drought),” or, “any fire, flood, or explosion.” The Act does not define “natural catastrophe” beyond the list of examples. While extreme heat is not listed, the string of examples is best read as an illustrative, rather than an exclusive list under established canons of statutory construction. FEMA Administrator Deanne Criswell offered congressional testimony last year stating her view that FEMA has legal authority to grant an extreme heat disaster application, if warranted, and that legislative change is not needed.
Agency practice confirms an expansive reading of the definition of a major disaster. In 2020, President Trump issued 59 disaster declarations for the COVID-19 pandemic, an unprecedented use of the Stafford Act to cover a major health disaster. FEMA also has confirmed disasters in the aftermath of extreme wind events and severe freezes, neither of which is specifically enumerated as a “natural catastrophe” under the Stafford Act definition. This history demonstrates that when new and unanticipated disasters arise, there is room under federal law for FEMA to adapt its practices to address current conditions.
Notably, the definition of “major disaster” was not the reason for FEMA’s denying prior state requests for extreme heat disaster declarations: rather, FEMA has never found that an extreme heatwave was of such severity and magnitude as to warrant a federal response. For example, in 1995, FEMA recommended the President deny a disaster declaration request after a heatwave in Chicago killed over 500 people, and in 2023, FEMA recommended the President deny a request for assistance from California after extreme heat and wildfires in the state. In each of these instances, the costs of the state response, as reported, did not demonstrate to FEMA that the heat wave was beyond the state’s capacity to respond.
To Help Unlock FEMA Disaster Funding, State and Local Governments Should Account for the True Costs of Extreme Heat with Updated Guidance from FEMA
Considering the likelihood of increasingly severe heat waves, there are actions that all levels of government should be taking now to ensure that federal money is allocated effectively to save lives.
First, state, local, and tribal governments should start accounting for the full costs associated with their extreme heat emergency responses. Working in concert with their health departments, social services agencies, hosts of cooling centers, and other involved entities, governments should start cataloging information such as which institutional are strained in a heat emergency, what their extra costs have been in previous heat emergencies, and other metrics. There is a dearth of public information on the true costs of extreme heatwaves to state and local governments, and an audit of this type would greatly assist in filling this data gap. Publicly available studies to date have focused on economic productivity impacts and healthcare costs, rather than direct costs to state and local governments. Because the cost threshold is critical to coverage under the Stafford Act, an accurate accounting of governmental costs is vital.
Just as critically, FEMA should support these state and local efforts by making overdue updates to its rules and guidance documents, not only to recognize extreme heat as potential “major disaster”—as this week's petition argues—but also to instruct states on what a successful emergency heat disaster application could look like. For example, FEMA could offer guidance on eligible heat-related disaster costs, other than structural property damages, which have been the focus of FEMA’s assessments of disaster applications. This could include guidance on how to quantify strains on health care, energy, and emergency response systems associated with extreme heat days. FEMA also should actively support states and local governments undertaking audits of extreme heat costs and utilize the information gathered when preparing its guidance.
All levels of government must act immediately to meet the ongoing emergency of extreme heat. While FEMA has been criticized in the past for its slow and bureaucratic performance, the agency should remember lessons from the COVID-19 pandemic, which necessitated quick and creative actions. That urgency led to notable innovations, such as guidance for state and local governments on how to calculate new medical sheltering costs under the Stafford Act. The same level of urgency is needed with regard to extreme heat. As this week’s heat-filled headlines indicate, the pressures of deadly heat on communities will only rise as this summer unfolds.
*The authors would like to thank Joshua Podolsky who contributed research for this post.