1.This Act may be cited as
the Emergency Preparedness and
Response Security, Accountability, and Flexibility Enhancement
Act
or the SAFE Act
.
2.Accountability
with respect to preparedness funding
(a)Section 319C–1 of the
Public Health Service Act (42 U.S.C. 247d–3a) is amended—
(1)in subsection
(b)—
(A)in paragraph
(1)—
(i)in
subparagraph (A), by striking or
at the end;
(ii)in
subparagraph (B), by striking the period and inserting ; or
;
and
(iii)by adding at
the end the following:
(C)a consortium of
States that, with respect to the States that make up the consortium, comply
with the requirements of subparagraph (A) individually or as part of the
consortium.
;
and
(B)by adding at the
end the following:
(3)Achievement of
measurable critical benchmarks and performance measuresIn making
awards under subsection (a), the Secretary shall develop and require the
application of measurable critical benchmarks and performance standards so that
grantees can demonstrate achievement with respect to such benchmarks and
measures in a reasonable timeframe, as determined by the Secretary. Such
benchmarks and measures shall require grantees to—
(A)annually report
grant expenditures to the Secretary and the Secretary of Homeland Security who
shall ensure that such information is included on the Federal-Internet based
point of access developed under section 2(b) of the SAFE Act; and
(B)at a minimum,
annually test and exercise the emergency preparedness capabilities of the
grantee, acting in coordination with the applicable State readiness plan under
subsection (c), based on criteria established by the Secretary and the
Secretary of Homeland Security.
(4)In making awards under subsection (a), the Secretary
shall give preference to eligible entities that submit applications that, in
the determination of the Secretary will—
(A)enhance
coordination—
(i)among one or more
health care institutions, including but not limited to Federal Government
medical facilities, academic medical centers, clinics, health centers, primary
care facilities, or nursing homes; and
(ii)between entities
described in clause (i) and one or more States, sub-State regions of States or
other sub-State groups, or any combination of States and sub-State regions;
and
(B)serve the needs
of a defined geographic
area.
;
(2)in subsection
(h)—
(A)in paragraph (1),
by striking and
at the end;
(B)in paragraph (2),
by striking the period and inserting ; and
; and
(C)by adding at the
end the following:
(3)coordinate with
the Secretary of Homeland Security to prevent the duplicative funding of
programs or activities and to ensure that the use of awards is in compliance
with State
plans.
;
(3)by striking
subsection (j) and inserting the following:
(j)
(1)For the purpose of carrying out this section, there is
authorized to be appropriated, $1,300,000,000 for fiscal year 2007, and such
sums as may be necessary for each of fiscal years 2008 through 2010, of
which—
(A)not to exceed
$875,000,000 shall be made available in each fiscal year for making awards
under subsection (a) to States, notwithstanding the eligibility conditions
under subsection (j) (as such subsection existed on the day before the date of
enactment of the Emergency Preparedness and
Response Security, Accountability, and Flexibility Enhancement
Act, for the purpose of enhancing the all-hazards emergency
preparedness and medical response capabilities of States; and
(B)not to exceed 5
percent of the amount made available under subparagraph (A) for each fiscal
year shall be made available for Federal, State, and local planning and
administrative activities related to awards described in such
subparagraph.
(2)Contingent
additional authorizationIf a significant change in circumstances
warrants an increase in this amount authorized to be appropriated under
paragraph (1) for fiscal year 2007, there are authorized to be appropriated
such sums as may be necessary for such year for carrying out this section, in
addition to the amount authorized under paragraph (1).
(3)Amounts appropriated under paragraph (1) shall be used
to supplement and not supplant other State and local public funds provided for
activities under this section.
(4)
(A)For fiscal year 2006 and any subsequent fiscal year, the
Secretary, in coordination with the Secretary of Homeland Security, shall,
before making awards pursuant to subsection (a) for such year—
(i)reserve from the
amount appropriated under paragraph (1) for the fiscal year an amount
determined necessary by the Secretary to make awards under subsection (a) to
eligible entities that face a particularly high degree of risk of such a
threat, as determined by the Secretary in coordination with the Secretary of
Homeland Security; and
(ii)after making the
reservation required under clause (i), provide funds to eligible entities that
have a significant unmet need, as determined by the Secretary, in coordination
with the Secretary of Homeland Security, to build capacity to identify, detect,
monitor, and respond to a public health emergency, which need will not
otherwise be met by awards pursuant to subsection (a).
(B)Awards pursuant to subparagraph (A) may be supplemental
awards to States that receive awards pursuant to subsection (a), or may be
awards to eligible entities described in subsection (b)(1)(B) within such
States.
(5)The Secretary may not make a grant to a State under
this section unless the State agrees that, with respect to the costs to be
incurred by the State in carrying out the activities for which the grant was
awarded, the State will make available (directly or through donations from
public or private entities) non-Federal contributions toward such costs in an
amount equal to—
(A)with respect to a
State with a population of more than 2,000,000, not less than $1 for each $1 of
Federal funds provided in the grant; and
(B)with respect to a
State with a population of 2,000,000 or less, not less than $1 for each $4 of
Federal funds provided in the grant.
;
and
(4)by adding at the
end the following:
(k)Return of
unobligated fundsAny portion of an award under subsection (a)
that remains unobligated after the expiration of the 3-year period beginning on
the date on which the award is made shall be returned to the
Secretary.
.
(b)The Secretary of Health and Human Services and the
Secretary of Homeland Security shall jointly establish a single Federal
Internet-based point of access to enable States and other entities to apply for
available Federal assistance for public health and hospital preparedness and
response to bioterrorism and other public health threats, including applying
for awards under section 319C–1 of the Public Health Service Act (42 U.S.C.
247d–3a).
3.National
Notifiable Disease Surveillance ProgramPart B of title III of the
Public Health Service Act (42 U.S.C.
243 et seq.) is amended—
(1)by striking
section 314; and
(2)by inserting
after section 311, the following:
311A.National
Notifiable Disease Surveillance Program
(a)The Secretary is authorized to develop a real-time
surveillance program for collecting and reporting information on notifiable
diseases and conditions.
(b)Not later than 180 days after the date of enactment of
the Emergency Preparedness and Response
Security, Accountability, and Flexibility Enhancement Act, and
annually thereafter, the Secretary, in consultation with State and local health
authorities and appropriate private professional societies, shall certify a
list of infectious diseases, environmental exposures or poisons, and other
conditions, the real-time surveillance and control of which, in each State and
territory of the United States, constitute a critical public health need. For
purposes of this part, the term notifiable disease means a
disease, exposures or poison, or other condition that appears on the list under
this section.
(c)Federal
Informatics Activities
(1)In order to meet the urgent need for critical electronic
surveillance of notifiable diseases, the Director of the Centers for Disease
Control and Prevention, in consultation with State and local health
authorities, shall, not later than 1 year after the date of enactment of the
Emergency Preparedness and Response Security,
Accountability, and Flexibility Enhancement Act, establish and
maintain a national electronic surveillance program that includes the following
components:
(A)Procedures to
provide for the collection (in a standardized form) and analysis of data on all
notifiable diseases and on certain other conditions that States or regions
elect to report to the program.
(B)A procedure to
enable all major public and private clinical laboratories to automatically
report data, in compliance with the regulations promulgated under section
264(c) of the Health Insurance Portability and
Accountability Act of 1996, to the program concerning notifiable
diseases, antimicrobial resistance testing, and other data determined
appropriate by the Director.
(C)A procedure to
provide for syndromic and disease-specific surveillance by monitoring, in
compliance with the regulations promulgated under section 264(c) of the
Health Insurance Portability and Accountability
Act of 1996, of private sector health-related electronic data (such
as pharmaceutical purchase data and health insurance claims data).
(D)A procedure to
enable States to report data on suspicious cases of conditions that are not on
the notifiable disease list but that may warrant further investigation.
(E)A procedure to
enable the program to automatically identify certain trends and suspicious
patterns with respect to data reported to the program.
(F)A procedure to
enable the program to provide regular reports to regional, State, and local
government entities concerning disease trends, suspicious disease patterns,
incidence and prevalence of diseases, laboratory data, and other information
determined appropriate. Such information shall include data on comparative
national disease trends.
(G)A procedure to
enable the program to collect and analyze data from certain seminal veterinary
and environmental sources where appropriate.
(H)A procedure to
enable the program to export data in a form appropriate for aggregation,
statistical analysis, and reporting.
(I)A procedure to
enable the program to receive and report data relating to non-notifiable
diseases, including vital records, registries, chronic disease, and maternal
and child health data.
(2)The procedures developed under paragraph (1) for the
reporting of data shall ensure that such data are reported in a timely
manner.
(3)To meet the deadline described in paragraph (1), the
Director of the Centers for Disease Control and Prevention may, on a temporary
or permanent basis, implement systems or products developed by the private
sector.
(4)In carrying out this subsection, the Director of the
Centers for Disease Control and Prevention may enter into contracts with public
and private entities.
(d)National
Biointelligence UnitThe Director of the Centers for Disease
Control and Prevention shall analyze data maintained by the national electronic
surveillance program under subsection (b), and data from other sources, to
report on the prevalence and incidence of notifiable diseases and conditions,
trends and patterns in public health, emerging health problems, regional
differences, and other analyses determined appropriate by the Director of the
Centers for Disease Control and Prevention.
(e)Federal
Technical Assistance, Communication, and Coordination
(1)In carrying out this section, the Secretary shall provide
technical assistance to, and provide for appropriate communications to the
public, scientific, public health and medical communities, and other key
stakeholders, and to provide for the coordination of the activities of—
(A)State and local
health authorities to integrate State and local surveillance activities and
systems with the national notifiable disease surveillance program developed
under this section and to generally improve State and local notifiable disease
reporting and communications; and
(B)private
corporations, professional associations, or other entities that may have
sources of surveillance data or access to health care providers, health
officials, or other individuals who would need to participate in a surveillance
program.
(2)Assistance provided under paragraph (1)(B) may include
financial assistance for the purpose of formatting or translating data into a
form that is most compatible and appropriate for use in the national notifiable
disease surveillance program developed under this section.
(3)Health alert
registration and information
(A)Each
health care provider and facility that receives funds under title XVIII of the
Social Security Act (42 U.S.C. 1395 et
seq.) or that receives funds under a State program under title XIX of such Act
(42 U.S.C. 1396 et seq.) shall annually submit to the Secretary a registration
that contains the e-mail address or fax number of the provider or facility for
purposes of enabling the Secretary to provide health alerts in the case of a
public health emergency or other circumstance requiring active
surveillance.
(B)The Secretary shall establish a system to maintain the
information provided by providers and facilities under subparagraph (A). Such
system shall be designed—
(i)to enable
providers and facilities—
(I)to provide and
update information contained in the system; and
(II)to request
information or to elect to receive additional types of non-emergency health
alerts or communications; and
(ii)to enable the
Director of the Centers for Disease Control and Prevention to provide updated
contact information for providers and facilities to State and local health
authorities for the purpose of emergency health communications.
(f)Grants to
States for Disease Reporting
(1)The
Secretary shall award grants to States to enable such States to conduct
passive, active, and when appropriate syndromic surveillance, and timely
reporting activities with respect to notifiable diseases.
(2)To
be eligible to receive a grant under paragraph (1), a State shall prepare and
submit to the Secretary an application at such time, in such manner, and
containing such information as the Secretary may require, including—
(A)a description of
the manner in which grants funds will be used to enhance the timeliness and
comprehensiveness of the State’s effort to report notifiable diseases to the
program under subsection (c); and
(B)a plan for
identifying and reporting to the Secretary the identity of health care
providers and facilities that consistently fail to report to the State
instances of notifiable diseases in a timely manner.
(3)In the case of a State that submits a plan, as part of the
application under paragraph (2), to transition State and local reporting of
notifiable diseases to an electronic system that is compatible with the program
under subsection (c), the amount of the grant awarded to a State under
paragraph (1) shall be increased by an amount determined by the Secretary to be
necessary to complete such transition.
(4)Supplement not
supplant funds for activitiesA State shall use amounts received
under a grant under this subsection to supplement and not supplant other funds
made available by the State for the conduct of reporting activities with
respect to notifiable diseases.
(5)Reduction in
block grant fundingFor fiscal year beginning with fiscal year
2008, if the Secretary determines that a State is not reporting all notifiable
diseases to the program established under subsection (c) in a timely manner
through the use of an electronic system that is compatible with the program,
the State shall not be eligible to receive a grant under part A of title XIX
for such fiscal year.
(6)A health care provider or facility shall not be eligible
to receive funds under title XVIII of the Social
Security Act (42 U.S.C. 1395 et seq.) or under a State program under
title XIX of such Act (42 U.S.C. 1396 et seq.) if the Secretary determines,
based on a State notification received under the plan described in paragraph
(2)(B), that such provider or facility has consistently failed to report, in a
timely manner, instances of notifiable diseases to the State for submission to
the program under subsection (c).
(g)Authorization
of AppropriationsThere are authorized to be appropriated such
sums as may be necessary to carry out this
section.
.
4.Enhancing
critical capacity for illness detectionSection 319C(c) of the
Public Health Service Act (42 U.S.C.
247d–3(c)) is amended—
(1)in paragraph (3),
by striking and
at the end;
(2)in paragraph (4),
by striking the period and inserting ; and
; and
(3)by adding at the
end the following:
(5)develop
benchmarks for meeting critical capacity for food or water borne disease
detection and
response.
.
5.Evaluation of
public health capacity outcomesSection 319C–1(b) of the
Public Health Service Act (42 U.S.C.
247d–3a(b)), as amended by section 2(a), is further amended by adding at the
end the following:
(5)Evaluation of
public health capacity outcomesThe Director of the Centers for
Disease Control and Prevention shall enter into contracts with independent
entities for the periodic evaluation of the progress made by State and local
governments in meeting the benchmarks established in the plan under paragraph
(1)(A)(ii)(V).
.
6.Inspection, screening,
and quarantining of live animalsSection 362 of the
Public Health Service Act (42 U.S.C.
265) is amended by adding at the end the following: The Secretary shall
establish procedures for the appropriate inspection, screening, and quarantine
of live animals entering the United States for commercial purposes, including
procedures to protect domestic animal and human populations from diseases
carried by imported live animals
.
7.
National Disaster Medical System
(a)Section 2811(b) of the Public Health
Service Act (42 U.S.C. 300hh–11) is amended by adding at the end the
following:
(4)Coordination of
planning and preparedness activities
(A)The Federal agency partners of the National Disaster
Medical System shall coordinate all planning and preparedness activities of the
National Disaster Medical System with the Secretary of Homeland Security in a
manner that ensures that such activities are consistent with the National
Response Plan, the National Incident Management System, and Homeland Security
Presidential Directives #5 and #8.
(B)In
this section, the term Federal agency partners of the National Disaster
Medical System means the Department of Homeland Security, the Department
of Health and Human Services, the Department of Defense, and the Department of
Veterans
Affairs.
;
(b)Section 2811 of the Public Health Service Act (42 U.S.C.
300hh–11) is amended—
(1)by redesignating
subsection (h) as subsection (i); and
(2)by inserting
after subsection (g), the following:
(h)
(1)Not later than December 31, 2007, the Federal agency
partners of the National Disaster Medical System in coordination with the
Secretary of Homeland Security shall conduct a joint review of the National
Disaster Medical System infrastructure including organization, various teams,
staffing levels, training programs, equipment and supplies, supply chain
management and interoperability, and the role of each of the Federal agency
partners of the National Disaster Medical System, and any other applicable
issues.
(2)Based
on the results of the review conducted under paragraph (1), the Secretary of
Homeland Security shall, with respect to the National Disaster Medical
System—
(A)modify the
policies of the System for the deployment of System assets during a national
emergency, including command and coordination, licensure, credentialing or
privileging, resource typing and allocation, supplies and logistics, and
inter-agency and public communications;
(B)refine,
standardize, and implement training curricula for System participants based on
the modifications made under subparagraph (A), including planning for
continuing educational programs to ensure that System participants are aware of
programmatic changes within the System; and
(C)refine,
implement, and maintain standards for System staffing, equipment, and
supply-chain management to ensure the adequacy of available assets in the
System.
.
(c)Section 2811 of
the Public Health Service Act (42 U.S.C. 300hh–11) is amended—
(1)in subsection
(b)(3)—
(A)in subparagraph
(A)—
(i)by
redesignating clauses (i) and (ii) as clauses (ii) and (iii), respectively;
and
(ii)by
inserting before clause (ii) (as so redesignated), the following:
(i)provide an
initial rapid Federal medical response, consistent with the National Response
Plan and National Incident Management System, to an emergency and to maintain
capability to sustain disaster medical operations through an established
transition period as determined by the Federal agency partners of the National
Disaster Medical System;
;
and
(B)by adding at the
end the following:
(D)Continued
monitoring of performanceThe Secretary of Homeland Security,
acting through the Chief Medical Officer, shall design, develop, and implement
quantitative standards and metrics under which programmatic changes with
respect to the National Disaster Medical System may be isolated, measured,
validated, and revised if needed on a real-time basis as determined by the
performance of the System in drills and exercises or actual deployments.
(E)Nonduplication
of activitiesThe National Disaster Medical System shall carry
out activities in coordination with Department of Health and Human Services
emergency response teams (including the uniformed corps of the United States
Public Health Service and the Medical Reserve Corps) to minimize duplicative
activities.
;
and
(2)in subsection (i)
(as so redesignated), by striking 2002 through 2006
and
inserting 2006 through 2010
.