[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[S. 3678 Introduced in Senate (IS)]
109th CONGRESS
2d Session
S. 3678
To amend the Public Health Service Act with respect to public health
security and all-hazards preparedness and response, and for other
purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
July 18, 2006
Mr. Burr (for himself, Mr. Kennedy, Mr. Enzi, Mr. Harkin, Mr. Gregg,
Mr. Frist, and Ms. Mikulski) introduced the following bill; which was
read twice and referred to the Committee on Health, Education, Labor,
and Pensions
_______________________________________________________________________
A BILL
To amend the Public Health Service Act with respect to public health
security and all-hazards preparedness and response, and for other
purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Pandemic and All-
Hazards Preparedness Act''.
(b) Table of Contents.--The table of contents of this Act is as
follows:
Sec. 1. Short title; table of contents.
TITLE I--NATIONAL PREPAREDNESS AND RESPONSE, LEADERSHIP, ORGANIZATION,
AND PLANNING
Sec. 101. Public health and medical preparedness and response functions
of the Secretary of Health and Human
Services.
Sec. 102. Assistant Secretary for Preparedness and Response.
Sec. 103. National Health Security Strategy.
TITLE II--PUBLIC HEALTH SECURITY PREPAREDNESS
Sec. 201. Improving State and local public health security.
Sec. 202. Using information technology to improve situational awareness
in public health emergencies.
Sec. 203. Public health workforce enhancements.
Sec. 204. Vaccine tracking and distribution.
Sec. 205. National Science Advisory Board for Biosecurity.
TITLE III--ALL-HAZARDS MEDICAL SURGE CAPACITY
Sec. 301. National Disaster Medical System.
Sec. 302. Enhancing medical surge capacity.
Sec. 303. Encouraging health professional volunteers.
Sec. 304. Core education and training.
Sec. 305. Partnerships for state and regional hospital preparedness to
improve surge capacity.
Sec. 306. Enhancing the role of the Department of Veterans Affairs.
TITLE I--NATIONAL PREPAREDNESS AND RESPONSE, LEADERSHIP, ORGANIZATION,
AND PLANNING
SEC. 101. PUBLIC HEALTH AND MEDICAL PREPAREDNESS AND RESPONSE FUNCTIONS
OF THE SECRETARY OF HEALTH AND HUMAN SERVICES.
Title XXVIII of the Public Health Service Act (42 U.S.C. 300hh-11
et seq.) is amended--
(1) by striking the title heading and inserting the
following:
``TITLE XXVIII--NATIONAL ALL-HAZARDS PREPAREDNESS FOR PUBLIC HEALTH
EMERGENCIES'';
(2) by amending subtitle A to read as follows:
``Subtitle A--National All-Hazards Preparedness and Response Planning,
Coordinating, and Reporting
``SEC. 2801. PUBLIC HEALTH AND MEDICAL PREPAREDNESS AND RESPONSE
FUNCTIONS.
``(a) In General.--The Secretary of Health and Human Services shall
lead all Federal public health and medical response to public health
emergencies and incidents covered by the National Response Plan
developed pursuant to section 502(6) of the Homeland Security Act of
2002, or any successor plan.
``(b) Interagency Agreement.--The Secretary, in collaboration with
the Secretary of Veterans Affairs, the Secretary of Transportation, the
Secretary of Defense, the Secretary of Homeland Security, and the head
of any other relevant Federal agency, shall establish an interagency
agreement, consistent with the National Response Plan or any successor
plan, under which agreement the Secretary of Health and Human Services
shall assume operational control of emergency public health and medical
response assets, as necessary, in the event of a public health
emergency.''.
SEC. 102. ASSISTANT SECRETARY FOR PREPAREDNESS AND RESPONSE.
(a) Assistant Secretary for Preparedness and Response.--Subtitle B
of title XXVIII of the Public Health Service Act (42 U.S.C. 300hh-11 et
seq.) is amended--
(1) in the subtitle heading, by inserting ``All-Hazards''
before ``Emergency Preparedness'';
(2) by redesignating section 2811 as section 2812;
(3) by inserting after the subtitle heading the following
new section:
``SEC. 2811. COORDINATION OF PREPAREDNESS FOR AND RESPONSE TO ALL-
HAZARDS PUBLIC HEALTH EMERGENCIES.
``(a) In General.--There is established within the Department of
Health and Human Services the position of the Assistant Secretary for
Preparedness and Response. The President, with the advice and consent
of the Senate, shall appoint an individual to serve in such position.
Such Assistant Secretary shall report to the Secretary.
``(b) Duties.--Subject to the authority of the Secretary, the
Assistant Secretary for Preparedness and Response shall carry out the
following functions:
``(1) Leadership.--Serve as the principal advisor to the
Secretary on all matters related to Federal public health and
medical preparedness and response for public health
emergencies.
``(2) Personnel.--Register, credential, organize, train,
equip, and have the authority to deploy Federal public health
and medical personnel under the authority of the Secretary,
including the National Disaster Medical System, and coordinate
such personnel with the Medical Reserve Corps and the Emergency
System for Advance Registration of Volunteer Health
Professionals.
``(3) Countermeasures.--
``(A) Oversight.--Oversee advanced research,
development, and procurement of qualified
countermeasures (as defined in section 319F-1) and
qualified pandemic or epidemic products (as defined in
section 319F-3).
``(B) Strategic national stockpile.--Maintain the
Strategic National Stockpile in accordance with section
319F-2, including conducting an annual review (taking
into account at-risk individuals) of the contents of
the stockpile, including non-pharmaceutical supplies,
and make necessary additions or modifications to the
contents based on such review.
``(4) Coordination.--
``(A) Federal integration.--Coordinate with
relevant Federal officials to ensure integration of
Federal preparedness and response activities for public
health emergencies.
``(B) State, local, and tribal integration.--
Coordinate with State, local, and tribal public health
officials, the Emergency Management Assistance Compact,
health care systems, and emergency medical service
systems to ensure effective integration of Federal
public health and medical assets during a public health
emergency.
``(C) Emergency medical services.--Promote improved
emergency medical services medical direction, system
integration, research, and uniformity of data
collection, treatment protocols, and policies with
regard to public health emergencies.
``(5) Logistics.--In coordination with the Secretary of
Veterans Affairs, the Secretary of Homeland Security, the
General Services Administration, and other public and private
entities, provide logistical support for medical and public
health aspects of Federal responses to public health
emergencies.
``(6) Leadership.--Provide leadership in international
programs, initiatives, and policies that deal with public
health and medical emergency preparedness and response.
``(c) Functions.--The Assistant Secretary for Preparedness and
Response shall--
``(1) have authority over and responsibility for the
functions, personnel, assets, and liabilities of the
following--
``(A) the National Disaster Medical System (in
accordance with section 301 of the Pandemic and All-
Hazards Preparedness Act);
``(B) the Hospital Preparedness Cooperative
Agreement Program pursuant to section 319C-2; and
``(C) the Public Health Preparedness Cooperative
Agreement Program pursuant to section 319C-1;
``(2) exercise the responsibilities and authorities of the
Secretary with respect to the coordination of--
``(A) the Medical Reserve Corps pursuant to section
2813 as added by the Pandemic and All-Hazards
Preparedness Act;
``(B) the Emergency System for Advance Registration
of Volunteer Health Professionals pursuant to section
319I;
``(C) the Strategic National Stockpile; and
``(D) the Cities Readiness Initiative; and
``(3) assume other duties as determined appropriate by the
Secretary.''; and
(4) by striking ``Assistant Secretary for Public Health
Emergency Preparedness'' each place it appears and inserting
``Assistant Secretary for Preparedness and Response''.
(b) Transfer of Functions; References.--
(1) Transfer of functions.--There shall be transferred to
the Office of the Assistant Secretary for Preparedness and
Response the functions, personnel, assets, and liabilities of
the Assistant Secretary for Public Health Emergency
Preparedness as in effect on the day before the date of
enactment of this Act.
(2) References.--Any reference in any Federal law,
Executive order, rule, regulation, or delegation of authority,
or any document of or pertaining to the Assistant Secretary for
Public Health Emergency Preparedness as in effect the day
before the date of enactment of this Act, shall be deemed to be
a reference to the Assistant Secretary for Preparedness and
Response.
SEC. 103. NATIONAL HEALTH SECURITY STRATEGY.
Title XXVIII of the Public Health Service Act (300hh-11 et seq.),
as amended by section 101, is amended by inserting after section 2801
the following:
``SEC. 2802. NATIONAL HEALTH SECURITY STRATEGY.
``(a) In General.--
``(1) Preparedness and response regarding public health
emergencies.--Beginning in 2009 and every 4 years thereafter,
the Secretary shall prepare and submit to the relevant
Committees of Congress a coordinated strategy and any revisions
thereof, and an accompanying implementation plan for public
health emergency preparedness and response. The strategy shall
identify the process for achieving the preparedness goals
described in subsection (b) and shall be consistent with the
National Preparedness Goal, the National Incident Management
System, and the National Response Plan developed pursuant to
section 502(6) of the Homeland Security Act of 2002, or any
successor plan.
``(2) Evaluation of progress.--The National Health Security
Strategy shall include an evaluation of the progress made by
Federal, State, local, and tribal entities, based on the
evidence-based benchmarks and objective standards that measure
levels of preparedness established pursuant to section 319C-
1(g). Such evaluation shall include aggregate and State-
specific breakdowns of obligated funding spent by major
category (as defined by the Secretary) for activities funded
through awards pursuant to sections 319C-1 and 319C-2.
``(3) Public health workforce.--In 2009, the National
Health Security Strategy shall include a national strategy for
establishing an effective and prepared public health workforce,
including defining the functions, capabilities, and gaps in
such workforce, and identifying strategies to recruit, retain,
and protect such workforce from workplace exposures during
public health emergencies.
``(b) Preparedness Goals.--The strategy under subsection (a) shall
include provisions in furtherance of the following:
``(1) Integration.--Integrating public health and public
and private medical capabilities with other first responder
systems, including through--
``(A) the periodic evaluation of Federal, State,
local, and tribal preparedness and response
capabilities through drills and exercises; and
``(B) integrating public and private sector public
health and medical donations and volunteers.
``(2) Public health.--Developing and sustaining Federal,
State, local, and tribal essential public health security
capabilities, including the following:
``(A) Disease situational awareness domestically
and abroad, including detection, identification, and
investigation.
``(B) Disease containment including capabilities
for isolation, quarantine, social distancing, and
decontamination.
``(C) Risk communication and public preparedness.
``(D) Rapid distribution and administration of
medical countermeasures.
``(3) Medical.--Increasing the preparedness, response
capabilities, and surge capacity of hospitals, other health
care facilities (including mental health facilities), and
trauma care and emergency medical service systems with respect
to public health emergencies, which shall include developing
plans for the following:
``(A) Strengthening public health emergency medical
management and treatment capabilities.
``(B) Medical evacuation and fatality management.
``(C) Rapid distribution and administration of
medical countermeasures.
``(D) Effective utilization of any available public
and private mobile medical assets and integration of
other Federal assets.
``(E) Protecting health care workers and health
care first responders from workplace exposures during a
public health emergency.
``(4) At-risk individuals.--
``(A) Taking into account the public health and
medical needs of at-risk individuals in the event of a
public health emergency.
``(B) For purpose of this title and section 319,
the term `at-risk individuals' means children, pregnant
women, senior citizens and other individuals who have
special needs in the event of a public health
emergency, as determined by the Secretary.
``(5) Coordination.--Minimizing duplication of, and
ensuring coordination between Federal, State, local, and tribal
planning, preparedness, and response activities (including the
State Emergency Management Assistance Compact). Such planning
shall be consistent with the National Response Plan, or any
successor plan, and National Incident Management System and the
National Preparedness Goal.
``(6) Continuity of operations.--Maintaining vital public
health and medical services to allow for optimal Federal,
State, local, and tribal operations in the event of a public
health emergency.''.
TITLE II--PUBLIC HEALTH SECURITY PREPAREDNESS
SEC. 201. IMPROVING STATE AND LOCAL PUBLIC HEALTH SECURITY.
Section 319C-1 of the Public Health Service Act (42 U.S.C. 247d-3a)
is amended--
(1) by amending the heading to read as follows: ``improving
state and local public health security.'';
(2) by striking subsections (a) through (i) and inserting
the following:
``(a) In General.--To enhance the security of the United States
with respect to public health emergencies, the Secretary shall award
cooperative agreements to eligible entities to enable such entities to
conduct the activities described in subsection (d).
``(b) Eligible Entities.--To be eligible to receive an award under
subsection (a), an entity shall--
``(1)(A) be a State;
``(B) be a political subdivision determined by the
Secretary to be eligible for an award under this section (based
on criteria described in subsection (h)(4); or
``(C) be a consortium of entities described in subparagraph
(A); and
``(2) prepare and submit to the Secretary an application at
such time, and in such manner, and containing such information
as the Secretary may require, including--
``(A) an All-Hazards Public Health Emergency
Preparedness and Response Plan which shall include--
``(i) a description of the activities such
entity will carry out under the agreement to
meet the goals identified under section 2802;
``(ii) a pandemic influenza plan consistent
with the requirements of paragraphs (2) and (5)
of subsection (g);
``(iii) preparedness and response
strategies and capabilities that take into
account the medical and public health needs of
at-risk individuals in the event of a public
health emergency;
``(iv) a description of the mechanism the
entity will implement to utilize the Emergency
Management Assistance Compact or other mutual
aid agreements for medical and public health
mutual aid; and
``(v) a description of how the entity will
include the State Area Agency on Aging in
public health emergency preparedness;
``(B) an assurance that the entity will report to
the Secretary on an annual basis (or more frequently as
determined by the Secretary) on the evidence-based
benchmarks and objective standards established by the
Secretary to evaluate the preparedness and response
capabilities of such entity;
``(C) an assurance that the entity will conduct, on
at least an annual basis, an exercise or drill that
meets any criteria established by the Secretary to test
the preparedness and response capabilities of such
entity, and that the entity will report back to the
Secretary within the application of the following year
on the strengths and weaknesses identified through such
exercise or drill, and corrective actions taken to
address material weaknesses;
``(D) an assurance that the entity will provide to
the Secretary the data described under section
319D(d)(3) as determined feasible by the Secretary;
``(E) an assurance that the entity will conduct
activities to inform and educate the hospitals within
the jurisdiction of such entity on the role of such
hospitals in the plan required under subparagraph (A);
``(F) an assurance that the entity, with respect to
the plan described under subparagraph (A), has
developed and will implement an accountability system
to ensure that such entity make satisfactory annual
improvement and describe such system in the plan under
subparagraph (A);
``(G) a description of the means by which to obtain
public comment and input on the plan described in
subparagraph (A) and on the implementation of such
plan, that shall include an advisory committee or other
similar mechanism for obtaining comment from the public
and from other State, local, and tribal stakeholders;
and
``(H) as relevant, a description of the process
used by the entity to consult with local departments of
public health to reach consensus, approval, or
concurrence on the relative distribution of amounts
received under this section.
``(c) Limitation.--Beginning in fiscal year 2009, the Secretary may
not award a cooperative agreement to a State unless such State is a
participant in the Emergency System for Advance Registration of
Volunteer Health Professionals described in section 319I.
``(d) Use of Funds.--
``(1) In general.--An award under subsection (a) shall be
expended for activities to achieve the preparedness goals
described under paragraphs (1), (2), (4), (5), and (6) of
section 2802(b).
``(2) Effect of section.--Nothing in this subsection may be
construed as establishing new regulatory authority or as
modifying any existing regulatory authority.
``(e) Coordination With Local Response Capabilities.--An entity
shall, to the extent practicable, ensure that activities carried out
under an award under subsection (a) are coordinated with activities of
relevant Metropolitan Medical Response Systems, local public health
departments, the Cities Readiness Initiative, and local emergency
plans.
``(f) Consultation With Homeland Security.--In making awards under
subsection (a), the Secretary shall consult with the Secretary of
Homeland Security to--
``(1) ensure maximum coordination of public health and
medical preparedness and response activities with the
Metropolitan Medical Response System, and other relevant
activities;
``(2) minimize duplicative funding of programs and
activities;
``(3) analyze activities, including exercises and drills,
conducted under this section to develop recommendations and
guidance on best practices for such activities, and
``(4) disseminate such recommendations and guidance,
including through expanding existing lessons learned
information system to create a single Internet-based point of
access for sharing and distributing medical and public health
best practices and lessons learned from drills, exercises,
disasters, and other emergencies.
``(g) Achievement of Measurable Evidence-Based Benchmarks and
Objective Standards.--
``(1) In general.--Not later than 180 days after the date
of enactment of the Pandemic and All-Hazards Preparedness Act,
the Secretary shall develop or where appropriate adopt, and
require the application of measurable evidence-based benchmarks
and objective standards that measure levels of preparedness
with respect to the activities described in this section and
with respect to activities described in section 319C-2. In
developing such benchmarks and standards, the Secretary shall
consult with and seek comments from State, local, and tribal
officials and private entities, as appropriate. Where
appropriate, the Secretary shall incorporate existing objective
standards. Such benchmarks and standards shall, at a minimum,
require entities to--
``(A) demonstrate progress toward achieving the
preparedness goals described in section 2802 in a
reasonable timeframe determined by the Secretary;
``(B) annually report grant expenditures to the
Secretary (in a form prescribed by the Secretary) who
shall ensure that such information is included on the
Federal Internet-based point of access developed under
subsection (f); and
``(C) at least annually, test and exercise the
public health and medical emergency preparedness and
response capabilities of the grantee, based on criteria
established by the Secretary.
``(2) Criteria for pandemic influenza plans.--
``(A) In general.--Not later than 180 days after
the date of enactment of the Pandemic and All-Hazards
Preparedness Act, the Secretary shall develop and
disseminate to the chief executive officer of each
State criteria for an effective State plan for
responding to pandemic influenza.
``(B) Rule of construction.--Nothing in this
section shall be construed to require the duplication
of Federal efforts with respect to the development of
criteria or standards, without regard to whether such
efforts were carried out prior to or after the date of
enactment of this section.
``(3) Technical assistance.--The Secretary shall, as
determined appropriate by the Secretary, provide to a State,
upon request, technical assistance in meeting the requirements
of this section, including the provision of advice by experts
in the development of high-quality assessments, the setting of
State objectives and assessment methods, the development of
measures of satisfactory annual improvement that are valid and
reliable, and other relevant areas.
``(4) Notification of failures.--The Secretary shall
develop and implement a process to notify entities that are
determined by the Secretary to have failed to meet the
requirements of paragraph (1) or (2). Such process shall
provide such entities with the opportunity to correct such
noncompliance. An entity that fails to correct such
noncompliance shall be subject to paragraph (5).
``(5) Withholding of amounts from entities that fail to
achieve benchmarks or submit influenza plan.--Beginning with
fiscal year 2009, and in each succeeding fiscal year, the
Secretary shall--
``(A) withhold from each entity that has failed
substantially to meet the benchmarks and performance
measures described in paragraph (1) for a previous
fiscal year (beginning with fiscal year 2008), pursuant
to the process developed under paragraph (4), the
amount described in paragraph (6); and
``(B) withhold from each entity that has failed to
submit to the Secretary a plan for responding to
pandemic influenza that meets the criteria developed
under paragraph (2), the amount described in paragraph
(6).
``(6) Amounts described.--
``(A) In general.--The amounts described in this
paragraph are the following amounts that are payable to
an entity for activities described in section 319C-1 or
319C-2:
``(i) For the fiscal year immediately
following a fiscal year in which an entity
experienced a failure described in subparagraph
(A) or (B) of paragraph (5) by the entity, an
amount equal to 10 percent of the amount the
entity was eligible to receive for such fiscal
year.
``(ii) For the fiscal year immediately
following two consecutive fiscal years in which
an entity experienced such a failure, an amount
equal to 15 percent of the amount the entity
was eligible to receive for such fiscal year,
taking into account the withholding of funds
for the immediately preceding fiscal year under
clause (i).
``(iii) For the fiscal year immediately
following three consecutive fiscal years in
which an entity experienced such a failure, an
amount equal to 20 percent of the amount the
entity was eligible to receive for such fiscal
year, taking into account the withholding of
funds for the immediately preceding fiscal
years under clauses (i) and (ii).
``(iv) For the fiscal year immediately
following four consecutive fiscal years in
which an entity experienced such a failure, an
amount equal to 25 percent of the amount the
entity was eligible to receive for such a
fiscal year, taking into account the
withholding of funds for the immediately
preceding fiscal years under clauses (i), (ii),
and (iii).
``(B) Separate accounting.--Each failure described
in subparagraph (A) or (B) of paragraph (5) shall be
treated as a separate failure for purposes of
calculating amounts withheld under subparagraph (A).
``(7) Reallocation of amounts withheld.--
``(A) In general.--The Secretary shall make amounts
withheld under paragraph (6) available for making
awards under section 319C-2 to entities described in
subsection (b)(1) of such section.
``(B) Preference in reallocation.--In making awards
under section 319C-2 with amounts described in
subparagraph (A), the Secretary shall give preference
to eligible entities (as described in section 319C-
2(b)(1)) that are located in whole or in part in States
from which amounts have been withheld under paragraph
(6).
``(8) Waiver or reduce withholding.--The Secretary may
waive or reduce the withholding described in paragraph (6), for
a single entity or for all entities in a fiscal year, if the
Secretary determines that mitigating conditions exist that
justify the waiver or reduction.'';
(3) by redesignating subsection (j) as subsection (h);
(4) in subsection (h), as so redesignated--
(A) by striking paragraphs (1) through (3)(A) and
inserting the following:
``(1) Authorization of appropriations.--
``(A) In general.--For the purpose of carrying out
this section, there is authorized to be appropriated
$824,000,000 fiscal year 2007 for awards pursuant to
paragraph (3) (subject to the authority of the
Secretary to make awards pursuant to paragraphs (4) and
(5)), and such sums as may be necessary for each of
fiscal years 2008 through 2011.
``(B) Coordination.--There are authorized to be
appropriated, $10,000,000 for fiscal year 2007 to carry
out subsection (f)(3).
``(C) Requirement for state matching funds.--
Beginning in fiscal year 2009, in the case of any State
or consortium of two or more States, the Secretary may
not award a cooperative agreement under this section
unless the State or consortium of States agree that,
with respect to the amount of the cooperative agreement
awarded by the Secretary, the State or consortium of
States will make available (directly or through
donations from public or private entities) non-Federal
contributions in an amount equal to--
``(i) for the first fiscal year of the
cooperative agreement, not less than 5 percent
of such costs ($1 for each $20 of Federal funds
provided in the cooperative agreement); and
``(ii) for any second fiscal year of the
cooperative agreement, and for any subsequent
fiscal year of such cooperative agreement, not
less than 10 percent of such costs ($1 for each
$10 of Federal funds provided in the
cooperative agreement).
``(D) Determination of amount of non-federal
contributions.--As determined by the Secretary, non-
Federal contributions required in subparagraph (C) may
be provided directly or through donations from public
or private entities and may be in cash or in kind,
fairly evaluated, including plant, equipment or
services. Amounts provided by the Federal government,
or services assisted or subsidized to any significant
extent by the Federal government, may not be included
in determining the amount of such non-Federal
contributions.
``(2) Maintaining state funding.--
``(A) In general.--An entity that receives an award
under this section shall maintain expenditures for
public health security at a level that is not less than
the average level of such expenditures maintained by
the entity for the preceding 2 year period.
``(B) Rule of construction.--Nothing in this
section shall be construed to prohibit the use of
awards under this section to pay salary and related
expenses of public health and other professionals
employed by State, local, or tribal public health
agencies who are carrying out activities supported by
such awards (regardless of whether the primary
assignment of such personnel is to carry out such
activities).
``(3) Determination of amount.--
``(A) In general.--The Secretary shall award
cooperative agreements under subsection (a) to each
State or consortium of 2 or more States that submits to
the Secretary an application that meets the criteria of
the Secretary for the receipt of such an award and that
meets other implementation conditions established by
the Secretary for such awards.'';
(B) in paragraph (4)(A)--
(i) by striking ``2003'' and inserting
``2007''; and
(ii) by striking ``(A)(i)(I)'';
(C) in paragraph (4)(D), by striking ``2002'' and
inserting ``2006'';
(D) in paragraph (5), by striking ``2003'' and
inserting ``2007''; and
(E) by striking paragraph (6) and inserting the
following:
``(6) Funding of local entities.--The Secretary shall, in
making awards under this section, ensure that with respect to
the cooperative agreement awarded, the entity make available
appropriate portions of such award to political subdivisions
and local departments of public health through a process
involving the consensus, approval or concurrence with such
local entities.''; and
(5) by adding at the end the following:
``(i) Administrative and Fiscal Responsibility.--
``(1) Annual reporting requirements.--Each entity shall
prepare and submit to the Secretary annual reports on its
activities under this section and section 319C-2. Each such
report shall be prepared by, or in consultation with, the
health department. In order to properly evaluate and compare
the performance of different entities assisted under this
section and section 319C-2 and to assure the proper expenditure
of funds under this section and section 319C-2, such reports
shall be in such standardized form and contain such information
as the Secretary determines (after consultation with the
States) to be necessary to--
``(A) secure an accurate description of those
activities;
``(B) secure a complete record of the purposes for
which funds were spent, and of the recipients of such
funds;
``(C) describe the extent to which the entity has
met the goals and objectives it set forth under this
section or section 319C-2; and
``(D) determine the extent to which funds were
expended consistent with the entity's application
transmitted under this section or section 319C-2.
``(2) Audits; implementation.--
``(A) In general.--Each entity receiving funds
under this section or section 319C-2 shall, not less
often than once every 2 years, audit its expenditures
from amounts received under this section or section
319C-2. Such audits shall be conducted by an entity
independent of the agency administering a program
funded under this section or section 319C-2 in
accordance with the Comptroller General's standards for
auditing governmental organizations, programs,
activities, and functions and generally accepted
auditing standards. Within 30 days following the
completion of each audit report, the entity shall
submit a copy of that audit report to the Secretary.
``(B) Repayment.--Each entity shall repay to the
United States amounts found by the Secretary, after
notice and opportunity for a hearing to the entity, not
to have been expended in accordance with this section
or section 319C-2 and, if such repayment is not made,
the Secretary may offset such amounts against the
amount of any allotment to which the entity is or may
become entitled under this section or section 319C-2 or
may otherwise recover such amounts.
``(C) Withholding of payment.--The Secretary may,
after notice and opportunity for a hearing, withhold
payment of funds to any entity which is not using its
allotment under this section or section 319C-2 in
accordance with such section. The Secretary may
withhold such funds until the Secretary finds that the
reason for the withholding has been removed and there
is reasonable assurance that it will not recur.
``(3) Maximum carryover amount.--
``(A) In general.--For each fiscal year, the
Secretary, in consultation with the States and
political subdivisions, shall determine the maximum
percentage amount of an award under this section that
an entity may carryover to the succeeding fiscal year.
``(B) Amount exceeded.--For each fiscal year, if
the percentage amount of an award under this section
unexpended by an entity exceeds the maximum percentage
permitted by the Secretary under subparagraph (A), the
entity shall return to the Secretary the portion of the
unexpended amount that exceeds the maximum amount
permitted to be carried over by the Secretary.
``(C) Action by secretary.--The Secretary shall
make amounts returned to the Secretary under
subparagraph (B) available for awards under section
319C-2(b)(1). In making awards under section 319C-
2(b)(1) with amounts collected under this paragraph the
Secretary shall give preference to entities that are
located in whole or in part in States from which
amounts have been returned under subparagraph (B).
``(D) Waiver.--An entity may apply to the Secretary
for a waiver of the maximum percentage amount under
subparagraph (A). Such an application for a waiver
shall include an explanation why such requirement
should not apply to the entity and the steps taken by
such entity to ensure that all funds under an award
under this section will be expended appropriately.
``(E) Waive or reduce withholding.--The Secretary
may waive the application of subparagraph (B) for a
single entity pursuant to subparagraph (D) or for all
entities in a fiscal year, if the Secretary determines
that mitigating conditions exist that justify the
waiver or reduction.''.
SEC. 202. USING INFORMATION TECHNOLOGY TO IMPROVE SITUATIONAL AWARENESS
IN PUBLIC HEALTH EMERGENCIES.
Section 319D of the Public Health Service Act (42 U.S.C. 247d-4) is
amended--
(1) in subsection (a)(1), by inserting ``domestically and
abroad'' after ``public health threats''; and
(2) by adding at the end the following:
``(d) Public Health Situational Awareness.--
``(1) In general.--Not later than 2 years after the date of
enactment of the Pandemic and All-Hazards Preparedness Act, the
Secretary, in collaboration with State, local, and tribal
public health officials, shall establish a near real-time
electronic nationwide public health situational awareness
capability through an interoperable network of systems to share
data and information to enhance early detection of rapid
response to, and management of, potentially catastrophic
infectious disease outbreaks and other public health
emergencies that originate domestically or abroad. Such network
shall be built on existing State situational awareness systems
or enhanced systems that enable such connectivity.
``(2) Strategic plan.--Not later than 180 days after the
date of enactment the Pandemic and All-Hazards Preparedness
Act, the Secretary shall submit to the appropriate committees
of Congress, a strategic plan that demonstrates the steps the
Secretary will undertake to develop, implement, and evaluate
the network described in paragraph (1), utilizing the elements
described in paragraph (3).
``(3) Elements.--The network described in paragraph (1)
shall include data and information transmitted in a
standardized format from--
``(A) State, local, and tribal public health
entities, including public health laboratories;
``(B) Federal health agencies;
``(C) zoonotic disease monitoring systems;
``(D) public and private sector health care
entities, hospitals, pharmacies, poison control centers
or professional organizations in the field of poison
control, and clinical laboratories, to the extent
practicable and provided that such data are voluntarily
provided simultaneously to the Secretary and
appropriate State, local, and tribal public health
agencies; and
``(E) such other sources as the Secretary may deem
appropriate.
``(4) Rule of construction.--Paragraph (3) shall not be
construed as requiring separate reporting of data and
information from each source listed.
``(5) Required activities.--In establishing and operating
the network described in paragraph (1), the Secretary shall--
``(A) utilize applicable interoperability standards
as determined by the Secretary through a joint public
and private sector process;
``(B) define minimal data elements for such
network;
``(C) in collaboration with State, local, and
tribal public health officials, integrate and build
upon existing State, local, and tribal capabilities,
ensuring simultaneous sharing of data, information, and
analyses from the network described in paragraph (1)
with State, local, and tribal public health agencies;
and
``(D) in collaboration with State, local, and
tribal public health officials, develop procedures and
standards for the collection, analysis, and
interpretation of data that States, regions, or other
entities collect and report to the network described in
paragraph (1).
``(e) State and Regional Systems To Enhance Situational Awareness
in Public Health Emergencies.--
``(1) In general.--To implement the network described in
section (d), the Secretary may award grants to States to
enhance the ability of such States to establish or operate a
coordinated public health situational awareness system for
regional or Statewide early detection of, rapid response to,
and management of potentially catastrophic infectious disease
outbreaks and public health emergencies, in collaboration with
public health agencies, sentinel hospitals, clinical
laboratories, pharmacies, poison control centers, other health
care organizations, or animal health organizations within such
States.
``(2) Eligibility.--To be eligible to receive a grant under
paragraph (1), the State shall submit to the Secretary an
application at such time, in such manner, and containing such
information as the Secretary may require, including an
assurance that the State will submit to the Secretary--
``(A) reports of such data, information, and
metrics as the Secretary may require;
``(B) a report on the effectiveness of the systems
funded under the grant; and
``(C) a description of the manner in which grant
funds will be used to enhance the timelines and
comprehensiveness of efforts to detect, respond to, and
manage potentially catastrophic infectious disease
outbreaks and public health emergencies.
``(3) Use of funds.--A State that receives an award under
this subsection--
``(A) shall establish, enhance, or operate a
coordinated public health situational awareness system
for regional or Statewide early detection of, rapid
response to, and management of potentially catastrophic
infectious disease outbreaks and public health
emergencies; and
``(B) may award grants or contracts to entities
described in paragraph (1) within or serving such State
to assist such entities in improving the operation of
information technology systems, facilitating the secure
exchange of data and information, and training
personnel to enhance the operation of the system
described in paragraph (A).
``(4) Limitation.--Information technology systems acquired
or implemented using grants awarded under this section must be
compliant with--
``(A) interoperability and other technological
standards, as determined by the Secretary; and
``(B) data collection and reporting requirements
for the network described in subsection (d).
``(5) Independent evaluation.--Not later than 4 years after
the date of enactment of the Pandemic and All-Hazards
Preparedness Act, the Government Accountability Office shall
conduct an independent evaluation, and submit to the Secretary
and the appropriate committees of Congress a report, concerning
the activities conducted under this subsection and subsection
(d).
``(f) Grants for Real-Time Surveillance Improvement.--
``(1) In general.--The Secretary may award grants to
eligible entities to carry out projects described under
paragraph (4).
``(2) Eligible entity.--For purposes of this section, the
term `eligible entity' means an entity that is--
``(A)(i) a hospital, clinical laboratory,
university; or
``(ii) poison control center or professional
organization in the field of poison control; and
``(B) a participant in the network established
under subsection (d).
``(3) Application.--Each eligible entity desiring a grant
under this section shall submit to the Secretary an application
at such time, in such manner, and containing such information
as the Secretary may require.
``(4) Use of funds.--
``(A) In general.--An eligible entity described in
paragraph (2)(A)(i) that receives a grant under this
section shall use the funds awarded pursuant to such
grant to carry out a pilot demonstration project to
purchase and implement the use of advanced diagnostic
medical equipment to analyze real-time clinical
specimens for pathogens of public health or
bioterrorism significance and report any results from
such project to State, local, and tribal public health
entities and the network established under subsection
(d).
``(B) Other entities.--An eligible entity described
in paragraph (2)(A)(ii) that receives a grant under
this section shall use the funds awarded pursuant to
such grant to--
``(i) improve the early detection,
surveillance, and investigative capabilities of
poison control centers for chemical,
biological, radiological, and nuclear events by
training poison information personnel to
improve the accuracy of surveillance data,
improving the definitions used by the poison
control centers for surveillance, and enhancing
timely and efficient investigation of data
anomalies;
``(ii) improve the capabilities of poison
control centers to provide information to
health care providers and the public with
regard to chemical, biological, radiological,
or nuclear threats or exposures, in
consultation with the appropriate State, local,
and tribal public health entities; or
``(iii) provide surge capacity in the event
of a chemical, biological, radiological, or
nuclear event through the establishment of
alternative poison control center worksites and
the training of nontraditional personnel.
``(g) Authorization of Appropriations.--
``(1) Fiscal year 2007.--There are authorized to be
appropriated to carry out subsections (d), (e), and (f)
$102,000,000 for fiscal year 2007, of which $35,000,000 is
authorized to be appropriated to carry out subsection (f).
``(2) Subsequent fiscal years.--There are authorized to be
appropriated such sums as may be necessary to carry out
subsections (d), (e), and (f) for each of fiscal years 2008
through 2011.''.
SEC. 203. PUBLIC HEALTH WORKFORCE ENHANCEMENTS.
(a) Demonstration Project.--Section 338L of the Public Health
Service Act (42 U.S.C. 254t) is amended by adding at the end the
following:
``(h) Public Health Departments.--
``(1) In general.--To the extent that funds are
appropriated under paragraph (5), the Secretary shall establish
a demonstration project to provide for the participation of
individuals who are eligible for the Loan Repayment Program
described in section 338B and who agree to complete their
service obligation in a State health department that serves a
significant number of health professional shortage areas or
areas at risk of a public health emergency, as determined by
the Secretary, or in a local health department that serves a
health professional shortage area or an area at risk of a
public health emergency.
``(2) Procedure.--To be eligible to receive assistance
under paragraph (1), with respect to the program described in
section 338B, an individual shall--
``(A) comply with all rules and requirements
described in such section (other than section
338B(f)(1)(B)(iv)); and
``(B) agree to serve for a time period equal to 2
years, or such longer period as the individual may
agree to, in a State, local, or tribal health
department, consistent with paragraph (1).
``(3) Designations.--The demonstration project described in
paragraph (1), and any healthcare providers who are selected to
participate in such project, shall not be considered by the
Secretary in the designation of health professional shortage
areas under section 332 during fiscal years 2007 through 2010.
``(4) Report.--Not later than 3 years after the date of
enactment of this subsection, the Secretary shall submit a
report to the relevant committees of Congress that evaluates
the participation of individuals in the demonstration project
under paragraph (1), the impact of such participation on State,
local, and tribal health departments, and the benefit and
feasibility of permanently allowing such placements in the Loan
Repayment Program.
``(5) Authorization of appropriations.--There are
authorized to be appropriated to carry out this subsection,
such sums as may be necessary for each of fiscal years 2007
through 2010.''.
(b) Grants for Loan Repayment Program.--Section 338I of the Public
Health Service Act (42 U.S.C. 254q-1) is amended by adding at the end
the following:
``(i) Public Health Loan Repayment.--
``(1) In general.--The Secretary may award grants to States
for the purpose of assisting such States in operating loan
repayment programs under which such States enter into contracts
to repay all or part of the eligible loans borrowed by, or on
behalf of, individuals who agree to serve in State, local, or
tribal health departments that serve health professional
shortage areas or other areas at risk of a public health
emergency, as designated by the Secretary.
``(2) Loans eligible for repayment.--To be eligible for
repayment under this subsection, a loan shall be a loan made,
insured, or guaranteed by the Federal Government that is
borrowed by, or on behalf of, an individual to pay the cost of
attendance for a program of education leading to a degree
appropriate for serving in a State, local, or tribal health
department as determined by the Secretary and the chief
executive officer of the State in which the grant is
administered, at an institution of higher education (as defined
in section 102 of the Higher Education Act of 1965), including
principal, interest, and related expenses on such loan.
``(3) Applicability of existing requirements.--With respect
to awards made under paragraph (1)--
``(A) the requirements of subsections (b), (f), and
(g) shall apply to such awards; and
``(B) the requirements of subsection (c) shall
apply to such awards except that with respect to
paragraph (1) of such subsection, the State involved
may assign an individual only to public and nonprofit
private entities that serve health professional
shortage areas or areas at risk of a public health
emergency, as determined by the Secretary.
``(4) Authorization of appropriations.--There are
authorized to be appropriated to carry out this subsection,
such sums as may be necessary for each of fiscal years 2007
through 2010.''.
SEC. 204. VACCINE TRACKING AND DISTRIBUTION.
Section 319A of the Public Health Service Act (42 U.S.C. 247d-1) is
amended to read as follows:
``SEC. 319A. VACCINE TRACKING AND DISTRIBUTION.
``(a) Tracking.--The Secretary, together with relevant
manufacturers, wholesalers, and distributors as may agree to cooperate,
may track the initial distribution of federally purchased influenza
vaccine in an influenza pandemic. Such tracking information shall be
used to inform Federal, State, local, and tribal decision makers during
an influenza pandemic.
``(b) Distribution.--The Secretary shall promote communication
between State, local, and tribal public health officials and such
manufacturers, wholesalers, and distributors as agree to participate,
regarding the effective distribution of seasonal influenza vaccine.
Such communication shall include estimates of high priority
populations, as determined by the Secretary, in State, local, and
tribal jurisdictions in order to inform Federal, State, local, and
tribal decision makers during vaccine shortages and supply disruptions.
``(c) Confidentiality.--The information submitted to the Secretary
or its contractors, if any, under this section or under any other
section of this Act related to vaccine distribution information shall
remain confidential in accordance with the exception from the public
disclosure of trade secrets, commercial or financial information, and
information obtained from an individual that is privileged and
confidential, as provided for in section 552(b)(4) of title 5, United
States Code, and subject to the penalties and exceptions under sections
1832 and 1833 of title 18, United States Code, relating to the
protection and theft of trade secrets, and subject to privacy
protections that are consistent with the regulations promulgated under
section 264(c) of the Health Insurance Portability and Accountability
Act of 1996. None of such information provided by a manufacturer,
wholesaler, or distributor shall be disclosed without its consent to
another manufacturer, wholesaler, or distributor, or shall be used in
any manner to give a manufacturer, wholesaler, or distributor a
proprietary advantage.
``(d) Guidelines.--The Secretary, in order to maintain the
confidentiality of relevant information and ensure that none of the
information contained in the systems involved may be used to provide
proprietary advantage within the vaccine market, while allowing State,
local, and tribal health officials access to such information to
maximize the delivery and availability of vaccines to high priority
populations, during times of influenza pandemics, vaccine shortages,
and supply disruptions, in consultation with manufacturers,
distributors, wholesalers and State, local, and tribal health
departments, shall develop guidelines for subsections (a) and (b).
``(e) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section, such sums for each of fiscal
years 2007 through 2011.
``(f) Report to Congress.--As part of the National Health Security
Strategy described in section 2802, the Secretary shall provide an
update on the implementation of subsections (a) through (d).''.
SEC. 205. NATIONAL SCIENCE ADVISORY BOARD FOR BIOSECURITY.
The National Science Advisory Board for Biosecurity shall, when
requested by the Secretary of Health and Human Services, provide to
relevant Federal departments and agencies, advice, guidance, or
recommendations concerning--
(1) a core curriculum and training requirements for workers
in maximum containment biological laboratories; and
(2) periodic evaluations of maximum containment biological
laboratory capacity nationwide and assessments of the future
need for increased laboratory capacity;
TITLE III--ALL-HAZARDS MEDICAL SURGE CAPACITY
SEC. 301. NATIONAL DISASTER MEDICAL SYSTEM.
(a) National Disaster Medical System.--Section 2812 of subtitle B
of title XXVIII of the Public Health Service Act (42 U.S.C. 300hh-11 et
seq.), as redesignated by section 102, is amended--
(1) by striking the section heading and inserting
``national disaster medical system'';
(2) by striking subsection (a);
(3) by redesignating subsections (b) through (h) as
subsections (a) through (g);
(4) in subsection (a), as so redesignated--
(A) in paragraph (2)(B), by striking ``Federal
Emergency Management Agency'' and inserting
``Department of Homeland Security''; and
(B) in paragraph (3)(C), by striking ``Public
Health Security and Bioterrorism Preparedness and
Response Act of 2002'' and inserting ``Pandemic and
All-Hazards Preparedness Act'';
(5) in subsection (b), as so redesignated, by--
(A) striking the subsection heading and inserting
``Modifications'';
(B) redesignating paragraph (2) as paragraph (3);
and
(C) striking paragraph (1) and inserting the
following:
``(1) In general.--Taking into account the findings from
the joint review described under paragraph (2), the Secretary
shall modify the policies of the National Disaster Medical
System as necessary.
``(2) Joint review and medical surge capacity strategic
plan.--Not later than 180 days after the date of enactment of
the Pandemic and All-Hazards Preparedness Act, the Secretary,
in coordination with the Secretary of Homeland Security, the
Secretary of Defense, and the Secretary of Veterans Affairs,
shall conduct a joint review of the National Disaster Medical
System. Such review shall include an evaluation of medical
surge capacity, as described by section 2804(a). As part of the
National Health Security Strategy under section 2802, the
Secretary shall update the findings from such review and
further modify the policies of the National Disaster Medical
System as necessary.'';
(6) by striking ``subsection (b)'' each place it appears
and inserting ``subsection (a)'';
(7) by striking ``subsection (d)'' each place it appears
and inserting ``subsection (c)''; and
(8) in subsection (g), as so redesignated, by striking
``2002 through 2006'' and inserting ``2007 through 2011''.
(b) Transfer of National Disaster Medical System to the Department
of Health and Human Services.--There shall be transferred to the
Secretary of Health and Human Services the functions, personnel,
assets, and liabilities of the National Disaster Medical System of the
Department of Homeland Security, including the functions of the
Secretary of Homeland Security and the Under Secretary for Emergency
Preparedness and Response relating thereto.
(c) Conforming Amendments to the Homeland Security Act of 2002.--
The Homeland Security Act of 2002 (6 U.S.C. 312(3)(B), 313(5))) is
amended--
(1) in section 502(3)(B), by striking ``, the National
Disaster Medical System,''; and
(2) in section 503(5), by striking ``, the National
Disaster Medical System''.
(d) Update of Certain Provision.--Section 319F(b)(2) of the Public
Health Service Act (42 U.S.C. 247d-6(b)(2)) is amended--
(1) in the paragraph heading, by striking ``Children and
terrorism'' and inserting ``At-risk individuals and public
health emergencies'';
(2) in subparagraph (A), by striking ``Children and
Terrorism'' and inserting ``At-Risk Individuals and Public
Health Emergencies'';
(3) in subparagraph (B)--
(A) in clause (i), by striking ``bioterrorism as it
relates to children'' and inserting ``public health
emergencies as they relate to at-risk individuals'';
(B) in clause (ii), by striking ``children'' and
inserting ``at-risk individuals''; and
(C) in clause (iii), by striking ``children'' and
inserting ``at-risk individuals'';
(4) in subparagraph (C), by striking ``children'' and all
that follows through the period and inserting ``at-risk
populations.''; and
(5) in subparagraph (D), by striking ``one year'' and
inserting ``six years''.
(e) Effective Date.--The amendments made by subsections (b) and (c)
shall take effect on January 1, 2007.
SEC. 302. ENHANCING MEDICAL SURGE CAPACITY.
(a) In General.--Title XXVIII of the Public Health Service Act
(300hh-11 et seq.), as amended by section 103, is amended by inserting
after section 2802 the following:
``SEC. 2804. ENHANCING MEDICAL SURGE CAPACITY.
``(a) Study of Enhancing Medical Surge Capacity.--As part of the
joint review described in section 2812(b), the Secretary shall evaluate
the benefits and feasibility of improving the capacity of the
Department of Health and Human Services to provide additional medical
surge capacity to local communities in the event of a public health
emergency. Such study shall include an assessment of the need for and
feasibility of improving surge capacity through--
``(1) acquisition and operation of mobile medical assets by
the Secretary to be deployed, on a contingency basis, to a
community in the event of a public health emergency; and
``(2) other strategies to improve such capacity as
determined appropriate by the Secretary.
``(b) Authority To Acquire and Operate Mobile Medical Assets.--In
addition to any other authority to acquire, deploy, and operate mobile
medical assets, the Secretary may acquire, deploy, and operate mobile
medical assets if, taking into consideration the evaluation conducted
under subsection (a), such acquisition, deployment, and operation is
determined to be beneficial and feasible in improving the capacity of
the Department of Health and Human Services to provide additional
medical surge capacity to local communities in the event of a public
health emergency.
``(c) Using Federal Facilities To Enhance Medical Surge Capacity.--
``(1) Analysis.--The Secretary shall conduct an analysis of
whether there are Federal facilities which, in the event of a
public health emergency, could practicably be used as
facilities in which to provide health care.
``(2) Memoranda of understanding.--If, based on the
analysis conducted under paragraph (1), the Secretary
determines that there are Federal facilities which, in the
event of a public health emergency, could be used as facilities
in which to provide health care, the Secretary shall, with
respect to each such facility, seek to conclude a memorandum of
understanding with the head of the Department or agency that
operates such facility that permits the use of such facility to
provide health care in the event of a public health
emergency.''.
(b) EMTALA.--
(1) In general.--Section 1135(b) of the Social Security Act
(42 U.S.C. 1320b-5(b)) is amended--
(A) in paragraph (3), by striking subparagraph (B)
and inserting the following:
``(B) the direction or relocation of an individual
to receive medical screening in an alternative
location--
``(i) pursuant to an appropriate State
emergency preparedness plan; or
``(ii) in the case of a public health
emergency described in subsection (g)(1)(B)
that involves a pandemic infectious disease,
pursuant to a State pandemic preparedness plan
or a plan referred to in clause (i), whichever
is applicable in the State;'';
(B) in the third sentence, by striking ``and shall
be limited to'' and inserting ``and, except in the case
of a waiver or modification to which the fifth sentence
of this subsection applies, shall be limited to''; and
(C) by adding at the end the following: ``If a
public health emergency described in subsection
(g)(1)(B) involves a pandemic infectious disease (such
as pandemic influenza), the duration of a waiver or
modification under paragraph (3) shall be determined in
accordance with subsection (e) as such subsection
applies to public health emergencies.''.
(2) Effective date.--The amendments made by paragraph (1)
shall take effect on the date of the enactment of this Act and
shall apply to public health emergencies declared pursuant to
section 319 of the Public Health Service Act (42 U.S.C. 247d)
on or after such date.
SEC. 303. ENCOURAGING HEALTH PROFESSIONAL VOLUNTEERS.
(a) Volunteer Medical Reserve Corps.--Title XXVIII of the Public
Health Service Act (42 U.S.C. 300hh-11 et seq.), as amended by this
Act, is amended by inserting after section 2812 the following:
``SEC. 2813. VOLUNTEER MEDICAL RESERVE CORPS.
``(a) In General.--Not later than 180 days after the date of
enactment of the Pandemic and All-Hazards Preparedness Act, the
Secretary, in collaboration with State, local, and tribal officials,
shall build on State, local, and tribal programs in existence on the
date of enactment of such Act to establish and maintain a Medical
Reserve Corps (referred to in this section as the `Corps') to provide
for an adequate supply of volunteers in the case of a Federal, State,
local, or tribal public health emergency. The Corps shall be headed by
a Director who shall be appointed by the Secretary and shall oversee
the activities of the Corps chapters that exist at the State, local,
and tribal levels.
``(b) State, Local, and Tribal Coordination.--The Corps shall be
established using existing State, local, and tribal teams and shall not
alter such teams.
``(c) Composition.--The Corps shall be composed of individuals
who--
``(1)(A) are health professionals who have appropriate
professional training and expertise as determined appropriate
by the Director of the Corps; or
``(B) are non-health professionals who have an interest in
serving in an auxiliary or support capacity to facilitate
access to health care services in a public health emergency;
``(2) are certified in accordance with the certification
program developed under subsection (d);
``(3) are geographically diverse in residence;
``(4) have registered and carry out training exercises with
a local chapter of the Medical Reserve Corps; and
``(5) indicate whether they are willing to be deployed
outside the area in which they reside in the event of a public
health emergency.
``(d) Certification; Drills.--
``(1) Certification.--The Director, in collaboration with
State, local, and tribal officials, shall establish a process
for the periodic certification of individuals who volunteer for
the Corps, as determined by the Secretary, which shall include
the completion by each individual of the core training programs
developed under section 319F, as required by the Director. Such
certification shall not supercede State licensing or
credentialing requirements.
``(2) Drills.--In conjunction with the core training
programs referred to in paragraph (1), and in order to
facilitate the integration of trained volunteers into the
health care system at the local level, Corps members shall
engage in periodic training exercises to be carried out at the
local level.
``(e) Deployment.--During a public health emergency, the Secretary
shall have the authority to activate and deploy willing members of the
Corps to areas of need, taking into consideration the public health and
medical expertise required, with the concurrence of the State, local,
or tribal officials from the area where the members reside.
``(f) Expenses and Transportation.--While engaged in performing
duties as a member of the Corps pursuant to an assignment by the
Secretary (including periods of travel to facilitate such assignment),
members of the Corps who are not otherwise employed by the Federal
Government shall be allowed travel or transportation expenses,
including per diem in lieu of subsistence.
``(g) Identification.--The Secretary, in cooperation and
consultation with the States, shall develop a Medical Reserve Corps
Identification Card that describes the licensure and certification
information of Corps members, as well as other identifying information
determined necessary by the Secretary.
``(h) Intermittent Disaster-Response Personnel.--
``(1) In general.--For the purpose of assisting the Corps
in carrying out duties under this section, during a public
health emergency, the Secretary may appoint selected
individuals to serve as intermittent personnel of such Corps in
accordance with applicable civil service laws and regulations.
In all other cases, members of the Corps are subject to the
laws of the State in which the activities of the Corps are
undertaken.
``(2) Applicable protections.--Subsections (c)(2), (d), and
(e) of section 2812 shall apply to an individual appointed
under paragraph (1) in the same manner as such subsections
apply to an individual appointed under section 2812(c).
``(3) Limitation.--State, local, and tribal officials shall
have no authority to designate a member of the Corps as Federal
intermittent disaster-response personnel, but may request the
services of such members.
``(i) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, $22,000,000 for fiscal year
2007, and such sums as may be necessary for each of fiscal years 2008
through 2011.''.
(b) Encouraging Health Professions Volunteers.--Section 319I of the
Public Health Service Act (42 U.S.C. 247d-7b) is amended--
(1) by redesignating subsections (e) and (f) as subsections
(j) and (k), respectively;
(2) by striking subsections (a) and (b) and inserting the
following:
``(a) In General.--Not later than 12 months after the date of
enactment of the Pandemic and All-Hazards Preparedness Act, the
Secretary shall link existing State verification systems to maintain a
single national interoperable network of systems, each system being
maintained by a State or group of States, for the purpose of verifying
the credentials and licenses of health care professionals who volunteer
to provide health services during a public health emergency (such
network shall be referred to in this section as the `verification
network').
``(b) Requirements.--The interoperable network of systems
established under subsection (a) shall include--
``(1) with respect to each volunteer health professional
included in the system--
``(A) information necessary for the rapid
identification of, and communication with, such
professionals; and
``(B) the credentials, certifications, licenses,
and relevant training of such individuals; and
``(2) the name of each member of the Medical Reserve Corps,
the National Disaster Medical System, and any other relevant
federally-sponsored or administered programs determined
necessary by the Secretary.'';
(3) by striking subsection (d) and inserting the following:
``(d) Accessibility.--The Secretary shall ensure that the network
established under subsection (a) is electronically accessible by State,
local, and tribal health departments and can be linked with the
identification cards under section 2813.
``(e) Confidentiality.--The Secretary shall establish and require
the application of and compliance with measures to ensure the effective
security of, integrity of, and access to the data included in the
network.
``(f) Coordination.--The Secretary shall coordinate with the
Secretary of Veterans Affairs and the Secretary of Homeland Security to
assess the feasibility of integrating the verification network under
this section with the VetPro system of the Department of Veterans
Affairs and the National Emergency Responder Credentialing System of
the Department of Homeland Security. The Secretary shall, if feasible,
integrate the verification network under this section with such VetPro
system and the National Emergency Responder Credentialing System.
``(g) Updating of Information.--The States that are participants in
the network established under subsection (a) shall, on at least a
quarterly basis, work with the Director to provide for the updating of
the information contained in such network.
``(h) Clarification.--Inclusion of a health professional in the
verification network established pursuant to this section shall not
constitute appointment of such individual as a Federal employee for any
purpose, either under section 2812(c) or otherwise. Such appointment
may only be made under section 2812 or 2813.
``(i) Health Care Provider Licenses.--The Secretary shall encourage
States to establish and implement mechanisms to waive the application
of licensing requirements applicable to health professionals, who are
seeking to provide medical services (within their scope of practice),
during a national, State, local, or tribal public health emergency upon
verification that such health professionals are licensed and in good
standing in another State and have not been disciplined by any State
health licensing or disciplinary board.''; and
(4) in subsection (k) (as so redesignated), by striking
``2006'' and inserting ``2011''.
SEC. 304. CORE EDUCATION AND TRAINING.
Section 319F of the Public Health Service Act (42 U.S.C. 247d-6) is
amended--
(1) by striking subsections (a) through (g) and inserting
the following;
``(a) All-Hazards Public Health and Medical Response Curricula and
Training.--
``(1) In general.--The Secretary, in collaboration with the
Secretary of Defense, and in consultation with relevant public
and private entities, shall develop core health and medical
response curricula and trainings by adapting applicable
existing curricula and training programs to improve responses
to public health emergencies.
``(2) Curriculum.--The public health and medical response
training program may include course work related to--
``(A) medical management of casualties, taking into
account the needs of at-risk individuals;
``(B) public health aspects of public health
emergencies;
``(C) mental health aspects of public health
emergencies;
``(D) national incident management, including
coordination among Federal, State, local, tribal,
international agencies, and other entities; and
``(E) protecting health care workers and health
care first responders from workplace exposures during a
public health emergency.
``(3) Peer review.--On a periodic basis, products prepared
as part of the program shall be rigorously tested and peer-
reviewed by experts in the relevant fields.
``(4) Credit.--The Secretary and the Secretary of Defense
shall--
``(A) take into account continuing professional
education requirements of public health and healthcare
professions; and
``(B) cooperate with State, local, and tribal
accrediting agencies and with professional associations
in arranging for students enrolled in the program to
obtain continuing professional education credit for
program courses.
``(5) Dissemination and training.--
``(A) In general.--The Secretary may provide for
the dissemination and teaching of the materials
described in paragraphs (1) and (2) by appropriate
means, as determined by the Secretary.
``(B) Certain entities.--The education and training
activities described in subparagraph (A) may be carried
out by Federal public health or medical entities,
appropriate educational entities, professional
organizations and societies, private accrediting
organizations, and other nonprofit institutions or
entities meeting criteria established by the Secretary.
``(C) Grants and contracts.--In carrying out this
subsection, the Secretary may carry out activities
directly or through the award of grants and contracts,
and may enter into interagency agreements with other
Federal agencies.
``(b) Expansion of Epidemic Intelligence Service Program.--The
Secretary may establish 20 officer positions in the Epidemic
Intelligence Service Program, in addition to the number of the officer
positions offered under such Program in 2006 for individuals who agree
to participate, for a period of not less than 2 years, in the Career
Epidemiology Field Officer program in a State, local, or tribal health
department that serves a health professional shortage area (as defined
under section 332(a)), a medically underserved population (as defined
under section 330(b)(3)), or a medically underserved area or area at
high risk of a public health emergency as designated by the Secretary.
``(c) Centers for Public Health Preparedness; Core Curricula and
Training.--
``(1) In general.--The Secretary may establish at
accredited schools of public health, Centers for Public Health
Preparedness (hereafter referred to in this section as the
`Centers').
``(2) Eligibility.--To be eligible to receive an award
under this subsection to establish a Center, an accredited
school of public health shall agree to conduct activities
consistent with the requirements of this subsection.
``(3) Core curricula.--The Secretary, in collaboration with
the Centers and other public or private entities shall
establish core curricula based on established competencies
leading to a 4-year bachelor's degree, a graduate degree, a
combined bachelor and master's degree, or a certificate
program, for use by each Center. The Secretary shall
disseminate such curricula to other accredited schools of
public health and other health professions schools determined
appropriate by the Secretary, for voluntary use by such
schools.
``(4) Core competency-based training program.--The
Secretary, in collaboration with the Centers and other public
or private entities shall facilitate the development of a
competency-based training program to train public health
practitioners. The Centers shall use such training program to
train public health practitioners. The Secretary shall
disseminate such training program to other accredited schools
of public health, and other health professions schools as
determined by the Secretary, for voluntary use by such schools.
``(5) Content of core curricula and training program.--The
Secretary shall ensure that the core curricula and training
program established pursuant to this subsection respond to the
needs of State, local, and tribal public health authorities and
integrate and emphasize essential public health security
capabilities consistent with section 2802(b)(2).
``(6) Academic-workforce communication.--As a condition of
receiving funding from the Secretary under this subsection, a
Center shall collaborate with a State, local, or tribal public
health department to--
``(A) define the public health preparedness and
response needs of the community involved;
``(B) assess the extent to which such needs are
fulfilled by existing preparedness and response
activities of such school or health department, and how
such activities may be improved;
``(C) prior to developing new materials or
trainings, evaluate and utilize relevant materials and
trainings developed by others Centers; and
``(D) evaluate community impact and the
effectiveness of any newly developed materials or
trainings.
``(7) Public health systems research.--In consultation with
relevant public and private entities, the Secretary shall
define the existing knowledge base for public health
preparedness and response systems, and establish a research
agenda based on Federal, State, local, and tribal public health
preparedness priorities. As a condition of receiving funding
from the Secretary under this subsection, a Center shall
conduct public health systems research that is consistent with
the agenda described under this paragraph.'';
(2) by redesignating subsection (h) as subsection (d);
(3) by inserting after subsection (d) (as so redesignated),
the following:
``(e) Authorization of Appropriations.--
``(1) Fiscal year 2007.--There are authorized to be
appropriated to carry out this section for fiscal year 2007--
``(A) to carry out subsection (a), $12,000,000, of
which $5,000,000 shall be used to carry out paragraphs
(1) through (4) of such subsection, and $7,000,000
shall be used to carry out paragraph (5) of such
subsection;
``(B) to carry out subsection (b), $3,000,000; and
``(C) to carry out subsection (c), $31,000,000, of
which $5,000,000 shall be used to carry out paragraphs
(3) through (5) of such subsection.
``(2) Subsequent fiscal years.--There are authorized to be
appropriated such sums as may be necessary to carry out this
section for fiscal year 2008 and each subsequent fiscal
year.''; and
(4) by striking subsections (i) and (j).
SEC. 305. PARTNERSHIPS FOR STATE AND REGIONAL HOSPITAL PREPAREDNESS TO
IMPROVE SURGE CAPACITY.
Section 319C-2 of the Public Health Service Act (42 U.S.C. 247d-3b)
is amended to read as follows:
``SEC. 319C-2. PARTNERSHIPS FOR STATE AND REGIONAL HOSPITAL
PREPAREDNESS TO IMPROVE SURGE CAPACITY.
``(a) In General.--The Secretary shall award competitive grants or
cooperative agreements to eligible entities to enable such entities to
improve surge capacity and enhance community and hospital preparedness
for public health emergencies.
``(b) Eligibility.--To be eligible for an award under subsection
(a), an entity shall--
``(1)(A) be a partnership consisting of--
``(i) one or more hospitals, at least one of which
shall be a designated trauma center, consistent with
section 1213(c);
``(ii) one or more other local health care
facilities, including clinics, health centers, primary
care facilities, mental health centers, mobile medical
assets, or nursing homes; and
``(iii)(I) one or more political subdivisions;
``(II) one or more States; or
``(III) one or more States and one or more
political subdivisions; and
``(B) prepare, in consultation with the Chief Executive
Officer and the lead health officials of the State, District,
or territory in which the hospital and health care facilities
described in subparagraph (A) are located, and submit to the
Secretary, an application at such time, in such manner, and
containing such information as the Secretary may require; or
``(2)(A) be an entity described in section 319C-1(b)(1);
and
``(B) submit an application at such time, in such manner,
and containing such information as the Secretary may require,
including the information or assurances required under section
319C-1(b)(2) and an assurance that the State will retain not
more than 25 percent of the funds awarded for administrative
and other support functions.
``(c) Use of Funds.--An award under subsection (a) shall be
expended for activities to achieve the preparedness goals described
under paragraphs (1), (3), (4), (5), and (6) of section 2802(b).
``(d) Preferences.--
``(1) Regional coordination.--In making awards under
subsection (a), the Secretary shall give preference to eligible
entities that submit applications that, in the determination of
the Secretary--
``(A) will enhance coordination--
``(i) among the entities described in
subsection (b)(1)(A)(i); and
``(ii) between such entities and the
entities described in subsection (b)(1)(A)(ii);
and
``(B) include, in the partnership described in
subsection (b)(1)(A), a significant percentage of the
hospitals and health care facilities within the
geographic area served by such partnership.
``(2) Other preferences.--In making awards under subsection
(a), the Secretary shall give preference to eligible entities
that, in the determination of the Secretary--
``(A) include one or more hospitals that are
participants in the National Disaster Medical System;
``(B) are located in a geographic area that faces a
high degree of risk, as determined by the Secretary in
consultation with the Secretary of Homeland Security;
or
``(C) have a significant need for funds to achieve
the medical preparedness goals described in section
2802(b)(2).
``(e) Consistency of Planned Activities.--The Secretary may not
award a cooperative agreement to an eligible entity described in
subsection (b)(1) unless the application submitted by the entity is
coordinated and consistent with an applicable State All-Hazards Public
Health Emergency Preparedness and Response Plan and relevant local
plans, as determined by the Secretary in consultation with relevant
State health officials.
``(f) Limitation on Awards.--A political subdivision shall not
participate in more than one partnership described in subsection
(b)(1).
``(g) Coordination With Local Response Capabilities.--An eligible
entity shall, to the extent practicable, ensure that activities carried
out under an award under subsection (a) are coordinated with activities
of relevant local Metropolitan Medical Response Systems, local Medical
Reserve Corps, the Cities Readiness Initiative, and local emergency
plans.
``(h) Maintenance of State Funding.--
``(1) In general.--An entity that receives an award under
this section shall maintain expenditures for health care
preparedness at a level that is not less than the average level
of such expenditures maintained by the entity for the preceding
2 year period.
``(2) Rule of construction.--Nothing in this section shall
be construed to prohibit the use of awards under this section
to pay salary and related expenses of public health and other
professionals employed by State, local, or tribal agencies who
are carrying out activities supported by such awards
(regardless of whether the primary assignment of such personnel
is to carry out such activities).
``(i) Performance and Accountability.--The requirements of section
319C-1(g) and (i) shall apply to entities receiving awards under this
section (regardless of whether such entities are described under
subsection (b)(1)(A) or (b)(2)(A)) in the same manner as such
requirements apply to entities under section 319C-1.
``(j) Authorization of Appropriations.--
``(1) In general.--For the purpose of carrying out this
section, there is authorized to be appropriated $474,000,000
for fiscal year 2007, and such sums as may be necessary for
each of fiscal years 2008 through 2011.
``(2) Reservation of amounts for partnerships.--Prior to
making awards described in paragraph (3), the Secretary may
reserve from the amount appropriated under paragraph (1) for a
fiscal year, an amount determined appropriate by the Secretary
for making awards to entities described in subsection
(b)(1)(A).
``(3) Awards to states and political subdivisions.--
``(A) In general.--From amounts appropriated for a
fiscal year under paragraph (1) and not reserved under
paragraph (2), the Secretary shall make awards to
entities described in subsection (b)(2)(A) that have
completed an application as described in subsection
(b)(2)(B).
``(B) Amount.--The Secretary shall determine the
amount of an award to each entity described in
subparagraph (A) in the same manner as such amounts are
determined under section 319C-1(h).''.
SEC. 306. ENHANCING THE ROLE OF THE DEPARTMENT OF VETERANS AFFAIRS.
(a) In General.--Section 8117 of title 38, United States Code, is
amended--
(1) in subsection (a)--
(A) in paragraph (1), by--
(i) striking ``chemical or biological
attack'' and inserting ``a public health
emergency (as defined in section 2801 of the
Public Health Service Act)'';
(ii) striking ``an attack'' and inserting
``such an emergency''; and
(iii) striking ``public health
emergencies'' and inserting ``such
emergencies''; and
(B) in paragraph (2)--
(i) in subparagraph (A), by striking ``;
and'' and inserting a semicolon;
(ii) in subparagraph (B), by striking the
period and inserting a semicolon; and
(iii) by adding at the end the following:
``(C) organizing, training, and equipping the staff
of such centers to support the activities carried out
by the Secretary of Health and Human Services under
section 2801 of the Public Health Service Act in the
event of a public health emergency and incidents
covered by the National Response Plan developed
pursuant to section 502(6) of the Homeland Security Act
of 2002, or any successor plan; and
``(D) providing medical logistical support to the
National Disaster Medical System and the Secretary of
Health and Human Services as necessary, on a
reimbursable basis, and in coordination with other
designated Federal agencies.'';
(2) in subsection (c), by striking ``a chemical or
biological attack or other terrorist attack.'' and inserting
``a public health emergency. The Secretary shall, through
existing medical procurement contracts, and on a reimbursable
basis, make available as necessary, medical supplies,
equipment, and pharmaceuticals in response to a public health
emergency in support of the Secretary of Health and Human
Services.'';
(3) in subsection (d), by--
(A) striking ``develop and'';
(B) striking ``biological, chemical, or
radiological attacks'' and inserting ``public health
emergencies''; and
(C) by inserting ``consistent with section 319F(a)
of the Public Health Service Act'' before the period;
and
(4) in subsection (e)--
(A) in paragraph (1), by striking ``2811(b)'' and
inserting ``2812''; and
(B) in paragraph (2)--
(i) by striking ``bioterrorism and other'';
and
(ii) by striking ``319F(a)'' and inserting
``319F''.
(b) Authorization of Appropriations.--Section 8117 of title 38,
United States Code, is amended by adding at the end the following:
``(g) Authorization of Appropriations.--There are authorized to be
appropriated, such sums as may be necessary to carry out this section
for each of fiscal years 2007 through 2011.''.
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