[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1532 Enrolled Bill (ENR)]
H.R.1532
One Hundred Tenth Congress
of the
United States of America
AT THE SECOND SESSION
Begun and held at the City of Washington on Thursday,
the third day of January, two thousand and eight
An Act
To amend the Public Health Service Act with respect to making progress
toward the goal of eliminating tuberculosis, 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 ``Comprehensive
Tuberculosis Elimination Act of 2008''.
(b) Table of Contents.--The table of contents for this Act is as
follows:
Sec. 1. Short title; table of contents.
TITLE I--DEPARTMENT OF HEALTH AND HUMAN SERVICES IN COORDINATION WITH
THE CENTERS FOR DISEASE CONTROL AND PREVENTION AND OTHER APPROPRIATE
AGENCIES
Subtitle A--National Strategy for Combating and Eliminating Tuberculosis
Sec. 101. National strategy.
Subtitle B--Interagency Collaboration
Sec. 111. Advisory Council for Elimination of Tuberculosis and the
Federal Tuberculosis Task Force .
Subtitle C--Evaluation of Public Health Authorities
Sec. 121. Evaluation of public health authorities.
Subtitle D--Authorization of Appropriations
Sec. 131. Authorizations of appropriations.
TITLE II--NATIONAL INSTITUTES OF HEALTH
Sec. 201. Research and development concerning tuberculosis.
TITLE I--DEPARTMENT OF HEALTH AND HUMAN SERVICES IN COORDINATION WITH
THE CENTERS FOR DISEASE CONTROL AND PREVENTION AND OTHER APPROPRIATE
AGENCIES
Subtitle A--National Strategy for Combating and Eliminating
Tuberculosis
SEC. 101. NATIONAL STRATEGY.
Section 317E of the Public Health Service Act (42 U.S.C. 247b-6) is
amended--
(1) by striking the heading for the section and inserting the
following: ``national strategy for combating and eliminating
tuberculosis'';
(2) by amending subsection (b) to read as follows:
``(b) Research and Development; Demonstration Projects; Education
and Training.--With respect to the prevention, treatment, control, and
elimination of tuberculosis, the Secretary may, directly or through
grants to public or nonprofit private entities, carry out the
following:
``(1) Research, with priority given to research and development
concerning latent tuberculosis infection, strains of tuberculosis
resistant to drugs, and research concerning cases of tuberculosis
that affect certain populations at risk for tuberculosis.
``(2) Research and development and related activities to
develop new tools for the elimination of tuberculosis, including
drugs, diagnostics, vaccines, and public health interventions, such
as directly observed therapy and non-pharmaceutical intervention,
and methods to enhance detection and response to outbreaks of
tuberculosis, including multidrug resistant tuberculosis. The
Secretary is encouraged to give priority to programmatically
relevant research so that new tools can be utilized in public
health practice.
``(3) Demonstration projects for--
``(A) the development of regional capabilities to prevent,
control, and eliminate tuberculosis and prevent multidrug
resistant and extensively drug resistant strains of
tuberculosis;
``(B) the intensification of efforts to reduce health
disparities in the incidence of tuberculosis;
``(C) the intensification of efforts to control
tuberculosis along the United States-Mexico border and among
United States-Mexico binational populations, including through
expansion of the scope and number of programs that--
``(i) detect and treat binational cases of
tuberculosis; and
``(ii) treat high-risk cases of tuberculosis referred
from Mexican health departments;
``(D) the intensification of efforts to prevent, detect,
and treat tuberculosis among foreign-born persons who are in
the United States;
``(E) the intensification of efforts to prevent, detect,
and treat tuberculosis among populations and settings
documented as having a high risk for tuberculosis; and
``(F) tuberculosis detection, control, and prevention.
``(4) Public information and education activities.
``(5) Education, training, clinical skills improvement
activities, and workplace exposure prevention for health
professionals, including allied health personnel and emergency
response employees.
``(6) Support of Centers to carry out activities under
paragraphs (1) through (4).
``(7) Collaboration with international organizations and
foreign countries in carrying out such activities.
``(8) Develop, enhance, and expand information technologies
that support tuberculosis control including surveillance and
database management systems with cross-jurisdictional capabilities,
which shall conform to the standards and implementation
specifications for such information technologies as recommended by
the Secretary.''; and
(3) in subsection (d), by adding at the end the following:
``(3) Determination of amount of nonfederal contributions.--
``(A) Priority.--In awarding grants under subsection (a) or
(b), the Secretary shall give highest priority to an applicant
that provides assurances that the applicant will contribute
non-Federal funds to carry out activities under this section,
which may be provided directly or through donations from public
or private entities and may be in cash or in kind, including
equipment or services.
``(B) Federal amounts not to be included as
contributions.--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 non-Federal contributions as described in
subparagraph (A).''.
Subtitle B--Interagency Collaboration
SEC. 111. ADVISORY COUNCIL FOR ELIMINATION OF TUBERCULOSIS AND THE
FEDERAL TUBERCULOSIS TASK FORCE.
(a) In General.--Section 317E(f) of the Public Health Service Act
(42 U.S.C. 247b-6(f)) is amended--
(1) by redesignating paragraph (5) as paragraph (6); and
(2) by striking paragraphs (2) through (4), and inserting the
following:
``(2) Duties.--The Council shall provide advice and
recommendations regarding the elimination of tuberculosis to the
Secretary. In addition, the Council shall, with respect to
eliminating such disease, provide to the Secretary and other
appropriate Federal officials advice on--
``(A) coordinating the activities of the Department of
Health and Human Services and other Federal agencies that
relate to the disease, including activities under subsection
(b);
``(B) responding rapidly and effectively to emerging issues
in tuberculosis; and
``(C) efficiently utilizing the Federal resources involved.
``(3) Comprehensive plan.--
``(A) In general.--In carrying out paragraph (2), the
Council shall make or update recommendations on the
development, revision, and implementation of a comprehensive
plan to eliminate tuberculosis in the United States.
``(B) Consultation.--In carrying out subparagraph (A), the
Council may consult with appropriate public and private
entities, which may, subject to the direction or discretion of
the Secretary, include--
``(i) individuals who are scientists, physicians,
laboratorians, and other health professionals, who are not
officers or employees of the Federal Government and who
represent the disciplines relevant to tuberculosis
elimination;
``(ii) members of public-private partnerships or
private entities established to address the elimination of
tuberculosis;
``(iii) members of national and international
nongovernmental organizations whose purpose is to eliminate
tuberculosis;
``(iv) members from the general public who are
knowledgeable with respect to tuberculosis elimination
including individuals who have or have had tuberculosis;
and
``(v) scientists, physicians, laboratorians, and other
health professionals who reside in a foreign country with a
substantial incidence or prevalence of tuberculosis, and
who represent the specialties and disciplines relevant to
the research under consideration.
``(C) Certain components of plan.--In carrying out
subparagraph (A), the Council shall, subject to the direction
or discretion of the Secretary--
``(i) consider recommendations for the involvement of
the United States in continuing global and cross-border
tuberculosis control activities in countries where a high
incidence of tuberculosis directly affects the United
States; and
``(ii) review the extent to which progress has been
made toward eliminating tuberculosis.
``(4) Biennial report.--
``(A) In general.--The Council shall submit a biennial
report to the Secretary, as determined necessary by the
Secretary, on the activities carried under this section. Each
such report shall include the opinion of the Council on the
extent to which its recommendations regarding the elimination
of tuberculosis have been implemented, including with respect
to--
``(i) activities under subsection (b); and
``(ii) the national plan referred to in paragraph (3).
``(B) Public.--The Secretary shall make a report submitted
under subparagraph (A) public.
``(5) Composition.--The Council shall be composed of--
``(A) ex officio representatives from the Centers for
Disease Control and Prevention, the National Institutes of
Health, the United States Agency for International Development,
the Agency for Healthcare Research and Quality, the Health
Resources and Services Administration, the United States-Mexico
Border Health Commission, and other Federal departments and
agencies that carry out significant activities related to
tuberculosis;
``(B) State and local tuberculosis control and public
health officials;
``(C) individuals who are scientists, physicians,
laboratorians, and other health professionals who represent
disciplines relevant to tuberculosis elimination; and
``(D) members of national and international nongovernmental
organizations established to address the elimination of
tuberculosis.''.
(b) Rule of Construction Regarding Current Membership.--With
respect to the advisory council under section 317E(f) of the Public
Health Service Act, the amendments made by subsection (a) may not be
construed as terminating the membership on such council of any
individual serving as such a member as of the day before the date of
the enactment of this Act.
(c) Federal Tuberculosis Task Force.--Section 317E of the Public
Health Service Act (42 U.S.C. 247b-6) is amended--
(1) by redesignating subsection (g) as subsection (h); and
(2) by inserting after subsection (f) the following subsection:
``(g) Federal Tuberculosis Task Force.--
``(1) Duties.--The Federal Tuberculosis Task Force (in this
subsection referred to as the `Task Force') shall provide to the
Secretary and other appropriate Federal officials advice on
research into new tools under subsection (b)(2), including advice
regarding the efficient utilization of the Federal resources
involved.
``(2) Comprehensive plan for new tools development.--In
carrying out paragraph (1), the Task Force shall make
recommendations on the development of a comprehensive plan for the
creation of new tools for the elimination of tuberculosis,
including drugs, diagnostics, and vaccines.
``(3) Consultation.--In developing the comprehensive plan under
paragraph (1), the Task Force shall consult with external parties
including representatives from groups such as--
``(A) scientists, physicians, laboratorians, and other
health professionals who represent the specialties and
disciplines relevant to the research under consideration;
``(B) members from public-private partnerships, private
entities, or foundations (or both) engaged in activities
relevant to research under consideration;
``(C) members of national and international nongovernmental
organizations established to address tuberculosis elimination;
``(D) members from the general public who are knowledgeable
with respect to tuberculosis including individuals who have or
have had tuberculosis; and
``(E) scientists, physicians, laboratorians, and other
health professionals who reside in a foreign country with a
substantial incidence or prevalence of tuberculosis, and who
represent the specialties and disciplines relevant to the
research under consideration.''.
Subtitle C--Evaluation of Public Health Authorities
SEC. 121. EVALUATION OF PUBLIC HEALTH AUTHORITIES.
(a) In General.--Not later than 180 days after the date of
enactment of the Comprehensive Tuberculosis Elimination Act of 2008,
the Secretary of Health and Human Services shall prepare and submit to
the appropriate committees of Congress a report that evaluates and
provides recommendations on changes needed to Federal and State public
health authorities to address current disease containment challenges
such as isolation and quarantine.
(b) Contents of Evaluation.--The report described in subsection (a)
shall include--
(1) an evaluation of the effectiveness of current policies to
detain patients with active tuberculosis;
(2) an evaluation of whether Federal laws should be
strengthened to expressly address the movement of individuals with
active tuberculosis; and
(3) specific legislative recommendations for changes to Federal
laws, if any.
(c) Update of Quarantine Regulations.--Not later than 240 days
after the date of enactment of this Act, the Secretary of Health and
Human Services shall promulgate regulations to update the current
interstate and foreign quarantine regulations found in parts 70 and 71
of title 42, Code of Federal Regulations.
Subtitle D--Authorization of Appropriations
SEC. 131. AUTHORIZATIONS OF APPROPRIATIONS.
Section 317E of the Public Health Service Act, as amended by
section 111(c) of this Act, is amended by striking subsection (h) and
inserting the following:
``(h) Authorization of Appropriations.--
``(1) General program.--
``(A) In general.--For the purpose of carrying out this
section, there are authorized to be appropriated $200,000,000
for fiscal year 2009, $210,000,000 for fiscal year 2010,
$220,500,000 for fiscal year 2011, $231,525,000 for fiscal year
2012, and $243,101,250 for fiscal year 2013.
``(B) Reservation for emergency grants.--Of the amounts
appropriated under subparagraph (A) for a fiscal year, the
Secretary may reserve not more than 25 percent for emergency
grants under subsection (a) for any geographic area, State,
political subdivision of a State, or other public entity in
which there is, relative to other areas, a substantial number
of cases of tuberculosis, multidrug resistant tuberculosis, or
extensively drug resistant tuberculosis or a substantial rate
of increase in such cases.
``(C) Priority.--In allocating amounts appropriated under
subparagraph (A), the Secretary shall give priority to
allocating such amounts for grants under subsection (a).
``(D) Allocation of funds.--
``(i) Requirement of formula.--Of the amounts
appropriated under subparagraph (A), not reserved under
subparagraph (B), and allocated by the Secretary for grants
under subsection (a), the Secretary shall distribute a
portion of such amounts to grantees under subsection (a) on
the basis of a formula.
``(ii) Relevant factors.--The formula developed by the
Secretary under clause (i) shall take into account the
level of tuberculosis morbidity and case complexity in the
respective geographic area and may consider other factors
relevant to tuberculosis in such area.
``(iii) No change to formula required.--This
subparagraph does not require the Secretary to modify the
formula that was used by the Secretary to distribute funds
to grantees under subsection (a) for fiscal year 2009.
``(2) Limitation.--The authorization of appropriations
established in paragraph (1) for a fiscal year is effective only if
the amount appropriated under such paragraph for such year equals
or exceeds the amount appropriated to carry out this section for
fiscal year 2009.''.
TITLE II--NATIONAL INSTITUTES OF HEALTH
SEC. 201. RESEARCH AND DEVELOPMENT CONCERNING TUBERCULOSIS.
Subpart 2 of part C of title IV of the Public Health Service Act
(42 U.S.C. 285b et seq.) is amended by inserting after section 424B the
following section:
``SEC. 424C. TUBERCULOSIS.
``(a) In General.--The Director of the National Institutes of
Health may expand, intensify, and coordinate research and development
and related activities of the Institutes with respect to tuberculosis
including activities toward the goal of eliminating such disease.
``(b) Certain Activities.--Activities under subsection (a) may
include--
``(1) enhancing basic and clinical research on tuberculosis,
including drug resistant tuberculosis;
``(2) expanding research on the relationship between such
disease and the human immunodeficiency virus; and
``(3) developing new tools for the elimination of tuberculosis,
including public health interventions and methods to enhance
detection and response to outbreaks of tuberculosis, including
multidrug resistant tuberculosis.''.
Speaker of the House of Representatives.
Vice President of the United States and
President of the Senate.