[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.