[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1532 Reported in House (RH)]
Union Calendar No. 569
110th CONGRESS
2d Session
H. R. 1532
[Report No. 110-873]
To amend the Public Health Service Act with respect to making progress
toward the goal of eliminating tuberculosis, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
March 15, 2007
Mr. Gene Green of Texas (for himself, Mrs. Wilson of New Mexico, and
Ms. Baldwin) introduced the following bill; which was referred to the
Committee on Energy and Commerce
September 23, 2008
Additional sponsors: Mr. Engel, Mr. Holt, Mr. Moran of Virginia, Mr.
Waxman, Ms. McCollum of Minnesota, Mrs. Capps, Mr. Filner, Mr. Rahall,
Mrs. Davis of California, Ms. Moore of Wisconsin, Ms. Zoe Lofgren of
California, Mr. Rush, Mr. Smith of Washington, Mr. Allen, Mr. George
Miller of California, Mr. Hinojosa, Mr. Platts, Mr. Grijalva, Mr.
Sires, Mr. Reyes, Mr. Etheridge, Mr. Spratt, Mr. Larsen of Washington,
Mr. Hastings of Florida, Mr. Honda, Mrs. Lowey, Mr. Marshall, Mr. Young
of Alaska, Mr. McDermott, Mr. Frank of Massachusetts, Mrs. Gillibrand,
Mr. Kucinich, Mr. Ortiz, Mr. Berman, Ms. Lee, Mr. Doggett, Mr.
Gonzalez, Mr. Serrano, Ms. Schakowsky, Mr. Payne, Mr. McNulty, Mr.
McNerney, Mr. Carney, Ms. Slaughter, Ms. Eshoo, Mr. Stark, Mr. Brady of
Texas, Mr. Carson, Mr. Gordon of Tennessee, Mr. Welch of Vermont, Mr.
Bilbray, Mrs. Tauscher, Ms. DeGette, Mr. Lampson, Mr. Cuellar, and Mr.
Rodriguez
September 23, 2008
Reported with an amendment, committed to the Committee of the Whole
House on the State of the Union, and ordered to be printed
[Strike out all after the enacting clause and insert the part printed
in italic]
[For text of introduced bill, see copy of bill as introduced on March
15, 2007]
_______________________________________________________________________
A BILL
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
$300,000,000 for fiscal year 2009, $315,000,000 for
fiscal year 2010, $330,750,000 for fiscal year 2011,
$347,287,500 for fiscal year 2012, and $364,651,900 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.''.
Union Calendar No. 569
110th CONGRESS
2d Session
H. R. 1532
[Report No. 110-873]
_______________________________________________________________________
A BILL
To amend the Public Health Service Act with respect to making progress
toward the goal of eliminating tuberculosis, and for other purposes.
_______________________________________________________________________
September 23, 2008
Reported with an amendment, committed to the Committee of the Whole
House on the State of the Union, and ordered to be printed