[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[S. 2851 Introduced in Senate (IS)]

<DOC>






115th CONGRESS
  2d Session
                                S. 2851

  To improve regional health care emergency preparedness and response 
                    systems, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                              May 15, 2018

  Mr. Casey (for himself and Mr. Burr) introduced the following bill; 
     which was read twice and referred to the Committee on Health, 
                     Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
  To improve regional health care emergency preparedness and response 
                    systems, 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.

    This Act may be cited as the ``Regional Health Care Emergency 
Preparedness and Response Systems Act''.

SEC. 2. REGIONAL HEALTH CARE EMERGENCY PREPAREDNESS AND RESPONSE 
              SYSTEMS.

    (a) In General.--Part B of title III of the Public Health Service 
Act (42 U.S.C. 243 et seq.) is amended by inserting after section 319C-
2 the following:

``SEC. 319C-3. GUIDELINES FOR REGIONAL HEALTH CARE EMERGENCY 
              PREPAREDNESS AND RESPONSE SYSTEMS.

    ``(a) Purpose.--It is the purpose of this section to identify and 
provide guidelines for regional systems of hospitals, health care 
facilities, and other public and private sector entities, with varying 
levels of capability to treat patients and increase medical surge 
capacity during, and in advance of, a public health emergency, 
including threats posed by one or more chemical, biological, 
radiological, and nuclear agents, including emerging infectious 
diseases.
    ``(b) Guidelines.--The Assistant Secretary for Preparedness and 
Response, in consultation with the Director of the Centers for Disease 
Control and Prevention, the Administrator of the Centers for Medicare & 
Medicaid Services, the Administrator of the Health Resources and 
Services Administration, the Commissioner of Food and Drugs, the 
Assistant Secretary for Mental Health and Substance Use, the Assistant 
Secretary of Labor for Occupational Safety and Health, the Secretary of 
Veterans Affairs, heads of such other Federal agencies as the Secretary 
determines to be appropriate, and State, local, tribal, and territorial 
public health officials, shall, not later than 2 years after the date 
of enactment of this section--
            ``(1) identify and develop a set of guidelines relating to 
        practices and protocols for all-hazards public health emergency 
        preparedness and response for hospitals and health care 
        facilities to provide appropriate patient care during, in 
        advance of, or immediately following, a public health 
        emergency, resulting from one or more chemical, biological, 
        radiological, or nuclear agents, including emerging infectious 
        diseases (which may include existing practices, such as trauma 
        care and medical surge capacity and capabilities), with respect 
        to--
                    ``(A) a regional approach to identifying hospitals 
                and health care facilities based on varying 
                capabilities and capacity to treat patients affected by 
                such emergency, including--
                            ``(i) the manner in which the system will 
                        coordinate with and integrate the partnerships 
                        established under section 319C-2(b); and
                            ``(ii) informing and educating appropriate 
                        first responders and health care supply chain 
                        partners of the regional emergency preparedness 
                        and response capabilities and medical surge 
                        capacity of such hospitals and health care 
                        facilities in the community;
                    ``(B) physical and technological infrastructure, 
                laboratory capacity, staffing, blood supply, and other 
                supply chain needs, taking into account resiliency, 
                geographic considerations, and rural considerations;
                    ``(C) protocols or best practices for the safety 
                and personal protection of workers who handle human 
                remains and health care workers (including with respect 
                to protective equipment and supplies, waste management 
                processes, and decontamination), sharing of specialized 
                experience among the health care workforce, behavioral 
                health, psychological resilience, and training of the 
                workforce, as applicable;
                    ``(D) in a manner that allows for disease 
                containment (within the meaning of section 
                2802(b)(2)(B)), coordinated medical triage, treatment, 
                and transportation of patients, based on patient 
                medical need (including patients in rural areas), to 
                the appropriate hospitals or health care facilities 
                within the regional system or, as applicable and 
                appropriate, between systems in different States or 
                regions; and
                    ``(E) the needs of children and other at-risk 
                individuals;
            ``(2) make such guidelines available on the internet 
        website of the Department of Health and Human Services in a 
        manner that does not compromise national security; and
            ``(3) update such guidelines as appropriate, including 
        based on input received pursuant to subsections (c), (e), and 
        (f), to address new and emerging public health threats.
    ``(c) Considerations.--In identifying, developing, and updating 
guidelines under subsection (b), the Assistant Secretary for 
Preparedness and Response shall--
            ``(1) include input from hospitals and health care 
        facilities, including health care coalitions under section 
        319C-2, State, local, tribal, and territorial public health 
        departments, and health care or subject matter experts, 
        including experts with relevant expertise in chemical, 
        biological, radiological, or nuclear threats, and emerging 
        infectious disease as the Assistant Secretary determines 
        appropriate, to meet the goals under section 2802(b)(3);
            ``(2) consult and engage with appropriate health care 
        providers and professionals, including physicians, nurses, 
        first responders, health care facilities (including hospitals, 
        primary care clinics, community health centers, mental health 
        facilities, ambulatory care facilities, and dental health 
        facilities), pharmacies, emergency medical providers, trauma 
        care providers, environmental health agencies, public health 
        laboratories, poison control centers, blood banks, and other 
        experts that the Assistant Secretary determines appropriate, to 
        meet the goals under section 2802(b)(3);
            ``(3) consider feedback related to financial implications 
        for hospitals, health care facilities, public health agencies, 
        laboratories, and other entities engaged in regional 
        preparedness planning to implement and follow such guidelines, 
        as applicable; and
            ``(4) consider financial requirements and potential 
        incentives for entities to prepare for, and respond to, public 
        health emergencies as part of the regional health care 
        emergency preparedness and response system.
    ``(d) Technical Assistance.--The Assistant Secretary for 
Preparedness and Response, in consultation with the Director of the 
Centers for Disease Control and Prevention and the Assistant Secretary 
of Labor for Occupational Safety and Health, may provide technical 
assistance and consultation towards meeting the guidelines described in 
subsection (b).
    ``(e) Demonstration Project for Regional Health Care Preparedness 
and Response Systems.--
            ``(1) In general.--The Assistant Secretary for Preparedness 
        and Response may establish a demonstration project pursuant to 
        the development and implementation of guidelines under 
        subsection (b) to improve medical surge capacity for all 
        hazards, build and integrate regional medical response 
        capabilities, improve specialty care expertise for all-hazards 
        response, and coordinate medical preparedness and response 
        across State, local, tribal, territorial, and regional 
        jurisdictions.
            ``(2) Sunset.--The authority under this subsection shall 
        expire on September 30, 2023.
    ``(f) GAO Report to Congress.--
            ``(1) Report.--Not later than 3 years after the date of 
        enactment of this section, the Comptroller General of the 
        United States (referred to in this subsection as the 
        `Comptroller General') shall submit to the Committee on Health, 
        Education, Labor, and Pensions and the Committee on Finance of 
        the Senate and the Committee on Energy and Commerce and the 
        Committee on Ways and Means of the House of Representatives, a 
        report on the extent to which hospitals and health care 
        facilities have implemented the recommended guidelines under 
        subsection (b), including an analysis and evaluation of any 
        challenges hospitals or health care facilities experienced in 
        implementing such guidelines.
            ``(2) Content.--The Comptroller General shall include in 
        the report under paragraph (1)--
                    ``(A) data on the preparedness and response 
                capabilities that have been informed by the guidelines 
                under subsection (b) to improve regional emergency 
                health care preparedness and response capability, 
                including hospital and health care facility capacity 
                and medical surge capabilities to prepare for, and 
                respond to, public health emergencies; and
                    ``(B) recommendations to reduce gaps in incentives 
                for regional health partners, including hospitals and 
                health care facilities to improve capacity and medical 
                surge capabilities to prepare for, and respond to, 
                public health emergencies, consistent with subsection 
                (a), which may include consideration of facilities 
                participating in programs under section 319C-2, 
                programs under the Centers for Medicare & Medicaid 
                Services (including innovative health care delivery and 
                payment models), and input from private sector 
                financial institutions.
            ``(3) Consultation.--In carrying out paragraphs (1) and 
        (2), the Comptroller General shall consult with the heads of 
        appropriate Federal agencies, including--
                    ``(A) the Assistant Secretary for Preparedness and 
                Response;
                    ``(B) the Director of the Centers for Disease 
                Control and Prevention;
                    ``(C) the Administrator of the Centers for Medicare 
                & Medicaid Services;
                    ``(D) the Assistant Secretary for Mental Health and 
                Substance Use;
                    ``(E) the Assistant Secretary of Labor for 
                Occupational Safety and Health;
                    ``(F) the Secretary of Veterans Affairs; and
                    ``(G) the heads of such other Federal agencies as 
                the Secretary determines appropriate.''.
    (b) Annual Reports.--Section 319C-2(i)(1) of the Public Health 
Service Act (42 U.S.C. 247d-3b(i)(1)) is amended by inserting after the 
first sentence the following ``The reports submitted under this 
paragraph shall also include progress towards the implementation of 
section 319C-3.''.
    (c) National Health Security Strategy Incorporation of Regionalized 
Emergency Preparedness and Response.--Section 2802(b)(3) of the Public 
Health Service Act (42 U.S.C. 300hh-1(b)(3)) is amended--
            (1) in the matter preceding subparagraph (A), by striking 
        ``including mental health'' and inserting ``including 
        pharmacies, mental health facilities,''; and
            (2) by amending subparagraph (G) to read as follows:
                    ``(G) Optimizing a coordinated and flexible 
                approach to the emergency response and medical surge 
                capacity of hospitals, other health care facilities, 
                critical care, trauma care (which may include trauma 
                centers), and emergency medical systems, which may 
                include the implementation of guidelines for regional 
                health care emergency preparedness and response systems 
                under section 319C-3.''.
    (d) Improving State and Local Public Health Security.--
            (1) State and local security.--Section 319C-1(e) of the 
        Public Health Service Act (42 U.S.C. 247d-3a(e)) is amended by 
        striking ``, and local emergency plans.'' and inserting ``, 
        local emergency plans, and any regional health care emergency 
        preparedness and response system established pursuant to the 
        applicable guidelines under section 319C-3.''.
            (2) Partnerships.--Section 319C-2(d)(1)(A) of the Public 
        Health Service Act (42 U.S.C. 247d-3b(d)(1)(A)) is amended--
                    (A) in clause (i), by striking ``; and'' and 
                inserting ``;'';
                    (B) by redesignating clause (ii) as clause (iii); 
                and
                    (C) inserting after clause (i), the following:
                            ``(ii) among one or more facilities in a 
                        regional health care emergency system under 
                        section 319C-3; and''.
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