[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 3436 Introduced in Senate (IS)]

<DOC>






116th CONGRESS
  2d Session
                                S. 3436

   To establish grant programs to improve the health of border area 
residents and for all hazards preparedness in the border area including 
bioterrorism, infectious disease, and noncommunicable emerging threats, 
                        and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             March 11, 2020

Mr. Udall (for himself, Mr. Heinrich, Mrs. Gillibrand, Ms. McSally, Ms. 
 Sinema, and Mr. Cornyn) introduced the following bill; which was read 
        twice and referred to the Committee on Foreign Relations

_______________________________________________________________________

                                 A BILL


 
   To establish grant programs to improve the health of border area 
residents and for all hazards preparedness in the border area including 
bioterrorism, infectious disease, and noncommunicable emerging threats, 
                        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 ``Border Health Security Act of 
2020''.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) The United States-Mexico border is an interdependent 
        and dynamic region of approximately 15,000,000 residents and 
        millions of border crossings each year, with significant and 
        unique public health challenges.
            (2) These challenges include low rates of health insurance 
        coverage, poor access to health care services, lack of 
        education or access to information, poverty, and high rates of 
        dangerous diseases, such as tuberculosis and West Nile virus, 
        as well as other noncommunicable diseases such as 
        cardiovascular disease, asthma, diabetes, and obesity.
            (3) As the 2020 dengue outbreak in Mexico and many parts of 
        Latin America illustrates, diseases do not respect 
        international boundaries, and a strong public health effort at 
        and along the borders is crucial to not only protect and 
        improve the health of Americans but also to help secure the 
        country against threats to biosecurity and other emerging 
        threats.
            (4) For 20 years, the United States-Mexico Border Health 
        Commission has served as a crucial binational institution to 
        address these unique and truly cross-border health issues.
            (5) In 2016, 66 percent of Canadians lived within 100 miles 
        of the United States border. The 2003 epidemic of severe acute 
        respiratory syndrome caused more than 250 illnesses in the 
        Greater Toronto Area, just 80 miles from New York.
            (6) The recent coronavirus outbreak has highlighted the 
        need for continued coordination of resources, effective 
        communication, and information sharing between countries to 
        address emerging public health crises.

SEC. 3. UNITED STATES-MEXICO BORDER HEALTH COMMISSION ACT AMENDMENTS.

    The United States-Mexico Border Health Commission Act (22 U.S.C. 
290n et seq.) is amended--
            (1) in section 3--
                    (A) in paragraph (1), by striking ``; and'' and 
                inserting ``;'';
                    (B) in paragraph (2)(B), by striking the period and 
                inserting a semicolon; and
                    (C) by adding at the end the following:
            ``(3) to evaluate the Commission's progress in carrying out 
        the duties described in paragraphs (1) and (2) and report on 
        such progress and make recommendations, as appropriate, to the 
        Secretary of Health and Human Services and Congress regarding 
        such duties;
            ``(4) to cooperate with the Canada-United States Pan Border 
        Public Health Preparedness Council (referred to in this Act as 
        the `Council'), as appropriate; and
            ``(5) to serve as an independent and objective body to both 
        recommend and implement initiatives that solve border health 
        issues.'';
            (2) in section 5(b), by striking ``should be the leader'' 
        and inserting ``shall be the Chair'';
            (3) by redesignating section 8 as section 12;
            (4) by striking section 7 and inserting the following:

``SEC. 7. BORDER HEALTH GRANTS.

    ``(a) Eligible Entity Defined.--In this section, the term `eligible 
entity' means a State, public institution of higher education, local 
government, Indian Tribe, Tribal organization, urban Indian 
organization, nonprofit health organization, trauma center, critical 
access hospital or other hospital that serves rural or other vulnerable 
communities and populations, faith-based entity, or community health 
center receiving assistance under section 330 of the Public Health 
Service Act (42 U.S.C. 254b), that is located in the United States-
Mexico border area or the United States-Canada border area.
    ``(b) Authorization.--From amounts appropriated under section 11, 
the Secretary, in consultation with members of the Commission and 
Council and in coordination with the Office of Global Affairs, shall 
award grants to eligible entities to improve the health of residents of 
the United States-Mexico and United States-Canada border areas with 
appropriate priority given to grants that address recommendations 
outlined by the strategic plan and operational work plan of the 
Commission and the Council under section 9.
    ``(c) Application.--An eligible entity that desires a grant under 
subsection (b) shall submit an application to the Secretary at such 
time, in such manner, and containing such information as the Secretary 
may require.
    ``(d) Use of Funds.--An eligible entity that receives a grant under 
subsection (b) shall use the grant funds for any of the following:
            ``(1) Programs relating to any one or more of the 
        following:
                    ``(A) Maternal and child health.
                    ``(B) Primary care and preventative health.
                    ``(C) Infectious disease testing, monitoring, and 
                surveillance.
                    ``(D) Public health and public health 
                infrastructure.
                    ``(E) Health promotion, health literacy, and health 
                education.
                    ``(F) Oral health.
                    ``(G) Behavioral and mental health.
                    ``(H) Substance abuse prevention and harm 
                reduction.
                    ``(I) Health conditions that have a high prevalence 
                in the United States-Mexico border area or United 
                States-Canada border area.
                    ``(J) Medical and health services research.
                    ``(K) Workforce training and development.
                    ``(L) Community health workers and promotoras.
                    ``(M) Health care infrastructure problems in the 
                United States-Mexico border area or United States-
                Canada border area (including planning and construction 
                grants).
                    ``(N) Health disparities in the United States-
                Mexico border area or United States-Canada border area.
                    ``(O) Environmental health.
                    ``(P) Bioterrorism and zoonosis.
                    ``(Q) Outreach and enrollment services with respect 
                to Federal programs (including programs authorized 
                under titles XIX and XXI of the Social Security Act (42 
                U.S.C. 1396 et seq., 42 U.S.C. 1397aa et seq.)).
                    ``(R) Trauma care.
                    ``(S) Health research with an emphasis on 
                infectious disease, such as measles, and pressing 
                issues related to noncommunicable diseases.
                    ``(T) Epidemiology and health research.
                    ``(U) Cross-border health surveillance coordinated 
                with Mexican Health Authorities or Canadian Health 
                Authorities.
                    ``(V) Chronic diseases, such as diabetes and 
                obesity, particularly childhood obesity.
                    ``(W) Community-based participatory research on 
                border health issues.
                    ``(X) Domestic violence and violence prevention.
                    ``(Y) Cross-border public health preparedness.
            ``(2) Other programs as the Secretary determines 
        appropriate.
    ``(e) Supplement, Not Supplant.--Amounts provided to an eligible 
entity awarded a grant under subsection (b) shall be used to supplement 
and not supplant other funds available to the eligible entity to carry 
out the activities described in subsection (d).

``SEC. 8. GRANTS FOR EARLY WARNING INFECTIOUS DISEASE SURVEILLANCE IN 
              THE BORDER AREA.

    ``(a) Eligible Entity Defined.--In this section, the term `eligible 
entity' means a State, local government, Indian Tribe, Tribal 
organization, urban Indian organization, trauma center, regional trauma 
center coordinating entity, or public health entity.
    ``(b) Authorization.--From funds appropriated under section 11, the 
Secretary shall award grants for Early Warning Infectious Disease 
Surveillance to eligible entities for infectious disease surveillance 
activities in the United States-Mexico border area or United States-
Canada border area.
    ``(c) Application.--An eligible entity that desires a grant under 
this section shall submit an application to the Secretary at such time, 
in such manner, and containing such information as the Secretary may 
require.
    ``(d) Uses of Funds.--An eligible entity that receives a grant 
under subsection (b) shall use the grant funds, in coordination with 
State and local all hazards programs, to--
            ``(1) develop and implement infectious disease surveillance 
        plans and networks and public health emergency and readiness 
        assessments and preparedness plans, and purchase items 
        necessary for such plans;
            ``(2) coordinate infectious disease surveillance planning 
        and interjurisdictional risk assessments in the region with 
        appropriate United States-based agencies and organizations and 
        appropriate authorities in Mexico or Canada;
            ``(3) improve infrastructure, including surge capacity, 
        syndromic surveillance, and isolation and decontamination 
        capacity, and policy preparedness, including for mutual 
        assistance and for the sharing of information and resources;
            ``(4) improve laboratory capacity, in order to maintain and 
        enhance capability and capacity to detect potential infectious 
        disease, whether naturally occurring or the result of 
        terrorism;
            ``(5) create and maintain a health alert network, including 
        risk communication and information dissemination that is 
        culturally competent and takes into account the needs of at-
        risk populations, including individuals with disabilities;
            ``(6) educate and train clinicians, epidemiologists, 
        laboratories, and emergency management personnel;
            ``(7) implement electronic data and infrastructure 
        inventory systems to coordinate the triage, transportation, and 
        treatment of multicasualty incident victims;
            ``(8) provide infectious disease testing in the United 
        States-Mexico border area or United States-Canada border area; 
        and
            ``(9) carry out such other activities identified by the 
        Secretary, members of the Commission, members of the Council, 
        State or local public health authorities, representatives of 
        border health offices, or authorities at the United States-
        Mexico or United States-Canada borders.

``SEC. 9. PLANS, REPORTS, AUDITS, AND BY-LAWS.

    ``(a) Strategic Plan.--
            ``(1) In general.--Not later than 2 years after the date of 
        enactment of this section, and every 5 years thereafter, the 
        Commission (including the participation of members representing 
        both the United States and Mexican sections) and the Council 
        (including the participation of members representing both the 
        United States and Canada) shall each prepare a binational 
        strategic plan to guide the operations of the Commission and 
        the Council and submit such plan to the Secretary and Congress.
            ``(2) Requirements.--The binational strategic plan under 
        paragraph (1) shall include--
                    ``(A) health-related priority areas determined most 
                important by the full membership of the Commission or 
                Council, as applicable;
                    ``(B) recommendations for goals, objectives, 
                strategies, and actions designed to address such 
                priority areas; and
                    ``(C) a proposed evaluation framework with output 
                and outcome indicators appropriate to gauge progress 
                toward meeting the objectives and priorities of the 
                Commission or Council, as applicable.
    ``(b) Work Plan.--Not later than January 1, 2023, and every 2 years 
thereafter, the Commission and the Council shall develop and approve an 
operational work plan and budget based on the strategic plan under 
subsection (a).
    ``(c) GAO Review.--Not later than January 1, 2024, and every 2 
years thereafter, the Comptroller General of the United States shall 
conduct an evaluation of the activities conducted by the Commission and 
the Council based on the operational work plans described in subsection 
(b) for the previous year and the output and outcome indicators 
included in the strategic plan described in subsection (a). The 
evaluation shall include a request for written evaluations from members 
of the Commission and the Council about barriers and facilitators to 
executing successfully the work plans of the Commission and the 
Council.
    ``(d) Biannual Reporting.--The Commission and Council shall each 
issue a biannual report to the Secretary that provides independent 
policy recommendations related to border health issues. Not later than 
3 months following receipt of each such biannual report, the Secretary 
shall provide to Congress the report and any studies or other materials 
produced independently by the Commission and Council.
    ``(e) Audits.--The Secretary shall annually prepare an audited 
financial report to account for all appropriated assets expended by the 
Commission and Council to address both the strategic and operational 
work plans for the year involved.
    ``(f) By-Laws.--Not later than 6 months after the date of enactment 
of this section, the Commission and Council shall develop and approve 
bylaws to provide fully for compliance with the requirements of this 
section.
    ``(g) Transmittal to Congress.--The Commission and Council shall 
submit copies of the operational work plan and by-laws to Congress. The 
Comptroller General of the United States shall submit a copy of each 
evaluation completed under subsection (c) to Congress.

``SEC. 10. COORDINATION.

    ``(a) In General.--To the extent practicable and appropriate, 
plans, systems, and activities to be funded (or supported) under this 
Act for all hazard preparedness, and general border health, including 
with respect to infectious disease, shall be coordinated with Federal, 
State, and local authorities in Mexico, Canada, and the United States.
    ``(b) Coordination of Health Services and Surveillance.--The 
Secretary, acting through the Assistant Secretary for Preparedness and 
Response, when appropriate, may coordinate with the Secretary of 
Homeland Security in establishing a health alert system that--
            ``(1) alerts clinicians and public health officials of 
        emerging disease clusters and syndromes along the United 
        States-Mexico border area and United States-Canada border area; 
        and
            ``(2) warns of health threats, extreme weather conditions, 
        disasters of mass scale, bioterrorism, and other emerging 
        threats along the United States-Mexico border area and United 
        States-Canada border area.

``SEC. 11. AUTHORIZATION OF APPROPRIATIONS.

    ``There is authorized to be appropriated to carry out this Act 
$10,500,000 for fiscal year 2021 and each succeeding year, subject to 
the availability of appropriations for such purpose, of which 
$7,000,000 shall be made available to fund operationally feasible 
functions, activities, and grants with respect to the United States-
Mexico border and the border health activities under cooperative 
agreements with the border health offices of the States of California, 
Arizona, New Mexico, and Texas, and $3,500,000 shall be allocated for 
the administration of United States activities under this Act on the 
United States-Canada border and the border health authorities, acting 
through the Canada-United States Pan-Border Public Health Preparedness 
Council.''; and
            (5) in section 12 (as so redesignated)--
                    (A) by redesignating paragraphs (3) and (4) as 
                paragraphs (4) and (6), respectively;
                    (B) by inserting after paragraph (2), the 
                following:
            ``(3) Indians; indian tribe; tribal organization; urban 
        indian organization.--The terms `Indian', `Indian Tribe', 
        `Tribal organization', and `urban Indian organization' have the 
        meanings given such terms in section 4 of the Indian Health 
        Care Improvement Act (25 U.S.C. 1603).''; and
                    (C) by inserting after paragraph (4), as so 
                redesignated, the following:
            ``(5) United states-canada border area.--The term `United 
        States-Canada border area' means the area located in the United 
        States and Canada within 100 kilometers of the border between 
        the United States and Canada.''.
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