[Congressional Record (Bound Edition), Volume 160 (2014), Part 2]
[House]
[Pages 2362-2365]
[From the U.S. Government Publishing Office, www.gpo.gov]




                 MEDICAL PREPAREDNESS ALLOWABLE USE ACT

  Mrs. BROOKS. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 1791) to amend the Homeland Security Act of 2002 to codify 
authority under existing grant guidance authorizing use of Urban Area 
Security Initiative and State Homeland Security Grant Program funding 
for enhancing medical preparedness, medical surge capacity, and mass 
prophylaxis capabilities, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 1791

       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 ``Medical Preparedness 
     Allowable Use Act''.

     SEC. 2. USE OF CERTAIN HOMELAND SECURITY GRANT FUNDS FOR 
                   ENHANCING MEDICAL PREPAREDNESS, MEDICAL SURGE 
                   CAPACITY, AND MASS PROPHYLAXIS CAPABILITIES.

       Section 2008 of the Homeland Security Act of 2002 (6 U.S.C. 
     609) is amended--
       (1) in subsection (a), by redesignating paragraphs (10) 
     through (13) as paragraphs (11) through (14), respectively, 
     and by inserting after paragraph (9) the following:
       ``(10) enhancing medical preparedness, medical surge 
     capacity, and mass prophylaxis capabilities, including the 
     development and maintenance of an initial pharmaceutical 
     stockpile, including medical kits, and diagnostics sufficient 
     to protect first responders, their families, immediate 
     victims, and vulnerable populations from a chemical or 
     biological event;''; and
       (2) in subsection (b)(3)(B), by striking ``(a)(10)'' and 
     inserting ``(a)(11)''.


[[Page 2363]]


  The SPEAKER pro tempore. Pursuant to the rule, the gentlewoman from 
Indiana (Mrs. Brooks) and the gentleman from New Jersey (Mr. Payne) 
each will control 20 minutes.
  The Chair recognizes the gentlewoman from Indiana.


                             General Leave

  Mrs. BROOKS. Mr. Speaker, I ask unanimous consent that all Members 
have 5 legislative days within which to revise and extend their remarks 
and include any extraneous material on the bill under consideration.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentlewoman from Indiana?
  There was no objection.
  Mrs. BROOKS. Mr. Speaker, I yield myself as much time as I may 
consume.
  Mr. Speaker, I rise today in support of H.R. 1791, the Medical 
Preparedness Allowable Use Act, introduced by my colleague and the 
former chairman of the Subcommittee on Emergency Preparedness, 
Response, and Communications, the honorable Congressman Bilirakis from 
Florida.
  This bill amends the Homeland Security Act of 2002 to make it clear 
that grant funds under the State Homeland Security Grant Program and 
Urban Area Security Initiative may be used to enhance medical 
preparedness and purchase medical countermeasures.
  The Emergency Preparedness, Response, and Communications Subcommittee 
held a series of hearings in the 112th Congress on medical 
preparedness. The subcommittee heard about the importance of medical 
countermeasures from representatives of the emergency response 
community, and this bill is in response to those concerns.
  In August, I held a field hearing in my district looking at central 
Indiana's ability to handle a mass casualty event. Like the witnesses 
who testified at the hearings held in the 112th Congress, these 
witnesses at the field hearing stressed the importance of building 
medical preparedness.
  As a result of this bill, grant funds could be used for items such as 
pre-deployed medical kits for first responders and their families, 
caches of equipment, training and exercises, and planning activities. 
The grant guidance for these programs currently allows funds to be used 
for medical preparedness equipment and activities.
  This bill codifies those activities to ensure that they will continue 
to be allowable, and it will not cost any additional money to do so. We 
have seen the benefits that grant funds, including those used for 
medical preparedness activities, have provided when it comes to 
response capabilities. This was clearly demonstrated in response to the 
Boston Marathon bombings.
  We know that the threat of chemical or biological attack is real. In 
fact, my subcommittee will be holding a hearing next week to get an 
update on the bioterrorism threat and preparedness here in this 
country.
  We must ensure that our first responders have the tools and 
capabilities they need if such an event should occur. This bill has the 
support of several first responder groups, including the International 
Association of Emergency Managers, the International Association of 
Fire Chiefs, and the Emergency Services Coalition for Medical 
Preparedness. I will insert their letters of support into the Record.
  H.R. 1791 was approved by the Committee on Homeland Security last 
year by a bipartisan voice vote. I am pleased that, during the markup, 
the committee approved an amendment offered by the ranking member of 
the subcommittee, the gentleman from New Jersey (Mr. Payne), to ensure 
that in addition to protecting first responders funds can also be used 
to protect vulnerable populations such as children.
  I urge fellow Members to support this bill, and I reserve the balance 
of my time.
                                      Emergency Services Coalition


                                     for Medical Preparedness,

                                                   April 26, 2013.
     Hon. Gus Bilirakis,
     House of Representatives,
     Washington, DC.
       Dear Representative Bilirakis: The Emergency Services 
     Coalition for Medical Preparedness is pleased to support the 
     Medical Preparedness Allowable Use Act. The events of the 
     last two weeks again demonstrate the need for immediate, at 
     hand protections for our emergency services personnel and 
     their families and households. The Congressionally-chartered 
     WMD Commission has issued warnings for years about the 
     continuing threat from biological weapons.
       Emergency services professionals are uniquely expected to 
     continue operating in hazardous conditions when others are 
     sheltering. Whether responding to industrial fires, bombs 
     placed in cities, or other situations with unknown secondary 
     risks, the protections described in the Medical Preparedness 
     Allowable Use Act will enable emergency services to more 
     confidently carry out their tasks.
       Pre-event medical caches have been provided for federal 
     workers and hundreds of postal employees. Your bill addresses 
     the lack of protection of the millions of local and state 
     protectors who daily provide law enforcement, public works, 
     emergency management, fire, rescue and emergency medical 
     services.
       The Coalition looks forward to working with you and your 
     staff in passage of the Bill. Thank you for your leadership 
     and continuing support for ``protecting the protectors.''
           Sincerely,
                                                     Tim Stephens,
     Advisor.
                                  ____

                                         International Association


                                               of Fire Chiefs,

                                      Fairfax, VA, April 26, 2013.
     Hon. Michael McCaul,
     Chairman, House Committee on Homeland Security, Washington, 
         DC.
     Hon. Bennie Thompson,
     Ranking Member, House Committee on Homeland Security, 
         Washington, DC.
       Dear Chairman McCaul and Ranking Member Thompson: On behalf 
     of the 12,000 chief fire and emergency officers of the 
     International Association of Fire Chiefs (IAFC), I urge you 
     to support the Medical Preparedness Allowable Use Act. This 
     bill addresses an important aspect of America's homeland 
     security and emergency preparedness through improving the 
     resiliency of emergency first responders by helping provide 
     pre-event Medkits to first responders and their families.
       Individual physician-based prescription efforts and federal 
     planning have already provided protections for countless 
     employees of the U.S. Postal Service and the federal 
     government--first responders however have not been included 
     in these pre-event protections. The Medical Preparedness 
     Allowable Use Act addresses this gap by allowing 
     jurisdictions to use the Urban Areas Security Initiative and 
     State Homeland Security Grant Program funding to improve 
     their medical preparedness through the procurement of Medkits 
     and other medical countermeasures.
       In 2008, the Commission on the Prevention of Weapons of 
     Mass Destruction Proliferation and Terrorism issued their 
     report in which the Commission identified a biological attack 
     as the most likely threat to the United States. In the event 
     of a biological attack, our nation's first responders will 
     play crucial roles such as treating patients and mitigating 
     the effects of such a biological attack. One of the most 
     effective ways to ensure the resiliency of emergency first 
     responders is the provision of pre-event Medkits for first 
     responders and their families. These Medkits will allow first 
     responders to focus on protecting and serving the public 
     rather than worrying about the safety of themselves or their 
     families. The Medical Preparedness Allowable Use Act will 
     help jurisdictions provide these crucial protections to their 
     first responders.
       Thank you for your support for America's first responders. 
     We urge you to continue your support by ensuring first 
     responders and their families are protected while they 
     protect their communities.
           Sincerely,
                                            Chief Hank Clemmensen,
     President and Chairman of the Board.
                                  ____

                                      International Association of


                                           Emergency Managers,

                                    Falls Church, VA, May 1, 2013.
     Hon. Gus Bilirakis,
     House of Representatives,
     Washington, DC.
       Dear Representative Bilirakis: The U.S. Council of the 
     International Association of Emergency Managers (IAEM USA) is 
     pleased to support the Medical Preparedness Allowable Use 
     Act. We thank you for introducing a bill which addresses the 
     lack of protection for the emergency services protectors by 
     providing funding to enhance medical preparedness, medical 
     surge capacity and mass prophylaxis capabilities. We were 
     pleased to testify before you in support of a similar bill 
     last session.
       Helping local and state jurisdictions provide crucial 
     protection to first responders, their families, and immediate 
     victims from a

[[Page 2364]]

     chemical or biological event through Medkits and other 
     medical countermeasures will ensure the resiliency of first 
     responders. These Medkits will allow first responders to 
     focus on protecting and serving the public rather than 
     worrying about the safety of themselves or their families.
       Thank you for your continued support to protect America's 
     first responders and their families.
           Sincerely,
                                                      Jeff Walker,
                                          CEM, IAEM USA President.

  Mr. PAYNE. Mr. Speaker, I rise in support of H.R. 1791 the Medical 
Preparedness Allowable Use Act, and I yield myself as much time as I 
may consume.
  Mr. Speaker, H.R. 1791 would formally authorize grant recipients 
under the State Homeland Security Grant or Urban Area Security 
Initiative programs to use the funding to enhance medical preparedness 
and medical surge capacity.
  Although the Federal Emergency Management Agency already permits 
grantees to use these funds to enhance medical preparedness, this 
measure will give some predictability to grant recipients as they 
struggle to rebuild and maintain a robust medical response capability 
at the State and local level.
  Additionally, I am proud to support this effort to provide resources 
that will equip our first responders with home medical kits. When 
disaster strikes, we have an obligation to protect our protectors. We 
also have an obligation to protect the most vulnerable in our 
communities.
  During the full committee markup of H.R. 1791, the committee 
unanimously approved an amendment I offered. This amendment would 
ensure that resources are available to develop plans to distribute 
countermeasures to schools and child care facilities, the elderly, 
individuals with special needs, and low-income communities in the event 
of a biological incident.
  I would like to thank the full committee chair, Mr. McCaul, and the 
subcommittee chairwoman, Mrs. Brooks, for supporting my amendment. I 
also look forward to continuing to work with both of you in the future 
on other initiatives such as H.R. 3158, the SAFE in our Schools Act, to 
ensure that the needs of our schoolchildren and other vulnerable 
populations are adequately addressed in emergency preparedness and 
response plans.
  On behalf of the ranking member, Mr. Thompson, I would also like to 
thank Chairman McCaul for working with us to reauthorize the 
Metropolitan Medical Response System, the MMRS. This program provided 
targeted grants to 124 highly populated jurisdictions to support the 
integration of emergency management, health and medical systems into an 
organized response to mass casualty events.
  The program has not been funded since fiscal year 2011 and its 
authorization has lapsed. I sincerely hope that the next time we meet 
here on the House floor to address medical preparedness, it will be to 
consider bipartisan reauthorization legislation for the MMRS. As State 
and local governments continue to stretch their budgets to make up the 
reduced Federal support across many programs, we must make sure that 
the public health community is prepared and equipped to keep our 
constituents safe.
  I look forward to working with my ranking member and the majority to 
ensure that MMRS remains a priority for this committee.
  In the meantime, I urge my colleagues to support H.R. 1791. With 
that, Mr. Speaker, I reserve the balance of my time.
  Mrs. BROOKS of Indiana. Mr. Speaker, I yield such time as he may 
consume to the distinguished gentleman from Florida (Mr. Bilirakis), 
the sponsor of this legislation.
  Mr. BILIRAKIS. I must say, Madam Chair, you are doing an outstanding 
job chairing this committee. Thank you for your help on this bill. I 
also want to thank Mr. Payne. Your father would be very proud of you 
today. He was a good friend of mine.
  Mr. Speaker, I rise in support of H.R. 1791, the Medical Preparedness 
Allowable Use Act, which amends the Homeland Security Act of 2002 to 
make it clear that grant funds under the State Homeland Security Grant 
Program and the Urban Area Security Initiative may be used to enhance 
medical preparedness and purchase medical countermeasures.
  I originally introduced the Medical Preparedness Allowable Use Act in 
2012 after a series of hearings on medical countermeasures in the 
Committee on Homeland Security's Subcommittee on Emergency 
Preparedness, Response, and Communications.
  At these hearings, we received testimony from representatives of the 
emergency response community on the importance of stockpiling medical 
countermeasures in the event of a WMD attack. This includes pre-
deployed medical kits for first responders and their families similar 
to those provided to postal workers participating in the national U.S. 
Postal Medical Countermeasures Dispensing Pilot Program.
  The grant guidance for the State Homeland Security Grant Program and 
the Urban Area Security Initiative currently permits this funding to be 
used to procure medical countermeasures and for other medical 
preparedness and medical surge capacity equipment and activities. 
However, this guidance is developed on an annual basis, as our chair 
said, and there is no guarantee that these uses will be authorized in 
the future. That is why this bill is so very important.
  To be clear, no new funding is authorized in this bill. However, 
these expenditures authorized and codified by the bill we are 
considering today can make a big difference in the protection of the 
public, including emergency responders, in the event of an attack, and 
there should be no doubt that grant funding may be used to support them 
now and in the future.
  As the former chairman of the Subcommittee on Emergency Preparedness, 
Response, and Communications, I consistently find myself in awe of our 
first responders and the sacrifices that they make for the public. In 
the wake of events such as Hurricane Sandy, I am committed to ensuring 
Congress does all that it can to support those brave men and women.
  I am pleased that this legislation is supported by the Emergency 
Services Coalition on Medical Preparedness, which works to ensure that 
we ``protect the protectors,'' and other agencies as well. I also thank 
the ranking member for adding that great amendment because we must 
protect our children as well.
  I thank and commend, of course, Representative Susan Brooks, our 
chair, for her assistance with this bill and for her willingness to 
join me as an original cosponsor.
  I urge all Members to support this great, very important bill.
  Mr. PAYNE. I yield myself such time as I may consume.
  Mr. Speaker, in closing, I urge passage of this measure as a small 
step to address gaping needs at the State and local level when it comes 
to medical preparedness.
  I urge my colleagues to support H.R. 1791, and I yield back the 
balance of my time.
  Mrs. BROOKS of Indiana. Mr. Speaker, as the gentleman from Florida 
noted in his statement, this bill passed the House the last Congress by 
a bipartisan vote of 397-1. I hope Members will once again express 
their support for the men and women who protect us every day by voting 
for this bill.
  I want to thank my ranking member for his dedication and his 
commitment to protecting the protectors, as he so eloquently stated, 
and we certainly request that our fellow Members support this bill.
  I yield back the balance of my time.
  Ms. JACKSON LEE. Mr. Speaker, I rise in strong support of H.R. 1791, 
the Medical Preparedness Allowable Use Act for two reasons.
  First, the bill will save lives. Second, the legislation is necessary 
to support the vital work of first responders in the event of a 
biological and chemical terrorists attack or incident.
  The legislation provides for the development and maintenance of an 
initial pharmaceutical stockpile, including medical kits, and 
diagnostics sufficient to protect first responders, their families, and 
immediate victims from a chemical or biological event.
  The Medical Preparedness Allowable Use Act will amend the Homeland 
Security Act of 2002 to authorize the use of Urban Area Security 
Initiative and State Homeland Security

[[Page 2365]]

Grant Program funding for enhancing medical preparedness, medical surge 
capacity, and mass prophylaxis capabilities.
  This legislation ensures that first responders have necessary 
medicines and treatments to protect themselves, their families and 
those within their vicinity immediately should a biological and 
chemical terrorist attack occurs.
  In short, first responders will not be able to do the work of saving 
lives if they fall victim to an attack or are distracted by worry 
regarding how their family may be fairing during a biological or 
chemical attack should one occur.
  First responders often include law enforcement officers, fire 
fighters, and emergency medical personnel.
  The city of Houston covers over a 1000 square mile region in 
Southeast Texas. It has an evening population of nearly two million 
people and over three million during the day when commuters are in the 
city.
  There are 103 fire stations that serve the city of Houston with most 
offering ambulance or medic support, but there is only one station, 
Number 22, that specializes in hazardous material.
  In the city of Houston one out of every ten citizens use Emergency 
Management Services (EMS) and within a year there are over 200,000 EMS 
incidents involving over 225,000 patients or potential patients.
  EMS response services have 88 City of Houston EMS vehicles, with just 
under fifty percent staffed by two paramedics and can provide Advanced 
Life Support (ALS) to patients.
  These consist of 15 ALS Squads, and 22 ALS transport units with eight 
functioning in a ``Dual'' capacity as both Advanced Life Support and 
Basic Life Support (BLS).
  The remaining fifty-one transport units are Basic Life Support (BLS), 
and staffed by two Emergency Medical Technicians.
  Law enforcement agencies that serve the city of Houston include the 
Houston Police Department, Harris County Sheriff's Department, Harris 
County Constables, Port of Houston Authority Police and Corrections 
Officers.
  Because of the nature of chemical or biological terrorist attacks 
mass casualties are the objective and the impressive resources of our 
nation's 4th largest city would likely be overwhelmed immediately 
should an attack occur it is important to provide them with the 
resources provided by this legislation.
  The prepositioning of resources in the form of medicines that can 
support pulmonary respiratory function or arrest neurological damage as 
a result of poisoning lives can be saved that could otherwise be lost. 
This bill can reduce deaths and give victims the greatest chance for 
survival and recovery.
  Emergency responders because of this bill would have treatments in 
the communities where they serve and live to help neighbors, coworkers, 
and people who are immediate need to live saving help.
  As a senior member of the House Homeland Security Committee, I am 
mindful of the need for our first responders to be prepared and well 
trained to manage a wide range of potential threats both conventional 
and unconventional.
  This bill offers one more resource that will be available to first 
responders to do the work they have dedicated their lives to doing--
saving lives.
  I urge my colleagues to join me in supporting H.R. 1791, the Medical 
Preparedness Allowable Use Act for two reasons.

  Mr. WAXMAN. Mr. Speaker, I support H.R. 1791, the ``Medical 
Preparedness Allowable Use Act'', but I have serious concerns about 
this legislation and its overlap with the policies appropriately 
established in the Pandemic and All-Hazards Preparedness Act (PAHPA).
  Of course, we all agree that it is important for States, territories, 
tribes, and high-risk urban areas to be prepared for possible acts of 
terrorism. And we also agree that medical preparedness and related 
activities are an important part of this.
  However, I worry that this bill may result in duplicative and 
uncoordinated efforts across the government.
  The Department of Health and Human Services (HHS) is the lead federal 
entity on the public health and medical response to public health 
emergencies and incidents, including bioterrorist attacks. 
Specifically, this bill conflicts with HHS's authority under PAHPA. 
Legislation reauthorizing the PAHPA authorities at HHS was passed on an 
overwhelmingly bipartisan basis by the House and Senate and signed into 
law just last March.
  HHS already undertakes a number of activities related to enhancing 
medical preparedness and medical surge capacity in States and cities. 
The Department also maintains a stockpile of countermeasures and other 
pharmaceutical supplies for terrorist attacks and other public health 
emergencies--which is managed by the Centers for Disease Control and 
Prevention, in consultation with the Department of Homeland Security 
(DHS).
  I believe the use of DHS grant funds for medical preparedness 
activities authorized in H.R. 1791 without any consultation requirement 
or acknowledgement of HHS's role in public health and medical response 
efforts is short-sighted. It has the potential to undermine HHS's 
leadership and expertise on this important issue and impede a unified 
federal response to terrorist attacks.
  If my colleagues believe that there should be enhanced support of 
medical preparedness activities, I hope that we can work together to 
find a way to ensure coordination of efforts and preserve HHS's 
important role.

  The SPEAKER pro tempore. The question is on the motion offered by the 
gentlewoman from Indiana (Mrs. Brooks) that the House suspend the rules 
and pass the bill, H.R. 1791, as amended.
  The question was taken.
  The SPEAKER pro tempore. In the opinion of the Chair, two-thirds 
being in the affirmative, the ayes have it.
  Mrs. BROOKS of Indiana. Mr. Speaker, on that I demand the yeas and 
nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX, further 
proceedings on this motion will be postponed.

                          ____________________