[Senate Report 119-69]
[From the U.S. Government Publishing Office]


                                                       Calendar No. 174
                                                       
119th Congress }                                                {  Report
                         SENATE
 1st Session   }                                                { 119-69

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 VETERINARY SERVICES TO IMPROVE PUBLIC HEALTH IN RURAL COMMUNITIES ACT

                                _______
                                

               September 29, 2025.--Ordered to be printed

                                _______
                                

          Ms. Murkowski, from the Committee on Indian Affairs,
                        submitted the following

                              R E P O R T

                         [To accompany S. 620]

      [Including cost estimate of the Congressional Budget Office]

    The Committee on Indian Affairs, to which was referred the 
bill (S. 620) to provide public health veterinary services to 
Indian Tribes and Tribal organizations for rabies prevention, 
and for other purposes, having considered the same, reports 
favorably thereon without amendment and recommends that the 
bill do pass.

                                PURPOSE

    S. 620 would authorize the Secretary of the U.S. Department 
of Health and Human Services (HHS) to use funds for public 
health veterinary services and to assign or deploy veterinary 
officers from the U.S. Public Health Service (USPHS) 
Commissioned Corps to prevent and control rabies and other 
zoonotic diseases\1\ in Indian Health Service (IHS) Service 
areas where those diseases are endemic in wildlife and there is 
risk of disease transmission to domestic animals or humans.
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    \1\Zoonotic diseases, or zoonoses, are diseases caused by harmful 
germs that spread between animals and people. See About Zoonotic 
Diseases, U.S. CENTERS FOR DISEASE CONTROL AND PREVENTION, https://
www.cdc.gov/one-health/about/about-zoonotic-diseases.html.
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                          BACKGROUND AND NEED

    Veterinary public health services represent a critical and 
often overlooked component of human healthcare and disease 
prevention. The World Health Organization defines veterinary 
public health as ``a component of public health that focuses on 
the application of veterinary science as a contribution to the 
protection and improvement of human well-being.''\2\ In the 
context of the bill's purpose, veterinary services are focused 
on protecting human populations from zoonotic diseases 
(infections transmitted between animals and humans) and animal-
related injuries.
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    \2\Veterinary public health. See Control of Neglected Tropical 
Diseases, WORLD HEALTH ORGANIZATION, Control of Neglected Tropical 
Diseases.
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    Rural communities, including those on or near Tribal lands, 
often face inadequate access to veterinary services, placing 
them at increased risk of injury and exposure to zoonotic 
diseases including rabies.\3\ The IHS, whose mission is to 
raise the health status of American Indians and Alaska Natives, 
does not currently have authority to employ public health 
service veterinarians or provide funding for public health 
veterinary interventions such as rabies vaccinations or 
population control of uncontrolled dogs.\4\ These services, 
while directed at animals, are fundamentally human public 
health measures that reduce the risk of disease transmission 
and injury to the human population. Without this authority, the 
IHS is unable to address significant threats to human health in 
Tribal communities through proven veterinary public health 
approaches. Consequently, Indian Tribes, Tribal health 
organizations, and Alaska Native Corporations are also, 
therefore, unable enter into Indian Self-Determination and 
Education Assistance Act (ISDEAA) contracts or compacts with 
the IHS to take over these services.\5\
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    \3\Facts about Diseases that Can Spread Between Animals and People, 
U.S. Centers for Disease Control and Prevention, https://www.cdc.gov/
healthy-pets/diseases/index.html (last visited September 22, 2025).
    \4\IHS interprets 25 U.S.C. 1601, et seq. and 25 U.S.C. 13 to 
support its position that it lacks authority to hire veterinarians or 
provide veterinary services, including spaying, neutering, and rabies 
vaccinations.
    \5\Pub. L. No. 93-638, 88 Stat. 2203 (1975).
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    The public health impact of this gap in services is 
substantial. According to testimony from HHS in 2024, over the 
past five years, more than 200 American Indian and Alaska 
Native patients required hospitalization from dog bite injuries 
or attacks at IHS facilities, with the Navajo and Alaska Areas 
reporting the highest numbers.\6\ During this same period, over 
24,000 patients received ambulatory care for dog bites across 
all IHS Service areas. The Navajo, Alaska, Great Plains, and 
Phoenix Areas have consistently reported the highest numbers of 
bite-related incidents requiring medical attention. Studies 
show that Native children face disproportionately higher rates 
of dog bite hospitalizations, particularly in Alaska and the 
Southwest region, where rates exceed the national average for 
children.\7\
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    \6\See Legislative Hearing on S. 4365 Before the S. Comm. on Indian 
Affs., 118th Cong. (2024) (statement of Melanie Egorin, U.S. Dep't of 
Health and Human Services).
    \7\Adam Bjork, Dog Bite Injuries among American Indian and Alaska 
Native Children, 162 J. of Pediatrics 1270, 1271-72 (2013) 
(highlighting the need for consistent veterinary services to address 
injury prevention and rabies control in these communities).
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    The USPHS Commissioned Corps is one of the nation's eight 
uniformed services.\8\ Public Health Service officers serve as 
physicians, nurses, dentists, veterinarians, scientists, 
engineers, environmental health officers, and other professions 
across the federal government with the mission of protecting, 
promoting, and advancing the health and safety of the nation. 
No officers currently serve as veterinarians within any of the 
IHS Service areas.\9\
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    \8\See generally U.S. Public Health Service, https://www.usphs.gov/ 
(last visited September 22, 2025).
    \9\Most USPHS Commissioned Corps officers serving as veterinarians 
are stationed with the Department of Agriculture, the Centers for 
Disease Control, the Food and Drug Administration, the National 
Institutes of Health, or the National Park Service. See Where We Serve, 
U.S. Public Health Service, https://www.usphs.gov/about-us (last 
visited March 28, 2025). According to the Congressional Research 
Service, there is one USPHS Commissioned Corps officer serving as a 
veterinarian detailed to IHS, however, that officer serves in an 
administrative role within IHS Headquarters. See generally 
Veterinarian, U.S. Public Health Service, https://www.usphs.gov/
professions/veterinarian (last visited September 22, 2025).
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    USPHS environmental health officers have served as liaisons 
between the armed forces and Tribes during Department of 
Defense training missions, transporting Army veterinary 
officers to Tribal communities to provide general veterinary 
care and rabies vaccinations.\10\ However, these services do 
not always extend to more complicated services, such as spaying 
and neutering to control dog populations.\11\ Because the IHS 
does not offer veterinary services, and the United States 
Department of Agriculture's (USDA) Animal and Plant Health 
Inspection Service (APHIS) is limited to controlling zoonotic 
diseases within wildlife populations, Tribes have had to rely 
on non-profit organizations, local health organizations, and 
state lay vaccinator programs to address public health risks 
from zoonotic disease transmission.\12\
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    \10\See U.S. Public Health Service, 2010 Operation Arctic Care, 
U.S. PUBLIC HEALTH SERVICE COMMISSIONED CORPS, https://dcp.psc.gov/
ccbulletin/articles/Operation_
Arctic_Care_10_2010.aspx.
    \11\Fort Sill Cannoneer staff, Soldiers help Tribes fight rabies, 
U.S. Army (June 20, 2011), https://www.army.mil/article/60085/
soldiers_help_tribes_fight_rabies.
    \12\See Legislative Hearing on S. 4365 Before the S. Comm. on 
Indian Affs., 118th Cong. (2024) (statement of Brian Lefferts, Yukon 
Kuskokwim Health Corporation); Legislative Hearing on S. 4365 Before 
the S. Comm. on Indian Affs., 118th Cong. (2024) (statement of Melanie 
Egorin, U.S. Dep't of Health and Human Services).
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    As a result, Tribes face limited and inconsistent access to 
these preventive public health services that, while delivered 
through veterinary interventions, are designed to protect human 
health. In absence of these services, Tribal communities remain 
at heightened risk for zoonotic disease transmission and 
animal-related injuries. The current regulatory framework 
creates a separation between human and animal health that fails 
to recognize the ``One Health'' approach endorsed by major 
public health organizations worldwide, which acknowledges the 
interconnection between human health, animal health, and the 
environment. S. 620 would apply the One Health approach to 
advance public health preparedness.

                                SUMMARY

    S. 620 authorizes the Secretary of HHS to use funds to 
provide public health veterinary services directly by the 
agency or under ISDEAA self-determination contracts and self-
governance compacts and funding agreements. The legislation 
would authorize the Secretary to assign or deploy veterinary 
officers from the USPHS to prevent and control rabies and other 
zoonotic disease transmission in IHS Service areas where the 
risk for disease occurrence between humans, wildlife, and 
domestic animals is endemic. The bill also requires the USDA 
APHIS to study the delivery of oral rabies vaccinations in 
Arctic regions of the United States and adds the IHS Director 
to the coordination of the One Health framework.

                          LEGISLATIVE HISTORY

    S. 620 was introduced by Senators Murkowski and Heinrich, 
on February 18, 2025, with Senators Peters and Schatz as 
original cosponsors.
    In the 118th Congress, a similar bill, S. 4365, was 
introduced by Senator Murkowski on May 16, 2024. Senators 
Schatz and Heinrich later joined as cosponsors. The Committee 
held a hearing on S. 4365 on July 10, 2024 (S. Hrg. 118-530). 
On July 25, 2024, the Committee held a business meeting and 
ordered the bill to be reported favorably with an amendment in 
the nature of a substitute (S. Rept. 118-248).

                        COMMITTEE RECOMMENDATION

    The Senate Committee on Indian Affairs in an open business 
meeting on March 5, 2025, by a majority voice vote of a quorum 
present, recommends that the Senate pass S. 620, without 
amendment.

                      SECTION-BY-SECTION ANALYSIS

Section 1--Short title

    This section sets forth the short title as the ``Veterinary 
Services to Improve Public Health in Rural Communities Act.''

Section 2--Sense of Congress

    This section sets forth a sense of Congress that HHS and 
IHS are uniquely suited to address zoonotic disease threats in 
Native communities by providing public health veterinary 
services.

Section 3--Public Health Veterinary Services

    This section amends the Indian Health Care Improvement Act 
(IHCIA) by adding a new section, titled ``Public Health 
Veterinary Services.'' This new section--
           Establishes definitions for public health 
        veterinary services and zoonotic disease;
           Authorizes the Secretary of HHS, acting 
        through the IHS, to expend funds for public health 
        veterinary services to prevent and control zoonotic 
        disease infection and transmission in IHS Service areas 
        where the risk for disease occurrence in humans and 
        wildlife is endemic--directly or through self-
        determination contracts or self-governance compacts;
           Authorizes the Secretary of HHS to assign or 
        deploy veterinary public health officers from the 
        Commissioned Corps of the USPHS to IHS Service areas;
           Authorizes the Secretary of HHS to 
        coordinate and implement activities with the Director 
        of the CDC and the Secretary of Agriculture; and
           Directs the Secretary of HHS to submit a 
        biennial report to Congress on program implementation.

Section 4--APHIS Wildlife Services study on oral rabies vaccines in 
        arctic regions of the United States

    This section requires the Secretary of Agriculture to 
conduct a feasibility study within one year of enactment of the 
Act on the delivery of oral rabies vaccines to wildlife 
reservoir species directly connected to the transmission of 
rabies to Tribal members living in Arctic regions of the United 
States, on the efficacy of these vaccines, and on 
recommendations to improve delivery of these vaccines. This 
study will focus on the identified wildlife reservoir species, 
including the Arctic fox (Vulpes lagopus), in the Arctic 
regions of Alaska.

Section 5--One Health Framework

    This section amends the Prepare for and Respond to Existing 
Viruses, Emerging New Threats, and Pandemics Act by directing 
the Secretary of HHS, acting through the Director of the 
Centers for Disease Control (CDC), to coordinate with the 
Director of the IHS (in addition to the Secretary of 
Agriculture and the Secretary of the Interior) and develop the 
federal government's One Health framework.\13\
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    \13\In 2009, the CDC's One Health Office was established and 
located within the National Center for Emerging and Zoonotic Infectious 
Diseases at CDC. The One Health Office works with partners to prevent 
the spread of zoonotic diseases, to respond to outbreaks and public 
health emergencies, and to protect people from diseases that can be 
transmitted from pets. See About CDC's One Health Office, Center for 
Disease Control, https://www.cdc.gov/one-health/php/about/index.html 
(last visited September 22, 2025).
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                   COST AND BUDGETARY CONSIDERATIONS



    S. 620 would authorize the Department of Health and Human 
Services (HHS), acting through the Indian Health Service (IHS), 
to provide veterinary services to prevent and control zoonotic 
(animal to human) disease transmission. HHS would be required 
to report biennially to the Congress on those services, as well 
as on data from surveillance of zoonotic disease transmission. 
In addition, the bill would require the Department of 
Agriculture's Animal and Plant Health Inspection Service to 
study the delivery of oral rabies vaccines to wildlife 
reservoir species that are implicated in rabies transmission to 
tribal members in Arctic regions of the United States.
    Using information from IHS, CBO expects that under the 
bill, the agency would employ 18 veterinarians to cover its 12 
service regions at a cost of $14 million over the 2025-2030 
period and $46 million over the 2025-2035 period. CBO estimates 
that the costs of implementing the bill's reporting 
requirements would be insignificant for HHS and that the 
Department of Agriculture's vaccine studies would cost $1 
million over the 2025-2035 period. Any related spending would 
be subject to the availability of appropriated funds.
    The costs of the legislation, detailed in Table 1, fall 
within budget functions 350 (agriculture) and 550 (health).

                                           TABLE 1.--ESTIMATED SPENDING SUBJECT TO APPROPRIATION UNDER S. 620
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                                                                                        By fiscal year, millions of dollars--
                                                            --------------------------------------------------------------------------------------------
                                                                                                                                           2025-   2025-
                                                              2025   2026   2027   2028   2029   2030   2031   2032   2033   2034   2035   2030    2035
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Veterinary Services and Reports:
    Estimated Authorization................................      0      2      3      3      3      3      3      3      4      4      4      14      46
    Estimated Outlays......................................      0      2      3      3      3      3      3      3      4      4      4      14      46
USDA Vaccine Studies:
    Estimated Authorization................................      0      1      0      0      0      0      0      0      0      0      0       1       1
    Estimated Outlays......................................      0      *      *      1      0      0      0      0      0      0      0       1       1
    Total Changes:
        Estimated Authorization............................      0      3      3      3      3      3      3      3      4      4      4      15      47
        Estimated Outlays..................................      0      3      3      4      3      3      3      3      4      4      4      15      47
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USDA = Department of Agriculture; * = between zero and $500,000.

    The CBO staff contacts for this estimate are Erik 
O'Donoghue (for the Department of Agriculture) and Robert 
Stewart (for the Indian Health Service). The estimate was 
reviewed by Emily Stern, Senior Adviser for Budget Analysis.

               REGULATORY AND PAPERWORK IMPACT STATEMENT

    Paragraph 11(b) of rule XXVI of the Standing Rules of the 
Senate requires each report accompanying a bill to evaluate the 
regulatory and paperwork impact that would be incurred in 
carrying out the bill. The Committee believes that S. 620 will 
have minimal impact on regulatory or paperwork requirements.

                 EXECUTIVE TESTIMONY AND COMMUNICATIONS

    The testimonies provided by the U.S. Department of the 
Health and Human Services and the U.S. Department of 
Agriculture Animal and Plant Health Inspection Service from the 
July 10, 2024 hearing on S. 4365 follow:


     statement of dr. melanie anne egorin, assistant secretary for 
       legislation, u.s. department of health and human services


S. 4365--Veterinary Services to Improve Public Health in Rural 
        Communities Act
    Good afternoon Chair Schatz, Vice Chair Murkowski, and 
Members of the Committee. Thank you for the opportunity to 
provide testimony on an important legislative proposal before 
your Committee, and for your continued support of the Indian 
Health Service (IHS) and efforts from the Department of Health 
and Human Services to improve the health and well-being of 
American Indians and Alaska Natives (AI/AN). Your consideration 
today of S. 620, the Veterinary Services to Improve Public 
Health in Rural Communities Act underscores that commitment to 
improving the quality of life in Indian Country.
    I am Melanie Anne Egorin, the Assistant Secretary for 
Legislation (ASL) at the Department of Health and Human 
Services (HHS or Department). My office serves as the primary 
link between the Department and Congress. The Office of the ASL 
provides technical assistance on legislation to Members of 
Congress and their staff, facilitates informational briefings 
relating to Department programs to support policy development 
by Congress, and supports implementation of legislation passed 
by Congress. It is a pleasure to join the Committee again, as 
we work together to combat the public health challenges in 
tribal communities.
            Background
    The Department and the IHS agree that the increase of 
injuries and zoonotic disease spread by domesticated and wild 
animals in Indian Country represents a significant public 
health issue for tribal members in these rural communities. 
There are an estimated 70 million stray dogs and cats in the 
U.S., Tribal Lands, and territories, which contribute to 
traumatic events and injuries, zoonotic disease spread, and 
road traffic accidents. In recent years, free-roaming domestic 
animals have contributed to rabies outbreaks on Tribal lands, 
human deaths due to zoonotic diseases, and severe injury and 
death due to mauling.
    The Department is working as a whole through diverse 
offices and mission areas to address the public health concerns 
related to zoonotic diseases, including rabies. The IHS already 
coordinates with and assists tribes with animal population 
control efforts to the extent practicable within its 
authorities. Additionally, the Centers for Disease Control and 
Prevention (CDC) and the Commissioned Corps of the United 
States Public Health Service (USPHS) help to lead Department 
efforts on the national surveillance of and education about 
rabies and other zoonotic diseases.
    The IHS operates its mission, in partnership with AI/AN 
tribal communities, through a network of over 600 federal and 
tribal health facilities and 41 Urban Indian Organizations that 
are located across 37 states and provide health care services 
to approximately 2.87 million AI/AN people annually.
    As you may know, appropriated funds to the IHS are used to 
provide health care to IHS-eligible AI/ANs--the IHS' defined 
service population. The Department and the IHS have worked hard 
to prioritize resources provided by Congress to ensure that 
patients have access to accessible--and affordable--quality 
care. The IHS works hard every day to ensure that limited 
resources are used wisely to ensure the greatest impact on its 
defined service population--from direct care services to 
sanitation and facilities construction, and health care 
facilities construction.
    While it recognizes the importance of this emerging threat 
to Indian Country, the IHS has to balance its limited resources 
to deliver direct services to its defined population while 
combating a number of unique public health issues facing Indian 
Country, including the fentanyl and opioid crisis, the maternal 
mortality crisis, domestic and interpersonal violence, and high 
diabetes rates--to name a few. The Biden Harris Administration 
has advocated for additional resources to combat these growing 
threats in Indian Country and is committed to fighting to 
reduce health disparities impacting tribal members.
            IHS Health Issues Related to Rabies Incidents in Rural 
                    Communities
    The IHS has examined first-hand and heard directly from 
tribes about the real public health risk from the high rates of 
dog bite injuries in AI/AN communities. Over the past five 
years, there have been over 200 patients hospitalized from dog 
bite injuries or attacks at IHS clinics. The Navajo and Alaska 
Areas have had the highest number of bites requiring 
hospitalizations. During that same period, there were over 
24,000 patients receiving ambulatory care from dog bites. The 
Navajo, Alaska, Great Plains, and Phoenix Areas have had the 
highest numbers of bite-related hospitalizations over the last 
5 years.
    The IHS has also heard from tribes--especially from those 
in Northern Alaska--who are desperate for assistance addressing 
the problem at its source. A multitude of challenges have 
created a perfect storm for risk of injury and disease spread 
from animals in especially rural areas. AI/ANs living on 
reservations often have little to no access to veterinary care. 
Gaps exist in the availability of free rabies vaccines to rural 
pets, resulting in a higher risk of rabies exposure in humans 
and animals. The lack of regular parasite control for pets in 
these areas has led to an increased risk of exposure to 
transmissible parasites to human beings. There is also a lack 
of access to veterinary spay-neuter surgery to reduce unplanned 
litters, which has led to an overpopulation of strays and 
abandoned dogs--thus increasing exposure to disease, parasite 
infestation, and dog bites.
    The Indian Self-Determination and Education Assistance Act 
(ISDEAA) only authorizes contracts for certain programs 
prescribed by Congress. As the Committee knows, the IHS' 
foundational purpose is to provide health care for AI/ANs. IHS' 
authorizing statutes do not currently convey authority to carry 
out veterinary services. As IHS does not have the authority, 
there is no authority for a tribal health program to add the 
activity to its ISDEAA agreement.
            HHS Public Health Surveillance, Education, and Partnerships
    Within their authorities, the IHS, the CDC, and USPHS 
collaborate in careful coordination with other tribal, federal, 
state, county, and external partners to reduce the risk of 
zoonotic disease spread in Indian Country. The IHS Division of 
Environmental Health Services staff work on surveillance, 
training, and capacity building, and have been involved for 
decades with novel vector borne and zoonotic diseases not 
previously identified in Indian Country. This Division has 
implemented Hantavirus and Rocky Mountain Spotted Fever 
prevention strategies, conducted arbovirus surveillance and 
risk reduction strategies, and assisted tribal communities in 
the development of and adoption of lay vaccinator programs for 
rabies virus. It has also coordinated with outside partners to 
facilitate the delivery of spay, neuter, and rabies clinics for 
domestic dogs and cats. The U.S. Department of Agriculture's 
Animal and Plant Inspection Service has collaborated with the 
IHS Division of Environmental Health Services at the local 
level as needed on zoonotic disease prevention or risk factor 
reduction projects.
    The CDC collects data on domestic human rabies cases and 
conducts near real-time animal rabies surveillance in 54 
jurisdictions, including Alaska, through the National Rabies 
Surveillance System. No Tribal communities have their own 
rabies laboratories and therefore they rely on relevant state 
laboratories for all testing. This may present a barrier to 
sample collection, testing, and reporting, which further 
obscures the burden of rabies in these communities. The CDC has 
conducted several surveillance evaluations to characterize 
rabies risks in Tribal Lands. In several high-risk Tribal 
communities in the southwestern U.S., rabies testing and 
reporting rates are up to 15-times lower compared to their 
adjacent non-Tribal communities.
    An evaluation of the risk of rabies re-introduction into 
the U.S. found that the highest risk is in Tribal Lands where 
free roaming dog populations remain a major public health 
issue. It was found that the Navajo Nation is home to 
approximately 250,000 free roaming dogs, with many remaining 
unvaccinated against rabies. Rabies risk mapping performed by 
CDC, which considers road connectivity, urbanicity, and human-
to-unvaccinated dog ratios found that up to 185,000 
unvaccinated dogs likely reside in areas that could support and 
sustain dog-to-dog transmission of rabies. This highlights the 
realistic potential for reintroduction of dog-mediated rabies 
or spillover from local rabies reservoir wildlife in the Navajo 
Nation. These findings likely reflect similar vulnerabilities 
in other Tribal Lands across the United States.
            S. 4365, Veterinary Services to Improve Public Health in 
                    Rural Communities Act
    The Veterinary Services to Improve Public Health in Rural 
Communities Act would amend the Indian Health Care Improvement 
Act to combat zoonotic disease outbreaks and advance public 
health preparedness for Native communities, Alaska Native 
villages, or Indian reservations, including by providing spay 
and neuter services and vaccinations for animals.
    S. 620 would authorize the Secretary to expend funds for 
public health veterinary services to prevent and control 
zoonotic disease infection and transmission in IHS Service 
areas where the risk for disease occurrence in humans and 
wildlife is endemic. The bill would also enable the Secretary 
to deploy veterinary public health officers from USPHS to IHS 
Service areas to combat, prevent and control zoonotic disease 
infection and transmission in IHS Service areas where the risk 
is endemic.
    The proposed legislation also mandates the Secretary and 
IHS to coordinate with the Director of the CDC, and the 
Secretary of Agriculture. Further, the bill would require the 
Secretary of HHS to submit to certain Committees in Congress on 
a biennial basis, a report on the use of funds, the assignment 
and deployment of veterinary public health officers from the 
USPHS, data related to the monitoring and disease surveillance 
of zoonotic diseases, and related services provided under the 
proposed legislation. Finally, S. 620 would amend the Prepare 
for and Respond to Existing Viruses, Emerging New Threats, and 
Pandemics Act, to include the Director of the IHS, in the ``One 
Health framework.''
    Controlling the pet population would decrease the incidence 
of dog bites, which have caused an increase of injuries and 
deaths on Tribal Lands. This bill would potentially limit the 
incidence and spread of zoonotic diseases and also allow people 
to walk safely in their communities. The Department shares the 
same goal as the drafters--to combat zoonotic disease spreading 
in IHS Service areas and ensure that tribal members throughout 
Indian Country are protected with robust public health outbreak 
prevention. Like the bill's drafters, the Department and IHS 
are looking to improve response to any zoonotic related disease 
and improve safety in tribal communities.
    That being said, the bill, in its current form, does not 
include any additional resources for the Department to stand up 
a new program without compromising its efforts to provide 
direct care or combat other emergent public health challenges 
in Indian Country. The legislation could include language to 
authorize such sums that may be necessary to provide these 
services in Indian Country and the Appropriations Committees 
could then be able to decide whether to fund these new 
activities.
    We look forward to continuing our work with Congress on 
improving the health of AI/AN populations including the issues 
related to this bill. As always, HHS welcomes the opportunity 
to provide technical assistance as requested by the Committee 
or its members.
    Thank you again for the opportunity to testify today, and I 
am happy to answer any questions the Committee may have.
                              ----------                              

    Dr. Michael Watson, Administrator of the Animal and Plant 
Health Inspection Service, U.S. Department of Agriculture, on 
S. 4365, and the following testimonies in its entirety were 
submitted for the record:


  written statement of dr. michael watson, administrator, animal and 
     plant health inspection service u.s. department of agricuture


    Thank you for the opportunity to provide written testimony 
to discuss our rabies management program and S. 4365, the 
Veterinary Services to Improve Public Health in Rural 
Communities Act.
    Rabies is a serious disease of wildlife in the United 
States that can have a significant impact on human and animal 
health. If left untreated, it has a 100% fatality rate in 
humans and kills almost 60,000 people around the world each 
year. Thankfully, compulsory pet vaccination laws and mass 
vaccination campaigns have eliminated the canine variant of 
rabies from wild and domestic animals in the United States. 
However, there are several other variants in wildlife, 
including raccoon rabies in the east and Arctic fox rabies in 
Alaska.
    Since 1997, acting through its Wildlife Services program, 
the Animal and Plant Health Inspection Service (APHIS) and its 
National Rabies Management Program have led Federal efforts to 
control the virus in wildlife, thereby protecting domestic 
animals and the public. APHIS activities include:
           Conducting enhanced rabies surveillance as a 
        complement to public health surveillance to better 
        understand where the disease is, allowing us to better 
        focus our control and elimination efforts.
           Distribution of oral rabies vaccines to 
        create a zone free of disease and moving these rabies-
        free zones appropriately.
           Conducting research to increase scientific 
        knowledge and to better inform rabies management 
        strategies.
           Coordinating on effective strategies for 
        rabies elimination with all partners, collaborators, 
        and stakeholders in the U.S. and with partner agencies 
        in Canada and Mexico.
    The oral rabies vaccination program is the key to expanding 
U.S. rabies-free zones. Each year, APHIS drops approximately 8 
million oral rabies vaccination baits in 13 eastern states, 
from Maine to Alabama, creating a rabies-free zone that 
prevents the spread of raccoon rabies further westward.
    In urban and suburban areas, APHIS and cooperators 
distribute vaccine bait by helicopter or vehicles. In rural 
areas, APHIS typically distributes vaccine bait from a plane. 
When a raccoon bites into the vaccine bait, the packet 
ruptures, allowing the vaccine to coat the animal's mouth and 
throat. Animals that receive an adequate dose of the vaccine 
develop antibodies against rabies. As the number of vaccinated 
animals in a population increases, disease transmission 
decreases, creating an ``immunity barrier'' to stop the further 
spread of rabies.
    Although raccoon vaccination is our largest rabies 
prevention effort, APHIS helped the Texas Department of State 
Health Services successfully eliminate canine rabies in coyotes 
in 2004. Our efforts using oral rabies vaccination also reduced 
the spread and eventually eliminated a unique variant of the 
disease in gray foxes. In Arizona, APHIS works on a variety of 
collaborative rabies research and management projects focused 
on gray foxes, skunks, and bats, as well as free-ranging dogs 
on tribal lands.
    Alaska has a unique variant of rabies in Artic foxes. It 
has a broad circumpolar distribution throughout North America, 
Europe, and Asia. In Alaska, rabies outbreaks routinely occur 
during winter and the number of red foxes with this variant has 
increased over the past decade. This observation, along with 
modeling, suggests regional warming trends may be associated 
with increased contact rates and transmission between Arctic 
and red foxes. We currently do not have a rabies vaccination 
program targeting Arctic foxes due in part to the remote 
geographic area this variant encompasses. There are also 
challenges with Arctic fox behavior, including their large home 
ranges, distance they travel, and varying behavior in summer 
and winter.
    But the bill before us today understands these challenges 
and would accordingly direct APHIS to conduct a more in-depth 
study of the viability of a wildlife rabies control program in 
Arctic regions. This would allow us to work with our state, 
tribal, and other partners to identify the potential barriers 
for a successful program and possible mitigations for those 
impediments.
    Ontario, Canada, successfully eliminated Arctic fox rabies 
in red foxes in southern Ontario, but the situation in Alaska 
will be different. Better understanding the unique challenges 
of Alaska, the different species involved and their ecology, 
will be important. In Alaska, we would most likely need to use 
selective intervention with oral rabies vaccine in and around 
remote communities. This will not eliminate arctic fox rabies 
in red foxes or Arctic foxes, but instead would likely be part 
of an integrated rabies prevention and control strategy carried 
out in cooperation with the Indian Health Service and other 
partners.
    A few thoughts and concerns for consideration:
           The study focuses on potential management 
        strategies to reduce the risk of transmission to Tribal 
        members in Arctic regions, which would only include the 
        northernmost parts of the state, and probably excluding 
        fox populations in other areas of the state.
           The study targets fox species, but we know 
        that the disease is also transmitted through domestic 
        animals, such as unowned or difficult to capture dogs. 
        We have had success with orally vaccinating dogs in 
        other areas including free ranging dogs. Implementation 
        of similar strategies could strengthen rabies 
        prevention and control efforts in remote communities.
           While we appreciate the study, it is very 
        likely to identify the need for a valuable program to 
        protect the health and safety of native Alaskans. 
        However, without resources for a program, it is highly 
        unlikely that APHIS will be able to implement a program 
        that stands any chance of success. Further, diverting 
        resources from other regions could potentially erase 
        years of success with virus control and local 
        elimination elsewhere.
           Under the sections authorizing the use of 
        public health officers, it may be helpful to include 
        mention of USDA or APHIS such that future control 
        activities could be coordinated or conducted with 
        assistance from our Wildlife Services program.
    Thank you again for the opportunity to discuss this 
important program.

                        CHANGES IN EXISTING LAW

    In the opinion of the Committee, it is necessary to 
dispense with the requirements of subsection 12 of rule XXVI of 
the Standing Rules of the Senate to expedite business of the 
Senate.