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[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[S. 3042 Introduced in Senate (IS)]

109th CONGRESS
  2d Session
                                S. 3042

To amend the Public Health Service Act to improve preparedness for and 
 response to bioterrorism and other public health emergencies, and for 
                            other purposes.

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

                              May 25, 2006

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

_______________________________________________________________________

                                 A BILL

 
To amend the Public Health Service Act to improve preparedness for and 
 response to bioterrorism and other public health emergencies, 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 ``All-Hazards Public Health Emergency 
and Bioterrorism Preparedness and Response Act''.

     TITLE I--ALL-HAZARDS PUBLIC HEALTH EMERGENCY AND BIOTERRORISM 
                       PREPAREDNESS AND RESPONSE

SEC. 101. NATIONAL NEEDS TO COMBAT THREATS TO PUBLIC HEALTH.

    Section 319A(d) of the Public Health Service Act (42 U.S.C. 247d-
1(d)) is amended to read as follows:
    ``(d) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section $5,000,000 for fiscal year 2007 
and such sums as may be necessary for each subsequent fiscal year.''.

SEC. 102. ASSESSMENT OF PUBLIC HEALTH NEEDS.

    Section 319B of the Public Health Service Act (42 U.S.C. 247d-2) is 
amended--
            (1) in subsection (a), by inserting after the first 
        sentence the following: ``Such evaluation shall also include an 
        assessment, using the assessment guidelines described under 
        subsection (d), of each of the specific critical public health 
        threats likely to occur in the State, or consortium of 2 or 
        more States or political subdivision of States performing the 
        evaluation, including threats resulting from natural disasters, 
        outbreaks of disease, or a terrorist attack involving a 
        biological, chemical, or nuclear agent, or catastrophic 
        accident, and the capacity of such State, and localities within 
        the State, or consortium of 2 or more States or political 
        subdivisions of States, to respond to each such threat.'';
            (2) by striking subsection (e);
            (3) by redesignating subsection (d) as subsection (e);
            (4) by inserting after subsection (c) the following:
    ``(d) Assessment Guidelines.--
            ``(1) In general.--Not later than 180 days after the date 
        of enactment of the All-Hazards Public Health Emergency and 
        Bioterrorism Preparedness and Response Act the Secretary shall 
        establish guidelines for each recipient of a grant under 
        subsection (a) to use to conduct the assessment required under 
        such subsection. The Secretary shall ensure that such 
        guidelines--
                    ``(A) enable such recipient to--
                            ``(i) assess the preparedness of such 
                        recipient, and all local jurisdictions within 
                        the boundaries of such recipient, as well as 
                        businesses, individuals, healthcare providers, 
                        and community organizations to respond to the 
                        threats described under subsection (a), 
                        consistent with the National Response Plan 
                        prepared under section 502(6) of the Homeland 
                        Security Act of 2002; and
                            ``(ii) evaluate the progress and 
                        performance under a grant awarded under this 
                        section and section 319C-1 with respect to such 
                        preparedness;
                    ``(B) are based on specific, reasonable 
                preparedness goals that may be objectively measured;
                    ``(C) define the responsibilities of the public 
                health entities involved in preparedness and 
                specifically describe the activities that are the 
                responsibility of the Federal Government, the State and 
                local public health authorities, healthcare providers, 
                and other organizations, respectively, consistent with 
                the National Response Plan prepared under section 
                502(6) of the Homeland Security Act of 2002;
                    ``(D) to the extent practicable and applicable, are 
                harmonized with the standards of the Health Resources 
                and Services Administration and the Joint Commission on 
                Accreditation of Healthcare Organizations; and
                    ``(E) clearly describe a priority system with 
                respect to preparedness activities.
            ``(2) Annual review and update.--
                    ``(A) Review.--The Secretary shall review the 
                guidelines described under paragraph (1) on an annual 
                basis.
                    ``(B) Update.--Based on the review conducted under 
                subparagraph (A), the Secretary may update the 
                guidelines described under paragraph (1) as the 
                Secretary determines necessary.
            ``(3) Consultation.--In developing and revising the 
        guidelines under this subsection, the Secretary shall consult 
        with State, local, and community public health organizations 
        and expert individuals.''; and
            (5) by inserting after subsection (e), as so redesignated, 
        the following:
    ``(f) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section $75,000,000 for fiscal year 2007 
and such sums as may be necessary for each subsequent fiscal year.''.

SEC. 103. GRANTS TO IMPROVE STATE, LOCAL, AND HOSPITAL ALL-HAZARDS 
              PUBLIC HEALTH EMERGENCY AND BIOTERRORISM PREPAREDNESS AND 
              RESPONSE.

    (a) Additional Requirements.--Section 319C-1(b) of the Public 
Health Service Act (42 U.S.C. 247d-3a(b)) is amended by adding at the 
end the following:
            ``(3) Other requirements.--
                    ``(A) Application content.--An application under 
                paragraph (1) shall include a letter from the Governor 
                or chief elected official of the eligible entity 
                involved that includes--
                            ``(i) a description of the amount of any 
                        funds of the eligible entity involved (without 
                        regard to any Federal funds allocated to the 
                        eligible entity) allocated to carry out the 
                        activities described under the award under this 
                        section;
                            ``(ii) includes assurance by the Governor 
                        or chief elected official of the eligible 
                        entity involved that the eligible entity will 
                        conduct periodic simulation exercises to test 
                        State and local public health emergency 
                        preparedness and, as appropriate, will test 
                        existing emergency systems and capacity in 
                        conjunction with response to ongoing public 
                        health challenges, such as seasonal influenza; 
                        and
                            ``(iii) demonstrates understanding by the 
                        eligible entity involved of the performance 
                        standards that will be used to evaluate the use 
                        of the grant funds by such eligible entity 
                        under this section.
                    ``(B) Report on use of funding.--Not later than 60 
                days after the last day of each grant year in which an 
                eligible entity described in subsection (b)(1)(A) has 
                received amounts under an award under this section, 
                such eligible entity shall submit to the Secretary a 
                report that includes--
                            ``(i) a detailed description of the use of 
                        the funds made available under such award, 
                        including the amounts made available directly 
                        for expenditure by local jurisdictions through 
                        a grant, contract, or other arrangement;
                            ``(ii)(I) progress on the efforts to meet 
                        the performance standards described in the 
                        application under paragraph (1) and the 
                        assessment guidelines under section 319B(d);
                            ``(II) an explanation of any failures to 
                        meet such performance standards or guidelines; 
                        and
                            ``(III) the current capacity of the entity 
                        to meet such performance standards and 
                        guidelines;
                            ``(iii) the findings of any simulation 
                        exercises conducted by the entity, or local 
                        jurisdiction within the boundaries of such 
                        entity, to test emergency preparedness, and the 
                        remediation steps taken or planned in response 
                        to such findings; and
                            ``(iv) a detailed description of the State 
                        budget expenditures of the entity on public 
                        health emergency preparedness for the fiscal 
                        year that is the subject of the report.''.
    (b) Accountability for Eligible Entities.--Section 319C-1 of the 
Public Health Service Act (42 U.S.C. 247d-3a) is amended--
            (1) by striking subsection (c) and inserting the following:
    ``(c) All-Hazards Public Health Emergency and Bioterrorism 
Preparedness and Response Plan.--
            ``(1) In general.--Not later than 60 days after 
        notification of receipt of an award under subsection (a), an 
        eligible entity described in subsection (b)(1)(A) shall prepare 
        and submit to the Secretary an All-Hazards Public Health 
        Emergency and Bioterrorism Preparedness and Response Plan.
            ``(2) Content of plan.--Recognizing the assessment of 
        public health needs and threats conducted under section 319B, 
        an All-Hazards Public Health Emergency and Bioterrorism 
        Preparedness and Response Plan submitted to the Secretary under 
        paragraph (1) shall--
                    ``(A) include an assessment of basic preparedness 
                for the threats described in section 319B(a), using the 
                assessment guidelines established under section 
                319B(d);
                    ``(B) describe the performance standards under 
                subsection (i), which shall be used to measure the 
                performance of the eligible entity described in 
                subsection (b)(1)(A);
                    ``(C) include a description of activities to be 
                carried out by the eligible entity to address the needs 
                and threats identified in such assessment (or an 
                equivalent assessment);
                    ``(D) include a description of any simulation 
                exercises planned by the entity to test emergency 
                preparedness;
                    ``(E) include a description of the means by which 
                the entity will provide support to, and coordinate 
                with, local jurisdictions in planning and in conducting 
                simulation exercises to test emergency preparedness, 
                performance assessments, and other preparedness 
                activities; and
                    ``(F) include evidence that a majority of local 
                jurisdictions with a majority of the population of the 
                entity concur with the entity's plan.
            ``(3) Approval of plan prior to receipt of funds.--
                    ``(A) In general.--The Secretary shall dispense 
                only 50 percent of the amount of an award under this 
                section for an eligible entity described in subsection 
                (b)(1)(A) unless the Secretary has approved the All-
                Hazards Public Health Emergency and Bioterrorism 
                Preparedness and Response Plan submitted under 
                paragraph (1) by such entity.
                    ``(B) Modification.--The Secretary may require such 
                entity to modify the All-Hazards Public Health 
                Emergency and Bioterrorism Preparedness and Response 
                Plan of such eligible entity prior to dispensing any 
                amount of an award not dispensed under subparagraph 
                (A).
                    ``(C) Approval of plan.--The Secretary shall ensure 
                that the total amount of an award under this section is 
                dispensed not later than 60 days after the date of 
                approval by the Secretary of such All-Hazards Public 
                Health Emergency and Bioterrorism Preparedness and 
                Response Plan.'';
            (2) in subsection (e)(1)(A), by striking clause (i) and 
        inserting the following:
                            ``(i) Bioterrorism, acute outbreaks of 
                        infectious diseases, or other threats 
                        identified in an assessment of public health 
                        needs pursuant to section 319B(a).'';
            (3) by redesignating subsections (i) and (j) as subsections 
        (l) and (m), respectively; and
            (4) by inserting after subsection (h) the following:
    ``(i) Performance Standards.--
            ``(1) In general.--
                    ``(A) Establishment.--Not later than 180 days after 
                the date of enactment of the All-Hazards Public Health 
                Emergency and Bioterrorism Preparedness and Response 
                Act, the Secretary shall establish measurable 
                performance standards with respect to basic 
                preparedness for the public health threats described 
                under section 319B(a).
                    ``(B) Annual review.--The Secretary shall review 
                such performance standards on an annual basis, and 
                revise such standards as necessary.
            ``(2) Content.--The Secretary shall ensure that such 
        performance standards--
                    ``(A) provide guidance to each eligible entity 
                described in subsection (b)(1)(A) in evaluating the 
                performance of such entity under a grant under this 
                section;
                    ``(B) include standards related to--
                            ``(i) improving laboratory capacity;
                            ``(ii) measuring the capacity of States and 
                        localities to distribute and administer medical 
                        resources from the Strategic National Stockpile 
                        during a public health emergency;
                            ``(iii) measuring the adequacy of State and 
                        local plans to address the needs of special 
                        needs populations (including low-income 
                        individuals and families, disabled individuals, 
                        the homeless, individuals who do not speak 
                        English, and the elderly) during a public 
                        health emergency;
                            ``(iv) measuring public health surge 
                        capacity including planning to assure the 
                        ability of the health care system to rapidly 
                        expand beyond normal services to meet the 
                        increased demand for qualified personnel, 
                        medical care, and public health services, which 
                        would include the ability to obtain additional 
                        resources as needed;
                            ``(v) improving emergency risk 
                        communication plans, health information 
                        dissemination, and public participation and 
                        understanding;
                            ``(vi) improving public health workforce 
                        training and recruitment;
                            ``(vii) integrating public health 
                        preparedness with State and local emergency 
                        management plans;
                            ``(viii) assuring coherent command and 
                        control authority at the State and local levels 
                        for emergency response; and
                            ``(ix) any other issue as determined 
                        appropriate by the Secretary;
                    ``(C) are based on specific, reasonable 
                preparedness goals that may be objectively measured;
                    ``(D) define the responsibilities of the public 
                health entities involved in preparedness and 
                specifically describe the activities that are the 
                responsibility of the Federal Government, the State or 
                local public health authority, healthcare providers, 
                and other organizations, respectively, consistent with 
                the National Response Plan prepared under section 
                502(6) of the Homeland Security Act of 2002;
                    ``(E) to the extent practicable and applicable, are 
                harmonized with the standards of the Health Resources 
                and Services Administration and the Joint Commission on 
                Accreditation of Healthcare Organizations; and
                    ``(F) clearly describe a priority system with 
                respect to preparedness activities.
            ``(3) Consultation.--In developing and revising the 
        performance standards under this subsection, the Secretary 
        shall consult with State, local, and community public health 
        organizations and expert individuals.
    ``(j) Biennial Evaluation; Report.--
            ``(1) In general.--Not later than September 30, 2008, and 
        on a biennial basis thereafter, the Secretary--
                    ``(A) shall conduct an evaluation of each eligible 
                entity described in subsection (b)(1)(A) with respect 
                to--
                            ``(i) preparedness for the threats 
                        described under section 319B(a); and
                            ``(ii) the progress and performance of such 
                        eligible entity under a grant awarded under 
                        this section;
                    ``(B) shall include in such evaluation an 
                assessment of the extent to which the eligible entity 
                meets each performance standard established pursuant to 
                subsection (i); and
                    ``(C) may contract with an entity to conduct such 
                evaluation.
            ``(2) Report.--On a biennial basis, the Secretary shall 
        publish by October 1, a report that describes the outcome of 
        each evaluation conducted under paragraph (1).
            ``(3) Dissemination to the public.--The Secretary shall 
        make available to the public the report described under 
        paragraph (2) to the extent that such availability does not 
        threaten national security, as determined by the Secretary.
    ``(k) Working Group.--
            ``(1) In general.--The Secretary shall convene a working 
        group that shall develop successful means for the eligible 
        entity described in subsection (b)(1)(A) to disseminate 
        information regarding best practices of preparing for the 
        threats described under section 319B(a) using the funding 
        awarded under a grant under this section.
            ``(2) Consultation.--In convening the working group under 
        paragraph (1), the Secretary may consult with national and 
        local public health organizations, healthcare providers, and 
        other stakeholders that have expertise in preparedness for 
        bioterrorism and other public health emergencies.''.
    (c) Funding.--Section 319C-1(m) of the Public Health Service Act 
(42 U.S.C. 247d-3a(j)), as redesignated by subsection (b), is amended--
            (1) in paragraph (1), by striking subparagraph (A) and (B) 
        and inserting the following:
                    ``(A) Fiscal year 2007.--
                            ``(i) Authorizations.--For the purpose of 
                        carrying out this section, there is authorized 
                        to be appropriated $1,700,000,000 for fiscal 
                        year 2007, of which--
                                    ``(I) $950,000,000 is authorized to 
                                be appropriated for awards pursuant to 
                                paragraph (3) (subject to the authority 
                                of the Secretary to make awards 
                                pursuant to paragraphs (4) and (5)); 
                                and
                                    ``(II) $750,000,000 is authorized 
                                to be appropriated--
                                            ``(aa) for awards under 
                                        subsection (a) to States, 
                                        notwithstanding the eligibility 
                                        conditions under subsection 
                                        (b), for the purpose of 
                                        enhancing the preparedness of 
                                        hospitals (including children's 
                                        hospitals), clinics, health 
                                        centers, and primary care 
                                        facilities for bioterrorism and 
                                        other public health 
                                        emergencies; and
                                            ``(bb) for Federal, State, 
                                        and local planning and 
                                        administrative activities 
                                        related to such purpose.
                            ``(ii) Contingent additional 
                        authorization.--If a significant change in 
                        circumstances warrants an increase in the 
                        amount authorized to be appropriated under 
                        clause (i) for fiscal year 2007, there are 
                        authorized to be appropriated such sums as may 
                        be necessary for such year for carrying out 
                        this section, in addition to the amount 
                        authorized in clause (i).
                    ``(B) Fiscal year 2008.--For the purpose of 
                carrying out this section, there are authorized to be 
                appropriated $1,800,000,000 for fiscal year 2008, of 
                which--
                            ``(i) $950,000,000 is authorized for awards 
                        described under subparagraph (A)(i)(I); and
                            ``(ii) $850,000,000 is authorized to be 
                        appropriated for awards and activities 
                        described under subparagraph (A)(i)(II).
                    ``(C) Fiscal year 2009.--For the purpose of 
                carrying out this section, there are authorized to be 
                appropriated $1,800,000,000 of which--
                            ``(i) $950,000,000 is authorized for awards 
                        described under subparagraph (A)(i)(I); and
                            ``(ii) $850,000,000 is authorized for 
                        awards described under subparagraph (A)(i)(II).
                    ``(D) Other fiscal years.--For the purpose of 
                carrying out this section, there are authorized to be 
                appropriated such sums as may be necessary for fiscal 
                year 2010 and each fiscal year thereafter.'';
            (2) in paragraphs (3), (4), (5), and (6), by--
                    (A) striking ``2003'' each place it appears and 
                inserting ``2007''; and
                    (B) striking ``2002'' each place it appears and 
                inserting ``2006''; and
            (3) by adding at the end the following:
            ``(7) Other funding requirements.--
                    ``(A) Withholding of funds.--
                            ``(i) In general.--Beginning in fiscal year 
                        2008, and each fiscal year thereafter, the 
                        Secretary may withhold distributions of funding 
                        under an award under this section if the 
                        Secretary determines--
                                    ``(I) that the eligible entity has 
                                not sufficiently met the guidelines 
                                under section 319B(d) and performance 
                                standards described in the application 
                                under subsection (b)(3) involved for 
                                the previous fiscal year and has not 
                                demonstrated that efforts to meet such 
                                guidelines and performance standards 
                                are in place;
                                    ``(II) that such eligible entity 
                                has expended such funding for the 
                                previous fiscal year on activities 
                                inconsistent with the applicable All-
                                Hazards Public Health Emergency and 
                                Bioterrorism Preparedness and Response 
                                Plan.
                            ``(ii) Exception.--For purposes of applying 
                        clause (i), the Secretary may grant a waiver 
                        with respect to the designated activities 
                        described in clause (i)(II).
                    ``(B) Maximum carryover amount.--
                            ``(i) In general.--For each fiscal year, 
                        the Secretary shall determine the maximum 
                        percentage amount of an award under this 
                        section that an eligible entity may carryover 
                        to the succeeding fiscal year.
                            ``(ii) Amount exceeded.--For each fiscal 
                        year, if the percentage amount of an award 
                        under this section unexpended by an eligible 
                        entity exceeds the maximum percentage permitted 
                        by the Secretary under clause (i), the eligible 
                        entity shall return to the Secretary the 
                        portion of the unexpended amount that exceeds 
                        the maximum amount permitted to be carried over 
                        by the Secretary.
                            ``(iii) Action by secretary.--The Secretary 
                        shall redistribute any amount returned to the 
                        Secretary under clause (ii) to other eligible 
                        entities that demonstrate need and capacity to 
                        expend such funds appropriately within the next 
                        fiscal year, as determined by the Secretary.
                            ``(iv) Waiver.--An eligible entity may 
                        apply to the Secretary for a waiver of the 
                        maximum percentage amount under clause (i). 
                        Such an application for a waiver shall include 
                        an explanation why such requirement should not 
                        apply to the eligible entity and the steps 
                        taken by such eligible entity to ensure that 
                        all funds under an award under this section 
                        will be expended appropriately.''.
    (d) Conforming Amendments.--Section 319C-1 of the Public Health 
Service Act (42 U.S.C. 247d-3a) is amended--
            (1) in subsection (b)(1)(A)(iii)--
                    (A) in subclause (III), by striking the semicolon 
                and inserting ``; and'';
                    (B) in subclause (IV), by striking ``; and'' and 
                inserting ``; or''; and
                    (C) by striking subclause (V); and
            (2) by striking ``Bioterrorism and Other Public Health 
        Emergency Preparedness and Response Plan'' each place it 
        appears and inserting ``All-Hazards Public Health Emergency and 
        Bioterrorism Preparedness and Response Plan''.

SEC. 104. STUDY OF THE PUBLIC HEALTH EMERGENCY WORKFORCE.

    (a) In General.--
            (1) Study.--The Secretary of Health and Human Services 
        shall conduct a study that analyzes the size and scope of the 
        healthcare and public health workforces necessary to respond to 
        a range of common public health issues and public health 
        emergencies.
            (2) Report to congress.--Not later than 270 days after the 
        date of enactment of this Act, the Secretary of Health and 
        Human Services shall submit to Congress a report that describes 
        the outcomes of the study conducted pursuant to paragraph (1), 
        including any recommendations for legislation.
    (b) Authorization of Appropriations.--There are authorized to be 
appropriated $1,000,000 to carry out this section.

SEC. 105. ASSISTANT SECRETARY FOR PUBLIC HEALTH.

    (a) In General.--
            (1) Public health service.--Title II of the Public Health 
        Service Act (42 U.S.C. 202 et seq.) is amended by striking 
        section 201 and inserting the following:

     ``assistant secretary for public health; public health service

    ``Sec. 201.  There is established within the Department of Health 
and Human Services the Office of the Assistant Secretary for Public 
Health. The Public Health Service in such Department shall be 
administered by the Assistant Secretary for Public Health under the 
supervision and direction of the Secretary.''.
            (2) Bioterrorism and other public health emergency 
        preparedness.--Section 2811(a) of the Public Health Service Act 
        (42 U.S.C. 300hh-11(a)) is amended--
                    (A) by amending the subsection heading to read as 
                follows: ``Assistant Secretary for Public Health'';
                    (B) by amending paragraph (1) to read as follows:
            ``(1) In general.--The provisions of this title and all 
        other public health preparedness functions of the Department of 
        Health and Human Services shall be administered by the 
        Assistant Secretary for Public Health under the supervision and 
        direction of the Secretary.''; and
                    (C) in paragraph (2), by striking ``Assistant 
                Secretary for Public Health Emergency Preparedness'' 
                and inserting ``Assistant Secretary for Public 
                Health''.
    (b) Conforming Amendments.--The Public Health Service Act (42 
U.S.C. 201 et seq.) is amended by--
            (1) striking ``Assistant Secretary for Health'' each place 
        it appears and inserting ``Assistant Secretary for Public 
        Health''; and
            (2) striking ``Assistant Secretary for Public Health 
        Emergency Preparedness'' each place it appears and inserting 
        ``Assistant Secretary for Public Health''.
    (c) Transfer of Functions; References.--
            (1) Transfer of functions.--There shall be transferred to 
        the Office of the Assistant Secretary for Public Health 
        established under section 201 of the Public Health Service Act 
        (as amended by subsection (a)) the functions, personnel, 
        assets, and obligations of the Assistant Secretary for Health 
        and the Assistant Secretary for Public Health Emergency 
        Preparedness under the Public Health Service Act (42 U.S.C. 202 
        et seq.) as in effect on the day before the date of enactment 
        of this Act.
            (2) References.--Any reference in any Federal law, 
        Executive order, rule, regulation, or delegation of authority, 
        or any document of or pertaining to the Assistant Secretary for 
        Health or the Assistant Secretary for Public Health Emergency 
        Preparedness under the Public Health Service Act (42 U.S.C. 202 
        et seq.) as in effect the day before the date of enactment of 
        this Act, shall be deemed to be a reference to the Assistant 
        Secretary for Public Health under section 201 of the Public 
        Health Service Act (as amended by subsection (a)).

SEC. 106. REQUIREMENT OF PUBLIC HEALTH EMERGENCY CONTINGENCY PLANS.

    Subtitle B of title XXVIII of the Public Health Service Act (42 
U.S.C. 300hh-11 et seq.) is amended by adding at the end the following:

``SEC. 2812. BIOTERRORISM AND OTHER PUBLIC HEALTH EMERGENCY CONTINGENCY 
              PLANS.

    ``Notwithstanding any other provision of this Act, beginning with 
fiscal year 2008, any entity that receives a grant under this Act to 
provide health-related services, or any other entity as the Secretary 
determines appropriate, shall, as a condition of receiving such a 
grant, provide assurance to the Secretary that such entity has a plan 
for operational continuity in the event of bioterrorism or other public 
health emergency.''.

SEC. 107. BIOTERRORISM AND PUBLIC HEALTH RESPONSE EMERGENCY FUND.

    Subtitle B of title XXVIII of the Public Health Service Act (42 
U.S.C. 300hh-11 et seq.), as amended by section 7, is further amended 
by adding at the end the following:

``SEC. 2813. BIOTERRORISM AND PUBLIC HEALTH RESPONSE EMERGENCY FUND.

    ``(a) In General.--There is established a fund to provide short-
term assistance to hospitals, federally qualified health centers, rural 
health clinics, public health laboratories, and other healthcare 
providers and other members of the public health workforce, as 
determined appropriate by the Secretary, in the event of bioterrorism 
or other public health emergency.
    ``(b) Authorization of Appropriations.--There are authorized to be 
appropriated such sums as may be necessary to carry out this section 
for fiscal year 2007 and each subsequent fiscal year.''.

SEC. 108. AUTHORITY TO WAIVE STATE SHARE REQUIREMENTS AND TO ALLOW 
              PRESUMPTIVE ELIGIBILITY FOR ANY CATEGORY OF ELIGIBLE 
              INDIVIDUALS UNDER MEDICAID AND SCHIP DURING STATE 
              EMERGENCIES.

    Section 1135(b) of the Social Security Act (42 U.S.C. 1320b-5(b)) 
is amended--
            (1) in paragraph (6), by striking ``and'' at the end;
            (2) in paragraph (7)(C)(ii), by striking the period at the 
        end and inserting a semicolon; and
            (3) by inserting after paragraph (7)(C)(ii), the following 
        new paragraphs:
            ``(8) the Federal matching rate being below 100 percent 
        under title XIX or XXI for healthcare items and services 
        furnished by a healthcare provider and administrative costs 
        related to the furnishing of such items and services; and
            ``(9) providing for a period of presumptive eligibility 
        under title XIX or XXI for any category of individuals eligible 
        for medical assistance or child health assistance under such 
        title (including under waiver authority).''.

       TITLE II--PUBLIC HEALTH PREPAREDNESS WORKFORCE DEVELOPMENT

SEC. 201. PUBLIC HEALTH WORKFORCE SCHOLARSHIP AND LOAN REPAYMENT 
              PROGRAM.

    Part E of title VII of the Public Health Service Act (42 U.S.C. 
294n et seq.) is amended by adding at the end the following:

  ``Subpart 3--Public Health Workforce Scholarship and Loan Repayment 
                                Program

``SEC. 780. PUBLIC HEALTH WORKFORCE SCHOLARSHIP PROGRAM.

    ``(a) Establishment.--The Secretary shall establish the Public 
Health Workforce Scholarship Program (referred to in this section as 
the `Program') to assure an adequate supply of public health 
professionals to eliminate critical public health preparedness 
workforce shortages in Federal, State, local, and tribal public health 
agencies.
    ``(b) Eligibility.--To be eligible to participate in the Program, 
an individual shall--
            ``(1) be accepted for enrollment, or be enrolled, as a 
        full-time student--
                    ``(A) in an accredited (as determined by the 
                Secretary) educational institution in a State or 
                territory; and
                    ``(B) in a course of study or program, offered by 
                such institution and approved by the Secretary, leading 
                to a health professions degree (graduate, 
                undergraduate, or associate) or certificate, which may 
                include laboratory sciences, epidemiology, 
                environmental health, health communications, health 
                education and behavioral sciences, information 
                sciences, or public administration;
            ``(2) be a United States citizen;
            ``(3) submit an application to the Secretary to participate 
        in the Program; and
            ``(4) sign and submit to the Secretary, at the time of the 
        submittal of such application, a written contract (described in 
        subsection (d)) to serve, upon the completion of the course of 
        study or program involved, for the applicable period of 
        obligated service in the full-time employment of a Federal, 
        State, local, or tribal public health agency.
    ``(c) Dissemination of Information.--
            ``(1) Application and contract forms.--The Secretary shall 
        disseminate application forms and contract forms to individuals 
        desiring to participate in the Program. The Secretary shall 
        include with such forms--
                    ``(A) a fair summary of the rights and liabilities 
                of an individual whose application is approved (and 
                whose contract is accepted) by the Secretary, including 
                in the summary a clear explanation of the damages to 
                which the United States is entitled to recover in the 
                case of the individual's breach of the contract; and
                    ``(B) information relating to the service 
                obligation and such other information as may be 
                necessary for the individual to understand the 
                individual's prospective participation in the Program.
            ``(2) Information for schools.--The Secretary shall 
        distribute to health professions schools and other appropriate 
        accredited academic institutions and relevant Federal, State, 
        local, and tribal public health agencies, materials providing 
        information on the Program and shall encourage such schools, 
        institutions, and agencies to disseminate such materials to 
        potentially eligible students.
            ``(3) Understandability and timing.--The application form, 
        contract form, and all other information furnished by the 
        Secretary under this section shall--
                    ``(A) be written in a manner calculated to be 
                understood by the average individual applying to 
                participate in the Program; and
                    ``(B) be made available by the Secretary on a date 
                sufficiently early to ensure that such individuals have 
                adequate time to carefully review and evaluate such 
                forms and information.
    ``(d) Contract.--The written contract (referred to in this section) 
between the Secretary and an individual shall contain--
            ``(1) an agreement on the part of the Secretary that the 
        Secretary will provide the individual with a scholarship for a 
        period of years (not to exceed 4 academic years) during which 
        the individual shall pursue an approved course of study or 
        program to prepare the individual to serve in the public health 
        workforce;
            ``(2) an agreement on the part of the individual that the 
        individual will--
                    ``(A) maintain full-time enrollment in the approved 
                course of study or program described in subsection 
                (b)(1) until the individual completes that course of 
                study or program;
                    ``(B) while enrolled in the course of study or 
                program, maintain an acceptable level of academic 
                standing (as determined under regulations of the 
                Secretary by the educational institution offering such 
                course of study or program); and
                    ``(C) immediately upon graduation, serve in the 
                full-time employment of a Federal, State, local, or 
                tribal public health agency in a position related to 
                the course of study or program for which the contract 
                was awarded for a period of time (referred to in this 
                section as the `period of obligated service') equal to 
                the greater of--
                            ``(i) 1 year for each academic year for 
                        which the individual was provided a scholarship 
                        under the Program; or
                            ``(ii) 2 years;
            ``(3) an agreement by both parties as to the nature and 
        extent of the scholarship assistance, which may include--
                    ``(A) payment of the tuition expenses of the 
                individual;
                    ``(B) payment of all other reasonable educational 
                expenses of the individual including fees, books, 
                equipment and laboratory expenses; and
                    ``(C) payment of a stipend of not more than $1,200 
                per month for each month of the academic year involved 
                (indexed to account for increases in the Consumer Price 
                Index); and
            ``(4) a provision that any financial obligation of the 
        United States arising out of a contract entered into under this 
        section and any obligation of the individual which is 
        conditioned thereon, is contingent upon funds being 
        appropriated for scholarships under this section;
            ``(5) a statement of the damages to which the United States 
        is entitled for the individual's breach of the contract; and
            ``(6) such other statements of the rights and liabilities 
        of the Secretary and of the individual, not inconsistent with 
        the provisions of this section.
    ``(e) Postponing Obligated Service.--With respect to an individual 
receiving a degree or certificate from a school of medicine, public 
health, nursing, osteopathic medicine, dentistry, veterinary medicine, 
optometry, podiatry, pharmacy, psychology, or social work under a 
scholarship under the Program, the date of the initiation of the period 
of obligated service may be postponed, upon the submission by the 
individual of a petition for such postponement and approval by the 
Secretary, to the date on which the individual completes an approved 
internship, residency, or other relevant public health preparedness 
advanced training program.
    ``(f) Administrative Provisions.--
            ``(1) Contracts with institutions.--The Secretary may 
        contract with an educational institution in which a participant 
        in the Program is enrolled, for the payment to the educational 
        institution of the amounts of tuition and other reasonable 
        educational expenses described in subsection (d)(3).
            ``(2) Employment ceilings.--Notwithstanding any other 
        provision of law, individuals who have entered into written 
        contracts with the Secretary under this section, while 
        undergoing academic training, shall not be counted against any 
        employment ceiling affecting the Department or any other 
        Federal agency.
    ``(g) Breach of Contract.--An individual who fails to comply with 
the contract entered into under subsection (d) shall be subject to the 
same financial penalties as provided for under section 338E for 
breaches of scholarship contracts under sections 338A.

``SEC. 781. PUBLIC HEALTH WORKFORCE LOAN REPAYMENT PROGRAM.

    ``(a) Establishment.--The Secretary shall establish the Public 
Health Workforce Loan Repayment Program (referred to in this section as 
the `Program') to assure an adequate supply of public health 
professionals to eliminate critical public health preparedness 
workforce shortages in Federal, State, local, and tribal public health 
agencies.
    ``(b) Eligibility.--To be eligible to participate in the Program, 
an individual shall--
            ``(1)(A) be accepted for enrollment, or be enrolled, as a 
        full-time or part-time student in an accredited academic 
        educational institution in a State or territory in the final 
        year of a course of study or program offered by that 
        institution leading to a health professions degree or 
        certificate, which may include a degree (graduate, 
        undergraduate, or associate) or certificate relating to 
        laboratory sciences, epidemiology, environmental health, health 
        communications, health education and behavioral sciences, 
        information sciences, or public administration; or
            ``(B) have graduated, within 10 years, from an accredited 
        educational institution in a State or territory and received a 
        health professions degree (graduate, undergraduate, or 
        associate) or certificate, which may include a degree 
        (graduate, undergraduate, or associate) or certificate relating 
        to laboratory sciences, epidemiology, environmental health, 
        health communications, health education and behavioral 
        sciences, information sciences, or public administration;
            ``(2)(A) in the case of an individual described in 
        paragraph (1)(A), have accepted employment with a Federal, 
        State, local, or tribal public health agency, as recognized by 
        the Secretary, to commence upon graduation; or
            ``(B) in the case of an individual described in paragraph 
        (1)(B), be employed by, or have accepted employment with, a 
        Federal, State, local, or tribal public health agency, as 
        recognized by the Secretary;
            ``(3) be a United States citizen;
            ``(4) submit an application to the Secretary to participate 
        in the Program; and
            ``(5) sign and submit to the Secretary, at the time of the 
        submittal of such application, a written contract (described in 
        subsection (d)) to serve for the applicable period of obligated 
        service in the full-time employment of a Federal, State, local, 
        or tribal public health agency.
    ``(c) Dissemination of Information.--
            ``(1) Application and contract forms.--The Secretary shall 
        disseminate application forms and contract forms to individuals 
        desiring to participate in the Program. The Secretary shall 
        include with such forms--
                    ``(A) a fair summary of the rights and liabilities 
                of an individual whose application is approved (and 
                whose contract is accepted) by the Secretary, including 
                in the summary a clear explanation of the damages to 
                which the United States is entitled to recover in the 
                case of the individual's breach of the contract; and
                    ``(B) information relating to the service 
                obligation and such other information as may be 
                necessary for the individual to understand the 
                individual's prospective participation in the Program.
            ``(2) Information for schools.--The Secretary shall 
        distribute to health professions schools and other appropriate 
        accredited academic institutions and relevant Federal, State, 
        local, and tribal public health agencies, materials providing 
        information on the Program and shall encourage such schools, 
        institutions, and agencies to disseminate such materials to 
        potentially eligible students.
            ``(3) Understandability and timing.--The application form, 
        contract form, and all other information furnished by the 
        Secretary under this section shall--
                    ``(A) be written in a manner calculated to be 
                understood by the average individual applying to 
                participate in the Program; and
                    ``(B) be made available by the Secretary on a date 
                sufficiently early to ensure that such individuals have 
                adequate time to carefully review and evaluate such 
                forms and information.
    ``(d) Contract.--The written contract (referred to in this section) 
between the Secretary and an individual shall contain--
            ``(1) an agreement on the part of the Secretary that the 
        Secretary will repay on behalf of the individual loans incurred 
        by the individual in the pursuit of the relevant public health 
        preparedness workforce educational degree or certificate in 
        accordance with the terms of the contract;
            ``(2) an agreement on the part of the individual that the 
        individual will serve, immediately upon graduation in the case 
        of an individual described in subsection (b)(1)(A) service, or 
        in the case of an individual described in subsection (b)(1)(B) 
        continue to serve, in the full-time employment of a Federal, 
        State, local, or tribal public health agency in a position 
        related to the course of study or program for which the 
        contract was awarded for a period of time (referred to in this 
        section as the `period of obligated service') equal to the 
        greater of--
                    ``(A) 3 years; or
                    ``(B) such longer period of time as determined 
                appropriate by the Secretary and the individual;
            ``(3) an agreement, as appropriate, on the part of the 
        individual to relocate for the entire period of obligated 
        service to a political jurisdiction designated by the Secretary 
        to be a priority service area in exchange for an additional 
        loan repayment incentive amount that does not exceed 20 percent 
        of the individual's eligible loan repayment award per academic 
        year such that the total of the loan repayment and the 
        incentive amount shall not exceed \1/3\ of the eligible loan 
        balance per year;
            ``(4) in the case of an individual described in subsection 
        (b)(1)(A) who is in the final year of study and who has 
        accepted employment with a Federal, State, local, or tribal 
        public health agency upon graduation, an agreement on the part 
        of the individual to complete the education or training, 
        maintain an acceptable level of academic standing (as 
        determined by the education institution offering the course of 
        study or training), and agree to the period of obligated 
        service;
            ``(5) a provision that any financial obligation of the 
        United States arising out of a contract entered into under this 
        section and any obligation of the individual that is 
        conditioned thereon, is contingent on funds being appropriated 
        for loan repayments under this section;
            ``(6) a statement of the damages to which the United States 
        is entitled, under this section for the individual's breach of 
        the contract; and
            ``(7) such other statements of the rights and liabilities 
        of the Secretary and of the individual, not inconsistent with 
        this section.
    ``(e) Payments.--
            ``(1) In general.--A loan repayment provided for an 
        individual under a written contract under the Program shall 
        consist of payment, in accordance with paragraph (2), on behalf 
        of the individual of the principal, interest, and related 
        expenses on government and commercial loans received by the 
        individual regarding the undergraduate or graduate education of 
        the individual (or both), which loans were made for--
                    ``(A) tuition expenses; or
                    ``(B) all other reasonable educational expenses, 
                including fees, books, and laboratory expenses, 
                incurred by the individual.
            ``(2) Payments for years served.--
                    ``(A) In general.--For each year of obligated 
                service that an individual contracts to serve under 
                subsection (d) the Secretary may pay up to $35,000 on 
                behalf of the individual for loans described in 
                paragraph (1). With respect to participants under the 
                Program whose total eligible loans are less than 
                $105,000, the Secretary shall pay an amount that does 
                not exceed \1/3\ of the eligible loan balance for each 
                year of obligated service of the individual.
                    ``(B) Repayment schedule.--Any arrangement made by 
                the Secretary for the making of loan repayments in 
                accordance with this subsection shall provide that any 
                repayments for a year of obligated service shall be 
                made no later than the end of the fiscal year in which 
                the individual completes such year of service.
            ``(3) Tax liability.--For the purpose of providing 
        reimbursements for tax liability resulting from payments under 
        paragraph (2) on behalf of an individual--
                    ``(A) the Secretary shall, in addition to such 
                payments, make payments to the individual in an amount 
                not to exceed 39 percent of the total amount of loan 
                repayments made for the taxable year involved; and
                    ``(B) may make such additional payments as the 
                Secretary determines to be appropriate with respect to 
                such purpose.
            ``(4) Payment schedule.--The Secretary may enter into an 
        agreement with the holder of any loan for which payments are 
        made under the Program to establish a schedule for the making 
        of such payments.
    ``(f) Postponing Obligated Service.--With respect to an individual 
receiving a degree or certificate from a school of medicine, public 
health, nursing, osteopathic medicine, dentistry, veterinary medicine, 
optometry, podiatry, pharmacy, psychology, or social work, the date of 
the initiation of the period of obligated service may be postponed, 
upon the submission by the individual of a petition for such 
postponement and approval by the Secretary, to the date on which the 
individual completes an approved internship, residency, or other 
relevant public health preparedness advanced training program.
    ``(g) Administrative Provisions.--
            ``(1) Hiring priority.--Notwithstanding any other provision 
        of law, Federal, State, local, and tribal public health 
        agencies may give hiring priority to any individual who has 
        qualified for and is willing to execute a contract to 
        participate in the Program.
            ``(2) Employment ceilings.--Notwithstanding any other 
        provision of law, individuals who have entered into written 
        contracts with the Secretary under this section, who are 
        serving as full-time employees of a State, local, or tribal 
        public health agency, or who are in the last year of public 
        health workforce academic preparation, shall not be counted 
        against any employment ceiling affecting the Department or any 
        other Federal agency.
    ``(h) Breach of Contract.--An individual who fails to comply with 
the contract entered into under subsection (d) shall be subject to the 
same financial penalties as provided for under section 338E for 
breaches of loan repayment contracts under section 338B.

``SEC. 782. GRANTS FOR STATE AND LOCAL PROGRAMS.

    ``(a) In General.--For the purpose of operating State, local, and 
tribal public health workforce loan repayment programs, the Secretary 
shall award a grant to any public health agency that receives public 
health preparedness cooperative agreements, or other successor 
cooperative agreements, from the Department of Health and Human 
Services.
    ``(b) Requirements.--A State or local loan repayment program 
operated with a grant under subsection (a) shall incorporate all 
provisions of the Public Health Workforce Loan Repayment Program under 
section 781, including the ability to designate priority service areas 
within the relevant political jurisdiction.
    ``(c) Administration.--The head of the State or local office that 
receives a grant under subsection (a) shall be responsible for 
contracting and operating the loan repayment program under the grant.
    ``(d) Rule of Construction.--Nothing in this section shall be 
construed to obligate or limit any State, local, or tribal government 
entity from implementing independent or supplemental public health 
workforce development programs within their borders.

``SEC. 783. CATALOGUE OF FEDERAL PUBLIC HEALTH WORKFORCE EMPLOYMENT 
              OPPORTUNITIES.

    ``(a) In General.--The Director of the Office of Personnel 
Management, in cooperation with the Secretary, shall ensure that within 
the Office of Personnel Management's website, there is an on-line 
catalogue of public health workforce employment opportunities in the 
Federal Government.
    ``(b) Requirements.--To the extent practical, the catalogue 
described in subsection (a) shall include--
            ``(1) existing and projected job openings in the Federal 
        public health workforce; and
            ``(2) a general discussion of the occupations that comprise 
        the Federal public health workforce.
    ``(c) Information.--The Secretary shall include a copy of the 
catalogue, or a prominent reference to the catalogue, in--
            ``(1) the information for schools provided under section 
        780(c)(2) and 781(c)(2); and
            ``(2) the application forms provided under sections 
        780(c)(1) and 781(c)(1).

``SEC. 784. AUTHORIZATION OF APPROPRIATIONS.

    ``(a) Scholarship Program.--For the purpose of carrying out section 
780, there is authorized to be appropriated $35,000,000 for fiscal year 
2006, and such sums as may be necessary for each of fiscal years 2007 
through 2011.
    ``(b) Loan Repayment Programs.--
            ``(1) In general.--For the purpose of carrying out sections 
        781 and 782, there is authorized to be appropriated 
        $195,000,000 for fiscal year 2006, and such sums as may be 
        necessary for each of fiscal years 2007 through 2011.
            ``(2) Allocation.--Not less than 80 percent of the amount 
        appropriated under paragraph (1) in each fiscal year shall be 
        made available to carry out section 782.

``SEC. 785. SEVERABILITY.

    ``If any provision of this subpart, or the application of such 
provision to any person or circumstance, is held to be 
unconstitutional, the remainder of this subpart and the application of 
the provisions of this subpart to any person or circumstance shall not 
be affected thereby.''.
                                 <all>
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