II 

112TH CONGRESS 

1ST SESSION S. 1257 

To establish grant programs to improve the health of border area residents 

and for all hazards preparedness in the border area including bioterrorism and infectious disease, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

JUNE 22, 2011 

Mr. BINGAMAN (for himself and Mrs. HUTCHISON) introduced the following 

bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To establish grant programs to improve the health of border 

area residents and for all hazards preparedness in the 

border area including bioterrorism and infectious disease, 

and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Border Health Secu5 rity Act of 2011’’. 

6 SEC. 2. FINDINGS. 

7 Congress makes the following findings: 


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1 (1) The United States-Mexico border is an 

2 interdependent and dynamic region of 14,538,209 

3 people with significant and unique public health 

4 challenges. 

5 (2) These challenges include low rates of health 

6 insurance coverage, poor access to health care serv7 ices, and high rates of dangerous diseases, such as 

8 tuberculosis, diabetes, and obesity. 

9 (3) As the 2009 novel influenza A (H1N1) out10 break illustrates, diseases do not respect inter11 national boundaries, therefore, a strong public 

12 health effort at and along the U.S.-Mexico border is 

13 crucial to not only protect and improve the health of 

14 Americans but also to help secure the country 

15 against biosecurity threats. 

16 (4) For 11 years, the United States-Mexico 

17 Border Health Commission has served as a crucial 

18 bi-national institution to address these unique and 

19 truly cross-border health issues. 

20 (5) Two initiatives resulting from the United 

21 States-Mexico Border Health Commission’s work 

22 speak to the importance of an infrastructure that fa23 cilitates cross-border communication at the ground 

24 level. First, the Early Warning Infectious Disease 

25 Surveillance (EWIDS), started in 2004, surveys inVerDate Mar 15 2010 03:52 Jun 28, 2011 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1257.IS S1257

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1 fectious diseases passing among border States allow2 ing for early detection and intervention. Second, the 

3 Ventanillas de Salud program, allows Mexican con4 sulates, in collaboration with United States non5 profit health organizations, to provide information 

6 and education to Mexican citizens living and working 

7 in the United States through a combination of Mexi8 can state funds and private grants. This program 

9 reaches an estimated 1,500,000 people in the United 

10 States. 

11 (6) As the United States-Mexico Border Health 

12 Commission enters its second decade, and as these 

13 issues grow in number and complexity, the Commis14 sion requires additional resources and modifications 

15 which will allow it to provide stronger leadership to 

16 optimize health and quality of life along the United 

17 States-Mexico border. 

18 SEC. 3. UNITED STATES-MEXICO BORDER HEALTH COMMIS19 SION ACT AMENDMENTS. 

20 The United States-Mexico Border Health Commis21 sion Act (22 U.S.C. 290n et seq.) is amended— 

22 (1) in section 3— 

23 (A) in paragraph (1), by striking ‘‘and’’ at 

24 the end; 


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1 (B) in paragraph (2), by striking the pe2 riod and inserting ‘‘; and’’; and 

3 (C) by adding at the end the following: 

4 ‘‘(3) to serve as an independent and objective 

5 body to both recommend and implement initiatives 

6 that solve border health issues’’; 

7 (2) in section 5— 

8 (A) in subsection (b), by striking ‘‘should 

9 be the leader’’ and inserting ‘‘shall be the 

10 Chair’’; and 

11 (B) by adding at the end the following: 

12 ‘‘(d) PROVIDING ADVICE AND RECOMMENDATIONS

13 TO CONGRESS.—A member of the Commission may at any 

14 time provide advice or recommendations to Congress con15 cerning issues that are considered by the Commission. 

16 Such advice or recommendations may be provided whether 

17 or not a request for such is made by a member of Congress 

18 and regardless of whether the member or individual is au19 thorized to provide such advice or recommendations by the 

20 Commission or any other Federal official.’’; 

21 (3) by redesignating section 8 as section 13; 

22 (4) by striking section 7 and inserting the fol23 lowing: 


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1 ‘‘SEC. 7. BORDER HEALTH GRANTS. 

2 ‘‘(a) ELIGIBLE ENTITY DEFINED.—In this section, 

3 the term ‘eligible entity’ means a State, public institution 

4 of higher education, local government, Indian tribe, tribal 

5 organization, urban Indian organization, nonprofit health 

6 organization, trauma center, or community health center 

7 receiving assistance under section 330 of the Public 

8 Health Service Act (42 U.S.C. 254b), that is located in 

9 the border area. 

10 ‘‘(b) AUTHORIZATION.—From amounts appropriated 

11 under section 12, the Secretary, acting through the Com12 missioners, shall award grants to eligible entities to ad13 dress priorities and recommendations outlined by the 

14 Commission’s Strategic and Operational Plans, as author15 ized under section 9, to improve the health of border area 

16 residents. 

17 ‘‘(c) APPLICATION.—An eligible entity that desires a 

18 grant under subsection (b) shall submit an application to 

19 the Secretary at such time, in such manner, and con20 taining such information as the Secretary may require. 

21 ‘‘(d) USE OF FUNDS.—An eligible entity that receives 

22 a grant under subsection (b) shall use the grant funds 

23 for— 

24 ‘‘(1) programs relating to— 

25 ‘‘(A) maternal and child health; 

26 ‘‘(B) primary care and preventative health; 


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1 ‘‘(C) infectious disease testing and moni2 toring; 

3 ‘‘(D) public health and public health infra4 structure; 

5 ‘‘(E) health promotion; 

6 ‘‘(F) oral health; 

7 ‘‘(G) behavioral and mental health; 

8 ‘‘(H) substance abuse; 

9 ‘‘(I) health conditions that have a high 

10 prevalence in the border area; 

11 ‘‘(J) medical and health services research; 

12 ‘‘(K) workforce training and development; 

13 ‘‘(L) community health workers or 

14 promotoras; 

15 ‘‘(M) health care infrastructure problems 

16 in the border area (including planning and con17 struction grants); 

18 ‘‘(N) health disparities in the border area; 

19 ‘‘(O) environmental health; 

20 ‘‘(P) health education; 

21 ‘‘(Q) outreach and enrollment services with 

22 respect to Federal programs (including pro23 grams authorized under titles XIX and XXI of 

24 the Social Security Act (42 U.S.C. 1396 and 

25 1397aa)); 


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1 ‘‘(R) trauma care; 

2 ‘‘(S) health research with an emphasis on 

3 infectious disease; 

4 ‘‘(T) epidemiology and health research; 

5 ‘‘(U) cross-border health surveillance co6 ordinated with Mexican Health Authorities; 

7 ‘‘(V) obesity, particularly childhood obe8 sity; 

9 ‘‘(W) crisis communication, domestic vio10 lence, substance abuse, health literacy, and can11 cer; or 

12 ‘‘(X) community-based participatory re13 search on border health issues; or 

14 ‘‘(2) other programs determined appropriate by 

15 the Secretary. 

16 ‘‘(e) SUPPLEMENT, NOT SUPPLANT.—Amounts pro17 vided to an eligible entity awarded a grant under sub18 section (b) shall be used to supplement and not supplant 

19 other funds available to the eligible entity to carry out the 

20 activities described in subsection (d). 

21 ‘‘SEC. 8. GRANTS FOR EARLY WARNING INFECTIOUS DIS22 EASE SURVEILLANCE (EWIDS) PROJECTS IN 

23 THE BORDER AREA. 

24 ‘‘(a) ELIGIBLE ENTITY DEFINED.—In this section, 

25 the term ‘eligible entity’ means a State, local government, 


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1 Indian tribe, tribal organization, urban Indian organiza2 tion, trauma centers, regional trauma center coordinating 

3 entity, or public health entity. 

4 ‘‘(b) AUTHORIZATION.—From funds appropriated 

5 under section 12, the Secretary shall award grants under 

6 the Early Warning Infectious Disease Surveillance 

7 (EWIDS) project to eligible entities for infectious disease 

8 surveillance activities in the border area. 

9 ‘‘(c) APPLICATION.—An eligible entity that desires a 

10 grant under this section shall submit an application to the 

11 Secretary at such time, in such manner, and containing 

12 such information as the Secretary may require. 

13 ‘‘(d) USES OF FUNDS.—An eligible entity that re14 ceives a grant under subsection (b) shall use the grant 

15 funds to, in coordination with State and local all hazards 

16 programs— 

17 ‘‘(1) develop and implement infectious disease 

18 surveillance plans and readiness assessments and 

19 purchase items necessary for such plans; 

20 ‘‘(2) coordinate infectious disease surveillance 

21 planning in the region with appropriate United 

22 States-based agencies and organizations as well as 

23 appropriate authorities in Mexico or Canada; 


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1 ‘‘(3) improve infrastructure, including surge ca2 pacity, syndromic surveillance, laboratory capacity, 

3 and isolation/decontamination capacity; 

4 ‘‘(4) create a health alert network, including 

5 risk communication and information dissemination; 

6 ‘‘(5) educate and train clinicians, epidemiolo7 gists, laboratories, and emergency personnel; 

8 ‘‘(6) implement electronic data systems to co9 ordinate the triage, transportation, and treatment of 

10 multi-casualty incident victims; 

11 ‘‘(7) provide infectious disease testing in the 

12 border area; and 

13 ‘‘(8) carry out such other activities identified by 

14 the Secretary, the United States-Mexico Border 

15 Health Commission, State and local public health of16 fices, and border health offices at the United States17 Mexico or United States-Canada borders. 

18 ‘‘SEC. 9. PLANS, REPORTS, AUDITS, AND BY-LAWS. 

19 ‘‘(a) STRATEGIC PLAN.— 

20 ‘‘(1) IN GENERAL.—Not later than 5 years 

21 after the date of enactment of this section, and every 

22 5 years thereafter, the Commission (including the 

23 participation of members of both the United States 

24 and Mexican sections) shall prepare a binational 

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1 mission and submit such plan to the Secretary and 

2 Congress (and the Mexican legislature). 

3 ‘‘(2) REQUIREMENTS.—The binational strategic 

4 plan under paragraph (1) shall include— 

5 ‘‘(A) health-related priority areas deter6 mined most important by the full membership 

7 of the Commission; 

8 ‘‘(B) recommendations for goals, objec9 tives, strategies and actions designed to address 

10 such priority areas; and 

11 ‘‘(C) a proposed evaluation framework with 

12 output and outcome indicators appropriate to 

13 gauge progress toward meeting the objectives 

14 and priorities of the Commission. 

15 ‘‘(b) WORK PLAN.—Not later than January 1, 2012, 

16 and every other January 1 thereafter, the Commission 

17 shall develop and approve an operational work plan and 

18 budget based on the strategic plan under subsection (a). 

19 At the end of each such work plan cycle, the Government 

20 Accountability Office shall conduct an evaluation of the 

21 activities conducted by the Commission based on output 

22 and outcome indicators included in the strategic plan. The 

23 evaluation shall include a request for written evaluations 

24 from the commissioners about barriers and facilitators to 

25 executing successfully the Commission work plan. 


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1 ‘‘(c) BIANNUAL REPORTING.—The Commission shall 

2 issue a biannual report to the Secretary which provides 

3 independent policy recommendations related to border 

4 health issues. Not later than 3 months following receipt 

5 of each such biannual report, the Secretary shall provide 

6 the report and any studies or other material produced 

7 independently by the Commission to Congress. 

8 ‘‘(d) AUDITS.—The Secretary shall annually prepare 

9 an audited financial report to account for all appropriated 

10 assets expended by the Commission to address both the 

11 strategic and operational work plans for the year involved. 

12 ‘‘(e) BY-LAWS.—Not less than 6 months after the 

13 date of enactment of this section, the Commission shall 

14 develop and approve bylaws to provide fully for compliance 

15 with the requirements of this section. 

16 ‘‘(f) TRANSMITTAL TO CONGRESS.—The Commission 

17 shall submit copies of the work plan and by-laws to Con18 gress. The Government Accountability Office shall submit 

19 a copy of the evaluation to Congress. 

20 ‘‘SEC. 10. BINATIONAL HEALTH INFRASTRUCTURE AND 

21 HEALTH INSURANCE. 

22 ‘‘(a) IN GENERAL.—The Secretary shall enter into 

23 a contract with the Institute of Medicine for the conduct 

24 of a study concerning binational health infrastructure (in25 cluding trauma and emergency care) and health insurance 


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1 efforts. In conducting such study, the Institute shall solicit 

2 input from border health experts and health insurance 

3 issuers. 

4 ‘‘(b) REPORT.—Not later than 1 year after the date 

5 on which the Secretary enters into the contract under sub6 section (a), the Institute of Medicine shall submit to the 

7 Secretary and the appropriate committees of Congress a 

8 report concerning the study conducted under such con9 tract. Such report shall include the recommendations of 

10 the Institute on ways to establish, expand, or improve bi11 national health infrastructure and health insurance ef12 forts. 

13 ‘‘SEC. 11. COORDINATION. 

14 ‘‘(a) IN GENERAL.—To the extent practicable and 

15 appropriate, plans, systems and activities to be funded (or 

16 supported) under this Act for all hazard preparedness, and 

17 general border health, should be coordinated with Federal, 

18 State, and local authorities in Mexico and the United 

19 States. 

20 ‘‘(b) COORDINATION OF HEALTH SERVICES AND

21 SURVEILLANCE.—The Secretary may coordinate with the 

22 Secretary of Homeland Security in establishing a health 

23 alert system that— 


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1 ‘‘(1) alerts clinicians and public health officials 

2 of emerging disease clusters and syndromes along 

3 the border area; and 

4 ‘‘(2) is alerted to signs of health threats, disas5 ters of mass scale, or bioterrorism along the border 

6 area. 

7 ‘‘SEC. 12. AUTHORIZATION OF APPROPRIATIONS. 

8 ‘‘There is authorized to be appropriated to carry out 

9 this Act $31,000,000 for fiscal year 2012 and each suc10 ceeding year subject to the availability of appropriations 

11 for such purpose. Of the amount appropriated for each 

12 fiscal year, at least $1,000,000 shall be made available 

13 to fund operationally feasible functions and activities with 

14 respect to Mexico. The remaining funds shall be allocated 

15 for the administration of United States activities under 

16 this Act, border health activities under cooperative agree17 ments with the border health offices of the States of Cali18 fornia, Arizona, New Mexico, and Texas, the border health 

19 and EWIDS grant programs, and the Institute of Medi20 cine and Government Accountability Office reports.’’; and 

21 (5) in section 13 (as so redesignated)— 

22 (A) by redesignating paragraphs (3) and 

23 (4) as paragraphs (4) and (5), respectively; and 

24 (B) by inserting after paragraph (2), the 

25 following: 


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1 ‘‘(3) INDIANS; INDIAN TRIBE; TRIBAL ORGANI2 ZATION; URBAN INDIAN ORGANIZATION.—The terms 

3 ‘Indian’, ‘Indian tribe’, ‘tribal organization’, and 

4 ‘urban Indian organization’ have the meanings given 

5 such terms in section 4 of the Indian Health Care 

6 Improvement Act (25 U.S.C. 1603).’’. 

Æ 


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