I 

117TH CONGRESS 

1ST SESSION H. R. 1849 

To authorize the Secretary of Health and Human Services, acting through 

the Director of the Centers for Disease Control and Prevention, to 

establish a core public health infrastructure program, and for other 

purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 11, 2021 

Miss RICE of New York introduced the following bill; which was referred to 

the Committee on Energy and Commerce 

A BILL 

To authorize the Secretary of Health and Human Services, 

acting through the Director of the Centers for Disease 

Control and Prevention, to establish a core public health 

infrastructure program, 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. CORE PUBLIC HEALTH INFRASTRUCTURE FOR 

4 STATE, LOCAL, TRIBAL, AND TERRITORIAL 

5 HEALTH DEPARTMENTS. 

6 (a) PROGRAM.—The Secretary of Health and Human 

7 Services (in this Act referred to as the ‘‘Secretary’’), act8 ing through the Director of the Centers for Disease ConVerDate Sep 11 2014 20:34 May 03, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H1849.IH H1849

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1 trol and Prevention, shall establish a core public health 

2 infrastructure program consisting of awarding grants 

3 under subsection (b). 

4 (b) GRANTS.— 

5 (1) AWARD.—For the purpose of addressing 

6 core public health infrastructure needs, the Sec7 retary— 

8 (A) shall award a grant to each State 

9 health department; and 

10 (B) may award grants on a competitive 

11 basis to State, local, Tribal, or territorial health 

12 departments. 

13 (2) ALLOCATION.—Of the total amount of 

14 funds awarded as grants under this subsection for a 

15 fiscal year— 

16 (A) not less than 50 percent shall be for 

17 grants to State health departments under para18 graph (1)(A); and 

19 (B) not less than 30 percent shall be for 

20 grants to State, local, Tribal, or territorial 

21 health departments under paragraph (1)(B). 

22 (c) USE OF FUNDS.—A State, local, Tribal, or terri23 torial health department receiving a grant under sub24 section (b) shall use the grant funds to address core public 


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1 health infrastructure needs, including those identified in 

2 the accreditation process under subsection (g). 

3 (d) FORMULA GRANTS TO STATE HEALTH DEPART4 MENTS.—In making grants under subsection (b)(1)(A), 

5 the Secretary shall award funds to each State health de6 partment in accordance with— 

7 (1) a formula based on population size, burden 

8 of preventable disease and disability, and core public 

9 health infrastructure gaps, including those identified 

10 in the accreditation process under subsection (g); 

11 and 

12 (2) application requirements established by the 

13 Secretary, including a requirement that the State 

14 health department submit a plan that demonstrates 

15 to the satisfaction of the Secretary that the State’s 

16 health department will— 

17 (A) address its highest priority core public 

18 health infrastructure needs; and 

19 (B) as appropriate, allocate funds to local 

20 health departments within the State. 

21 (e) COMPETITIVE GRANTS TO STATE, LOCAL, TRIB22 AL, AND TERRITORIAL HEALTH DEPARTMENTS.—In 

23 making grants under subsection (b)(1)(B), the Secretary 

24 shall give priority to applicants demonstrating core public 


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1 health infrastructure needs identified in the accreditation 

2 process under subsection (g). 

3 (f) MAINTENANCE OF EFFORT.—The Secretary may 

4 award a grant to an entity under subsection (b) only if 

5 the entity demonstrates to the satisfaction of the Sec6 retary that— 

7 (1) funds received through the grant will be ex8 pended only to supplement, and not supplant, non9 Federal and Federal funds otherwise available to the 

10 entity for the purpose of addressing core public 

11 health infrastructure needs; and 

12 (2) with respect to activities for which the grant 

13 is awarded, the entity will maintain expenditures of 

14 non-Federal amounts for such activities at a level 

15 not less than the level of such expenditures main16 tained by the entity for the fiscal year preceding the 

17 fiscal year for which the entity receives the grant. 

18 (g) ESTABLISHMENT OF A PUBLIC HEALTH ACCRED19 ITATION PROGRAM.— 

20 (1) IN GENERAL.—The Secretary shall— 

21 (A) develop, and periodically review and 

22 update, standards for voluntary accreditation of 

23 State, local, Tribal, and territorial health de24 partments and public health laboratories for the 


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1 purpose of advancing the quality and perform2 ance of such departments and laboratories; and 

3 (B) implement a program to accredit such 

4 health departments and laboratories in accord5 ance with such standards. 

6 (2) COOPERATIVE AGREEMENT.—The Secretary 

7 may enter into a cooperative agreement with a pri8 vate nonprofit entity to carry out paragraph (1). 

9 (h) REPORT.—The Secretary shall submit to the Con10 gress an annual report on progress being made to accredit 

11 entities under subsection (g), including— 

12 (1) a strategy, including goals and objectives, 

13 for accrediting entities under subsection (g) and 

14 achieving the purpose described in subsection 

15 (g)(1)(A); 

16 (2) identification of gaps in research related to 

17 core public health infrastructure; and 

18 (3) recommendations of priority areas for such 

19 research. 

20 (i) DEFINITION.—In this section, the term ‘‘core pub21 lic health infrastructure’’ includes— 

22 (1) workforce capacity and competency; 

23 (2) laboratory systems; 

24 (3) testing capacity, including test platforms, 

25 mobile testing units, and personnel; 


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1 (4) health information, health information sys2 tems, and health information analysis; 

3 (5) disease surveillance; 

4 (6) contact tracing; 

5 (7) communications; 

6 (8) financing; 

7 (9) other relevant components of organizational 

8 capacity; and 

9 (10) other related activities. 

10 (j) AUTHORIZATION OF APPROPRIATIONS.—To carry 

11 out this section, there are authorized to be appropriated 

12 $6,000,000,000 for the period of fiscal years 2022 

13 through 2026. 

14 SEC. 2. CORE PUBLIC HEALTH INFRASTRUCTURE AND AC15 TIVITIES FOR CDC. 

16 (a) IN GENERAL.—The Secretary, acting through the 

17 Director of the Centers for Disease Control and Preven18 tion, shall expand and improve the core public health in19 frastructure and activities of the Centers for Disease Con20 trol and Prevention to address unmet and emerging public 

21 health needs. 

22 (b) REPORT.—The Secretary shall submit to the Con23 gress an annual report on the activities funded through 

24 this section. 


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1 (c) DEFINITION.—In this section, the term ‘‘core 

2 public health infrastructure’’ has the meaning given to 

3 such term in section 1. 

4 (d) AUTHORIZATION OF APPROPRIATIONS.—To carry 

5 out this section, there is authorized to be appropriated 

6 $1,000,000,000 for the period of fiscal years 2022 

7 through 2026. 

Æ 


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