II 

115TH CONGRESS 

1ST SESSION S. 196 

To provide for a Public Health Emergency Fund, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

JANUARY 24, 2017 

Mr. CASSIDY (for himself, Mr. SCHATZ, Mr. RUBIO, Mr. DURBIN, Mr. NELSON, and Mr. COONS) introduced the following bill; which was read twice 

and referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To provide for a Public Health Emergency Fund, 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 ‘‘Public Health Emer5 gency Response and Accountability Act’’. 

6 SEC. 2. PUBLIC HEALTH EMERGENCIES. 

7 (a) IN GENERAL.—Section 319 of the Public Health 

8 Service Act (42 U.S.C. 247d) is amended— 

9 (1) in subsection (a), by striking ‘‘after con10 sultation’’ and inserting ‘‘in consultation with the 


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1 Assistant Secretary for Preparedness and Response 

2 and’’; 

3 (2) by redesignating subsections (b) through (e) 

4 as subsections (c) through (f), respectively; 

5 (3) by inserting after subsection (a), the fol6 lowing: 

7 ‘‘(b) REPORTING REQUIREMENTS.— 

8 ‘‘(1) IN GENERAL.—Upon the determination of 

9 a public health emergency under subsection (a), the 

10 Secretary shall request the Assistant Secretary for 

11 Preparedness and Response to convene a group of 

12 Federal public health and other Federal officials 

13 that shall prepare monthly reports related to such 

14 emergency for the period described in paragraph (3) 

15 and submit such reports to Congress. 

16 ‘‘(2) CONTENTS.—The reports prepared under 

17 paragraph (1) shall include— 

18 ‘‘(A) in the first monthly report, the pro19 posed budget of the response to the emergency, 

20 and, in each subsequent report, updates to such 

21 budget; 

22 ‘‘(B) a description of how the Secretary 

23 plans to use best practices and lessons learned 

24 from previous public health emergency re25 sponses; 


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1 ‘‘(C) a description of how collaboration 

2 among public health agencies and departments 

3 will be achieved, strategies for public commu4 nication, and acquisition and distribution of 

5 supplies; 

6 ‘‘(D) an identification of additional au7 thorities needed, if any, to respond to the emer8 gency; and 

9 ‘‘(E) in the first monthly report, the jus10 tification for triggering the public health emer11 gency response. 

12 ‘‘(3) PERIOD.—The period described in this 

13 paragraph is the period beginning not later than 30 

14 days after the determination of a public health emer15 gency under subsection (a) and ending 30 days after 

16 the determination of the emergency terminates in 

17 accordance with such subsection.’’; and 

18 (4) in subsection (c) (as so redesignated)— 

19 (A) in paragraph (2), by striking ‘‘Com20 mittee on Commerce’’ and inserting ‘‘Com21 mittee on Energy and Commerce’’; and 

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

23 ‘‘(3) FUNDING.— 

24 ‘‘(A) DEFINITIONS.—In this paragraph: 


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1 ‘‘(i) PUBLIC HEALTH EMERGENCY RE2 LIEF.—The term ‘public health emergency 

3 relief’ means, for the purpose of clause (ii), 

4 the expenditures to address a public health 

5 emergency determined under subsection (a) 

6 from— 

7 ‘‘(I) amounts made available by 

8 emergency supplemental appropria9 tions to appropriations accounts of 

10 the Department of Health and 

11 Human Services to address a public 

12 health emergency (excluding funds 

13 transferred to the Department from 

14 the appropriations account for the 

15 ‘Federal Emergency Management 

16 Agency, Disaster Relief Fund’ or pur17 suant to the Oil Pollution Act of 

18 1990); and 

19 ‘‘(II) any amounts expended from 

20 the Public Health Emergency Fund 

21 under this subsection. 

22 ‘‘(ii) TARGET AMOUNT.—The term 

23 ‘target amount’ means the amount that is 

24 the rolling annual average of expenditures 

25 for public health emergency relief over the 


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1 full 14 fiscal years immediately preceding 

2 the fiscal year for which the determination 

3 of a public health emergency is made 

4 under subsection (a), excluding the highest 

5 and lowest years. 

6 ‘‘(B) APPROPRIATIONS.— 

7 ‘‘(i) IN GENERAL.—Subject to clause 

8 (iv), upon the determination of each public 

9 health emergency under subsection (a), 

10 there is appropriated to the Public Health 

11 Emergency Fund, out of any money in the 

12 Treasury not otherwise appropriated, for 

13 the fiscal year of the determination, an 

14 amount determined under subparagraph 

15 (C), to remain available until expended, 

16 which may be used in accordance with sub17 paragraph (D). 

18 ‘‘(ii) REPORTING.—The reporting re19 quirements contained in subsection (b) 

20 shall apply with respect to amounts appro21 priated under clause (i). 

22 ‘‘(iii) EMERGENCY DESIGNATIONS.— 

23 ‘‘(I) IN GENERAL.—Amounts ap24 propriated under clause (i) are des25 ignated as an emergency requirement 


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1 pursuant to section 4(g) of the Statu2 tory Pay-As-You-Go Act of 2010 (2 

3 U.S.C. 933(g)). 

4 ‘‘(II) DESIGNATION IN THE SEN5 ATE.—In the Senate, amounts appro6 priated under clause (i) are des7 ignated as an emergency requirement 

8 pursuant to section 403(a) of S. Con. 

9 Res. 13 (111th Congress), the concur10 rent resolution on the budget for fis11 cal year 2010. 

12 ‘‘(iv) LIMITATION.—Clause (i) shall 

13 not apply if the amount available for ex14 penditure in the Public Health Emergency 

15 Fund, as of the date of the determination 

16 as a public health emergency under sub17 section (a), is equal to or greater than the 

18 target amount. 

19 ‘‘(C) FORMULA.— 

20 ‘‘(i) IN GENERAL.—Subject to clause 

21 (ii), the amount determined under this 

22 subparagraph shall be equal to the dif23 ference between the target amount and the 

24 amount available for expenditure in the 

25 Public Health Emergency Fund, as of the 


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1 date of the determination of the public 

2 health emergency under subsection (a). 

3 ‘‘(ii) REPORT BY OMB.—Not later 

4 than 30 days after the date of enactment 

5 of this paragraph, the Director of the Of6 fice of Management and Budget shall sub7 mit to the Committee on Appropriations 

8 and the Committee on the Budget of the 

9 Senate and the Committee on Appropria10 tions and the Committee on the Budget of 

11 the House of Representatives, a report on 

12 the rolling average calculated for purposes 

13 of determining the target amount. 

14 ‘‘(D) USE OF FUNDS.— 

15 ‘‘(i) IN GENERAL.—Amounts appro16 priated to the Public Health Emergency 

17 Fund under subparagraph (B) shall be 

18 used by the Secretary in accordance with 

19 the proposed budget described in sub20 section (b)(2) for any public health emer21 gency determined under subsection (a) that 

22 has not terminated under such subsection. 

23 Such funds shall be used— 

24 ‘‘(I) to provide assistance for im25 mediate Federal, State, local, or interVerDate Sep 11 2014 21:57 Feb 01, 2017 Jkt 069200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S196.IS S196

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1 national response needs with respect 

2 to any public health emergency deter3 mined under subsection (a); and 

4 ‘‘(II) for activities determined ap5 propriate by the Secretary to improve 

6 preparedness and response to protect 

7 human health for all populations in 

8 any public health emergency deter9 mined under subsection (a). 

10 ‘‘(ii) AVAILABILITY.—Amounts appro11 priated to the Public Health Emergency 

12 Fund under subparagraph (B) shall re13 main available for the uses described in 

14 this subparagraph so long as any public 

15 health emergency is determined under sub16 section (a) and the determination for any 

17 such emergency has not terminated under 

18 such subsection. 

19 ‘‘(iii) AUTHORITY.—In expending 

20 funds appropriated under subparagraph 

21 (B) and carrying out activities under this 

22 subparagraph, the Secretary shall have the 

23 authority to— 

24 ‘‘(I) transfer funds and enter 

25 into contracts; 


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1 ‘‘(II) utilize flexible hiring mech2 anisms, including direct hiring author3 ity and personal service contracts; ex4 emptions from certain administrative 

5 restrictions (such as travel, informa6 tion technology, printing and sup7 plies); motor vehicle authority; and 

8 flexible compensation for responders, 

9 including overtime and danger pay; 

10 and 

11 ‘‘(III) utilize flexible transaction 

12 mechanisms.’’. 

13 (b) EXEMPTION OF THE PUBLIC HEALTH EMER14 GENCY FUND FROM SEQUESTRATION.— 

15 (1) IN GENERAL.—Section 255(g)(1)(A) of the 

16 Balanced Budget and Emergency Deficit Control 

17 Act of 1985 is amended by inserting ‘‘Public Health 

18 Emergency Fund (009–91–9913).’’ after the item 

19 relating to ‘‘Postal Service Fund (18–4020–0–3– 

20 372).’’. 

21 (2) APPLICATION.—The amendment made by 

22 paragraph (1) shall apply to any sequestration order 

23 issued under such Act on or after the date of enact24 ment of this section. 

25 (c) GAO REPORTS.— 


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1 (1) IN GENERAL.—Not later than 180 days 

2 after the date of enactment of this Act, the Comp3 troller General of the United States, in consultation 

4 with relevant Federal, State, and local government 

5 entities, shall prepare and submit to the appropriate 

6 committees of Congress, a report— 

7 (A) reviewing the capacity of the United 

8 States public health system, including the pub9 lic health workforce, to respond effectively to in10 fectious disease outbreaks; 

11 (B) identifying areas of potential improve12 ment in coordination between Federal, State, 

13 and local government entities to respond more 

14 effectively to infectious disease outbreaks; 

15 (C) making recommendations on how to 

16 provide or allocate most effectively resources for 

17 public health emergency response, specifically 

18 considering how to utilize most effectively the 

19 emergency fund established under section 319 

20 of the Public Health Service Act (42 U.S.C. 

21 247d); and 

22 (D) containing an audit of how funds for 

23 public health emergencies have been expended 

24 within the 2 years preceding the date of the re25 port. 


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1 (2) POST-EMERGENCY REPORT.— 

2 (A) IN GENERAL.—Not later than 6 

3 months after the termination of a determination 

4 of a public health emergency under section 319 

5 of the Public Health Service Act (42 U.S.C. 

6 247d), the Comptroller General of the United 

7 States shall review response efforts by Federal, 

8 State, and local government entities, as well as 

9 any other relevant entities engaged in response 

10 efforts, and submit a report to the appropriate 

11 committees of Congress to determine— 

12 (i) the compliance of such efforts with 

13 best practices identified in the report 

14 under paragraph (1); 

15 (ii) the effectiveness of such best prac16 tices; 

17 (iii) the cost of such efforts; 

18 (iv) the areas of potential continued 

19 improvement in coordination between Fed20 eral, State, and local government entities 

21 to respond more effectively to infectious 

22 disease outbreaks; and 

23 (v) how to incorporate additional best 

24 practices which may be incorporated in fu25 ture response efforts. 


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1 (B) AUDIT.—The report under subpara2 graph (A) shall include an audit indicating how 

3 funds used for public health emergencies deter4 mined under section 319 of the Public Health 

5 Service Act have been expended during the 2 

6 years preceding the submission of the report 

7 under such subparagraph. 

8 SEC. 3. APPLICABILITY. 

9 Nothing in this Act, or an amendment made by this 

10 Act, shall affect the applicability of the Robert T. Stafford 

11 Disaster Relief and Emergency Assistance Act (42 U.S.C. 

12 5121 et seq.) or the Oil Pollution Act of 1990 (33 U.S.C. 

13 2701 et seq.) in the case of a public health emergency. 

Æ 


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