II 

117TH CONGRESS 

1ST SESSION S. 2467 

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

IN THE SENATE OF THE UNITED STATES 

JULY 26, 2021 

Mr. CASSIDY 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 (f) 

4 as subsections (c) through (g), 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) that 

10 is an infectious disease outbreak, a bioterrorist at11 tack, or a disaster, the Secretary shall request the 

12 Assistant Secretary for Preparedness and Response 

13 to convene a group of Federal public health and 

14 other Federal officials that shall prepare monthly re15 ports related to such emergency for the period de16 scribed in paragraph (3) and submit such reports to 

17 Congress. 

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

19 paragraph (1) shall include— 

20 ‘‘(A) in the first monthly report, the pro21 posed budget of the response to the emergency, 

22 and, in each subsequent report, updates to such 

23 budget; 

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

25 plans to use best practices and lessons learned 


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1 from previous public health emergency re2 sponses; 

3 ‘‘(C) a description of how collaboration 

4 among public health agencies and departments 

5 will be achieved, strategies for public commu6 nication, and acquisition and distribution of 

7 supplies; 

8 ‘‘(D) an identification of additional au9 thorities needed, if any, to respond to the emer10 gency; and 

11 ‘‘(E) in the first monthly report, the jus12 tification for triggering the public health emer13 gency response. 

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

15 paragraph is the period beginning not later than 30 

16 days after the determination of a public health emer17 gency under subsection (a) that is an infectious dis18 ease outbreak, a bioterrorist attack, or a disaster, 

19 and ending 30 days after the determination of such 

20 emergency terminates in accordance with such sub21 section.’’; and 

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

23 (A) in paragraph (3), by striking ‘‘Com24 mittee on Commerce’’ and inserting ‘‘Com25 mittee on Energy and Commerce’’; and 


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

2 ‘‘(6) FUNDING.— 

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

4 ‘‘(i) PUBLIC HEALTH EMERGENCY RE5 LIEF.—The term ‘public health emergency 

6 relief’ means the expenditures to address a 

7 public health emergency determined under 

8 subsection (a) that is an infectious disease 

9 outbreak, a bioterrorist attack, or a dis10 aster from— 

11 ‘‘(I) amounts made available by 

12 emergency supplemental appropria13 tions to appropriations accounts of 

14 the Department of Health and 

15 Human Services to address a public 

16 health emergency that is an infectious 

17 disease outbreak, a bioterrorist attack, 

18 or a disaster (excluding funds trans19 ferred to the Department from the ap20 propriations account for the ‘Federal 

21 Emergency Management Agency, Dis22 aster Relief Fund’ or pursuant to the 

23 Oil Pollution Act of 1990); and 


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1 ‘‘(II) any amounts expended from 

2 the Public Health Emergency Fund 

3 under this subsection. 

4 ‘‘(ii) TARGET AMOUNT.—The term 

5 ‘target amount’ means the amount that is 

6 the rolling annual average of expenditures 

7 for public health emergency relief over the 

8 full 14 fiscal years immediately preceding 

9 the fiscal year for which the determination 

10 of a public health emergency is made 

11 under subsection (a) that is an infectious 

12 disease outbreak, a bioterrorist attack, or a 

13 disaster, excluding the highest and lowest 

14 years. 

15 ‘‘(B) APPROPRIATIONS.— 

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

17 (iv), upon the determination of each public 

18 health emergency under subsection (a) that 

19 is an infectious disease outbreak, a bioter20 rorist attack, or a disaster, there is appro21 priated to the Public Health Emergency 

22 Fund, out of any money in the Treasury 

23 not otherwise appropriated, for the fiscal 

24 year of the determination, an amount de25 termined under subparagraph (C), to reVerDate Sep 11 2014 04:14 Jul 27, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S2467.IS S2467

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1 main available until expended, which may 

2 be used in accordance with subparagraph 

3 (D). 

4 ‘‘(ii) REPORTING.—The reporting re5 quirements contained in subsection (b) 

6 shall apply with respect to amounts appro7 priated under clause (i). 

8 ‘‘(iii) EMERGENCY DESIGNATIONS.— 

9 ‘‘(I) IN GENERAL.—Amounts ap10 propriated under clause (i) are des11 ignated as an emergency requirement 

12 pursuant to section 4(g) of the Statu13 tory Pay-As-You-Go Act of 2010 (2 

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

15 ‘‘(II) DESIGNATION IN THE SEN16 ATE.—In the Senate, amounts appro17 priated under clause (i) are des18 ignated as an emergency requirement 

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

20 Res. 13 (111th Congress), the concur21 rent resolution on the budget for fis22 cal year 2010. 

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

24 not apply if the amount available for ex25 penditure in the Public Health Emergency 


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1 Fund, as of the date of the determination 

2 as a public health emergency under sub3 section (a) that is an infectious disease 

4 outbreak, a bioterrorist attack, or a dis5 aster, is equal to or greater than the target 

6 amount. 

7 ‘‘(C) FORMULA.— 

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

9 (ii), the amount determined under this 

10 subparagraph shall be equal to the dif11 ference between the target amount and the 

12 amount available for expenditure in the 

13 Public Health Emergency Fund, as of the 

14 date of the determination of the public 

15 health emergency under subsection (a). 

16 ‘‘(ii) REPORT BY OMB.—Not later 

17 than 30 days after the date of enactment 

18 of this paragraph, the Director of the Of19 fice of Management and Budget shall sub20 mit to the Committee on Appropriations 

21 and the Committee on the Budget of the 

22 Senate and the Committee on Appropria23 tions and the Committee on the Budget of 

24 the House of Representatives, a report on 


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1 the rolling average calculated for purposes 

2 of determining the target amount. 

3 ‘‘(D) USE OF FUNDS.— 

4 ‘‘(i) IN GENERAL.—Amounts appro5 priated to the Public Health Emergency 

6 Fund under subparagraph (B) shall be 

7 used by the Secretary in accordance with 

8 the proposed budget described in sub9 section (b)(2) for any public health emer10 gency determined under subsection (a) that 

11 is an infectious disease outbreak, a bioter12 rorist attack, or a disaster that has not 

13 terminated under such subsection. Such 

14 funds shall be used— 

15 ‘‘(I) to provide assistance for im16 mediate Federal, State, local, or inter17 national response needs with respect 

18 to any public health emergency deter19 mined under subsection (a) that is an 

20 infectious disease outbreak, a bioter21 rorist attack, or a disaster; and 

22 ‘‘(II) for activities determined ap23 propriate by the Secretary to improve 

24 preparedness and response to protect 

25 human health for all populations in 


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1 any public health emergency deter2 mined under subsection (a) that is an 

3 infectious disease outbreak, a bioter4 rorist attack, or a disaster. 

5 ‘‘(ii) AVAILABILITY.—Amounts appro6 priated to the Public Health Emergency 

7 Fund under subparagraph (B) shall re8 main available for the uses described in 

9 this subparagraph so long as any public 

10 health emergency is determined under sub11 section (a) that is an infectious disease 

12 outbreak, a bioterrorist attack, or a dis13 aster, and the determination for any such 

14 emergency has not terminated under such 

15 subsection. 

16 ‘‘(iii) AUTHORITY.—In expending 

17 funds appropriated under subparagraph 

18 (B) and carrying out activities under this 

19 subparagraph, the Secretary shall have the 

20 authority to— 

21 ‘‘(I) transfer funds and enter 

22 into contracts; 

23 ‘‘(II) utilize flexible hiring mech24 anisms, including direct hiring author25 ity and personal service contracts; exVerDate Sep 11 2014 04:14 Jul 27, 2021 Jkt 019200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S2467.IS S2467

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1 emptions from certain administrative 

2 restrictions (such as travel, informa3 tion technology, printing and sup4 plies); motor vehicle authority; and 

5 flexible compensation for responders, 

6 including overtime and danger pay; 

7 and 

8 ‘‘(III) utilize flexible transaction 

9 mechanisms.’’. 

10 (b) EXEMPTION OF THE PUBLIC HEALTH EMER11 GENCY FUND FROM SEQUESTRATION.— 

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

13 Balanced Budget and Emergency Deficit Control 

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

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

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

17 372).’’. 

18 (2) APPLICATION.—The amendment made by 

19 paragraph (1) shall apply to any sequestration order 

20 issued under such Act on or after the date of enact21 ment of this section. 

22 (c) GAO REPORTS.— 

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

24 after the date of enactment of this Act, the Comp25 troller General of the United States, in consultation 


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1 with relevant Federal, State, and local government 

2 entities, shall prepare and submit to the appropriate 

3 committees of Congress, a report— 

4 (A) reviewing the capacity of the United 

5 States public health system, including the pub6 lic health workforce, to respond effectively to in7 fectious disease outbreaks; 

8 (B) identifying areas of potential improve9 ment in coordination between Federal, State, 

10 and local government entities to respond more 

11 effectively to infectious disease outbreaks; 

12 (C) making recommendations on how to 

13 provide or allocate most effectively resources for 

14 public health emergency response, specifically 

15 considering how to utilize most effectively the 

16 emergency fund established under section 319 

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

18 247d); and 

19 (D) containing an audit of how funds for 

20 public health emergencies have been expended 

21 within the 2 years preceding the date of the re22 port. 

23 (2) POST-EMERGENCY REPORT.— 

24 (A) IN GENERAL.—Not later than 6 

25 months after the termination of a determination 


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1 of a public health emergency under section 319 

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

3 247d) that is an infectious disease outbreak, a 

4 bioterrorist attack, or a disaster, the Comp5 troller General of the United States shall review 

6 response efforts by Federal, State, and local 

7 government entities, as well as any other rel8 evant entities engaged in response efforts, and 

9 submit a report to the appropriate committees 

10 of Congress to determine— 

11 (i) the compliance of such efforts with 

12 best practices identified in the report 

13 under paragraph (1); 

14 (ii) the effectiveness of such best prac15 tices; 

16 (iii) the cost of such efforts; 

17 (iv) the areas of potential continued 

18 improvement in coordination between Fed19 eral, State, and local government entities 

20 to respond more effectively to infectious 

21 disease outbreaks; and 

22 (v) how to incorporate additional best 

23 practices which may be incorporated in fu24 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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