II 

117TH CONGRESS 

1ST SESSION S. 2570 

To establish grant programs to improve the health of residents along the 

United States-Mexico and United States-Canada borders and for all 

hazards preparedness in the border areas, including with respect to 

bioterrorism, infectious disease, and other emerging biothreats, and for 

other purposes. 

IN THE SENATE OF THE UNITED STATES 

JULY 29, 2021 

Mr. LUJA ́N (for himself and Mr. HEINRICH) introduced the following bill; 

which was read twice and referred to the Committee on Foreign Relations 

A BILL 

To establish grant programs to improve the health of residents along the United States-Mexico and United StatesCanada borders and for all hazards preparedness in the 

border areas, including with respect to bioterrorism, infectious disease, and other emerging biothreats, 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 2021’’. 


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1 SEC. 2. FINDINGS. 

2 Congress makes the following findings: 

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

4 interdependent and dynamic region of approximately 

5 15,000,000 residents and millions of border cross6 ings each year, with significant and unique public 

7 health challenges. 

8 (2) These challenges include low rates of health 

9 insurance coverage, poor access to health care serv10 ices, lack of education or access to information, pov11 erty-related illness, including undernutrition, and 

12 high rates of infectious diseases, such as tuber13 culosis, West Nile virus, and Zika virus, as well as 

14 other noncommunicable diseases such as cardio15 vascular disease, asthma, diabetes, and obesity. 

16 (3) As the COVID–19 pandemic has illustrated, 

17 diseases do not respect international boundaries, and 

18 strong public health effort at and along the United 

19 States-Mexico and United States-Canada borders is 

20 crucial to not only protect and improve the health of 

21 Americans but also to help secure the country 

22 against biosecurity and other emerging threats. 

23 (4) For 20 years, the United States-Mexico 

24 Border Health Commission has served as a crucial 

25 binational institution to address these unique and 

26 truly cross-border health issues. 


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1 (5) The COVID–19 pandemic outbreak has also 

2 highlighted the need for continued coordination of 

3 resources, effective communication, and information 

4 sharing between countries to address emerging pub5 lic health crises. 

6 SEC. 3. UNITED STATES-MEXICO BORDER HEALTH COMMIS7 SION ACT AMENDMENTS. 

8 The United States-Mexico Border Health Commis9 sion Act (22 U.S.C. 290n et seq.) is amended— 

10 (1) in section 3— 

11 (A) by striking ‘‘It should be the duty’’ 

12 and inserting the following: 

13 ‘‘(a) IN GENERAL.—It should be the duty’’; 

14 (B) in paragraph (1), by striking ‘‘; and’’ 

15 and inserting ‘‘;’’; 

16 (C) in paragraph (2)(B), by striking the 

17 period and inserting a semicolon; 

18 (D) by adding at the end the following: 

19 ‘‘(3) to evaluate the Commission’s progress in 

20 carrying out the duties described in paragraphs (1) 

21 and (2) and report on such progress and make rec22 ommendations, as appropriate, to the Secretary and 

23 Congress regarding such duties; and 


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

2 body to both recommend and implement initiatives 

3 that solve border health issues.’’; and 

4 (E) by adding after paragraph (4) (as 

5 added by subparagraph (D) of this paragraph) 

6 the following: 

7 ‘‘(b) UNITED STATES SECTION MEMBERS.—The 

8 members of the United States section of the Commission, 

9 acting independently of the Commission overall, may— 

10 ‘‘(1) provide reports and recommendations to, 

11 and consult with, the Secretary and Congress on the 

12 matters described in subsection (a)(3); and 

13 ‘‘(2) cooperate with the Canada-United States 

14 Pan Border Public Health Preparedness Council (re15 ferred to in this Act as the ‘Council’), as appro16 priate.’’; 

17 (2) in section 5(b), by striking ‘‘should be the 

18 leader’’ and inserting ‘‘shall be the Chair’’; 

19 (3) by redesignating section 8 as section 12; 

20 (4) by striking section 7 and inserting the fol21 lowing: 

22 ‘‘SEC. 7. BORDER HEALTH GRANTS. 

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

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

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1 al organization, urban Indian organization, nonprofit 

2 health organization, trauma center, critical access hospital 

3 or other hospital that serves rural or other vulnerable com4 munities and populations, faith-based entity, or commu5 nity health center receiving assistance under section 330 

6 of the Public Health Service Act (42 U.S.C. 254b), that 

7 is located in the United States-Mexico border area or the 

8 United States-Canada border area. 

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

10 under section 11, the Secretary, in consultation with mem11 bers of the Commission and Council and in coordination 

12 with the Office of Global Affairs, shall award grants to 

13 eligible entities to improve the health of residents of the 

14 United States-Mexico and United States-Canada border 

15 areas with appropriate priority given to grants that ad16 dress recommendations outlined by the strategic plan and 

17 operational work plan of the Commission and the Council 

18 under section 9. 

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

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

21 the Secretary at such time, in such manner, and con22 taining such information as the Secretary may require. 

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

24 a grant under subsection (b) shall use the grant funds for 

25 any of the following: 


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1 ‘‘(1) Programs relating to any one or more of 

2 the following: 

3 ‘‘(A) Maternal and child health. 

4 ‘‘(B) Primary care and preventative health. 

5 ‘‘(C) Infectious disease testing, monitoring, 

6 and surveillance. 

7 ‘‘(D) Public health and public health infra8 structure. 

9 ‘‘(E) Health promotion, health literacy, 

10 and health education. 

11 ‘‘(F) Oral health. 

12 ‘‘(G) Behavioral and mental health. 

13 ‘‘(H) Substance abuse prevention and 

14 harm reduction. 

15 ‘‘(I) Health conditions that have a high 

16 prevalence in the United States-Mexico border 

17 area or United States-Canada border area. 

18 ‘‘(J) Medical and health services research 

19 in border communities. 

20 ‘‘(K) Workforce training and development. 

21 ‘‘(L) Community health workers and 

22 promotoras. 

23 ‘‘(M) Health care infrastructure problems 

24 in the United States-Mexico border area or 


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1 United States-Canada border area (including 

2 planning and construction grants). 

3 ‘‘(N) Health disparities in the United 

4 States-Mexico border area or United States5 Canada border area. 

6 ‘‘(O) Environmental health. 

7 ‘‘(P) Bioterrorism and zoonosis. 

8 ‘‘(Q) Outreach and enrollment services 

9 with respect to Federal programs (including 

10 programs authorized under titles XIX and XXI 

11 of the Social Security Act (42 U.S.C. 1396 et 

12 seq., 42 U.S.C. 1397aa et seq.)). 

13 ‘‘(R) Trauma care. 

14 ‘‘(S) Health research with an emphasis on 

15 infectious disease, such as measles, in the bor16 der areas, as well as other pressing issues, in17 cluding noncommunicable diseases such as dia18 betes and obesity. 

19 ‘‘(T) Epidemiology and health research. 

20 ‘‘(U) Cross-border health surveillance co21 ordinated with Mexican Health Authorities or 

22 Canadian Health Authorities. 

23 ‘‘(V) Community-based participatory re24 search on border health issues. 


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1 ‘‘(W) Domestic violence and violence pre2 vention. 

3 ‘‘(X) Cross-border public health prepared4 ness. 

5 ‘‘(2) Other programs as the Secretary deter6 mines appropriate. 

7 ‘‘(e) SUPPLEMENT, NOT SUPPLANT.—Amounts pro8 vided to an eligible entity awarded a grant under sub9 section (b) shall be used to supplement and not supplant 

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

11 activities described in subsection (d). 

12 ‘‘SEC. 8. GRANTS FOR EARLY WARNING INFECTIOUS DIS13 EASE SURVEILLANCE IN THE BORDER AREA. 

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

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

16 Indian Tribe, Tribal organization, urban Indian organiza17 tion, trauma center, regional trauma center coordinating 

18 entity, or public health entity. 

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

20 under section 11, the Secretary shall award grants for 

21 Early Warning Infectious Disease Surveillance to eligible 

22 entities for infectious disease surveillance activities in the 

23 United States-Mexico border area or United States-Can24 ada border area. 


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

2 grant under this section shall submit an application to the 

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

4 such information as the Secretary may require. 

5 ‘‘(d) USES OF FUNDS.—An eligible entity that re6 ceives a grant under subsection (b) shall use the grant 

7 funds, in coordination with State and local all hazards pro8 grams, to— 

9 ‘‘(1) develop and implement infectious disease 

10 surveillance plans and networks and public health 

11 emergency and readiness assessments and prepared12 ness plans, and purchase items necessary for such 

13 plans; 

14 ‘‘(2) coordinate infectious disease surveillance 

15 planning and interjurisdictional risk assessments in 

16 the region with appropriate United States-based 

17 agencies and organizations and appropriate authori18 ties in Mexico or Canada; 

19 ‘‘(3) improve infrastructure, including surge ca20 pacity, syndromic surveillance, and isolation and de21 contamination capacity, and policy preparedness, in22 cluding for mutual assistance and for the sharing of 

23 information and resources; 

24 ‘‘(4) improve laboratory capacity, in order to 

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1 tect potential infectious disease, whether naturally 

2 occurring or the result of terrorism; 

3 ‘‘(5) create and maintain a health alert net4 work, including risk communication and information 

5 dissemination that is culturally competent and takes 

6 into account the needs of at-risk populations; 

7 ‘‘(6) educate and train clinicians, epidemiolo8 gists, laboratories, and emergency management per9 sonnel; 

10 ‘‘(7) implement electronic data and infrastruc11 ture inventory systems to coordinate the triage, 

12 transportation, and treatment of multicasualty inci13 dent victims; 

14 ‘‘(8) provide infectious disease testing in the 

15 United States-Mexico border area or United States16 Canada border area; and 

17 ‘‘(9) carry out such other activities identified by 

18 the Secretary, members of the Commission, members 

19 of the Council, State or local public health authori20 ties, representatives of border health offices, or au21 thorities at the United States-Mexico or United 

22 States-Canada borders. 

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

24 ‘‘(a) STRATEGIC PLAN.— 


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1 ‘‘(1) IN GENERAL.—Not later than 2 years 

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

3 5 years thereafter, the Commission (including the 

4 participation of members representing both the 

5 United States and Mexican sections) and the Coun6 cil (including the participation of members rep7 resenting both the United States and Canada) shall 

8 each prepare a binational strategic plan to guide the 

9 operations of the Commission and the Council and 

10 submit such plan to the Secretary and Congress. 

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

12 plan under paragraph (1) shall include— 

13 ‘‘(A) health-related priority areas identified 

14 by the full membership of the Commission or 

15 Council, as applicable; 

16 ‘‘(B) recommendations for goals, objec17 tives, strategies, and actions designed to ad18 dress such priority areas; and 

19 ‘‘(C) a proposed evaluation framework with 

20 output and outcome indicators appropriate to 

21 gauge progress toward meeting the objectives 

22 and priorities of the Commission or Council, as 

23 applicable. 

24 ‘‘(b) WORK PLAN.—Not later than January 1, 2024, 

25 and every 2 years thereafter, the Commission and the 


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1 Council shall develop and approve an operational work 

2 plan and budget based on the strategic plan under sub3 section (a). 

4 ‘‘(c) GAO REVIEW.—Not later than January 1, 

5 2025, and every 2 years thereafter, the Comptroller Gen6 eral of the United States shall conduct an evaluation of 

7 the activities conducted by the Commission and the Coun8 cil based on the operational work plans described in sub9 section (b) for the previous year and the output and out10 come indicators included in the strategic plan described 

11 in subsection (a). The evaluation shall include a request 

12 for written evaluations from members of the Commission 

13 and the Council about barriers and facilitators to exe14 cuting successfully the work plans of the Commission and 

15 the Council. 

16 ‘‘(d) BIANNUAL REPORTING.— 

17 ‘‘(1) REPORTING BY COMMISSION AND COUN18 CIL.—The Commission and Council shall each issue 

19 a biannual report to the Secretary that— 

20 ‘‘(A) provides independent policy rec21 ommendations related to border health issues; 

22 and 

23 ‘‘(B) details the expenditures of the Com24 mission and Council over the reporting period. 


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1 ‘‘(2) REPORTING BY SECRETARY.—Not later 

2 than 3 months following receipt of each such bian3 nual report, the Secretary shall provide to Congress 

4 the report and any studies or other materials pro5 duced independently by the Commission and Coun6 cil. 

7 ‘‘(e) AUDITS.—The Secretary shall annually prepare 

8 an audited financial report to account for all appropriated 

9 assets expended by the Commission and Council to ad10 dress both the strategic and operational work plans for 

11 the year involved. 

12 ‘‘(f) BY-LAWS.—Not later than 6 months after the 

13 date of enactment of this section, the Commission and 

14 Council shall develop and approve bylaws to provide fully 

15 for compliance with the requirements of this section. 

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

17 and Council shall submit copies of the operational work 

18 plan and by-laws to Congress. The Comptroller General 

19 of the United States shall submit a copy of each evaluation 

20 completed under subsection (c) to Congress. 

21 ‘‘SEC. 10. COORDINATION. 

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

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

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

25 general border health, including with respect to infectious 


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1 disease, shall be coordinated with Federal, State, and local 

2 authorities in Mexico, Canada, and the United States. 

3 ‘‘(b) COORDINATION OF HEALTH SERVICES AND

4 SURVEILLANCE.—The Secretary, acting through the As5 sistant Secretary for Preparedness and Response, when 

6 appropriate, may coordinate with the Secretary of Home7 land Security in establishing a health alert system that— 

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

9 of emerging disease clusters and syndromes along 

10 the United States-Mexico border area and United 

11 States-Canada border area; 

12 ‘‘(2) warns of health threats, extreme weather 

13 conditions, disasters of mass scale, bioterrorism, and 

14 other emerging threats along the United States-Mex15 ico border area and United States-Canada border 

16 area; and 

17 ‘‘(3) is coordinated with other systems and 

18 agencies to avoid duplication. 

19 ‘‘SEC. 11. AUTHORIZATION OF APPROPRIATIONS. 

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

21 this Act $20,000,000 for fiscal year 2022 and each suc22 ceeding year, of which for each fiscal year— 

23 ‘‘(1) $14,000,000 shall be made available to 

24 fund operationally feasible functions, activities, and 

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1 der and the border health activities under coopera2 tive agreements with the border health offices of the 

3 States of California, Arizona, New Mexico, and 

4 Texas; and 

5 ‘‘(2) $6,000,000 shall be made available for the 

6 administration of United States activities under this 

7 Act on the United States-Canada border and the 

8 border health authorities, acting through the Can9 ada-United States Pan-Border Public Health Pre10 paredness Council.’’; and 

11 (5) in section 12 (as so redesignated)— 

12 (A) by redesignating paragraphs (3) and 

13 (4) as paragraphs (4) and (6), respectively; 

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

15 following: 

16 ‘‘(3) INDIANS; INDIAN TRIBE; TRIBAL ORGANI17 ZATION; URBAN INDIAN ORGANIZATION.—The terms 

18 ‘Indian’, ‘Indian Tribe’, ‘Tribal organization’, and 

19 ‘urban Indian organization’ have the meanings given 

20 such terms in section 4 of the Indian Health Care 

21 Improvement Act (25 U.S.C. 1603).’’; and 

22 (C) by inserting after paragraph (4), as so 

23 redesignated, the following: 

24 ‘‘(5) UNITED STATES-CANADA BORDER AREA.— 

25 The term ‘United States-Canada border area’ means 


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1 the area located in the United States and Canada 

2 within 100 kilometers of the border between the 

3 United States and Canada.’’. 

Æ 


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