II 

117TH CONGRESS 

2D SESSION S. 3968 

To improve State, local, and Tribal public health security. 

IN THE SENATE OF THE UNITED STATES 

MARCH 30, 2022 

Ms. WARREN (for herself, Mr. HEINRICH, Ms. SMITH, Ms. KLOBUCHAR, Mr. 

BOOKER, Ms. BALDWIN, and Mr. SANDERS) introduced the following bill; 

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

A BILL 

To improve State, local, and Tribal public health security. 

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 ‘‘CDC Tribal Public 

5 Health Security and Preparedness Act’’. 

6 SEC. 2. IMPROVING STATE, LOCAL, AND TRIBAL PUBLIC 

7 HEALTH SECURITY. 

8 Section 319C–1 of the Public Health Service Act (42 

9 U.S.C. 247d–3a) is amended— 

10 (1) in the section heading, by striking ‘‘AND

11 LOCAL’’ and inserting ‘‘, LOCAL, AND TRIBAL’’; 


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1 (2) in subsection (b)— 

2 (A) in paragraph (1)— 

3 (i) in subparagraph (B), by striking 

4 ‘‘or’’ at the end; 

5 (ii) in subparagraph (C), by striking 

6 ‘‘and’’ at the end and inserting ‘‘or’’; and 

7 (iii) by adding at the end the fol8 lowing: 

9 ‘‘(D) be an Indian Tribe, a Tribal organi10 zation, or a consortium of Indian Tribes or 

11 Tribal organizations; and’’; and 

12 (B) in paragraph (2)— 

13 (i) in subparagraph (A)(viii)— 

14 (I) by inserting ‘‘and Tribal’’ 

15 after ‘‘with State’’; 

16 (II) by striking ‘‘(as defined in 

17 section 8101 of the Elementary and 

18 Secondary Education Act of 1965)’’ 

19 and inserting ‘‘and Tribal educational 

20 agencies (as defined in sections 8101 

21 and 6132, respectively, of the Elemen22 tary and Secondary Education Act of 

23 1965)’’; and 

24 (III) by inserting ‘‘and Tribal’’ 

25 after ‘‘and State’’; 


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1 (ii) in subparagraph (G), by inserting 

2 ‘‘(including Indian Tribes, Tribal organiza3 tions, and urban Indian organizations)’’ 

4 after ‘‘stakeholders’’; and 

5 (iii) in subparagraph (H), by inserting 

6 ‘‘, Indian Tribes, and urban Indian organi7 zations’’ after ‘‘public health’’; 

8 (3) in subsection (e), by inserting ‘‘Indian 

9 Tribes, Tribal organizations, urban Indian organiza10 tions,’’ after ‘‘local emergency plans,’’; 

11 (4) in subsection (h)— 

12 (A) by amending subparagraph (A) of 

13 paragraph (1) to read as follows: 

14 ‘‘(A) IN GENERAL.—For the purpose of 

15 carrying out this section, there is authorized to 

16 be appropriated $750,000,000 for each of fiscal 

17 years 2023 through 2025 for awards pursuant 

18 to paragraph (3) (subject to the authority of 

19 the Secretary to make awards pursuant to 

20 paragraphs (4) and (5)) and paragraph (8), of 

21 which not less than 5 percent shall be reserved 

22 each fiscal year for awards under paragraph 

23 (8).’’; 

24 (B) in the heading of paragraph (3), by in25 serting ‘‘FOR STATES’’ after ‘‘AMOUNT’’; and 


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

2 ‘‘(8) TRIBAL ELIGIBLE ENTITIES.— 

3 ‘‘(A) DETERMINATION OF FUNDING

4 AMOUNT.— 

5 ‘‘(i) IN GENERAL.—The Secretary 

6 shall award at least 10 cooperative agree7 ments under this section, in amounts not 

8 less than the minimum amount determined 

9 under clause (ii), to eligible entities de10 scribed in subsection (b)(1)(D) that submit 

11 to the Secretary an application that meets 

12 the criteria of the Secretary for the receipt 

13 of such an award and that meets other 

14 reasonable implementation conditions es15 tablished by the Secretary, in consultation 

16 with Indian Tribes, for such awards. 

17 ‘‘(ii) MINIMUM AMOUNT.—In deter18 mining the minimum amount of an award 

19 pursuant to clause (i), the Secretary, in 

20 consultation with Indian Tribes, shall first 

21 determine an amount the Secretary con22 siders appropriate for the eligible entity. 

23 ‘‘(B) AVAILABLE UNTIL EXPENDED.— 

24 Amounts provided to a Tribal eligible entity 

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1 tion for a fiscal year and remaining unobligated 

2 at the end of such year shall remain available 

3 to such entity during the entirety of the per4 formance period, for the purposes for which 

5 said funds were provided. 

6 ‘‘(C) NO MATCHING REQUIREMENT.—Sub7 paragraphs (B) and (C) of paragraph (1) shall 

8 not apply with respect to cooperative agree9 ments awarded under this section to eligible en10 tities described in subsection (b)(1)(D).’’; and 

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

12 ‘‘(l) SPECIAL RULES RELATED TO TRIBAL ELIGIBLE

13 ENTITIES.— 

14 ‘‘(1) MODIFICATIONS.—After consultation with 

15 Indian Tribes, the Secretary may make necessary 

16 and appropriate modifications with respect to sub17 sections (b)(2), (g), and (i) to facilitate the use of 

18 the cooperative agreement program by eligible enti19 ties described in subsection (b)(1)(D). 

20 ‘‘(2) WAIVERS.— 

21 ‘‘(A) IN GENERAL.—Except as provided in 

22 subparagraph (B), the Secretary shall waive or 

23 specify alternative requirements for any provi24 sion of this section (including regulations) that 

25 the Secretary administers in connection with 


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1 this section if the Secretary, after consultation 

2 with Indian Tribes, finds that the waiver or al3 ternative requirement is appropriate for the ef4 fective delivery and administration of this pro5 gram with respect to eligible entities described 

6 in subsection (b)(1)(D). 

7 ‘‘(B) EXCEPTION.—The Secretary may not 

8 waive or specify alternative requirements under 

9 subparagraph (A) relating to labor standards or 

10 the environment. 

11 ‘‘(3) CONSULTATION.—The Secretary shall con12 sult with Indian Tribes and Tribal organizations on 

13 the design of this program with respect to such 

14 Tribes and organizations to ensure the effectiveness 

15 of the program in enhancing the security of Indian 

16 Tribes with respect to public health emergencies. 

17 ‘‘(4) REPORTING.— 

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

19 after the date of enactment of this subsection, 

20 and as an addendum to the biennial evaluations 

21 required under subsection (k), the Secretary, in 

22 coordination with the Director of the Indian 

23 Health Service, shall— 

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1 ble entities described in subsection 

2 (b)(1)(D), including any factors that may 

3 have limited its success; 

4 ‘‘(ii) compile a report containing— 

5 ‘‘(I) a description of the results 

6 of the review described in clause (i); 

7 ‘‘(II) a breakdown of the eligible 

8 entities described in subsection 

9 (b)(1)(D) that— 

10 ‘‘(aa) received an award 

11 under this section; 

12 ‘‘(bb) received an award 

13 under this section and a waiver 

14 as described in paragraph (2); 

15 and 

16 ‘‘(cc) applied under this sec17 tion but did not receive an 

18 award; 

19 ‘‘(III) a list of any requirements 

20 of this section for which the Secretary 

21 provided a waiver or alternative re22 quirement, and the reasoning for 

23 issuing a waiver or alternative re24 quirement; and 


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1 ‘‘(IV) recommendations to Con2 gress for program modifications nec3 essary to improve the implementation 

4 of the program with respect to eligible 

5 entities described in subsection 

6 (b)(1)(D); and 

7 ‘‘(iii) submit the report described in 

8 clause (ii) to— 

9 ‘‘(I) the Committee on Indian Af10 fairs, the Committee on Health, Edu11 cation, Labor, and Pensions, and the 

12 Committee on Appropriations of the 

13 Senate; and 

14 ‘‘(II) the Subcommittee on Indig15 enous People of the Committee on 

16 Natural Resources, the Committee on 

17 Energy and Commerce, and the Com18 mittee on Appropriations of the House 

19 of Representatives. 

20 ‘‘(B) ANALYSIS OF TRIBAL PUBLIC

21 HEALTH EMERGENCY INFRASTRUCTURE LIMI22 TATION.—The Secretary shall include in the 

23 initial report submitted under subparagraph (A) 

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1 frastructure limitation encountered by eligible 

2 entities described in subsection (b)(1)(D).’’. 

Æ 


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