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[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1532 Received in Senate (RDS)]

  2d Session
                                H. R. 1532

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

           September 25 (legislative day, September 17), 2008

                                Received

_______________________________________________________________________

                                 AN ACT

 
To amend the Public Health Service Act with respect to making progress 
  toward the goal of eliminating tuberculosis, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Comprehensive 
Tuberculosis Elimination Act of 2008''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.
 TITLE I--DEPARTMENT OF HEALTH AND HUMAN SERVICES IN COORDINATION WITH 
 THE CENTERS FOR DISEASE CONTROL AND PREVENTION AND OTHER APPROPRIATE 
                                AGENCIES

      Subtitle A--National Strategy for Combating and Eliminating 
                              Tuberculosis

Sec. 101. National strategy.
                 Subtitle B--Interagency Collaboration

Sec. 111. Advisory Council for Elimination of Tuberculosis and the 
                            Federal Tuberculosis Task Force .
          Subtitle C--Evaluation of Public Health Authorities

Sec. 121. Evaluation of public health authorities.
              Subtitle D--Authorization of Appropriations

Sec. 131. Authorizations of appropriations.
                TITLE II--NATIONAL INSTITUTES OF HEALTH

Sec. 201. Research and development concerning tuberculosis.

 TITLE I--DEPARTMENT OF HEALTH AND HUMAN SERVICES IN COORDINATION WITH 
 THE CENTERS FOR DISEASE CONTROL AND PREVENTION AND OTHER APPROPRIATE 
                                AGENCIES

      Subtitle A--National Strategy for Combating and Eliminating 
                              Tuberculosis

SEC. 101. NATIONAL STRATEGY.

    Section 317E of the Public Health Service Act (42 U.S.C. 247b-6) is 
amended--
            (1) by striking the heading for the section and inserting 
        the following: ``national strategy for combating and 
        eliminating tuberculosis'';
            (2) by amending subsection (b) to read as follows:
    ``(b) Research and Development; Demonstration Projects; Education 
and Training.--With respect to the prevention, treatment, control, and 
elimination of tuberculosis, the Secretary may, directly or through 
grants to public or nonprofit private entities, carry out the 
following:
            ``(1) Research, with priority given to research and 
        development concerning latent tuberculosis infection, strains 
        of tuberculosis resistant to drugs, and research concerning 
        cases of tuberculosis that affect certain populations at risk 
        for tuberculosis.
            ``(2) Research and development and related activities to 
        develop new tools for the elimination of tuberculosis, 
        including drugs, diagnostics, vaccines, and public health 
        interventions, such as directly observed therapy and non-
        pharmaceutical intervention, and methods to enhance detection 
        and response to outbreaks of tuberculosis, including multidrug 
        resistant tuberculosis. The Secretary is encouraged to give 
        priority to programmatically relevant research so that new 
        tools can be utilized in public health practice.
            ``(3) Demonstration projects for--
                    ``(A) the development of regional capabilities to 
                prevent, control, and eliminate tuberculosis and 
                prevent multidrug resistant and extensively drug 
                resistant strains of tuberculosis;
                    ``(B) the intensification of efforts to reduce 
                health disparities in the incidence of tuberculosis;
                    ``(C) the intensification of efforts to control 
                tuberculosis along the United States-Mexico border and 
                among United States-Mexico binational populations, 
                including through expansion of the scope and number of 
                programs that--
                            ``(i) detect and treat binational cases of 
                        tuberculosis; and
                            ``(ii) treat high-risk cases of 
                        tuberculosis referred from Mexican health 
                        departments;
                    ``(D) the intensification of efforts to prevent, 
                detect, and treat tuberculosis among foreign-born 
                persons who are in the United States;
                    ``(E) the intensification of efforts to prevent, 
                detect, and treat tuberculosis among populations and 
                settings documented as having a high risk for 
                tuberculosis; and
                    ``(F) tuberculosis detection, control, and 
                prevention.
            ``(4) Public information and education activities.
            ``(5) Education, training, clinical skills improvement 
        activities, and workplace exposure prevention for health 
        professionals, including allied health personnel and emergency 
        response employees.
            ``(6) Support of Centers to carry out activities under 
        paragraphs (1) through (4).
            ``(7) Collaboration with international organizations and 
        foreign countries in carrying out such activities.
            ``(8) Develop, enhance, and expand information technologies 
        that support tuberculosis control including surveillance and 
        database management systems with cross-jurisdictional 
        capabilities, which shall conform to the standards and 
        implementation specifications for such information technologies 
        as recommended by the Secretary.''; and
            (3) in subsection (d), by adding at the end the following:
            ``(3) Determination of amount of nonfederal 
        contributions.--
                    ``(A) Priority.--In awarding grants under 
                subsection (a) or (b), the Secretary shall give highest 
                priority to an applicant that provides assurances that 
                the applicant will contribute non-Federal funds to 
                carry out activities under this section, which may be 
                provided directly or through donations from public or 
                private entities and may be in cash or in kind, 
                including equipment or services.
                    ``(B) Federal amounts not to be included as 
                contributions.--Amounts provided by the Federal 
                Government, or services assisted or subsidized to any 
                significant extent by the Federal Government, may not 
                be included in determining the amount of non-Federal 
                contributions as described in subparagraph (A).''.

                 Subtitle B--Interagency Collaboration

SEC. 111. ADVISORY COUNCIL FOR ELIMINATION OF TUBERCULOSIS AND THE 
              FEDERAL TUBERCULOSIS TASK FORCE.

    (a) In General.--Section 317E(f) of the Public Health Service Act 
(42 U.S.C. 247b-6(f)) is amended--
            (1) by redesignating paragraph (5) as paragraph (6); and
            (2) by striking paragraphs (2) through (4), and inserting 
        the following:
            ``(2) Duties.--The Council shall provide advice and 
        recommendations regarding the elimination of tuberculosis to 
        the Secretary. In addition, the Council shall, with respect to 
        eliminating such disease, provide to the Secretary and other 
        appropriate Federal officials advice on--
                    ``(A) coordinating the activities of the Department 
                of Health and Human Services and other Federal agencies 
                that relate to the disease, including activities under 
                subsection (b);
                    ``(B) responding rapidly and effectively to 
                emerging issues in tuberculosis; and
                    ``(C) efficiently utilizing the Federal resources 
                involved.
            ``(3) Comprehensive plan.--
                    ``(A) In general.--In carrying out paragraph (2), 
                the Council shall make or update recommendations on the 
                development, revision, and implementation of a 
                comprehensive plan to eliminate tuberculosis in the 
                United States.
                    ``(B) Consultation.--In carrying out subparagraph 
                (A), the Council may consult with appropriate public 
                and private entities, which may, subject to the 
                direction or discretion of the Secretary, include--
                            ``(i) individuals who are scientists, 
                        physicians, laboratorians, and other health 
                        professionals, who are not officers or 
                        employees of the Federal Government and who 
                        represent the disciplines relevant to 
                        tuberculosis elimination;
                            ``(ii) members of public-private 
                        partnerships or private entities established to 
                        address the elimination of tuberculosis;
                            ``(iii) members of national and 
                        international nongovernmental organizations 
                        whose purpose is to eliminate tuberculosis;
                            ``(iv) members from the general public who 
                        are knowledgeable with respect to tuberculosis 
                        elimination including individuals who have or 
                        have had tuberculosis; and
                            ``(v) scientists, physicians, 
                        laboratorians, and other health professionals 
                        who reside in a foreign country with a 
                        substantial incidence or prevalence of 
                        tuberculosis, and who represent the specialties 
                        and disciplines relevant to the research under 
                        consideration.
                    ``(C) Certain components of plan.--In carrying out 
                subparagraph (A), the Council shall, subject to the 
                direction or discretion of the Secretary--
                            ``(i) consider recommendations for the 
                        involvement of the United States in continuing 
                        global and cross-border tuberculosis control 
                        activities in countries where a high incidence 
                        of tuberculosis directly affects the United 
                        States; and
                            ``(ii) review the extent to which progress 
                        has been made toward eliminating tuberculosis.
            ``(4) Biennial report.--
                    ``(A) In general.--The Council shall submit a 
                biennial report to the Secretary, as determined 
                necessary by the Secretary, on the activities carried 
                under this section. Each such report shall include the 
                opinion of the Council on the extent to which its 
                recommendations regarding the elimination of 
                tuberculosis have been implemented, including with 
                respect to--
                            ``(i) activities under subsection (b); and
                            ``(ii) the national plan referred to in 
                        paragraph (3).
                    ``(B) Public.--The Secretary shall make a report 
                submitted under subparagraph (A) public.
            ``(5) Composition.--The Council shall be composed of--
                    ``(A) ex officio representatives from the Centers 
                for Disease Control and Prevention, the National 
                Institutes of Health, the United States Agency for 
                International Development, the Agency for Healthcare 
                Research and Quality, the Health Resources and Services 
                Administration, the United States-Mexico Border Health 
                Commission, and other Federal departments and agencies 
                that carry out significant activities related to 
                tuberculosis;
                    ``(B) State and local tuberculosis control and 
                public health officials;
                    ``(C) individuals who are scientists, physicians, 
                laboratorians, and other health professionals who 
                represent disciplines relevant to tuberculosis 
                elimination; and
                    ``(D) members of national and international 
                nongovernmental organizations established to address 
                the elimination of tuberculosis.''.
    (b) Rule of Construction Regarding Current Membership.--With 
respect to the advisory council under section 317E(f) of the Public 
Health Service Act, the amendments made by subsection (a) may not be 
construed as terminating the membership on such council of any 
individual serving as such a member as of the day before the date of 
the enactment of this Act.
    (c) Federal Tuberculosis Task Force.--Section 317E of the Public 
Health Service Act (42 U.S.C. 247b-6) is amended--
            (1) by redesignating subsection (g) as subsection (h); and
            (2) by inserting after subsection (f) the following 
        subsection:
    ``(g) Federal Tuberculosis Task Force.--
            ``(1) Duties.--The Federal Tuberculosis Task Force (in this 
        subsection referred to as the `Task Force') shall provide to 
        the Secretary and other appropriate Federal officials advice on 
        research into new tools under subsection (b)(2), including 
        advice regarding the efficient utilization of the Federal 
        resources involved.
            ``(2) Comprehensive plan for new tools development.--In 
        carrying out paragraph (1), the Task Force shall make 
        recommendations on the development of a comprehensive plan for 
        the creation of new tools for the elimination of tuberculosis, 
        including drugs, diagnostics, and vaccines.
            ``(3) Consultation.--In developing the comprehensive plan 
        under paragraph (1), the Task Force shall consult with external 
        parties including representatives from groups such as--
                    ``(A) scientists, physicians, laboratorians, and 
                other health professionals who represent the 
                specialties and disciplines relevant to the research 
                under consideration;
                    ``(B) members from public-private partnerships, 
                private entities, or foundations (or both) engaged in 
                activities relevant to research under consideration;
                    ``(C) members of national and international 
                nongovernmental organizations established to address 
                tuberculosis elimination;
                    ``(D) members from the general public who are 
                knowledgeable with respect to tuberculosis including 
                individuals who have or have had tuberculosis; and
                    ``(E) scientists, physicians, laboratorians, and 
                other health professionals who reside in a foreign 
                country with a substantial incidence or prevalence of 
                tuberculosis, and who represent the specialties and 
                disciplines relevant to the research under 
                consideration.''.

          Subtitle C--Evaluation of Public Health Authorities

SEC. 121. EVALUATION OF PUBLIC HEALTH AUTHORITIES.

    (a) In General.--Not later than 180 days after the date of 
enactment of the Comprehensive Tuberculosis Elimination Act of 2008, 
the Secretary of Health and Human Services shall prepare and submit to 
the appropriate committees of Congress a report that evaluates and 
provides recommendations on changes needed to Federal and State public 
health authorities to address current disease containment challenges 
such as isolation and quarantine.
    (b) Contents of Evaluation.--The report described in subsection (a) 
shall include--
            (1) an evaluation of the effectiveness of current policies 
        to detain patients with active tuberculosis;
            (2) an evaluation of whether Federal laws should be 
        strengthened to expressly address the movement of individuals 
        with active tuberculosis; and
            (3) specific legislative recommendations for changes to 
        Federal laws, if any.
    (c) Update of Quarantine Regulations.--Not later than 240 days 
after the date of enactment of this Act, the Secretary of Health and 
Human Services shall promulgate regulations to update the current 
interstate and foreign quarantine regulations found in parts 70 and 71 
of title 42, Code of Federal Regulations.

              Subtitle D--Authorization of Appropriations

SEC. 131. AUTHORIZATIONS OF APPROPRIATIONS.

    Section 317E of the Public Health Service Act, as amended by 
section 111(c) of this Act, is amended by striking subsection (h) and 
inserting the following:
    ``(h) Authorization of Appropriations.--
            ``(1) General program.--
                    ``(A) In general.--For the purpose of carrying out 
                this section, there are authorized to be appropriated 
                $200,000,000 for fiscal year 2009, $210,000,000 for 
                fiscal year 2010, $220,500,000 for fiscal year 2011, 
                $231,525,000 for fiscal year 2012, and $243,101,250 for 
                fiscal year 2013.
                    ``(B) Reservation for emergency grants.--Of the 
                amounts appropriated under subparagraph (A) for a 
                fiscal year, the Secretary may reserve not more than 25 
                percent for emergency grants under subsection (a) for 
                any geographic area, State, political subdivision of a 
                State, or other public entity in which there is, 
                relative to other areas, a substantial number of cases 
                of tuberculosis, multidrug resistant tuberculosis, or 
                extensively drug resistant tuberculosis or a 
                substantial rate of increase in such cases.
                    ``(C) Priority.--In allocating amounts appropriated 
                under subparagraph (A), the Secretary shall give 
                priority to allocating such amounts for grants under 
                subsection (a).
                    ``(D) Allocation of funds.--
                            ``(i) Requirement of formula.--Of the 
                        amounts appropriated under subparagraph (A), 
                        not reserved under subparagraph (B), and 
                        allocated by the Secretary for grants under 
                        subsection (a), the Secretary shall distribute 
                        a portion of such amounts to grantees under 
                        subsection (a) on the basis of a formula.
                            ``(ii) Relevant factors.--The formula 
                        developed by the Secretary under clause (i) 
                        shall take into account the level of 
                        tuberculosis morbidity and case complexity in 
                        the respective geographic area and may consider 
                        other factors relevant to tuberculosis in such 
                        area.
                            ``(iii) No change to formula required.--
                        This subparagraph does not require the 
                        Secretary to modify the formula that was used 
                        by the Secretary to distribute funds to 
                        grantees under subsection (a) for fiscal year 
                        2009.
            ``(2) Limitation.--The authorization of appropriations 
        established in paragraph (1) for a fiscal year is effective 
        only if the amount appropriated under such paragraph for such 
        year equals or exceeds the amount appropriated to carry out 
        this section for fiscal year 2009.''.

                TITLE II--NATIONAL INSTITUTES OF HEALTH

SEC. 201. RESEARCH AND DEVELOPMENT CONCERNING TUBERCULOSIS.

    Subpart 2 of part C of title IV of the Public Health Service Act 
(42 U.S.C. 285b et seq.) is amended by inserting after section 424B the 
following section:

``SEC. 424C. TUBERCULOSIS.

    ``(a) In General.--The Director of the National Institutes of 
Health may expand, intensify, and coordinate research and development 
and related activities of the Institutes with respect to tuberculosis 
including activities toward the goal of eliminating such disease.
    ``(b) Certain Activities.--Activities under subsection (a) may 
include--
            ``(1) enhancing basic and clinical research on 
        tuberculosis, including drug resistant tuberculosis;
            ``(2) expanding research on the relationship between such 
        disease and the human immunodeficiency virus; and
            ``(3) developing new tools for the elimination of 
        tuberculosis, including public health interventions and methods 
        to enhance detection and response to outbreaks of tuberculosis, 
        including multidrug resistant tuberculosis.''.

            Passed the House of Representatives September 24, 2008.

            Attest:

                                            LORRAINE C. MILLER,

                                                                 Clerk.
```