IB 

Union Calendar No. 569 

110TH CONGRESS 

2D SESSION H. R. 1532 

[Report No. 110–873] 

To amend the Public Health Service Act with respect to making progress 

toward the goal of eliminating tuberculosis, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 15, 2007 

Mr. GENE GREEN of Texas (for himself, Mrs. WILSON of New Mexico, and 

Ms. BALDWIN) introduced the following bill; which was referred to the 

Committee on Energy and Commerce 

SEPTEMBER 23, 2008 

Additional sponsors: Mr. ENGEL, Mr. HOLT, Mr. MORAN of Virginia, Mr. 

WAXMAN, Ms. MCCOLLUM of Minnesota, Mrs. CAPPS, Mr. FILNER, Mr. 

RAHALL, Mrs. DAVIS of California, Ms. MOORE of Wisconsin, Ms. ZOE

LOFGREN of California, Mr. RUSH, Mr. SMITH of Washington, Mr. 

ALLEN, Mr. GEORGE MILLER of California, Mr. HINOJOSA, Mr. PLATTS, 

Mr. GRIJALVA, Mr. SIRES, Mr. REYES, Mr. ETHERIDGE, Mr. SPRATT, 

Mr. LARSEN of Washington, Mr. HASTINGS of Florida, Mr. HONDA, Mrs. 

LOWEY, Mr. MARSHALL, Mr. YOUNG of Alaska, Mr. MCDERMOTT, Mr. 

FRANK of Massachusetts, Mrs. GILLIBRAND, Mr. KUCINICH, Mr. ORTIZ, 

Mr. BERMAN, Ms. LEE, Mr. DOGGETT, Mr. GONZALEZ, Mr. SERRANO, 

Ms. SCHAKOWSKY, Mr. PAYNE, Mr. MCNULTY, Mr. MCNERNEY, Mr. 

CARNEY, Ms. SLAUGHTER, Ms. ESHOO, Mr. STARK, Mr. BRADY of 

Texas, Mr. CARSON, Mr. GORDON of Tennessee, Mr. WELCH of Vermont, 

Mr. BILBRAY, Mrs. TAUSCHER, Ms. DEGETTE, Mr. LAMPSON, Mr. 

CUELLAR, and Mr. RODRIGUEZ

SEPTEMBER 23, 2008 

Reported with an amendment, committed to the Committee of the Whole 

House on the State of the Union, and ordered to be printed 


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[Strike out all after the enacting clause and insert the part printed in italic] 

[For text of introduced bill, see copy of bill as introduced on March 15, 2007] 

A BILL 

To amend the Public Health Service Act with respect to 

making progress toward the goal of eliminating tuberculosis, 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; TABLE OF CONTENTS. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘Comprehensive Tuberculosis Elimination Act of 2008’’. 

6 (b) TABLE OF CONTENTS.—The table of contents for 

7 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. 


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1 TITLE I—DEPARTMENT OF 

2 HEALTH AND HUMAN SERV3 ICES IN COORDINATION WITH 

4 THE CENTERS FOR DISEASE 

5 CONTROL AND PREVENTION 

6 AND OTHER APPROPRIATE 

7 AGENCIES 

8 Subtitle A—National Strategy for 

9 Combating and Eliminating Tu10 berculosis 

11 SEC. 101. NATIONAL STRATEGY. 

12 Section 317E of the Public Health Service Act (42 

13 U.S.C. 247b–6) is amended— 

14 (1) by striking the heading for the section and 

15 inserting the following: ‘‘NATIONAL STRATEGY FOR

16 COMBATING AND ELIMINATING TUBERCULOSIS’’; 

17 (2) by amending subsection (b) to read as fol18 lows: 

19 ‘‘(b) RESEARCH AND DEVELOPMENT; DEMONSTRATION

20 PROJECTS; EDUCATION AND TRAINING.—With respect to 

21 the prevention, treatment, control, and elimination of tuber22 culosis, the Secretary may, directly or through grants to 

23 public or nonprofit private entities, carry out the following: 

24 ‘‘(1) Research, with priority given to research 

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1 tion, strains of tuberculosis resistant to drugs, and re2 search concerning cases of tuberculosis that affect cer3 tain populations at risk for tuberculosis. 

4 ‘‘(2) Research and development and related ac5 tivities to develop new tools for the elimination of tu6 berculosis, including drugs, diagnostics, vaccines, and 

7 public health interventions, such as directly observed 

8 therapy and non-pharmaceutical intervention, and 

9 methods to enhance detection and response to out10 breaks of tuberculosis, including multidrug resistant 

11 tuberculosis. The Secretary is encouraged to give pri12 ority to programmatically relevant research so that 

13 new tools can be utilized in public health practice. 

14 ‘‘(3) Demonstration projects for— 

15 ‘‘(A) the development of regional capabili16 ties to prevent, control, and eliminate tuber17 culosis and prevent multidrug resistant and ex18 tensively drug resistant strains of tuberculosis; 

19 ‘‘(B) the intensification of efforts to reduce 

20 health disparities in the incidence of tuber21 culosis; 

22 ‘‘(C) the intensification of efforts to control 

23 tuberculosis along the United States-Mexico bor24 der and among United States-Mexico binational 


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1 populations, including through expansion of the 

2 scope and number of programs that— 

3 ‘‘(i) detect and treat binational cases of 

4 tuberculosis; and 

5 ‘‘(ii) treat high-risk cases of tuber6 culosis referred from Mexican health depart7 ments; 

8 ‘‘(D) the intensification of efforts to prevent, 

9 detect, and treat tuberculosis among foreign-born 

10 persons who are in the United States; 

11 ‘‘(E) the intensification of efforts to prevent, 

12 detect, and treat tuberculosis among populations 

13 and settings documented as having a high risk 

14 for tuberculosis; and 

15 ‘‘(F) tuberculosis detection, control, and 

16 prevention. 

17 ‘‘(4) Public information and education activities. 

18 ‘‘(5) Education, training, clinical skills improve19 ment activities, and workplace exposure prevention 

20 for health professionals, including allied health per21 sonnel and emergency response employees. 

22 ‘‘(6) Support of Centers to carry out activities 

23 under paragraphs (1) through (4). 


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1 ‘‘(7) Collaboration with international organiza2 tions and foreign countries in carrying out such ac3 tivities. 

4 ‘‘(8) Develop, enhance, and expand information 

5 technologies that support tuberculosis control includ6 ing surveillance and database management systems 

7 with cross-jurisdictional capabilities, which shall con8 form to the standards and implementation specifica9 tions for such information technologies as rec10 ommended by the Secretary.’’; and 

11 (3) in subsection (d), by adding at the end the 

12 following: 

13 ‘‘(3) DETERMINATION OF AMOUNT OF NON14 FEDERAL CONTRIBUTIONS.— 

15 ‘‘(A) PRIORITY.—In awarding grants under 

16 subsection (a) or (b), the Secretary shall give 

17 highest priority to an applicant that provides 

18 assurances that the applicant will contribute 

19 non-Federal funds to carry out activities under 

20 this section, which may be provided directly or 

21 through donations from public or private entities 

22 and may be in cash or in kind, including equip23 ment or services. 

24 ‘‘(B) FEDERAL AMOUNTS NOT TO BE IN25 CLUDED AS CONTRIBUTIONS.—Amounts provided 


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1 by the Federal Government, or services assisted 

2 or subsidized to any significant extent by the 

3 Federal Government, may not be included in de4 termining the amount of non-Federal contribu5 tions as described in subparagraph (A).’’. 

6 Subtitle B—Interagency 

7 Collaboration 

8 SEC. 111. ADVISORY COUNCIL FOR ELIMINATION OF TUBER9 CULOSIS AND THE FEDERAL TUBERCULOSIS 

10 TASK FORCE. 

11 (a) IN GENERAL.—Section 317E(f) of the Public 

12 Health Service Act (42 U.S.C. 247b–6(f)) is amended— 

13 (1) by redesignating paragraph (5) as para14 graph (6); and 

15 (2) by striking paragraphs (2) through (4), and 

16 inserting the following: 

17 ‘‘(2) DUTIES.—The Council shall provide advice 

18 and recommendations regarding the elimination of 

19 tuberculosis to the Secretary. In addition, the Council 

20 shall, with respect to eliminating such disease, pro21 vide to the Secretary and other appropriate Federal 

22 officials advice on— 

23 ‘‘(A) coordinating the activities of the De24 partment of Health and Human Services and 


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1 other Federal agencies that relate to the disease, 

2 including activities under subsection (b); 

3 ‘‘(B) responding rapidly and effectively to 

4 emerging issues in tuberculosis; and 

5 ‘‘(C) efficiently utilizing the Federal re6 sources involved. 

7 ‘‘(3) COMPREHENSIVE PLAN.— 

8 ‘‘(A) IN GENERAL.—In carrying out para9 graph (2), the Council shall make or update rec10 ommendations on the development, revision, and 

11 implementation of a comprehensive plan to 

12 eliminate tuberculosis in the United States. 

13 ‘‘(B) CONSULTATION.—In carrying out sub14 paragraph (A), the Council may consult with 

15 appropriate public and private entities, which 

16 may, subject to the direction or discretion of the 

17 Secretary, include— 

18 ‘‘(i) individuals who are scientists, 

19 physicians, laboratorians, and other health 

20 professionals, who are not officers or em21 ployees of the Federal Government and who 

22 represent the disciplines relevant to tuber23 culosis elimination; 


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1 ‘‘(ii) members of public-private part2 nerships or private entities established to 

3 address the elimination of tuberculosis; 

4 ‘‘(iii) members of national and inter5 national nongovernmental organizations 

6 whose purpose is to eliminate tuberculosis; 

7 ‘‘(iv) members from the general public 

8 who are knowledgeable with respect to tuber9 culosis elimination including individuals 

10 who have or have had tuberculosis; and 

11 ‘‘(v) scientists, physicians, 

12 laboratorians, and other health professionals 

13 who reside in a foreign country with a sub14 stantial incidence or prevalence of tuber15 culosis, and who represent the specialties 

16 and disciplines relevant to the research 

17 under consideration. 

18 ‘‘(C) CERTAIN COMPONENTS OF PLAN.—In 

19 carrying out subparagraph (A), the Council 

20 shall, subject to the direction or discretion of the 

21 Secretary— 

22 ‘‘(i) consider recommendations for the 

23 involvement of the United States in con24 tinuing global and cross-border tuberculosis 

25 control activities in countries where a high 


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1 incidence of tuberculosis directly affects the 

2 United States; and 

3 ‘‘(ii) review the extent to which 

4 progress has been made toward eliminating 

5 tuberculosis. 

6 ‘‘(4) BIENNIAL REPORT.— 

7 ‘‘(A) IN GENERAL.—The Council shall sub8 mit a biennial report to the Secretary, as deter9 mined necessary by the Secretary, on the activi10 ties carried under this section. Each such report 

11 shall include the opinion of the Council on the 

12 extent to which its recommendations regarding 

13 the elimination of tuberculosis have been imple14 mented, including with respect to— 

15 ‘‘(i) activities under subsection (b); 

16 and 

17 ‘‘(ii) the national plan referred to in 

18 paragraph (3). 

19 ‘‘(B) PUBLIC.—The Secretary shall make a 

20 report submitted under subparagraph (A) public. 

21 ‘‘(5) COMPOSITION.—The Council shall be com22 posed of— 

23 ‘‘(A) ex officio representatives from the Cen24 ters for Disease Control and Prevention, the Na25 tional Institutes of Health, the United States 


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1 Agency for International Development, the Agen2 cy for Healthcare Research and Quality, the 

3 Health Resources and Services Administration, 

4 the United States-Mexico Border Health Com5 mission, and other Federal departments and 

6 agencies that carry out significant activities re7 lated to tuberculosis; 

8 ‘‘(B) State and local tuberculosis control 

9 and public health officials; 

10 ‘‘(C) individuals who are scientists, physi11 cians, laboratorians, and other health profes12 sionals who represent disciplines relevant to tu13 berculosis elimination; and 

14 ‘‘(D) members of national and international 

15 nongovernmental organizations established to ad16 dress the elimination of tuberculosis.’’. 

17 (b) RULE OF CONSTRUCTION REGARDING CURRENT

18 MEMBERSHIP.—With respect to the advisory council under 

19 section 317E(f) of the Public Health Service Act, the 

20 amendments made by subsection (a) may not be construed 

21 as terminating the membership on such council of any indi22 vidual serving as such a member as of the day before the 

23 date of the enactment of this Act. 


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1 (c) FEDERAL TUBERCULOSIS TASK FORCE.—Section 

2 317E of the Public Health Service Act (42 U.S.C. 247b– 

3 6) is amended— 

4 (1) by redesignating subsection (g) as subsection 

5 (h); and 

6 (2) by inserting after subsection (f) the following 

7 subsection: 

8 ‘‘(g) FEDERAL TUBERCULOSIS TASK FORCE.— 

9 ‘‘(1) DUTIES.—The Federal Tuberculosis Task 

10 Force (in this subsection referred to as the ‘Task 

11 Force’) shall provide to the Secretary and other ap12 propriate Federal officials advice on research into 

13 new tools under subsection (b)(2), including advice re14 garding the efficient utilization of the Federal re15 sources involved. 

16 ‘‘(2) COMPREHENSIVE PLAN FOR NEW TOOLS DE17 VELOPMENT.—In carrying out paragraph (1), the 

18 Task Force shall make recommendations on the devel19 opment of a comprehensive plan for the creation of 

20 new tools for the elimination of tuberculosis, includ21 ing drugs, diagnostics, and vaccines. 

22 ‘‘(3) CONSULTATION.—In developing the com23 prehensive plan under paragraph (1), the Task Force 

24 shall consult with external parties including rep25 resentatives from groups such as— 


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1 ‘‘(A) scientists, physicians, laboratorians, 

2 and other health professionals who represent the 

3 specialties and disciplines relevant to the re4 search under consideration; 

5 ‘‘(B) members from public-private partner6 ships, private entities, or foundations (or both) 

7 engaged in activities relevant to research under 

8 consideration; 

9 ‘‘(C) members of national and international 

10 nongovernmental organizations established to ad11 dress tuberculosis elimination; 

12 ‘‘(D) members from the general public who 

13 are knowledgeable with respect to tuberculosis in14 cluding individuals who have or have had tuber15 culosis; and 

16 ‘‘(E) scientists, physicians, laboratorians, 

17 and other health professionals who reside in a 

18 foreign country with a substantial incidence or 

19 prevalence of tuberculosis, and who represent the 

20 specialties and disciplines relevant to the re21 search under consideration.’’. 


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1 Subtitle C—Evaluation of Public 

2 Health Authorities 

3 SEC. 121. EVALUATION OF PUBLIC HEALTH AUTHORITIES. 

4 (a) IN GENERAL.—Not later than 180 days after the 

5 date of enactment of the Comprehensive Tuberculosis Elimi6 nation Act of 2008, the Secretary of Health and Human 

7 Services shall prepare and submit to the appropriate com8 mittees of Congress a report that evaluates and provides rec9 ommendations on changes needed to Federal and State pub10 lic health authorities to address current disease contain11 ment challenges such as isolation and quarantine. 

12 (b) CONTENTS OF EVALUATION.—The report described 

13 in subsection (a) shall include— 

14 (1) an evaluation of the effectiveness of current 

15 policies to detain patients with active tuberculosis; 

16 (2) an evaluation of whether Federal laws should 

17 be strengthened to expressly address the movement of 

18 individuals with active tuberculosis; and 

19 (3) specific legislative recommendations for 

20 changes to Federal laws, if any. 

21 (c) UPDATE OF QUARANTINE REGULATIONS.—Not 

22 later than 240 days after the date of enactment of this Act, 

23 the Secretary of Health and Human Services shall promul24 gate regulations to update the current interstate and foreign 


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1 quarantine regulations found in parts 70 and 71 of title 

2 42, Code of Federal Regulations. 

3 Subtitle D—Authorization of 

4 Appropriations 

5 SEC. 131. AUTHORIZATIONS OF APPROPRIATIONS. 

6 Section 317E of the Public Health Service Act, as 

7 amended by section 111(c) of this Act, is amended by strik8 ing subsection (h) and inserting the following: 

9 ‘‘(h) AUTHORIZATION OF APPROPRIATIONS.— 

10 ‘‘(1) GENERAL PROGRAM.— 

11 ‘‘(A) IN GENERAL.—For the purpose of car12 rying out this section, there are authorized to be 

13 appropriated $300,000,000 for fiscal year 2009, 

14 $315,000,000 for fiscal year 2010, $330,750,000 

15 for fiscal year 2011, $347,287,500 for fiscal year 

16 2012, and $364,651,900 for fiscal year 2013. 

17 ‘‘(B) RESERVATION FOR EMERGENCY

18 GRANTS.—Of the amounts appropriated under 

19 subparagraph (A) for a fiscal year, the Secretary 

20 may reserve not more than 25 percent for emer21 gency grants under subsection (a) for any geo22 graphic area, State, political subdivision of a 

23 State, or other public entity in which there is, 

24 relative to other areas, a substantial number of 

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1 culosis, or extensively drug resistant tuberculosis 

2 or a substantial rate of increase in such cases. 

3 ‘‘(C) PRIORITY.—In allocating amounts ap4 propriated under subparagraph (A), the Sec5 retary shall give priority to allocating such 

6 amounts for grants under subsection (a). 

7 ‘‘(D) ALLOCATION OF FUNDS.— 

8 ‘‘(i) REQUIREMENT OF FORMULA.—Of 

9 the amounts appropriated under subpara10 graph (A), not reserved under subparagraph 

11 (B), and allocated by the Secretary for 

12 grants under subsection (a), the Secretary 

13 shall distribute a portion of such amounts 

14 to grantees under subsection (a) on the basis 

15 of a formula. 

16 ‘‘(ii) RELEVANT FACTORS.—The for17 mula developed by the Secretary under 

18 clause (i) shall take into account the level of 

19 tuberculosis morbidity and case complexity 

20 in the respective geographic area and may 

21 consider other factors relevant to tuber22 culosis in such area. 

23 ‘‘(iii) NO CHANGE TO FORMULA RE24 QUIRED.—This subparagraph does not re25 quire the Secretary to modify the formula 


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1 that was used by the Secretary to distribute 

2 funds to grantees under subsection (a) for 

3 fiscal year 2009. 

4 ‘‘(2) LIMITATION.—The authorization of appro5 priations established in paragraph (1) for a fiscal 

6 year is effective only if the amount appropriated 

7 under such paragraph for such year equals or exceeds 

8 the amount appropriated to carry out this section for 

9 fiscal year 2009.’’. 

10 TITLE II—NATIONAL INSTITUTES 

11 OF HEALTH 

12 SEC. 201. RESEARCH AND DEVELOPMENT CONCERNING TU13 BERCULOSIS. 

14 Subpart 2 of part C of title IV of the Public Health 

15 Service Act (42 U.S.C. 285b et seq.) is amended by inserting 

16 after section 424B the following section: 

17 ‘‘SEC. 424C. TUBERCULOSIS. 

18 ‘‘(a) IN GENERAL.—The Director of the National In19 stitutes of Health may expand, intensify, and coordinate 

20 research and development and related activities of the Insti21 tutes with respect to tuberculosis including activities toward 

22 the goal of eliminating such disease. 

23 ‘‘(b) CERTAIN ACTIVITIES.—Activities under sub24 section (a) may include— 


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1 ‘‘(1) enhancing basic and clinical research on tu2 berculosis, including drug resistant tuberculosis; 

3 ‘‘(2) expanding research on the relationship be4 tween such disease and the human immunodeficiency 

5 virus; and 

6 ‘‘(3) developing new tools for the elimination of 

7 tuberculosis, including public health interventions 

8 and methods to enhance detection and response to out9 breaks of tuberculosis, including multidrug resistant 

10 tuberculosis.’’. 


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Union Calendar No. 569 

110TH CONGRESS 

2D SESSION H. R. 1532 

[Report No. 110–873] 

A BILL 

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

SEPTEMBER 23, 2008 

Reported with an amendment, committed to the Comand ordered to be printed mittee of the Whole House on the State of the Union, 


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