II 

109TH CONGRESS 

2D SESSION S. 3678 

To amend the Public Health Service Act with respect to public health security 

and all-hazards preparedness and response, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

JULY 18, 2006 

Mr. BURR (for himself, Mr. KENNEDY, Mr. ENZI, Mr. HARKIN, Mr. GREGG, 

Mr. FRIST, and Ms. MIKULSKI) introduced the following bill; which was 

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

and Pensions 

A BILL 

To amend the Public Health Service Act with respect to 

public health security and all-hazards preparedness and 

response, 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 ‘‘Pandemic and All-Hazards Preparedness Act’’. 

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

7 this Act is as follows: 

Sec. 1. Short title; table of contents. 


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TITLE I—NATIONAL PREPAREDNESS AND RESPONSE, 

LEADERSHIP, ORGANIZATION, AND PLANNING 

Sec. 101. Public health and medical preparedness and response functions of the 

Secretary of Health and Human Services. 

Sec. 102. Assistant Secretary for Preparedness and Response. 

Sec. 103. National Health Security Strategy. 

TITLE II—PUBLIC HEALTH SECURITY PREPAREDNESS 

Sec. 201. Improving State and local public health security. 

Sec. 202. Using information technology to improve situational awareness in 

public health emergencies. 

Sec. 203. Public health workforce enhancements. 

Sec. 204. Vaccine tracking and distribution. 

Sec. 205. National Science Advisory Board for Biosecurity. 

TITLE III—ALL-HAZARDS MEDICAL SURGE CAPACITY 

Sec. 301. National Disaster Medical System. 

Sec. 302. Enhancing medical surge capacity. 

Sec. 303. Encouraging health professional volunteers. 

Sec. 304. Core education and training. 

Sec. 305. Partnerships for state and regional hospital preparedness to improve 

surge capacity. 

Sec. 306. Enhancing the role of the Department of Veterans Affairs. 

1 TITLE I—NATIONAL PREPARED2 NESS AND RESPONSE, LEAD3 ERSHIP, ORGANIZATION, AND 

4 PLANNING 

5 SEC. 101. PUBLIC HEALTH AND MEDICAL PREPAREDNESS 

6 AND RESPONSE FUNCTIONS OF THE SEC7 RETARY OF HEALTH AND HUMAN SERVICES. 

8 Title XXVIII of the Public Health Service Act (42 

9 U.S.C. 300hh–11 et seq.) is amended— 

10 (1) by striking the title heading and inserting 

11 the following: 


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1 ‘‘TITLE XXVIII—NATIONAL ALL2 HAZARDS PREPAREDNESS 

3 FOR PUBLIC HEALTH EMER4 GENCIES’’; 

5 (2) by amending subtitle A to read as follows: 

6 ‘‘Subtitle A—National All-Hazards 

7 Preparedness and Response 

8 Planning, Coordinating, and Re9 porting 

10 ‘‘SEC. 2801. PUBLIC HEALTH AND MEDICAL PREPAREDNESS 

11 AND RESPONSE FUNCTIONS. 

12 ‘‘(a) IN GENERAL.—The Secretary of Health and 

13 Human Services shall lead all Federal public health and 

14 medical response to public health emergencies and inci15 dents covered by the National Response Plan developed 

16 pursuant to section 502(6) of the Homeland Security Act 

17 of 2002, or any successor plan. 

18 ‘‘(b) INTERAGENCY AGREEMENT.—The Secretary, in 

19 collaboration with the Secretary of Veterans Affairs, the 

20 Secretary of Transportation, the Secretary of Defense, the 

21 Secretary of Homeland Security, and the head of any 

22 other relevant Federal agency, shall establish an inter23 agency agreement, consistent with the National Response 

24 Plan or any successor plan, under which agreement the 

25 Secretary of Health and Human Services shall assume 


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1 operational control of emergency public health and medical 

2 response assets, as necessary, in the event of a public 

3 health emergency.’’. 

4 SEC. 102. ASSISTANT SECRETARY FOR PREPAREDNESS AND 

5 RESPONSE. 

6 (a) ASSISTANT SECRETARY FOR PREPAREDNESS AND

7 RESPONSE.—Subtitle B of title XXVIII of the Public 

8 Health Service Act (42 U.S.C. 300hh–11 et seq.) is 

9 amended— 

10 (1) in the subtitle heading, by inserting ‘‘All11 Hazards’’ before ‘‘Emergency Preparedness’’; 

12 (2) by redesignating section 2811 as section 

13 2812; 

14 (3) by inserting after the subtitle heading the 

15 following new section: 

16 ‘‘SEC. 2811. COORDINATION OF PREPAREDNESS FOR AND 

17 RESPONSE TO ALL-HAZARDS PUBLIC HEALTH 

18 EMERGENCIES. 

19 ‘‘(a) IN GENERAL.—There is established within the 

20 Department of Health and Human Services the position 

21 of the Assistant Secretary for Preparedness and Response. 

22 The President, with the advice and consent of the Senate, 

23 shall appoint an individual to serve in such position. Such 

24 Assistant Secretary shall report to the Secretary. 


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1 ‘‘(b) DUTIES.—Subject to the authority of the Sec2 retary, the Assistant Secretary for Preparedness and Re3 sponse shall carry out the following functions: 

4 ‘‘(1) LEADERSHIP.—Serve as the principal ad5 visor to the Secretary on all matters related to Fed6 eral public health and medical preparedness and re7 sponse for public health emergencies. 

8 ‘‘(2) PERSONNEL.—Register, credential, orga9 nize, train, equip, and have the authority to deploy 

10 Federal public health and medical personnel under 

11 the authority of the Secretary, including the Na12 tional Disaster Medical System, and coordinate such 

13 personnel with the Medical Reserve Corps and the 

14 Emergency System for Advance Registration of Vol15 unteer Health Professionals. 

16 ‘‘(3) COUNTERMEASURES.— 

17 ‘‘(A) OVERSIGHT.—Oversee advanced re18 search, development, and procurement of quali19 fied countermeasures (as defined in section 

20 319F–1) and qualified pandemic or epidemic 

21 products (as defined in section 319F–3). 

22 ‘‘(B) STRATEGIC NATIONAL STOCKPILE.— 

23 Maintain the Strategic National Stockpile in ac24 cordance with section 319F–2, including con25 ducting an annual review (taking into account 


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1 at-risk individuals) of the contents of the stock2 pile, including non-pharmaceutical supplies, and 

3 make necessary additions or modifications to 

4 the contents based on such review. 

5 ‘‘(4) COORDINATION.— 

6 ‘‘(A) FEDERAL INTEGRATION.—Coordinate 

7 with relevant Federal officials to ensure inte8 gration of Federal preparedness and response 

9 activities for public health emergencies. 

10 ‘‘(B) STATE, LOCAL, AND TRIBAL INTE11 GRATION.—Coordinate with State, local, and 

12 tribal public health officials, the Emergency 

13 Management Assistance Compact, health care 

14 systems, and emergency medical service systems 

15 to ensure effective integration of Federal public 

16 health and medical assets during a public 

17 health emergency. 

18 ‘‘(C) EMERGENCY MEDICAL SERVICES.— 

19 Promote improved emergency medical services 

20 medical direction, system integration, research, 

21 and uniformity of data collection, treatment 

22 protocols, and policies with regard to public 

23 health emergencies. 

24 ‘‘(5) LOGISTICS.—In coordination with the Sec25 retary of Veterans Affairs, the Secretary of HomeVerDate Aug 31 2005 23:31 Jul 19, 2006 Jkt 049200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S3678.IS S3678

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1 land Security, the General Services Administration, 

2 and other public and private entities, provide 

3 logistical support for medical and public health as4 pects of Federal responses to public health emer5 gencies. 

6 ‘‘(6) LEADERSHIP.—Provide leadership in 

7 international programs, initiatives, and policies that 

8 deal with public health and medical emergency pre9 paredness and response. 

10 ‘‘(c) FUNCTIONS.—The Assistant Secretary for Pre11 paredness and Response shall— 

12 ‘‘(1) have authority over and responsibility for 

13 the functions, personnel, assets, and liabilities of the 

14 following— 

15 ‘‘(A) the National Disaster Medical System 

16 (in accordance with section 301 of the Pan17 demic and All-Hazards Preparedness Act); 

18 ‘‘(B) the Hospital Preparedness Coopera19 tive Agreement Program pursuant to section 

20 319C–2; and 

21 ‘‘(C) the Public Health Preparedness Co22 operative Agreement Program pursuant to sec23 tion 319C–1; 


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1 ‘‘(2) exercise the responsibilities and authorities 

2 of the Secretary with respect to the coordination 

3 of— 

4 ‘‘(A) the Medical Reserve Corps pursuant 

5 to section 2813 as added by the Pandemic and 

6 All-Hazards Preparedness Act; 

7 ‘‘(B) the Emergency System for Advance 

8 Registration of Volunteer Health Professionals 

9 pursuant to section 319I; 

10 ‘‘(C) the Strategic National Stockpile; and 

11 ‘‘(D) the Cities Readiness Initiative; and 

12 ‘‘(3) assume other duties as determined appro13 priate by the Secretary.’’; and 

14 (4) by striking ‘‘Assistant Secretary for Public 

15 Health Emergency Preparedness’’ each place it ap16 pears and inserting ‘‘Assistant Secretary for Pre17 paredness and Response’’. 

18 (b) TRANSFER OF FUNCTIONS; REFERENCES.— 

19 (1) TRANSFER OF FUNCTIONS.—There shall be 

20 transferred to the Office of the Assistant Secretary 

21 for Preparedness and Response the functions, per22 sonnel, assets, and liabilities of the Assistant Sec23 retary for Public Health Emergency Preparedness as 

24 in effect on the day before the date of enactment of 

25 this Act. 


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1 (2) REFERENCES.—Any reference in any Fed2 eral law, Executive order, rule, regulation, or delega3 tion of authority, or any document of or pertaining 

4 to the Assistant Secretary for Public Health Emer5 gency Preparedness as in effect the day before the 

6 date of enactment of this Act, shall be deemed to be 

7 a reference to the Assistant Secretary for Prepared8 ness and Response. 

9 SEC. 103. NATIONAL HEALTH SECURITY STRATEGY. 

10 Title XXVIII of the Public Health Service Act 

11 (300hh–11 et seq.), as amended by section 101, is amend12 ed by inserting after section 2801 the following: 

13 ‘‘SEC. 2802. NATIONAL HEALTH SECURITY STRATEGY. 

14 ‘‘(a) IN GENERAL.— 

15 ‘‘(1) PREPAREDNESS AND RESPONSE REGARD16 ING PUBLIC HEALTH EMERGENCIES.—Beginning in 

17 2009 and every 4 years thereafter, the Secretary 

18 shall prepare and submit to the relevant Committees 

19 of Congress a coordinated strategy and any revisions 

20 thereof, and an accompanying implementation plan 

21 for public health emergency preparedness and re22 sponse. The strategy shall identify the process for 

23 achieving the preparedness goals described in sub24 section (b) and shall be consistent with the National 

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1 ment System, and the National Response Plan devel2 oped pursuant to section 502(6) of the Homeland 

3 Security Act of 2002, or any successor plan. 

4 ‘‘(2) EVALUATION OF PROGRESS.—The Na5 tional Health Security Strategy shall include an 

6 evaluation of the progress made by Federal, State, 

7 local, and tribal entities, based on the evidence-based 

8 benchmarks and objective standards that measure 

9 levels of preparedness established pursuant to sec10 tion 319C–1(g). Such evaluation shall include aggre11 gate and State-specific breakdowns of obligated 

12 funding spent by major category (as defined by the 

13 Secretary) for activities funded through awards pur14 suant to sections 319C–1 and 319C–2. 

15 ‘‘(3) PUBLIC HEALTH WORKFORCE.—In 2009, 

16 the National Health Security Strategy shall include 

17 a national strategy for establishing an effective and 

18 prepared public health workforce, including defining 

19 the functions, capabilities, and gaps in such work20 force, and identifying strategies to recruit, retain, 

21 and protect such workforce from workplace expo22 sures during public health emergencies. 

23 ‘‘(b) PREPAREDNESS GOALS.—The strategy under 

24 subsection (a) shall include provisions in furtherance of 

25 the following: 


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1 ‘‘(1) INTEGRATION.—Integrating public health 

2 and public and private medical capabilities with 

3 other first responder systems, including through— 

4 ‘‘(A) the periodic evaluation of Federal, 

5 State, local, and tribal preparedness and re6 sponse capabilities through drills and exercises; 

7 and 

8 ‘‘(B) integrating public and private sector 

9 public health and medical donations and volun10 teers. 

11 ‘‘(2) PUBLIC HEALTH.—Developing and sus12 taining Federal, State, local, and tribal essential 

13 public health security capabilities, including the fol14 lowing: 

15 ‘‘(A) Disease situational awareness domes16 tically and abroad, including detection, identi17 fication, and investigation. 

18 ‘‘(B) Disease containment including capa19 bilities for isolation, quarantine, social 

20 distancing, and decontamination. 

21 ‘‘(C) Risk communication and public pre22 paredness. 

23 ‘‘(D) Rapid distribution and administra24 tion of medical countermeasures. 


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1 ‘‘(3) MEDICAL.—Increasing the preparedness, 

2 response capabilities, and surge capacity of hos3 pitals, other health care facilities (including mental 

4 health facilities), and trauma care and emergency 

5 medical service systems with respect to public health 

6 emergencies, which shall include developing plans for 

7 the following: 

8 ‘‘(A) Strengthening public health emer9 gency medical management and treatment ca10 pabilities. 

11 ‘‘(B) Medical evacuation and fatality man12 agement. 

13 ‘‘(C) Rapid distribution and administration 

14 of medical countermeasures. 

15 ‘‘(D) Effective utilization of any available 

16 public and private mobile medical assets and in17 tegration of other Federal assets. 

18 ‘‘(E) Protecting health care workers and 

19 health care first responders from workplace ex20 posures during a public health emergency. 

21 ‘‘(4) AT-RISK INDIVIDUALS.— 

22 ‘‘(A) Taking into account the public health 

23 and medical needs of at-risk individuals in the 

24 event of a public health emergency. 


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1 ‘‘(B) For purpose of this title and section 

2 319, the term ‘at-risk individuals’ means chil3 dren, pregnant women, senior citizens and other 

4 individuals who have special needs in the event 

5 of a public health emergency, as determined by 

6 the Secretary. 

7 ‘‘(5) COORDINATION.—Minimizing duplication 

8 of, and ensuring coordination between Federal, 

9 State, local, and tribal planning, preparedness, and 

10 response activities (including the State Emergency 

11 Management Assistance Compact). Such planning 

12 shall be consistent with the National Response Plan, 

13 or any successor plan, and National Incident Man14 agement System and the National Preparedness 

15 Goal. 

16 ‘‘(6) CONTINUITY OF OPERATIONS.—Maintain17 ing vital public health and medical services to allow 

18 for optimal Federal, State, local, and tribal oper19 ations in the event of a public health emergency.’’. 

20 TITLE II—PUBLIC HEALTH 

21 SECURITY PREPAREDNESS 

22 SEC. 201. IMPROVING STATE AND LOCAL PUBLIC HEALTH 

23 SECURITY. 

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

25 U.S.C. 247d–3a) is amended— 


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1 (1) by amending the heading to read as follows: 

2 ‘‘IMPROVING STATE AND LOCAL PUBLIC

3 HEALTH SECURITY.’’; 

4 (2) by striking subsections (a) through (i) and 

5 inserting the following: 

6 ‘‘(a) IN GENERAL.—To enhance the security of the 

7 United States with respect to public health emergencies, 

8 the Secretary shall award cooperative agreements to eligi9 ble entities to enable such entities to conduct the activities 

10 described in subsection (d). 

11 ‘‘(b) ELIGIBLE ENTITIES.—To be eligible to receive 

12 an award under subsection (a), an entity shall— 

13 ‘‘(1)(A) be a State; 

14 ‘‘(B) be a political subdivision determined by 

15 the Secretary to be eligible for an award under this 

16 section (based on criteria described in subsection 

17 (h)(4); or 

18 ‘‘(C) be a consortium of entities described in 

19 subparagraph (A); and 

20 ‘‘(2) prepare and submit to the Secretary an 

21 application at such time, and in such manner, and 

22 containing such information as the Secretary may 

23 require, including— 


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1 ‘‘(A) an All-Hazards Public Health Emer2 gency Preparedness and Response Plan which 

3 shall include— 

4 ‘‘(i) a description of the activities such 

5 entity will carry out under the agreement 

6 to meet the goals identified under section 

7 2802; 

8 ‘‘(ii) a pandemic influenza plan con9 sistent with the requirements of para10 graphs (2) and (5) of subsection (g); 

11 ‘‘(iii) preparedness and response strat12 egies and capabilities that take into ac13 count the medical and public health needs 

14 of at-risk individuals in the event of a pub15 lic health emergency; 

16 ‘‘(iv) a description of the mechanism 

17 the entity will implement to utilize the 

18 Emergency Management Assistance Com19 pact or other mutual aid agreements for 

20 medical and public health mutual aid; and 

21 ‘‘(v) a description of how the entity 

22 will include the State Area Agency on 

23 Aging in public health emergency pre24 paredness; 


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1 ‘‘(B) an assurance that the entity will re2 port to the Secretary on an annual basis (or 

3 more frequently as determined by the Sec4 retary) on the evidence-based benchmarks and 

5 objective standards established by the Secretary 

6 to evaluate the preparedness and response capa7 bilities of such entity; 

8 ‘‘(C) an assurance that the entity will con9 duct, on at least an annual basis, an exercise or 

10 drill that meets any criteria established by the 

11 Secretary to test the preparedness and response 

12 capabilities of such entity, and that the entity 

13 will report back to the Secretary within the ap14 plication of the following year on the strengths 

15 and weaknesses identified through such exercise 

16 or drill, and corrective actions taken to address 

17 material weaknesses; 

18 ‘‘(D) an assurance that the entity will pro19 vide to the Secretary the data described under 

20 section 319D(d)(3) as determined feasible by 

21 the Secretary; 

22 ‘‘(E) an assurance that the entity will con23 duct activities to inform and educate the hos24 pitals within the jurisdiction of such entity on 


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1 the role of such hospitals in the plan required 

2 under subparagraph (A); 

3 ‘‘(F) an assurance that the entity, with re4 spect to the plan described under subparagraph 

5 (A), has developed and will implement an ac6 countability system to ensure that such entity 

7 make satisfactory annual improvement and de8 scribe such system in the plan under subpara9 graph (A); 

10 ‘‘(G) a description of the means by which 

11 to obtain public comment and input on the plan 

12 described in subparagraph (A) and on the im13 plementation of such plan, that shall include an 

14 advisory committee or other similar mechanism 

15 for obtaining comment from the public and 

16 from other State, local, and tribal stakeholders; 

17 and 

18 ‘‘(H) as relevant, a description of the proc19 ess used by the entity to consult with local de20 partments of public health to reach consensus, 

21 approval, or concurrence on the relative dis22 tribution of amounts received under this sec23 tion. 

24 ‘‘(c) LIMITATION.—Beginning in fiscal year 2009, 

25 the Secretary may not award a cooperative agreement to 


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1 a State unless such State is a participant in the Emer2 gency System for Advance Registration of Volunteer 

3 Health Professionals described in section 319I. 

4 ‘‘(d) USE OF FUNDS.— 

5 ‘‘(1) IN GENERAL.—An award under subsection 

6 (a) shall be expended for activities to achieve the 

7 preparedness goals described under paragraphs (1), 

8 (2), (4), (5), and (6) of section 2802(b). 

9 ‘‘(2) EFFECT OF SECTION.—Nothing in this 

10 subsection may be construed as establishing new 

11 regulatory authority or as modifying any existing 

12 regulatory authority. 

13 ‘‘(e) COORDINATION WITH LOCAL RESPONSE CAPA14 BILITIES.—An entity shall, to the extent practicable, en15 sure that activities carried out under an award under sub16 section (a) are coordinated with activities of relevant Met17 ropolitan Medical Response Systems, local public health 

18 departments, the Cities Readiness Initiative, and local 

19 emergency plans. 

20 ‘‘(f) CONSULTATION WITH HOMELAND SECURITY.— 

21 In making awards under subsection (a), the Secretary 

22 shall consult with the Secretary of Homeland Security 

23 to— 

24 ‘‘(1) ensure maximum coordination of public 

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1 tivities with the Metropolitan Medical Response Sys2 tem, and other relevant activities; 

3 ‘‘(2) minimize duplicative funding of programs 

4 and activities; 

5 ‘‘(3) analyze activities, including exercises and 

6 drills, conducted under this section to develop rec7 ommendations and guidance on best practices for 

8 such activities, and 

9 ‘‘(4) disseminate such recommendations and 

10 guidance, including through expanding existing les11 sons learned information system to create a single 

12 Internet-based point of access for sharing and dis13 tributing medical and public health best practices 

14 and lessons learned from drills, exercises, disasters, 

15 and other emergencies. 

16 ‘‘(g) ACHIEVEMENT OF MEASURABLE EVIDENCE17 BASED BENCHMARKS AND OBJECTIVE STANDARDS.— 

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

19 after the date of enactment of the Pandemic and 

20 All-Hazards Preparedness Act, the Secretary shall 

21 develop or where appropriate adopt, and require the 

22 application of measurable evidence-based bench23 marks and objective standards that measure levels of 

24 preparedness with respect to the activities described 

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1 scribed in section 319C–2. In developing such bench2 marks and standards, the Secretary shall consult 

3 with and seek comments from State, local, and tribal 

4 officials and private entities, as appropriate. Where 

5 appropriate, the Secretary shall incorporate existing 

6 objective standards. Such benchmarks and standards 

7 shall, at a minimum, require entities to— 

8 ‘‘(A) demonstrate progress toward achiev9 ing the preparedness goals described in section 

10 2802 in a reasonable timeframe determined by 

11 the Secretary; 

12 ‘‘(B) annually report grant expenditures to 

13 the Secretary (in a form prescribed by the Sec14 retary) who shall ensure that such information 

15 is included on the Federal Internet-based point 

16 of access developed under subsection (f); and 

17 ‘‘(C) at least annually, test and exercise 

18 the public health and medical emergency pre19 paredness and response capabilities of the 

20 grantee, based on criteria established by the 

21 Secretary. 

22 ‘‘(2) CRITERIA FOR PANDEMIC INFLUENZA

23 PLANS.— 

24 ‘‘(A) IN GENERAL.—Not later than 180 

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1 demic and All-Hazards Preparedness Act, the 

2 Secretary shall develop and disseminate to the 

3 chief executive officer of each State criteria for 

4 an effective State plan for responding to pan5 demic influenza. 

6 ‘‘(B) RULE OF CONSTRUCTION.—Nothing 

7 in this section shall be construed to require the 

8 duplication of Federal efforts with respect to 

9 the development of criteria or standards, with10 out regard to whether such efforts were carried 

11 out prior to or after the date of enactment of 

12 this section. 

13 ‘‘(3) TECHNICAL ASSISTANCE.—The Secretary 

14 shall, as determined appropriate by the Secretary, 

15 provide to a State, upon request, technical assistance 

16 in meeting the requirements of this section, includ17 ing the provision of advice by experts in the develop18 ment of high-quality assessments, the setting of 

19 State objectives and assessment methods, the devel20 opment of measures of satisfactory annual improve21 ment that are valid and reliable, and other relevant 

22 areas. 

23 ‘‘(4) NOTIFICATION OF FAILURES.—The Sec24 retary shall develop and implement a process to no25 tify entities that are determined by the Secretary to 


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1 have failed to meet the requirements of paragraph 

2 (1) or (2). Such process shall provide such entities 

3 with the opportunity to correct such noncompliance. 

4 An entity that fails to correct such noncompliance 

5 shall be subject to paragraph (5). 

6 ‘‘(5) WITHHOLDING OF AMOUNTS FROM ENTI7 TIES THAT FAIL TO ACHIEVE BENCHMARKS OR SUB8 MIT INFLUENZA PLAN.—Beginning with fiscal year 

9 2009, and in each succeeding fiscal year, the Sec10 retary shall— 

11 ‘‘(A) withhold from each entity that has 

12 failed substantially to meet the benchmarks and 

13 performance measures described in paragraph 

14 (1) for a previous fiscal year (beginning with 

15 fiscal year 2008), pursuant to the process devel16 oped under paragraph (4), the amount de17 scribed in paragraph (6); and 

18 ‘‘(B) withhold from each entity that has 

19 failed to submit to the Secretary a plan for re20 sponding to pandemic influenza that meets the 

21 criteria developed under paragraph (2), the 

22 amount described in paragraph (6). 

23 ‘‘(6) AMOUNTS DESCRIBED.— 

24 ‘‘(A) IN GENERAL.—The amounts de25 scribed in this paragraph are the following 


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1 amounts that are payable to an entity for ac2 tivities described in section 319C–1 or 319C–2: 

3 ‘‘(i) For the fiscal year immediately 

4 following a fiscal year in which an entity 

5 experienced a failure described in subpara6 graph (A) or (B) of paragraph (5) by the 

7 entity, an amount equal to 10 percent of 

8 the amount the entity was eligible to re9 ceive for such fiscal year. 

10 ‘‘(ii) For the fiscal year immediately 

11 following two consecutive fiscal years in 

12 which an entity experienced such a failure, 

13 an amount equal to 15 percent of the 

14 amount the entity was eligible to receive 

15 for such fiscal year, taking into account 

16 the withholding of funds for the imme17 diately preceding fiscal year under clause 

18 (i). 

19 ‘‘(iii) For the fiscal year immediately 

20 following three consecutive fiscal years in 

21 which an entity experienced such a failure, 

22 an amount equal to 20 percent of the 

23 amount the entity was eligible to receive 

24 for such fiscal year, taking into account 

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1 diately preceding fiscal years under clauses 

2 (i) and (ii). 

3 ‘‘(iv) For the fiscal year immediately 

4 following four consecutive fiscal years in 

5 which an entity experienced such a failure, 

6 an amount equal to 25 percent of the 

7 amount the entity was eligible to receive 

8 for such a fiscal year, taking into account 

9 the withholding of funds for the imme10 diately preceding fiscal years under clauses 

11 (i), (ii), and (iii). 

12 ‘‘(B) SEPARATE ACCOUNTING.—Each fail13 ure described in subparagraph (A) or (B) of 

14 paragraph (5) shall be treated as a separate 

15 failure for purposes of calculating amounts 

16 withheld under subparagraph (A). 

17 ‘‘(7) REALLOCATION OF AMOUNTS WITH18 HELD.— 

19 ‘‘(A) IN GENERAL.—The Secretary shall 

20 make amounts withheld under paragraph (6) 

21 available for making awards under section 

22 319C–2 to entities described in subsection 

23 (b)(1) of such section. 

24 ‘‘(B) PREFERENCE IN REALLOCATION.—In 

25 making awards under section 319C–2 with 


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1 amounts described in subparagraph (A), the 

2 Secretary shall give preference to eligible enti3 ties (as described in section 319C–2(b)(1)) that 

4 are located in whole or in part in States from 

5 which amounts have been withheld under para6 graph (6). 

7 ‘‘(8) WAIVER OR REDUCE WITHHOLDING.—The 

8 Secretary may waive or reduce the withholding de9 scribed in paragraph (6), for a single entity or for 

10 all entities in a fiscal year, if the Secretary deter11 mines that mitigating conditions exist that justify 

12 the waiver or reduction.’’; 

13 (3) by redesignating subsection (j) as sub14 section (h); 

15 (4) in subsection (h), as so redesignated— 

16 (A) by striking paragraphs (1) through 

17 (3)(A) and inserting the following: 

18 ‘‘(1) AUTHORIZATION OF APPROPRIATIONS.— 

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

20 carrying out this section, there is authorized to 

21 be appropriated $824,000,000 fiscal year 2007 

22 for awards pursuant to paragraph (3) (subject 

23 to the authority of the Secretary to make 

24 awards pursuant to paragraphs (4) and (5)), 


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1 and such sums as may be necessary for each of 

2 fiscal years 2008 through 2011. 

3 ‘‘(B) COORDINATION.—There are author4 ized to be appropriated, $10,000,000 for fiscal 

5 year 2007 to carry out subsection (f)(3). 

6 ‘‘(C) REQUIREMENT FOR STATE MATCHING

7 FUNDS.—Beginning in fiscal year 2009, in the 

8 case of any State or consortium of two or more 

9 States, the Secretary may not award a coopera10 tive agreement under this section unless the 

11 State or consortium of States agree that, with 

12 respect to the amount of the cooperative agree13 ment awarded by the Secretary, the State or 

14 consortium of States will make available (di15 rectly or through donations from public or pri16 vate entities) non-Federal contributions in an 

17 amount equal to— 

18 ‘‘(i) for the first fiscal year of the co19 operative agreement, not less than 5 per20 cent of such costs ($1 for each $20 of Fed21 eral funds provided in the cooperative 

22 agreement); and 

23 ‘‘(ii) for any second fiscal year of the 

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1 ment, not less than 10 percent of such 

2 costs ($1 for each $10 of Federal funds 

3 provided in the cooperative agreement). 

4 ‘‘(D) DETERMINATION OF AMOUNT OF

5 NON-FEDERAL CONTRIBUTIONS.—As deter6 mined by the Secretary, non-Federal contribu7 tions required in subparagraph (C) may be pro8 vided directly or through donations from public 

9 or private entities and may be in cash or in 

10 kind, fairly evaluated, including plant, equip11 ment or services. Amounts provided by the Fed12 eral government, or services assisted or sub13 sidized to any significant extent by the Federal 

14 government, may not be included in deter15 mining the amount of such non-Federal con16 tributions. 

17 ‘‘(2) MAINTAINING STATE FUNDING.— 

18 ‘‘(A) IN GENERAL.—An entity that re19 ceives an award under this section shall main20 tain expenditures for public health security at a 

21 level that is not less than the average level of 

22 such expenditures maintained by the entity for 

23 the preceding 2 year period. 

24 ‘‘(B) RULE OF CONSTRUCTION.—Nothing 

25 in this section shall be construed to prohibit the 


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1 use of awards under this section to pay salary 

2 and related expenses of public health and other 

3 professionals employed by State, local, or tribal 

4 public health agencies who are carrying out ac5 tivities supported by such awards (regardless of 

6 whether the primary assignment of such per7 sonnel is to carry out such activities). 

8 ‘‘(3) DETERMINATION OF AMOUNT.— 

9 ‘‘(A) IN GENERAL.—The Secretary shall 

10 award cooperative agreements under subsection 

11 (a) to each State or consortium of 2 or more 

12 States that submits to the Secretary an applica13 tion that meets the criteria of the Secretary for 

14 the receipt of such an award and that meets 

15 other implementation conditions established by 

16 the Secretary for such awards.’’; 

17 (B) in paragraph (4)(A)— 

18 (i) by striking ‘‘2003’’ and inserting 

19 ‘‘2007’’; and 

20 (ii) by striking ‘‘(A)(i)(I)’’; 

21 (C) in paragraph (4)(D), by striking 

22 ‘‘2002’’ and inserting ‘‘2006’’; 

23 (D) in paragraph (5), by striking ‘‘2003’’ 

24 and inserting ‘‘2007’’; and 


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1 (E) by striking paragraph (6) and insert2 ing the following: 

3 ‘‘(6) FUNDING OF LOCAL ENTITIES.—The Sec4 retary shall, in making awards under this section, 

5 ensure that with respect to the cooperative agree6 ment awarded, the entity make available appropriate 

7 portions of such award to political subdivisions and 

8 local departments of public health through a process 

9 involving the consensus, approval or concurrence 

10 with such local entities.’’; and 

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

12 ‘‘(i) ADMINISTRATIVE AND FISCAL RESPONSI13 BILITY.— 

14 ‘‘(1) ANNUAL REPORTING REQUIREMENTS.— 

15 Each entity shall prepare and submit to the Sec16 retary annual reports on its activities under this sec17 tion and section 319C–2. Each such report shall be 

18 prepared by, or in consultation with, the health de19 partment. In order to properly evaluate and compare 

20 the performance of different entities assisted under 

21 this section and section 319C–2 and to assure the 

22 proper expenditure of funds under this section and 

23 section 319C–2, such reports shall be in such stand24 ardized form and contain such information as the 


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1 Secretary determines (after consultation with the 

2 States) to be necessary to— 

3 ‘‘(A) secure an accurate description of 

4 those activities; 

5 ‘‘(B) secure a complete record of the pur6 poses for which funds were spent, and of the re7 cipients of such funds; 

8 ‘‘(C) describe the extent to which the enti9 ty has met the goals and objectives it set forth 

10 under this section or section 319C–2; and 

11 ‘‘(D) determine the extent to which funds 

12 were expended consistent with the entity’s ap13 plication transmitted under this section or sec14 tion 319C–2. 

15 ‘‘(2) AUDITS; IMPLEMENTATION.— 

16 ‘‘(A) IN GENERAL.—Each entity receiving 

17 funds under this section or section 319C–2 

18 shall, not less often than once every 2 years, 

19 audit its expenditures from amounts received 

20 under this section or section 319C–2. Such au21 dits shall be conducted by an entity independent 

22 of the agency administering a program funded 

23 under this section or section 319C–2 in accord24 ance with the Comptroller General’s standards 

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1 grams, activities, and functions and generally 

2 accepted auditing standards. Within 30 days 

3 following the completion of each audit report, 

4 the entity shall submit a copy of that audit re5 port to the Secretary. 

6 ‘‘(B) REPAYMENT.—Each entity shall 

7 repay to the United States amounts found by 

8 the Secretary, after notice and opportunity for 

9 a hearing to the entity, not to have been ex10 pended in accordance with this section or sec11 tion 319C–2 and, if such repayment is not 

12 made, the Secretary may offset such amounts 

13 against the amount of any allotment to which 

14 the entity is or may become entitled under this 

15 section or section 319C–2 or may otherwise re16 cover such amounts. 

17 ‘‘(C) WITHHOLDING OF PAYMENT.—The 

18 Secretary may, after notice and opportunity for 

19 a hearing, withhold payment of funds to any 

20 entity which is not using its allotment under 

21 this section or section 319C–2 in accordance 

22 with such section. The Secretary may withhold 

23 such funds until the Secretary finds that the 

24 reason for the withholding has been removed 


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1 and there is reasonable assurance that it will 

2 not recur. 

3 ‘‘(3) MAXIMUM CARRYOVER AMOUNT.— 

4 ‘‘(A) IN GENERAL.—For each fiscal year, 

5 the Secretary, in consultation with the States 

6 and political subdivisions, shall determine the 

7 maximum percentage amount of an award 

8 under this section that an entity may carryover 

9 to the succeeding fiscal year. 

10 ‘‘(B) AMOUNT EXCEEDED.—For each fis11 cal year, if the percentage amount of an award 

12 under this section unexpended by an entity ex13 ceeds the maximum percentage permitted by 

14 the Secretary under subparagraph (A), the enti15 ty shall return to the Secretary the portion of 

16 the unexpended amount that exceeds the max17 imum amount permitted to be carried over by 

18 the Secretary. 

19 ‘‘(C) ACTION BY SECRETARY.—The Sec20 retary shall make amounts returned to the Sec21 retary under subparagraph (B) available for 

22 awards under section 319C–2(b)(1). In making 

23 awards under section 319C–2(b)(1) with 

24 amounts collected under this paragraph the 

25 Secretary shall give preference to entities that 


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1 are located in whole or in part in States from 

2 which amounts have been returned under sub3 paragraph (B). 

4 ‘‘(D) WAIVER.—An entity may apply to 

5 the Secretary for a waiver of the maximum per6 centage amount under subparagraph (A). Such 

7 an application for a waiver shall include an ex8 planation why such requirement should not 

9 apply to the entity and the steps taken by such 

10 entity to ensure that all funds under an award 

11 under this section will be expended appro12 priately. 

13 ‘‘(E) WAIVE OR REDUCE WITHHOLDING.— 

14 The Secretary may waive the application of 

15 subparagraph (B) for a single entity pursuant 

16 to subparagraph (D) or for all entities in a fis17 cal year, if the Secretary determines that miti18 gating conditions exist that justify the waiver or 

19 reduction.’’. 

20 SEC. 202. USING INFORMATION TECHNOLOGY TO IMPROVE 

21 SITUATIONAL AWARENESS IN PUBLIC 

22 HEALTH EMERGENCIES. 

23 Section 319D of the Public Health Service Act (42 

24 U.S.C. 247d–4) is amended— 


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1 (1) in subsection (a)(1), by inserting ‘‘domesti2 cally and abroad’’ after ‘‘public health threats’’; and 

3 (2) by adding at the end the following: 

4 ‘‘(d) PUBLIC HEALTH SITUATIONAL AWARENESS.— 

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

6 after the date of enactment of the Pandemic and 

7 All-Hazards Preparedness Act, the Secretary, in col8 laboration with State, local, and tribal public health 

9 officials, shall establish a near real-time electronic 

10 nationwide public health situational awareness capa11 bility through an interoperable network of systems 

12 to share data and information to enhance early de13 tection of rapid response to, and management of, po14 tentially catastrophic infectious disease outbreaks 

15 and other public health emergencies that originate 

16 domestically or abroad. Such network shall be built 

17 on existing State situational awareness systems or 

18 enhanced systems that enable such connectivity. 

19 ‘‘(2) STRATEGIC PLAN.—Not later than 180 

20 days after the date of enactment the Pandemic and 

21 All-Hazards Preparedness Act, the Secretary shall 

22 submit to the appropriate committees of Congress, a 

23 strategic plan that demonstrates the steps the Sec24 retary will undertake to develop, implement, and 


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1 evaluate the network described in paragraph (1), uti2 lizing the elements described in paragraph (3). 

3 ‘‘(3) ELEMENTS.—The network described in 

4 paragraph (1) shall include data and information 

5 transmitted in a standardized format from— 

6 ‘‘(A) State, local, and tribal public health 

7 entities, including public health laboratories; 

8 ‘‘(B) Federal health agencies; 

9 ‘‘(C) zoonotic disease monitoring systems; 

10 ‘‘(D) public and private sector health care 

11 entities, hospitals, pharmacies, poison control 

12 centers or professional organizations in the field 

13 of poison control, and clinical laboratories, to 

14 the extent practicable and provided that such 

15 data are voluntarily provided simultaneously to 

16 the Secretary and appropriate State, local, and 

17 tribal public health agencies; and 

18 ‘‘(E) such other sources as the Secretary 

19 may deem appropriate. 

20 ‘‘(4) RULE OF CONSTRUCTION.—Paragraph (3) 

21 shall not be construed as requiring separate report22 ing of data and information from each source listed. 

23 ‘‘(5) REQUIRED ACTIVITIES.—In establishing 

24 and operating the network described in paragraph 

25 (1), the Secretary shall— 


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1 ‘‘(A) utilize applicable interoperability 

2 standards as determined by the Secretary 

3 through a joint public and private sector proc4 ess; 

5 ‘‘(B) define minimal data elements for 

6 such network; 

7 ‘‘(C) in collaboration with State, local, and 

8 tribal public health officials, integrate and build 

9 upon existing State, local, and tribal capabili10 ties, ensuring simultaneous sharing of data, in11 formation, and analyses from the network de12 scribed in paragraph (1) with State, local, and 

13 tribal public health agencies; and 

14 ‘‘(D) in collaboration with State, local, and 

15 tribal public health officials, develop procedures 

16 and standards for the collection, analysis, and 

17 interpretation of data that States, regions, or 

18 other entities collect and report to the network 

19 described in paragraph (1). 

20 ‘‘(e) STATE AND REGIONAL SYSTEMS TO ENHANCE

21 SITUATIONAL AWARENESS IN PUBLIC HEALTH EMER22 GENCIES.— 

23 ‘‘(1) IN GENERAL.—To implement the network 

24 described in section (d), the Secretary may award 

25 grants to States to enhance the ability of such 


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1 States to establish or operate a coordinated public 

2 health situational awareness system for regional or 

3 Statewide early detection of, rapid response to, and 

4 management of potentially catastrophic infectious 

5 disease outbreaks and public health emergencies, in 

6 collaboration with public health agencies, sentinel 

7 hospitals, clinical laboratories, pharmacies, poison 

8 control centers, other health care organizations, or 

9 animal health organizations within such States. 

10 ‘‘(2) ELIGIBILITY.—To be eligible to receive a 

11 grant under paragraph (1), the State shall submit to 

12 the Secretary an application at such time, in such 

13 manner, and containing such information as the Sec14 retary may require, including an assurance that the 

15 State will submit to the Secretary— 

16 ‘‘(A) reports of such data, information, 

17 and metrics as the Secretary may require; 

18 ‘‘(B) a report on the effectiveness of the 

19 systems funded under the grant; and 

20 ‘‘(C) a description of the manner in which 

21 grant funds will be used to enhance the 

22 timelines and comprehensiveness of efforts to 

23 detect, respond to, and manage potentially cata24 strophic infectious disease outbreaks and public 

25 health emergencies. 


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1 ‘‘(3) USE OF FUNDS.—A State that receives an 

2 award under this subsection— 

3 ‘‘(A) shall establish, enhance, or operate a 

4 coordinated public health situational awareness 

5 system for regional or Statewide early detection 

6 of, rapid response to, and management of po7 tentially catastrophic infectious disease out8 breaks and public health emergencies; and 

9 ‘‘(B) may award grants or contracts to en10 tities described in paragraph (1) within or serv11 ing such State to assist such entities in improv12 ing the operation of information technology sys13 tems, facilitating the secure exchange of data 

14 and information, and training personnel to en15 hance the operation of the system described in 

16 paragraph (A). 

17 ‘‘(4) LIMITATION.—Information technology sys18 tems acquired or implemented using grants awarded 

19 under this section must be compliant with— 

20 ‘‘(A) interoperability and other techno21 logical standards, as determined by the Sec22 retary; and 

23 ‘‘(B) data collection and reporting require24 ments for the network described in subsection 

25 (d). 


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1 ‘‘(5) INDEPENDENT EVALUATION.—Not later 

2 than 4 years after the date of enactment of the Pan3 demic and All-Hazards Preparedness Act, the Gov4 ernment Accountability Office shall conduct an inde5 pendent evaluation, and submit to the Secretary and 

6 the appropriate committees of Congress a report, 

7 concerning the activities conducted under this sub8 section and subsection (d). 

9 ‘‘(f) GRANTS FOR REAL-TIME SURVEILLANCE IM10 PROVEMENT.— 

11 ‘‘(1) IN GENERAL.—The Secretary may award 

12 grants to eligible entities to carry out projects de13 scribed under paragraph (4). 

14 ‘‘(2) ELIGIBLE ENTITY.—For purposes of this 

15 section, the term ‘eligible entity’ means an entity 

16 that is— 

17 ‘‘(A)(i) a hospital, clinical laboratory, uni18 versity; or 

19 ‘‘(ii) poison control center or professional 

20 organization in the field of poison control; and 

21 ‘‘(B) a participant in the network estab22 lished under subsection (d). 

23 ‘‘(3) APPLICATION.—Each eligible entity desir24 ing a grant under this section shall submit to the 

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1 ner, and containing such information as the Sec2 retary may require. 

3 ‘‘(4) USE OF FUNDS.— 

4 ‘‘(A) IN GENERAL.—An eligible entity de5 scribed in paragraph (2)(A)(i) that receives a 

6 grant under this section shall use the funds 

7 awarded pursuant to such grant to carry out a 

8 pilot demonstration project to purchase and im9 plement the use of advanced diagnostic medical 

10 equipment to analyze real-time clinical speci11 mens for pathogens of public health or bioter12 rorism significance and report any results from 

13 such project to State, local, and tribal public 

14 health entities and the network established 

15 under subsection (d). 

16 ‘‘(B) OTHER ENTITIES.—An eligible entity 

17 described in paragraph (2)(A)(ii) that receives a 

18 grant under this section shall use the funds 

19 awarded pursuant to such grant to— 

20 ‘‘(i) improve the early detection, sur21 veillance, and investigative capabilities of 

22 poison control centers for chemical, biologi23 cal, radiological, and nuclear events by 

24 training poison information personnel to 

25 improve the accuracy of surveillance data, 


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1 improving the definitions used by the poi2 son control centers for surveillance, and 

3 enhancing timely and efficient investigation 

4 of data anomalies; 

5 ‘‘(ii) improve the capabilities of poison 

6 control centers to provide information to 

7 health care providers and the public with 

8 regard to chemical, biological, radiological, 

9 or nuclear threats or exposures, in con10 sultation with the appropriate State, local, 

11 and tribal public health entities; or 

12 ‘‘(iii) provide surge capacity in the 

13 event of a chemical, biological, radiological, 

14 or nuclear event through the establishment 

15 of alternative poison control center work16 sites and the training of nontraditional 

17 personnel. 

18 ‘‘(g) AUTHORIZATION OF APPROPRIATIONS.— 

19 ‘‘(1) FISCAL YEAR 2007.—There are authorized 

20 to be appropriated to carry out subsections (d), (e), 

21 and (f) $102,000,000 for fiscal year 2007, of which 

22 $35,000,000 is authorized to be appropriated to 

23 carry out subsection (f). 

24 ‘‘(2) SUBSEQUENT FISCAL YEARS.—There are 

25 authorized to be appropriated such sums as may be 


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1 necessary to carry out subsections (d), (e), and (f) 

2 for each of fiscal years 2008 through 2011.’’. 

3 SEC. 203. PUBLIC HEALTH WORKFORCE ENHANCEMENTS. 

4 (a) DEMONSTRATION PROJECT.—Section 338L of 

5 the Public Health Service Act (42 U.S.C. 254t) is amend6 ed by adding at the end the following: 

7 ‘‘(h) PUBLIC HEALTH DEPARTMENTS.— 

8 ‘‘(1) IN GENERAL.—To the extent that funds 

9 are appropriated under paragraph (5), the Secretary 

10 shall establish a demonstration project to provide for 

11 the participation of individuals who are eligible for 

12 the Loan Repayment Program described in section 

13 338B and who agree to complete their service obli14 gation in a State health department that serves a 

15 significant number of health professional shortage 

16 areas or areas at risk of a public health emergency, 

17 as determined by the Secretary, or in a local health 

18 department that serves a health professional short19 age area or an area at risk of a public health emer20 gency. 

21 ‘‘(2) PROCEDURE.—To be eligible to receive as22 sistance under paragraph (1), with respect to the 

23 program described in section 338B, an individual 

24 shall— 


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1 ‘‘(A) comply with all rules and require2 ments described in such section (other than sec3 tion 338B(f)(1)(B)(iv)); and 

4 ‘‘(B) agree to serve for a time period equal 

5 to 2 years, or such longer period as the indi6 vidual may agree to, in a State, local, or tribal 

7 health department, consistent with paragraph 

8 (1). 

9 ‘‘(3) DESIGNATIONS.—The demonstration 

10 project described in paragraph (1), and any 

11 healthcare providers who are selected to participate 

12 in such project, shall not be considered by the Sec13 retary in the designation of health professional 

14 shortage areas under section 332 during fiscal years 

15 2007 through 2010. 

16 ‘‘(4) REPORT.—Not later than 3 years after the 

17 date of enactment of this subsection, the Secretary 

18 shall submit a report to the relevant committees of 

19 Congress that evaluates the participation of individ20 uals in the demonstration project under paragraph 

21 (1), the impact of such participation on State, local, 

22 and tribal health departments, and the benefit and 

23 feasibility of permanently allowing such placements 

24 in the Loan Repayment Program. 


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1 ‘‘(5) AUTHORIZATION OF APPROPRIATIONS.— 

2 There are authorized to be appropriated to carry out 

3 this subsection, such sums as may be necessary for 

4 each of fiscal years 2007 through 2010.’’. 

5 (b) GRANTS FOR LOAN REPAYMENT PROGRAM.— 

6 Section 338I of the Public Health Service Act (42 U.S.C. 

7 254q–1) is amended by adding at the end the following: 

8 ‘‘(i) PUBLIC HEALTH LOAN REPAYMENT.— 

9 ‘‘(1) IN GENERAL.—The Secretary may award 

10 grants to States for the purpose of assisting such 

11 States in operating loan repayment programs under 

12 which such States enter into contracts to repay all 

13 or part of the eligible loans borrowed by, or on be14 half of, individuals who agree to serve in State, local, 

15 or tribal health departments that serve health pro16 fessional shortage areas or other areas at risk of a 

17 public health emergency, as designated by the Sec18 retary. 

19 ‘‘(2) LOANS ELIGIBLE FOR REPAYMENT.—To 

20 be eligible for repayment under this subsection, a 

21 loan shall be a loan made, insured, or guaranteed by 

22 the Federal Government that is borrowed by, or on 

23 behalf of, an individual to pay the cost of attendance 

24 for a program of education leading to a degree ap25 propriate for serving in a State, local, or tribal 


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1 health department as determined by the Secretary 

2 and the chief executive officer of the State in which 

3 the grant is administered, at an institution of higher 

4 education (as defined in section 102 of the Higher 

5 Education Act of 1965), including principal, inter6 est, and related expenses on such loan. 

7 ‘‘(3) APPLICABILITY OF EXISTING REQUIRE8 MENTS.—With respect to awards made under para9 graph (1)— 

10 ‘‘(A) the requirements of subsections (b), 

11 (f), and (g) shall apply to such awards; and 

12 ‘‘(B) the requirements of subsection (c) 

13 shall apply to such awards except that with re14 spect to paragraph (1) of such subsection, the 

15 State involved may assign an individual only to 

16 public and nonprofit private entities that serve 

17 health professional shortage areas or areas at 

18 risk of a public health emergency, as deter19 mined by the Secretary. 

20 ‘‘(4) AUTHORIZATION OF APPROPRIATIONS.— 

21 There are authorized to be appropriated to carry out 

22 this subsection, such sums as may be necessary for 

23 each of fiscal years 2007 through 2010.’’. 


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1 SEC. 204. VACCINE TRACKING AND DISTRIBUTION. 

2 Section 319A of the Public Health Service Act (42 

3 U.S.C. 247d–1) is amended to read as follows: 

4 ‘‘SEC. 319A. VACCINE TRACKING AND DISTRIBUTION. 

5 ‘‘(a) TRACKING.—The Secretary, together with rel6 evant manufacturers, wholesalers, and distributors as may 

7 agree to cooperate, may track the initial distribution of 

8 federally purchased influenza vaccine in an influenza pan9 demic. Such tracking information shall be used to inform 

10 Federal, State, local, and tribal decision makers during 

11 an influenza pandemic. 

12 ‘‘(b) DISTRIBUTION.—The Secretary shall promote 

13 communication between State, local, and tribal public 

14 health officials and such manufacturers, wholesalers, and 

15 distributors as agree to participate, regarding the effective 

16 distribution of seasonal influenza vaccine. Such commu17 nication shall include estimates of high priority popu18 lations, as determined by the Secretary, in State, local, 

19 and tribal jurisdictions in order to inform Federal, State, 

20 local, and tribal decision makers during vaccine shortages 

21 and supply disruptions. 

22 ‘‘(c) CONFIDENTIALITY.—The information submitted 

23 to the Secretary or its contractors, if any, under this sec24 tion or under any other section of this Act related to vac25 cine distribution information shall remain confidential in 

26 accordance with the exception from the public disclosure 


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1 of trade secrets, commercial or financial information, and 

2 information obtained from an individual that is privileged 

3 and confidential, as provided for in section 552(b)(4) of 

4 title 5, United States Code, and subject to the penalties 

5 and exceptions under sections 1832 and 1833 of title 18, 

6 United States Code, relating to the protection and theft 

7 of trade secrets, and subject to privacy protections that 

8 are consistent with the regulations promulgated under sec9 tion 264(c) of the Health Insurance Portability and Ac10 countability Act of 1996. None of such information pro11 vided by a manufacturer, wholesaler, or distributor shall 

12 be disclosed without its consent to another manufacturer, 

13 wholesaler, or distributor, or shall be used in any manner 

14 to give a manufacturer, wholesaler, or distributor a propri15 etary advantage. 

16 ‘‘(d) GUIDELINES.—The Secretary, in order to main17 tain the confidentiality of relevant information and ensure 

18 that none of the information contained in the systems in19 volved may be used to provide proprietary advantage with20 in the vaccine market, while allowing State, local, and trib21 al health officials access to such information to maximize 

22 the delivery and availability of vaccines to high priority 

23 populations, during times of influenza pandemics, vaccine 

24 shortages, and supply disruptions, in consultation with 

25 manufacturers, distributors, wholesalers and State, local, 


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1 and tribal health departments, shall develop guidelines for 

2 subsections (a) and (b). 

3 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 

4 are authorized to be appropriated to carry out this section, 

5 such sums for each of fiscal years 2007 through 2011. 

6 ‘‘(f) REPORT TO CONGRESS.—As part of the National 

7 Health Security Strategy described in section 2802, the 

8 Secretary shall provide an update on the implementation 

9 of subsections (a) through (d).’’. 

10 SEC. 205. NATIONAL SCIENCE ADVISORY BOARD FOR BIO11 SECURITY. 

12 The National Science Advisory Board for Biosecurity 

13 shall, when requested by the Secretary of Health and 

14 Human Services, provide to relevant Federal departments 

15 and agencies, advice, guidance, or recommendations con16 cerning— 

17 (1) a core curriculum and training requirements 

18 for workers in maximum containment biological lab19 oratories; and 

20 (2) periodic evaluations of maximum contain21 ment biological laboratory capacity nationwide and 

22 assessments of the future need for increased labora23 tory capacity; 


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1 TITLE III—ALL-HAZARDS 

2 MEDICAL SURGE CAPACITY 

3 SEC. 301. NATIONAL DISASTER MEDICAL SYSTEM. 

4 (a) NATIONAL DISASTER MEDICAL SYSTEM.—Sec5 tion 2812 of subtitle B of title XXVIII of the Public 

6 Health Service Act (42 U.S.C. 300hh–11 et seq.), as re7 designated by section 102, is amended— 

8 (1) by striking the section heading and insert9 ing ‘‘NATIONAL DISASTER MEDICAL SYSTEM’’; 

10 (2) by striking subsection (a); 

11 (3) by redesignating subsections (b) through (h) 

12 as subsections (a) through (g); 

13 (4) in subsection (a), as so redesignated— 

14 (A) in paragraph (2)(B), by striking ‘‘Fed15 eral Emergency Management Agency’’ and in16 serting ‘‘Department of Homeland Security’’; 

17 and 

18 (B) in paragraph (3)(C), by striking ‘‘Pub19 lic Health Security and Bioterrorism Prepared20 ness and Response Act of 2002’’ and inserting 

21 ‘‘Pandemic and All-Hazards Preparedness Act’’; 

22 (5) in subsection (b), as so redesignated, by— 

23 (A) striking the subsection heading and in24 serting ‘‘MODIFICATIONS’’; 


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1 (B) redesignating paragraph (2) as para2 graph (3); and 

3 (C) striking paragraph (1) and inserting 

4 the following: 

5 ‘‘(1) IN GENERAL.—Taking into account the 

6 findings from the joint review described under para7 graph (2), the Secretary shall modify the policies of 

8 the National Disaster Medical System as necessary. 

9 ‘‘(2) JOINT REVIEW AND MEDICAL SURGE CA10 PACITY STRATEGIC PLAN.—Not later than 180 days 

11 after the date of enactment of the Pandemic and 

12 All-Hazards Preparedness Act, the Secretary, in co13 ordination with the Secretary of Homeland Security, 

14 the Secretary of Defense, and the Secretary of Vet15 erans Affairs, shall conduct a joint review of the Na16 tional Disaster Medical System. Such review shall 

17 include an evaluation of medical surge capacity, as 

18 described by section 2804(a). As part of the Na19 tional Health Security Strategy under section 2802, 

20 the Secretary shall update the findings from such re21 view and further modify the policies of the National 

22 Disaster Medical System as necessary.’’; 

23 (6) by striking ‘‘subsection (b)’’ each place it 

24 appears and inserting ‘‘subsection (a)’’; 


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1 (7) by striking ‘‘subsection (d)’’ each place it 

2 appears and inserting ‘‘subsection (c)’’; and 

3 (8) in subsection (g), as so redesignated, by 

4 striking ‘‘2002 through 2006’’ and inserting ‘‘2007 

5 through 2011’’. 

6 (b) TRANSFER OF NATIONAL DISASTER MEDICAL

7 SYSTEM TO THE DEPARTMENT OF HEALTH AND HUMAN

8 SERVICES.—There shall be transferred to the Secretary 

9 of Health and Human Services the functions, personnel, 

10 assets, and liabilities of the National Disaster Medical 

11 System of the Department of Homeland Security, includ12 ing the functions of the Secretary of Homeland Security 

13 and the Under Secretary for Emergency Preparedness and 

14 Response relating thereto. 

15 (c) CONFORMING AMENDMENTS TO THE HOMELAND

16 SECURITY ACT OF 2002.—The Homeland Security Act of 

17 2002 (6 U.S.C. 312(3)(B), 313(5))) is amended— 

18 (1) in section 502(3)(B), by striking ‘‘, the Na19 tional Disaster Medical System,’’; and 

20 (2) in section 503(5), by striking ‘‘, the Na21 tional Disaster Medical System’’. 

22 (d) UPDATE OF CERTAIN PROVISION.—Section 

23 319F(b)(2) of the Public Health Service Act (42 U.S.C. 

24 247d–6(b)(2)) is amended— 


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1 (1) in the paragraph heading, by striking 

2 ‘‘CHILDREN AND TERRORISM’’ and inserting ‘‘AT3 RISK INDIVIDUALS AND PUBLIC HEALTH EMER4 GENCIES’’; 

5 (2) in subparagraph (A), by striking ‘‘Children 

6 and Terrorism’’ and inserting ‘‘At-Risk Individuals 

7 and Public Health Emergencies’’; 

8 (3) in subparagraph (B)— 

9 (A) in clause (i), by striking ‘‘bioterrorism 

10 as it relates to children’’ and inserting ‘‘public 

11 health emergencies as they relate to at-risk in12 dividuals’’; 

13 (B) in clause (ii), by striking ‘‘children’’ 

14 and inserting ‘‘at-risk individuals’’; and 

15 (C) in clause (iii), by striking ‘‘children’’ 

16 and inserting ‘‘at-risk individuals’’; 

17 (4) in subparagraph (C), by striking ‘‘children’’ 

18 and all that follows through the period and inserting 

19 ‘‘at-risk populations.’’; and 

20 (5) in subparagraph (D), by striking ‘‘one 

21 year’’ and inserting ‘‘six years’’. 

22 (e) EFFECTIVE DATE.—The amendments made by 

23 subsections (b) and (c) shall take effect on January 1, 

24 2007. 


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1 SEC. 302. ENHANCING MEDICAL SURGE CAPACITY. 

2 (a) IN GENERAL.—Title XXVIII of the Public Health 

3 Service Act (300hh–11 et seq.), as amended by section 

4 103, is amended by inserting after section 2802 the fol5 lowing: 

6 ‘‘SEC. 2804. ENHANCING MEDICAL SURGE CAPACITY. 

7 ‘‘(a) STUDY OF ENHANCING MEDICAL SURGE CA8 PACITY.—As part of the joint review described in section 

9 2812(b), the Secretary shall evaluate the benefits and fea10 sibility of improving the capacity of the Department of 

11 Health and Human Services to provide additional medical 

12 surge capacity to local communities in the event of a pub13 lic health emergency. Such study shall include an assess14 ment of the need for and feasibility of improving surge 

15 capacity through— 

16 ‘‘(1) acquisition and operation of mobile med17 ical assets by the Secretary to be deployed, on a con18 tingency basis, to a community in the event of a 

19 public health emergency; and 

20 ‘‘(2) other strategies to improve such capacity 

21 as determined appropriate by the Secretary. 

22 ‘‘(b) AUTHORITY TO ACQUIRE AND OPERATE MO23 BILE MEDICAL ASSETS.—In addition to any other author24 ity to acquire, deploy, and operate mobile medical assets, 

25 the Secretary may acquire, deploy, and operate mobile 

26 medical assets if, taking into consideration the evaluation 


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1 conducted under subsection (a), such acquisition, deploy2 ment, and operation is determined to be beneficial and fea3 sible in improving the capacity of the Department of 

4 Health and Human Services to provide additional medical 

5 surge capacity to local communities in the event of a pub6 lic health emergency. 

7 ‘‘(c) USING FEDERAL FACILITIES TO ENHANCE

8 MEDICAL SURGE CAPACITY.— 

9 ‘‘(1) ANALYSIS.—The Secretary shall conduct 

10 an analysis of whether there are Federal facilities 

11 which, in the event of a public health emergency, 

12 could practicably be used as facilities in which to 

13 provide health care. 

14 ‘‘(2) MEMORANDA OF UNDERSTANDING.—If, 

15 based on the analysis conducted under paragraph 

16 (1), the Secretary determines that there are Federal 

17 facilities which, in the event of a public health emer18 gency, could be used as facilities in which to provide 

19 health care, the Secretary shall, with respect to each 

20 such facility, seek to conclude a memorandum of un21 derstanding with the head of the Department or 

22 agency that operates such facility that permits the 

23 use of such facility to provide health care in the 

24 event of a public health emergency.’’. 

25 (b) EMTALA.— 


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1 (1) IN GENERAL.—Section 1135(b) of the So2 cial Security Act (42 U.S.C. 1320b–5(b)) is amend3 ed— 

4 (A) in paragraph (3), by striking subpara5 graph (B) and inserting the following: 

6 ‘‘(B) the direction or relocation of an indi7 vidual to receive medical screening in an alter8 native location— 

9 ‘‘(i) pursuant to an appropriate State 

10 emergency preparedness plan; or 

11 ‘‘(ii) in the case of a public health 

12 emergency described in subsection 

13 (g)(1)(B) that involves a pandemic infec14 tious disease, pursuant to a State pan15 demic preparedness plan or a plan referred 

16 to in clause (i), whichever is applicable in 

17 the State;’’; 

18 (B) in the third sentence, by striking ‘‘and 

19 shall be limited to’’ and inserting ‘‘and, except 

20 in the case of a waiver or modification to which 

21 the fifth sentence of this subsection applies, 

22 shall be limited to’’; and 

23 (C) by adding at the end the following: ‘‘If 

24 a public health emergency described in sub25 section (g)(1)(B) involves a pandemic infectious 


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1 disease (such as pandemic influenza), the dura2 tion of a waiver or modification under para3 graph (3) shall be determined in accordance 

4 with subsection (e) as such subsection applies 

5 to public health emergencies.’’. 

6 (2) EFFECTIVE DATE.—The amendments made 

7 by paragraph (1) shall take effect on the date of the 

8 enactment of this Act and shall apply to public 

9 health emergencies declared pursuant to section 319 

10 of the Public Health Service Act (42 U.S.C. 247d) 

11 on or after such date. 

12 SEC. 303. ENCOURAGING HEALTH PROFESSIONAL VOLUN13 TEERS. 

14 (a) VOLUNTEER MEDICAL RESERVE CORPS.—Title 

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

16 300hh–11 et seq.), as amended by this Act, is amended 

17 by inserting after section 2812 the following: 

18 ‘‘SEC. 2813. VOLUNTEER MEDICAL RESERVE CORPS. 

19 ‘‘(a) IN GENERAL.—Not later than 180 days after 

20 the date of enactment of the Pandemic and All-Hazards 

21 Preparedness Act, the Secretary, in collaboration with 

22 State, local, and tribal officials, shall build on State, local, 

23 and tribal programs in existence on the date of enactment 

24 of such Act to establish and maintain a Medical Reserve 

25 Corps (referred to in this section as the ‘Corps’) to provide 


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1 for an adequate supply of volunteers in the case of a Fed2 eral, State, local, or tribal public health emergency. The 

3 Corps shall be headed by a Director who shall be ap4 pointed by the Secretary and shall oversee the activities 

5 of the Corps chapters that exist at the State, local, and 

6 tribal levels. 

7 ‘‘(b) STATE, LOCAL, AND TRIBAL COORDINATION.— 

8 The Corps shall be established using existing State, local, 

9 and tribal teams and shall not alter such teams. 

10 ‘‘(c) COMPOSITION.—The Corps shall be composed of 

11 individuals who— 

12 ‘‘(1)(A) are health professionals who have ap13 propriate professional training and expertise as de14 termined appropriate by the Director of the Corps; 

15 or 

16 ‘‘(B) are non-health professionals who have an 

17 interest in serving in an auxiliary or support capac18 ity to facilitate access to health care services in a 

19 public health emergency; 

20 ‘‘(2) are certified in accordance with the certifi21 cation program developed under subsection (d); 

22 ‘‘(3) are geographically diverse in residence; 

23 ‘‘(4) have registered and carry out training ex24 ercises with a local chapter of the Medical Reserve 

25 Corps; and 


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1 ‘‘(5) indicate whether they are willing to be de2 ployed outside the area in which they reside in the 

3 event of a public health emergency. 

4 ‘‘(d) CERTIFICATION; DRILLS.— 

5 ‘‘(1) CERTIFICATION.—The Director, in collabo6 ration with State, local, and tribal officials, shall es7 tablish a process for the periodic certification of in8 dividuals who volunteer for the Corps, as determined 

9 by the Secretary, which shall include the completion 

10 by each individual of the core training programs de11 veloped under section 319F, as required by the Di12 rector. Such certification shall not supercede State 

13 licensing or credentialing requirements. 

14 ‘‘(2) DRILLS.—In conjunction with the core 

15 training programs referred to in paragraph (1), and 

16 in order to facilitate the integration of trained volun17 teers into the health care system at the local level, 

18 Corps members shall engage in periodic training ex19 ercises to be carried out at the local level. 

20 ‘‘(e) DEPLOYMENT.—During a public health emer21 gency, the Secretary shall have the authority to activate 

22 and deploy willing members of the Corps to areas of need, 

23 taking into consideration the public health and medical ex24 pertise required, with the concurrence of the State, local, 

25 or tribal officials from the area where the members reside. 


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1 ‘‘(f) EXPENSES AND TRANSPORTATION.—While en2 gaged in performing duties as a member of the Corps pur3 suant to an assignment by the Secretary (including peri4 ods of travel to facilitate such assignment), members of 

5 the Corps who are not otherwise employed by the Federal 

6 Government shall be allowed travel or transportation ex7 penses, including per diem in lieu of subsistence. 

8 ‘‘(g) IDENTIFICATION.—The Secretary, in coopera9 tion and consultation with the States, shall develop a Med10 ical Reserve Corps Identification Card that describes the 

11 licensure and certification information of Corps members, 

12 as well as other identifying information determined nec13 essary by the Secretary. 

14 ‘‘(h) INTERMITTENT DISASTER-RESPONSE PER15 SONNEL.— 

16 ‘‘(1) IN GENERAL.—For the purpose of assist17 ing the Corps in carrying out duties under this sec18 tion, during a public health emergency, the Sec19 retary may appoint selected individuals to serve as 

20 intermittent personnel of such Corps in accordance 

21 with applicable civil service laws and regulations. In 

22 all other cases, members of the Corps are subject to 

23 the laws of the State in which the activities of the 

24 Corps are undertaken. 


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1 ‘‘(2) APPLICABLE PROTECTIONS.—Subsections 

2 (c)(2), (d), and (e) of section 2812 shall apply to an 

3 individual appointed under paragraph (1) in the 

4 same manner as such subsections apply to an indi5 vidual appointed under section 2812(c). 

6 ‘‘(3) LIMITATION.—State, local, and tribal offi7 cials shall have no authority to designate a member 

8 of the Corps as Federal intermittent disaster-re9 sponse personnel, but may request the services of 

10 such members. 

11 ‘‘(i) AUTHORIZATION OF APPROPRIATIONS.—There is 

12 authorized to be appropriated to carry out this section, 

13 $22,000,000 for fiscal year 2007, and such sums as may 

14 be necessary for each of fiscal years 2008 through 2011.’’. 

15 (b) ENCOURAGING HEALTH PROFESSIONS VOLUN16 TEERS.—Section 319I of the Public Health Service Act 

17 (42 U.S.C. 247d–7b) is amended— 

18 (1) by redesignating subsections (e) and (f) as 

19 subsections (j) and (k), respectively; 

20 (2) by striking subsections (a) and (b) and in21 serting the following: 

22 ‘‘(a) IN GENERAL.—Not later than 12 months after 

23 the date of enactment of the Pandemic and All-Hazards 

24 Preparedness Act, the Secretary shall link existing State 

25 verification systems to maintain a single national interVerDate Aug 31 2005 23:31 Jul 19, 2006 Jkt 049200 PO 00000 Frm 00060 Fmt 6652 Sfmt 6201 E:\BILLS\S3678.IS S3678

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1 operable network of systems, each system being main2 tained by a State or group of States, for the purpose of 

3 verifying the credentials and licenses of health care profes4 sionals who volunteer to provide health services during a 

5 public health emergency (such network shall be referred 

6 to in this section as the ‘verification network’). 

7 ‘‘(b) REQUIREMENTS.—The interoperable network of 

8 systems established under subsection (a) shall include— 

9 ‘‘(1) with respect to each volunteer health pro10 fessional included in the system— 

11 ‘‘(A) information necessary for the rapid 

12 identification of, and communication with, such 

13 professionals; and 

14 ‘‘(B) the credentials, certifications, li15 censes, and relevant training of such individ16 uals; and 

17 ‘‘(2) the name of each member of the Medical 

18 Reserve Corps, the National Disaster Medical Sys19 tem, and any other relevant federally-sponsored or 

20 administered programs determined necessary by the 

21 Secretary.’’; 

22 (3) by striking subsection (d) and inserting the 

23 following: 

24 ‘‘(d) ACCESSIBILITY.—The Secretary shall ensure 

25 that the network established under subsection (a) is elecVerDate Aug 31 2005 23:31 Jul 19, 2006 Jkt 049200 PO 00000 Frm 00061 Fmt 6652 Sfmt 6201 E:\BILLS\S3678.IS S3678

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1 tronically accessible by State, local, and tribal health de2 partments and can be linked with the identification cards 

3 under section 2813. 

4 ‘‘(e) CONFIDENTIALITY.—The Secretary shall estab5 lish and require the application of and compliance with 

6 measures to ensure the effective security of, integrity of, 

7 and access to the data included in the network. 

8 ‘‘(f) COORDINATION.—The Secretary shall coordinate 

9 with the Secretary of Veterans Affairs and the Secretary 

10 of Homeland Security to assess the feasibility of inte11 grating the verification network under this section with 

12 the VetPro system of the Department of Veterans Affairs 

13 and the National Emergency Responder Credentialing 

14 System of the Department of Homeland Security. The 

15 Secretary shall, if feasible, integrate the verification net16 work under this section with such VetPro system and the 

17 National Emergency Responder Credentialing System. 

18 ‘‘(g) UPDATING OF INFORMATION.—The States that 

19 are participants in the network established under sub20 section (a) shall, on at least a quarterly basis, work with 

21 the Director to provide for the updating of the information 

22 contained in such network. 

23 ‘‘(h) CLARIFICATION.—Inclusion of a health profes24 sional in the verification network established pursuant to 

25 this section shall not constitute appointment of such indiVerDate Aug 31 2005 23:31 Jul 19, 2006 Jkt 049200 PO 00000 Frm 00062 Fmt 6652 Sfmt 6201 E:\BILLS\S3678.IS S3678

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1 vidual as a Federal employee for any purpose, either under 

2 section 2812(c) or otherwise. Such appointment may only 

3 be made under section 2812 or 2813. 

4 ‘‘(i) HEALTH CARE PROVIDER LICENSES.—The Sec5 retary shall encourage States to establish and implement 

6 mechanisms to waive the application of licensing require7 ments applicable to health professionals, who are seeking 

8 to provide medical services (within their scope of practice), 

9 during a national, State, local, or tribal public health 

10 emergency upon verification that such health professionals 

11 are licensed and in good standing in another State and 

12 have not been disciplined by any State health licensing or 

13 disciplinary board.’’; and 

14 (4) in subsection (k) (as so redesignated), by 

15 striking ‘‘2006’’ and inserting ‘‘2011’’. 

16 SEC. 304. CORE EDUCATION AND TRAINING. 

17 Section 319F of the Public Health Service Act (42 

18 U.S.C. 247d–6) is amended— 

19 (1) by striking subsections (a) through (g) and 

20 inserting the following; 

21 ‘‘(a) ALL-HAZARDS PUBLIC HEALTH AND MEDICAL

22 RESPONSE CURRICULA AND TRAINING.— 

23 ‘‘(1) IN GENERAL.—The Secretary, in collabo24 ration with the Secretary of Defense, and in con25 sultation with relevant public and private entities, 


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1 shall develop core health and medical response cur2 ricula and trainings by adapting applicable existing 

3 curricula and training programs to improve re4 sponses to public health emergencies. 

5 ‘‘(2) CURRICULUM.—The public health and 

6 medical response training program may include 

7 course work related to— 

8 ‘‘(A) medical management of casualties, 

9 taking into account the needs of at-risk individ10 uals; 

11 ‘‘(B) public health aspects of public health 

12 emergencies; 

13 ‘‘(C) mental health aspects of public health 

14 emergencies; 

15 ‘‘(D) national incident management, in16 cluding coordination among Federal, State, 

17 local, tribal, international agencies, and other 

18 entities; and 

19 ‘‘(E) protecting health care workers and 

20 health care first responders from workplace ex21 posures during a public health emergency. 

22 ‘‘(3) PEER REVIEW.—On a periodic basis, prod23 ucts prepared as part of the program shall be rigor24 ously tested and peer-reviewed by experts in the rel25 evant fields. 


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1 ‘‘(4) CREDIT.—The Secretary and the Sec2 retary of Defense shall— 

3 ‘‘(A) take into account continuing profes4 sional education requirements of public health 

5 and healthcare professions; and 

6 ‘‘(B) cooperate with State, local, and tribal 

7 accrediting agencies and with professional asso8 ciations in arranging for students enrolled in 

9 the program to obtain continuing professional 

10 education credit for program courses. 

11 ‘‘(5) DISSEMINATION AND TRAINING.— 

12 ‘‘(A) IN GENERAL.—The Secretary may 

13 provide for the dissemination and teaching of 

14 the materials described in paragraphs (1) and 

15 (2) by appropriate means, as determined by the 

16 Secretary. 

17 ‘‘(B) CERTAIN ENTITIES.—The education 

18 and training activities described in subpara19 graph (A) may be carried out by Federal public 

20 health or medical entities, appropriate edu21 cational entities, professional organizations and 

22 societies, private accrediting organizations, and 

23 other nonprofit institutions or entities meeting 

24 criteria established by the Secretary. 


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1 ‘‘(C) GRANTS AND CONTRACTS.—In car2 rying out this subsection, the Secretary may 

3 carry out activities directly or through the 

4 award of grants and contracts, and may enter 

5 into interagency agreements with other Federal 

6 agencies. 

7 ‘‘(b) EXPANSION OF EPIDEMIC INTELLIGENCE SERV8 ICE PROGRAM.—The Secretary may establish 20 officer 

9 positions in the Epidemic Intelligence Service Program, in 

10 addition to the number of the officer positions offered 

11 under such Program in 2006 for individuals who agree 

12 to participate, for a period of not less than 2 years, in 

13 the Career Epidemiology Field Officer program in a State, 

14 local, or tribal health department that serves a health pro15 fessional shortage area (as defined under section 332(a)), 

16 a medically underserved population (as defined under sec17 tion 330(b)(3)), or a medically underserved area or area 

18 at high risk of a public health emergency as designated 

19 by the Secretary. 

20 ‘‘(c) CENTERS FOR PUBLIC HEALTH PREPARED21 NESS; CORE CURRICULA AND TRAINING.— 

22 ‘‘(1) IN GENERAL.—The Secretary may estab23 lish at accredited schools of public health, Centers 

24 for Public Health Preparedness (hereafter referred 

25 to in this section as the ‘Centers’). 


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1 ‘‘(2) ELIGIBILITY.—To be eligible to receive an 

2 award under this subsection to establish a Center, 

3 an accredited school of public health shall agree to 

4 conduct activities consistent with the requirements 

5 of this subsection. 

6 ‘‘(3) CORE CURRICULA.—The Secretary, in col7 laboration with the Centers and other public or pri8 vate entities shall establish core curricula based on 

9 established competencies leading to a 4-year bach10 elor’s degree, a graduate degree, a combined bach11 elor and master’s degree, or a certificate program, 

12 for use by each Center. The Secretary shall dissemi13 nate such curricula to other accredited schools of 

14 public health and other health professions schools 

15 determined appropriate by the Secretary, for vol16 untary use by such schools. 

17 ‘‘(4) CORE COMPETENCY-BASED TRAINING PRO18 GRAM.—The Secretary, in collaboration with the 

19 Centers and other public or private entities shall fa20 cilitate the development of a competency-based train21 ing program to train public health practitioners. The 

22 Centers shall use such training program to train 

23 public health practitioners. The Secretary shall dis24 seminate such training program to other accredited 

25 schools of public health, and other health professions 


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1 schools as determined by the Secretary, for vol2 untary use by such schools. 

3 ‘‘(5) CONTENT OF CORE CURRICULA AND

4 TRAINING PROGRAM.—The Secretary shall ensure 

5 that the core curricula and training program estab6 lished pursuant to this subsection respond to the 

7 needs of State, local, and tribal public health au8 thorities and integrate and emphasize essential pub9 lic health security capabilities consistent with section 

10 2802(b)(2). 

11 ‘‘(6) ACADEMIC-WORKFORCE COMMUNICA12 TION.—As a condition of receiving funding from the 

13 Secretary under this subsection, a Center shall col14 laborate with a State, local, or tribal public health 

15 department to— 

16 ‘‘(A) define the public health preparedness 

17 and response needs of the community involved; 

18 ‘‘(B) assess the extent to which such needs 

19 are fulfilled by existing preparedness and re20 sponse activities of such school or health de21 partment, and how such activities may be im22 proved; 

23 ‘‘(C) prior to developing new materials or 

24 trainings, evaluate and utilize relevant materials 

25 and trainings developed by others Centers; and 


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1 ‘‘(D) evaluate community impact and the 

2 effectiveness of any newly developed materials 

3 or trainings. 

4 ‘‘(7) PUBLIC HEALTH SYSTEMS RESEARCH.—In 

5 consultation with relevant public and private enti6 ties, the Secretary shall define the existing knowl7 edge base for public health preparedness and re8 sponse systems, and establish a research agenda 

9 based on Federal, State, local, and tribal public 

10 health preparedness priorities. As a condition of re11 ceiving funding from the Secretary under this sub12 section, a Center shall conduct public health systems 

13 research that is consistent with the agenda described 

14 under this paragraph.’’; 

15 (2) by redesignating subsection (h) as sub16 section (d); 

17 (3) by inserting after subsection (d) (as so re18 designated), the following: 

19 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.— 

20 ‘‘(1) FISCAL YEAR 2007.—There are authorized 

21 to be appropriated to carry out this section for fiscal 

22 year 2007— 

23 ‘‘(A) to carry out subsection (a), 

24 $12,000,000, of which $5,000,000 shall be used 

25 to carry out paragraphs (1) through (4) of such 


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1 subsection, and $7,000,000 shall be used to 

2 carry out paragraph (5) of such subsection; 

3 ‘‘(B) to carry out subsection (b), 

4 $3,000,000; and 

5 ‘‘(C) to carry out subsection (c), 

6 $31,000,000, of which $5,000,000 shall be used 

7 to carry out paragraphs (3) through (5) of such 

8 subsection. 

9 ‘‘(2) SUBSEQUENT FISCAL YEARS.—There are 

10 authorized to be appropriated such sums as may be 

11 necessary to carry out this section for fiscal year 

12 2008 and each subsequent fiscal year.’’; and 

13 (4) by striking subsections (i) and (j). 

14 SEC. 305. PARTNERSHIPS FOR STATE AND REGIONAL HOS15 PITAL PREPAREDNESS TO IMPROVE SURGE 

16 CAPACITY. 

17 Section 319C–2 of the Public Health Service Act (42 

18 U.S.C. 247d–3b) is amended to read as follows: 

19 ‘‘SEC. 319C–2. PARTNERSHIPS FOR STATE AND REGIONAL 

20 HOSPITAL PREPAREDNESS TO IMPROVE 

21 SURGE CAPACITY. 

22 ‘‘(a) IN GENERAL.—The Secretary shall award com23 petitive grants or cooperative agreements to eligible enti24 ties to enable such entities to improve surge capacity and 


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1 enhance community and hospital preparedness for public 

2 health emergencies. 

3 ‘‘(b) ELIGIBILITY.—To be eligible for an award under 

4 subsection (a), an entity shall— 

5 ‘‘(1)(A) be a partnership consisting of— 

6 ‘‘(i) one or more hospitals, at least one of 

7 which shall be a designated trauma center, con8 sistent with section 1213(c); 

9 ‘‘(ii) one or more other local health care 

10 facilities, including clinics, health centers, pri11 mary care facilities, mental health centers, mo12 bile medical assets, or nursing homes; and 

13 ‘‘(iii)(I) one or more political subdivisions; 

14 ‘‘(II) one or more States; or 

15 ‘‘(III) one or more States and one or more 

16 political subdivisions; and 

17 ‘‘(B) prepare, in consultation with the Chief 

18 Executive Officer and the lead health officials of the 

19 State, District, or territory in which the hospital and 

20 health care facilities described in subparagraph (A) 

21 are located, and submit to the Secretary, an applica22 tion at such time, in such manner, and containing 

23 such information as the Secretary may require; or 

24 ‘‘(2)(A) be an entity described in section 319C– 

25 1(b)(1); and 


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1 ‘‘(B) submit an application at such time, in 

2 such manner, and containing such information as 

3 the Secretary may require, including the information 

4 or assurances required under section 319C–1(b)(2) 

5 and an assurance that the State will retain not more 

6 than 25 percent of the funds awarded for adminis7 trative and other support functions. 

8 ‘‘(c) USE OF FUNDS.—An award under subsection 

9 (a) shall be expended for activities to achieve the prepared10 ness goals described under paragraphs (1), (3), (4), (5), 

11 and (6) of section 2802(b). 

12 ‘‘(d) PREFERENCES.— 

13 ‘‘(1) REGIONAL COORDINATION.—In making 

14 awards under subsection (a), the Secretary shall give 

15 preference to eligible entities that submit applica16 tions that, in the determination of the Secretary— 

17 ‘‘(A) will enhance coordination— 

18 ‘‘(i) among the entities described in 

19 subsection (b)(1)(A)(i); and 

20 ‘‘(ii) between such entities and the en21 tities described in subsection (b)(1)(A)(ii); 

22 and 

23 ‘‘(B) include, in the partnership described 

24 in subsection (b)(1)(A), a significant percentage 


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1 of the hospitals and health care facilities within 

2 the geographic area served by such partnership. 

3 ‘‘(2) OTHER PREFERENCES.—In making 

4 awards under subsection (a), the Secretary shall give 

5 preference to eligible entities that, in the determina6 tion of the Secretary— 

7 ‘‘(A) include one or more hospitals that are 

8 participants in the National Disaster Medical 

9 System; 

10 ‘‘(B) are located in a geographic area that 

11 faces a high degree of risk, as determined by 

12 the Secretary in consultation with the Secretary 

13 of Homeland Security; or 

14 ‘‘(C) have a significant need for funds to 

15 achieve the medical preparedness goals de16 scribed in section 2802(b)(2). 

17 ‘‘(e) CONSISTENCY OF PLANNED ACTIVITIES.—The 

18 Secretary may not award a cooperative agreement to an 

19 eligible entity described in subsection (b)(1) unless the ap20 plication submitted by the entity is coordinated and con21 sistent with an applicable State All-Hazards Public Health 

22 Emergency Preparedness and Response Plan and relevant 

23 local plans, as determined by the Secretary in consultation 

24 with relevant State health officials. 


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1 ‘‘(f) LIMITATION ON AWARDS.—A political subdivi2 sion shall not participate in more than one partnership 

3 described in subsection (b)(1). 

4 ‘‘(g) COORDINATION WITH LOCAL RESPONSE CAPA5 BILITIES.—An eligible entity shall, to the extent prac6 ticable, ensure that activities carried out under an award 

7 under subsection (a) are coordinated with activities of rel8 evant local Metropolitan Medical Response Systems, local 

9 Medical Reserve Corps, the Cities Readiness Initiative, 

10 and local emergency plans. 

11 ‘‘(h) MAINTENANCE OF STATE FUNDING.— 

12 ‘‘(1) IN GENERAL.—An entity that receives an 

13 award under this section shall maintain expenditures 

14 for health care preparedness at a level that is not 

15 less than the average level of such expenditures 

16 maintained by the entity for the preceding 2 year 

17 period. 

18 ‘‘(2) RULE OF CONSTRUCTION.—Nothing in 

19 this section shall be construed to prohibit the use of 

20 awards under this section to pay salary and related 

21 expenses of public health and other professionals 

22 employed by State, local, or tribal agencies who are 

23 carrying out activities supported by such awards (re24 gardless of whether the primary assignment of such 

25 personnel is to carry out such activities). 


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1 ‘‘(i) PERFORMANCE AND ACCOUNTABILITY.—The re2 quirements of section 319C–1(g) and (i) shall apply to en3 tities receiving awards under this section (regardless of 

4 whether such entities are described under subsection 

5 (b)(1)(A) or (b)(2)(A)) in the same manner as such re6 quirements apply to entities under section 319C–1. 

7 ‘‘(j) AUTHORIZATION OF APPROPRIATIONS.— 

8 ‘‘(1) IN GENERAL.—For the purpose of car9 rying out this section, there is authorized to be ap10 propriated $474,000,000 for fiscal year 2007, and 

11 such sums as may be necessary for each of fiscal 

12 years 2008 through 2011. 

13 ‘‘(2) RESERVATION OF AMOUNTS FOR PART14 NERSHIPS.—Prior to making awards described in 

15 paragraph (3), the Secretary may reserve from the 

16 amount appropriated under paragraph (1) for a fis17 cal year, an amount determined appropriate by the 

18 Secretary for making awards to entities described in 

19 subsection (b)(1)(A). 

20 ‘‘(3) AWARDS TO STATES AND POLITICAL SUB21 DIVISIONS.— 

22 ‘‘(A) IN GENERAL.—From amounts appro23 priated for a fiscal year under paragraph (1) 

24 and not reserved under paragraph (2), the Sec25 retary shall make awards to entities described 


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1 in subsection (b)(2)(A) that have completed an 

2 application as described in subsection (b)(2)(B). 

3 ‘‘(B) AMOUNT.—The Secretary shall deter4 mine the amount of an award to each entity de5 scribed in subparagraph (A) in the same man6 ner as such amounts are determined under sec7 tion 319C–1(h).’’. 

8 SEC. 306. ENHANCING THE ROLE OF THE DEPARTMENT OF 

9 VETERANS AFFAIRS. 

10 (a) IN GENERAL.—Section 8117 of title 38, United 

11 States Code, is amended— 

12 (1) in subsection (a)— 

13 (A) in paragraph (1), by— 

14 (i) striking ‘‘chemical or biological at15 tack’’ and inserting ‘‘a public health emer16 gency (as defined in section 2801 of the 

17 Public Health Service Act)’’; 

18 (ii) striking ‘‘an attack’’ and inserting 

19 ‘‘such an emergency’’; and 

20 (iii) striking ‘‘public health emer21 gencies’’ and inserting ‘‘such emergencies’’; 

22 and 

23 (B) in paragraph (2)— 

24 (i) in subparagraph (A), by striking ‘‘; 

25 and’’ and inserting a semicolon; 


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1 (ii) in subparagraph (B), by striking 

2 the period and inserting a semicolon; and 

3 (iii) by adding at the end the fol4 lowing: 

5 ‘‘(C) organizing, training, and equipping 

6 the staff of such centers to support the activi7 ties carried out by the Secretary of Health and 

8 Human Services under section 2801 of the 

9 Public Health Service Act in the event of a pub10 lic health emergency and incidents covered by 

11 the National Response Plan developed pursuant 

12 to section 502(6) of the Homeland Security Act 

13 of 2002, or any successor plan; and 

14 ‘‘(D) providing medical logistical support 

15 to the National Disaster Medical System and 

16 the Secretary of Health and Human Services as 

17 necessary, on a reimbursable basis, and in co18 ordination with other designated Federal agen19 cies.’’; 

20 (2) in subsection (c), by striking ‘‘a chemical or 

21 biological attack or other terrorist attack.’’ and in22 serting ‘‘a public health emergency. The Secretary 

23 shall, through existing medical procurement con24 tracts, and on a reimbursable basis, make available 

25 as necessary, medical supplies, equipment, and pharVerDate Aug 31 2005 23:31 Jul 19, 2006 Jkt 049200 PO 00000 Frm 00077 Fmt 6652 Sfmt 6201 E:\BILLS\S3678.IS S3678

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1 maceuticals in response to a public health emergency 

2 in support of the Secretary of Health and Human 

3 Services.’’; 

4 (3) in subsection (d), by— 

5 (A) striking ‘‘develop and’’; 

6 (B) striking ‘‘biological, chemical, or radio7 logical attacks’’ and inserting ‘‘public health 

8 emergencies’’; and 

9 (C) by inserting ‘‘consistent with section 

10 319F(a) of the Public Health Service Act’’ be11 fore the period; and 

12 (4) in subsection (e)— 

13 (A) in paragraph (1), by striking 

14 ‘‘2811(b)’’ and inserting ‘‘2812’’; and 

15 (B) in paragraph (2)— 

16 (i) by striking ‘‘bioterrorism and 

17 other’’; and 

18 (ii) by striking ‘‘319F(a)’’ and insert19 ing ‘‘319F’’. 

20 (b) AUTHORIZATION OF APPROPRIATIONS.—Section 

21 8117 of title 38, United States Code, is amended by add22 ing at the end the following: 

23 ‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—There 

24 are authorized to be appropriated, such sums as may be 


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1 necessary to carry out this section for each of fiscal years 

2 2007 through 2011.’’. 

Æ 


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