II 

Calendar No. 583 

109TH CONGRESS 

2D SESSION S. 3678 

[Report No. 109–319] 

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, Ms. MIKULSKI, Mr. HATCH, Mrs. CLINTON, Mr. ROBERTS, 

Mr. ISAKSON, Mr. DEWINE, and Mr. ALEXANDER) introduced the following bill; which was read twice and referred to the Committee on 

Health, Education, Labor, and Pensions 

AUGUST 3, 2006 

Reported by Mr. ENZI, with an amendment 

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

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, 


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1 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

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

3 ‘‘Pandemic and All-Hazards Preparedness Act’’. 

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

5 this Act is as follows: 

Sec. 1. Short title; table of contents. 

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. 


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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: 

12 ‘‘TITLE XXVIII—NATIONAL ALL13 HAZARDS PREPAREDNESS 

14 FOR PUBLIC HEALTH EMER15 GENCIES’’; 

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

17 ‘‘Subtitle A—National All-Hazards 

18 Preparedness and Response 

19 Planning, Coordinating, and Re20 porting 

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

22 AND RESPONSE FUNCTIONS. 

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

24 Human Services shall lead all Federal public health and 

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1 dents covered by the National Response Plan developed 

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

3 of 2002, or any successor plan. 

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

5 collaboration with the Secretary of Veterans Affairs, the 

6 Secretary of Transportation, the Secretary of Defense, the 

7 Secretary of Homeland Security, and the head of any 

8 other relevant Federal agency, shall establish an inter9 agency agreement, consistent with the National Response 

10 Plan or any successor plan, under which agreement the 

11 Secretary of Health and Human Services shall assume 

12 operational control of emergency public health and medical 

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

14 health emergency.’’. 

15 SEC. 102. ASSISTANT SECRETARY FOR PREPAREDNESS AND 

16 RESPONSE. 

17 (a) ASSISTANT SECRETARY FOR PREPAREDNESS AND

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

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

20 amended— 

21 (1) in the subtitle heading, by inserting ‘‘All22 Hazards’’ before ‘‘Emergency Preparedness’’; 

23 (2) by redesignating section 2811 as section 

24 2812; 


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1 (3) by inserting after the subtitle heading the 

2 following new section: 

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

4 RESPONSE TO ALL-HAZARDS PUBLIC HEALTH 

5 EMERGENCIES. 

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

7 Department of Health and Human Services the position 

8 of the Assistant Secretary for Preparedness and Response. 

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

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

11 Assistant Secretary shall report to the Secretary. 

12 ‘‘(b) DUTIES.—Subject to the authority of the Sec13 retary, the Assistant Secretary for Preparedness and Re14 sponse shall carry out the following functions: 

15 ‘‘(1) LEADERSHIP.—Serve as the principal ad16 visor to the Secretary on all matters related to Fed17 eral public health and medical preparedness and re18 sponse for public health emergencies. 

19 ‘‘(2) PERSONNEL.—Register, credential, orga20 nize, train, equip, and have the authority to deploy 

21 Federal public health and medical personnel under 

22 the authority of the Secretary, including the Na23 tional Disaster Medical System, and coordinate such 

24 personnel with the Medical Reserve Corps and the 


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1 Emergency System for Advance Registration of Vol2 unteer Health Professionals. 

3 ‘‘(3) COUNTERMEASURES.— 

4 ‘‘(A) OVERSIGHT.—Oversee advanced re5 search, development, and procurement of quali6 fied countermeasures (as defined in section 

7 319F–1) and qualified pandemic or epidemic 

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

9 ‘‘(B) STRATEGIC NATIONAL STOCKPILE.— 

10 Maintain the Strategic National Stockpile in ac11 cordance with section 319F–2, including con12 ducting an annual review (taking into account 

13 at-risk individuals) of the contents of the stock14 pile, including non-pharmaceutical supplies, and 

15 make necessary additions or modifications to 

16 the contents based on such review. 

17 ‘‘(4) COORDINATION.— 

18 ‘‘(A) FEDERAL INTEGRATION.—Coordinate 

19 with relevant Federal officials to ensure inte20 gration of Federal preparedness and response 

21 activities for public health emergencies. 

22 ‘‘(B) STATE, LOCAL, AND TRIBAL INTE23 GRATION.—Coordinate with State, local, and 

24 tribal public health officials, the Emergency 

25 Management Assistance Compact, health care 


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1 systems, and emergency medical service systems 

2 to ensure effective integration of Federal public 

3 health and medical assets during a public 

4 health emergency. 

5 ‘‘(C) EMERGENCY MEDICAL SERVICES.— 

6 Promote improved emergency medical services 

7 medical direction, system integration, research, 

8 and uniformity of data collection, treatment 

9 protocols, and policies with regard to public 

10 health emergencies. 

11 ‘‘(5) LOGISTICS.—In coordination with the Sec12 retary of Veterans Affairs, the Secretary of Home13 land Security, the General Services Administration, 

14 and other public and private entities, provide 

15 logistical support for medical and public health as16 pects of Federal responses to public health emer17 gencies. 

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

19 international programs, initiatives, and policies that 

20 deal with public health and medical emergency pre21 paredness and response. 

22 ‘‘(c) FUNCTIONS.—The Assistant Secretary for Pre23 paredness and Response shall— 


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

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

3 following— 

4 ‘‘(A) the National Disaster Medical System 

5 (in accordance with section 301 of the Pan6 demic and All-Hazards Preparedness Act); 

7 ‘‘(B) the Hospital Preparedness Coopera8 tive Agreement Program pursuant to section 

9 319C–2; and 

10 ‘‘(C) the Public Health Preparedness Co11 operative Agreement Program pursuant to sec12 tion 319C–1; 

13 ‘‘(2) exercise the responsibilities and authorities 

14 of the Secretary with respect to the coordination 

15 of— 

16 ‘‘(A) the Medical Reserve Corps pursuant 

17 to section 2813 as added by the Pandemic and 

18 All-Hazards Preparedness Act; 

19 ‘‘(B) the Emergency System for Advance 

20 Registration of Volunteer Health Professionals 

21 pursuant to section 319I; 

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

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

24 ‘‘(3) assume other duties as determined appro25 priate by the Secretary.’’; and 


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

2 Health Emergency Preparedness’’ each place it ap3 pears and inserting ‘‘Assistant Secretary for Pre4 paredness and Response’’. 

5 (b) TRANSFER OF FUNCTIONS; REFERENCES.— 

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

7 transferred to the Office of the Assistant Secretary 

8 for Preparedness and Response the functions, per9 sonnel, assets, and liabilities of the Assistant Sec10 retary for Public Health Emergency Preparedness as 

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

12 this Act. 

13 (2) REFERENCES.—Any reference in any Fed14 eral law, Executive order, rule, regulation, or delega15 tion of authority, or any document of or pertaining 

16 to the Assistant Secretary for Public Health Emer17 gency Preparedness as in effect the day before the 

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

19 a reference to the Assistant Secretary for Prepared20 ness and Response. 

21 SEC. 103. NATIONAL HEALTH SECURITY STRATEGY. 

22 Title XXVIII of the Public Health Service Act 

23 (300hh–11 et seq.), as amended by section 101, is amend24 ed by inserting after section 2801 the following: 


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

2 ‘‘(a) IN GENERAL.— 

3 ‘‘(1) PREPAREDNESS AND RESPONSE REGARD4 ING PUBLIC HEALTH EMERGENCIES.—Beginning in 

5 2009 and every 4 years thereafter, the Secretary 

6 shall prepare and submit to the relevant Committees 

7 of Congress a coordinated strategy and any revisions 

8 thereof, and an accompanying implementation plan 

9 for public health emergency preparedness and re10 sponse. The strategy shall identify the process for 

11 achieving the preparedness goals described in sub12 section (b) and shall be consistent with the National 

13 Preparedness Goal, the National Incident Manage14 ment System, and the National Response Plan devel15 oped pursuant to section 502(6) of the Homeland 

16 Security Act of 2002, or any successor plan. 

17 ‘‘(2) EVALUATION OF PROGRESS.—The Na18 tional Health Security Strategy shall include an 

19 evaluation of the progress made by Federal, State, 

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

21 benchmarks and objective standards that measure 

22 levels of preparedness established pursuant to sec23 tion 319C–1(g). Such evaluation shall include aggre24 gate and State-specific breakdowns of obligated 

25 funding spent by major category (as defined by the 


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1 Secretary) for activities funded through awards pur2 suant to sections 319C–1 and 319C–2. 

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

4 the National Health Security Strategy shall include 

5 a national strategy for establishing an effective and 

6 prepared public health workforce, including defining 

7 the functions, capabilities, and gaps in such work8 force, and identifying strategies to recruit, retain, 

9 and protect such workforce from workplace expo10 sures during public health emergencies. 

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

12 subsection (a) shall include provisions in furtherance of 

13 the following: 

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

15 and public and private medical capabilities with 

16 other first responder systems, including through— 

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

18 State, local, and tribal preparedness and re19 sponse capabilities through drills and exercises; 

20 and 

21 ‘‘(B) integrating public and private sector 

22 public health and medical donations and volun23 teers. 

24 ‘‘(2) PUBLIC HEALTH.—Developing and sus25 taining Federal, State, local, and tribal essential 


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1 public health security capabilities, including the fol2 lowing: 

3 ‘‘(A) Disease situational awareness domes4 tically and abroad, including detection, identi5 fication, and investigation. 

6 ‘‘(B) Disease containment including capa7 bilities for isolation, quarantine, social 

8 distancing, and decontamination. 

9 ‘‘(C) Risk communication and public pre10 paredness. 

11 ‘‘(D) Rapid distribution and administra12 tion of medical countermeasures. 

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

14 response capabilities, and surge capacity of hos15 pitals, other health care facilities (including mental 

16 health facilities), and trauma care and emergency 

17 medical service systems with respect to public health 

18 emergencies, which shall include developing plans for 

19 the following: 

20 ‘‘(A) Strengthening public health emer21 gency medical management and treatment ca22 pabilities. 

23 ‘‘(B) Medical evacuation and fatality man24 agement. 


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1 ‘‘(C) Rapid distribution and administration 

2 of medical countermeasures. 

3 ‘‘(D) Effective utilization of any available 

4 public and private mobile medical assets and in5 tegration of other Federal assets. 

6 ‘‘(E) Protecting health care workers and 

7 health care first responders from workplace ex8 posures during a public health emergency. 

9 ‘‘(4) AT-RISK INDIVIDUALS.— 

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

11 and medical needs of at-risk individuals in the 

12 event of a public health emergency. 

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

14 319, the term ‘at-risk individuals’ means chil15 dren, pregnant women, senior citizens and other 

16 individuals who have special needs in the event 

17 of a public health emergency, as determined by 

18 the Secretary. 

19 ‘‘(5) COORDINATION.—Minimizing duplication 

20 of, and ensuring coordination between Federal, 

21 State, local, and tribal planning, preparedness, and 

22 response activities (including the State Emergency 

23 Management Assistance Compact). Such planning 

24 shall be consistent with the National Response Plan, 

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1 agement System and the National Preparedness 

2 Goal. 

3 ‘‘(6) CONTINUITY OF OPERATIONS.—Maintain4 ing vital public health and medical services to allow 

5 for optimal Federal, State, local, and tribal oper6 ations in the event of a public health emergency.’’. 

7 TITLE II—PUBLIC HEALTH 

8 SECURITY PREPAREDNESS 

9 SEC. 201. IMPROVING STATE AND LOCAL PUBLIC HEALTH 

10 SECURITY. 

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

12 U.S.C. 247d–3a) is amended— 

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

14 ‘‘IMPROVING STATE AND LOCAL PUBLIC

15 HEALTH SECURITY.’’; 

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

17 inserting the following: 

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

19 United States with respect to public health emergencies, 

20 the Secretary shall award cooperative agreements to eligi21 ble entities to enable such entities to conduct the activities 

22 described in subsection (d). 

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

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

25 ‘‘(1)(A) be a State; 


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

2 the Secretary to be eligible for an award under this 

3 section (based on criteria described in subsection 

4 (h)(4); or 

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

6 subparagraph (A); and 

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

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

9 containing such information as the Secretary may 

10 require, including— 

11 ‘‘(A) an All-Hazards Public Health Emer12 gency Preparedness and Response Plan which 

13 shall include— 

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

15 entity will carry out under the agreement 

16 to meet the goals identified under section 

17 2802; 

18 ‘‘(ii) a pandemic influenza plan con19 sistent with the requirements of para20 graphs (2) and (5) of subsection (g); 

21 ‘‘(iii) preparedness and response strat22 egies and capabilities that take into ac23 count the medical and public health needs 

24 of at-risk individuals in the event of a pub25 lic health emergency; 


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1 ‘‘(iv) a description of the mechanism 

2 the entity will implement to utilize the 

3 Emergency Management Assistance Com4 pact or other mutual aid agreements for 

5 medical and public health mutual aid; and 

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

7 will include the State Area Agency on 

8 Aging in public health emergency pre9 paredness; 

10 ‘‘(B) an assurance that the entity will re11 port to the Secretary on an annual basis (or 

12 more frequently as determined by the Sec13 retary) on the evidence-based benchmarks and 

14 objective standards established by the Secretary 

15 to evaluate the preparedness and response capa16 bilities of such entity; 

17 ‘‘(C) an assurance that the entity will con18 duct, on at least an annual basis, an exercise or 

19 drill that meets any criteria established by the 

20 Secretary to test the preparedness and response 

21 capabilities of such entity, and that the entity 

22 will report back to the Secretary within the ap23 plication of the following year on the strengths 

24 and weaknesses identified through such exercise 


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1 or drill, and corrective actions taken to address 

2 material weaknesses; 

3 ‘‘(D) an assurance that the entity will pro4 vide to the Secretary the data described under 

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

6 the Secretary; 

7 ‘‘(E) an assurance that the entity will con8 duct activities to inform and educate the hos9 pitals within the jurisdiction of such entity on 

10 the role of such hospitals in the plan required 

11 under subparagraph (A); 

12 ‘‘(F) an assurance that the entity, with re13 spect to the plan described under subparagraph 

14 (A), has developed and will implement an ac15 countability system to ensure that such entity 

16 make satisfactory annual improvement and de17 scribe such system in the plan under subpara18 graph (A); 

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

20 to obtain public comment and input on the plan 

21 described in subparagraph (A) and on the im22 plementation of such plan, that shall include an 

23 advisory committee or other similar mechanism 

24 for obtaining comment from the public and 


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1 from other State, local, and tribal stakeholders; 

2 and 

3 ‘‘(H) as relevant, a description of the proc4 ess used by the entity to consult with local de5 partments of public health to reach consensus, 

6 approval, or concurrence on the relative dis7 tribution of amounts received under this sec8 tion. 

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

10 the Secretary may not award a cooperative agreement to 

11 a State unless such State is a participant in the Emer12 gency System for Advance Registration of Volunteer 

13 Health Professionals described in section 319I. 

14 ‘‘(d) USE OF FUNDS.— 

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

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

17 preparedness goals described under paragraphs (1), 

18 (2), (4), (5), and (6) of section 2802(b). 

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

20 subsection may be construed as establishing new 

21 regulatory authority or as modifying any existing 

22 regulatory authority. 

23 ‘‘(e) COORDINATION WITH LOCAL RESPONSE CAPA24 BILITIES.—An entity shall, to the extent practicable, en25 sure that activities carried out under an award under subVerDate Aug 31 2005 23:09 Aug 04, 2006 Jkt 049200 PO 00000 Frm 00018 Fmt 6652 Sfmt 6401 E:\BILLS\S3678.RS S3678

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1 section (a) are coordinated with activities of relevant Met2 ropolitan Medical Response Systems, local public health 

3 departments, the Cities Readiness Initiative, and local 

4 emergency plans. 

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

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

7 shall consult with the Secretary of Homeland Security 

8 to— 

9 ‘‘(1) ensure maximum coordination of public 

10 health and medical preparedness and response ac11 tivities with the Metropolitan Medical Response Sys12 tem, and other relevant activities; 

13 ‘‘(2) minimize duplicative funding of programs 

14 and activities; 

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

16 drills, conducted under this section to develop rec17 ommendations and guidance on best practices for 

18 such activities, and 

19 ‘‘(4) disseminate such recommendations and 

20 guidance, including through expanding existing les21 sons learned information system to create a single 

22 Internet-based point of access for sharing and dis23 tributing medical and public health best practices 

24 and lessons learned from drills, exercises, disasters, 

25 and other emergencies. 


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1 ‘‘(g) ACHIEVEMENT OF MEASURABLE EVIDENCE2 BASED BENCHMARKS AND OBJECTIVE STANDARDS.— 

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

4 after the date of enactment of the Pandemic and 

5 All-Hazards Preparedness Act, the Secretary shall 

6 develop or where appropriate adopt, and require the 

7 application of measurable evidence-based bench8 marks and objective standards that measure levels of 

9 preparedness with respect to the activities described 

10 in this section and with respect to activities de11 scribed in section 319C–2. In developing such bench12 marks and standards, the Secretary shall consult 

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

14 officials and private entities, as appropriate. Where 

15 appropriate, the Secretary shall incorporate existing 

16 objective standards. Such benchmarks and standards 

17 shall, at a minimum, require entities to— 

18 ‘‘(A) demonstrate progress toward achiev19 ing the preparedness goals described in section 

20 2802 in a reasonable timeframe determined by 

21 the Secretary; 

22 ‘‘(B) annually report grant expenditures to 

23 the Secretary (in a form prescribed by the Sec24 retary) who shall ensure that such information 


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1 is included on the Federal Internet-based point 

2 of access developed under subsection (f); and 

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

4 the public health and medical emergency pre5 paredness and response capabilities of the 

6 grantee, based on criteria established by the 

7 Secretary. 

8 ‘‘(2) CRITERIA FOR PANDEMIC INFLUENZA

9 PLANS.— 

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

11 days after the date of enactment of the Pan12 demic and All-Hazards Preparedness Act, the 

13 Secretary shall develop and disseminate to the 

14 chief executive officer of each State criteria for 

15 an effective State plan for responding to pan16 demic influenza. 

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

18 in this section shall be construed to require the 

19 duplication of Federal efforts with respect to 

20 the development of criteria or standards, with21 out regard to whether such efforts were carried 

22 out prior to or after the date of enactment of 

23 this section. 

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

25 shall, as determined appropriate by the Secretary, 


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1 provide to a State, upon request, technical assistance 

2 in meeting the requirements of this section, includ3 ing the provision of advice by experts in the develop4 ment of high-quality assessments, the setting of 

5 State objectives and assessment methods, the devel6 opment of measures of satisfactory annual improve7 ment that are valid and reliable, and other relevant 

8 areas. 

9 ‘‘(4) NOTIFICATION OF FAILURES.—The Sec10 retary shall develop and implement a process to no11 tify entities that are determined by the Secretary to 

12 have failed to meet the requirements of paragraph 

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

14 with the opportunity to correct such noncompliance. 

15 An entity that fails to correct such noncompliance 

16 shall be subject to paragraph (5). 

17 ‘‘(5) WITHHOLDING OF AMOUNTS FROM ENTI18 TIES THAT FAIL TO ACHIEVE BENCHMARKS OR SUB19 MIT INFLUENZA PLAN.—Beginning with fiscal year 

20 2009, and in each succeeding fiscal year, the Sec21 retary shall— 

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

23 failed substantially to meet the benchmarks and 

24 performance measures described in paragraph 

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


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1 fiscal year 2008), pursuant to the process devel2 oped under paragraph (4), the amount de3 scribed in paragraph (6); and 

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

5 failed to submit to the Secretary a plan for re6 sponding to pandemic influenza that meets the 

7 criteria developed under paragraph (2), the 

8 amount described in paragraph (6). 

9 ‘‘(6) AMOUNTS DESCRIBED.— 

10 ‘‘(A) IN GENERAL.—The amounts de11 scribed in this paragraph are the following 

12 amounts that are payable to an entity for ac13 tivities described in section 319C–1 or 319C–2: 

14 ‘‘(i) For the fiscal year immediately 

15 following a fiscal year in which an entity 

16 experienced a failure described in subpara17 graph (A) or (B) of paragraph (5) by the 

18 entity, an amount equal to 10 percent of 

19 the amount the entity was eligible to re20 ceive for such fiscal year. 

21 ‘‘(ii) For the fiscal year immediately 

22 following two consecutive fiscal years in 

23 which an entity experienced such a failure, 

24 an amount equal to 15 percent of the 

25 amount the entity was eligible to receive 


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1 for such fiscal year, taking into account 

2 the withholding of funds for the imme3 diately preceding fiscal year under clause 

4 (i). 

5 ‘‘(iii) For the fiscal year immediately 

6 following three consecutive fiscal years in 

7 which an entity experienced such a failure, 

8 an amount equal to 20 percent of the 

9 amount the entity was eligible to receive 

10 for such fiscal year, taking into account 

11 the withholding of funds for the imme12 diately preceding fiscal years under clauses 

13 (i) and (ii). 

14 ‘‘(iv) For the fiscal year immediately 

15 following four consecutive fiscal years in 

16 which an entity experienced such a failure, 

17 an amount equal to 25 percent of the 

18 amount the entity was eligible to receive 

19 for such a fiscal year, taking into account 

20 the withholding of funds for the imme21 diately preceding fiscal years under clauses 

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

23 ‘‘(B) SEPARATE ACCOUNTING.—Each fail24 ure described in subparagraph (A) or (B) of 

25 paragraph (5) shall be treated as a separate 


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1 failure for purposes of calculating amounts 

2 withheld under subparagraph (A). 

3 ‘‘(7) REALLOCATION OF AMOUNTS WITH4 HELD.— 

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

6 make amounts withheld under paragraph (6) 

7 available for making awards under section 

8 319C–2 to entities described in subsection 

9 (b)(1) of such section. 

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

11 making awards under section 319C–2 with 

12 amounts described in subparagraph (A), the 

13 Secretary shall give preference to eligible enti14 ties (as described in section 319C–2(b)(1)) that 

15 are located in whole or in part in States from 

16 which amounts have been withheld under para17 graph (6). 

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

19 Secretary may waive or reduce the withholding de20 scribed in paragraph (6), for a single entity or for 

21 all entities in a fiscal year, if the Secretary deter22 mines that mitigating conditions exist that justify 

23 the waiver or reduction.’’; 

24 (3) by redesignating subsection (j) as sub25 section (h); 


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

2 (A) by striking paragraphs (1) through 

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

4 ‘‘(1) AUTHORIZATION OF APPROPRIATIONS.— 

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

6 carrying out this section, there is authorized to 

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

8 for awards pursuant to paragraph (3) (subject 

9 to the authority of the Secretary to make 

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

11 and such sums as may be necessary for each of 

12 fiscal years 2008 through 2011. 

13 ‘‘(B) COORDINATION.—There are author14 ized to be appropriated, $10,000,000 for fiscal 

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

16 ‘‘(C) REQUIREMENT FOR STATE MATCHING

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

18 case of any State or consortium of two or more 

19 States, the Secretary may not award a coopera20 tive agreement under this section unless the 

21 State or consortium of States agree that, with 

22 respect to the amount of the cooperative agree23 ment awarded by the Secretary, the State or 

24 consortium of States will make available (di25 rectly or through donations from public or priVerDate Aug 31 2005 23:09 Aug 04, 2006 Jkt 049200 PO 00000 Frm 00026 Fmt 6652 Sfmt 6401 E:\BILLS\S3678.RS S3678

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1 vate entities) non-Federal contributions in an 

2 amount equal to— 

3 ‘‘(i) for the first fiscal year of the co4 operative agreement, not less than 5 per5 cent of such costs ($1 for each $20 of Fed6 eral funds provided in the cooperative 

7 agreement); and 

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

9 cooperative agreement, and for any subse10 quent fiscal year of such cooperative agree11 ment, not less than 10 percent of such 

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

13 provided in the cooperative agreement). 

14 ‘‘(D) DETERMINATION OF AMOUNT OF

15 NON-FEDERAL CONTRIBUTIONS.—As deter16 mined by the Secretary, non-Federal contribu17 tions required in subparagraph (C) may be pro18 vided directly or through donations from public 

19 or private entities and may be in cash or in 

20 kind, fairly evaluated, including plant, equip21 ment or services. Amounts provided by the Fed22 eral government, or services assisted or sub23 sidized to any significant extent by the Federal 

24 government, may not be included in deterVerDate Aug 31 2005 23:09 Aug 04, 2006 Jkt 049200 PO 00000 Frm 00027 Fmt 6652 Sfmt 6401 E:\BILLS\S3678.RS S3678

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1 mining the amount of such non-Federal con2 tributions. 

3 ‘‘(2) MAINTAINING STATE FUNDING.— 

4 ‘‘(A) IN GENERAL.—An entity that re5 ceives an award under this section shall main6 tain expenditures for public health security at a 

7 level that is not less than the average level of 

8 such expenditures maintained by the entity for 

9 the preceding 2 year period. 

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

11 in this section shall be construed to prohibit the 

12 use of awards under this section to pay salary 

13 and related expenses of public health and other 

14 professionals employed by State, local, or tribal 

15 public health agencies who are carrying out ac16 tivities supported by such awards (regardless of 

17 whether the primary assignment of such per18 sonnel is to carry out such activities). 

19 ‘‘(3) DETERMINATION OF AMOUNT.— 

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

21 award cooperative agreements under subsection 

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

23 States that submits to the Secretary an applica24 tion that meets the criteria of the Secretary for 

25 the receipt of such an award and that meets 


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1 other implementation conditions established by 

2 the Secretary for such awards.’’; 

3 (B) in paragraph (4)(A)— 

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

5 ‘‘2007’’; and 

6 (ii) by striking ‘‘(A)(i)(I)’’; 

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

8 ‘‘2002’’ and inserting ‘‘2006’’; 

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

10 and inserting ‘‘2007’’; and 

11 (E) by striking paragraph (6) and insert12 ing the following: 

13 ‘‘(6) FUNDING OF LOCAL ENTITIES.—The Sec14 retary shall, in making awards under this section, 

15 ensure that with respect to the cooperative agree16 ment awarded, the entity make available appropriate 

17 portions of such award to political subdivisions and 

18 local departments of public health through a process 

19 involving the consensus, approval or concurrence 

20 with such local entities.’’; and 

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

22 ‘‘(i) ADMINISTRATIVE AND FISCAL RESPONSI23 BILITY.— 

24 ‘‘(1) ANNUAL REPORTING REQUIREMENTS.— 

25 Each entity shall prepare and submit to the SecVerDate Aug 31 2005 23:09 Aug 04, 2006 Jkt 049200 PO 00000 Frm 00029 Fmt 6652 Sfmt 6401 E:\BILLS\S3678.RS S3678

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1 retary annual reports on its activities under this sec2 tion and section 319C–2. Each such report shall be 

3 prepared by, or in consultation with, the health de4 partment. In order to properly evaluate and compare 

5 the performance of different entities assisted under 

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

7 proper expenditure of funds under this section and 

8 section 319C–2, such reports shall be in such stand9 ardized form and contain such information as the 

10 Secretary determines (after consultation with the 

11 States) to be necessary to— 

12 ‘‘(A) secure an accurate description of 

13 those activities; 

14 ‘‘(B) secure a complete record of the pur15 poses for which funds were spent, and of the re16 cipients of such funds; 

17 ‘‘(C) describe the extent to which the enti18 ty has met the goals and objectives it set forth 

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

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

21 were expended consistent with the entity’s ap22 plication transmitted under this section or sec23 tion 319C–2. 

24 ‘‘(2) AUDITS; IMPLEMENTATION.— 


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

2 funds under this section or section 319C–2 

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

4 audit its expenditures from amounts received 

5 under this section or section 319C–2. Such au6 dits shall be conducted by an entity independent 

7 of the agency administering a program funded 

8 under this section or section 319C–2 in accord9 ance with the Comptroller General’s standards 

10 for auditing governmental organizations, pro11 grams, activities, and functions and generally 

12 accepted auditing standards. Within 30 days 

13 following the completion of each audit report, 

14 the entity shall submit a copy of that audit re15 port to the Secretary. 

16 ‘‘(B) REPAYMENT.—Each entity shall 

17 repay to the United States amounts found by 

18 the Secretary, after notice and opportunity for 

19 a hearing to the entity, not to have been ex20 pended in accordance with this section or sec21 tion 319C–2 and, if such repayment is not 

22 made, the Secretary may offset such amounts 

23 against the amount of any allotment to which 

24 the entity is or may become entitled under this 


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1 section or section 319C–2 or may otherwise re2 cover such amounts. 

3 ‘‘(C) WITHHOLDING OF PAYMENT.—The 

4 Secretary may, after notice and opportunity for 

5 a hearing, withhold payment of funds to any 

6 entity which is not using its allotment under 

7 this section or section 319C–2 in accordance 

8 with such section. The Secretary may withhold 

9 such funds until the Secretary finds that the 

10 reason for the withholding has been removed 

11 and there is reasonable assurance that it will 

12 not recur. 

13 ‘‘(3) MAXIMUM CARRYOVER AMOUNT.— 

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

15 the Secretary, in consultation with the States 

16 and political subdivisions, shall determine the 

17 maximum percentage amount of an award 

18 under this section that an entity may carryover 

19 to the succeeding fiscal year. 

20 ‘‘(B) AMOUNT EXCEEDED.—For each fis21 cal year, if the percentage amount of an award 

22 under this section unexpended by an entity ex23 ceeds the maximum percentage permitted by 

24 the Secretary under subparagraph (A), the enti25 ty shall return to the Secretary the portion of 


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1 the unexpended amount that exceeds the max2 imum amount permitted to be carried over by 

3 the Secretary. 

4 ‘‘(C) ACTION BY SECRETARY.—The Sec5 retary shall make amounts returned to the Sec6 retary under subparagraph (B) available for 

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

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

9 amounts collected under this paragraph the 

10 Secretary shall give preference to entities that 

11 are located in whole or in part in States from 

12 which amounts have been returned under sub13 paragraph (B). 

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

15 the Secretary for a waiver of the maximum per16 centage amount under subparagraph (A). Such 

17 an application for a waiver shall include an ex18 planation why such requirement should not 

19 apply to the entity and the steps taken by such 

20 entity to ensure that all funds under an award 

21 under this section will be expended appro22 priately. 

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

24 The Secretary may waive the application of 

25 subparagraph (B) for a single entity pursuant 


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1 to subparagraph (D) or for all entities in a fis2 cal year, if the Secretary determines that miti3 gating conditions exist that justify the waiver or 

4 reduction.’’. 

5 SEC. 202. USING INFORMATION TECHNOLOGY TO IMPROVE 

6 SITUATIONAL AWARENESS IN PUBLIC 

7 HEALTH EMERGENCIES. 

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

9 U.S.C. 247d–4) is amended— 

10 (1) in subsection (a)(1), by inserting ‘‘domesti11 cally and abroad’’ after ‘‘public health threats’’; and 

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

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

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

15 after the date of enactment of the Pandemic and 

16 All-Hazards Preparedness Act, the Secretary, in col17 laboration with State, local, and tribal public health 

18 officials, shall establish a near real-time electronic 

19 nationwide public health situational awareness capa20 bility through an interoperable network of systems 

21 to share data and information to enhance early de22 tection of rapid response to, and management of, po23 tentially catastrophic infectious disease outbreaks 

24 and other public health emergencies that originate 

25 domestically or abroad. Such network shall be built 


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1 on existing State situational awareness systems or 

2 enhanced systems that enable such connectivity. 

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

4 days after the date of enactment the Pandemic and 

5 All-Hazards Preparedness Act, the Secretary shall 

6 submit to the appropriate committees of Congress, a 

7 strategic plan that demonstrates the steps the Sec8 retary will undertake to develop, implement, and 

9 evaluate the network described in paragraph (1), uti10 lizing the elements described in paragraph (3). 

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

12 paragraph (1) shall include data and information 

13 transmitted in a standardized format from— 

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

15 entities, including public health laboratories; 

16 ‘‘(B) Federal health agencies; 

17 ‘‘(C) zoonotic disease monitoring systems; 

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

19 entities, hospitals, pharmacies, poison control 

20 centers or professional organizations in the field 

21 of poison control, and clinical laboratories, to 

22 the extent practicable and provided that such 

23 data are voluntarily provided simultaneously to 

24 the Secretary and appropriate State, local, and 

25 tribal public health agencies; and 


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

2 may deem appropriate. 

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

4 shall not be construed as requiring separate report5 ing of data and information from each source listed. 

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

7 and operating the network described in paragraph 

8 (1), the Secretary shall— 

9 ‘‘(A) utilize applicable interoperability 

10 standards as determined by the Secretary 

11 through a joint public and private sector proc12 ess; 

13 ‘‘(B) define minimal data elements for 

14 such network; 

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

16 tribal public health officials, integrate and build 

17 upon existing State, local, and tribal capabili18 ties, ensuring simultaneous sharing of data, in19 formation, and analyses from the network de20 scribed in paragraph (1) with State, local, and 

21 tribal public health agencies; and 

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

23 tribal public health officials, develop procedures 

24 and standards for the collection, analysis, and 

25 interpretation of data that States, regions, or 


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1 other entities collect and report to the network 

2 described in paragraph (1). 

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

4 SITUATIONAL AWARENESS IN PUBLIC HEALTH EMER5 GENCIES.— 

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

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

8 grants to States to enhance the ability of such 

9 States to establish or operate a coordinated public 

10 health situational awareness system for regional or 

11 Statewide early detection of, rapid response to, and 

12 management of potentially catastrophic infectious 

13 disease outbreaks and public health emergencies, in 

14 collaboration with public health agencies, sentinel 

15 hospitals, clinical laboratories, pharmacies, poison 

16 control centers, other health care organizations, or 

17 animal health organizations within such States. 

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

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

20 the Secretary an application at such time, in such 

21 manner, and containing such information as the Sec22 retary may require, including an assurance that the 

23 State will submit to the Secretary— 

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

25 and metrics as the Secretary may require; 


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

2 systems funded under the grant; and 

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

4 grant funds will be used to enhance the 

5 timelines and comprehensiveness of efforts to 

6 detect, respond to, and manage potentially cata7 strophic infectious disease outbreaks and public 

8 health emergencies. 

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

10 award under this subsection— 

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

12 coordinated public health situational awareness 

13 system for regional or Statewide early detection 

14 of, rapid response to, and management of po15 tentially catastrophic infectious disease out16 breaks and public health emergencies; and 

17 ‘‘(B) may award grants or contracts to en18 tities described in paragraph (1) within or serv19 ing such State to assist such entities in improv20 ing the operation of information technology sys21 tems, facilitating the secure exchange of data 

22 and information, and training personnel to en23 hance the operation of the system described in 

24 paragraph (A). 


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1 ‘‘(4) LIMITATION.—Information technology sys2 tems acquired or implemented using grants awarded 

3 under this section must be compliant with— 

4 ‘‘(A) interoperability and other techno5 logical standards, as determined by the Sec6 retary; and 

7 ‘‘(B) data collection and reporting require8 ments for the network described in subsection 

9 (d). 

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

11 than 4 years after the date of enactment of the Pan12 demic and All-Hazards Preparedness Act, the Gov13 ernment Accountability Office shall conduct an inde14 pendent evaluation, and submit to the Secretary and 

15 the appropriate committees of Congress a report, 

16 concerning the activities conducted under this sub17 section and subsection (d). 

18 ‘‘(f) GRANTS FOR REAL-TIME SURVEILLANCE IM19 PROVEMENT.— 

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

21 grants to eligible entities to carry out projects de22 scribed under paragraph (4). 

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

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

25 that is— 


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1 ‘‘(A)(i) a hospital, clinical laboratory, uni2 versity; or 

3 ‘‘(ii) poison control center or professional 

4 organization in the field of poison control; and 

5 ‘‘(B) a participant in the network estab6 lished under subsection (d). 

7 ‘‘(3) APPLICATION.—Each eligible entity desir8 ing a grant under this section shall submit to the 

9 Secretary an application at such time, in such man10 ner, and containing such information as the Sec11 retary may require. 

12 ‘‘(4) USE OF FUNDS.— 

13 ‘‘(A) IN GENERAL.—An eligible entity de14 scribed in paragraph (2)(A)(i) that receives a 

15 grant under this section shall use the funds 

16 awarded pursuant to such grant to carry out a 

17 pilot demonstration project to purchase and im18 plement the use of advanced diagnostic medical 

19 equipment to analyze real-time clinical speci20 mens for pathogens of public health or bioter21 rorism significance and report any results from 

22 such project to State, local, and tribal public 

23 health entities and the network established 

24 under subsection (d). 


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

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

3 grant under this section shall use the funds 

4 awarded pursuant to such grant to— 

5 ‘‘(i) improve the early detection, sur6 veillance, and investigative capabilities of 

7 poison control centers for chemical, biologi8 cal, radiological, and nuclear events by 

9 training poison information personnel to 

10 improve the accuracy of surveillance data, 

11 improving the definitions used by the poi12 son control centers for surveillance, and 

13 enhancing timely and efficient investigation 

14 of data anomalies; 

15 ‘‘(ii) improve the capabilities of poison 

16 control centers to provide information to 

17 health care providers and the public with 

18 regard to chemical, biological, radiological, 

19 or nuclear threats or exposures, in con20 sultation with the appropriate State, local, 

21 and tribal public health entities; or 

22 ‘‘(iii) provide surge capacity in the 

23 event of a chemical, biological, radiological, 

24 or nuclear event through the establishment 

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1 sites and the training of nontraditional 

2 personnel. 

3 ‘‘(g) AUTHORIZATION OF APPROPRIATIONS.— 

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

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

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

7 $35,000,000 is authorized to be appropriated to 

8 carry out subsection (f). 

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

10 authorized to be appropriated such sums as may be 

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

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

13 SEC. 203. PUBLIC HEALTH WORKFORCE ENHANCEMENTS. 

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

15 the Public Health Service Act (42 U.S.C. 254t) is amend16 ed by adding at the end the following: 

17 ‘‘(h) PUBLIC HEALTH DEPARTMENTS.— 

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

19 are appropriated under paragraph (5), the Secretary 

20 shall establish a demonstration project to provide for 

21 the participation of individuals who are eligible for 

22 the Loan Repayment Program described in section 

23 338B and who agree to complete their service obli24 gation in a State health department that serves a 

25 significant number of health professional shortage 


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

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

3 department that serves a health professional short4 age area or an area at risk of a public health emer5 gency. 

6 ‘‘(2) PROCEDURE.—To be eligible to receive as7 sistance under paragraph (1), with respect to the 

8 program described in section 338B, an individual 

9 shall— 

10 ‘‘(A) comply with all rules and require11 ments described in such section (other than sec12 tion 338B(f)(1)(B)(iv)); and 

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

14 to 2 years, or such longer period as the indi15 vidual may agree to, in a State, local, or tribal 

16 health department, consistent with paragraph 

17 (1). 

18 ‘‘(3) DESIGNATIONS.—The demonstration 

19 project described in paragraph (1), and any 

20 healthcare providers who are selected to participate 

21 in such project, shall not be considered by the Sec22 retary in the designation of health professional 

23 shortage areas under section 332 during fiscal years 

24 2007 through 2010. 


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

2 date of enactment of this subsection, the Secretary 

3 shall submit a report to the relevant committees of 

4 Congress that evaluates the participation of individ5 uals in the demonstration project under paragraph 

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

7 and tribal health departments, and the benefit and 

8 feasibility of permanently allowing such placements 

9 in the Loan Repayment Program. 

10 ‘‘(5) AUTHORIZATION OF APPROPRIATIONS.— 

11 There are authorized to be appropriated to carry out 

12 this subsection, such sums as may be necessary for 

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

14 (b) GRANTS FOR LOAN REPAYMENT PROGRAM.— 

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

16 254q–1) is amended by adding at the end the following: 

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

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

19 grants to States for the purpose of assisting such 

20 States in operating loan repayment programs under 

21 which such States enter into contracts to repay all 

22 or part of the eligible loans borrowed by, or on be23 half of, individuals who agree to serve in State, local, 

24 or tribal health departments that serve health pro25 fessional shortage areas or other areas at risk of a 


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1 public health emergency, as designated by the Sec2 retary. 

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

4 be eligible for repayment under this subsection, a 

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

6 the Federal Government that is borrowed by, or on 

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

8 for a program of education leading to a degree ap9 propriate for serving in a State, local, or tribal 

10 health department as determined by the Secretary 

11 and the chief executive officer of the State in which 

12 the grant is administered, at an institution of higher 

13 education (as defined in section 102 of the Higher 

14 Education Act of 1965), including principal, inter15 est, and related expenses on such loan. 

16 ‘‘(3) APPLICABILITY OF EXISTING REQUIRE17 MENTS.—With respect to awards made under para18 graph (1)— 

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

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

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

22 shall apply to such awards except that with re23 spect to paragraph (1) of such subsection, the 

24 State involved may assign an individual only to 

25 public and nonprofit private entities that serve 


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1 health professional shortage areas or areas at 

2 risk of a public health emergency, as deter3 mined by the Secretary. 

4 ‘‘(4) AUTHORIZATION OF APPROPRIATIONS.— 

5 There are authorized to be appropriated to carry out 

6 this subsection, such sums as may be necessary for 

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

8 SEC. 204. VACCINE TRACKING AND DISTRIBUTION. 

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

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

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

12 ‘‘(a) TRACKING.—The Secretary, together with rel13 evant manufacturers, wholesalers, and distributors as may 

14 agree to cooperate, may track the initial distribution of 

15 federally purchased influenza vaccine in an influenza pan16 demic. Such tracking information shall be used to inform 

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

18 an influenza pandemic. 

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

20 communication between State, local, and tribal public 

21 health officials and such manufacturers, wholesalers, and 

22 distributors as agree to participate, regarding the effective 

23 distribution of seasonal influenza vaccine. Such commu24 nication shall include estimates of high priority popu25 lations, as determined by the Secretary, in State, local, 


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

2 local, and tribal decision makers during vaccine shortages 

3 and supply disruptions. 

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

5 to the Secretary or its contractors, if any, under this sec6 tion or under any other section of this Act related to vac7 cine distribution information shall remain confidential in 

8 accordance with the exception from the public disclosure 

9 of trade secrets, commercial or financial information, and 

10 information obtained from an individual that is privileged 

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

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

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

14 United States Code, relating to the protection and theft 

15 of trade secrets, and subject to privacy protections that 

16 are consistent with the regulations promulgated under sec17 tion 264(c) of the Health Insurance Portability and Ac18 countability Act of 1996. None of such information pro19 vided by a manufacturer, wholesaler, or distributor shall 

20 be disclosed without its consent to another manufacturer, 

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

22 to give a manufacturer, wholesaler, or distributor a propri23 etary advantage. 

24 ‘‘(d) GUIDELINES.—The Secretary, in order to main25 tain the confidentiality of relevant information and ensure 


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1 that none of the information contained in the systems in2 volved may be used to provide proprietary advantage with3 in the vaccine market, while allowing State, local, and trib4 al health officials access to such information to maximize 

5 the delivery and availability of vaccines to high priority 

6 populations, during times of influenza pandemics, vaccine 

7 shortages, and supply disruptions, in consultation with 

8 manufacturers, distributors, wholesalers and State, local, 

9 and tribal health departments, shall develop guidelines for 

10 subsections (a) and (b). 

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

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

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

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

15 Health Security Strategy described in section 2802, the 

16 Secretary shall provide an update on the implementation 

17 of subsections (a) through (d).’’. 

18 SEC. 205. NATIONAL SCIENCE ADVISORY BOARD FOR BIO19 SECURITY. 

20 The National Science Advisory Board for Biosecurity 

21 shall, when requested by the Secretary of Health and 

22 Human Services, provide to relevant Federal departments 

23 and agencies, advice, guidance, or recommendations con24 cerning— 


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1 (1) a core curriculum and training requirements 

2 for workers in maximum containment biological lab3 oratories; and 

4 (2) periodic evaluations of maximum contain5 ment biological laboratory capacity nationwide and 

6 assessments of the future need for increased labora7 tory capacity; 

8 TITLE III—ALL-HAZARDS 

9 MEDICAL SURGE CAPACITY 

10 SEC. 301. NATIONAL DISASTER MEDICAL SYSTEM. 

11 (a) NATIONAL DISASTER MEDICAL SYSTEM.—Sec12 tion 2812 of subtitle B of title XXVIII of the Public 

13 Health Service Act (42 U.S.C. 300hh–11 et seq.), as re14 designated by section 102, is amended— 

15 (1) by striking the section heading and insert16 ing ‘‘NATIONAL DISASTER MEDICAL SYSTEM’’; 

17 (2) by striking subsection (a); 

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

19 as subsections (a) through (g); 

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

21 (A) in paragraph (2)(B), by striking ‘‘Fed22 eral Emergency Management Agency’’ and in23 serting ‘‘Department of Homeland Security’’; 

24 and 


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1 (B) in paragraph (3)(C), by striking ‘‘Pub2 lic Health Security and Bioterrorism Prepared3 ness and Response Act of 2002’’ and inserting 

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

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

6 (A) striking the subsection heading and in7 serting ‘‘MODIFICATIONS’’; 

8 (B) redesignating paragraph (2) as para9 graph (3); and 

10 (C) striking paragraph (1) and inserting 

11 the following: 

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

13 findings from the joint review described under para14 graph (2), the Secretary shall modify the policies of 

15 the National Disaster Medical System as necessary. 

16 ‘‘(2) JOINT REVIEW AND MEDICAL SURGE CA17 PACITY STRATEGIC PLAN.—Not later than 180 days 

18 after the date of enactment of the Pandemic and 

19 All-Hazards Preparedness Act, the Secretary, in co20 ordination with the Secretary of Homeland Security, 

21 the Secretary of Defense, and the Secretary of Vet22 erans Affairs, shall conduct a joint review of the Na23 tional Disaster Medical System. Such review shall 

24 include an evaluation of medical surge capacity, as 

25 described by section 2804(a). As part of the NaVerDate Aug 31 2005 23:09 Aug 04, 2006 Jkt 049200 PO 00000 Frm 00050 Fmt 6652 Sfmt 6401 E:\BILLS\S3678.RS S3678

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1 tional Health Security Strategy under section 2802, 

2 the Secretary shall update the findings from such re3 view and further modify the policies of the National 

4 Disaster Medical System as necessary.’’; 

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

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

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

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

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

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

11 through 2011’’. 

12 (b) TRANSFER OF NATIONAL DISASTER MEDICAL

13 SYSTEM TO THE DEPARTMENT OF HEALTH AND HUMAN

14 SERVICES.—There shall be transferred to the Secretary 

15 of Health and Human Services the functions, personnel, 

16 assets, and liabilities of the National Disaster Medical 

17 System of the Department of Homeland Security, includ18 ing the functions of the Secretary of Homeland Security 

19 and the Under Secretary for Emergency Preparedness and 

20 Response relating thereto. 

21 (c) CONFORMING AMENDMENTS TO THE HOMELAND

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

23 2002 (6 U.S.C. 312(3)(B), 313(5))) is amended— 

24 (1) in section 502(3)(B), by striking ‘‘, the Na25 tional Disaster Medical System,’’; and 


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1 (2) in section 503(5), by striking ‘‘, the Na2 tional Disaster Medical System’’. 

3 (d) UPDATE OF CERTAIN PROVISION.—Section 

4 319F(b)(2) of the Public Health Service Act (42 U.S.C. 

5 247d–6(b)(2)) is amended— 

6 (1) in the paragraph heading, by striking 

7 ‘‘CHILDREN AND TERRORISM’’ and inserting ‘‘AT8 RISK INDIVIDUALS AND PUBLIC HEALTH EMER9 GENCIES’’; 

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

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

12 and Public Health Emergencies’’; 

13 (3) in subparagraph (B)— 

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

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

16 health emergencies as they relate to at-risk in17 dividuals’’; 

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

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

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

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

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

23 and all that follows through the period and inserting 

24 ‘‘at-risk populations.’’; and 


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

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

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

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

5 2007. 

6 SEC. 302. ENHANCING MEDICAL SURGE CAPACITY. 

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

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

9 103, is amended by inserting after section 2802 the fol10 lowing: 

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

12 ‘‘(a) STUDY OF ENHANCING MEDICAL SURGE CA13 PACITY.—As part of the joint review described in section 

14 2812(b), the Secretary shall evaluate the benefits and fea15 sibility of improving the capacity of the Department of 

16 Health and Human Services to provide additional medical 

17 surge capacity to local communities in the event of a pub18 lic health emergency. Such study shall include an assess19 ment of the need for and feasibility of improving surge 

20 capacity through— 

21 ‘‘(1) acquisition and operation of mobile med22 ical assets by the Secretary to be deployed, on a con23 tingency basis, to a community in the event of a 

24 public health emergency; and 


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

2 as determined appropriate by the Secretary. 

3 ‘‘(b) AUTHORITY TO ACQUIRE AND OPERATE MO4 BILE MEDICAL ASSETS.—In addition to any other author5 ity to acquire, deploy, and operate mobile medical assets, 

6 the Secretary may acquire, deploy, and operate mobile 

7 medical assets if, taking into consideration the evaluation 

8 conducted under subsection (a), such acquisition, deploy9 ment, and operation is determined to be beneficial and fea10 sible in 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. 

14 ‘‘(c) USING FEDERAL FACILITIES TO ENHANCE

15 MEDICAL SURGE CAPACITY.— 

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

17 an analysis of whether there are Federal facilities 

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

19 could practicably be used as facilities in which to 

20 provide health care. 

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

22 based on the analysis conducted under paragraph 

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

24 facilities which, in the event of a public health emer25 gency, could be used as facilities in which to provide 


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

2 such facility, seek to conclude a memorandum of un3 derstanding with the head of the Department or 

4 agency that operates such facility that permits the 

5 use of such facility to provide health care in the 

6 event of a public health emergency.’’. 

7 (b) EMTALA.— 

8 (1) IN GENERAL.—Section 1135(b) of the So9 cial Security Act (42 U.S.C. 1320b–5(b)) is amend10 ed— 

11 (A) in paragraph (3), by striking subpara12 graph (B) and inserting the following: 

13 ‘‘(B) the direction or relocation of an indi14 vidual to receive medical screening in an alter15 native location— 

16 ‘‘(i) pursuant to an appropriate State 

17 emergency preparedness plan; or 

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

19 emergency described in subsection 

20 (g)(1)(B) that involves a pandemic infec21 tious disease, pursuant to a State pan22 demic preparedness plan or a plan referred 

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

24 the State;’’; 


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

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

3 in the case of a waiver or modification to which 

4 the fifth sentence of this subsection applies, 

5 shall be limited to’’; and 

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

7 a public health emergency described in sub8 section (g)(1)(B) involves a pandemic infectious 

9 disease (such as pandemic influenza), the dura10 tion of a waiver or modification under para11 graph (3) shall be determined in accordance 

12 with subsection (e) as such subsection applies 

13 to public health emergencies.’’. 

14 (2) EFFECTIVE DATE.—The amendments made 

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

16 enactment of this Act and shall apply to public 

17 health emergencies declared pursuant to section 319 

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

19 on or after such date. 

20 SEC. 303. ENCOURAGING HEALTH PROFESSIONAL VOLUN21 TEERS. 

22 (a) VOLUNTEER MEDICAL RESERVE CORPS.—Title 

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

24 300hh–11 et seq.), as amended by this Act, is amended 

25 by inserting after section 2812 the following: 


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

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

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

4 Preparedness Act, the Secretary, in collaboration with 

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

6 and tribal programs in existence on the date of enactment 

7 of such Act to establish and maintain a Medical Reserve 

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

9 for an adequate supply of volunteers in the case of a Fed10 eral, State, local, or tribal public health emergency. The 

11 Corps shall be headed by a Director who shall be ap12 pointed by the Secretary and shall oversee the activities 

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

14 tribal levels. 

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

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

17 and tribal teams and shall not alter such teams. 

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

19 individuals who— 

20 ‘‘(1)(A) are health professionals who have ap21 propriate professional training and expertise as de22 termined appropriate by the Director of the Corps; 

23 or 

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

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1 ity to facilitate access to health care services in a 

2 public health emergency; 

3 ‘‘(2) are certified in accordance with the certifi4 cation program developed under subsection (d); 

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

6 ‘‘(4) have registered and carry out training ex7 ercises with a local chapter of the Medical Reserve 

8 Corps; and 

9 ‘‘(5) indicate whether they are willing to be de10 ployed outside the area in which they reside in the 

11 event of a public health emergency. 

12 ‘‘(d) CERTIFICATION; DRILLS.— 

13 ‘‘(1) CERTIFICATION.—The Director, in collabo14 ration with State, local, and tribal officials, shall es15 tablish a process for the periodic certification of in16 dividuals who volunteer for the Corps, as determined 

17 by the Secretary, which shall include the completion 

18 by each individual of the core training programs de19 veloped under section 319F, as required by the Di20 rector. Such certification shall not supercede State 

21 licensing or credentialing requirements. 

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

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

24 in order to facilitate the integration of trained volun25 teers into the health care system at the local level, 


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1 Corps members shall engage in periodic training ex2 ercises to be carried out at the local level. 

3 ‘‘(e) DEPLOYMENT.—During a public health emer4 gency, the Secretary shall have the authority to activate 

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

6 taking into consideration the public health and medical ex7 pertise required, with the concurrence of the State, local, 

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

9 ‘‘(f) EXPENSES AND TRANSPORTATION.—While en10 gaged in performing duties as a member of the Corps pur11 suant to an assignment by the Secretary (including peri12 ods of travel to facilitate such assignment), members of 

13 the Corps who are not otherwise employed by the Federal 

14 Government shall be allowed travel or transportation ex15 penses, including per diem in lieu of subsistence. 

16 ‘‘(g) IDENTIFICATION.—The Secretary, in coopera17 tion and consultation with the States, shall develop a Med18 ical Reserve Corps Identification Card that describes the 

19 licensure and certification information of Corps members, 

20 as well as other identifying information determined nec21 essary by the Secretary. 

22 ‘‘(h) INTERMITTENT DISASTER-RESPONSE PER23 SONNEL.— 

24 ‘‘(1) IN GENERAL.—For the purpose of assist25 ing the Corps in carrying out duties under this secVerDate Aug 31 2005 23:09 Aug 04, 2006 Jkt 049200 PO 00000 Frm 00059 Fmt 6652 Sfmt 6401 E:\BILLS\S3678.RS S3678

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1 tion, during a public health emergency, the Sec2 retary may appoint selected individuals to serve as 

3 intermittent personnel of such Corps in accordance 

4 with applicable civil service laws and regulations. In 

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

6 the laws of the State in which the activities of the 

7 Corps are undertaken. 

8 ‘‘(2) APPLICABLE PROTECTIONS.—Subsections 

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

10 individual appointed under paragraph (1) in the 

11 same manner as such subsections apply to an indi12 vidual appointed under section 2812(c). 

13 ‘‘(3) LIMITATION.—State, local, and tribal offi14 cials shall have no authority to designate a member 

15 of the Corps as Federal intermittent disaster-re16 sponse personnel, but may request the services of 

17 such members. 

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

19 authorized to be appropriated to carry out this section, 

20 $22,000,000 for fiscal year 2007, and such sums as may 

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

22 (b) ENCOURAGING HEALTH PROFESSIONS VOLUN23 TEERS.—Section 319I of the Public Health Service Act 

24 (42 U.S.C. 247d–7b) is amended— 


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

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

3 (2) by striking subsections (a) and (b) and in4 serting the following: 

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

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

7 Preparedness Act, the Secretary shall link existing State 

8 verification systems to maintain a single national inter9 operable network of systems, each system being main10 tained by a State or group of States, for the purpose of 

11 verifying the credentials and licenses of health care profes12 sionals who volunteer to provide health services during a 

13 public health emergency (such network shall be referred 

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

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

16 systems established under subsection (a) shall include— 

17 ‘‘(1) with respect to each volunteer health pro18 fessional included in the system— 

19 ‘‘(A) information necessary for the rapid 

20 identification of, and communication with, such 

21 professionals; and 

22 ‘‘(B) the credentials, certifications, li23 censes, and relevant training of such individ24 uals; and 


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

2 Reserve Corps, the National Disaster Medical Sys3 tem, and any other relevant federally-sponsored or 

4 administered programs determined necessary by the 

5 Secretary.’’; 

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

7 following: 

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

9 that the network established under subsection (a) is elec10 tronically accessible by State, local, and tribal health de11 partments and can be linked with the identification cards 

12 under section 2813. 

13 ‘‘(e) CONFIDENTIALITY.—The Secretary shall estab14 lish and require the application of and compliance with 

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

16 and access to the data included in the network. 

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

18 with the Secretary of Veterans Affairs and the Secretary 

19 of Homeland Security to assess the feasibility of inte20 grating the verification network under this section with 

21 the VetPro system of the Department of Veterans Affairs 

22 and the National Emergency Responder Credentialing 

23 System of the Department of Homeland Security. The 

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1 work under this section with such VetPro system and the 

2 National Emergency Responder Credentialing System. 

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

4 are participants in the network established under sub5 section (a) shall, on at least a quarterly basis, work with 

6 the Director to provide for the updating of the information 

7 contained in such network. 

8 ‘‘(h) CLARIFICATION.—Inclusion of a health profes9 sional in the verification network established pursuant to 

10 this section shall not constitute appointment of such indi11 vidual as a Federal employee for any purpose, either under 

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

13 be made under section 2812 or 2813. 

14 ‘‘(i) HEALTH CARE PROVIDER LICENSES.—The Sec15 retary shall encourage States to establish and implement 

16 mechanisms to waive the application of licensing require17 ments applicable to health professionals, who are seeking 

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

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

20 emergency upon verification that such health professionals 

21 are licensed and in good standing in another State and 

22 have not been disciplined by any State health licensing or 

23 disciplinary board.’’; and 

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

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


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1 SEC. 304. CORE EDUCATION AND TRAINING. 

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

3 U.S.C. 247d–6) is amended— 

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

5 inserting the following; 

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

7 RESPONSE CURRICULA AND TRAINING.— 

8 ‘‘(1) IN GENERAL.—The Secretary, in collabo9 ration with the Secretary of Defense, and in con10 sultation with relevant public and private entities, 

11 shall develop core health and medical response cur12 ricula and trainings by adapting applicable existing 

13 curricula and training programs to improve re14 sponses to public health emergencies. 

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

16 medical response training program may include 

17 course work related to— 

18 ‘‘(A) medical management of casualties, 

19 taking into account the needs of at-risk individ20 uals; 

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

22 emergencies; 

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

24 emergencies; 

25 ‘‘(D) national incident management, in26 cluding coordination among Federal, State, 


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1 local, tribal, international agencies, and other 

2 entities; and 

3 ‘‘(E) protecting health care workers and 

4 health care first responders from workplace ex5 posures during a public health emergency. 

6 ‘‘(3) PEER REVIEW.—On a periodic basis, prod7 ucts prepared as part of the program shall be rigor8 ously tested and peer-reviewed by experts in the rel9 evant fields. 

10 ‘‘(4) CREDIT.—The Secretary and the Sec11 retary of Defense shall— 

12 ‘‘(A) take into account continuing profes13 sional education requirements of public health 

14 and healthcare professions; and 

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

16 accrediting agencies and with professional asso17 ciations in arranging for students enrolled in 

18 the program to obtain continuing professional 

19 education credit for program courses. 

20 ‘‘(5) DISSEMINATION AND TRAINING.— 

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

22 provide for the dissemination and teaching of 

23 the materials described in paragraphs (1) and 

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

25 Secretary. 


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

2 and training activities described in subpara3 graph (A) may be carried out by Federal public 

4 health or medical entities, appropriate edu5 cational entities, professional organizations and 

6 societies, private accrediting organizations, and 

7 other nonprofit institutions or entities meeting 

8 criteria established by the Secretary. 

9 ‘‘(C) GRANTS AND CONTRACTS.—In car10 rying out this subsection, the Secretary may 

11 carry out activities directly or through the 

12 award of grants and contracts, and may enter 

13 into interagency agreements with other Federal 

14 agencies. 

15 ‘‘(b) EXPANSION OF EPIDEMIC INTELLIGENCE SERV16 ICE PROGRAM.—The Secretary may establish 20 officer 

17 positions in the Epidemic Intelligence Service Program, in 

18 addition to the number of the officer positions offered 

19 under such Program in 2006 for individuals who agree 

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

21 the Career Epidemiology Field Officer program in a State, 

22 local, or tribal health department that serves a health pro23 fessional shortage area (as defined under section 332(a)), 

24 a medically underserved population (as defined under sec25 tion 330(b)(3)), or a medically underserved area or area 


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1 at high risk of a public health emergency as designated 

2 by the Secretary. 

3 ‘‘(c) CENTERS FOR PUBLIC HEALTH PREPARED4 NESS; CORE CURRICULA AND TRAINING.— 

5 ‘‘(1) IN GENERAL.—The Secretary may estab6 lish at accredited schools of public health, Centers 

7 for Public Health Preparedness (hereafter referred 

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

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

10 award under this subsection to establish a Center, 

11 an accredited school of public health shall agree to 

12 conduct activities consistent with the requirements 

13 of this subsection. 

14 ‘‘(3) CORE CURRICULA.—The Secretary, in col15 laboration with the Centers and other public or pri16 vate entities shall establish core curricula based on 

17 established competencies leading to a 4-year bach18 elor’s degree, a graduate degree, a combined bach19 elor and master’s degree, or a certificate program, 

20 for use by each Center. The Secretary shall dissemi21 nate such curricula to other accredited schools of 

22 public health and other health professions schools 

23 determined appropriate by the Secretary, for vol24 untary use by such schools. 


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1 ‘‘(4) CORE COMPETENCY-BASED TRAINING PRO2 GRAM.—The Secretary, in collaboration with the 

3 Centers and other public or private entities shall fa4 cilitate the development of a competency-based train5 ing program to train public health practitioners. The 

6 Centers shall use such training program to train 

7 public health practitioners. The Secretary shall dis8 seminate such training program to other accredited 

9 schools of public health, and other health professions 

10 schools as determined by the Secretary, for vol11 untary use by such schools. 

12 ‘‘(5) CONTENT OF CORE CURRICULA AND

13 TRAINING PROGRAM.—The Secretary shall ensure 

14 that the core curricula and training program estab15 lished pursuant to this subsection respond to the 

16 needs of State, local, and tribal public health au17 thorities and integrate and emphasize essential pub18 lic health security capabilities consistent with section 

19 2802(b)(2). 

20 ‘‘(6) ACADEMIC-WORKFORCE COMMUNICA21 TION.—As a condition of receiving funding from the 

22 Secretary under this subsection, a Center shall col23 laborate with a State, local, or tribal public health 

24 department to— 


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1 ‘‘(A) define the public health preparedness 

2 and response needs of the community involved; 

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

4 are fulfilled by existing preparedness and re5 sponse activities of such school or health de6 partment, and how such activities may be im7 proved; 

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

9 trainings, evaluate and utilize relevant materials 

10 and trainings developed by others Centers; and 

11 ‘‘(D) evaluate community impact and the 

12 effectiveness of any newly developed materials 

13 or trainings. 

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

15 consultation with relevant public and private enti16 ties, the Secretary shall define the existing knowl17 edge base for public health preparedness and re18 sponse systems, and establish a research agenda 

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

20 health preparedness priorities. As a condition of re21 ceiving funding from the Secretary under this sub22 section, a Center shall conduct public health systems 

23 research that is consistent with the agenda described 

24 under this paragraph.’’; 


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1 (2) by redesignating subsection (h) as sub2 section (d); 

3 (3) by inserting after subsection (d) (as so re4 designated), the following: 

5 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.— 

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

7 to be appropriated to carry out this section for fiscal 

8 year 2007— 

9 ‘‘(A) to carry out subsection (a), 

10 $12,000,000, of which $5,000,000 shall be used 

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

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

13 carry out paragraph (5) of such subsection; 

14 ‘‘(B) to carry out subsection (b), 

15 $3,000,000; and 

16 ‘‘(C) to carry out subsection (c), 

17 $31,000,000, of which $5,000,000 shall be used 

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

19 subsection. 

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

21 authorized to be appropriated such sums as may be 

22 necessary to carry out this section for fiscal year 

23 2008 and each subsequent fiscal year.’’; and 

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


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1 SEC. 305. PARTNERSHIPS FOR STATE AND REGIONAL HOS2 PITAL PREPAREDNESS TO IMPROVE SURGE 

3 CAPACITY. 

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

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

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

7 HOSPITAL PREPAREDNESS TO IMPROVE 

8 SURGE CAPACITY. 

9 ‘‘(a) IN GENERAL.—The Secretary shall award com10 petitive grants or cooperative agreements to eligible enti11 ties to enable such entities to improve surge capacity and 

12 enhance community and hospital preparedness for public 

13 health emergencies. 

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

15 subsection (a), an entity shall— 

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

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

18 which shall be a designated trauma center, con19 sistent with section 1213(c); 

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

21 facilities, including clinics, health centers, pri22 mary care facilities, mental health centers, mo23 bile medical assets, or nursing homes; and 

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

25 ‘‘(II) one or more States; or 


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

2 political subdivisions; and 

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

4 Executive Officer and the lead health officials of the 

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

6 health care facilities described in subparagraph (A) 

7 are located, and submit to the Secretary, an applica8 tion at such time, in such manner, and containing 

9 such information as the Secretary may require; or 

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

11 1(b)(1); and 

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

13 such manner, and containing such information as 

14 the Secretary may require, including the information 

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

16 and an assurance that the State will retain not more 

17 than 25 percent of the funds awarded for adminis18 trative and other support functions. 

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

20 (a) shall be expended for activities to achieve the prepared21 ness goals described under paragraphs (1), (3), (4), (5), 

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

23 ‘‘(d) PREFERENCES.— 

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

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


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1 preference to eligible entities that submit applica2 tions that, in the determination of the Secretary— 

3 ‘‘(A) will enhance coordination— 

4 ‘‘(i) among the entities described in 

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

6 ‘‘(ii) between such entities and the en7 tities described in subsection (b)(1)(A)(ii); 

8 and 

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

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

11 of the hospitals and health care facilities within 

12 the geographic area served by such partnership. 

13 ‘‘(2) OTHER PREFERENCES.—In making 

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

15 preference to eligible entities that, in the determina16 tion of the Secretary— 

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

18 participants in the National Disaster Medical 

19 System; 

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

21 faces a high degree of risk, as determined by 

22 the Secretary in consultation with the Secretary 

23 of Homeland Security; or 


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

2 achieve the medical preparedness goals de3 scribed in section 2802(b)(2). 

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

5 Secretary may not award a cooperative agreement to an 

6 eligible entity described in subsection (b)(1) unless the ap7 plication submitted by the entity is coordinated and con8 sistent with an applicable State All-Hazards Public Health 

9 Emergency Preparedness and Response Plan and relevant 

10 local plans, as determined by the Secretary in consultation 

11 with relevant State health officials. 

12 ‘‘(f) LIMITATION ON AWARDS.—A political subdivi13 sion shall not participate in more than one partnership 

14 described in subsection (b)(1). 

15 ‘‘(g) COORDINATION WITH LOCAL RESPONSE CAPA16 BILITIES.—An eligible entity shall, to the extent prac17 ticable, ensure that activities carried out under an award 

18 under subsection (a) are coordinated with activities of rel19 evant local Metropolitan Medical Response Systems, local 

20 Medical Reserve Corps, the Cities Readiness Initiative, 

21 and local emergency plans. 

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

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

24 award under this section shall maintain expenditures 

25 for health care preparedness at a level that is not 


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1 less than the average level of such expenditures 

2 maintained by the entity for the preceding 2 year 

3 period. 

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

5 this section shall be construed to prohibit the use of 

6 awards under this section to pay salary and related 

7 expenses of public health and other professionals 

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

9 carrying out activities supported by such awards (re10 gardless of whether the primary assignment of such 

11 personnel is to carry out such activities). 

12 ‘‘(i) PERFORMANCE AND ACCOUNTABILITY.—The re13 quirements of section 319C–1(g) and (i) shall apply to en14 tities receiving awards under this section (regardless of 

15 whether such entities are described under subsection 

16 (b)(1)(A) or (b)(2)(A)) in the same manner as such re17 quirements apply to entities under section 319C–1. 

18 ‘‘(j) AUTHORIZATION OF APPROPRIATIONS.— 

19 ‘‘(1) IN GENERAL.—For the purpose of car20 rying out this section, there is authorized to be ap21 propriated $474,000,000 for fiscal year 2007, and 

22 such sums as may be necessary for each of fiscal 

23 years 2008 through 2011. 

24 ‘‘(2) RESERVATION OF AMOUNTS FOR PART25 NERSHIPS.—Prior to making awards described in 


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

2 amount appropriated under paragraph (1) for a fis3 cal year, an amount determined appropriate by the 

4 Secretary for making awards to entities described in 

5 subsection (b)(1)(A). 

6 ‘‘(3) AWARDS TO STATES AND POLITICAL SUB7 DIVISIONS.— 

8 ‘‘(A) IN GENERAL.—From amounts appro9 priated for a fiscal year under paragraph (1) 

10 and not reserved under paragraph (2), the Sec11 retary shall make awards to entities described 

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

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

14 ‘‘(B) AMOUNT.—The Secretary shall deter15 mine the amount of an award to each entity de16 scribed in subparagraph (A) in the same man17 ner as such amounts are determined under sec18 tion 319C–1(h).’’. 

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

20 VETERANS AFFAIRS. 

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

22 States Code, is amended— 

23 (1) in subsection (a)— 

24 (A) in paragraph (1), by— 


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1 (i) striking ‘‘chemical or biological at2 tack’’ and inserting ‘‘a public health emer3 gency (as defined in section 2801 of the 

4 Public Health Service Act)’’; 

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

6 ‘‘such an emergency’’; and 

7 (iii) striking ‘‘public health emer8 gencies’’ and inserting ‘‘such emergencies’’; 

9 and 

10 (B) in paragraph (2)— 

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

12 and’’ and inserting a semicolon; 

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

14 the period and inserting a semicolon; and 

15 (iii) by adding at the end the fol16 lowing: 

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

18 the staff of such centers to support the activi19 ties carried out by the Secretary of Health and 

20 Human Services under section 2801 of the 

21 Public Health Service Act in the event of a pub22 lic health emergency and incidents covered by 

23 the National Response Plan developed pursuant 

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

25 of 2002, or any successor plan; and 


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1 ‘‘(D) providing medical logistical support 

2 to the National Disaster Medical System and 

3 the Secretary of Health and Human Services as 

4 necessary, on a reimbursable basis, and in co5 ordination with other designated Federal agen6 cies.’’; 

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

8 biological attack or other terrorist attack.’’ and in9 serting ‘‘a public health emergency. The Secretary 

10 shall, through existing medical procurement con11 tracts, and on a reimbursable basis, make available 

12 as necessary, medical supplies, equipment, and phar13 maceuticals in response to a public health emergency 

14 in support of the Secretary of Health and Human 

15 Services.’’; 

16 (3) in subsection (d), by— 

17 (A) striking ‘‘develop and’’; 

18 (B) striking ‘‘biological, chemical, or radio19 logical attacks’’ and inserting ‘‘public health 

20 emergencies’’; and 

21 (C) by inserting ‘‘consistent with section 

22 319F(a) of the Public Health Service Act’’ be23 fore the period; and 

24 (4) in subsection (e)— 


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

2 ‘‘2811(b)’’ and inserting ‘‘2812’’; and 

3 (B) in paragraph (2)— 

4 (i) by striking ‘‘bioterrorism and 

5 other’’; and 

6 (ii) by striking ‘‘319F(a)’’ and insert7 ing ‘‘319F’’. 

8 (b) AUTHORIZATION OF APPROPRIATIONS.—Section 

9 8117 of title 38, United States Code, is amended by add10 ing at the end the following: 

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

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

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

14 2007 through 2011.’’. 

15 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

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

17 ‘‘Pandemic and All-Hazards Preparedness Act’’. 

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

19 Act is as follows: 

Sec. 1. Short title; table of contents. 

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. 


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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: 

12 ‘‘TITLE XXVIII—NATIONAL ALL13 HAZARDS PREPAREDNESS 

14 FOR PUBLIC HEALTH EMER15 GENCIES’’; 

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


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1 ‘‘Subtitle A—National All-Hazards 

2 Preparedness and Response 

3 Planning, Coordinating, and Re4 porting 

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

6 AND RESPONSE FUNCTIONS. 

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

8 Human Services shall lead all Federal public health and 

9 medical response to public health emergencies and incidents 

10 covered by the National Response Plan developed pursuant 

11 to section 502(6) of the Homeland Security Act of 2002, 

12 or any successor plan. 

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

14 collaboration with the Secretary of Veterans Affairs, the 

15 Secretary of Transportation, the Secretary of Defense, the 

16 Secretary of Homeland Security, and the head of any other 

17 relevant Federal agency, shall establish an interagency 

18 agreement, consistent with the National Response Plan or 

19 any successor plan, under which agreement the Secretary 

20 of Health and Human Services shall assume operational 

21 control of emergency public health and medical response as22 sets, as necessary, in the event of a public health emer23 gency.’’. 


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1 SEC. 102. ASSISTANT SECRETARY FOR PREPAREDNESS AND 

2 RESPONSE. 

3 (a) ASSISTANT SECRETARY FOR PREPAREDNESS AND

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

5 Health Service Act (42 U.S.C. 300hh–11 et seq.) is amend6 ed— 

7 (1) in the subtitle heading, by inserting ‘‘All8 Hazards’’ before ‘‘Emergency Preparedness’’; 

9 (2) by redesignating section 2811 as section 

10 2812; 

11 (3) by inserting after the subtitle heading the fol12 lowing new section: 

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

14 RESPONSE TO ALL-HAZARDS PUBLIC HEALTH 

15 EMERGENCIES. 

16 ‘‘(a) IN GENERAL.—There is established within the De17 partment of Health and Human Services the position of 

18 the Assistant Secretary for Preparedness and Response. The 

19 President, with the advice and consent of the Senate, shall 

20 appoint an individual to serve in such position. Such As21 sistant Secretary shall report to the Secretary. 

22 ‘‘(b) DUTIES.—Subject to the authority of the Sec23 retary, the Assistant Secretary for Preparedness and Re24 sponse shall carry out the following functions: 

25 ‘‘(1) LEADERSHIP.—Serve as the principal advi26 sor to the Secretary on all matters related to Federal 


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1 public health and medical preparedness and response 

2 for public health emergencies. 

3 ‘‘(2) PERSONNEL.—Register, credential, orga4 nize, train, equip, and have the authority to deploy 

5 Federal public health and medical personnel under 

6 the authority of the Secretary, including the National 

7 Disaster Medical System, and coordinate such per8 sonnel with the Medical Reserve Corps and the Emer9 gency System for Advance Registration of Volunteer 

10 Health Professionals. 

11 ‘‘(3) COUNTERMEASURES.— 

12 ‘‘(A) OVERSIGHT.—Oversee advanced re13 search, development, and procurement of quali14 fied countermeasures (as defined in section 

15 319F–1) and qualified pandemic or epidemic 

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

17 ‘‘(B) STRATEGIC NATIONAL STOCKPILE.— 

18 Maintain the Strategic National Stockpile in ac19 cordance with section 319F–2, including con20 ducting an annual review (taking into account 

21 at-risk individuals) of the contents of the stock22 pile, including non-pharmaceutical supplies, and 

23 make necessary additions or modifications to the 

24 contents based on such review. 

25 ‘‘(4) COORDINATION.— 


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1 ‘‘(A) FEDERAL INTEGRATION.—Coordinate 

2 with relevant Federal officials to ensure integra3 tion of Federal preparedness and response activi4 ties for public health emergencies. 

5 ‘‘(B) STATE, LOCAL, AND TRIBAL INTEGRA6 TION.—Coordinate with State, local, and tribal 

7 public health officials, the Emergency Manage8 ment Assistance Compact, health care systems, 

9 and emergency medical service systems to ensure 

10 effective integration of Federal public health and 

11 medical assets during a public health emergency. 

12 ‘‘(C) EMERGENCY MEDICAL SERVICES.— 

13 Promote improved emergency medical services 

14 medical direction, system integration, research, 

15 and uniformity of data collection, treatment pro16 tocols, and policies with regard to public health 

17 emergencies. 

18 ‘‘(5) LOGISTICS.—In coordination with the Sec19 retary of Veterans Affairs, the Secretary of Homeland 

20 Security, the General Services Administration, and 

21 other public and private entities, provide logistical 

22 support for medical and public health aspects of Fed23 eral responses to public health emergencies. 

24 ‘‘(6) LEADERSHIP.—Provide leadership in inter25 national programs, initiatives, and policies that deal 


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1 with public health and medical emergency prepared2 ness and response. 

3 ‘‘(c) FUNCTIONS.—The Assistant Secretary for Pre4 paredness and Response shall— 

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

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

7 following— 

8 ‘‘(A) the National Disaster Medical System 

9 (in accordance with section 301 of the Pandemic 

10 and All-Hazards Preparedness Act); 

11 ‘‘(B) the Hospital Preparedness Cooperative 

12 Agreement Program pursuant to section 319C–2; 

13 and 

14 ‘‘(C) the Public Health Preparedness Coop15 erative Agreement Program pursuant to section 

16 319C–1; 

17 ‘‘(2) exercise the responsibilities and authorities 

18 of the Secretary with respect to the coordination of— 

19 ‘‘(A) the Medical Reserve Corps pursuant to 

20 section 2813; 

21 ‘‘(B) the Emergency System for Advance 

22 Registration of Volunteer Health Professionals 

23 pursuant to section 319I; 

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

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


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1 ‘‘(3) assume other duties as determined appro2 priate by the Secretary.’’; and 

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

4 Health Emergency Preparedness’’ each place it ap5 pears and inserting ‘‘Assistant Secretary for Pre6 paredness and Response’’. 

7 (b) TRANSFER OF FUNCTIONS; REFERENCES.— 

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

9 transferred to the Office of the Assistant Secretary for 

10 Preparedness and Response the functions, personnel, 

11 assets, and liabilities of the Assistant Secretary for 

12 Public Health Emergency Preparedness as in effect on 

13 the day before the date of enactment of this Act. 

14 (2) REFERENCES.—Any reference in any Federal 

15 law, Executive order, rule, regulation, or delegation of 

16 authority, or any document of or pertaining to the 

17 Assistant Secretary for Public Health Emergency Pre18 paredness as in effect the day before the date of enact19 ment of this Act, shall be deemed to be a reference to 

20 the Assistant Secretary for Preparedness and Re21 sponse. 

22 SEC. 103. NATIONAL HEALTH SECURITY STRATEGY. 

23 Title XXVIII of the Public Health Service Act (300hh– 

24 11 et seq.), as amended by section 101, is amended by in25 serting after section 2801 the following: 


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

2 ‘‘(a) IN GENERAL.— 

3 ‘‘(1) PREPAREDNESS AND RESPONSE REGARDING

4 PUBLIC HEALTH EMERGENCIES.—Beginning in 2009 

5 and every four years thereafter, the Secretary shall 

6 prepare and submit to the relevant Committees of 

7 Congress a coordinated strategy and any revisions 

8 thereof, and an accompanying implementation plan 

9 for public health emergency preparedness and re10 sponse. The strategy shall identify the process for 

11 achieving the preparedness goals described in sub12 section (b) and shall be consistent with the National 

13 Preparedness Goal, the National Incident Manage14 ment System, and the National Response Plan devel15 oped pursuant to section 502(6) of the Homeland Se16 curity Act of 2002, or any successor plan. 

17 ‘‘(2) EVALUATION OF PROGRESS.—The National 

18 Health Security Strategy shall include an evaluation 

19 of the progress made by Federal, State, local, and 

20 tribal entities, based on the evidence-based bench21 marks and objective standards that measure levels of 

22 preparedness established pursuant to section 319C– 

23 1(g). Such evaluation shall include aggregate and 

24 State-specific breakdowns of obligated funding spent 

25 by major category (as defined by the Secretary) for 


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1 activities funded through awards pursuant to sections 

2 319C–1 and 319C–2. 

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

4 the National Health Security Strategy shall include a 

5 national strategy for establishing an effective and pre6 pared public health workforce, including defining the 

7 functions, capabilities, and gaps in such workforce, 

8 and identifying strategies to recruit, retain, and pro9 tect such workforce from workplace exposures during 

10 public health emergencies. 

11 ‘‘(b) PREPAREDNESS GOALS.—The strategy under sub12 section (a) shall include provisions in furtherance of the fol13 lowing: 

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

15 and public and private medical capabilities with 

16 other first responder systems, including through— 

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

18 State, local, and tribal preparedness and re19 sponse capabilities through drills and exercises; 

20 and 

21 ‘‘(B) integrating public and private sector 

22 public health and medical donations and volun23 teers. 

24 ‘‘(2) PUBLIC HEALTH.—Developing and sus25 taining Federal, State, local, and tribal essential pubVerDate Aug 31 2005 02:47 Aug 05, 2006 Jkt 049200 PO 00000 Frm 00088 Fmt 6652 Sfmt 6203 E:\BILLS\S3678.RS S3678

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1 lic health security capabilities, including the fol2 lowing: 

3 ‘‘(A) Disease situational awareness domesti4 cally and abroad, including detection, identifica5 tion, and investigation. 

6 ‘‘(B) Disease containment including capa7 bilities for isolation, quarantine, social 

8 distancing, and decontamination. 

9 ‘‘(C) Risk communication and public pre10 paredness. 

11 ‘‘(D) Rapid distribution and administra12 tion of medical countermeasures. 

13 ‘‘(3) MEDICAL.—Increasing the preparedness, re14 sponse capabilities, and surge capacity of hospitals, 

15 other health care facilities (including mental health 

16 facilities), and trauma care and emergency medical 

17 service systems with respect to public health emer18 gencies, which shall include developing plans for the 

19 following: 

20 ‘‘(A) Strengthening public health emergency 

21 medical management and treatment capabilities. 

22 ‘‘(B) Medical evacuation and fatality man23 agement. 

24 ‘‘(C) Rapid distribution and administra25 tion of medical countermeasures. 


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1 ‘‘(D) Effective utilization of any available 

2 public and private mobile medical assets and in3 tegration of other Federal assets. 

4 ‘‘(E) Protecting health care workers and 

5 health care first responders from workplace expo6 sures during a public health emergency. 

7 ‘‘(4) AT-RISK INDIVIDUALS.— 

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

9 and medical needs of at-risk individuals in the 

10 event of a public health emergency. 

11 ‘‘(B) For purpose of the Pandemic and All12 Hazards Preparedness Act, the term ‘at-risk in13 dividuals’ means children, pregnant women, sen14 ior citizens and other individuals who have spe15 cial needs in the event of a public health emer16 gency, as determined by the Secretary. 

17 ‘‘(5) COORDINATION.—Minimizing duplication 

18 of, and ensuring coordination between Federal, State, 

19 local, and tribal planning, preparedness, and response 

20 activities (including the State Emergency Manage21 ment Assistance Compact). Such planning shall be 

22 consistent with the National Response Plan, or any 

23 successor plan, and National Incident Management 

24 System and the National Preparedness Goal. 


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1 ‘‘(6) CONTINUITY OF OPERATIONS.—Maintaining 

2 vital public health and medical services to allow for 

3 optimal Federal, State, local, and tribal operations in 

4 the event of a public health emergency.’’. 

5 TITLE II—PUBLIC HEALTH 

6 SECURITY PREPAREDNESS 

7 SEC. 201. IMPROVING STATE AND LOCAL PUBLIC HEALTH 

8 SECURITY. 

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

10 U.S.C. 247d–3a) is amended— 

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

12 ‘‘IMPROVING STATE AND LOCAL PUBLIC

13 HEALTH SECURITY.’’; 

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

15 inserting the following: 

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

17 United States with respect to public health emergencies, the 

18 Secretary shall award cooperative agreements to eligible en19 tities to enable such entities to conduct the activities de20 scribed in subsection (d). 

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

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

23 ‘‘(1)(A) be a State; 

24 ‘‘(B) be a political subdivision determined by the 

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1 tion (based on criteria described in subsection (h)(4)); 

2 or 

3 ‘‘(C) be a consortium of entities described in sub4 paragraph (A); and 

5 ‘‘(2) prepare and submit to the Secretary an ap6 plication at such time, and in such manner, and con7 taining such information as the Secretary may re8 quire, including— 

9 ‘‘(A) an All-Hazards Public Health Emer10 gency Preparedness and Response Plan which 

11 shall include— 

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

13 entity will carry out under the agreement to 

14 meet the goals identified under section 2802; 

15 ‘‘(ii) a pandemic influenza plan con16 sistent with the requirements of paragraphs 

17 (2) and (5) of subsection (g); 

18 ‘‘(iii) preparedness and response strat19 egies and capabilities that take into account 

20 the medical and public health needs of at21 risk individuals in the event of a public 

22 health emergency; 

23 ‘‘(iv) a description of the mechanism 

24 the entity will implement to utilize the 

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1 pact or other mutual aid agreements for 

2 medical and public health mutual aid; and 

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

4 will include the State Area Agency on 

5 Aging in public health emergency prepared6 ness; 

7 ‘‘(B) an assurance that the entity will re8 port to the Secretary on an annual basis (or 

9 more frequently as determined by the Secretary) 

10 on the evidence-based benchmarks and objective 

11 standards established by the Secretary to evalu12 ate the preparedness and response capabilities of 

13 such entity; 

14 ‘‘(C) an assurance that the entity will con15 duct, on at least an annual basis, an exercise or 

16 drill that meets any criteria established by the 

17 Secretary to test the preparedness and response 

18 capabilities of such entity, and that the entity 

19 will report back to the Secretary within the ap20 plication of the following year on the strengths 

21 and weaknesses identified through such exercise 

22 or drill, and corrective actions taken to address 

23 material weaknesses; 

24 ‘‘(D) an assurance that the entity will pro25 vide to the Secretary the data described under 


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1 section 319D(d)(3) as determined feasible by the 

2 Secretary; 

3 ‘‘(E) an assurance that the entity will con4 duct activities to inform and educate the hos5 pitals within the jurisdiction of such entity on 

6 the role of such hospitals in the plan required 

7 under subparagraph (A); 

8 ‘‘(F) an assurance that the entity, with re9 spect to the plan described under subparagraph 

10 (A), has developed and will implement an ac11 countability system to ensure that such entity 

12 make satisfactory annual improvement and de13 scribe such system in the plan under subpara14 graph (A); 

15 ‘‘(G) a description of the means by which to 

16 obtain public comment and input on the plan 

17 described in subparagraph (A) and on the imple18 mentation of such plan, that shall include an ad19 visory committee or other similar mechanism for 

20 obtaining comment from the public and from 

21 other State, local, and tribal stakeholders; and 

22 ‘‘(H) as relevant, a description of the proc23 ess used by the entity to consult with local de24 partments of public health to reach consensus, 


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1 approval, or concurrence on the relative distribu2 tion of amounts received under this section. 

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

4 Secretary may not award a cooperative agreement to a 

5 State unless such State is a participant in the Emergency 

6 System for Advance Registration of Volunteer Health Pro7 fessionals described in section 319I. 

8 ‘‘(d) USE OF FUNDS.— 

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

10 (a) shall be expended for activities to achieve the pre11 paredness goals described under paragraphs (1), (2), 

12 (4), (5), and (6) of section 2802(b). 

13 ‘‘(2) EFFECT OF SECTION.—Nothing in this sub14 section may be construed as establishing new regu15 latory authority or as modifying any existing regu16 latory authority. 

17 ‘‘(e) COORDINATION WITH LOCAL RESPONSE CAPA18 BILITIES.—An entity shall, to the extent practicable, ensure 

19 that activities carried out under an award under subsection 

20 (a) are coordinated with activities of relevant Metropolitan 

21 Medical Response Systems, local public health departments, 

22 the Cities Readiness Initiative, and local emergency plans. 

23 ‘‘(f) CONSULTATION WITH HOMELAND SECURITY.—In 

24 making awards under subsection (a), the Secretary shall 

25 consult with the Secretary of Homeland Security to— 


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1 ‘‘(1) ensure maximum coordination of public 

2 health and medical preparedness and response activi3 ties with the Metropolitan Medical Response System, 

4 and other relevant activities; 

5 ‘‘(2) minimize duplicative funding of programs 

6 and activities; 

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

8 drills, conducted under this section to develop rec9 ommendations and guidance on best practices for 

10 such activities, and 

11 ‘‘(4) disseminate such recommendations and 

12 guidance, including through expanding existing les13 sons learned information systems to create a single 

14 Internet-based point of access for sharing and distrib15 uting medical and public health best practices and 

16 lessons learned from drills, exercises, disasters, and 

17 other emergencies. 

18 ‘‘(g) ACHIEVEMENT OF MEASURABLE EVIDENCE19 BASED BENCHMARKS AND OBJECTIVE STANDARDS.— 

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

21 after the date of enactment of the Pandemic and All22 Hazards Preparedness Act, the Secretary shall develop 

23 or where appropriate adopt, and require the applica24 tion of measurable evidence-based benchmarks and ob25 jective standards that measure levels of preparedness 


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1 with respect to the activities described in this section 

2 and with respect to activities described in section 

3 319C–2. In developing such benchmarks and stand4 ards, the Secretary shall consult with and seek com5 ments from State, local, and tribal officials and pri6 vate entities, as appropriate. Where appropriate, the 

7 Secretary shall incorporate existing objective stand8 ards. Such benchmarks and standards shall, at a 

9 minimum, require entities to— 

10 ‘‘(A) demonstrate progress toward achieving 

11 the preparedness goals described in section 2802 

12 in a reasonable timeframe determined by the 

13 Secretary; 

14 ‘‘(B) annually report grant expenditures to 

15 the Secretary (in a form prescribed by the Sec16 retary) who shall ensure that such information is 

17 included on the Federal Internet-based point of 

18 access developed under subsection (f); and 

19 ‘‘(C) at least annually, test and exercise the 

20 public health and medical emergency prepared21 ness and response capabilities of the grantee, 

22 based on criteria established by the Secretary. 

23 ‘‘(2) CRITERIA FOR PANDEMIC INFLUENZA

24 PLANS.— 


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

2 days after the date of enactment of the Pandemic 

3 and All-Hazards Preparedness Act, the Secretary 

4 shall develop and disseminate to the chief execu5 tive officer of each State criteria for an effective 

6 State plan for responding to pandemic influenza. 

7 ‘‘(B) RULE OF CONSTRUCTION.—Nothing in 

8 this section shall be construed to require the du9 plication of Federal efforts with respect to the de10 velopment of criteria or standards, without re11 gard to whether such efforts were carried out 

12 prior to or after the date of enactment of this sec13 tion. 

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

15 shall, as determined appropriate by the Secretary, 

16 provide to a State, upon request, technical assistance 

17 in meeting the requirements of this section, including 

18 the provision of advice by experts in the development 

19 of high-quality assessments, the setting of State objec20 tives and assessment methods, the development of 

21 measures of satisfactory annual improvement that are 

22 valid and reliable, and other relevant 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 (1) 

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

3 the opportunity to correct such noncompliance. An 

4 entity that fails to correct such noncompliance shall 

5 be subject to paragraph (5). 

6 ‘‘(5) WITHHOLDING OF AMOUNTS FROM ENTITIES

7 THAT FAIL TO ACHIEVE BENCHMARKS OR SUBMIT IN8 FLUENZA PLAN.—Beginning with fiscal year 2009, 

9 and in each succeeding fiscal year, the Secretary 

10 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 the immediately preceding fiscal year (be15 ginning with fiscal year 2008), pursuant to the 

16 process developed under paragraph (4), the 

17 amount described 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 described 

25 in this paragraph are the following amounts that 


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1 are payable to an entity for activities described 

2 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 the 

8 amount the entity was eligible to receive for 

9 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 for 

15 such fiscal year, taking into account the 

16 withholding of funds for the immediately 

17 preceding fiscal year under clause (i). 

18 ‘‘(iii) For the fiscal year immediately 

19 following three consecutive fiscal years in 

20 which an entity experienced such a failure, 

21 an amount equal to 20 percent of the 

22 amount the entity was eligible to receive for 

23 such fiscal year, taking into account the 

24 withholding of funds for the immediately 


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1 preceding fiscal years under clauses (i) and 

2 (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 for 

8 such a fiscal year, taking into account the 

9 withholding of funds for the immediately 

10 preceding fiscal years under clauses (i), (ii), 

11 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 fail15 ure for purposes of calculating amounts withheld 

16 under subparagraph (A). 

17 ‘‘(7) REALLOCATION OF AMOUNTS WITHHELD.— 

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

19 make amounts withheld under paragraph (6) 

20 available for making awards under section 

21 319C–2 to entities described in subsection (b)(1) 

22 of such section. 

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

24 making awards under section 319C–2 with 

25 amounts described in subparagraph (A), the SecVerDate Aug 31 2005 02:47 Aug 05, 2006 Jkt 049200 PO 00000 Frm 00101 Fmt 6652 Sfmt 6203 E:\BILLS\S3678.RS S3678

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1 retary shall give preference to eligible entities (as 

2 described in section 319C–2(b)(1)) that are lo3 cated in whole or in part in States from which 

4 amounts have been withheld under paragraph 

5 (6). 

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

7 Secretary may waive or reduce the withholding de8 scribed in paragraph (6), for a single entity or for all 

9 entities in a fiscal year, if the Secretary determines 

10 that mitigating conditions exist that justify the waiv11 er or reduction.’’; 

12 (3) by redesignating subsection (j) as subsection 

13 (h); 

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

15 (A) by striking paragraphs (1) through 

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

17 ‘‘(1) AUTHORIZATION OF APPROPRIATIONS.— 

18 ‘‘(A) IN GENERAL.—For the purpose of car19 rying out this section, there is authorized to be 

20 appropriated $824,000,000 fiscal year 2007 for 

21 awards pursuant to paragraph (3) (subject to the 

22 authority of the Secretary to make awards pur23 suant to paragraphs (4) and (5)), and such sums 

24 as may be necessary for each of fiscal years 2008 

25 through 2011. 


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1 ‘‘(B) COORDINATION.—There are authorized 

2 to be appropriated, $10,000,000 for fiscal year 

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

4 ‘‘(C) REQUIREMENT FOR STATE MATCHING

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

6 case of any State or consortium of two or more 

7 States, the Secretary may not award a coopera8 tive agreement under this section unless the State 

9 or consortium of States agree that, with respect 

10 to the amount of the cooperative agreement 

11 awarded by the Secretary, the State or consor12 tium of States will make available (directly or 

13 through donations from public or private enti14 ties) non-Federal contributions in an amount 

15 equal to— 

16 ‘‘(i) for the first fiscal year of the coop17 erative agreement, not less than 5 percent of 

18 such costs ($1 for each $20 of Federal funds 

19 provided in the cooperative agreement); and 

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

21 cooperative agreement, and for any subse22 quent fiscal year of such cooperative agree23 ment, not less than 10 percent of such costs 

24 ($1 for each $10 of Federal funds provided 

25 in the cooperative agreement). 


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1 ‘‘(D) DETERMINATION OF AMOUNT OF NON2 FEDERAL CONTRIBUTIONS.—As determined by 

3 the Secretary, non-Federal contributions required 

4 in subparagraph (C) may be provided directly or 

5 through donations from public or private entities 

6 and may be in cash or in kind, fairly evaluated, 

7 including plant, equipment or services. Amounts 

8 provided by the Federal government, or services 

9 assisted or subsidized to any significant extent 

10 by the Federal government, may not be included 

11 in determining the amount of such non-Federal 

12 contributions. 

13 ‘‘(2) MAINTAINING FUNDING.— 

14 ‘‘(A) IN GENERAL.—An entity that receives 

15 an award under this section shall maintain ex16 penditures for public health security at a level 

17 that is not less than the average level of such ex18 penditures maintained by the entity for the pre19 ceding 2 year period. 

20 ‘‘(B) RULE OF CONSTRUCTION.—Nothing in 

21 this section shall be construed to prohibit the use 

22 of awards under this section to pay salary and 

23 related expenses of public health and other pro24 fessionals employed by State, local, or tribal pub25 lic health agencies who are carrying out activiVerDate Aug 31 2005 02:47 Aug 05, 2006 Jkt 049200 PO 00000 Frm 00104 Fmt 6652 Sfmt 6203 E:\BILLS\S3678.RS S3678

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1 ties supported by such awards (regardless of 

2 whether the primary assignment of such per3 sonnel is to carry out such activities). 

4 ‘‘(3) DETERMINATION OF AMOUNT.— 

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

6 award cooperative agreements under subsection 

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

8 States that submits to the Secretary an applica9 tion that meets the criteria of the Secretary for 

10 the receipt of such an award and that meets 

11 other implementation conditions established by 

12 the Secretary for such awards.’’; 

13 (B) in paragraph (4)(A)— 

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

15 ‘‘2007’’; and 

16 (ii) by striking ‘‘(A)(i)(I)’’; 

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

18 ‘‘2002’’ and inserting ‘‘2006’’; 

19 (D) in paragraph (5)— 

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

21 ‘‘2007’’; and 

22 (ii) By striking ‘‘(A)(i)(I)’’; and 

23 (E) by striking paragraph (6) and inserting 

24 the following: 


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1 ‘‘(6) FUNDING OF LOCAL ENTITIES.—The Sec2 retary shall, in making awards under this section, en3 sure that with respect to the cooperative agreement 

4 awarded, the entity make available appropriate por5 tions of such award to political subdivisions and local 

6 departments of public health through a process involv7 ing the consensus, approval or concurrence with such 

8 local entities.’’; and 

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

10 ‘‘(i) ADMINISTRATIVE AND FISCAL RESPONSIBILITY.— 

11 ‘‘(1) ANNUAL REPORTING REQUIREMENTS.— 

12 Each entity shall prepare and submit to the Secretary 

13 annual reports on its activities under this section and 

14 section 319C–2. Each such report shall be prepared 

15 by, or in consultation with, the health department. In 

16 order to properly evaluate and compare the perform17 ance of different entities assisted under this section 

18 and section 319C–2 and to assure the proper expendi19 ture of funds under this section and section 319C–2, 

20 such reports shall be in such standardized form and 

21 contain such information as the Secretary determines 

22 (after consultation with the States) to be necessary 

23 to— 

24 ‘‘(A) secure an accurate description of those 

25 activities; 


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1 ‘‘(B) secure a complete record of the pur2 poses for which funds were spent, and of the re3 cipients of such funds; 

4 ‘‘(C) describe the extent to which the entity 

5 has met the goals and objectives it set forth 

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

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

8 were expended consistent with the entity’s appli9 cation transmitted under this section or section 

10 319C–2. 

11 ‘‘(2) AUDITS; IMPLEMENTATION.— 

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

13 funds under this section or section 319C–2 shall, 

14 not less often than once every 2 years, audit its 

15 expenditures from amounts received under this 

16 section or section 319C–2. Such audits shall be 

17 conducted by an entity independent of the agen18 cy administering a program funded under this 

19 section or section 319C–2 in accordance with the 

20 Comptroller General’s standards for auditing 

21 governmental organizations, programs, activities, 

22 and functions and generally accepted auditing 

23 standards. Within 30 days following the comple24 tion of each audit report, the entity shall submit 

25 a copy of that audit report to the Secretary. 


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1 ‘‘(B) REPAYMENT.—Each entity shall repay 

2 to the United States amounts found by the Sec3 retary, after notice and opportunity for a hear4 ing to the entity, not to have been expended in 

5 accordance with this section or section 319C–2 

6 and, if such repayment is not made, the Sec7 retary may offset such amounts against the 

8 amount of any allotment to which the entity is 

9 or may become entitled under this section or sec10 tion 319C–2 or may otherwise recover such 

11 amounts. 

12 ‘‘(C) WITHHOLDING OF PAYMENT.—The 

13 Secretary may, after notice and opportunity for 

14 a hearing, withhold payment of funds to any en15 tity which is not using its allotment under this 

16 section or section 319C–2 in accordance with 

17 such section. The Secretary may withhold such 

18 funds until the Secretary finds that the reason 

19 for the withholding has been removed and there 

20 is reasonable assurance that it will not recur. 

21 ‘‘(3) MAXIMUM CARRYOVER AMOUNT.— 

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

23 the Secretary, in consultation with the States 

24 and political subdivisions, shall determine the 

25 maximum percentage amount of an award under 


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1 this section that an entity may carryover to the 

2 succeeding fiscal year. 

3 ‘‘(B) AMOUNT EXCEEDED.—For each fiscal 

4 year, if the percentage amount of an award 

5 under this section unexpended by an entity ex6 ceeds the maximum percentage permitted by the 

7 Secretary under subparagraph (A), the entity 

8 shall return to the Secretary the portion of the 

9 unexpended amount that exceeds the maximum 

10 amount permitted to be carried over by the Sec11 retary. 

12 ‘‘(C) ACTION BY SECRETARY.—The Sec13 retary shall make amounts returned to the Sec14 retary under subparagraph (B) available for 

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

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

17 amounts collected under this paragraph the Sec18 retary shall give preference to entities that are 

19 located in whole or in part in States from which 

20 amounts have been returned under subparagraph 

21 (B). 

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

23 Secretary for a waiver of the maximum percent24 age amount under subparagraph (A). Such an 

25 application for a waiver shall include an explaVerDate Aug 31 2005 02:47 Aug 05, 2006 Jkt 049200 PO 00000 Frm 00109 Fmt 6652 Sfmt 6203 E:\BILLS\S3678.RS S3678

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1 nation why such requirement should not apply 

2 to the entity and the steps taken by such entity 

3 to ensure that all funds under an award under 

4 this section will be expended appropriately. 

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

6 The Secretary may waive the application of sub7 paragraph (B) for a single entity pursuant to 

8 subparagraph (D) or for all entities in a fiscal 

9 year, if the Secretary determines that mitigating 

10 conditions exist that justify the waiver or reduc11 tion.’’. 

12 SEC. 202. USING INFORMATION TECHNOLOGY TO IMPROVE 

13 SITUATIONAL AWARENESS IN PUBLIC 

14 HEALTH EMERGENCIES. 

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

16 U.S.C. 247d–4) is amended— 

17 (1) in subsection (a)(1), by inserting ‘‘domesti18 cally and abroad’’ after ‘‘public health threats’’; and 

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

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

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

22 the date of enactment of the Pandemic and All-Haz23 ards Preparedness Act, the Secretary, in collaboration 

24 with State, local, and tribal public health officials, 

25 shall establish a near real-time electronic nationwide 


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1 public health situational awareness capability 

2 through an interoperable network of systems to share 

3 data and information to enhance early detection of 

4 rapid response to, and management of, potentially 

5 catastrophic infectious disease outbreaks and other 

6 public health emergencies that originate domestically 

7 or abroad. Such network shall be built on existing 

8 State situational awareness systems or enhanced sys9 tems that enable such connectivity. 

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

11 after the date of enactment the Pandemic and All12 Hazards Preparedness Act, the Secretary shall submit 

13 to the appropriate committees of Congress, a strategic 

14 plan that demonstrates the steps the Secretary will 

15 undertake to develop, implement, and evaluate the 

16 network described in paragraph (1), utilizing the ele17 ments described in paragraph (3). 

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

19 paragraph (1) shall include data and information 

20 transmitted in a standardized format from— 

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

22 entities, including public health laboratories; 

23 ‘‘(B) Federal health agencies; 

24 ‘‘(C) zoonotic disease monitoring systems; 


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

2 entities, hospitals, pharmacies, poison control 

3 centers or professional organizations in the field 

4 of poison control, and clinical laboratories, to the 

5 extent practicable and provided that such data 

6 are voluntarily provided simultaneously to the 

7 Secretary and appropriate State, local, and trib8 al public health agencies; and 

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

10 may deem appropriate. 

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

12 shall not be construed as requiring separate reporting 

13 of data and information from each source listed. 

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

15 and operating the network described in paragraph 

16 (1), the Secretary shall— 

17 ‘‘(A) utilize applicable interoperability 

18 standards as determined by the Secretary 

19 through a joint public and private sector process; 

20 ‘‘(B) define minimal data elements for such 

21 network; 

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

23 tribal public health officials, integrate and build 

24 upon existing State, local, and tribal capabili25 ties, ensuring simultaneous sharing of data, inVerDate Aug 31 2005 02:47 Aug 05, 2006 Jkt 049200 PO 00000 Frm 00112 Fmt 6652 Sfmt 6203 E:\BILLS\S3678.RS S3678

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1 formation, and analyses from the network de2 scribed in paragraph (1) with State, local, and 

3 tribal public health agencies; and 

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

5 tribal public health officials, develop procedures 

6 and standards for the collection, analysis, and 

7 interpretation of data that States, regions, or 

8 other entities collect and report to the network 

9 described in paragraph (1). 

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

11 SITUATIONAL AWARENESS IN PUBLIC HEALTH EMER12 GENCIES.— 

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

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

15 grants to States to enhance the ability of such States 

16 to establish or operate a coordinated public health sit17 uational awareness system for regional or Statewide 

18 early detection of, rapid response to, and management 

19 of potentially catastrophic infectious disease outbreaks 

20 and public health emergencies, in collaboration with 

21 public health agencies, sentinel hospitals, clinical lab22 oratories, pharmacies, poison control centers, other 

23 health care organizations, and animal health organi24 zations within such States. 


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

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

3 the Secretary an application at such time, in such 

4 manner, and containing such information as the Sec5 retary may require, including an assurance that the 

6 State will submit to the Secretary— 

7 ‘‘(A) reports of such data, information, and 

8 metrics as the Secretary may require; 

9 ‘‘(B) a report on the effectiveness of the sys10 tems funded under the grant; and 

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

12 grant funds will be used to enhance the timelines 

13 and comprehensiveness of efforts to detect, re14 spond to, and manage potentially catastrophic 

15 infectious disease outbreaks and public health 

16 emergencies. 

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

18 award under this subsection— 

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

20 coordinated public health situational awareness 

21 system for regional or Statewide early detection 

22 of, rapid response to, and management of poten23 tially catastrophic infectious disease outbreaks 

24 and public health emergencies; and 


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1 ‘‘(B) may award grants or contracts to en2 tities described in paragraph (1) within or serv3 ing such State to assist such entities in improv4 ing the operation of information technology sys5 tems, facilitating the secure exchange of data and 

6 information, and training personnel to enhance 

7 the operation of the system described in para8 graph (A). 

9 ‘‘(4) LIMITATION.—Information technology sys10 tems acquired or implemented using grants awarded 

11 under this section must be compliant with— 

12 ‘‘(A) interoperability and other techno13 logical standards, as determined by the Sec14 retary; and 

15 ‘‘(B) data collection and reporting require16 ments for the network described in subsection (d). 

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

18 than 4 years after the date of enactment of the Pan19 demic and All-Hazards Preparedness Act, the Govern20 ment Accountability Office shall conduct an inde21 pendent evaluation, and submit to the Secretary and 

22 the appropriate committees of Congress a report, con23 cerning the activities conducted under this subsection 

24 and subsection (d). 


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1 ‘‘(f) GRANTS FOR REAL-TIME SURVEILLANCE IM2 PROVEMENT.— 

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

4 grants to eligible entities to carry out projects de5 scribed under paragraph (4). 

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

7 section, the term ‘eligible entity’ means an entity that 

8 is— 

9 ‘‘(A)(i) a hospital, clinical laboratory, uni10 versity; or 

11 ‘‘(ii) poison control center or professional 

12 organization in the field of poison control; and 

13 ‘‘(B) a participant in the network estab14 lished under subsection (d). 

15 ‘‘(3) APPLICATION.—Each eligible entity desiring 

16 a grant under this section shall submit to the Sec17 retary an application at such time, in such manner, 

18 and containing such information as the Secretary 

19 may require. 

20 ‘‘(4) USE OF FUNDS.— 

21 ‘‘(A) IN GENERAL.—An eligible entity de22 scribed in paragraph (2)(A)(i) that receives a 

23 grant under this section shall use the funds 

24 awarded pursuant to such grant to carry out a 

25 pilot demonstration project to purchase and imVerDate Aug 31 2005 02:47 Aug 05, 2006 Jkt 049200 PO 00000 Frm 00116 Fmt 6652 Sfmt 6203 E:\BILLS\S3678.RS S3678

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1 plement the use of advanced diagnostic medical 

2 equipment to analyze real-time clinical speci3 mens for pathogens of public health or bioter4 rorism significance and report any results from 

5 such project to State, local, and tribal public 

6 health entities and the network established under 

7 subsection (d). 

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

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

10 grant under this section shall use the funds 

11 awarded pursuant to such grant to— 

12 ‘‘(i) improve the early detection, sur13 veillance, and investigative capabilities of 

14 poison control centers for chemical, biologi15 cal, radiological, and nuclear events by 

16 training poison information personnel to 

17 improve the accuracy of surveillance data, 

18 improving the definitions used by the poi19 son control centers for surveillance, and en20 hancing timely and efficient investigation of 

21 data anomalies; 

22 ‘‘(ii) improve the capabilities of poison 

23 control centers to provide information to 

24 health care providers and the public with 

25 regard to chemical, biological, radiological, 


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1 or nuclear threats or exposures, in consulta2 tion with the appropriate State, local, and 

3 tribal public health entities; or 

4 ‘‘(iii) provide surge capacity in the 

5 event of a chemical, biological, radiological, 

6 or nuclear event through the establishment 

7 of alternative poison control center work8 sites and the training of nontraditional per9 sonnel. 

10 ‘‘(g) AUTHORIZATION OF APPROPRIATIONS.— 

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

12 be appropriated to carry out subsections (d), (e), and 

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

14 $35,000,000 is authorized to be appropriated to carry 

15 out subsection (f). 

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

17 authorized to be appropriated such sums as may be 

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

19 each of fiscal years 2008 through 2011.’’. 

20 SEC. 203. PUBLIC HEALTH WORKFORCE ENHANCEMENTS. 

21 (a) DEMONSTRATION PROJECT.—Subpart III of part 

22 D of title III of the Public Health Service Act (42 U.S.C. 

23 254l) is amended by adding at the end the following: 


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1 ‘‘SEC. 338M. PUBLIC HEALTH DEPARTMENTS. 

2 ‘‘(a) IN GENERAL.—To the extent that funds are ap3 propriated under subsection (e), the Secretary shall estab4 lish a demonstration project to provide for the participation 

5 of individuals who are eligible for the Loan Repayment 

6 Program described in section 338B and who agree to com7 plete their service obligation in a State health department 

8 that provides a significant amount of service to health pro9 fessional shortage areas or areas at risk of a public health 

10 emergency, as determined by the Secretary, or in a local 

11 or tribal health department that serves a health professional 

12 shortage area or an area at risk of a public health emer13 gency. 

14 ‘‘(b) PROCEDURE.—To be eligible to receive assistance 

15 under subsection (a), with respect to the program described 

16 in section 338B, an individual shall— 

17 ‘‘(1) comply with all rules and requirements de18 scribed in such section (other than section 

19 338B(f)(1)(B)(iv)); and 

20 ‘‘(2) agree to serve for a time period equal to 2 

21 years, or such longer period as the individual may 

22 agree to, in a State, local, or tribal health depart23 ment, described in subsection (a). 

24 ‘‘(c) DESIGNATIONS.—The demonstration project de25 scribed in subsection (a), and any healthcare providers who 

26 are selected to participate in such project, shall not be conVerDate Aug 31 2005 02:47 Aug 05, 2006 Jkt 049200 PO 00000 Frm 00119 Fmt 6652 Sfmt 6203 E:\BILLS\S3678.RS S3678

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1 sidered by the Secretary in the designation of health profes2 sional shortage areas under section 332 during fiscal years 

3 2007 through 2010. 

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

5 of enactment of this section, the Secretary shall submit a 

6 report to the relevant committees of Congress that evaluates 

7 the participation of individuals in the demonstration 

8 project under subsection (a), the impact of such participa9 tion on State, local, and tribal health departments, and the 

10 benefit and feasibility of permanently allowing such place11 ments in the Loan Repayment Program. 

12 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There are 

13 authorized to be appropriated to carry out this section, such 

14 sums as may be necessary for each of fiscal years 2007 

15 through 2010.’’. 

16 (b) GRANTS FOR LOAN REPAYMENT PROGRAM.—Sec17 tion 338I of the Public Health Service Act (42 U.S.C. 254q– 

18 1) is amended by adding at the end the following: 

19 ‘‘(j) PUBLIC HEALTH LOAN REPAYMENT.— 

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

21 grants to States for the purpose of assisting such 

22 States in operating loan repayment programs under 

23 which such States enter into contracts to repay all or 

24 part of the eligible loans borrowed by, or on behalf of, 

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1 al health departments that serve health professional 

2 shortage areas or other areas at risk of a public health 

3 emergency, as designated by the Secretary. 

4 ‘‘(2) LOANS ELIGIBLE FOR REPAYMENT.—To be 

5 eligible for repayment under this subsection, a loan 

6 shall be a loan made, insured, or guaranteed by the 

7 Federal Government that is borrowed by, or on behalf 

8 of, an individual to pay the cost of attendance for a 

9 program of education leading to a degree appropriate 

10 for serving in a State, local, or tribal health depart11 ment as determined by the Secretary and the chief ex12 ecutive officer of the State in which the grant is ad13 ministered, at an institution of higher education (as 

14 defined in section 102 of the Higher Education Act 

15 of 1965), including principal, interest, and related ex16 penses on such loan. 

17 ‘‘(3) APPLICABILITY OF EXISTING REQUIRE18 MENTS.—With respect to awards made under para19 graph (1)— 

20 ‘‘(A) the requirements of subsections (b), (f), 

21 and (g) shall apply to such awards; and 

22 ‘‘(B) the requirements of subsection (c) shall 

23 apply to such awards except that with respect to 

24 paragraph (1) of such subsection, the State in25 volved may assign an individual only to public 


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1 and nonprofit private entities that serve health 

2 professional shortage areas or areas at risk of a 

3 public health emergency, as determined by the 

4 Secretary. 

5 ‘‘(4) AUTHORIZATION OF APPROPRIATIONS.— 

6 There are authorized to be appropriated to carry out 

7 this subsection, such sums as may be necessary for 

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

9 SEC. 204. VACCINE TRACKING AND DISTRIBUTION. 

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

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

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

13 ‘‘(a) TRACKING.—The Secretary, together with rel14 evant manufacturers, wholesalers, and distributors as may 

15 agree to cooperate, may track the initial distribution of fed16 erally purchased influenza vaccine in an influenza pan17 demic. Such tracking information shall be used to inform 

18 Federal, State, local, and tribal decision makers during an 

19 influenza pandemic. 

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

21 communication between State, local, and tribal public 

22 health officials and such manufacturers, wholesalers, and 

23 distributors as agree to participate, regarding the effective 

24 distribution of seasonal influenza vaccine. Such commu25 nication shall include estimates of high priority popuVerDate Aug 31 2005 02:47 Aug 05, 2006 Jkt 049200 PO 00000 Frm 00122 Fmt 6652 Sfmt 6203 E:\BILLS\S3678.RS S3678

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1 lations, as determined by the Secretary, in State, local, and 

2 tribal jurisdictions in order to inform Federal, State, local, 

3 and tribal decision makers during vaccine shortages and 

4 supply disruptions. 

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

6 to the Secretary or its contractors, if any, under this section 

7 or under any other section of this Act related to vaccine 

8 distribution information shall remain confidential in ac9 cordance with the exception from the public disclosure of 

10 trade secrets, commercial or financial information, and in11 formation obtained from an individual that is privileged 

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

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

14 exceptions under sections 1832 and 1833 of title 18, United 

15 States Code, relating to the protection and theft of trade 

16 secrets, and subject to privacy protections that are con17 sistent with the regulations promulgated under section 

18 264(c) of the Health Insurance Portability and Account19 ability Act of 1996. None of such information provided by 

20 a manufacturer, wholesaler, or distributor shall be disclosed 

21 without its consent to another manufacturer, wholesaler, or 

22 distributor, or shall be used in any manner to give a manu23 facturer, wholesaler, or distributor a proprietary advan24 tage. 


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1 ‘‘(d) GUIDELINES.—The Secretary, in order to main2 tain the confidentiality of relevant information and ensure 

3 that none of the information contained in the systems in4 volved may be used to provide proprietary advantage with5 in the vaccine market, while allowing State, local, and trib6 al health officials access to such information to maximize 

7 the delivery and availability of vaccines to high priority 

8 populations, during times of influenza pandemics, vaccine 

9 shortages, and supply disruptions, in consultation with 

10 manufacturers, distributors, wholesalers and State, local, 

11 and tribal health departments, shall develop guidelines for 

12 subsections (a) and (b). 

13 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There are 

14 authorized to be appropriated to carry out this section, such 

15 sums for each of fiscal years 2007 through 2011. 

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

17 Health Security Strategy described in section 2802, the Sec18 retary shall provide an update on the implementation of 

19 subsections (a) through (d).’’. 

20 SEC. 205. NATIONAL SCIENCE ADVISORY BOARD FOR BIO21 SECURITY. 

22 The National Science Advisory Board for Biosecurity 

23 shall, when requested by the Secretary of Health and 

24 Human Services, provide to relevant Federal departments 


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1 and agencies, advice, guidance, or recommendations con2 cerning— 

3 (1) a core curriculum and training requirements 

4 for workers in maximum containment biological lab5 oratories; and 

6 (2) periodic evaluations of maximum contain7 ment biological laboratory capacity nationwide and 

8 assessments of the future need for increased laboratory 

9 capacity; 

10 TITLE III—ALL-HAZARDS 

11 MEDICAL SURGE CAPACITY 

12 SEC. 301. NATIONAL DISASTER MEDICAL SYSTEM. 

13 (a) NATIONAL DISASTER MEDICAL SYSTEM.—Section 

14 2812 of subtitle B of title XXVIII of the Public Health Serv15 ice Act (42 U.S.C. 300hh–11 et seq.), as redesignated by 

16 section 102, is amended— 

17 (1) by striking the section heading and inserting 

18 ‘‘NATIONAL DISASTER MEDICAL SYSTEM’’; 

19 (2) by striking subsection (a); 

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

21 as subsections (a) through (g); 

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

23 (A) in paragraph (2)(B), by striking ‘‘Fed24 eral Emergency Management Agency’’ and inVerDate Aug 31 2005 02:47 Aug 05, 2006 Jkt 049200 PO 00000 Frm 00125 Fmt 6652 Sfmt 6203 E:\BILLS\S3678.RS S3678

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1 serting ‘‘Department of Homeland Security’’; 

2 and 

3 (B) in paragraph (3)(C), by striking ‘‘Pub4 lic Health Security and Bioterrorism Prepared5 ness and Response Act of 2002’’ and inserting 

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

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

8 (A) striking the subsection heading and in9 serting ‘‘MODIFICATIONS’’; 

10 (B) redesignating paragraph (2) as para11 graph (3); and 

12 (C) striking paragraph (1) and inserting 

13 the following: 

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

15 findings from the joint review described under para16 graph (2), the Secretary shall modify the policies of 

17 the National Disaster Medical System as necessary. 

18 ‘‘(2) JOINT REVIEW AND MEDICAL SURGE CAPAC19 ITY STRATEGIC PLAN.—Not later than 180 days after 

20 the date of enactment of the Pandemic and All-Haz21 ards Preparedness Act, the Secretary, in coordination 

22 with the Secretary of Homeland Security, the Sec23 retary of Defense, and the Secretary of Veterans Af24 fairs, shall conduct a joint review of the National 

25 Disaster Medical System. Such review shall include 


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1 an evaluation of medical surge capacity, as described 

2 by section 2804(a). As part of the National Health 

3 Security Strategy under section 2802, the Secretary 

4 shall update the findings from such review and fur5 ther modify the policies of the National Disaster Med6 ical System as necessary.’’; 

7 (6) by striking ‘‘subsection (b)’’ each place it ap8 pears and inserting ‘‘subsection (a)’’; 

9 (7) by striking ‘‘subsection (d)’’ each place it ap10 pears and inserting ‘‘subsection (c)’’; and 

11 (8) in subsection (g), as so redesignated, by strik12 ing ‘‘2002 through 2006’’ and inserting ‘‘2007 

13 through 2011’’. 

14 (b) TRANSFER OF NATIONAL DISASTER MEDICAL SYS15 TEM TO THE DEPARTMENT OF HEALTH AND HUMAN SERV16 ICES.—There shall be transferred to the Secretary of Health 

17 and Human Services the functions, personnel, assets, and 

18 liabilities of the National Disaster Medical System of the 

19 Department of Homeland Security, including the functions 

20 of the Secretary of Homeland Security and the Under Sec21 retary for Emergency Preparedness and Response relating 

22 thereto. 

23 (c) CONFORMING AMENDMENTS TO THE HOMELAND

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

25 2002 (6 U.S.C. 312(3)(B), 313(5))) is amended— 


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1 (1) in section 502(3)(B), by striking ‘‘, the Na2 tional Disaster Medical System,’’; and 

3 (2) in section 503(5), by striking ‘‘, the National 

4 Disaster Medical System’’. 

5 (d) UPDATE OF CERTAIN PROVISION.—Section 

6 319F(b)(2) of the Public Health Service Act (42 U.S.C. 

7 247d–6(b)(2)) is amended— 

8 (1) in the paragraph heading, by striking 

9 ‘‘CHILDREN AND TERRORISM’’ and inserting ‘‘AT10 RISK INDIVIDUALS AND PUBLIC HEALTH EMER11 GENCIES’’; 

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

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

14 and Public Health Emergencies’’; 

15 (3) in subparagraph (B)— 

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

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

18 health emergencies as they relate to at-risk indi19 viduals’’; 

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

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

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

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


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

2 and all that follows through the period and inserting 

3 ‘‘at-risk populations.’’; and 

4 (5) in subparagraph (D), by striking ‘‘one year’’ 

5 and inserting ‘‘six years’’. 

6 (e) CONFORMING AMENDMENT.—Section 

7 319F(b)(3)(B) of the Public Health Service Act (42 U.S.C. 

8 247d–6(b)(3)(B)) is amended by striking ‘‘and the working 

9 group under subsection (a)’’. 

10 (f) EFFECTIVE DATE.—The amendments made by sub11 sections (b) and (c) shall take effect on January 1, 2007. 

12 SEC. 302. ENHANCING MEDICAL SURGE CAPACITY. 

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

14 Service Act (300hh–11 et seq.), as amended by section 103, 

15 is amended by inserting after section 2802 the following: 

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

17 ‘‘(a) STUDY OF ENHANCING MEDICAL SURGE CAPAC18 ITY.—As part of the joint review described in section 

19 2812(b), the Secretary shall evaluate the benefits and feasi20 bility of improving the capacity of the Department of 

21 Health and Human Services to provide additional medical 

22 surge capacity to local communities in the event of a public 

23 health emergency. Such study shall include an assessment 

24 of the need for and feasibility of improving surge capacity 

25 through— 


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1 ‘‘(1) acquisition and operation of mobile medical 

2 assets by the Secretary to be deployed, on a contin3 gency basis, to a community in the event of a public 

4 health emergency; and 

5 ‘‘(2) other strategies to improve such capacity as 

6 determined appropriate by the Secretary. 

7 ‘‘(b) AUTHORITY TO ACQUIRE AND OPERATE MOBILE

8 MEDICAL ASSETS.—In addition to any other authority to 

9 acquire, deploy, and operate mobile medical assets, the Sec10 retary may acquire, deploy, and operate mobile medical as11 sets if, taking into consideration the evaluation conducted 

12 under subsection (a), such acquisition, deployment, and op13 eration is determined to be beneficial and feasible in im14 proving the capacity of the Department of Health and 

15 Human Services to provide additional medical surge capac16 ity to local communities in the event of a public health 

17 emergency. 

18 ‘‘(c) USING FEDERAL FACILITIES TO ENHANCE MED19 ICAL SURGE CAPACITY.— 

20 ‘‘(1) ANALYSIS.—The Secretary shall conduct an 

21 analysis of whether there are Federal facilities which, 

22 in the event of a public health emergency, could prac23 ticably be used as facilities in which to provide health 

24 care. 


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

2 based on the analysis conducted under paragraph (1), 

3 the Secretary determines that there are Federal facili4 ties which, in the event of a public health emergency, 

5 could be used as facilities in which to provide health 

6 care, the Secretary shall, with respect to each such fa7 cility, seek to conclude a memorandum of under8 standing with the head of the Department or agency 

9 that operates such facility that permits the use of such 

10 facility to provide health care in the event of a public 

11 health emergency.’’. 

12 (b) EMTALA.— 

13 (1) IN GENERAL.—Section 1135(b) of the Social 

14 Security Act (42 U.S.C. 1320b–5(b)) is amended— 

15 (A) in paragraph (3), by striking subpara16 graph (B) and inserting the following: 

17 ‘‘(B) the direction or relocation of an indi18 vidual to receive medical screening in an alter19 native location— 

20 ‘‘(i) pursuant to an appropriate State 

21 emergency preparedness plan; or 

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

23 emergency described in subsection (g)(1)(B) 

24 that involves a pandemic infectious disease, 

25 pursuant to a State pandemic preparedness 


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1 plan or a plan referred to in clause (i), 

2 whichever is applicable in the State;’’; 

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

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

5 in the case of a waiver or modification to which 

6 the fifth sentence of this subsection applies, shall 

7 be limited to’’; and 

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

9 a public health emergency described in subsection 

10 (g)(1)(B) involves a pandemic infectious disease 

11 (such as pandemic influenza), the duration of a 

12 waiver or modification under paragraph (3) 

13 shall be determined in accordance with sub14 section (e) as such subsection applies to public 

15 health emergencies.’’. 

16 (2) EFFECTIVE DATE.—The amendments made 

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

18 enactment of this Act and shall apply to public health 

19 emergencies declared pursuant to section 319 of the 

20 Public Health Service Act (42 U.S.C. 247d) on or 

21 after such date. 

22 SEC. 303. ENCOURAGING HEALTH PROFESSIONAL VOLUN23 TEERS. 

24 (a) VOLUNTEER MEDICAL RESERVE CORPS.—Title 

25 XXVIII of the Public Health Service Act (42 U.S.C. 300hh– 


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1 11 et seq.), as amended by this Act, is amended by inserting 

2 after section 2812 the following: 

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

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

5 date of enactment of the Pandemic and All-Hazards Pre6 paredness Act, the Secretary, in collaboration with State, 

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

8 tribal programs in existence on the date of enactment of 

9 such Act to establish and maintain a Medical Reserve Corps 

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

11 an adequate supply of volunteers in the case of a Federal, 

12 State, local, or tribal public health emergency. The Corps 

13 shall be headed by a Director who shall be appointed by 

14 the Secretary and shall oversee the activities of the Corps 

15 chapters that exist at the State, local, and tribal levels. 

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

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

18 and tribal teams and shall not alter such teams. 

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

20 individuals who— 

21 ‘‘(1)(A) are health professionals who have appro22 priate professional training and expertise as deter23 mined appropriate by the Director of the Corps; or 

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

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1 ity to facilitate access to health care services in a 

2 public health emergency; 

3 ‘‘(2) are certified in accordance with the certifi4 cation program developed under subsection (d); 

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

6 ‘‘(4) have registered and carry out training exer7 cises with a local chapter of the Medical Reserve 

8 Corps; and 

9 ‘‘(5) indicate whether they are willing to be de10 ployed outside the area in which they reside in the 

11 event of a public health emergency. 

12 ‘‘(d) CERTIFICATION; DRILLS.— 

13 ‘‘(1) CERTIFICATION.—The Director, in collabo14 ration with State, local, and tribal officials, shall es15 tablish a process for the periodic certification of indi16 viduals who volunteer for the Corps, as determined by 

17 the Secretary, which shall include the completion by 

18 each individual of the core training programs devel19 oped under section 319F, as required by the Director. 

20 Such certification shall not supercede State licensing 

21 or credentialing requirements. 

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

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

24 in order to facilitate the integration of trained volun25 teers into the health care system at the local level, 


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1 Corps members shall engage in periodic training exer2 cises to be carried out at the local level. 

3 ‘‘(e) DEPLOYMENT.—During a public health emer4 gency, the Secretary shall have the authority to activate and 

5 deploy willing members of the Corps to areas of need, taking 

6 into consideration the public health and medical expertise 

7 required, with the concurrence of the State, local, or tribal 

8 officials from the area where the members reside. 

9 ‘‘(f) EXPENSES AND TRANSPORTATION.—While en10 gaged in performing duties as a member of the Corps pursu11 ant to an assignment by the Secretary (including periods 

12 of travel to facilitate such assignment), members of the 

13 Corps who are not otherwise employed by the Federal Gov14 ernment shall be allowed travel or transportation expenses, 

15 including per diem in lieu of subsistence. 

16 ‘‘(g) IDENTIFICATION.—The Secretary, in cooperation 

17 and consultation with the States, shall develop a Medical 

18 Reserve Corps Identification Card that describes the licen19 sure and certification information of Corps members, as 

20 well as other identifying information determined necessary 

21 by the Secretary. 

22 ‘‘(h) INTERMITTENT DISASTER-RESPONSE PER23 SONNEL.— 

24 ‘‘(1) IN GENERAL.—For the purpose of assisting 

25 the Corps in carrying out duties under this section, 


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1 during a public health emergency, the Secretary may 

2 appoint selected individuals to serve as intermittent 

3 personnel of such Corps in accordance with applicable 

4 civil service laws and regulations. In all other cases, 

5 members of the Corps are subject to the laws of the 

6 State in which the activities of the Corps are under7 taken. 

8 ‘‘(2) APPLICABLE PROTECTIONS.—Subsections 

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

10 individual appointed under paragraph (1) in the 

11 same manner as such subsections apply to an indi12 vidual appointed under section 2812(c). 

13 ‘‘(3) LIMITATION.—State, local, and tribal offi14 cials shall have no authority to designate a member 

15 of the Corps as Federal intermittent disaster-response 

16 personnel, but may request the services of such mem17 bers. 

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

19 authorized to be appropriated to carry out this section, 

20 $22,000,000 for fiscal year 2007, and such sums as may 

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

22 (b) ENCOURAGING HEALTH PROFESSIONS VOLUN23 TEERS.—Section 319I of the Public Health Service Act (42 

24 U.S.C. 247d–7b) is amended— 


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

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

3 (2) by striking subsections (a) and (b) and in4 serting the following: 

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

6 date of enactment of the Pandemic and All-Hazards Pre7 paredness Act, the Secretary shall link existing State 

8 verification systems to maintain a single national inter9 operable network of systems, each system being maintained 

10 by a State or group of States, for the purpose of verifying 

11 the credentials and licenses of health care professionals who 

12 volunteer to provide health services during a public health 

13 emergency (such network shall be referred to in this section 

14 as the ‘verification network’). 

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

16 systems established under subsection (a) shall include— 

17 ‘‘(1) with respect to each volunteer health profes18 sional included in the system— 

19 ‘‘(A) information necessary for the rapid 

20 identification of, and communication with, such 

21 professionals; and 

22 ‘‘(B) the credentials, certifications, licenses, 

23 and relevant training of such individuals; and 

24 ‘‘(2) the name of each member of the Medical Re25 serve Corps, the National Disaster Medical System, 


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1 and any other relevant federally-sponsored or admin2 istered programs determined necessary by the Sec3 retary.’’; 

4 (3) in subsection (c), strike ‘‘system’’ and insert 

5 ‘‘network’’; 

6 (4) by striking subsection (d) and inserting the 

7 following: 

8 ‘‘(d) ACCESSIBILITY.—The Secretary shall ensure that 

9 the network established under subsection (a) is electroni10 cally accessible by State, local, and tribal health depart11 ments and can be linked with the identification cards under 

12 section 2813. 

13 ‘‘(e) CONFIDENTIALITY.—The Secretary shall establish 

14 and require the application of and compliance with meas15 ures to ensure the effective security of, integrity of, and ac16 cess to the data included in the network. 

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

18 with the Secretary of Veterans Affairs and the Secretary 

19 of Homeland Security to assess the feasibility of integrating 

20 the verification network under this section with the VetPro 

21 system of the Department of Veterans Affairs and the Na22 tional Emergency Responder Credentialing System of the 

23 Department of Homeland Security. The Secretary shall, if 

24 feasible, integrate the verification network under this secVerDate Aug 31 2005 02:47 Aug 05, 2006 Jkt 049200 PO 00000 Frm 00138 Fmt 6652 Sfmt 6203 E:\BILLS\S3678.RS S3678

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1 tion with such VetPro system and the National Emergency 

2 Responder Credentialing System. 

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

4 are participants in the network established under subsection 

5 (a) shall, on at least a quarterly basis, work with the Direc6 tor to provide for the updating of the information contained 

7 in such network. 

8 ‘‘(h) CLARIFICATION.—Inclusion of a health profes9 sional in the verification network established pursuant to 

10 this section shall not constitute appointment of such indi11 vidual as a Federal employee for any purpose, either under 

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

13 be made under section 2812 or 2813. 

14 ‘‘(i) HEALTH CARE PROVIDER LICENSES.—The Sec15 retary shall encourage States to establish and implement 

16 mechanisms to waive the application of licensing require17 ments applicable to health professionals, who are seeking 

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

19 during a national, State, local, or tribal public health emer20 gency upon verification that such health professionals are 

21 licensed and in good standing in another State and have 

22 not been disciplined by any State health licensing or dis23 ciplinary board.’’; and 

24 (5) in subsection (k) (as so redesignated), by 

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


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1 SEC. 304. CORE EDUCATION AND TRAINING. 

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

3 U.S.C. 247d–6) is amended— 

4 (1) by striking subsection (a) and inserting the 

5 following; 

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

7 RESPONSE CURRICULA AND TRAINING.— 

8 ‘‘(1) IN GENERAL.—The Secretary, in collabora9 tion with the Secretary of Defense, and in consulta10 tion with relevant public and private entities, shall 

11 develop core health and medical response curricula 

12 and trainings by adapting applicable existing cur13 ricula and training programs to improve responses to 

14 public health emergencies. 

15 ‘‘(2) CURRICULUM.—The public health and med16 ical response training program may include course 

17 work related to— 

18 ‘‘(A) medical management of casualties, 

19 taking into account the needs of at-risk individ20 uals; 

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

22 emergencies; 

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

24 emergencies; 

25 ‘‘(D) national incident management, in26 cluding coordination among Federal, State, 


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1 local, tribal, international agencies, and other 

2 entities; and 

3 ‘‘(E) protecting health care workers and 

4 health care first responders from workplace expo5 sures during a public health emergency. 

6 ‘‘(3) PEER REVIEW.—On a periodic basis, prod7 ucts prepared as part of the program shall be rigor8 ously tested and peer-reviewed by experts in the rel9 evant fields. 

10 ‘‘(4) CREDIT.—The Secretary and the Secretary 

11 of Defense shall— 

12 ‘‘(A) take into account continuing profes13 sional education requirements of public health 

14 and healthcare professions; and 

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

16 accrediting agencies and with professional asso17 ciations in arranging for students enrolled in the 

18 program to obtain continuing professional edu19 cation credit for program courses. 

20 ‘‘(5) DISSEMINATION AND TRAINING.— 

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

22 provide for the dissemination and teaching of the 

23 materials described in paragraphs (1) and (2) by 

24 appropriate means, as determined by the Sec25 retary. 


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

2 and training activities described in subpara3 graph (A) may be carried out by Federal public 

4 health or medical entities, appropriate edu5 cational entities, professional organizations and 

6 societies, private accrediting organizations, and 

7 other nonprofit institutions or entities meeting 

8 criteria established by the Secretary. 

9 ‘‘(C) GRANTS AND CONTRACTS.—In car10 rying out this subsection, the Secretary may 

11 carry out activities directly or through the 

12 award of grants and contracts, and may enter 

13 into interagency agreements with other Federal 

14 agencies.’’; 

15 (2) by striking subsections (c) through (g) and 

16 inserting the following: 

17 ‘‘(c) EXPANSION OF EPIDEMIC INTELLIGENCE SERV18 ICE PROGRAM.—The Secretary may establish 20 officer po19 sitions in the Epidemic Intelligence Service Program, in 

20 addition to the number of the officer positions offered under 

21 such Program in 2006, for individuals who agree to partici22 pate, for a period of not less than 2 years, in the Career 

23 Epidemiology Field Officer program in a State, local, or 

24 tribal health department that serves a health professional 

25 shortage area (as defined under section 332(a)), a medically 


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1 underserved population (as defined under section 

2 330(b)(3)), or a medically underserved area or area at high 

3 risk of a public health emergency as designated by the Sec4 retary. 

5 ‘‘(d) CENTERS FOR PUBLIC HEALTH PREPAREDNESS; 

6 CORE CURRICULA AND TRAINING.— 

7 ‘‘(1) IN GENERAL.—The Secretary may establish 

8 at accredited schools of public health, Centers for Pub9 lic Health Preparedness (hereafter referred to in this 

10 section as the ‘Centers’). 

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

12 award under this subsection to establish a Center, an 

13 accredited school of public health shall agree to con14 duct activities consistent with the requirements of this 

15 subsection. 

16 ‘‘(3) CORE CURRICULA.—The Secretary, in col17 laboration with the Centers and other public or pri18 vate entities shall establish core curricula based on es19 tablished competencies leading to a 4-year bachelor’s 

20 degree, a graduate degree, a combined bachelor and 

21 master’s degree, or a certificate program, for use by 

22 each Center. The Secretary shall disseminate such 

23 curricula to other accredited schools of public health 

24 and other health professions schools determined apVerDate Aug 31 2005 02:47 Aug 05, 2006 Jkt 049200 PO 00000 Frm 00143 Fmt 6652 Sfmt 6203 E:\BILLS\S3678.RS S3678

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1 propriate by the Secretary, for voluntary use by such 

2 schools. 

3 ‘‘(4) CORE COMPETENCY-BASED TRAINING PRO4 GRAM.—The Secretary, in collaboration with the Cen5 ters and other public or private entities shall facili6 tate the development of a competency-based training 

7 program to train public health practitioners. The 

8 Centers shall use such training program to train pub9 lic health practitioners. The Secretary shall dissemi10 nate such training program to other accredited 

11 schools of public health, health professions schools, and 

12 other public or private entities as determined by the 

13 Secretary, for voluntary use by such entities. 

14 ‘‘(5) CONTENT OF CORE CURRICULA AND TRAIN15 ING PROGRAM.—The Secretary shall ensure that the 

16 core curricula and training program established pur17 suant to this subsection respond to the needs of State, 

18 local, and tribal public health authorities and inte19 grate and emphasize essential public health security 

20 capabilities consistent with section 2802(b)(2). 

21 ‘‘(6) ACADEMIC-WORKFORCE COMMUNICATION.— 

22 As a condition of receiving funding from the Sec23 retary under this subsection, a Center shall collabo24 rate with a State, local, or tribal public health de25 partment to— 


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1 ‘‘(A) define the public health preparedness 

2 and response needs of the community involved; 

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

4 are fulfilled by existing preparedness and re5 sponse activities of such school or health depart6 ment, and how such activities may be improved; 

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

8 trainings, evaluate and utilize relevant materials 

9 and trainings developed by others Centers; and 

10 ‘‘(D) evaluate community impact and the 

11 effectiveness of any newly developed materials or 

12 trainings. 

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

14 consultation with relevant public and private entities, 

15 the Secretary shall define the existing knowledge base 

16 for public health preparedness and response systems, 

17 and establish a research agenda based on Federal, 

18 State, local, and tribal public health preparedness 

19 priorities. As a condition of receiving funding from 

20 the Secretary under this subsection, a Center shall 

21 conduct public health systems research that is con22 sistent with the agenda described under this para23 graph.’’; 

24 (3) by redesignating subsection (h) as subsection 

25 (e); 


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1 (4) by inserting after subsection (e) (as so redes2 ignated), the following: 

3 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.— 

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

5 be appropriated to carry out this section for fiscal 

6 year 2007— 

7 ‘‘(A) to carry out subsection (a)— 

8 ‘‘(i) $5,000,000 to carry out para9 graphs (1) through (4); and 

10 ‘‘(ii) $7,000,000 to carry out para11 graph (5); 

12 ‘‘(B) to carry out subsection (c), $3,000,000; 

13 and 

14 ‘‘(C) to carry out subsection (d), 

15 $31,000,000, of which $5,000,000 shall be used to 

16 carry out paragraphs (3) through (5) of such 

17 subsection. 

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

19 authorized to be appropriated such sums as may be 

20 necessary to carry out this section for fiscal year 2008 

21 and each subsequent fiscal year.’’; and 

22 (5) by striking subsections (i) and (j). 


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1 SEC. 305. PARTNERSHIPS FOR STATE AND REGIONAL HOS2 PITAL PREPAREDNESS TO IMPROVE SURGE 

3 CAPACITY. 

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

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

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

7 HOSPITAL PREPAREDNESS TO IMPROVE 

8 SURGE CAPACITY. 

9 ‘‘(a) IN GENERAL.—The Secretary shall award com10 petitive grants or cooperative agreements to eligible entities 

11 to enable such entities to improve surge capacity and en12 hance community and hospital preparedness for public 

13 health emergencies. 

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

15 subsection (a), an entity shall— 

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

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

18 which shall be a designated trauma center, con19 sistent with section 1213(c); 

20 ‘‘(ii) one or more other local health care fa21 cilities, including clinics, health centers, primary 

22 care facilities, mental health centers, mobile med23 ical assets, or nursing homes; and 

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

25 ‘‘(II) one or more States; or 


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

2 political subdivisions; and 

3 ‘‘(B) prepare, in consultation with the Chief Ex4 ecutive Officer and the lead health officials of the 

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

6 health care facilities described in subparagraph (A) 

7 are located, and submit to the Secretary, an applica8 tion at such time, in such manner, and containing 

9 such information as the Secretary may require; or 

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

11 1(b)(1); and 

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

13 such manner, and containing such information as the 

14 Secretary may require, including the information or 

15 assurances required under section 319C–1(b)(2) and 

16 an assurance that the State will retain not more than 

17 25 percent of the funds awarded for administrative 

18 and other support functions. 

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

20 shall be expended for activities to achieve the preparedness 

21 goals described under paragraphs (1), (3), (4), (5), and (6) 

22 of section 2802(b). 

23 ‘‘(d) PREFERENCES.— 

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

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


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1 preference to eligible entities that submit applications 

2 that, in the determination of the Secretary— 

3 ‘‘(A) will enhance coordination— 

4 ‘‘(i) among the entities described in 

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

6 ‘‘(ii) between such entities and the en7 tities described in subsection (b)(1)(A)(ii); 

8 and 

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

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

11 of the hospitals and health care facilities within 

12 the geographic area served by such partnership. 

13 ‘‘(2) OTHER PREFERENCES.—In making awards 

14 under subsection (a), the Secretary shall give pref15 erence to eligible entities that, in the determination of 

16 the Secretary— 

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

18 participants in the National Disaster Medical 

19 System; 

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

21 faces a high degree of risk, as determined by the 

22 Secretary in consultation with the Secretary of 

23 Homeland Security; or 


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

2 achieve the medical preparedness goals described 

3 in section 2802(b)(3). 

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

5 Secretary may not award a cooperative agreement to an 

6 eligible entity described in subsection (b)(1) unless the ap7 plication submitted by the entity is coordinated and con8 sistent with an applicable State All-Hazards Public Health 

9 Emergency Preparedness and Response Plan and relevant 

10 local plans, as determined by the Secretary in consultation 

11 with relevant State health officials. 

12 ‘‘(f) LIMITATION ON AWARDS.—A political subdivision 

13 shall not participate in more than one partnership de14 scribed in subsection (b)(1). 

15 ‘‘(g) COORDINATION WITH LOCAL RESPONSE CAPA16 BILITIES.—An eligible entity shall, to the extent practicable, 

17 ensure that activities carried out under an award under 

18 subsection (a) are coordinated with activities of relevant 

19 local Metropolitan Medical Response Systems, local Medical 

20 Reserve Corps, the Cities Readiness Initiative, and local 

21 emergency plans. 

22 ‘‘(h) MAINTENANCE OF FUNDING.— 

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

24 award under this section shall maintain expenditures 

25 for health care preparedness at a level that is not less 


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1 than the average level of such expenditures main2 tained by the entity for the preceding 2 year period. 

3 ‘‘(2) RULE OF CONSTRUCTION.—Nothing in this 

4 section shall be construed to prohibit the use of 

5 awards under this section to pay salary and related 

6 expenses of public health and other professionals em7 ployed by State, local, or tribal agencies who are car8 rying out activities supported by such awards (re9 gardless of whether the primary assignment of such 

10 personnel is to carry out such activities). 

11 ‘‘(i) PERFORMANCE AND ACCOUNTABILITY.—The re12 quirements of section 319C–1(g) and (i) shall apply to enti13 ties receiving awards under this section (regardless of 

14 whether such entities are described under subsection 

15 (b)(1)(A) or (b)(2)(A)) in the same manner as such require16 ments apply to entities under section 319C–1. An entity 

17 described in subsection (b)(1)(A) shall make such reports 

18 available to the lead health official of the State in which 

19 such partnership is located. 

20 ‘‘(j) AUTHORIZATION OF APPROPRIATIONS.— 

21 ‘‘(1) IN GENERAL.—For the purpose of carrying 

22 out this section, there is authorized to be appropriated 

23 $474,000,000 for fiscal year 2007, and such sums as 

24 may be necessary for each of fiscal years 2008 through 

25 2011. 


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1 ‘‘(2) RESERVATION OF AMOUNTS FOR PARTNER2 SHIPS.—Prior to making awards described in para3 graph (3), the Secretary may reserve from the amount 

4 appropriated under paragraph (1) for a fiscal year, 

5 an amount determined appropriate by the Secretary 

6 for making awards to entities described in subsection 

7 (b)(1)(A). 

8 ‘‘(3) AWARDS TO STATES AND POLITICAL SUB9 DIVISIONS.— 

10 ‘‘(A) IN GENERAL.—From amounts appro11 priated for a fiscal year under paragraph (1) 

12 and not reserved under paragraph (2), the Sec13 retary shall make awards to entities described in 

14 subsection (b)(2)(A) that have completed an ap15 plication as described in subsection (b)(2)(B). 

16 ‘‘(B) AMOUNT.—The Secretary shall deter17 mine the amount of an award to each entity de18 scribed in subparagraph (A) in the same manner 

19 as such amounts are determined under section 

20 319C–1(h).’’. 

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

22 VETERANS AFFAIRS. 

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

24 States Code, is amended— 

25 (1) in subsection (a)— 


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1 (A) in paragraph (1), by— 

2 (i) striking ‘‘chemical or biological at3 tack’’ and inserting ‘‘a public health emer4 gency (as defined in section 2801 of the 

5 Public Health Service Act)’’; 

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

7 ‘‘such an emergency’’; and 

8 (iii) striking ‘‘public health emer9 gencies’’ and inserting ‘‘such emergencies’’; 

10 and 

11 (B) in paragraph (2)— 

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

13 and’’ and inserting a semicolon; 

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

15 the period and inserting a semicolon; and 

16 (iii) by adding at the end the fol17 lowing: 

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

19 the staff of such centers to support the activities 

20 carried out by the Secretary of Health and 

21 Human Services under section 2801 of the Pub22 lic Health Service Act in the event of a public 

23 health emergency and incidents covered by the 

24 National Response Plan developed pursuant to 


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1 section 502(6) of the Homeland Security Act of 

2 2002, or any successor plan; and 

3 ‘‘(D) providing medical logistical support to 

4 the National Disaster Medical System and the 

5 Secretary of Health and Human Services as nec6 essary, on a reimbursable basis, and in coordina7 tion with other designated Federal agencies.’’; 

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

9 biological attack or other terrorist attack.’’ and insert10 ing ‘‘a public health emergency. The Secretary shall, 

11 through existing medical procurement contracts, and 

12 on a reimbursable basis, make available as necessary, 

13 medical supplies, equipment, and pharmaceuticals in 

14 response to a public health emergency in support of 

15 the Secretary of Health and Human Services.’’; 

16 (3) in subsection (d), by— 

17 (A) striking ‘‘develop and’’; 

18 (B) striking ‘‘biological, chemical, or radio19 logical attacks’’ and inserting ‘‘public health 

20 emergencies’’; and 

21 (C) by inserting ‘‘consistent with section 

22 319F(a) of the Public Health Service Act’’ before 

23 the period; and 

24 (4) in subsection (e)— 


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1 (A) in paragraph (1), by striking ‘‘2811(b)’’ 

2 and inserting ‘‘2812’’; and 

3 (B) in paragraph (2)— 

4 (i) by striking ‘‘bioterrorism and 

5 other’’; and 

6 (ii) by striking ‘‘319F(a)’’ and insert7 ing ‘‘319F’’. 

8 (b) AUTHORIZATION OF APPROPRIATIONS.—Section 

9 8117 of title 38, United States Code, is amended by adding 

10 at the end the following: 

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

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

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

14 2007 through 2011.’’. 


sroberts on PROD1PC70 with BILLS
Calendar No. 583 

109TH CONGRESS 

2D SESSION S. 3678 

[Report No. 109

–319] 

A BILL 

To amend the Public Health Service Act with reposes. preparedness and response, and for other pur- spect to public health security and all-hazards 

AUGUST 3, 2006 

Reported with an amendment 


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