I 

112TH CONGRESS 

1ST SESSION H. R. 2298 

To establish grant programs to improve the health of border area residents 

and for all hazards preparedness in the border area including bioterrorism and infectious disease, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JUNE 22, 2011 

Mr. REYES (for himself, Mr. GENE GREEN of Texas, Mr. FILNER, Mr. 

CUELLAR, Mr. GRIJALVA, and Mr. HINOJOSA) introduced the following 

bill; which was referred to the Committee on Energy and Commerce, and 

in addition to the Committee on Foreign Affairs, for a period to be subsequently determined by the Speaker, in each case for consideration of such 

provisions as fall within the jurisdiction of the committee concerned 

A BILL 

To establish grant programs to improve the health of border 

area residents and for all hazards preparedness in the 

border area including bioterrorism and infectious disease, 

and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Border Health Secu5 rity Act of 2011’’. 


emcdonald on DSK2BSOYB1PROD with BILLS
2 

•HR 2298 IH

1 SEC. 2. FINDINGS. 

2 Congress makes the following findings: 

3 (1) The United States-Mexico border is an 

4 interdependent and dynamic region of 14,538,209 

5 people with significant and unique public health 

6 challenges. 

7 (2) These challenges include low rates of health 

8 insurance coverage, poor access to health care serv9 ices, and high rates of dangerous diseases, such as 

10 tuberculosis, diabetes, and obesity. 

11 (3) As the 2009 novel influenza A (H1N1) out12 break illustrates, diseases do not respect inter13 national boundaries, therefore, a strong public 

14 health effort at and along the United States-Mexico 

15 border is crucial to not only protect and improve the 

16 health of Americans but also to help secure the 

17 United States against biosecurity threats. 

18 (4) For 11 years, the United States-Mexico 

19 Border Health Commission has served as a crucial 

20 bi-national institution to address these unique and 

21 truly cross-border health issues. 

22 (5) Two initiatives resulting from the United 

23 States-Mexico Border Health Commission’s work 

24 speak to the importance of an infrastructure that fa25 cilitates cross border communication at the ground 

26 level. First, the Early Warning Infectious Disease 


emcdonald on DSK2BSOYB1PROD with BILLS
3 

•HR 2298 IH

1 Surveillance (EWIDS), started in 2004, surveys in2 fectious diseases passing among border States allow3 ing for early detection and intervention. Second, the 

4 Ventanillas de Salud program, allows Mexican con5 sulates, in collaboration with United States non6 profit health organizations, to provide information 

7 and education to Mexican citizens living and working 

8 in the United States through a combination of Mexi9 can state funds and private grants. This program 

10 reaches an estimated 1,500,000 people in the United 

11 States. 

12 (6) As the United States-Mexico Border Health 

13 Commission enters its second decade, and as these 

14 issues grow in number and complexity, the Commis15 sion requires additional resources and modifications 

16 which will allow it to provide stronger leadership to 

17 optimize health and quality of life along the United 

18 States-Mexico border. 

19 SEC. 3. UNITED STATES-MEXICO BORDER HEALTH COMMIS20 SION ACT AMENDMENTS. 

21 The United States-Mexico Border Health Commis22 sion Act (22 U.S.C. 290n et seq.) is amended— 

23 (1) in section 3— 

24 (A) in paragraph (1), by striking ‘‘and’’ at 

25 the end; 


emcdonald on DSK2BSOYB1PROD with BILLS
4 

•HR 2298 IH

1 (B) in paragraph (2), by striking the pe2 riod and inserting ‘‘; and’’; and 

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

4 ‘‘(3) to serve as an independent and objective 

5 body to both recommend and implement initiatives 

6 that solve border health issues’’; 

7 (2) in section 5— 

8 (A) in subsection (b), by striking ‘‘should 

9 be the leader’’ and inserting ‘‘shall be the 

10 Chair’’; and 

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

12 ‘‘(d) PROVIDING ADVICE AND RECOMMENDATIONS

13 TO CONGRESS.—A member of the Commission may at any 

14 time provide advice or recommendations to Congress con15 cerning issues that are considered by the Commission. 

16 Such advice or recommendations may be provided whether 

17 or not a request for such is made by a member of Congress 

18 and regardless of whether the member or individual is au19 thorized to provide such advice or recommendations by the 

20 Commission or any other Federal official.’’; 

21 (3) by redesignating section 8 as section 13; 

22 (4) by striking section 7 and inserting the fol23 lowing: 


emcdonald on DSK2BSOYB1PROD with BILLS
5 

•HR 2298 IH

1 ‘‘SEC. 7. BORDER HEALTH GRANTS. 

2 ‘‘(a) ELIGIBLE ENTITY DEFINED.—In this section, 

3 the term ‘eligible entity’ means a State, public institution 

4 of higher education, local government, Indian tribe, tribal 

5 organization, urban Indian organization, nonprofit health 

6 organization, trauma center, or community health center 

7 receiving assistance under section 330 of the Public 

8 Health Service Act (42 U.S.C. 254b), that is located in 

9 the United States-Mexico Border Area. 

10 ‘‘(b) AUTHORIZATION.—From amounts appropriated 

11 under section 12, the Secretary of Health and Human 

12 Services, acting through the members of the Commission, 

13 shall award grants to eligible entities to address priorities 

14 and recommendations outlined by the strategic plan under 

15 section 9(a) and operational work plan under section 9(b) 

16 to improve the health of individuals residing in the United 

17 States-Mexico Border Area. 

18 ‘‘(c) APPLICATION.—An eligible entity that desires a 

19 grant under subsection (b) shall submit an application to 

20 the Secretary of Health and Human Services at such time, 

21 in such manner, and containing such information as the 

22 Secretary may require. 

23 ‘‘(d) USE OF FUNDS.—An eligible entity that receives 

24 a grant under subsection (b) shall use the grant funds 

25 for— 

26 ‘‘(1) programs relating to— 


emcdonald on DSK2BSOYB1PROD with BILLS
6 

•HR 2298 IH

1 ‘‘(A) maternal and child health; 

2 ‘‘(B) primary care and preventative health; 

3 ‘‘(C) infectious disease testing and moni4 toring; 

5 ‘‘(D) public health and public health infra6 structure; 

7 ‘‘(E) health promotion; 

8 ‘‘(F) oral health; 

9 ‘‘(G) behavioral and mental health; 

10 ‘‘(H) substance abuse; 

11 ‘‘(I) health conditions that have a high 

12 prevalence in the United States-Mexico Border 

13 Area; 

14 ‘‘(J) medical and health services research; 

15 ‘‘(K) workforce training and development; 

16 ‘‘(L) community health workers or 

17 promotoras; 

18 ‘‘(M) health care infrastructure problems 

19 in the United States-Mexico Border Area (in20 cluding planning and construction grants); 

21 ‘‘(N) health disparities in the United 

22 States-Mexico Border Area; 

23 ‘‘(O) environmental health; 

24 ‘‘(P) health education; 


emcdonald on DSK2BSOYB1PROD with BILLS
7 

•HR 2298 IH

1 ‘‘(Q) outreach and enrollment services with 

2 respect to Federal programs (including pro3 grams authorized under titles XIX and XXI of 

4 the Social Security Act (42 U.S.C. 1396 and 

5 1397aa)); 

6 ‘‘(R) trauma care; 

7 ‘‘(S) health research with an emphasis on 

8 infectious disease; 

9 ‘‘(T) epidemiology and health research; 

10 ‘‘(U) cross-border health surveillance co11 ordinated with Mexican Health Authorities; 

12 ‘‘(V) obesity, particularly childhood obe13 sity; 

14 ‘‘(W) crisis communication, domestic vio15 lence, substance abuse, health literacy, and can16 cer; or 

17 ‘‘(X) community-based participatory re18 search on border health issues, as defined by 

19 the Secretary of Health and Human Services; 

20 or 

21 ‘‘(2) other programs determined appropriate by 

22 the Secretary of Health and Human Services. 

23 ‘‘(e) SUPPLEMENT, NOT SUPPLANT.—Amounts pro24 vided to an eligible entity awarded a grant under sub25 section (b) shall be used to supplement and not supplant 


emcdonald on DSK2BSOYB1PROD with BILLS
8 

•HR 2298 IH

1 other funds available to the eligible entity to carry out the 

2 activities described in subsection (d). 

3 ‘‘SEC. 8. GRANTS FOR EARLY WARNING INFECTIOUS DIS4 EASE SURVEILLANCE (EWIDS) PROJECTS IN 

5 THE BORDER AREA. 

6 ‘‘(a) ELIGIBLE ENTITY DEFINED.—In this section, 

7 the term ‘eligible entity’ means a State, local government, 

8 Indian tribe, tribal organization, urban Indian organiza9 tion, trauma center, regional trauma center coordinating 

10 entity, or public health entity, that is located in the United 

11 States-Mexico Border Area. 

12 ‘‘(b) AUTHORIZATION.—From amounts appropriated 

13 under section 12, the Secretary of Health and Human 

14 Services shall award grants under the Early Warning In15 fectious Disease Surveillance (EWIDS) project to eligible 

16 entities for infectious disease surveillance activities in the 

17 United States-Mexico Border Area. 

18 ‘‘(c) APPLICATION.—An eligible entity that desires a 

19 grant under this section shall submit an application to the 

20 Secretary of Health and Human Services at such time, 

21 in such manner, and containing such information as the 

22 Secretary may require. 

23 ‘‘(d) USES OF FUNDS.—An eligible entity that re24 ceives a grant under subsection (b) shall use the grant 

25 funds to, in coordination with State and local all hazards 


emcdonald on DSK2BSOYB1PROD with BILLS
9 

•HR 2298 IH

1 programs, as specified by the Secretary of Health and 

2 Human Services— 

3 ‘‘(1) develop and implement infectious disease 

4 surveillance plans and readiness assessments and 

5 purchase items necessary for such plans; 

6 ‘‘(2) coordinate infectious disease surveillance 

7 planning in the region with appropriate United 

8 States-based agencies and organizations as well as 

9 appropriate authorities in Mexico or Canada; 

10 ‘‘(3) improve infrastructure, including surge ca11 pacity, syndromic surveillance, laboratory capacity, 

12 and isolation/decontamination capacity; 

13 ‘‘(4) create a health alert network, including 

14 risk communication and information dissemination; 

15 ‘‘(5) educate and train clinicians, epidemiolo16 gists, laboratories, and emergency personnel; 

17 ‘‘(6) implement electronic data systems to co18 ordinate the triage, transportation, and treatment of 

19 multi-casualty incident victims; 

20 ‘‘(7) provide infectious disease testing in the 

21 United States-Mexico Border Area; and 

22 ‘‘(8) carry out such other activities identified by 

23 the Secretary of Health and Human Services, the 

24 United States-Mexico Border Health Commission, 

25 State and local public health offices, and border 


emcdonald on DSK2BSOYB1PROD with BILLS
10 

•HR 2298 IH

1 health offices at the United States-Mexico or United 

2 States-Canada borders. 

3 ‘‘SEC. 9. PLANS, REPORTS, AUDITS, AND BY-LAWS. 

4 ‘‘(a) STRATEGIC PLAN.— 

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

6 after the date of enactment of this section, and every 

7 5 years thereafter, the Commission (including the 

8 participation of members of both the United States 

9 and Mexican sections) shall prepare a binational 

10 strategic plan to guide the operations of the Com11 mission and submit such plan to the Secretary and 

12 Congress (and the Mexican legislature). 

13 ‘‘(2) REQUIREMENTS.—The binational strategic 

14 plan under paragraph (1) shall include— 

15 ‘‘(A) health-related priority areas deter16 mined most important by the full membership 

17 of the Commission; 

18 ‘‘(B) recommendations for goals, objec19 tives, strategies and actions designed to address 

20 such priority areas; and 

21 ‘‘(C) a proposed evaluation framework with 

22 output and outcome indicators appropriate to 

23 gauge progress toward meeting the objectives 

24 and priorities of the Commission. 


emcdonald on DSK2BSOYB1PROD with BILLS
11 

•HR 2298 IH

1 ‘‘(b) WORK PLAN.—Not later than January 1, 2012, 

2 and every other January 1 thereafter, the Commission 

3 shall develop and approve an operational work plan and 

4 budget based on the strategic plan under subsection (a). 

5 At the end of each such work plan cycle, the Government 

6 Accountability Office shall conduct an evaluation of the 

7 activities conducted by the Commission based on output 

8 and outcome indicators included in the strategic plan. The 

9 evaluation shall include a request for written evaluations 

10 from the commissioners about barriers and facilitators to 

11 executing successfully the Commission work plan. 

12 ‘‘(c) BIANNUAL REPORTING.—The Commission shall 

13 issue a biannual report to the Secretary of Health and 

14 Human Services which provides independent policy rec15 ommendations related to border health issues. Not later 

16 than 3 months following receipt of each such biannual re17 port, the Secretary shall provide the report and any stud18 ies or other material produced independently by the Com19 mission to Congress. 

20 ‘‘(d) AUDITS.—The Secretary of Health and Human 

21 Services shall annually prepare an audited financial report 

22 to account for all appropriated assets expended by the 

23 Commission to address both the strategic and operational 

24 work plans for the year involved. 


emcdonald on DSK2BSOYB1PROD with BILLS
12 

•HR 2298 IH

1 ‘‘(e) BY-LAWS.—Not less than 6 months after the 

2 date of enactment of this section, the Commission shall 

3 develop and approve bylaws to provide fully for compliance 

4 with the requirements of this section. 

5 ‘‘(f) TRANSMITTAL TO CONGRESS.—The Commission 

6 shall submit copies of the work plan and by-laws to Con7 gress. The Government Accountability Office shall submit 

8 a copy of the evaluation to Congress. 

9 ‘‘SEC. 10. BINATIONAL HEALTH INFRASTRUCTURE AND 

10 HEALTH INSURANCE. 

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

12 Human Services shall enter into a contract with the Insti13 tute of Medicine for the conduct of a study concerning 

14 binational health infrastructure, with respect to the 

15 United States and Mexico and with respect to the United 

16 States and Canada (including trauma and emergency 

17 care) and health insurance efforts. In conducting such 

18 study, the Institute shall solicit input from border health 

19 experts, as specified by the Secretary of Health and 

20 Human Services, and health insurance issuers. 

21 ‘‘(b) REPORT.—Not later than 1 year after the date 

22 on which the Secretary enters into the contract under sub23 section (a), the Institute of Medicine shall submit to the 

24 Secretary and the appropriate committees of Congress a 

25 report concerning the study conducted under such conVerDate Mar 15 2010 22:40 Jun 27, 2011 Jkt 099200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\H2298.IH H2298

emcdonald on DSK2BSOYB1PROD with BILLS
13 

•HR 2298 IH

1 tract. Such report shall include the recommendations of 

2 the Institute on ways to establish, expand, or improve bi3 national health infrastructure and health insurance ef4 forts. 

5 ‘‘SEC. 11. COORDINATION. 

6 ‘‘(a) IN GENERAL.—To the extent practicable and 

7 appropriate, plans, systems, and activities to be funded (or 

8 supported) under this Act for all hazard preparedness, as 

9 defined by the Secretary of Health and Human Services, 

10 and general areas of health of individuals residing in the 

11 United States-Mexico Border area, should be coordinated 

12 with Federal, State, and local authorities in Mexico and 

13 the United States. 

14 ‘‘(b) COORDINATION OF HEALTH SERVICES AND

15 SURVEILLANCE.—The Secretary of Health and Human 

16 Services may coordinate with the Secretary of Homeland 

17 Security in establishing a health alert system that— 

18 ‘‘(1) alerts clinicians and public health officials 

19 of emerging disease clusters and syndromes along 

20 the United States-Mexico Border Area; and 

21 ‘‘(2) is alerted to signs of health threats, disas22 ters of mass scale, or bioterrorism along the United 

23 States-Mexico Border Area. 


emcdonald on DSK2BSOYB1PROD with BILLS
14 

•HR 2298 IH

1 ‘‘SEC. 12. AUTHORIZATION OF APPROPRIATIONS. 

2 ‘‘There is authorized to be appropriated to carry out 

3 this Act $31,000,000 for fiscal year 2012 and each suc4 ceeding fiscal year. Of the amount appropriated for each 

5 fiscal year, at least $1,000,000 shall be made available 

6 to fund operationally feasible functions and activities with 

7 respect to Mexico. The remaining funds shall be allocated 

8 for the administration of United States activities under 

9 this Act, border health activities under cooperative agree10 ments with the border health offices of the States of Cali11 fornia, Arizona, New Mexico, and Texas, the border health 

12 and EWIDS grant programs under sections 7 and 8, re13 spectively, and the Institute of Medicine and Government 

14 Accountability Office reports under this Act.’’; and 

15 (5) in section 13 (as so redesignated)— 

16 (A) by redesignating paragraphs (3) and 

17 (4) as paragraphs (4) and (5), respectively; and 

18 (B) by inserting after paragraph (2), the 

19 following: 

20 ‘‘(3) INDIANS; INDIAN TRIBE; TRIBAL ORGANI21 ZATION; URBAN INDIAN ORGANIZATION.—The terms 

22 ‘Indian’, ‘Indian tribe’, ‘tribal organization’, and 

23 ‘urban Indian organization’ have the meanings given 

24 such terms in section 4 of the Indian Health Care 

25 Improvement Act (25 U.S.C. 1603).’’. 

Æ 


emcdonald on DSK2BSOYB1PROD with BILLS