II 

115TH CONGRESS 

2D SESSION S. 2851 

To improve regional health care emergency preparedness and response 

systems, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

MAY 15, 2018 

Mr. CASEY (for himself and Mr. BURR) introduced the following bill; which 

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

Labor, and Pensions 

A BILL 

To improve regional health care emergency preparedness and 

response systems, 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 ‘‘Regional Health Care 

5 Emergency Preparedness and Response Systems Act’’. 

6 SEC. 2. REGIONAL HEALTH CARE EMERGENCY PREPARED7 NESS AND RESPONSE SYSTEMS. 

8 (a) IN GENERAL.—Part B of title III of the Public 

9 Health Service Act (42 U.S.C. 243 et seq.) is amended 

10 by inserting after section 319C–2 the following: 


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1 ‘‘SEC. 319C–3. GUIDELINES FOR REGIONAL HEALTH CARE 

2 EMERGENCY PREPAREDNESS AND RESPONSE 

3 SYSTEMS. 

4 ‘‘(a) PURPOSE.—It is the purpose of this section to 

5 identify and provide guidelines for regional systems of hos6 pitals, health care facilities, and other public and private 

7 sector entities, with varying levels of capability to treat 

8 patients and increase medical surge capacity during, and 

9 in advance of, a public health emergency, including threats 

10 posed by one or more chemical, biological, radiological, 

11 and nuclear agents, including emerging infectious dis12 eases. 

13 ‘‘(b) GUIDELINES.—The Assistant Secretary for Pre14 paredness and Response, in consultation with the Director 

15 of the Centers for Disease Control and Prevention, the Ad16 ministrator of the Centers for Medicare & Medicaid Serv17 ices, the Administrator of the Health Resources and Serv18 ices Administration, the Commissioner of Food and 

19 Drugs, the Assistant Secretary for Mental Health and 

20 Substance Use, the Assistant Secretary of Labor for Occu21 pational Safety and Health, the Secretary of Veterans Af22 fairs, heads of such other Federal agencies as the Sec23 retary determines to be appropriate, and State, local, trib24 al, and territorial public health officials, shall, not later 

25 than 2 years after the date of enactment of this section— 


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1 ‘‘(1) identify and develop a set of guidelines re2 lating to practices and protocols for all-hazards pub3 lic health emergency preparedness and response for 

4 hospitals and health care facilities to provide appro5 priate patient care during, in advance of, or imme6 diately following, a public health emergency, result7 ing from one or more chemical, biological, radio8 logical, or nuclear agents, including emerging infec9 tious diseases (which may include existing practices, 

10 such as trauma care and medical surge capacity and 

11 capabilities), with respect to— 

12 ‘‘(A) a regional approach to identifying 

13 hospitals and health care facilities based on 

14 varying capabilities and capacity to treat pa15 tients affected by such emergency, including— 

16 ‘‘(i) the manner in which the system 

17 will coordinate with and integrate the part18 nerships established under section 319C– 

19 2(b); and 

20 ‘‘(ii) informing and educating appro21 priate first responders and health care sup22 ply chain partners of the regional emer23 gency preparedness and response capabili24 ties and medical surge capacity of such 


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1 hospitals and health care facilities in the 

2 community; 

3 ‘‘(B) physical and technological infrastruc4 ture, laboratory capacity, staffing, blood supply, 

5 and other supply chain needs, taking into ac6 count resiliency, geographic considerations, and 

7 rural considerations; 

8 ‘‘(C) protocols or best practices for the 

9 safety and personal protection of workers who 

10 handle human remains and health care workers 

11 (including with respect to protective equipment 

12 and supplies, waste management processes, and 

13 decontamination), sharing of specialized experi14 ence among the health care workforce, behav15 ioral health, psychological resilience, and train16 ing of the workforce, as applicable; 

17 ‘‘(D) in a manner that allows for disease 

18 containment (within the meaning of section 

19 2802(b)(2)(B)), coordinated medical triage, 

20 treatment, and transportation of patients, based 

21 on patient medical need (including patients in 

22 rural areas), to the appropriate hospitals or 

23 health care facilities within the regional system 

24 or, as applicable and appropriate, between sys25 tems in different States or regions; and 


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1 ‘‘(E) the needs of children and other at2 risk individuals; 

3 ‘‘(2) make such guidelines available on the 

4 internet website of the Department of Health and 

5 Human Services in a manner that does not com6 promise national security; and 

7 ‘‘(3) update such guidelines as appropriate, in8 cluding based on input received pursuant to sub9 sections (c), (e), and (f), to address new and emerg10 ing public health threats. 

11 ‘‘(c) CONSIDERATIONS.—In identifying, developing, 

12 and updating guidelines under subsection (b), the Assist13 ant Secretary for Preparedness and Response shall— 

14 ‘‘(1) include input from hospitals and health 

15 care facilities, including health care coalitions under 

16 section 319C–2, State, local, tribal, and territorial 

17 public health departments, and health care or sub18 ject matter experts, including experts with relevant 

19 expertise in chemical, biological, radiological, or nu20 clear threats, and emerging infectious disease as the 

21 Assistant Secretary determines appropriate, to meet 

22 the goals under section 2802(b)(3); 

23 ‘‘(2) consult and engage with appropriate 

24 health care providers and professionals, including 

25 physicians, nurses, first responders, health care faVerDate Sep 11 2014 03:55 May 23, 2018 Jkt 079200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S2851.IS S2851

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1 cilities (including hospitals, primary care clinics, 

2 community health centers, mental health facilities, 

3 ambulatory care facilities, and dental health facili4 ties), pharmacies, emergency medical providers, 

5 trauma care providers, environmental health agen6 cies, public health laboratories, poison control cen7 ters, blood banks, and other experts that the Assist8 ant Secretary determines appropriate, to meet the 

9 goals under section 2802(b)(3); 

10 ‘‘(3) consider feedback related to financial im11 plications for hospitals, health care facilities, public 

12 health agencies, laboratories, and other entities en13 gaged in regional preparedness planning to imple14 ment and follow such guidelines, as applicable; and 

15 ‘‘(4) consider financial requirements and poten16 tial incentives for entities to prepare for, and re17 spond to, public health emergencies as part of the 

18 regional health care emergency preparedness and re19 sponse system. 

20 ‘‘(d) TECHNICAL ASSISTANCE.—The Assistant Sec21 retary for Preparedness and Response, in consultation 

22 with the Director of the Centers for Disease Control and 

23 Prevention and the Assistant Secretary of Labor for Occu24 pational Safety and Health, may provide technical assistVerDate Sep 11 2014 03:55 May 23, 2018 Jkt 079200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S2851.IS S2851

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1 ance and consultation towards meeting the guidelines de2 scribed in subsection (b). 

3 ‘‘(e) DEMONSTRATION PROJECT FOR REGIONAL

4 HEALTH CARE PREPAREDNESS AND RESPONSE SYS5 TEMS.— 

6 ‘‘(1) IN GENERAL.—The Assistant Secretary for 

7 Preparedness and Response may establish a dem8 onstration project pursuant to the development and 

9 implementation of guidelines under subsection (b) to 

10 improve medical surge capacity for all hazards, build 

11 and integrate regional medical response capabilities, 

12 improve specialty care expertise for all-hazards re13 sponse, and coordinate medical preparedness and re14 sponse across State, local, tribal, territorial, and re15 gional jurisdictions. 

16 ‘‘(2) SUNSET.—The authority under this sub17 section shall expire on September 30, 2023. 

18 ‘‘(f) GAO REPORT TO CONGRESS.— 

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

20 date of enactment of this section, the Comptroller 

21 General of the United States (referred to in this 

22 subsection as the ‘Comptroller General’) shall submit 

23 to the Committee on Health, Education, Labor, and 

24 Pensions and the Committee on Finance of the Sen25 ate and the Committee on Energy and Commerce 


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1 and the Committee on Ways and Means of the 

2 House of Representatives, a report on the extent to 

3 which hospitals and health care facilities have imple4 mented the recommended guidelines under sub5 section (b), including an analysis and evaluation of 

6 any challenges hospitals or health care facilities ex7 perienced in implementing such guidelines. 

8 ‘‘(2) CONTENT.—The Comptroller General shall 

9 include in the report under paragraph (1)— 

10 ‘‘(A) data on the preparedness and re11 sponse capabilities that have been informed by 

12 the guidelines under subsection (b) to improve 

13 regional emergency health care preparedness 

14 and response capability, including hospital and 

15 health care facility capacity and medical surge 

16 capabilities to prepare for, and respond to, pub17 lic health emergencies; and 

18 ‘‘(B) recommendations to reduce gaps in 

19 incentives for regional health partners, includ20 ing hospitals and health care facilities to im21 prove capacity and medical surge capabilities to 

22 prepare for, and respond to, public health emer23 gencies, consistent with subsection (a), which 

24 may include consideration of facilities partici25 pating in programs under section 319C–2, proVerDate Sep 11 2014 03:55 May 23, 2018 Jkt 079200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S2851.IS S2851

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1 grams under the Centers for Medicare & Med2 icaid Services (including innovative health care 

3 delivery and payment models), and input from 

4 private sector financial institutions. 

5 ‘‘(3) CONSULTATION.—In carrying out para6 graphs (1) and (2), the Comptroller General shall 

7 consult with the heads of appropriate Federal agen8 cies, including— 

9 ‘‘(A) the Assistant Secretary for Prepared10 ness and Response; 

11 ‘‘(B) the Director of the Centers for Dis12 ease Control and Prevention; 

13 ‘‘(C) the Administrator of the Centers for 

14 Medicare & Medicaid Services; 

15 ‘‘(D) the Assistant Secretary for Mental 

16 Health and Substance Use; 

17 ‘‘(E) the Assistant Secretary of Labor for 

18 Occupational Safety and Health; 

19 ‘‘(F) the Secretary of Veterans Affairs; 

20 and 

21 ‘‘(G) the heads of such other Federal agen22 cies as the Secretary determines appropriate.’’. 

23 (b) ANNUAL REPORTS.—Section 319C–2(i)(1) of the 

24 Public Health Service Act (42 U.S.C. 247d–3b(i)(1)) is 

25 amended by inserting after the first sentence the following 


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1 ‘‘The reports submitted under this paragraph shall also 

2 include progress towards the implementation of section 

3 319C–3.’’. 

4 (c) NATIONAL HEALTH SECURITY STRATEGY INCOR5 PORATION OF REGIONALIZED EMERGENCY PREPARED6 NESS AND RESPONSE.—Section 2802(b)(3) of the Public 

7 Health Service Act (42 U.S.C. 300hh–1(b)(3)) is amend8 ed— 

9 (1) in the matter preceding subparagraph (A), 

10 by striking ‘‘including mental health’’ and inserting 

11 ‘‘including pharmacies, mental health facilities,’’; 

12 and 

13 (2) by amending subparagraph (G) to read as 

14 follows: 

15 ‘‘(G) Optimizing a coordinated and flexible 

16 approach to the emergency response and med17 ical surge capacity of hospitals, other health 

18 care facilities, critical care, trauma care (which 

19 may include trauma centers), and emergency 

20 medical systems, which may include the imple21 mentation of guidelines for regional health care 

22 emergency preparedness and response systems 

23 under section 319C–3.’’. 

24 (d) IMPROVING STATE AND LOCAL PUBLIC HEALTH

25 SECURITY.— 


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1 (1) STATE AND LOCAL SECURITY.—Section 

2 319C–1(e) of the Public Health Service Act (42 

3 U.S.C. 247d–3a(e)) is amended by striking ‘‘, and 

4 local emergency plans.’’ and inserting ‘‘, local emer5 gency plans, and any regional health care emergency 

6 preparedness and response system established pursu7 ant to the applicable guidelines under section 319C– 

8 3.’’. 

9 (2) PARTNERSHIPS.—Section 319C–2(d)(1)(A) 

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

11 3b(d)(1)(A)) is amended— 

12 (A) in clause (i), by striking ‘‘; and’’ and 

13 inserting ‘‘;’’; 

14 (B) by redesignating clause (ii) as clause 

15 (iii); and 

16 (C) inserting after clause (i), the following: 

17 ‘‘(ii) among one or more facilities in a 

18 regional health care emergency system 

19 under section 319C–3; and’’. 

Æ 


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