I 
117TH CONGRESS 
1ST SESSION H. R. 1849 
To authorize the Secretary of Health and Human Services, acting through 
the Director of the Centers for Disease Control and Prevention, to 
establish a core public health infrastructure program, and for other 
purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 11, 2021 
Miss RICE of New York introduced the following bill; which was referred to 
the Committee on Energy and Commerce 
A BILL 
To authorize the Secretary of Health and Human Services, 
acting through the Director of the Centers for Disease 
Control and Prevention, to establish a core public health 
infrastructure program, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. CORE PUBLIC HEALTH INFRASTRUCTURE FOR 
STATE, LOCAL, TRIBAL, AND TERRITORIAL 
HEALTH DEPARTMENTS. 
(a) PROGRAM.—The Secretary of Health and Human 
Services (in this Act referred to as the ‘‘Secretary’’), act-
ing through the Director of the Centers for Disease Con-
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trol and Prevention, shall establish a core public health 
infrastructure program consisting of awarding grants 
under subsection (b). 
(b) GRANTS.— 
(1) AWARD.—For the purpose of addressing 
core public health infrastructure needs, the Sec-
retary— 
(A) shall award a grant to each State 
health department; and 
(B) may award grants on a competitive 
basis to State, local, Tribal, or territorial health 
departments. 
(2) ALLOCATION.—Of the total amount of 
funds awarded as grants under this subsection for a 
fiscal year— 
(A) not less than 50 percent shall be for 
grants to State health departments under para-
graph (1)(A); and 
(B) not less than 30 percent shall be for 
grants to State, local, Tribal, or territorial 
health departments under paragraph (1)(B). 
(c) USE OF FUNDS.—A State, local, Tribal, or terri-
torial health department receiving a grant under sub-
section (b) shall use the grant funds to address core public 
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health infrastructure needs, including those identified in 
the accreditation process under subsection (g). 
(d) FORMULA GRANTS TO STATE HEALTH DEPART-
MENTS.—In making grants under subsection (b)(1)(A), 
the Secretary shall award funds to each State health de-
partment in accordance with— 
(1) a formula based on population size, burden 
of preventable disease and disability, and core public 
health infrastructure gaps, including those identified 
in the accreditation process under subsection (g); 
and 
(2) application requirements established by the 
Secretary, including a requirement that the State 
health department submit a plan that demonstrates 
to the satisfaction of the Secretary that the State’s 
health department will— 
(A) address its highest priority core public 
health infrastructure needs; and 
(B) as appropriate, allocate funds to local 
health departments within the State. 
(e) COMPETITIVE GRANTS TO STATE, LOCAL, TRIB-
AL, AND
TERRITORIAL
HEALTH
DEPARTMENTS.—In 
making grants under subsection (b)(1)(B), the Secretary 
shall give priority to applicants demonstrating core public 
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health infrastructure needs identified in the accreditation 
process under subsection (g). 
(f) MAINTENANCE OF EFFORT.—The Secretary may 
award a grant to an entity under subsection (b) only if 
the entity demonstrates to the satisfaction of the Sec-
retary that— 
(1) funds received through the grant will be ex-
pended only to supplement, and not supplant, non- 
Federal and Federal funds otherwise available to the 
entity for the purpose of addressing core public 
health infrastructure needs; and 
(2) with respect to activities for which the grant 
is awarded, the entity will maintain expenditures of 
non-Federal amounts for such activities at a level 
not less than the level of such expenditures main-
tained by the entity for the fiscal year preceding the 
fiscal year for which the entity receives the grant. 
(g) ESTABLISHMENT OF A PUBLIC HEALTH ACCRED-
ITATION PROGRAM.— 
(1) IN GENERAL.—The Secretary shall— 
(A) develop, and periodically review and 
update, standards for voluntary accreditation of 
State, local, Tribal, and territorial health de-
partments and public health laboratories for the 
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purpose of advancing the quality and perform-
ance of such departments and laboratories; and 
(B) implement a program to accredit such 
health departments and laboratories in accord-
ance with such standards. 
(2) COOPERATIVE AGREEMENT.—The Secretary 
may enter into a cooperative agreement with a pri-
vate nonprofit entity to carry out paragraph (1). 
(h) REPORT.—The Secretary shall submit to the Con-
gress an annual report on progress being made to accredit 
entities under subsection (g), including— 
(1) a strategy, including goals and objectives, 
for accrediting entities under subsection (g) and 
achieving the purpose described in subsection 
(g)(1)(A); 
(2) identification of gaps in research related to 
core public health infrastructure; and 
(3) recommendations of priority areas for such 
research. 
(i) DEFINITION.—In this section, the term ‘‘core pub-
lic health infrastructure’’ includes— 
(1) workforce capacity and competency; 
(2) laboratory systems; 
(3) testing capacity, including test platforms, 
mobile testing units, and personnel; 
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(4) health information, health information sys-
tems, and health information analysis; 
(5) disease surveillance; 
(6) contact tracing; 
(7) communications; 
(8) financing; 
(9) other relevant components of organizational 
capacity; and 
(10) other related activities. 
(j) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there are authorized to be appropriated 
$6,000,000,000 for the period of fiscal years 2022 
through 2026. 
SEC. 2. CORE PUBLIC HEALTH INFRASTRUCTURE AND AC-
TIVITIES FOR CDC. 
(a) IN GENERAL.—The Secretary, acting through the 
Director of the Centers for Disease Control and Preven-
tion, shall expand and improve the core public health in-
frastructure and activities of the Centers for Disease Con-
trol and Prevention to address unmet and emerging public 
health needs. 
(b) REPORT.—The Secretary shall submit to the Con-
gress an annual report on the activities funded through 
this section. 
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(c) DEFINITION.—In this section, the term ‘‘core 
public health infrastructure’’ has the meaning given to 
such term in section 1. 
(d) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there is authorized to be appropriated 
$1,000,000,000 for the period of fiscal years 2022 
through 2026. 
Æ 
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