424 
threats’’ before the period at the end of the 
first sentence; 
(B) in paragraph (2)— 
(i) in the paragraph heading, by strik-
ing ‘‘INFLUENZA’’ and inserting ‘‘RE-
SPONSE’’; and 
(ii) in subparagraph (A)— 
(I) by striking ‘‘to pandemic in-
fluenza’’ and inserting ‘‘to a pathogen 
causing a pandemic, including pan-
demic influenza’’; and 
(II) by striking ‘‘such pandemic 
influenza’’ and inserting ‘‘such pan-
demic response’’; 
(C) in paragraph (5)— 
(i) in the paragraph heading, by strik-
ing ‘‘INFLUENZA’’ and inserting ‘‘PAN-
DEMIC RESPONSE’’; 
(ii) in the matter preceding subpara-
graph (A), by striking ‘‘2019’’ and insert-
ing ‘‘2026’’; 
(iii) in subparagraph (A), by striking 
‘‘2018’’ and inserting ‘‘2025’’; and 
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(iv) in subparagraph (B), by striking 
‘‘pandemic influenza’’ and inserting ‘‘a 
pathogen causing a pandemic’’; and 
(D) in paragraph (6)— 
(i) in subparagraph (A), in the matter 
preceding clause (i), by striking ‘‘The 
amounts described in this paragraph are 
the following amounts that are payable to 
an entity for activities described in this 
section or section 319C–2’’ and inserting 
‘‘The Secretary shall withhold from an en-
tity pursuant to paragraph (5) for non-
compliance with the requirements of this 
section or section 319C–2 as follows’’; and 
(ii) in subparagraph (B), by inserting 
‘‘with respect to the requirements of this 
section or section 319C–2’’ after ‘‘para-
graph (5)’’; and 
(3) 
in 
subsection 
(h)(1)(A), 
by 
striking 
‘‘$685,000,000 for each of fiscal years 2019 through 
2023’’ and inserting ‘‘$735,000,000 for each of fis-
cal years 2025 and 2026, to remain available 
through December 31, 2026’’. 
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SEC. 613. HOSPITAL PREPAREDNESS PROGRAM. 
(a) INCREASING PARTICIPATION BY EMS IN THE 
HOSPITAL PREPAREDNESS PROGRAM.— 
(1) IN GENERAL.—Section 319C–2 of the Pub-
lic Health Service Act (42 U.S.C. 247d–3b) is 
amended— 
(A) in subsection (b)(1)(A)— 
(i) in clause (iii)(III), by striking ‘‘; 
and’’ and inserting a semicolon; and 
(ii) by striking clause (iv) and insert-
ing the following: 
‘‘(iv) one or more emergency medical 
service organizations; and 
‘‘(v) to the extent practicable, one or 
more emergency management organiza-
tions; and’’; and 
(B) in subsection (g)(1)— 
(i) by striking ‘‘(1) LOCAL RESPONSE 
CAPABILITIES’’ and inserting: 
‘‘(1) LOCAL RESPONSE CAPABILITIES.— 
‘‘(A) PROGRAM COORDINATION.—’’; 
(ii) by striking ‘‘extent practicable, 
ensure’’ and inserting the following: ‘‘ex-
tent practicable— 
‘‘(i) ensure’’; 
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(iii) by striking the period and insert-
ing ‘‘; and’’; and 
(iv) by adding at the end the fol-
lowing: 
‘‘(ii) seek to increase participation of 
eligible entities described in subsection 
(b)(1)(A) with lower participation rates 
relative to other eligible entities, such as 
emergency medical services organizations 
and health care facilities in underserved 
areas.’’. 
(2) 
PREFERENCES.—Section 
319C– 
2(d)(1)(A)(iii) of the Public Health Service Act (42 
U.S.C. 247d–3b(d)(1)(A)(iii)) is amended by strik-
ing ‘‘subsection (b)(1)(A)(ii)’’ and inserting ‘‘clauses 
(ii) and (iv) of subsection (b)(1)(A)’’. 
(b) IMPROVING MEDICAL READINESS AND RESPONSE 
CAPABILITIES.—Section 319C–2 of the Public Health 
Service Act (42 U.S.C. 247d–3b) is amended— 
(1) in subsection (b)(2)— 
(A) in subparagraph (A), by striking 
‘‘and’’ at the end; 
(B) in subparagraph (B), by striking the 
period and inserting ‘‘; and’’; and 
(C) by inserting at the end the following: 
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‘‘(C) designate a lead entity to administer such 
award and support coordination between entities de-
scribed in this subsection.’’; 
(2) in subsection (g)(1), as amended by sub-
section (a)(1)(B), by adding at the end the fol-
lowing: 
‘‘(B) REGIONAL OPERATIONS.—An eligible 
entity shall establish and maintain, or leverage 
an existing, capability to enable coordination of 
regional medical operations, which may include 
systems to facilitate information sharing and 
coordination, within a coalition described under 
subsection 
(b)(1)(A) 
and, 
as 
appropriate, 
among multiple coalitions that are in close geo-
graphic proximity to each other.’’; and 
(3) in subsection (j)(1)— 
(A) in subparagraph (A), by striking ‘‘for 
each of fiscal years 2019 through 2023’’ and 
inserting ‘‘for each of fiscal years 2025 and 
2026, to remain available through December 
31, 2026’’; and 
(B) in subparagraph (B)(iii), by striking 
‘‘September 30, 2023’’ and inserting ‘‘Decem-
ber 31, 2026’’. 
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SEC. 614. FACILITIES AND CAPACITIES OF THE CENTERS 
FOR DISEASE CONTROL AND PREVENTION TO 
COMBAT 
PUBLIC 
HEALTH 
SECURITY 
THREATS. 
Section 319D(h) of the Public Health Service Act (42 
U.S.C. 247d–4(h)) is amended— 
(1) in paragraph (1), by striking ‘‘$25,000,000 
for each of fiscal years 2022 and 2023’’ and insert-
ing ‘‘$40,000,000 for each of fiscal years 2025 and 
2026, to remain available through December 31, 
2026’’; and 
(2) in paragraph (2), by striking ‘‘2022 and 
2023’’ and inserting ‘‘2025 and 2026, to remain 
available through December 31, 2026’’. 
SEC. 615. PILOT PROGRAM TO SUPPORT STATE MEDICAL 
STOCKPILES. 
(a) IN GENERAL.—Section 319F–2(i) of the Public 
Health Service Act (42 U.S.C. 247d–6b(i)) is amended— 
(1) in paragraph (2)(B)(i)— 
(A) in subclause (I), by striking ‘‘and 
2024’’ and inserting ‘‘through 2025’’; and 
(B) in subclause (II), by striking ‘‘2025’’ 
and inserting ‘‘2026’’; 
(2) in paragraph (4)— 
(A) in subparagraph (G), by striking ‘‘; 
and’’ at the end and inserting a semicolon; 
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(B) by redesignating subparagraph (H) as 
subparagraph (I); 
(C) by inserting after subparagraph (G) 
the following: 
‘‘(H) facilitate the sharing of best practices 
among States within a consortia of States in re-
ceipt of funding related to establishing and 
maintaining a stockpile of medical products; 
and’’; and 
(D) in subparagraph (I), as so redesig-
nated, by striking ‘‘State efforts’’ and inserting 
‘‘State or regional efforts’’; 
(3) by redesignating paragraphs (5) through 
(9) as paragraphs (6) through (10), respectively; 
(4) by inserting after paragraph (4) the fol-
lowing: 
‘‘(5) COORDINATION.—An entity in receipt of 
an award under paragraph (1), in carrying out the 
activities under this subsection, shall coordinate with 
appropriate health care entities, health officials, and 
emergency management officials within the jurisdic-
tion of such State or States.’’; and 
(5) in paragraph (10), as so redesignated, by 
striking ‘‘$3,500,000,000 for each of fiscal years 
2023 and 2024’’ and inserting ‘‘$3,365,000,000 for 
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fiscal year 2025, and $3,265,000,000 for fiscal year 
2026’’. 
(b) GAO REPORT.—Section 2409(b) of the PRE-
VENT Pandemics Act (Public Law 117–328) is amend-
ed— 
(1) in paragraph (2), by striking ‘‘; and’’ and 
inserting a semicolon; 
(2) in paragraph (3), by striking the period and 
inserting ‘‘; and’’; and 
(3) by adding at the end the following: 
‘‘(4) the impact of any regional stockpiling ap-
proaches carried out under subsection (i)(1) of sec-
tion 319F–2 of the Public Health Service Act (42 
U.S.C. 247d–6b).’’. 
SEC. 616. ENHANCING DOMESTIC WASTEWATER SURVEIL-
LANCE FOR PATHOGEN DETECTION. 
(a) IN GENERAL.—Title III of the Public Health 
Service Act is amended by inserting after section 317V 
(42 U.S.C. 247b–24) the following: 
‘‘SEC. 317W. WASTEWATER SURVEILLANCE FOR PATHOGEN 
DETECTION. 
‘‘(a) WASTEWATER SURVEILLANCE SYSTEM.—The 
Secretary, acting through the Director of the Centers for 
Disease Control and Prevention and in coordination with 
other Federal departments and agencies, shall award 
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grants, contracts, or cooperative agreements to eligible en-
tities to establish, maintain, or improve activities related 
to the detection and monitoring of infectious diseases 
through wastewater for public health emergency prepared-
ness and response purposes. 
‘‘(b) ELIGIBLE ENTITIES.—To be eligible to receive 
an award under this section, an entity shall— 
‘‘(1) be a State, Tribal, or local health depart-
ment, or a partnership between such a health de-
partment and other public and private entities; and 
‘‘(2) submit to the Secretary an application at 
such time, in such manner, and containing such in-
formation as the Secretary may reasonably require, 
which shall include— 
‘‘(A) a description of activities proposed to 
be carried out pursuant to an award under sub-
section (a); 
‘‘(B) factors such entity proposes to use to 
select wastewater sampling sites; 
‘‘(C) factors such entity proposes to use to 
determine whether a response to findings from 
such wastewater sampling may be warranted, 
and a plan for responding, as appropriate, con-
sistent with applicable plans developed by such 
entity pursuant to section 319C–1; 
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‘‘(D) a plan to sustain such wastewater 
surveillance activities described in such applica-
tion following the conclusion of the award pe-
riod; and 
‘‘(E) any additional information the Sec-
retary may require. 
‘‘(c) CONSIDERATION.—In making awards under sub-
section (a), the Secretary may give priority to eligible enti-
ties that have submitted an application that— 
‘‘(1) details plans to provide public access to 
deidentified data generated through such wastewater 
surveillance activities in a manner that allows for 
comparison to such data generated by other recipi-
ents of an award under subsection (a); and 
‘‘(2) provides an assessment of community 
needs related to ongoing infectious disease moni-
toring, including estimates of the incidence and 
prevalence of infectious diseases that can be detected 
in wastewater and availability, at the time of the ap-
plication, of other forms of infectious disease detec-
tion in the jurisdiction. 
‘‘(d) USE OF FUNDS.—An eligible entity shall, as ap-
propriate, use amounts awarded under this section to— 
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‘‘(1) establish or enhance existing capacity and 
capabilities to conduct wastewater sampling, testing, 
and related analysis; 
‘‘(2) conduct wastewater surveillance, as appro-
priate, in areas or facilities with increased risk of in-
fectious disease outbreaks and limited ability to uti-
lize other forms of infectious disease detection, such 
as at individual facilities, institutions, and locations 
in rural areas or areas in which wastewater is not 
treated through the relevant local utility of the juris-
diction; and 
‘‘(3) implement projects that use evidence-based 
or innovative practices to conduct wastewater sur-
veillance activities. 
‘‘(e) PARTNERSHIPS.—In carrying out activities 
under this section, eligible entities shall identify opportuni-
ties to partner with other public or private entities to le-
verage relevant capabilities maintained by such entities, 
as appropriate and consistent with this section. 
‘‘(f) TECHNICAL ASSISTANCE.—The Secretary, in 
consultation with the heads of other applicable Federal 
agencies and departments, as appropriate, shall provide 
technical assistance to recipients of awards under this sec-
tion to facilitate the planning, development, and imple-
mentation of activities described in subsection (d). 
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‘‘(g) AUTHORIZATION
OF
APPROPRIATIONS.—To 
carry out this section, there is authorized to be appro-
priated $20,000,000 for each of fiscal years 2025 and 
2026, to remain available through December 31, 2026.’’. 
(b) WASTEWATER SURVEILLANCE RESEARCH.— 
(1) IN GENERAL.—The Secretary of Health and 
Human Services (in this subsection referred to as 
the ‘‘Secretary’’) shall continue to conduct or sup-
port research on the use of wastewater surveillance 
to detect and monitor emerging infectious diseases, 
which may include— 
(A) research to improve the efficiency and 
effectiveness of wastewater sample collection 
and analysis and increase the sensitivity and 
specificity of wastewater testing methods; and 
(B) implementation and development of 
evidence-based practices to facilitate the esti-
mation of the incidence and prevalence of infec-
tious disease within a community. 
(2) NON-DUPLICATION OF EFFORT.—The Sec-
retary shall ensure that activities carried out under 
this subsection do not unnecessarily duplicate efforts 
of other agencies and offices within the Department 
of Health and Human Services related to wastewater 
surveillance. 
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SEC. 617. REAUTHORIZATION OF MOSQUITO ABATEMENT 
FOR SAFETY AND HEALTH PROGRAM. 
Section 317S of the Public Health Service Act (42 
U.S.C. 247b–21) is amended— 
(1) in subsection (a)(3)(A), by striking ‘‘sub-
section (b)(3)’’ and inserting ‘‘subsection (b)(4)’’; 
(2) in subsection (b)— 
(A) 
by 
redesignating 
paragraphs 
(3) 
through (6) as paragraphs (4) through (7), re-
spectively; and 
(B) by inserting after paragraph (2) the 
following: 
‘‘(3) CONSIDERATIONS.—The Secretary may 
consider the use of innovative and novel technology 
for mosquito prevention and control in making 
grants under paragraph (1).’’; 
(3) by amending subsection (d) to read as fol-
lows: 
‘‘(d) USES OF FUNDS.—Amounts appropriated under 
subsection (f) may be used by the Secretary to provide 
training and technical assistance with respect to the plan-
ning, development, and operation of assessments and 
plans under subsection (a) and control programs under 
subsection (b). The Secretary may provide such training 
and technical assistance directly or through awards of 
grants or contracts to public and private entities.’’; and 
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(4) in subsection (f)(1), by striking ‘‘2019 
through 2023’’ and inserting ‘‘2025 and 2026, to re-
main available through December 31, 2026’’. 
Subtitle B—Federal Planning and 
Coordination 
SEC. 621. ALL-HAZARDS EMERGENCY PREPAREDNESS AND 
RESPONSE. 
Section 2811 of the Public Health Service Act (42 
U.S.C. 300hh–10) is amended— 
(1) in subsection (b)— 
(A) in paragraph (3)— 
(i) by striking ‘‘Oversee advanced re-
search, development, and procurement’’ 
and inserting the following: 
‘‘(A) IN GENERAL.—Oversee advanced re-
search, development, procurement, and replen-
ishment’’; and 
(ii) by adding at the end the fol-
lowing: 
‘‘(B) 
DEVELOPMENT
OF
REQUIRE-
MENTS.—Lead the development and approval, 
and, on a routine basis, the review and update, 
of requirements for such countermeasures and 
products, including related capabilities, to in-
form the advanced research, development, pro-
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curement, and replenishment decisions of the 
Secretary.’’; 
(B) in paragraph (4)— 
(i) in subparagraph (F)— 
(I) in the matter preceding clause 
(i), by striking ‘‘and in consultation 
with the Secretary of Homeland Secu-
rity,’’; and 
(II) in clause (i), by inserting 
‘‘enhance’’ after ‘‘capabilities and’’; 
(ii) in subparagraph (G)— 
(I) in the matter preceding clause 
(i), by inserting ‘‘the Office of Pan-
demic Preparedness and Response 
Policy,’’ after ‘‘Veterans Affairs,’’; 
(II) in clause (i), by striking 
‘‘based on’’ and inserting ‘‘based on— 
’’; 
(III) in clause (ii), by striking ‘‘; 
and’’ at the end and inserting a semi-
colon; 
(IV) in clause (iii), by striking 
the period and inserting ‘‘; and’’; and 
(V) by adding at the end the fol-
lowing: 
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‘‘(iv) that include, as appropriate, par-
ticipation by relevant industry, academia, 
professional societies, and other stake-
holders.’’; 
(iii) in subparagraph (H)— 
(I) by inserting ‘‘and the Direc-
tor of the Office of Pandemic Pre-
paredness and Response Policy’’ after 
‘‘Security Affairs’’; and 
(II) by inserting ‘‘and medical 
product and supply capacity planning 
pursuant to subparagraph (J), includ-
ing discussion of any relevant identi-
fied supply chain vulnerabilities’’ be-
fore the period at the end; 
(iv) in subparagraph (I), by inserting 
‘‘the Director of the Office of Pandemic 
Preparedness and Response Policy,’’ after 
‘‘Security Affairs,’’; and 
(v) in subparagraph (J)(i), in the 
matter preceding subclause (I), by insert-
ing ‘‘(including ancillary medical supplies 
and components of medical products, such 
as active pharmaceutical ingredients, key 
starting materials, medical device compo-
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nents, testing kits, reagents, and other 
testing supplies)’’ after ‘‘supply needs’’; 
and 
(C) in paragraph (7)— 
(i) in the matter preceding subpara-
graph (A), by inserting ‘‘and the require-
ments developed pursuant to paragraph 
(3)(B)’’ after ‘‘subsection (d)’’; 
(ii) by redesignating subparagraphs 
(E) and (F) as subparagraphs (F) and 
(G), respectively; and 
(iii) by inserting after subparagraph 
(D) the following: 
‘‘(E) include a professional judgment of 
anticipated budget needs for each future fiscal 
year accounted for in such plan to account for 
the full range of anticipated medical counter-
measure needs and life-cycle costs to address 
such priorities and requirements;’’; 
(2) in subsection (d)— 
(A) by amending paragraph (1) to read as 
follows: 
‘‘(1) IN GENERAL.—Not later than March 15, 
2020, and biennially thereafter, the Assistant Sec-
retary for Preparedness and Response shall develop 
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