I 
117TH CONGRESS 
1ST SESSION H. R. 4812 
To establish grant programs to improve the health of residents along the 
United States-Mexico and United States-Canada borders and for all 
hazards preparedness in the border areas, including with respect to 
bioterrorism, infectious disease, and other emerging biothreats, and for 
other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 29, 2021 
Ms. ESCOBAR (for herself, Mr. TONY GONZALES of Texas, Mrs. KIRKPATRICK, 
Mr. GRIJALVA, Mr. VARGAS, Mr. VICENTE GONZALEZ of Texas, Mr. 
CUELLAR, and Mr. VELA) introduced the following bill; which was re-
ferred to the Committee on Energy and Commerce, and in addition to 
the Committee on Foreign Affairs, for a period to be subsequently deter-
mined 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 resi-
dents along the United States-Mexico and United States- 
Canada borders and for all hazards preparedness in the 
border areas, including with respect to bioterrorism, in-
fectious disease, and other emerging biothreats, and for 
other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Border Health Secu-
rity Act of 2021’’. 
SEC. 2. FINDINGS. 
Congress makes the following findings: 
(1) The United States-Mexico border is an 
interdependent and dynamic region of approximately 
15,000,000 residents and millions of border cross-
ings each year, with significant and unique public 
health challenges. 
(2) These challenges include low rates of health 
insurance coverage, poor access to health care serv-
ices, lack of education or access to information, pov-
erty-related illness, including undernutrition, and 
high rates of infectious diseases, such as tuber-
culosis, West Nile virus, and Zika virus, as well as 
other noncommunicable diseases such as cardio-
vascular disease, asthma, diabetes, and obesity. 
(3) As the COVID–19 pandemic has illustrated, 
diseases do not respect international boundaries, and 
a strong public health effort at and along the United 
States, Mexico, and Canada borders is crucial to not 
only protect and improve the health of Americans 
but also to help secure the country against biosecu-
rity and other emerging threats. 
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(4) For over 20 years, the United States-Mex-
ico Border Health Commission has served as a cru-
cial binational institution to address these unique 
and truly cross-border health issues. 
(5) The COVID–19 pandemic has also high-
lighted the need for continued coordination of re-
sources, effective communication, and information 
sharing between countries to address emerging pub-
lic health crises. 
SEC. 3. UNITED STATES-MEXICO BORDER HEALTH COMMIS-
SION ACT AMENDMENTS. 
The United States-Mexico Border Health Commis-
sion Act (22 U.S.C. 290n et seq.) is amended— 
(1) in section 3— 
(A) by striking ‘‘It should be the duty’’ 
and inserting the following: 
‘‘(a) IN GENERAL.—It should be the duty’’; 
(B) in paragraph (1), by striking ‘‘; and’’ 
and inserting ‘‘;’’; 
(C) in paragraph (2)(B), by striking the 
period and inserting a semicolon; 
(D) by adding at the end the following: 
‘‘(3) to evaluate the Commission’s progress in 
carrying out the duties described in paragraphs (1) 
and (2) and report on such progress and make rec-
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ommendations, as appropriate, to the Secretary of 
Health and Human Services and Congress regarding 
such duties; and 
‘‘(4) to serve as an independent and objective 
body to both recommend and implement initiatives 
that solve border health issues.’’; and 
(E) by adding at the end the following: 
‘‘(b) UNITED STATES SECTION MEMBERS.—The 
members of the United States section of the Commission, 
acting independently of the Commission overall, may— 
‘‘(1) provide reports and recommendations to, 
and consult with, the Secretary of Health and 
Human Services and Congress on the matters de-
scribed in subsection (a)(3); and 
‘‘(2) cooperate with the Canada-United States 
Pan Border Public Health Preparedness Council (re-
ferred to in this Act as the ‘Council’), as appro-
priate.’’; 
(2) in section 5(b), by striking ‘‘should be the 
leader’’ and inserting ‘‘shall be the Chair’’; 
(3) by redesignating section 8 as section 12; 
(4) by striking section 7 and inserting the fol-
lowing: 
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‘‘SEC. 7. BORDER HEALTH GRANTS. 
‘‘(a) ELIGIBLE ENTITY DEFINED.—In this section, 
the term ‘eligible entity’ means a State, public institution 
of higher education, local government, Indian Tribe, Trib-
al organization, urban Indian organization, nonprofit 
health organization, trauma center, critical access hospital 
or other hospital that serves rural or other vulnerable com-
munities and populations, faith-based entity, or commu-
nity health center receiving assistance under section 330 
of the Public Health Service Act (42 U.S.C. 254b), that 
is located in the United States-Mexico border area or the 
United States-Canada border area. 
‘‘(b) AUTHORIZATION.—From amounts appropriated 
under section 11, the Secretary, in consultation with mem-
bers of the Commission and Council and in coordination 
with the Office of Global Affairs, shall award grants to 
eligible entities to improve the health of residents of the 
United States-Mexico and United States-Canada border 
areas with appropriate priority given to grants that ad-
dress recommendations outlined by the strategic plan and 
operational work plan of the Commission and the Council 
under section 9. 
‘‘(c) APPLICATION.—An eligible entity that desires a 
grant under subsection (b) shall submit an application to 
the Secretary at such time, in such manner, and con-
taining such information as the Secretary may require. 
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‘‘(d) USE OF FUNDS.—An eligible entity that receives 
a grant under subsection (b) shall use the grant funds for 
any of the following: 
‘‘(1) Programs relating to any one or more of 
the following: 
‘‘(A) Maternal and child health. 
‘‘(B) Primary care and preventative health. 
‘‘(C) Infectious disease testing, monitoring, 
and surveillance. 
‘‘(D) Public health and public health infra-
structure. 
‘‘(E) Health promotion, health literacy, 
and health education. 
‘‘(F) Oral health. 
‘‘(G) Behavioral and mental health. 
‘‘(H) Substance abuse prevention and 
harm reduction. 
‘‘(I) Health conditions that have a high 
prevalence in the United States-Mexico border 
area or United States-Canada border area. 
‘‘(J) Medical and health services research 
in border communities. 
‘‘(K) Workforce training and development. 
‘‘(L) Community health workers and 
promotoras. 
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‘‘(M) Health care infrastructure problems 
in the United States-Mexico border area or 
United States-Canada border area (including 
planning and construction grants). 
‘‘(N) Health disparities in the United 
States-Mexico border area or United States- 
Canada border area. 
‘‘(O) Environmental health. 
‘‘(P) Bioterrorism and zoonosis. 
‘‘(Q) Outreach and enrollment services 
with respect to Federal programs (including 
programs authorized under titles XIX and XXI 
of the Social Security Act (42 U.S.C. 1396 et 
seq., 42 U.S.C. 1397aa et seq.)). 
‘‘(R) Trauma care. 
‘‘(S) Health research with an emphasis on 
the prevalence of infectious diseases, such as 
measles, in the border areas, as well as other 
pressing health issues, such as noncommu-
nicable diseases like diabetes and obesity. 
‘‘(T) Epidemiology and health research. 
‘‘(U) Cross-border health surveillance co-
ordinated with Mexican Health Authorities or 
Canadian Health Authorities. 
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‘‘(V) Community-based participatory re-
search on border health issues. 
‘‘(W) Domestic violence and violence pre-
vention. 
‘‘(X) Cross-border public health prepared-
ness. 
‘‘(2) Other programs as the Secretary deter-
mines appropriate. 
‘‘(e) SUPPLEMENT, NOT SUPPLANT.—Amounts pro-
vided to an eligible entity awarded a grant under sub-
section (b) shall be used to supplement and not supplant 
other funds available to the eligible entity to carry out the 
activities described in subsection (d). 
‘‘SEC. 8. GRANTS FOR EARLY WARNING INFECTIOUS DIS-
EASE SURVEILLANCE IN THE BORDER AREA. 
‘‘(a) ELIGIBLE ENTITY DEFINED.—In this section, 
the term ‘eligible entity’ means a State, local government, 
Indian Tribe, Tribal organization, urban Indian organiza-
tion, trauma center, regional trauma center coordinating 
entity, or public health entity. 
‘‘(b) AUTHORIZATION.—From funds appropriated 
under section 11, the Secretary shall award grants for 
Early Warning Infectious Disease Surveillance to eligible 
entities for infectious disease surveillance activities in the 
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United States-Mexico border area or United States-Can-
ada border area. 
‘‘(c) APPLICATION.—An eligible entity that desires a 
grant under this section shall submit an application to the 
Secretary at such time, in such manner, and containing 
such information as the Secretary may require. 
‘‘(d) USES OF FUNDS.—An eligible entity that re-
ceives a grant under subsection (b) shall use the grant 
funds, in coordination with State and local all hazards pro-
grams, to— 
‘‘(1) develop and implement infectious disease 
surveillance plans and networks and public health 
emergency and readiness assessments and prepared-
ness plans, and purchase items necessary for such 
plans; 
‘‘(2) coordinate infectious disease surveillance 
planning and interjurisdictional risk assessments in 
the region with appropriate United States-based 
agencies and organizations and appropriate authori-
ties in Mexico or Canada; 
‘‘(3) improve infrastructure, including surge ca-
pacity, syndromic surveillance, and isolation and de-
contamination capacity, and policy preparedness, in-
cluding for mutual assistance and for the sharing of 
information and resources; 
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