SEC. 2. INDEPENDENCE OF THE SURGEON GENERAL OF 
THE PUBLIC HEALTH SERVICE. 
(a) IN GENERAL.—Section 204 of the Public Health 
Service Act (42 U.S.C. 205) is amended to read as follows: 
‘‘SURGEON GENERAL 
‘‘SEC. 204. (a) APPOINTMENT.— 
‘‘(1) IN GENERAL.—The Surgeon General shall 
be appointed for a 4-year term by the President, in 
accordance with paragraph (2), by and with the ad-
vice and consent of the Senate. 
‘‘(2) REQUIREMENTS FOR APPOINTMENT.—The 
Surgeon General shall be appointed from individuals 
who— 
‘‘(A) are licensed physicians with special-
ized training and significant experience in pub-
lic health; 
‘‘(B) are, or agree upon appointment to 
become, members of the Regular Corps; and 
‘‘(C) are nominated by the Secretary pur-
suant to paragraph (3). 
‘‘(3) NOMINATIONS.—The Regular Corps shall 
submit to the Secretary and the President a list of 
6 nominees, who meet the requirements of para-
graph (2), and of whom not fewer than 3 shall be 
Regular Corps officers of flag rank, to fill any exist-
ing or pending vacancy in the position of Surgeon 
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General. The Secretary shall forward such list to the 
President, the Committee on Energy and Commerce 
of the House of Representatives, and the Committee 
on Health, Education, Labor, and Pensions of the 
Senate. 
‘‘(4) TERM
LIMIT.—An individual shall not 
serve more than 3 full terms as Surgeon General. 
‘‘(5) GRADE AND NUMBER.—Upon expiration of 
an individual’s service as the Surgeon General, the 
individual, unless reappointed, shall revert to the 
grade and number in the Regular Corps or Reserve 
Corps which the individual would have occupied if 
not for such service. 
‘‘(b) REMOVAL.—The President may only remove the 
Surgeon General during a term for cause. If a Surgeon 
General is removed, the Secretary shall provide to the 
Committee on Energy and Commerce of the House of 
Representatives and the Committee on Health, Education, 
Labor, and Pensions of the Senate a written explanation 
as to the cause for the removal. 
‘‘(c) LINE OF AUTHORITY.—Notwithstanding section 
201, the Surgeon General, under the supervision and di-
rection of the Secretary, shall administer the Office of the 
Surgeon General, the Regular Corps, and the Reserve 
Corps. 
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‘‘(d) BUDGET AUTHORITY.—Notwithstanding any 
other provision of law, for each fiscal year, the Surgeon 
General shall prepare and submit, directly to the President 
for review and transmittal to the Congress, an annual 
budget estimate (including the number and type of per-
sonnel needs for the Surgeon General) for the Office of 
the Surgeon General, after reasonable opportunity for 
comment (but without change) by the Secretary. 
‘‘(e) STAFF.—Subject to the availability of appropria-
tions, the provisions of this title, and applicable Federal 
civil service laws, the Surgeon General shall have the au-
thority to hire and terminate employees of and consultants 
to the Office of the Surgeon General without obtaining 
approval by, or clearance from, any employee of or con-
sultant to the Department of Health and Human Services. 
‘‘(f) REPORTS, CALLS TO ACTION, AND OTHER COM-
MUNICATIONS.— 
‘‘(1) IN GENERAL.—The Surgeon General shall 
from time to time issue reports, calls to action, and 
other communications on matters of importance to 
the health of the American people. 
‘‘(2) ANNUAL REPORT.—In carrying out para-
graph (1), the Surgeon General shall submit to the 
Congress and make publicly available an annual re-
port on the state of the Nation’s health. Each such 
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report shall include an analysis of the potential im-
pact of global health trends on the Nation’s health. 
‘‘(3) PUBLIC HEALTH SCIENCE.—The reports, 
calls to action, and other communications issued 
under paragraphs (1) and (2) shall be based on the 
Surgeon General’s professional judgment regarding 
the best available public health science. 
‘‘(4) ROLE
OF
THE
SECRETARY.—The Sec-
retary shall have exclusive authority to disapprove 
the issuance of a report, call to action, or other com-
munication proposed by the Surgeon General. If the 
Secretary disapproves the issuance of a report, call 
to action, or other communication proposed by the 
Surgeon General, the Secretary shall, within 10 days 
of disapproval, submit to the Committee on Energy 
and Commerce of the House of Representatives and 
the Committee on Health, Education, Labor, and 
Pensions of the Senate a full explanation of the rea-
sons for such disapproval.’’. 
(b) CONFORMING AMENDMENT.—Section 201 of the 
Public Health Service Act (42 U.S.C. 202) is amended 
by striking ‘‘The Public Health Service’’ and inserting 
‘‘Subject to section 204(c), the Public Health Service’’. 
Æ 
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