gress a recommendation on whether the Advisory 
Committee should be extended.’’. 
SEC. 111. CONSIDERATION FOR AT-RISK INDIVIDUALS. 
(a) AT-RISK
INDIVIDUALS
IN
THE
NATIONAL 
HEALTH SECURITY STRATEGY.—Section 2802(b)(4)(B) 
(42 U.S.C. 300hh–1(b)(4)(B)) is amended by striking 
‘‘this section and sections 319C–1, 319F, and 319L’’ and 
inserting ‘‘this Act’’. 
(b) COUNTERMEASURE CONSIDERATIONS.—Section 
319L(c)(6) (42 U.S.C. 247d–7e(c)(6)) is amended— 
(1) by striking ‘‘elderly’’ and inserting ‘‘senior 
citizens’’; and 
(2) by inserting ‘‘with relevant characteristics 
that warrant consideration during the process of re-
searching and developing such countermeasures and 
products’’ before the period at the end. 
SEC. 112. PUBLIC HEALTH SURVEILLANCE. 
(a) GOAL.—Section 2802(b) of the Public Health 
Service Act (42 U.S.C. 300hh–1(b)), as amended by sec-
tions 103 and 111, is further amended by adding at the 
end the following: 
‘‘(11) 
PUBLIC
HEALTH
SURVEILLANCE.— 
Strengthening the ability of State, tribal, territorial, 
and local health departments to adapt and expand 
existing public health surveillance infrastructure to 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00038
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
develop a robust national surveillance capacity to 
capture data on the impact of emerging public 
health threats. Such capacity shall include emerging 
threats to pregnant and postpartum women and in-
fants, including through monitoring birth defects, 
developmental disabilities, and other short-term and 
long-term adverse outcomes.’’. 
(b) ASSURANCE
OF
CONFIDENTIALITY.—Section 
308(d) of the Public Health Service Act (42 U.S.C. 
242m(d)) is amended— 
(1) by striking ‘‘or 307’’ and inserting ‘‘307, or 
2802(b)(11)’’; and 
(2) by striking ‘‘or 306’’ and inserting ‘‘306, or 
2802(b)(11)’’. 
SEC. 113. GAO STUDY AND REPORT ON DISASTER MEDICAL 
ASSISTANCE TEAMS. 
(a) STUDY AND REPORT.— 
(1) STUDY.—The Comptroller General of the 
United States shall conduct a study on the mission 
readiness of disaster medical assistance teams with 
respect to current and emerging natural and man-
made threats. 
(2) COMPONENTS.—The study conducted pur-
suant to paragraph (1) shall include an assessment, 
in relation to disaster medical assistance teams, of— 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00039
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
(A) whether the mission readiness of such 
teams, and the needs relating to such readiness, 
have changed over time; 
(B) the standards the Assistant Secretary 
for Preparedness and Response of the Depart-
ment of Health and Human Services uses to de-
termine— 
(i) the training needs of such teams; 
and 
(ii) whether such teams are mission 
ready; 
(C) how to improve the determinations de-
scribed in subparagraph (B); 
(D) the extent to which the provision of 
additional resources (including personnel, train-
ing, and equipment) has addressed mission 
readiness concerns; and 
(E) the extent to which the Assistant Sec-
retary has developed plans to address mission 
readiness issues. 
(3) REPORT.—Not later than one year after the 
date of enactment of this Act, the Comptroller Gen-
eral shall submit to the Committee on Energy and 
Commerce of the House of Representatives and the 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00040
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
Committee on Health, Education, Labor and Pen-
sions of the Senate a report containing— 
(A) the findings of the study conducted 
pursuant to paragraph (1); and 
(B) related recommendations. 
(b) DISASTER MEDICAL ASSISTANCE TEAM DE-
FINED.—In this section, the term ‘‘disaster medical assist-
ance team’’ means a disaster medical assistance team op-
erating pursuant to the National Disaster Medical System 
established under section 2812 of the Public Health Serv-
ice Act (42 U.S.C. 300hh–11). 
SEC. 114. MILITARY AND CIVILIAN PARTNERSHIP FOR 
TRAUMA READINESS GRANT PROGRAM. 
Title XII of the Public Health Service Act (42 U.S.C. 
300d et seq.) is amended by adding at the end the fol-
lowing new part: 
‘‘PART I—MILITARY AND CIVILIAN PARTNERSHIP 
FOR TRAUMA READINESS GRANT PROGRAM 
‘‘SEC. 1291. MILITARY AND CIVILIAN PARTNERSHIP FOR 
TRAUMA READINESS GRANT PROGRAM. 
‘‘(a) MILITARY TRAUMA TEAM PLACEMENT PRO-
GRAM.— 
‘‘(1) IN GENERAL.—The Secretary shall award 
grants to not more than 20 eligible high-acuity trau-
ma centers to enable military trauma teams to pro-
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00041
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
vide, on a full-time basis, trauma care and related 
acute care at such trauma centers. 
‘‘(2) LIMITATIONS.—In the case of a grant 
awarded under paragraph (1) to an eligible high- 
acuity trauma center, such grant— 
‘‘(A) shall be for a period of at least 3 
years and not more than 5 years (and may be 
renewed at the end of such period); and 
‘‘(B) shall be in an amount that does not 
exceed $1,000,000 per year. 
‘‘(3) AVAILABILITY
OF
FUNDS
AFTER
PER-
FORMANCE PERIOD.—Notwithstanding section 1552 
of title 31, United States Code, or any other provi-
sion of law, funds available to the Secretary for obli-
gation for a grant under this subsection shall remain 
available for expenditure for 100 days after the last 
day of the performance period of such grant. 
‘‘(b) MILITARY TRAUMA CARE PROVIDER PLACE-
MENT PROGRAM.— 
‘‘(1) IN GENERAL.—The Secretary shall award 
grants to eligible trauma centers to enable military 
trauma care providers to provide trauma care and 
related acute care at such trauma centers. 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00042
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
‘‘(2) LIMITATIONS.—In the case of a grant 
awarded under paragraph (1) to an eligible trauma 
center, such grant— 
‘‘(A) shall be for a period of at least 1 year 
and not more than 3 years (and may be re-
newed at the end of such period); and 
‘‘(B) shall be in an amount that does not 
exceed, in a year— 
‘‘(i) $100,000 for each military trau-
ma care provider that is a physician at 
such eligible trauma center; and 
‘‘(ii) $50,000 for each other military 
trauma care provider at such eligible trau-
ma center. 
‘‘(c) GRANT REQUIREMENTS.— 
‘‘(1) DEPLOYMENT.—As a condition of receipt 
of a grant under this section, a grant recipient shall 
agree to allow military trauma care providers pro-
viding care pursuant to such grant to be deployed by 
the Secretary of Defense for military operations, for 
training, or for response to a mass casualty incident. 
‘‘(2) USE OF FUNDS.—Grants awarded under 
this section to an eligible trauma center may be used 
to train and incorporate military trauma care pro-
viders into such trauma center, including expendi-
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00043
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
tures for malpractice insurance, office space, infor-
mation technology, specialty education and super-
vision, trauma programs, research, and State license 
fees for such military trauma care providers. 
‘‘(d) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed to affect the extent to which State 
licensing requirements for health care professionals are 
preempted by other Federal law from applying to military 
trauma care providers. 
‘‘(e) REPORTING REQUIREMENTS.— 
‘‘(1) REPORT
TO
THE
SECRETARY
AND
THE 
SECRETARY
OF
DEFENSE.—Each eligible trauma 
center or eligible high-acuity trauma center awarded 
a grant under subsection (a) or (b) for a year shall 
submit to the Secretary and the Secretary of De-
fense a report for such year that includes informa-
tion on— 
‘‘(A) the number and types of trauma 
cases managed by military trauma teams or 
military trauma care providers pursuant to such 
grant during such year; 
‘‘(B) the financial impact of such grant on 
the trauma center; 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00044
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
‘‘(C) the educational impact on resident 
trainees in centers where military trauma teams 
are assigned; 
‘‘(D) any research conducted during such 
year supported by such grant; and 
‘‘(E) any other information required by the 
Secretaries for the purpose of evaluating the ef-
fect of such grant. 
‘‘(2) REPORT
TO
CONGRESS.—Not less than 
once every 2 years, the Secretary, in consultation 
with the Secretary of Defense, shall submit a report 
to Congress that includes information on the effect 
of placing military trauma care providers in trauma 
centers awarded grants under this section on— 
‘‘(A) maintaining readiness of military 
trauma care providers for battlefield injuries; 
‘‘(B) providing health care to civilian trau-
ma patients in both urban and rural settings; 
‘‘(C) the capability to respond to surges in 
trauma cases, including as a result of a large 
scale event; and 
‘‘(D) the financial State of the trauma cen-
ters. 
‘‘(f) DEFINITIONS.—For purposes of this part: 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00045
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
‘‘(1) ELIGIBLE
TRAUMA
CENTER.—The term 
‘eligible trauma center’ means a Level I, II, or III 
trauma center that satisfies each of the following: 
‘‘(A) Such trauma center has an agree-
ment with the Secretary of Defense to enable 
military trauma care providers to provide trau-
ma care and related acute care at such trauma 
center. 
‘‘(B) Such trauma center utilizes a risk-ad-
justed benchmarking system to measure per-
formance and outcomes, such as the Trauma 
Quality Improvement Program of the American 
College of Surgeons. 
‘‘(C) Such trauma center demonstrates a 
need for integrated military trauma care pro-
viders to maintain or improve the trauma clin-
ical capability of such trauma center. 
‘‘(2) ELIGIBLE
HIGH-ACUITY
TRAUMA
CEN-
TER.—The term ‘eligible high-acuity trauma center’ 
means a Level I trauma center that satisfies each of 
the following: 
‘‘(A) Such trauma center has an agree-
ment with the Secretary of Defense to enable 
military trauma teams to provide trauma care 
and related acute care at such trauma center. 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00046
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
‘‘(B) At least 20 percent of patients of 
such trauma center in the most recent 3-month 
period for which data is available are treated 
for a major trauma at such trauma center. 
‘‘(C) Such trauma center utilizes a risk-ad-
justed benchmarking system to measure per-
formance and outcomes, such as the Trauma 
Quality Improvement Program of the American 
College of Surgeons. 
‘‘(D) Such trauma center is an academic 
training center— 
‘‘(i) affiliated with a medical school; 
‘‘(ii) that maintains residency pro-
grams and fellowships in critical trauma 
specialties and subspecialties, and provides 
education and supervision of military trau-
ma team members according to those spe-
cialties and subspecialties; and 
‘‘(iii) that undertakes research in the 
prevention and treatment of traumatic in-
jury. 
‘‘(E) Such trauma center serves as a dis-
aster response leader for its community, such 
as by participating in a partnership for State 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00047
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
and regional hospital preparedness established 
under section 319C–2. 
‘‘(3) MAJOR TRAUMA.—The term ‘major trau-
ma’ means an injury that is greater than or equal 
to 15 on the injury severity score. 
‘‘(4) MILITARY
TRAUMA
TEAM.—The term 
‘military trauma team’ means a complete military 
trauma team consisting of military trauma care pro-
viders. 
‘‘(5) MILITARY TRAUMA CARE PROVIDER.—The 
term ‘military trauma care provider’ means a mem-
ber of the Armed Forces who furnishes emergency, 
critical care, and other trauma acute care, including 
a physician, military surgeon, physician assistant, 
nurse, respiratory therapist, flight paramedic, com-
bat medic, or enlisted medical technician. 
‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section, 
$15,000,000 for each of fiscal years 2019 through 2023, 
of which— 
‘‘(1) $10,000,000 shall be for carrying out sub-
section (a); and 
‘‘(2) $5,000,000 shall be for carrying out sub-
section (b).’’. 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00048
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
SEC. 115. IMPROVEMENT OF LOAN REPAYMENT PROGRAM 
FOR PREVENTION ACTIVITIES. 
Section 317F of the Public Health Service Act (42 
U.S.C. Sec. 247b–7) is amended— 
(1) in subsection (a)(1)— 
(A) by inserting after ‘‘conduct prevention 
activities’’ the following: ‘‘, including rapid re-
sponse to major health threats,’’; and 
(B) by striking ‘‘$35,000’’ and inserting 
‘‘$50,000’’; 
(2) in subsection (a)(2)(B), by striking ‘‘3 
years’’ and inserting ‘‘2 years’’; and 
(3) in subsection (c), by striking ‘‘$500,000’’ 
and all that follows through the period at the end 
and inserting ‘‘$1,000,000 for each of the fiscal 
years 2019 through 2023.’’. 
SEC. 116. REPORT ON ADEQUATE NATIONAL BLOOD SUP-
PLY. 
Not later than 1 year after the date of the enactment 
of this Act, the Secretary of Health and Human Services 
shall submit to Congress a report containing recommenda-
tions related to maintaining an adequate national blood 
supply, including challenges associated with continuous re-
cruitment of blood donors, ensuring adequacy of blood 
supply in the case of public health emergencies, and imple-
mentation of safety measures and innovation. 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00049
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
TITLE 
II—OPTIMIZING 
STATE 
AND 
LOCAL 
ALL-HAZARDS 
PREPAREDNESS 
AND 
RE-
SPONSE 
SEC. 201. PUBLIC HEALTH EMERGENCIES. 
(a) RESPONSE FUND.—Section 319 of the Public 
Health Service Act (42 U.S.C. 247d) is amended— 
(1) in subsection (b)— 
(A) in paragraph (1)— 
(i) in the first sentence, by inserting 
before the period the following: ‘‘, or if the 
Secretary determines there is the signifi-
cant potential for a public health emer-
gency, to allow the Secretary to rapidly re-
spond to the immediate needs resulting 
from such public health emergency or po-
tential public health emergency’’; and 
(ii) by inserting after the first sen-
tence the following: ‘‘The Secretary shall 
plan for the expedited distribution of 
amounts in the Fund to appropriate agen-
cies and entities.’’; 
(B) by redesignating paragraph (2) as 
paragraph (3); 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00050
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
(C) by inserting after paragraph (1) the 
following: 
‘‘(2) USES.—The Secretary may use amounts 
in the Fund established under paragraph (1)— 
‘‘(A) to facilitate coordination between and 
among Federal, State, local, tribal, and terri-
torial entities and public and private health 
care entities that the Secretary determines may 
be affected by a public health emergency or po-
tential public health emergency referred to in 
paragraph (1) (including communication of 
such entities with relevant international enti-
ties, as applicable); 
‘‘(B) to make grants, provide for awards, 
enter into contracts, and conduct supportive in-
vestigations pertaining to such a public health 
emergency or potential public health emergency, 
including further supporting programs under 
sections 319C–1 and 319C–2; 
‘‘(C) to facilitate and accelerate, as appli-
cable, advanced research and development of se-
curity countermeasures (as defined in section 
319F–2), qualified countermeasures (as defined 
in section 319F–1), or qualified pandemic or 
epidemic products (as defined in section 319F– 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00051
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
3), that are applicable to such a public health 
emergency or potential public health emergency; 
‘‘(D) to strengthen biosurveillance capabili-
ties and laboratory capacity to identify, collect, 
and analyze information regarding such a pub-
lic health emergency or potential public health 
emergency, including the systems under section 
319D; 
‘‘(E) to support initial emergency oper-
ations and assets related to preparation and de-
ployment of intermittent disaster-response per-
sonnel under section 2812, and the Medical Re-
serve Corps under section 2813; and 
‘‘(F) to carry out other activities, as the 
Secretary determines applicable and appro-
priate.’’; and 
(D) by inserting after paragraph (3), as so 
redesignated, the following: 
‘‘(4) REVIEW.—Not later than 2 years after the 
date of enactment of the Pandemic and All-Hazards 
Preparedness Reauthorization Act of 2018, the Sec-
retary, in coordination with the Assistant Secretary 
for Preparedness and Response, shall conduct a re-
view of the Fund under this subsection, and provide 
recommendations to the Committee on Health, Edu-
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00052
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
cation, Labor, and Pensions and the Committee on 
Appropriations of the Senate and the Committee on 
Energy and Commerce and the Committee on Ap-
propriations of the House of Representatives on poli-
cies to improve such Fund for the uses described in 
paragraph (2). 
‘‘(5) GAO REVIEW AND REPORT.—The Comp-
troller General of the United States shall conduct a 
review of the Fund under this subsection, including 
the uses and the resources available in the Fund. 
Not later than 4 years after the date of enactment 
of the Pandemic and All-Hazards Preparedness Re-
authorization Act of 2018, the Comptroller General 
shall submit to the Committee on Energy and Com-
merce of the House of Representatives and the Com-
mittee on Health, Education, Labor, and Pensions 
of the Senate a report on such review, including rec-
ommendations related to such review.’’; and 
(2) in subsection (c), by striking ‘‘section.’’ and 
inserting ‘‘section or funds otherwise provided for 
emergency response.’’. 
(b) TEMPORARY REASSIGNMENT
OF FEDERALLY 
FUNDED PERSONNEL.—Section 319(e)(8) of the Public 
Health Service Act (42 U.S.C. 247d(e)(8)) is amended by 
striking ‘‘2018’’ and inserting ‘‘2023’’. 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00053
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
SEC. 202. IMPROVING STATE AND LOCAL PUBLIC HEALTH 
SECURITY. 
(a) IN GENERAL.—Section 319C–1 of the Public 
Health Service Act (42 U.S.C. 247d–3a) is amended— 
(1) in subsection (a), by inserting ‘‘, acting 
through the Director of the Centers for Disease 
Control and Prevention,’’ after ‘‘the Secretary’’; 
(2) in subsection (b)(2)(A)— 
(A) in clause (viii), by striking at the end 
‘‘and’’; 
(B) in clause (ix), by adding at the end 
‘‘and’’; and 
(C) by inserting after clause (ix) the fol-
lowing new clause: 
‘‘(x) a description of— 
‘‘(I) the measures the entity will 
have in place to prioritize nursing fa-
cilities and skilled nursing facilities 
with respect to public health emer-
gency preparedness in the same man-
ner as such plan will prioritize hos-
pitals, 
while 
ensuring 
that, 
in 
prioritizing nursing facilities, skilled 
nursing facilities, and hospitals, the 
entity will retain the discretion to 
prioritize among such facilities; and 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00054
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
‘‘(II) the plans that each electric 
utility company within the entity’s ju-
risdiction has in place to ensure that 
each such company will remain func-
tioning or return to functioning as 
soon as practicable during power out-
ages caused by natural or manmade 
disasters;’’; 
(3) in subsection (e), by striking ‘‘, and local 
emergency plans.’’ and inserting ‘‘, local emergency 
plans, and any regional health care emergency pre-
paredness and response system established pursuant 
to the applicable guidelines under section 319C–3.’’; 
and 
(4) 
in 
subsection 
(h)(1)(A), 
by 
striking 
‘‘$641,900,000 for fiscal year 2014 for awards pur-
suant to paragraph (3) (subject to the authority of 
the Secretary to make awards pursuant to para-
graphs (4) and (5)), and $641,900,000 for each of 
fiscal years 2015 through 2018’’ and inserting 
‘‘$670,000,000 for each of fiscal years 2019 through 
2023’’. 
(b) EFFECTIVE DATE.—The amendments made by 
subsection (a) shall take effect on the date of enactment 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00055
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
of this Act and apply with respect to cooperative agree-
ments awarded on or after such date of enactment. 
SEC. 203. STRENGTHENING THE HOSPITAL PREPAREDNESS 
PROGRAM. 
Section 319C–2 of the Public Health Service Act (42 
U.S.C. 247d–3b) is amended— 
(1) by amending the section heading to read as 
follows: ‘‘STATE AND REGIONAL HEALTH CARE 
PREPAREDNESS AND RESPONSE TO IMPROVE 
SURGE CAPACITY’’; 
(2) in subsection (a), by striking ‘‘hospital pre-
paredness for’’ and inserting ‘‘health care prepared-
ness for and response to’’; 
(3) in subsection (b)(1)(A)— 
(A) in the matter preceding clause (i)— 
(i) by striking ‘‘partnership’’ and in-
serting ‘‘coalition’’; and 
(ii) by striking ‘‘consisting of’’ and in-
serting ‘‘that includes’’; 
(B) in clause (ii), by striking ‘‘and’’ at the 
end; 
(C) in clause (iii)(III), by striking ‘‘and’’ 
at the end; and 
(D) by adding at the end the following: 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00056
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
‘‘(iv) an emergency medical service or-
ganization; and 
‘‘(v) an emergency management orga-
nization; and’’; 
(4) in subsection (c), by inserting after ‘‘pre-
paredness’’ the following: ‘‘and response’’; 
(5) in subsection (d)— 
(A) in paragraph (1)(A)— 
(i) in clause (i), by striking ‘‘; and’’ 
and inserting a semicolon; 
(ii) by redesignating clause (ii) as 
clause (iii); and 
(iii) by inserting after clause (i) the 
following: 
‘‘(ii) among one or more facilities in a 
regional health care emergency system 
under section 319C–3; and’’; 
(B) in paragraph (1)(B), by striking 
‘‘partnership’’ each place it appears and insert-
ing ‘‘coalition’’; and 
(C) in paragraph (2)(C), by striking ‘‘med-
ical preparedness’’ and inserting ‘‘preparedness 
and response’’; 
(6) in subsection (f), by striking ‘‘partnership’’ 
and inserting ‘‘coalition’’; 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00057
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
(7) in subsection (g)(2)— 
(A) by striking ‘‘Partnerships’’ and insert-
ing ‘‘Coalitions’’; 
(B) by striking ‘‘partnerships’’ and insert-
ing ‘‘coalitions’’; and 
(C) by inserting after ‘‘preparedness’’ the 
following: ‘‘and response’’; 
(8) in subsection (i)— 
(A) in paragraph (1)— 
(i) by striking ‘‘The requirements’’ 
and inserting ‘‘Except as provided in para-
graph (2), the requirements’’; 
(ii) by striking ‘‘An entity’’ and in-
serting ‘‘A coalition’’; 
(iii) by striking ‘‘such partnership’’ 
and inserting ‘‘such coalition’’; and 
(iv) by adding at the end the fol-
lowing: ‘‘In submitting reports pursuant to 
this paragraph, an entity shall include in-
formation on the progress (if any) that the 
entity has made towards the implementa-
tion of section 319C–3.’’; 
(B) by redesignating paragraph (2) as 
paragraph (3); and 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00058
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
(C) by inserting after paragraph (1) the 
following: 
‘‘(2) EXCEPTION RELATING TO APPLICATION OF 
CERTAIN
REQUIREMENTS.—Beginning with fiscal 
year 2019, and in each succeeding fiscal year, with 
respect to entities receiving awards under this sec-
tion— 
‘‘(A) paragraph (5)(A) of section 319C– 
1(g) shall be applied— 
‘‘(i) by substituting ‘for the imme-
diately preceding fiscal year’ with the fol-
lowing: ‘for either of the two immediately 
preceding fiscal years’; and 
‘‘(ii) by substituting ‘2019’ for ‘2008’; 
and 
‘‘(B) paragraph (6)(A) of section 319C– 
1(g) shall be applied by substituting— 
‘‘(i) clause (i) of such paragraph with 
the following: ‘For each of the first two fis-
cal years immediately following a fiscal 
year in which an entity experienced a fail-
ure described in subparagraph (A) or (B) 
of paragraph (5) by the entity, an amount 
equal to 10 percent of the amount the enti-
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00059
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
ty was eligible to receive for each such fis-
cal year.’; 
‘‘(ii) clause (ii) of such paragraph 
with the following: ‘For each of the first 
two fiscal years immediately following two 
consecutive fiscal years in which an entity 
experienced such a failure, an amount 
equal to 15 percent of the amount the enti-
ty was eligible to receive for each of such 
first two fiscal years, disregarding any 
withholding of funds that would have been 
made in each such year by virtue of clause 
(i). The amount determined pursuant to 
the previous sentence shall be in lieu of 
any amount that would have been withheld 
for each such year by virtue of clause (i).’; 
‘‘(iii) clause (iii) of such paragraph 
with the following: ‘For each of the first 
two fiscal years immediately following 
three consecutive fiscal years in which an 
entity experienced such a failure, an 
amount equal to 20 percent of the amount 
the entity was eligible to receive for each 
of such first two fiscal years, disregarding 
any withholding of funds that would have 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00060
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
been made in each such year by virtue of 
clauses (i) and (ii). The amount deter-
mined pursuant to the previous sentence 
shall be in lieu of any amount that would 
have been withheld for each such year by 
virtue of clauses (i) and (ii).’; and 
‘‘(iv) clause (iv) of such paragraph 
with the following: ‘For each of the first 
two fiscal years immediately following four 
consecutive fiscal years in which an entity 
experienced such a failure, an amount 
equal to 25 percent of the amount the enti-
ty was eligible to receive for each of such 
first two fiscal years, disregarding any 
withholding of funds that would have been 
made in each such year by virtue of 
clauses (i), (ii), and (iii). The amount de-
termined pursuant to the previous sentence 
shall be in lieu of any amount that would 
have been withheld for each such year by 
virtue of clauses (i), (ii), and (iii).’.’’; and 
(9) in subsection (j)(2), in the paragraph head-
ing, by striking ‘‘PARTNERSHIPS’’ and inserting 
‘‘COALITIONS’’. 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00061
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
SEC. 204. IMPROVING BENCHMARKS AND STANDARDS FOR 
PREPAREDNESS AND RESPONSE. 
(a) EVALUATING MEASURABLE EVIDENCE-BASED 
BENCHMARKS
AND
OBJECTIVE
STANDARDS.—Section 
319C–1 (42 U.S.C. 247d–3a) is amended by inserting 
after subsection (j) the following: 
‘‘(k) EVALUATION.— 
‘‘(1) IN
GENERAL.—Not later than 2 years 
after the date of enactment of the Pandemic and 
All-Hazards Preparedness and Advancing Innovation 
Act of 2018 and every 2 years thereafter, the Sec-
retary shall conduct an evaluation of the evidence- 
based benchmarks and objective standards required 
under subsection (g). Such evaluation shall be sub-
mitted to the congressional committees of jurisdic-
tion together with the National Health Security 
Strategy under section 2802, at such time as such 
strategy is submitted. 
‘‘(2) CONTENT.—The evaluation under this 
paragraph shall include— 
‘‘(A) a review of evidence-based bench-
marks and objective standards, and associated 
metrics and targets; 
‘‘(B) a discussion of changes to any evi-
dence-based benchmarks and objective stand-
ards, and the effect of such changes on the abil-
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00062
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
ity to track whether entities are meeting or 
making progress toward the goals under this 
section and, to the extent practicable, the appli-
cable goals of the National Health Security 
Strategy under section 2802; 
‘‘(C) a description of amounts received by 
eligible entities, as described in subsection (b) 
and section 319C–2(b), and amounts received 
by subrecipients and the effect of such funding 
on meeting evidence-based benchmarks and ob-
jective standards; and 
‘‘(D) recommendations, as applicable and 
appropriate, to improve evidence-based bench-
marks and objective standards to more accu-
rately assess the ability of entities receiving 
awards under this section to better achieve the 
goals under this section and section 2802.’’. 
(b) EVALUATING THE PARTNERSHIP FOR STATE AND 
REGIONAL HOSPITAL PREPAREDNESS.—Section 319C– 
2(i)(1) (42 U.S.C. 247–3b(i)(1)), as amended by section 
203, is further amended by striking ‘‘section 319C–1(g), 
(i), and (j)’’ and inserting ‘‘section 319C–1(g), (i), (j), and 
(k)’’. 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00063
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
SEC. 205. AUTHORIZATION OF APPROPRIATIONS FOR REVI-
TALIZING THE CENTERS FOR DISEASE CON-
TROL AND PREVENTION. 
Section 319D(f) of the Public Health Service Act (42 
U.S.C. 247d–4(f)) is amended by striking ‘‘$138,300,000 
for each of fiscal years 2014 through 2018’’ and inserting 
‘‘$161,800,000 for each of fiscal years 2019 through 
2023’’. 
SEC. 
206. 
AUTHORIZATION 
OF 
APPROPRIATIONS 
FOR 
EMERGENCY SYSTEM FOR ADVANCED REG-
ISTRATION OF VOLUNTEER HEALTH PROFES-
SIONALS. 
Section 319I(k) of the Public Health Service Act (42 
U.S.C. 247d–7b(k)) is amended by striking ‘‘fiscal years 
2014 through 2018’’ and inserting ‘‘fiscal years 2019 
through 2023’’. 
SEC. 207. REGIONAL HEALTH CARE EMERGENCY PRE-
PAREDNESS AND RESPONSE SYSTEMS. 
Part B of title III of the Public Health Service Act 
(42 U.S.C. 243 et seq.) is amended by inserting after sec-
tion 319C–2 the following new section: 
‘‘SEC. 319C–3. GUIDELINES FOR REGIONAL HEALTH CARE 
EMERGENCY PREPAREDNESS AND RESPONSE 
SYSTEMS. 
‘‘(a) PURPOSE.—It is the purpose of this section to 
identify and provide guidelines for regional systems of hos-
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00064
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
pitals, health care facilities, and other public and private 
sector entities, with varying levels of capability to treat 
patients and increase medical surge capacity during, in ad-
vance of, and immediately following a public health emer-
gency, including threats posed by one or more chemical, 
biological, radiological, and nuclear agents, including 
emerging infectious diseases. 
‘‘(b) GUIDELINES.—The Assistant Secretary for Pre-
paredness and Response, in consultation with the Director 
of the Centers for Disease Control and Prevention, the Ad-
ministrator of the Centers for Medicare & Medicaid Serv-
ices, the Administrator of the Health Resources and Serv-
ices Administration, the Commissioner of Food and 
Drugs, the Assistant Secretary for Mental Health and 
Substance Use, the Assistant Secretary of Labor for Occu-
pational Safety and Health, the Secretary of Veterans Af-
fairs, the heads of such other Federal agencies as the Sec-
retary determines to be appropriate, and State, local, trib-
al, and territorial public health officials, shall, not later 
than 2 years after the date of enactment of this section— 
‘‘(1) identify and develop a set of guidelines re-
lating to practices and protocols for all-hazards pub-
lic health emergency preparedness and response for 
hospitals and health care facilities to provide appro-
priate patient care during, in advance of, or imme-
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00065
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
diately following, a public health emergency, result-
ing from one or more chemical, biological, radio-
logical, or nuclear agents, including emerging infec-
tious diseases (which may include existing practices, 
such as trauma care and medical surge capacity and 
capabilities), with respect to— 
‘‘(A) a regional approach to identifying 
hospitals and health care facilities based on 
varying capabilities and capacity to treat pa-
tients affected by such emergency, including— 
‘‘(i) the manner in which the system 
will coordinate with and integrate the 
health care coalitions and entities de-
scribed in section 319C–2(b); and 
‘‘(ii) informing and educating appro-
priate first responders and health care sup-
ply chain partners of the regional emer-
gency preparedness and response capabili-
ties and medical surge capacity of such 
hospitals and health care facilities in the 
community; 
‘‘(B) physical and technological infrastruc-
ture, laboratory capacity, staffing, blood supply, 
and other supply chain needs, taking into ac-
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00066
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
count resiliency, geographic considerations, and 
rural considerations; 
‘‘(C) protocols or best practices for the 
safety and personal protection of workers who 
handle human remains and health care workers 
(including with respect to protective equipment 
and supplies, waste management processes, and 
decontamination), sharing of specialized experi-
ence among the health care workforce, behav-
ioral health, psychological resilience, and train-
ing of the workforce, as applicable; 
‘‘(D) in a manner that allows for disease 
containment (within the meaning of section 
2802(b)(2)(B)), coordinated medical triage, 
treatment, and transportation of patients, based 
on patient medical need (including patients in 
rural areas), to the appropriate hospitals or 
health care facilities within the regional system 
or, as applicable and appropriate, between sys-
tems in different States or regions; and 
‘‘(E) the needs of children and other at- 
risk individuals; 
‘‘(2) make such guidelines available on the pub-
lic website of the Department of Health and Human 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00067
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
Services in a manner that does not compromise na-
tional security; and 
‘‘(3) update such guidelines as appropriate, in-
cluding based on input received pursuant to sub-
sections (c) and (f), to address new and emerging 
public health threats. 
‘‘(c) CONSIDERATIONS.—In identifying, developing, 
and updating guidelines under subsection (b), the Assist-
ant Secretary for Preparedness and Response shall— 
‘‘(1) include input from hospitals and health 
care facilities (including health care coalitions under 
section 319C–2), State, local, tribal, and territorial 
public health departments, and health care or sub-
ject matter experts (including experts with relevant 
expertise in chemical, biological, radiological, or nu-
clear threats, and emerging infectious disease), as 
the Assistant Secretary determines appropriate, to 
meet the goals under section 2802(b)(3); 
‘‘(2) consult and engage with appropriate 
health care providers and professionals, including 
physicians, nurses, first responders, health care fa-
cilities (including hospitals, primary care clinics, 
community health centers, mental health facilities, 
ambulatory care facilities, and dental health facili-
ties), pharmacies, emergency medical providers, 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00068
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
trauma care providers, environmental health agen-
cies, public health laboratories, poison control cen-
ters, blood banks, and other experts that the Assist-
ant Secretary determines appropriate, to meet the 
goals under section 2802(b)(3); 
‘‘(3) consider feedback related to financial im-
plications for hospitals, health care facilities, public 
health agencies, laboratories, blood banks, and other 
entities engaged in regional preparedness planning 
to implement and follow such guidelines, as applica-
ble; and 
‘‘(4) consider financial requirements and poten-
tial incentives for entities to prepare for, and re-
spond to, public health emergencies as part of the 
regional health care emergency preparedness and re-
sponse system. 
‘‘(d) TECHNICAL ASSISTANCE.—The Assistant Sec-
retary for Preparedness and Response, in consultation 
with the Director of the Centers for Disease Control and 
Prevention and the Assistant Secretary of Labor for Occu-
pational Safety and Health, may provide technical assist-
ance and consultation towards meeting the guidelines de-
scribed in subsection (b). 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00069
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
‘‘(e) DEMONSTRATION
PROJECT
FOR
REGIONAL 
HEALTH CARE PREPAREDNESS
AND RESPONSE SYS-
TEMS.— 
‘‘(1) IN GENERAL.—The Assistant Secretary for 
Preparedness and Response may establish a dem-
onstration project pursuant to the development and 
implementation of guidelines under subsection (b) to 
award grants to improve medical surge capacity for 
all hazards, build and integrate regional medical re-
sponse capabilities, improve specialty care expertise 
for all-hazards response, and coordinate medical pre-
paredness and response across State, local, tribal, 
territorial, and regional jurisdictions. 
‘‘(2) SUNSET.—The authority under this sub-
section shall expire on September 30, 2023. 
‘‘(f) GAO REPORT TO CONGRESS.— 
‘‘(1) REPORT.—Not later than 3 years after the 
date of enactment of this section, the Comptroller 
General of the United States (referred to in this 
subsection as the ‘Comptroller General’) shall submit 
to the Committee on Health, Education, Labor, and 
Pensions and the Committee on Finance of the Sen-
ate and the Committee on Energy and Commerce 
and the Committee on Ways and Means of the 
House of Representatives a report on the extent to 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00070
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
which hospitals and health care facilities have imple-
mented the recommended guidelines under sub-
section (b), including an analysis and evaluation of 
any challenges hospitals or health care facilities ex-
perienced in implementing such guidelines. 
‘‘(2) CONTENT.—The Comptroller General shall 
include in the report under paragraph (1)— 
‘‘(A) data on the preparedness and re-
sponse capabilities that have been informed by 
the guidelines under subsection (b) to improve 
regional emergency health care preparedness 
and response capability, including hospital and 
health care facility capacity and medical surge 
capabilities to prepare for, and respond to, pub-
lic health emergencies; and 
‘‘(B) recommendations to reduce gaps in 
incentives for regional health partners, includ-
ing hospitals and health care facilities, to im-
prove capacity and medical surge capabilities to 
prepare for, and respond to, public health emer-
gencies, consistent with subsection (a), which 
may include consideration of facilities partici-
pating in programs under section 319C–2, pro-
grams under the Centers for Medicare & Med-
icaid Services (including innovative health care 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00071
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
delivery and payment models), and input from 
private sector financial institutions. 
‘‘(3) CONSULTATION.—In carrying out para-
graphs (1) and (2), the Comptroller General shall 
consult with the heads of appropriate Federal agen-
cies, including— 
‘‘(A) the Assistant Secretary for Prepared-
ness and Response; 
‘‘(B) the Director of the Centers for Dis-
ease Control and Prevention; 
‘‘(C) the Administrator of the Centers for 
Medicare & Medicaid Services; 
‘‘(D) the Assistant Secretary for Mental 
Health and Substance Use; 
‘‘(E) the Assistant Secretary of Labor for 
Occupational Safety and Health; 
‘‘(F) the Secretary of Veterans Affairs; 
and 
‘‘(G) the heads of such other Federal agen-
cies as the Secretary determines appropriate.’’. 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00072
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
SEC. 208. NATIONAL ACADEMY OF MEDICINE EVALUATION 
AND REPORT ON THE PREPAREDNESS OF 
HOSPITALS, LONG-TERM CARE FACILITIES, 
DIALYSIS CENTERS, AND OTHER MEDICAL 
FACILITIES 
FOR 
PUBLIC 
HEALTH 
EMER-
GENCIES. 
(a) EVALUATION.— 
(1) IN GENERAL.—Not later than 60 days after 
the date of enactment of this Act, the Secretary of 
Health and Human Services shall enter into an ar-
rangement with the National Academy of Medicine 
or, if the National Academy declines to enter into 
such an arrangement, another appropriate entity 
under which the National Academy (or other appro-
priate entity) agrees to evaluate the preparedness of 
hospitals, long-term care facilities, dialysis centers, 
and other medical facilities nationwide for public 
health emergencies, including natural disasters. 
(2) SPECIFIC MATTERS EVALUATED.—The ar-
rangement under paragraph (1) shall require the 
National Academy of Medicine (or other appropriate 
entity)— 
(A) to catalogue, review, and evaluate the 
efficacy of current rules and regulations for 
hospitals, long-term care facilities, dialysis cen-
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00073
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
(F) to identify and recommend best prac-
tices and guidelines for emergency preparedness 
planning related to access to clean water at hos-
pitals, long-term care facilities, dialysis centers, 
and other medical facilities. 
(b) REPORT.— 
(1) IN GENERAL.—The arrangement under sub-
section (a)(1) shall require the National Academy of 
Medicine (or other appropriate entity) to submit to 
the Secretary of Health and Human Services and 
the Congress, not later than 18 months after the 
date of enactment of this Act, a report on the re-
sults of the evaluation conducted pursuant to this 
section. 
(2) CONTENTS.—The report under paragraph 
(1) shall— 
(A) describe the findings and conclusions 
of the evaluation conducted pursuant to this 
section; and 
(B) include a strategy for improving the 
preparedness of hospitals, long-term care facili-
ties, dialysis centers, and other medical facili-
ties nationwide for public health emergencies, 
including natural disasters. 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00075
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
SEC. 209. LIMITATION ON LIABILITY FOR VOLUNTEER 
HEALTH CARE PROFESSIONALS. 
(a) IN GENERAL.—Title II of the Public Health Serv-
ice Act is amended by inserting after section 224 (42 
U.S.C. 233) the following new section: 
‘‘SEC. 224A. LIMITATION ON LIABILITY FOR VOLUNTEER 
HEALTH CARE PROFESSIONALS. 
‘‘(a) LIMITATION ON LIABILITY.—Except as provided 
in subsection (b), a health care professional serving, for 
purposes of responding to a disaster, as a volunteer shall 
not be liable under Federal or State law for any harm 
caused by an act or omission of the professional in the 
provision of health care services if the act or omission oc-
curs— 
‘‘(1) during the period of the disaster; 
‘‘(2) in the State or States for which the dis-
aster is declared; 
‘‘(3) while the health care professional is acting 
in the professional’s capacity as a volunteer; 
‘‘(4) in the course of providing health care serv-
ices that are within the scope of the license, registra-
tion, or certification of the volunteer, as defined by 
the State of licensure, registration, or certification; 
and 
‘‘(5) while the health care professional is acting 
in a good faith belief that the individual being pro-
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00076
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
vided such health care services is in need of such 
health care services. 
‘‘(b) EXCEPTIONS.—Subsection (a) does not apply 
with respect to harm caused by an act or omission of a 
health care professional in the provision of health care 
services as described in such subsection if— 
‘‘(1) the harm was caused by an act or omission 
constituting willful or criminal misconduct, gross 
negligence, reckless misconduct, or a conscious fla-
grant indifference to the rights or safety of the indi-
vidual harmed by the health care professional; or 
‘‘(2) the health care professional provided such 
health care services under the influence (as deter-
mined pursuant to applicable State law) of alcohol 
or an intoxicating drug. 
‘‘(c) PREEMPTION.—No State or political subdivision 
of a State may establish or continue in effect any laws 
relating to the liability for acts or omissions relating to 
the provision of health care services by health care profes-
sionals serving, for purposes of responding to a disaster, 
as volunteers that are inconsistent with this section, unless 
such laws provide greater protection from such liability. 
‘‘(d) RELATIONSHIP
TO VOLUNTEER PROTECTION 
ACT OF 1997.—The protections from liability under this 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00077
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
section are in addition to the protections from liability 
under the Volunteer Protection Act of 1997. 
‘‘(e) DEFINITIONS.—In this section: 
‘‘(1) The term ‘disaster’ means— 
‘‘(A) a national emergency declared by the 
President under the National Emergencies Act; 
‘‘(B) an emergency or major disaster de-
clared by the President under the Robert T. 
Stafford Disaster Relief and Emergency Assist-
ance Act; or 
‘‘(C) a public health emergency that is de-
termined by the Secretary under section 319 of 
this Act with respect to one or more States 
specified in such determination— 
‘‘(i) during only the initial period cov-
ered by such determination; and 
‘‘(ii) excluding any period covered by 
a renewal of such determination. 
‘‘(2) The term ‘harm’ includes physical, non-
physical, economic, and noneconomic losses. 
‘‘(3) The term ‘health care professional’ means 
an individual who is licensed, registered, or certified 
under Federal or State law to provide health care 
services. 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00078
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
‘‘(4) The term ‘health care services’ means any 
services provided by a health care professional, or by 
any individual working under the supervision of a 
health care professional, that relate to— 
‘‘(A) the diagnosis, prevention, or treat-
ment of any human disease or impairment; or 
‘‘(B) the assessment or care of the health 
of a human being. 
‘‘(5) The term ‘State’ includes each of the sev-
eral States, the District of Columbia, the Common-
wealth of Puerto Rico, the Virgin Islands, Guam, 
American Samoa, the Northern Mariana Islands, 
and any other territory or possession of the United 
States. 
‘‘(6)(A) The term ‘volunteer’ means a health 
care professional who, in providing health care serv-
ices in response to a disaster, does not receive— 
‘‘(i) compensation; or 
‘‘(ii) any other thing of value in lieu of 
compensation, in excess of $500 per year. 
‘‘(B) For purposes of subparagraph (A), the 
term ‘compensation’— 
‘‘(i) includes payment under any insurance 
policy or health plan, or under any Federal 
health care program (as defined in section 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00079
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
1128B(f) of the Social Security Act) or State 
health benefits program; and 
‘‘(ii) excludes— 
‘‘(I) reasonable reimbursement or al-
lowance for expenses actually incurred; 
‘‘(II) receipt of paid leave; and 
‘‘(III) receipt of items to be used ex-
clusively for providing the health care serv-
ices referred to in subparagraph (A).’’. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall apply with respect to claims for relief 
for which the act or omission giving rise to the claim oc-
curred on or after the date that is 90 days after the date 
of the enactment of this Act. 
(c) SENSE OF CONGRESS.—It is the sense of the Con-
gress that— 
(1) health care professionals should be encour-
aged, to register with the Emergency System for Ad-
vance Registration of Volunteer Health Professionals 
(ESARVHP), and States should employ online reg-
istration with the promptest processing possible of 
such registrations to foster the rapid deployment 
and utilization of volunteer health care professionals 
following a disaster; 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00080
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
(2) Federal and State agencies and licensing 
boards should cooperate to facilitate the timely 
movement of properly licensed volunteer health care 
professionals to areas affected by a disaster; and 
(3) the appropriate licensing entities should 
verify the licenses of volunteer health care profes-
sionals serving disaster victims as soon as is reason-
ably practical following a disaster. 
TITLE III—ACCELERATING MED-
ICAL COUNTERMEASURE AD-
VANCED RESEARCH AND DE-
VELOPMENT 
SEC. 301. STRATEGIC NATIONAL STOCKPILE AND SECURITY 
COUNTERMEASURE PROCUREMENT. 
(a) IN GENERAL.— 
(1) COORDINATION
WITH
THE
ASPR.—Sub-
section (a)(1) of section 319F–2 of the Public 
Health Service Act (42 U.S.C. 247d–6b) is amended 
by inserting ‘‘the Assistant Secretary for Prepared-
ness and Response and’’ before ‘‘the Director of the 
Centers for Disease Control and Prevention’’. 
(2) CONFORMING
AMENDMENTS.—Subsection 
(c) of section 2811 of the Public Health Service Act 
(42 U.S.C. 300hh–10), as amended by section 101, 
is further amended— 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00081
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
(A) in paragraph (2)— 
(i) by redesignating subparagraphs 
(C) through (F) as subparagraphs (D) 
through (G), respectively; and 
(ii) by inserting after subparagraph 
(B) the following new subparagraph: 
‘‘(C) the Strategic National Stockpile pur-
suant to section 319F–2;’’; and 
(B) in paragraph (3)— 
(i) in subparagraph (A), by adding 
‘‘and’’ at the end; 
(ii) by striking subparagraph (B); and 
(iii) by redesignating subparagraph 
(C) as subparagraph (B). 
(b) CONGRESSIONAL NOTIFICATION OF MATERIAL 
THREAT DETERMINATION.—Section 319F–2(c)(2)(C) (42 
U.S.C. 247d–6b(c)(2)(C)) is amended by striking ‘‘The 
Secretary and the Homeland Security Secretary shall 
promptly notify the appropriate committees of Congress’’ 
and inserting ‘‘The Secretary and the Secretary of Home-
land Security shall send to Congress, on an annual basis, 
all current material threat determinations and shall 
promptly notify the Committee on Health, Education, 
Labor, and Pensions and the Committee on Homeland Se-
curity and Government Affairs of the Senate and the Com-
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00082
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
mittee on Energy and Commerce and the Committee on 
Homeland Security of the House of Representatives’’. 
(c) AUTHORIZATION OF APPROPRIATIONS.—Section 
319F–2(f)(1) of the Public Health Service Act (42 U.S.C. 
247d–6b(f)(1)) is amended by striking ‘‘$533,800,000 for 
each of fiscal years 2014 through 2018’’ and inserting 
‘‘$610,000,000 for each of fiscal years 2019 through 
2023, to remain available until expended’’. 
(d) BIOSHIELD SPECIAL RESERVE FUND.—Para-
graph (1) of section 319F–2(g) of the Public Health Serv-
ice Act (42 U.S.C. 247d–6b(g)) is amended to read as fol-
lows: 
‘‘(1) AUTHORIZATION OF APPROPRIATIONS.—In 
addition to amounts appropriated to the special re-
serve fund prior to the date of the enactment of this 
subsection, there is authorized to be appropriated, 
for the procurement of security countermeasures 
under subsection (c) and for carrying out section 
319L (relating to the Biomedical Advanced Research 
and Development Authority), $7,100,000,000 for the 
fiscal years 2019 through 2028. Funds authorized 
by the preceding sentence for fiscal years 2020 
through 2027 may be provided by advance appro-
priation, to be obligated at a rate of not less than 
$710,000,000 per year. Amounts appropriated pur-
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00083
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
suant to this paragraph are authorized to remain 
available until expended.’’. 
SEC. 302. BIOMEDICAL ADVANCED RESEARCH AND DEVEL-
OPMENT AUTHORITY. 
(a) PREPARING FOR PANDEMIC INFLUENZA, ANTI-
MICROBIAL
RESISTANCE, 
AND
OTHER
SIGNIFICANT 
THREATS.—Section 319L(c)(4) of the Public Health Serv-
ice Act (247d–7e(c)(4)) is amended by adding at the end 
the following: 
‘‘(F) STRATEGIC
INITIATIVES.—The Sec-
retary, acting through the Director of BARDA, 
may implement strategic initiatives, including 
by building on existing programs and by award-
ing grants supporting innovative candidate 
products in preclinical and clinical development, 
to address priority, naturally occurring and 
man-made threats that, as determined by the 
Secretary, pose a significant level of risk to na-
tional security based on the characteristics of a 
chemical, biological, radiological or nuclear 
threat, or existing capabilities to respond to 
such a threat (including medical response and 
treatment capabilities and manufacturing infra-
structure). Such initiatives shall accelerate and 
support the advanced research, development, 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00084
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
and procurement of, countermeasures and prod-
ucts, as applicable, to address areas including— 
‘‘(i) chemical, biological, radiological, 
or nuclear threats, including emerging in-
fectious diseases, for which insufficient ap-
proved, licensed, or authorized counter-
measures exist, or for which such threat, 
or the result of an exposure to such threat, 
may become resistant to countermeasures 
or existing countermeasures may be ren-
dered ineffective; 
‘‘(ii) threats that consistently exist or 
continually circulate and have significant 
potential to become a pandemic, such as 
pandemic influenza, which may include the 
advanced research and development, manu-
facturing, and appropriate stockpiling of 
qualified pandemic or epidemic products, 
and products, technologies, or processes to 
support the advanced research and devel-
opment of such countermeasures (including 
multiuse 
platform 
technologies 
for 
diagnostics, vaccines, and therapeutics; 
virus seeds; clinical trial lots; novel virus 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00085
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
strains; and antigen and adjuvant mate-
rial); and 
‘‘(iii) threats that may result pri-
marily or secondarily from a chemical, bio-
logical, radiological, or nuclear agent, or 
emerging infectious disease, and which 
may present increased treatment complica-
tions such as the occurrence of resistance 
to available countermeasures or potential 
countermeasures, including antimicrobial 
resistant pathogens.’’. 
(b) 
TRANSACTION
AUTHORITIES.—Section 
319L(c)(5)(A) of the Public Health Service Act (42 
U.S.C. 247d–7e(c)(5)(A)) is amended— 
(1) by amending clause (i) to read as follows: 
‘‘(i) IN
GENERAL.—The Secretary 
shall have the authority to engage in trans-
actions other than a contract, grant, or co-
operative 
agreement 
with 
respect 
to 
projects under this section.’’; and 
(2) in clause (ii)— 
(A) by amending subclause (I) to read as 
follows: 
‘‘(I) To the maximum extent 
practicable, 
competitive 
procedures 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00086
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
shall be used when entering into 
agreements to carry out projects 
under this section.’’; and 
(B) 
in 
subclause 
(II), 
by 
striking 
‘‘$20,000,000’’ and inserting ‘‘$100,000,000’’. 
(c) PANDEMIC INFLUENZA PROGRAM.—Section 319L 
of the Public Health Service Act (42 U.S.C. 247d–7e) is 
amended— 
(1) by redesignating subsections (d) through (f) 
as subsections (f) through (h), respectively; and 
(2) by inserting after subsection (c) the fol-
lowing new subsections: 
‘‘(d) PANDEMIC INFLUENZA PROGRAM.—The Sec-
retary, acting through the Director of BARDA, shall es-
tablish and implement a program that— 
‘‘(1) supports research and development activi-
ties for qualified pandemic or epidemic products (as 
defined in section 319F–3(i)), including by devel-
oping innovative technologies to enhance rapid re-
sponse to threats relating to pandemic influenza; 
‘‘(2) ensures readiness to respond to pandemic 
influenza threats by supporting the development and 
manufacturing of influenza virus seeds, clinical trial 
lots, and stockpiles of novel influenza strains; and 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00087
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
‘‘(3) sustains and replenishes pandemic stock-
piles of bulk antigen and adjuvant material, includ-
ing annually testing the potency and shelf-life poten-
tial of all existing pandemic stockpiles held by the 
Department of Health and Human Services. 
‘‘(e) EMERGING INFECTIOUS DISEASE PROGRAM.— 
The Secretary, acting through the Director of BARDA, 
shall establish and implement a program that supports re-
search and development, and manufacturing infrastruc-
ture, activities with respect to an emerging infectious dis-
ease.’’. 
(d) FUNDING.—Subsection (f) of section 319L of the 
Public Health Service Act (42 U.S.C. 247d–7e), as redes-
ignated by subsection (b)(1), is amended— 
(1) in paragraph (2)— 
(A) by inserting ‘‘(other than subsections 
(d) and (e))’’ after ‘‘purposes of this section’’; 
and 
(B) by striking ‘‘$415,000,000 for each of 
fiscal years 2014 through 2018’’ and inserting 
‘‘$536,700,000 for each of fiscal years 2019 
through 2023’’; and 
(2) by adding at the end the following new 
paragraphs: 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00088
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
‘‘(3) FUNDING FOR PANDEMIC INFLUENZA PRO-
GRAM.— 
‘‘(A) IN GENERAL.—To carry out the pur-
poses of subsection (d), there is authorized to 
be appropriated $250,000,000 for each of fiscal 
years 2019 through 2023, to remain available 
until expended. 
‘‘(B) SUPPLEMENT NOT SUPPLANT.—Any 
funds provided to the Secretary under this 
paragraph shall be used to supplement and not 
supplant any other Federal funds provided to 
carry out the purposes of subsection (d). 
‘‘(4) FUNDING FOR EMERGING INFECTIOUS DIS-
EASE PROGRAM.— 
‘‘(A) IN GENERAL.—To carry out the pur-
poses of subsection (e), there is authorized to 
be appropriated $250,000,000 for each of fiscal 
years 2019 through 2023, to remain available 
until expended. 
‘‘(B) SUPPLEMENT NOT SUPPLANT.—Any 
funds provided to the Secretary under this 
paragraph shall be used to supplement and not 
supplant any other Federal funds provided to 
carry out the purposes of subsection (e).’’. 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00089
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
SEC. 303. REPORT ON THE DEVELOPMENT OF VACCINES TO 
PREVENT FUTURE EPIDEMICS. 
Not later than one year after the date of the enact-
ment of this Act, the Secretary of Health and Human 
Services shall submit to Congress a report detailing the 
activities carried out by the Department of Health and 
Human Services to support the development of vaccines 
to prevent future epidemics, including work carried out 
through domestic and global public-private partnerships 
and other collaborations intended to spur the development 
of such vaccines. Such report shall include information re-
lated to the provision of any funding or technical assist-
ance to such entities. 
TITLE IV—MISCELLANEOUS 
PROVISIONS 
SEC. 401. CYBERSECURITY. 
(a) NATIONAL HEALTH SECURITY STRATEGY.—Sec-
tion 2802(a) of the Public Health Service Act (42 U.S.C. 
300h–1(a)) is amended by adding at the end the following: 
‘‘(4) CYBERSECURITY THREATS.—In the next 
version of the National Health Security Strategy 
prepared after the date of the enactment of this 
paragraph, the National Health Security Strategy 
shall include a national strategy focused on address-
ing cybersecurity threats to the public health and 
health care system, including— 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00090
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
‘‘(A) defining the functions, capabilities, 
and gaps in such system; and 
‘‘(B) identifying strategies to strengthen 
the preparedness and response of such system 
to cybersecurity threats and incidents, including 
with respect to continuity of care and risk miti-
gation to prevent harm to human health in case 
of a cybersecurity incident.’’. 
(b) COORDINATION OF PREPAREDNESS FOR AND RE-
SPONSE
TO
ALL-HAZARDS
PUBLIC
HEALTH
EMER-
GENCIES.—Section 2811(c) of the Public Health Service 
Act (42 U.S.C. 300hh–10), as amended by sections 101 
and 301, is further amended— 
(1) by redesignating paragraph (4) as para-
graph (5); and 
(2) by inserting after paragraph (3) the fol-
lowing: 
‘‘(4) have lead responsibility within the Depart-
ment of Health and Human Services for ensuring 
the ability of the health care sector to provide con-
tinuity of care during a cybersecurity incident; and’’. 
SEC. 402. MISCELLANEOUS FDA AMENDMENTS. 
(a) DRUG DEVELOPMENT TOOLS.—Section 507(c) of 
the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 
357) is amended— 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00091
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
(1) by redesignating paragraph (3) as para-
graph (4); and 
(2) by inserting after paragraph (2) the fol-
lowing: 
‘‘(3) NATIONAL
SECURITY
LIMITATION.—In 
making information publicly available pursuant to 
paragraph (1), the Secretary— 
‘‘(A) shall not disclose information that 
would compromise national security; and 
‘‘(B) may make available summaries in 
lieu of data and evidence contained in qualifica-
tion submissions.’’. 
(b) EMERGENCY
USE
INSTRUCTIONS.—Subpara-
graph (A) of section 564A(e)(2) of the Federal Food, 
Drug, and Cosmetic Act (21 U.S.C. 360bbb–3a(e)(2)) is 
amended by striking ‘‘subsection (a)(1)(C)(i)’’ and insert-
ing ‘‘subsection (a)(1)(C)’’. 
(c) PRODUCTS HELD FOR EMERGENCY USE.—Sec-
tion 564B(2) of the Federal Food, Drug, and Cosmetic 
Act (21 U.S.C. 360bbb–3b) is amended— 
(1) in subparagraph (B), by inserting a comma 
after ‘‘505’’; and 
(2) in subparagraph (C), by inserting ‘‘or sec-
tion 564A’’ before the period at the end. 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00092
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
SEC. 403. FORMAL STRATEGY RELATING TO CHILDREN 
SEPARATED FROM PARENTS AND GUARD-
IANS AS A RESULT OF ZERO TOLERANCE POL-
ICY. 
Not later than 14 days after the date of the enact-
ment of this Act, the Assistant Secretary for Preparedness 
and Response shall submit to the Committee on Energy 
and Commerce of the House of Representatives a formal 
strategy— 
(1) to reunify with their parent or guardian 
each child who, as a result of the ‘‘zero tolerance’’ 
policy, was separated from their parent or guardian 
and placed into a facility funded by the Department 
of Health and Human Services; and 
(2) to address deficiencies identified by the pre-
vious work of the Committee, which began in 2014, 
regarding the oversight of, and care for, unaccom-
panied alien children in the custody of the Depart-
ment. 
SEC. 404. BIOLOGICAL THREAT DETECTION. 
Part B of title III of the Public Health Service Act 
(42 U.S.C. 243 et seq.), as amended by section 104, is 
further amended by inserting after section 319D–1 of 
such Act, the following new section: 
‘‘SEC. 319D–2. BIOLOGICAL THREAT DETECTION. 
‘‘(a) EXCHANGE OF INFORMATION.— 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00093
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
‘‘(1) IN GENERAL.—The Secretary of Health 
and Human Services, in coordination with the Sec-
retary of Defense and the Secretary of Homeland 
Security, shall— 
‘‘(A) facilitate the identification by Federal 
departments and agencies of technological, 
operational, and programmatic successes and 
failures of domestic detection programs for in-
tentionally introduced, accidentally released, 
and naturally occurring infectious diseases; 
‘‘(B) facilitate the exchange of information 
described in subparagraph (A) among Federal 
departments and agencies that utilize biological 
threat detection technology; and 
‘‘(C) make recommendations on research, 
development, and procurement to Federal de-
partments and agencies to replace and enhance 
biological threat detection systems in use, in-
cluding recommendation for the transfer of bio-
logical threat detection technology among Fed-
eral departments and agencies. 
‘‘(2) CONSIDERATIONS.—In carrying out para-
graph (1), the Secretary of Health and Human 
Services shall take into consideration the capabilities 
of the system with respect to each of the following: 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00094
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
‘‘(A) Rapidly detecting, identifying, charac-
terizing, and confirming the presence of biologi-
cal threat agents. 
‘‘(B) Recovering live biological agents from 
collection devices. 
‘‘(C) Determining the geographical dis-
tribution of biological agents. 
‘‘(D) Determining the extent of environ-
mental contamination and persistence of bio-
logical agents. 
‘‘(E) 
Providing 
advanced 
molecular 
diagnostics to State, local, tribal, and territorial 
public health and other laboratories that sup-
port biological threat detection activities. 
‘‘(b) COLLABORATION.—The Secretary of Health and 
Human Services, in consultation with Secretary of De-
fense, the Secretary of Homeland Security, the Director 
of the Centers for Disease Control and Prevention, and 
the heads of other Federal departments and agencies that 
utilize biological threat detection technology, shall collabo-
rate with State, local, tribal, and territorial public health 
laboratories and other users of current and future biologi-
cal threat detection systems to develop— 
‘‘(1) biological threat detection requirements, 
including— 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00095
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
‘‘(A) technical, quality, and biosafety 
standards, including the review of validation 
data prior to and throughout deployment of a 
biological threat detection system; and 
‘‘(B) requirements for— 
‘‘(i) the assessment of quality stand-
ards and the development and deployment 
of biological threat detection systems; and 
‘‘(ii) metrics for, collaborative assess-
ment of, and deployment of biosafety 
standards; 
‘‘(2) a standardized integration strategy for— 
‘‘(A) the level to which biological threat de-
tection processes and systems are defined and 
executed; 
‘‘(B) the locations at which such processes 
and systems are performed; and 
‘‘(C) the extent to which data is shared 
among State, local, tribal, and territorial public 
health laboratories and Federal departments 
and agencies; 
‘‘(3) State, local, tribal, and territorial labora-
tory training requirements for— 
‘‘(A) supporting and participating in bio-
logical threat detection systems; and 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00096
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
‘‘(B) addressing flexibility at the jurisdic-
tional level allowing for adoption of technology 
based on need and assessment of the efficacy 
and local utility of technology by the jurisdic-
tion; 
‘‘(4) guidelines for a coordinated public health 
response addressing all aspect of a response, includ-
ing clinical and epidemiological guidelines for uti-
lizing information produced by biological threat de-
tection systems and responding to intentionally in-
troduced, accidentally released, and naturally occur-
ring infectious diseases; and 
‘‘(5) a coordinated remediation plan with Fed-
eral departments and agencies and State and local 
public health agencies to facilitate rapid, safe, and 
coordinated restoration of facilities and localities 
after a contaminating biological event.’’. 
SEC. 405. STRENGTHENING MOSQUITO ABATEMENT FOR 
SAFETY AND HEALTH. 
(a) 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)(1)(B)— 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00097
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
(ii) by amending subparagraph (D) to 
read as follows: 
‘‘(D)(i) is located in a State that has re-
ceived a grant under subsection (a); or 
‘‘(ii) demonstrates to the Secretary that 
the control program for which a grant is sought 
is consistent with existing State mosquito con-
trol plans or policies, and other applicable State 
preparedness plans.’’; 
(C) in paragraph (4)(C), by striking ‘‘that 
extraordinary’’ and all that follows through the 
period at the end and inserting the following: 
‘‘that— 
‘‘(i) extraordinary economic conditions 
in the political subdivision or consortium of 
political subdivisions involved justify the 
waiver; or 
‘‘(ii) the geographical area covered by 
a political subdivision or consortium for a 
grant under paragraph (1) has an extreme 
mosquito control need due to— 
‘‘(I) the size or density of the po-
tentially impacted human population; 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00099
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
100 
‘‘(II) the size or density of a 
mosquito population that requires 
heightened control; or 
‘‘(III) the severity of the mos-
quito-borne disease, such that ex-
pected serious adverse health out-
comes for the human population jus-
tify the waiver.’’; and 
(D) by amending paragraph (6) to read as 
follows: 
‘‘(6) NUMBER OF GRANTS.—A political subdivi-
sion or a consortium of political subdivisions may 
not receive more than one grant under paragraph 
(1).’’; and 
(3) in subsection (d), by striking ‘‘Amounts ap-
propriated under subsection (f)’’ and inserting 
‘‘Amounts appropriated to carry out this section’’. 
(b) 
EPIDEMIOLOGY-LABORATORY
CAPACITY 
GRANTS.—Section 2821 of the Public Health Service Act 
(42 U.S.C. 300hh–31) is amended— 
(1) in subsection (a)(1), by inserting ‘‘, includ-
ing mosquito and other vector-borne diseases,’’ after 
‘‘infectious diseases’’; and 
(2) by amending subsection (b) to read as fol-
lows: 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00100
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
101 
‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
$40,000,000 for each of fiscal years 2019 through 2023.’’. 
(c) GAO STUDY.— 
(1) STUDY.—The Comptroller General of the 
United States shall conduct a study on the state of 
surveillance and control of mosquito-borne infectious 
diseases in the United States, including Indian 
Country (as defined in section 1151 of title 18, 
United States Code) and territories, including the 
state of preparedness for conducting such surveil-
lance and control. The study shall include— 
(A) a description of the infrastructure and 
programs for mosquito control in the United 
States (including Indian Country (as so de-
fined) and such territories), including— 
(i) how such infrastructure and pro-
grams are organized and implemented at 
the Federal, State and local levels, includ-
ing with respect to departments and agen-
cies of the States, and local organizations 
(including special districts) involved in 
such control programs; 
(ii) the role of the private sector in 
such activities; 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00101
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
102 
(iii) how the authority for mosquito 
control impacts such activities; and 
(iv) the funding sources for such in-
frastructure and programs, including Fed-
eral, State, and local funding sources; 
(B) how mosquito-borne and other vector- 
borne disease surveillance and control is inte-
grated into Federal, State, and local prepared-
ness plans and actions, including how zoonotic 
surveillance is integrated into infectious disease 
surveillance to support real-time situational sur-
veillance and awareness; 
(C) Federal, State, and local laboratory ca-
pacity for emerging vector-borne diseases, in-
cluding mosquito-borne and other zoonotic dis-
eases; and 
(D) any regulatory challenges for devel-
oping and utilizing vector-control technologies 
and platforms as part of mosquito control strat-
egies. 
(2) CONSULTATIONS.—In conducting the study 
under paragraph (1), the Comptroller General of the 
United States shall consult with— 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00102
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
103 
(A) State and local public health officials 
involved in mosquito and other vector-borne dis-
ease surveillance and control efforts; 
(B) researchers and manufacturers of mos-
quito control products; 
(C) stakeholders involved in mosquito 
abatement activities; 
(D) infectious disease experts; and 
(E) entomologists involved in mosquito- 
borne disease surveillance and control efforts. 
(3) REPORT.—Not later than 18 months after 
the date of enactment of this Act, the Comptroller 
General of the United States shall submit to the 
Committee on Health, Education, Labor, and Pen-
sions of the Senate and the Committee on Energy 
and Commerce of the House of Representatives a re-
port containing— 
(A) the results of the study conducted 
under paragraph (1); and 
(B) any relevant recommendations of the 
Comptroller General for preparedness and re-
sponse efforts with respect to Zika virus and 
other mosquito-borne diseases. 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00103
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS
104 
SEC. 406. ADDITIONAL STRATEGIES FOR COMBATING ANTI-
BIOTIC RESISTANCE. 
Part B of title III of the Public Health Service Act 
(42 U.S.C. 243 et seq.) is amended by inserting after sec-
tion 319E the following: 
‘‘SEC. 319E–1. ADVISORY COUNCIL ON COMBATING ANTI-
BIOTIC-RESISTANT BACTERIA. 
‘‘(a) DEFINITIONS.—In this section: 
‘‘(1) ACTION PLAN.—The term ‘Action Plan’ 
means the Action Plan described in section 
319E(a)(1). 
‘‘(2) ADVISORY COUNCIL.—The term ‘Advisory 
Council’ means the Advisory Council on Combating 
Antibiotic-Resistant Bacteria established by Execu-
tive Order 13676 of September 18, 2014 (79 Fed. 
Reg. 56931; relating to combating antibiotic-resist-
ant bacteria). 
‘‘(3) NATIONAL
STRATEGY.—The term ‘Na-
tional Strategy’ means the National Strategy for 
Combating Antibiotic-Resistant Bacteria issued by 
the White House in September 2014, and any subse-
quent update to such strategy or a successor strat-
egy. 
‘‘(b) ADVISORY COUNCIL.—The Advisory Council 
shall provide advice, information, and recommendations to 
the Secretary regarding programs and policies intended to 
VerDate Sep 11 2014 
01:54 Jul 17, 2018
Jkt 079200
PO 00000
Frm 00104
Fmt 6652
Sfmt 6201
E:\BILLS\H6378.IH
H6378
pbinns on DSK79D2C42PROD with BILLS