I 
112TH CONGRESS 
1ST SESSION H. R. 2298 
To establish grant programs to improve the health of border area residents 
and for all hazards preparedness in the border area including bioter-
rorism and infectious disease, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 22, 2011 
Mr. REYES (for himself, Mr. GENE GREEN of Texas, Mr. FILNER, Mr. 
CUELLAR, Mr. GRIJALVA, and Mr. HINOJOSA) introduced the following 
bill; which was referred to the Committee on Energy and Commerce, and 
in addition to the Committee on Foreign Affairs, for a period to be subse-
quently determined 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 border 
area residents and for all hazards preparedness in the 
border area including bioterrorism and infectious disease, 
and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Border Health Secu-
rity Act of 2011’’. 
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SEC. 2. FINDINGS. 
Congress makes the following findings: 
(1) The United States-Mexico border is an 
interdependent and dynamic region of 14,538,209 
people with significant and unique public health 
challenges. 
(2) These challenges include low rates of health 
insurance coverage, poor access to health care serv-
ices, and high rates of dangerous diseases, such as 
tuberculosis, diabetes, and obesity. 
(3) As the 2009 novel influenza A (H1N1) out-
break illustrates, diseases do not respect inter-
national boundaries, therefore, a strong public 
health effort at and along the United States-Mexico 
border is crucial to not only protect and improve the 
health of Americans but also to help secure the 
United States against biosecurity threats. 
(4) For 11 years, the United States-Mexico 
Border Health Commission has served as a crucial 
bi-national institution to address these unique and 
truly cross-border health issues. 
(5) Two initiatives resulting from the United 
States-Mexico Border Health Commission’s work 
speak to the importance of an infrastructure that fa-
cilitates cross border communication at the ground 
level. First, the Early Warning Infectious Disease 
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Surveillance (EWIDS), started in 2004, surveys in-
fectious diseases passing among border States allow-
ing for early detection and intervention. Second, the 
Ventanillas de Salud program, allows Mexican con-
sulates, in collaboration with United States non-
profit health organizations, to provide information 
and education to Mexican citizens living and working 
in the United States through a combination of Mexi-
can state funds and private grants. This program 
reaches an estimated 1,500,000 people in the United 
States. 
(6) As the United States-Mexico Border Health 
Commission enters its second decade, and as these 
issues grow in number and complexity, the Commis-
sion requires additional resources and modifications 
which will allow it to provide stronger leadership to 
optimize health and quality of life along the United 
States-Mexico border. 
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) in paragraph (1), by striking ‘‘and’’ at 
the end; 
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(B) in paragraph (2), by striking the pe-
riod and inserting ‘‘; and’’; and 
(C) by adding at the end the following: 
‘‘(3) to serve as an independent and objective 
body to both recommend and implement initiatives 
that solve border health issues’’; 
(2) in section 5— 
(A) in subsection (b), by striking ‘‘should 
be the leader’’ and inserting ‘‘shall be the 
Chair’’; and 
(B) by adding at the end the following: 
‘‘(d) PROVIDING ADVICE AND RECOMMENDATIONS 
TO CONGRESS.—A member of the Commission may at any 
time provide advice or recommendations to Congress con-
cerning issues that are considered by the Commission. 
Such advice or recommendations may be provided whether 
or not a request for such is made by a member of Congress 
and regardless of whether the member or individual is au-
thorized to provide such advice or recommendations by the 
Commission or any other Federal official.’’; 
(3) by redesignating section 8 as section 13; 
(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, tribal 
organization, urban Indian organization, nonprofit health 
organization, trauma center, or community 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. 
‘‘(b) AUTHORIZATION.—From amounts appropriated 
under section 12, the Secretary of Health and Human 
Services, acting through the members of the Commission, 
shall award grants to eligible entities to address priorities 
and recommendations outlined by the strategic plan under 
section 9(a) and operational work plan under section 9(b) 
to improve the health of individuals residing in the United 
States-Mexico Border Area. 
‘‘(c) APPLICATION.—An eligible entity that desires a 
grant under subsection (b) shall submit an application to 
the Secretary of Health and Human Services at such time, 
in such manner, and containing such information as the 
Secretary may require. 
‘‘(d) USE OF FUNDS.—An eligible entity that receives 
a grant under subsection (b) shall use the grant funds 
for— 
‘‘(1) programs relating to— 
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‘‘(A) maternal and child health; 
‘‘(B) primary care and preventative health; 
‘‘(C) infectious disease testing and moni-
toring; 
‘‘(D) public health and public health infra-
structure; 
‘‘(E) health promotion; 
‘‘(F) oral health; 
‘‘(G) behavioral and mental health; 
‘‘(H) substance abuse; 
‘‘(I) health conditions that have a high 
prevalence in the United States-Mexico Border 
Area; 
‘‘(J) medical and health services research; 
‘‘(K) workforce training and development; 
‘‘(L) 
community 
health 
workers 
or 
promotoras; 
‘‘(M) health care infrastructure problems 
in the United States-Mexico Border Area (in-
cluding planning and construction grants); 
‘‘(N) health disparities in the United 
States-Mexico Border Area; 
‘‘(O) environmental health; 
‘‘(P) health education; 
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‘‘(Q) outreach and enrollment services with 
respect to Federal programs (including pro-
grams authorized under titles XIX and XXI of 
the Social Security Act (42 U.S.C. 1396 and 
1397aa)); 
‘‘(R) trauma care; 
‘‘(S) health research with an emphasis on 
infectious disease; 
‘‘(T) epidemiology and health research; 
‘‘(U) cross-border health surveillance co-
ordinated with Mexican Health Authorities; 
‘‘(V) obesity, particularly childhood obe-
sity; 
‘‘(W) crisis communication, domestic vio-
lence, substance abuse, health literacy, and can-
cer; or 
‘‘(X) community-based participatory re-
search on border health issues, as defined by 
the Secretary of Health and Human Services; 
or 
‘‘(2) other programs determined appropriate by 
the Secretary of Health and Human Services. 
‘‘(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 
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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 (EWIDS) PROJECTS 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, that is located in the United 
States-Mexico Border Area. 
‘‘(b) AUTHORIZATION.—From amounts appropriated 
under section 12, the Secretary of Health and Human 
Services shall award grants under the Early Warning In-
fectious Disease Surveillance (EWIDS) project to eligible 
entities for infectious disease surveillance activities in the 
United States-Mexico Border Area. 
‘‘(c) APPLICATION.—An eligible entity that desires a 
grant under this section shall submit an application to the 
Secretary of Health and Human Services 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 to, in coordination with State and local all hazards 
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programs, as specified by the Secretary of Health and 
Human Services— 
‘‘(1) develop and implement infectious disease 
surveillance plans and readiness assessments and 
purchase items necessary for such plans; 
‘‘(2) coordinate infectious disease surveillance 
planning in the region with appropriate United 
States-based agencies and organizations as well as 
appropriate authorities in Mexico or Canada; 
‘‘(3) improve infrastructure, including surge ca-
pacity, syndromic surveillance, laboratory capacity, 
and isolation/decontamination capacity; 
‘‘(4) create a health alert network, including 
risk communication and information dissemination; 
‘‘(5) educate and train clinicians, epidemiolo-
gists, laboratories, and emergency personnel; 
‘‘(6) implement electronic data systems to co-
ordinate the triage, transportation, and treatment of 
multi-casualty incident victims; 
‘‘(7) provide infectious disease testing in the 
United States-Mexico Border Area; and 
‘‘(8) carry out such other activities identified by 
the Secretary of Health and Human Services, the 
United States-Mexico Border Health Commission, 
State and local public health offices, and border 
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health offices at the United States-Mexico or United 
States-Canada borders. 
‘‘SEC. 9. PLANS, REPORTS, AUDITS, AND BY-LAWS. 
‘‘(a) STRATEGIC PLAN.— 
‘‘(1) IN
GENERAL.—Not later than 5 years 
after the date of enactment of this section, and every 
5 years thereafter, the Commission (including the 
participation of members of both the United States 
and Mexican sections) shall prepare a binational 
strategic plan to guide the operations of the Com-
mission and submit such plan to the Secretary and 
Congress (and the Mexican legislature). 
‘‘(2) REQUIREMENTS.—The binational strategic 
plan under paragraph (1) shall include— 
‘‘(A) health-related priority areas deter-
mined most important by the full membership 
of the Commission; 
‘‘(B) recommendations for goals, objec-
tives, strategies and actions designed to address 
such priority areas; and 
‘‘(C) a proposed evaluation framework with 
output and outcome indicators appropriate to 
gauge progress toward meeting the objectives 
and priorities of the Commission. 
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‘‘(b) WORK PLAN.—Not later than January 1, 2012, 
and every other January 1 thereafter, the Commission 
shall develop and approve an operational work plan and 
budget based on the strategic plan under subsection (a). 
At the end of each such work plan cycle, the Government 
Accountability Office shall conduct an evaluation of the 
activities conducted by the Commission based on output 
and outcome indicators included in the strategic plan. The 
evaluation shall include a request for written evaluations 
from the commissioners about barriers and facilitators to 
executing successfully the Commission work plan. 
‘‘(c) BIANNUAL REPORTING.—The Commission shall 
issue a biannual report to the Secretary of Health and 
Human Services which provides independent policy rec-
ommendations related to border health issues. Not later 
than 3 months following receipt of each such biannual re-
port, the Secretary shall provide the report and any stud-
ies or other material produced independently by the Com-
mission to Congress. 
‘‘(d) AUDITS.—The Secretary of Health and Human 
Services shall annually prepare an audited financial report 
to account for all appropriated assets expended by the 
Commission to address both the strategic and operational 
work plans for the year involved. 
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‘‘(e) BY-LAWS.—Not less than 6 months after the 
date of enactment of this section, the Commission shall 
develop and approve bylaws to provide fully for compliance 
with the requirements of this section. 
‘‘(f) TRANSMITTAL TO CONGRESS.—The Commission 
shall submit copies of the work plan and by-laws to Con-
gress. The Government Accountability Office shall submit 
a copy of the evaluation to Congress. 
‘‘SEC. 10. BINATIONAL HEALTH INFRASTRUCTURE AND 
HEALTH INSURANCE. 
‘‘(a) IN GENERAL.—The Secretary of Health and 
Human Services shall enter into a contract with the Insti-
tute of Medicine for the conduct of a study concerning 
binational health infrastructure, with respect to the 
United States and Mexico and with respect to the United 
States and Canada (including trauma and emergency 
care) and health insurance efforts. In conducting such 
study, the Institute shall solicit input from border health 
experts, as specified by the Secretary of Health and 
Human Services, and health insurance issuers. 
‘‘(b) REPORT.—Not later than 1 year after the date 
on which the Secretary enters into the contract under sub-
section (a), the Institute of Medicine shall submit to the 
Secretary and the appropriate committees of Congress a 
report concerning the study conducted under such con-
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tract. Such report shall include the recommendations of 
the Institute on ways to establish, expand, or improve bi-
national health infrastructure and health insurance ef-
forts. 
‘‘SEC. 11. COORDINATION. 
‘‘(a) IN GENERAL.—To the extent practicable and 
appropriate, plans, systems, and activities to be funded (or 
supported) under this Act for all hazard preparedness, as 
defined by the Secretary of Health and Human Services, 
and general areas of health of individuals residing in the 
United States-Mexico Border area, should be coordinated 
with Federal, State, and local authorities in Mexico and 
the United States. 
‘‘(b) COORDINATION
OF HEALTH SERVICES
AND 
SURVEILLANCE.—The Secretary of Health and Human 
Services may coordinate with the Secretary of Homeland 
Security in establishing a health alert system that— 
‘‘(1) alerts clinicians and public health officials 
of emerging disease clusters and syndromes along 
the United States-Mexico Border Area; and 
‘‘(2) is alerted to signs of health threats, disas-
ters of mass scale, or bioterrorism along the United 
States-Mexico Border Area. 
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