H. R. 1770
One Hundred Eighth Congress
of the
United States of America
AT THE FIRST SESSION
Begun and held at the City of Washington on Tuesday,
the seventh day of January, two thousand and three
An Act
To provide benefits and other compensation for certain individuals with injuries
resulting from administration of smallpox countermeasures, and for other purposes.
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Smallpox Emergency Personnel
Protection Act of 2003’’.
SEC. 2. SMALLPOX EMERGENCY PERSONNEL PROTECTION.
Title II of the Public Health Service Act (42 U.S.C. 202 et
seq.) is amended by adding at the end the following part:
‘‘PART C—SMALLPOX EMERGENCY PERSONNEL PROTECTION
‘‘SEC. 261. GENERAL PROVISIONS.
‘‘(a) DEFINITIONS.—For purposes of this part:
‘‘(1) 
COVERED
COUNTERMEASURE.—The 
term 
‘covered
countermeasure’ means a covered countermeasure as specified
in a Declaration made pursuant to section 224(p).
‘‘(2) COVERED INDIVIDUAL.—The term ‘covered individual’
means an individual—
‘‘(A) who is a health care worker, law enforcement
officer, firefighter, security personnel, emergency medical
personnel, other public safety personnel, or support per-
sonnel for such occupational specialities;
‘‘(B) who is or will be functioning in a role identified
in a State, local, or Department of Health and Human
Services smallpox emergency response plan (as defined in
paragraph (7)) approved by the Secretary;
‘‘(C) who has volunteered and been selected to be a
member of a smallpox emergency response plan described
in subparagraph (B) prior to the time at which the Sec-
retary publicly announces that an active case of smallpox
has been identified either within or outside of the United
States; and
‘‘(D) to whom a smallpox vaccine is administered pursu-
ant to such approved plan during the effective period of
the Declaration (including the portion of such period before
the enactment of this part).
‘‘(3) COVERED INJURY.—The term ‘covered injury’ means
an injury, disability, illness, condition, or death (other than
a minor injury such as minor scarring or minor local reaction)
H. R. 1770—2
determined, pursuant to the procedures established under sec-
tion 262, to have been sustained by an individual as the direct
result of—
‘‘(A) administration to the individual of a covered
countermeasure during the effective period of the Declara-
tion; or
‘‘(B) accidental vaccinia inoculation of the individual
in circumstances in which—
‘‘(i) the vaccinia is contracted during the effective
period of the Declaration or within 30 days after the
end of such period;
‘‘(ii) smallpox vaccine has not been administered
to the individual; and
‘‘(iii) the individual has been in contact with an
individual who is (or who was accidentally inoculated
by) a covered individual.
‘‘(4) DECLARATION.—The term ‘Declaration’ means the Dec-
laration Regarding Administration of Smallpox Counter-
measures issued by the Secretary on January 24, 2003, and
published in the Federal Register on January 28, 2003.
‘‘(5) EFFECTIVE PERIOD OF THE DECLARATION.—The term
‘effective period of the Declaration’ means the effective period
specified in the Declaration, unless extended by the Secretary.
‘‘(6) ELIGIBLE INDIVIDUAL.—The term ‘eligible individual’
means an individual who is (as determined in accordance with
section 262)—
‘‘(A) a covered individual who sustains a covered injury
in the manner described in paragraph (3)(A); or
‘‘(B) an individual who sustains a covered injury in
the manner described in paragraph (3)(B).
‘‘(7) SMALLPOX
EMERGENCY
RESPONSE
PLAN.—The term
‘smallpox emergency response plan’ or ‘plan’ means a response
plan detailing actions to be taken in preparation for a possible
smallpox-related emergency during the period prior to the
identification of an active case of smallpox either within or
outside the United States.
‘‘(b) VOLUNTARY PROGRAM.—The Secretary shall ensure that
a State, local, or Department of Health and Human Services plan
to vaccinate individuals that is approved by the Secretary estab-
lishes procedures to ensure, consistent with the Declaration and
any applicable guidelines of the Centers for Disease Control and
Prevention, that—
‘‘(1) potential participants are educated with respect to
contraindications, the voluntary nature of the program, and
the availability of potential benefits and compensation under
this part;
‘‘(2) there is voluntary screening provided to potential
participants that can identify health conditions relevant to
contraindications; and
‘‘(3) there is appropriate post-inoculation medical surveil-
lance that includes an evaluation of adverse health effects
that may reasonably appear to be due to such vaccine and
prompt referral of, or the provision of appropriate information
to, any individual requiring health care as a result of such
adverse health event.
H. R. 1770—3
‘‘SEC. 262. DETERMINATION OF ELIGIBILITY AND BENEFITS.
‘‘(a) IN GENERAL.—The Secretary shall establish procedures
for determining, as applicable with respect to an individual—
‘‘(1) whether the individual is an eligible individual;
‘‘(2) whether an eligible individual has sustained a covered
injury or injuries for which medical benefits or compensation
may be available under sections 264 and 265, and the amount
of such benefits or compensation; and
‘‘(3) whether the covered injury or injuries of an eligible
individual caused the individual’s death for purposes of benefits
under section 266.
‘‘(b) COVERED INDIVIDUALS.—The Secretary may accept a certifi-
cation, by a Federal, State, or local government entity or private
health care entity participating in the administration of covered
countermeasures under the Declaration, that an individual is a
covered individual.
‘‘(c) CRITERIA FOR REIMBURSEMENT.—
‘‘(1) INJURIES
SPECIFIED
IN
INJURY
TABLE.—In any case
where an injury or other adverse effect specified in the injury
table established under section 263 as a known effect of a
vaccine manifests in an individual within the time period speci-
fied in such table, such injury or other effect shall be presumed
to have resulted from administration of such vaccine.
‘‘(2) OTHER DETERMINATIONS.—In making determinations
other than those described in paragraph (1) as to the causation
or severity of an injury, the Secretary shall employ a preponder-
ance of the evidence standard and take into consideration all
relevant medical and scientific evidence presented for consider-
ation, and may obtain and consider the views of qualified
medical experts.
‘‘(d) DEADLINE FOR FILING REQUEST.—The Secretary shall not
consider any request for a benefit under this part with respect
to an individual, unless—
‘‘(1) in the case of a request based on the administration
of the vaccine to the individual, the individual files with the
Secretary an initial request for benefits or compensation under
this part not later than one year after the date of administration
of the vaccine; or
‘‘(2) in the case of a request based on accidental vaccinia
inoculation, the individual files with the Secretary an initial
request for benefits or compensation under this part not later
than two years after the date of the first symptom or manifesta-
tion of onset of the adverse effect.
‘‘(e) STRUCTURED SETTLEMENTS AT SECRETARY’S OPTION.—In
any case in which there is a reasonable likelihood that compensation
or payment under section 264, 265, or 266(b) will be required
for a period in excess of one year from the date an individual
is determined eligible for such compensation or payment, the Sec-
retary shall have the discretion to make a lump-sum payment,
purchase an annuity or medical insurance policy, or execute an
appropriate structured settlement agreement, provided that such
payment, annuity, policy, or agreement is actuarially determined
to have a value equal to the present value of the projected total
amount of benefits or compensation that the individual is eligible
to receive under such section or sections.
‘‘(f) REVIEW OF DETERMINATION.—