To authorize the Secretary of Health and Human Services, acting through the Director of the Centers for Disease Control and Prevention, to establish a core public health infrastructure program, and for other purposes.
Bill: H.R.1849 | Sponsor: Rep. Rice, Kathleen M. (D-NY)
Policy area: Health

Summary:
This bill requires the Centers for Disease Control and Prevention (CDC) to carry out activities to strengthen core public health infrastructure. Core public health infrastructure includes the elements and workforce capabilities that enable health departments to perform critical functions such as disease surveillance and emergency response.
Specifically, the CDC must award grants to state health departments for their core infrastructure needs. The CDC may also award grants to address core infrastructure needs on a competitive basis to state, tribal, territorial, or local health departments. In addition, the CDC must develop accreditation standards for health departments and public health laboratories.
The CDC must also take steps to expand and improve its own public health infrastructure.

To authorize the Secretary of Health and Human Services, acting through 
  the Director of the Centers for Disease Control and Prevention, to 
 establish a core public health infrastructure program, 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. CORE PUBLIC HEALTH INFRASTRUCTURE FOR STATE, LOCAL, TRIBAL, 
              AND TERRITORIAL HEALTH DEPARTMENTS.

    (a) Program.--The Secretary of Health and Human Services (in this 
Act referred to as the ``Secretary''), acting through the Director of 
the Centers for Disease Control and Prevention, shall establish a core 
public health infrastructure program consisting of awarding grants 
under subsection (b).
    (b) Grants.--
            (1) Award.--For the purpose of addressing core public 
        health infrastructure needs, the Secretary--
                    (A) shall award a grant to each State health 
                department; and
                    (B) may award grants on a competitive basis to 
                State, local, Tribal, or territorial health 
                departments.
            (2) Allocation.--Of the total amount of funds awarded as 
        grants under this subsection for a fiscal year--
                    (A) not less than 50 percent shall be for grants to 
                State health departments under paragraph (1)(A); and
                    (B) not less than 30 percent shall be for grants to 
                State, local, Tribal, or territorial health departments 
                under paragraph (1)(B).
    (c) Use of Funds.--A State, local, Tribal, or territorial health 
department receiving a grant under subsection (b) shall use the grant 
funds to address core public health infrastructure needs, including 
those identified in the accreditation process under subsection (g).
    (d) Formula Grants to State Health Departments.--In making grants 
under subsection (b)(1)(A), the Secretary shall award funds to each 
State health department in accordance with--
            (1) a formula based on population size, burden of 
        preventable disease and disability, and core public health 
        infrastructure gaps, including those identified in the 
        accreditation process under subsection (g); and
            (2) application requirements established by the Secretary, 
        including a requirement that the State health department submit 
        a plan that demonstrates to the satisfaction of the Secretary 
        that the State's health department will--
                    (A) address its highest priority core public health 
                infrastructure needs; and
                    (B) as appropriate, allocate funds to local health 
                departments within the State.
    (e) Competitive Grants to State, Local, Tribal, and Territorial 
Health Departments.--In making grants under subsection (b)(1)(B), the 
Secretary shall give priority to applicants demonstrating core public 
health infrastructure needs identified in the accreditation process 
under subsection (g).
    (f) Maintenance of Effort.--The Secretary may award a grant to an 
entity under subsection (b) only if the entity demonstrates to the 
satisfaction of the Secretary that--
            (1) funds received through the grant will be expended only 
        to supplement, and not supplant, non-Federal and Federal funds 
        otherwise available to the entity for the purpose of addressing 
        core public health infrastructure needs; and
            (2) with respect to activities for which the grant is 
        awarded, the entity will maintain expenditures of non-Federal 
        amounts for such activities at a level not less than the level 
        of such expenditures maintained by the entity for the fiscal 
        year preceding the fiscal year for which the entity receives 
        the grant.
    (g) Establishment of a Public Health Accreditation Program.--
            (1) In general.--The Secretary shall--
                    (A) develop, and periodically review and update, 
                standards for voluntary accreditation of State, local, 
                Tribal, and territorial health departments and public 
                health laboratories for the purpose of advancing the 
                quality and performance of such departments and 
                laboratories; and
                    (B) implement a program to accredit such health 
                departments and laboratories in accordance with such 
                standards.
            (2) Cooperative agreement.--The Secretary may enter into a 
        cooperative agreement with a private nonprofit entity to carry 
        out paragraph (1).
    (h) Report.--The Secretary shall submit to the Congress an annual 
report on progress being made to accredit entities under subsection 
(g), including--
            (1) a strategy, including goals and objectives, for 
        accrediting entities under subsection (g) and achieving the 
        purpose described in subsection (g)(1)(A);
            (2) identification of gaps in research related to core 
        public health infrastructure; and
            (3) recommendations of priority areas for such research.
    (i) Definition.--In this section, the term ``core public health 
infrastructure'' includes--
            (1) workforce capacity and competency;
            (2) laboratory systems;
            (3) testing capacity, including test platforms, mobile 
        testing units, and personnel;
            (4) health information, health information systems, and 
        health information analysis;
            (5) disease surveillance;
            (6) contact tracing;
            (7) communications;
            (8) financing;
            (9) other relevant components of organizational capacity; 
        and
            (10) other related activities.
    (j) Authorization of Appropriations.--To carry out this section, 
there are authorized to be appropriated $6,000,000,000 for the period 
of fiscal years 2022 through 2026.

SEC. 2. CORE PUBLIC HEALTH INFRASTRUCTURE AND ACTIVITIES FOR CDC.

    (a) In General.--The Secretary, acting through the Director of the 
Centers for Disease Control and Prevention, shall expand and improve 
the core public health infrastructure and activities of the Centers for 
Disease Control and Prevention to address unmet and emerging public 
health needs.
    (b) Report.--The Secretary shall submit to the Congress an annual 
report on the activities funded through this section.
    (c) Definition.--In this section, the term ``core public health 
infrastructure'' has the meaning given to such term in section 1.
    (d) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated $1,000,000,000 for the period of 
fiscal years 2022 through 2026.
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