CDC Tribal Public Health Security and Preparedness Act
Bill: S.3968 | Sponsor: Sen. Warren, Elizabeth (D-MA)
Policy area: Native Americans

Summary:
CDC Tribal Public Health Security and Preparedness Act
This bill allows tribes and tribal organizations to apply directly to the Centers for Disease Control and Prevention (CDC) for Public Health Emergency Preparedness (PHEP) program funds. Currently, only states and certain local entities may apply for PHEP funds to respond to public health emergencies, such as COVID-19.
The CDC must award at least 10 cooperative agreements to tribal applicants.
Additionally, the CDC must consult with tribes and tribal organizations to ensure the PHEP program enables these entities to respond to public health emergencies. The CDC may make certain modifications to the program after the consultation.

To improve State, local, and Tribal public health security.

    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 ``CDC Tribal Public Health Security 
and Preparedness Act''.

SEC. 2. IMPROVING STATE, LOCAL, AND TRIBAL PUBLIC HEALTH SECURITY.

    Section 319C-1 of the Public Health Service Act (42 U.S.C. 247d-3a) 
is amended--
            (1) in the section heading, by striking ``and local'' and 
        inserting ``, local, and tribal'';
            (2) in subsection (b)--
                    (A) in paragraph (1)--
                            (i) in subparagraph (B), by striking ``or'' 
                        at the end;
                            (ii) in subparagraph (C), by striking 
                        ``and'' at the end and inserting ``or''; and
                            (iii) by adding at the end the following:
                    ``(D) be an Indian Tribe, a Tribal organization, or 
                a consortium of Indian Tribes or Tribal organizations; 
                and''; and
                    (B) in paragraph (2)--
                            (i) in subparagraph (A)(viii)--
                                    (I) by inserting ``and Tribal'' 
                                after ``with State'';
                                    (II) by striking ``(as defined in 
                                section 8101 of the Elementary and 
                                Secondary Education Act of 1965)'' and 
                                inserting ``and Tribal educational 
                                agencies (as defined in sections 8101 
                                and 6132, respectively, of the 
                                Elementary and Secondary Education Act 
                                of 1965)''; and
                                    (III) by inserting ``and Tribal'' 
                                after ``and State'';
                            (ii) in subparagraph (G), by inserting 
                        ``(including Indian Tribes, Tribal 
                        organizations, and urban Indian 
                        organizations)'' after ``stakeholders''; and
                            (iii) in subparagraph (H), by inserting ``, 
                        Indian Tribes, and urban Indian organizations'' 
                        after ``public health'';
            (3) in subsection (e), by inserting ``Indian Tribes, Tribal 
        organizations, urban Indian organizations,'' after ``local 
        emergency plans,'';
            (4) in subsection (h)--
                    (A) by amending subparagraph (A) of paragraph (1) 
                to read as follows:
                    ``(A) In general.--For the purpose of carrying out 
                this section, there is authorized to be appropriated 
                $750,000,000 for each of fiscal years 2023 through 2025 
                for awards pursuant to paragraph (3) (subject to the 
                authority of the Secretary to make awards pursuant to 
                paragraphs (4) and (5)) and paragraph (8), of which not 
                less than 5 percent shall be reserved each fiscal year 
                for awards under paragraph (8).'';
                    (B) in the heading of paragraph (3), by inserting 
                ``for states'' after ``amount''; and
                    (C) by adding at the end the following:
            ``(8) Tribal eligible entities.--
                    ``(A) Determination of funding amount.--
                            ``(i) In general.--The Secretary shall 
                        award at least 10 cooperative agreements under 
                        this section, in amounts not less than the 
                        minimum amount determined under clause (ii), to 
                        eligible entities described in subsection 
                        (b)(1)(D) that submit to the Secretary an 
                        application that meets the criteria of the 
                        Secretary for the receipt of such an award and 
                        that meets other reasonable implementation 
                        conditions established by the Secretary, in 
                        consultation with Indian Tribes, for such 
                        awards.
                            ``(ii) Minimum amount.--In determining the 
                        minimum amount of an award pursuant to clause 
                        (i), the Secretary, in consultation with Indian 
                        Tribes, shall first determine an amount the 
                        Secretary considers appropriate for the 
                        eligible entity.
                    ``(B) Available until expended.--Amounts provided 
                to a Tribal eligible entity under a cooperative 
                agreement under this section for a fiscal year and 
                remaining unobligated at the end of such year shall 
                remain available to such entity during the entirety of 
                the performance period, for the purposes for which said 
                funds were provided.
                    ``(C) No matching requirement.--Subparagraphs (B) 
                and (C) of paragraph (1) shall not apply with respect 
                to cooperative agreements awarded under this section to 
                eligible entities described in subsection (b)(1)(D).''; 
                and
            (5) by adding at the end the following:
    ``(l) Special Rules Related to Tribal Eligible Entities.--
            ``(1) Modifications.--After consultation with Indian 
        Tribes, the Secretary may make necessary and appropriate 
        modifications with respect to subsections (b)(2), (g), and (i) 
        to facilitate the use of the cooperative agreement program by 
        eligible entities described in subsection (b)(1)(D).
            ``(2) Waivers.--
                    ``(A) In general.--Except as provided in 
                subparagraph (B), the Secretary shall waive or specify 
                alternative requirements for any provision of this 
                section (including regulations) that the Secretary 
                administers in connection with this section if the 
                Secretary, after consultation with Indian Tribes, finds 
                that the waiver or alternative requirement is 
                appropriate for the effective delivery and 
                administration of this program with respect to eligible 
                entities described in subsection (b)(1)(D).
                    ``(B) Exception.--The Secretary may not waive or 
                specify alternative requirements under subparagraph (A) 
                relating to labor standards or the environment.
            ``(3) Consultation.--The Secretary shall consult with 
        Indian Tribes and Tribal organizations on the design of this 
        program with respect to such Tribes and organizations to ensure 
        the effectiveness of the program in enhancing the security of 
        Indian Tribes with respect to public health emergencies.
            ``(4) Reporting.--
                    ``(A) In general.--Not later than 2 years after the 
                date of enactment of this subsection, and as an 
                addendum to the biennial evaluations required under 
                subsection (k), the Secretary, in coordination with the 
                Director of the Indian Health Service, shall--
                            ``(i) conduct a review of the 
                        implementation of this section with respect to 
                        eligible entities described in subsection 
                        (b)(1)(D), including any factors that may have 
                        limited its success;
                            ``(ii) compile a report containing--
                                    ``(I) a description of the results 
                                of the review described in clause (i);
                                    ``(II) a breakdown of the eligible 
                                entities described in subsection 
                                (b)(1)(D) that--
                                            ``(aa) received an award 
                                        under this section;
                                            ``(bb) received an award 
                                        under this section and a waiver 
                                        as described in paragraph (2); 
                                        and
                                            ``(cc) applied under this 
                                        section but did not receive an 
                                        award;
                                    ``(III) a list of any requirements 
                                of this section for which the Secretary 
                                provided a waiver or alternative 
                                requirement, and the reasoning for 
                                issuing a waiver or alternative 
                                requirement; and
                                    ``(IV) recommendations to Congress 
                                for program modifications necessary to 
                                improve the implementation of the 
                                program with respect to eligible 
                                entities described in subsection 
                                (b)(1)(D); and
                            ``(iii) submit the report described in 
                        clause (ii) to--
                                    ``(I) the Committee on Indian 
                                Affairs, the Committee on Health, 
                                Education, Labor, and Pensions, and the 
                                Committee on Appropriations of the 
                                Senate; and
                                    ``(II) the Subcommittee on 
                                Indigenous People of the Committee on 
                                Natural Resources, the Committee on 
                                Energy and Commerce, and the Committee 
                                on Appropriations of the House of 
                                Representatives.
                    ``(B) Analysis of tribal public health emergency 
                infrastructure limitation.--The Secretary shall include 
                in the initial report submitted under subparagraph (A) 
                a description of any public health emergency 
                infrastructure limitation encountered by eligible 
                entities described in subsection (b)(1)(D).''.
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