Title: Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018
Policy area: Health

Summary:
Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018
This bill amends the Public Health Service Act to establish several programs and entities relating to public health emergency preparedness and response, including:
The bill also reauthorizes for FY2019-FY2023 and revises several other programs and entities relating to public health emergencies, including the National Disaster Medical System, the Volunteer Medical Reserve Corps, and the Biomedical Advanced Research and Development Authority.
The bill also expands the responsibilities of the Assistant Secretary for Preparedness and Response (ASPR) and the scope of the National Health Security Strategy.
ASPR must also develop a strategy to reunify children and parents who were separated at the U.S.-Mexico border under a specified immigration enforcement policy (i.e., the "zero-tolerance" policy) and submit weekly reports on the status and welfare of children awaiting reunification.

[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6378 Introduced in House (IH)]

<DOC>






115th CONGRESS
  2d Session
                                H. R. 6378

To reauthorize certain programs under the Public Health Service Act and 
the Federal Food, Drug, and Cosmetic Act with respect to public health 
   security and all-hazards preparedness and response, and for other 
                               purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             July 16, 2018

  Mrs. Brooks of Indiana (for herself, Ms. Eshoo, Mr. Walden, and Mr. 
   Pallone) introduced the following bill; which was referred to the 
Committee on Energy and Commerce, and in addition to the Committees on 
 the Judiciary, Veterans' Affairs, and Homeland Security, for a period 
    to be subsequently determined by the Speaker, in each case for 
consideration of such provisions as fall within the jurisdiction of the 
                          committee concerned

_______________________________________________________________________

                                 A BILL


 
To reauthorize certain programs under the Public Health Service Act and 
the Federal Food, Drug, and Cosmetic Act with respect to public health 
   security and all-hazards preparedness and response, 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 ``Pandemic and All-Hazards 
Preparedness and Advancing Innovation Act of 2018''.

SEC. 2. TABLE OF CONTENTS.

    The table of contents of this Act is as follows:

Sec. 1. Short title.
Sec. 2. Table of contents.
 TITLE I--STRENGTHENING NATIONAL PREPAREDNESS AND RESPONSE FOR PUBLIC 
                           HEALTH EMERGENCIES

Sec. 101. Coordination of preparedness for and response to all-hazards 
                            public health emergencies.
Sec. 102. Public health emergency medical countermeasures enterprise.
Sec. 103. National Health Security Strategy.
Sec. 104. Improving emergency preparedness and response considerations 
                            for children.
Sec. 105. Reauthorizing the National Advisory Committee on Children and 
                            Disasters.
Sec. 106. National Disaster Medical System.
Sec. 107. Volunteer Medical Reserve Corps.
Sec. 108. Continuing the role of the Department of Veterans Affairs.
Sec. 109. Authorizing the National Advisory Committee on Seniors and 
                            Disasters.
Sec. 110. National Advisory Committee on Individuals with Disabilities 
                            in All-Hazards Emergencies.
Sec. 111. Consideration for at-risk individuals.
Sec. 112. Public health surveillance.
Sec. 113. GAO study and report on disaster medical assistance teams.
Sec. 114. Military and civilian partnership for trauma readiness grant 
                            program.
Sec. 115. Improvement of loan repayment program for prevention 
                            activities.
Sec. 116. Report on adequate national blood supply.
   TITLE II--OPTIMIZING STATE AND LOCAL ALL-HAZARDS PREPAREDNESS AND 
                                RESPONSE

Sec. 201. Public health emergencies.
Sec. 202. Improving State and local public health security.
Sec. 203. Strengthening the hospital preparedness program.
Sec. 204. Improving benchmarks and standards for preparedness and 
                            response.
Sec. 205. Authorization of appropriations for revitalizing the Centers 
                            for Disease Control and Prevention.
Sec. 206. Authorization of appropriations for Emergency System for 
                            Advanced Registration of Volunteer Health 
                            Professionals.
Sec. 207. Regional health care emergency preparedness and response 
                            systems.
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 
                            emergencies.
Sec. 209. Limitation on liability for volunteer health care 
                            professionals.
 TITLE III--ACCELERATING MEDICAL COUNTERMEASURE ADVANCED RESEARCH AND 
                              DEVELOPMENT

Sec. 301. Strategic national stockpile and security countermeasure 
                            procurement.
Sec. 302. Biomedical advanced research and development authority.
Sec. 303. Report on the development of vaccines to prevent future 
                            epidemics.
                   TITLE IV--MISCELLANEOUS PROVISIONS

Sec. 401. Cybersecurity.
Sec. 402. Miscellaneous FDA amendments.
Sec. 403. Formal strategy relating to children separated from parents 
                            and guardians as a result of zero tolerance 
                            policy.
Sec. 404. Biological threat detection.
Sec. 405. Strengthening Mosquito Abatement for Safety and Health.
Sec. 406. Additional strategies for combating antibiotic resistance.
Sec. 407. Additional purposes for grants for certain trauma centers.

 TITLE I--STRENGTHENING NATIONAL PREPAREDNESS AND RESPONSE FOR PUBLIC 
                           HEALTH EMERGENCIES

SEC. 101. COORDINATION OF PREPAREDNESS FOR AND RESPONSE TO ALL-HAZARDS 
              PUBLIC HEALTH EMERGENCIES.

    (a) In General.--Section 2811 of the Public Health Service Act (42 
U.S.C. 300hh-10) is amended--
            (1) in subsection (b)--
                    (A) in paragraph (4)--
                            (i) in subparagraph (G)--
                                    (I) by inserting ``the pandemic 
                                influenza and emerging infectious 
                                disease program established under 
                                section 319L(d), or'' before ``all-
                                hazards medical and public health 
                                preparedness and response''; and
                                    (II) by adding at the end (after 
                                and below clause (ii)) the following:
                ``Such drills and operations exercises shall be 
                comprehensive, synchronized, and mutually 
                supportive.''; and
                            (ii) by adding at the end the following new 
                        subparagraph:
                    ``(I) Threat awareness.--Coordinate with the 
                Director of the Centers for Disease Control and 
                Prevention, the Director of National Intelligence, the 
                Secretary of Homeland Security, the Assistant to the 
                President for National Security Affairs, the Secretary 
                of Defense, and other relevant Federal officials, such 
                as the Secretary of Agriculture, to maintain a current 
                assessment of national security threats and inform 
                preparedness and response capabilities based on the 
                range of the threats that have the potential to result 
                in a public health emergency.'';
                    (B) in paragraph (5), by adding at the end the 
                following: ``Such logistical support shall include 
                working with other relevant Federal, State, local, 
                tribal, and territorial public health officials and 
                private sector entities to identify the critical 
                infrastructure assets, systems, and networks needed for 
                the proper functioning of the health care and public 
                health sectors that need to be maintained through any 
                emergency or disaster, including entities capable of 
                assisting with, responding to, and mitigating the 
                effect of a public health emergency, including a public 
                health emergency declared by the Secretary pursuant to 
                section 319, or an emergency or major disaster declared 
                by the President pursuant to the Robert T. Stafford 
                Disaster Relief and Emergency Assistance Act or the 
                National Emergencies Act, including by establishing 
                methods to exchange critical information and deliver 
                products consumed or used to preserve, protect, or 
                sustain life, health, or safety, and sharing of 
                specialized expertise.'';
                    (C) in paragraph (7)--
                            (i) in the matter preceding subparagraph 
                        (A)--
                                    (I) by inserting ``the research and 
                                development activities of the pandemic 
                                influenza and emerging infectious 
                                disease program established under 
                                section 319L(d) with respect to 
                                qualified pandemic or epidemic products 
                                (as defined in section 319F-3), and'' 
                                before ``the medical countermeasure 
                                priorities described in subsection 
                                (d)''; and
                                    (II) by striking ``Develop, and 
                                update not later than March 1 of each 
                                year'' and inserting ``Develop, by not 
                                later than September 30, 2019, and 
                                update no later than every two years 
                                after the initial development,''; and
                            (ii) in each of subparagraphs (D) and (E), 
                        by striking ``not later than March 15 of each 
                        year'' and inserting in each such place ``not 
                        later than 14 days after each biennial 
                        development date''; and
                    (D) by adding at the end the following new 
                paragraph:
            ``(8) Reporting.--The Assistant Secretary for Preparedness 
        and Response shall, beginning on the date of the enactment of 
        this paragraph, submit to the Committee on Energy and Commerce 
        of the House of Representatives weekly reports on the status 
        and welfare of the children who, as a result of the `zero 
        tolerance' policy, were separated from their parent or guardian 
        and are awaiting reunification with their parent or guardian, 
        as well as the number of such children in facilities funded by 
        the Department of Health and Human Services.'';
            (2) in subsection (c), in the matter preceding paragraph 
        (1), by striking ``shall'' and inserting ``shall, utilizing 
        experience related to public health emergency preparedness and 
        response, biodefense, medical countermeasures, and other 
        relevant topics''; and
            (3) in subsection (d)--
                    (A) in paragraph (1), by striking ``Not later than 
                180 days after the date of enactment of this 
                subsection, and every year thereafter'' and inserting 
                ``Not later than September 30, 2019, and every second 
                year thereafter'';
                    (B) in paragraph (2)(C), by inserting after 
                ``products'' the following: ``, and ancillary medical 
                supplies to assist with the utilization of such 
                products,''; and
                    (C) in paragraph (2)(J)(v), by striking ``the one-
                year period for which the report is submitted'' and 
                inserting ``the two-year period for which the report is 
                submitted''.
    (b) Countermeasures Budget Plan.--Section 2811(b)(7) of the Public 
Health Service Act (42 U.S.C. 300hh-10(b)(7)) is amended--
            (1) by striking subparagraph (A) and inserting the 
        following:
                    ``(A) include consideration of the entire medical 
                countermeasures enterprise, including--
                            ``(i) basic research and advanced research 
                        and development;
                            ``(ii) approval, clearance, licensure, and 
                        authorized uses of products;
                            ``(iii) procurement, stockpiling, 
                        maintenance, and potential replenishment 
                        (including manufacturing capabilities) of all 
                        products in the Strategic National Stockpile; 
                        and
                            ``(iv) the availability of technologies 
                        that may assist in the advanced research and 
                        development of countermeasures and 
                        opportunities to use such technologies to 
                        accelerate and navigate challenges unique to 
                        countermeasure research and development;'';
            (2) by redesignating subparagraphs (D) and (E) as 
        subparagraphs (E) and (F), respectively; and
            (3) by inserting after subparagraph (C) the following:
                    ``(D) identify the full range of anticipated 
                medical countermeasure needs related to research and 
                development, procurement, and stockpiling, including 
                the potential need for indications, dosing, and 
                administration technologies, and other countermeasure 
                needs as applicable and appropriate;''.

SEC. 102. PUBLIC HEALTH EMERGENCY MEDICAL COUNTERMEASURES ENTERPRISE.

    Subtitle B of title XXVIII of the Public Health Service Act (42 
U.S.C. 300hh-10 et seq.) is amended--
            (1) by redesignating section 2811A as 2811B; and
            (2) by inserting after section 2811 the following:

``SEC. 2811A. PUBLIC HEALTH EMERGENCY MEDICAL COUNTERMEASURES 
              ENTERPRISE.

    ``(a) In General.--The Secretary shall establish and the Assistant 
Secretary for Preparedness and Response may convene an interagency 
panel of advisors to be known as the Public Health Emergency Medical 
Countermeasures Enterprise (in this section referred to as the 
`PHEMCE').
    ``(b) Members.--
            ``(1) In general.--In addition to the Assistant Secretary 
        for Preparedness and Response, who shall serve as chair, the 
        PHEMCE shall include the voting members described in paragraph 
        (2) and the non-voting members described in paragraph (3).
            ``(2) Voting members.--For purposes of paragraph (1), the 
        voting members described in this paragraph are following 
        members:
                    ``(A) The Director of the Biomedical Advanced 
                Research and Development Authority (or the Director's 
                designee).
                    ``(B) The Director of the Centers for Disease 
                Control and Prevention (or the Director's designee).
                    ``(C) The Director of the National Institutes of 
                Health (or the Director's designee).
                    ``(D) The Commissioner of Food and Drugs (or the 
                Commissioner's designee).
                    ``(E) The Secretary of Defense (or the Secretary's 
                designee).
                    ``(F) The Secretary of Homeland Security (or the 
                Secretary's designee).
                    ``(G) The Secretary of Agriculture (or the 
                Secretary's designee).
                    ``(H) The Secretary of Veterans Affairs (or the 
                Secretary's designee).
                    ``(I) Representatives of any other Federal 
                agencies, as the Assistant Secretary for Preparedness 
                and Response determines appropriate.
            ``(3) Non-voting members.--For purposes of paragraph (1), 
        the non-voting members described in this paragraph are the 
        following members:
                    ``(A) The Secretary of State (or the Secretary's 
                designee).
                    ``(B) The Director of National Intelligence (or the 
                Director's designee).
                    ``(C) The Director of the Central Intelligence 
                Agency (or the Director's designee).
    ``(c) Functions.--The PHEMCE shall--
            ``(1) advise the Assistant Secretary for Preparedness and 
        Response regarding research, development, and procurement of 
        security countermeasures (as defined in section 319F-2(c)) 
        based on the health security needs of the United States; and
            ``(2) assist the Assistant Secretary for Preparedness and 
        Response in the identification of gaps in public health 
        preparedness and response related to such security 
        countermeasures and challenges to addressing such needs 
        (including any regulatory challenges).''.

SEC. 103. NATIONAL HEALTH SECURITY STRATEGY.

    Section 2802 of the Public Health Service Act (42 U.S.C. 300hh-1) 
is amended--
            (1) in subsection (a)--
                    (A) in paragraph (1)--
                            (i) by striking ``2014'' and inserting 
                        ``2018''; and
                            (ii) by striking the second sentence and 
                        inserting the following: ``Such National Health 
                        Security Strategy shall describe potential 
                        emergency health security threats and identify 
                        the process for achieving the preparedness 
                        goals described in subsection (b) to be 
                        prepared to identify and respond to such 
                        threats and shall be consistent with the 
                        national preparedness goal (as described in 
                        section 504(a)(19) of the Homeland Security Act 
                        of 2002), the National Incident Management 
                        System (as defined in section 501(7) of such 
                        Act), and the National Response Plan developed 
                        pursuant to section 504 of such Act, or any 
                        successor plan.'';
                    (B) in paragraph (2), by inserting before the 
                period at the end of the second sentence the following: 
                ``, and an analysis of any changes to the evidence-
                based benchmarks and objective standards under sections 
                319C-1 and 319C-2''; and
                    (C) in paragraph (3)--
                            (i) by striking ``2009'' and inserting 
                        ``2022'';
                            (ii) by inserting ``(including gaps in the 
                        environmental health and animal health 
                        workforces, as applicable), describing the 
                        status of such workforce'' after ``gaps in such 
                        workforce'';
                            (iii) by striking ``and identifying 
                        strategies'' and inserting ``identifying 
                        strategies''; and
                            (iv) by inserting before the period at the 
                        end ``, and identifying current capabilities to 
                        meet the requirements of section 2803''; and
            (2) in subsection (b)--
                    (A) in paragraph (2)--
                            (i) in subparagraph (A), by striking ``and 
                        investigation'' and inserting ``investigation, 
                        and related information technology 
                        activities'';
                            (ii) in subparagraph (B), by striking ``and 
                        decontamination'' and inserting 
                        ``decontamination, relevant health care 
                        services and supplies, and transportation and 
                        disposal of medical waste''; and
                            (iii) by adding at the end the following:
                    ``(E) Response to environmental hazards.'';
                    (B) in paragraph (3)--
                            (i) in the matter preceding subparagraph 
                        (A), by striking ``including mental health'' 
                        and inserting ``including pharmacies, mental 
                        health facilities,'';
                            (ii) in subparagraph (F), by inserting ``or 
                        exposures to agents that could cause a public 
                        health emergency'' before the period; and
                            (iii) by amending subparagraph (G) to read 
                        as follows:
                    ``(G) Optimizing a coordinated and flexible 
                approach to the emergency response and medical surge 
                capacity of hospitals, other health care facilities, 
                critical care, trauma care (which may include trauma 
                centers), and emergency medical systems, which may 
                include the implementation of guidelines for regional 
                health care emergency preparedness and response systems 
                under section 319C-3.'';
                    (C) in paragraph (5), by inserting ``and other 
                applicable compacts'' after ``Compact''; and
                    (D) by adding at the end the following:
            ``(9) Zoonotic disease, food, and agriculture.--Improving 
        coordination among Federal, State, local, tribal, and 
        territorial entities (including through consultation with the 
        Secretary of Agriculture) to prevent, detect, and respond to 
        outbreaks of plant or animal disease (including zoonotic 
        disease) that could compromise national security resulting from 
        a deliberate attack, a naturally occurring threat, the 
        intentional adulteration of food, or other public health 
        threats, taking into account interactions between animal 
        health, human health, and animals' and humans' shared 
        environment as directly related to public health emergency 
        preparedness and response capabilities, as applicable.
            ``(10) Global health security.--Assessing current or 
        potential health security threats from abroad to inform 
        domestic public health preparedness and response 
        capabilities.''.

SEC. 104. IMPROVING EMERGENCY PREPAREDNESS AND RESPONSE CONSIDERATIONS 
              FOR CHILDREN.

    Part B of title III of the Public Health Service Act (42 U.S.C. 243 
et seq.) is amended by inserting after section 319D the following:

``SEC. 319D-1. CHILDREN'S PREPAREDNESS UNIT.

    ``(a) Enhancing Emergency Preparedness for Children.--The 
Secretary, acting through the Director of the Centers for Disease 
Control and Prevention (referred to in this subsection as the 
`Director'), shall maintain an internal team of experts, to be known as 
the Children's Preparedness Unit (referred to in this subsection as the 
`Unit'), to work collaboratively to provide guidance on the 
considerations for, and the specific needs of, children before, during, 
and after public health emergencies. The Unit shall inform the Director 
regarding emergency preparedness and response efforts pertaining to 
children at the Centers for Disease Control and Prevention.
    ``(b) Expertise.--The team described in subsection (a) shall 
include one or more pediatricians, which may be a developmental-
behavioral pediatrician, and may also include behavioral scientists, 
child psychologists, epidemiologists, biostatisticians, health 
communications staff, and individuals with other areas of expertise, as 
the Secretary determines appropriate.
    ``(c) Duties.--The team described in subsection (a) may--
            ``(1) assist State, local, tribal, and territorial 
        emergency planning and response activities related to children, 
        which may include developing, identifying, and sharing best 
        practices;
            ``(2) provide technical assistance, training, and 
        consultation to Federal, State, local, tribal, and territorial 
        public health officials to improve preparedness and response 
        capabilities with respect to the needs of children, including 
        providing such technical assistance, training, and consultation 
        to eligible entities in order to support the achievement of 
        measurable evidence-based benchmarks and objective standards 
        applicable to sections 319C-1 and 319C-2;
            ``(3) improve the utilization of methods to incorporate the 
        needs of children in planning for and responding to a public 
        health emergency, including public awareness of such methods;
            ``(4) coordinate with, and improve, public-private 
        partnerships, such as health care coalitions pursuant to 
        sections 319C-2 and 319C-3, to address gaps and inefficiencies 
        in emergency preparedness and response efforts for children;
            ``(5) provide expertise and input during the development of 
        guidance and clinical recommendations to address the needs of 
        children when preparing for, and responding to, public health 
        emergencies, including pursuant to section 319C-3; and
            ``(6) carry out other duties related to preparedness and 
        response activities for children, as the Secretary determines 
        appropriate.''.

SEC. 105. REAUTHORIZING THE NATIONAL ADVISORY COMMITTEE ON CHILDREN AND 
              DISASTERS.

    Section 2811B of the Public Health Service Act, as redesignated by 
section 102(1), is amended--
            (1) in subsection (b)(2), by inserting ``, mental and 
        behavioral,'' after ``medical'';
            (2) in subsection (d)--
                    (A) in paragraph (1), by striking ``15'' and 
                inserting ``25''; and
                    (B) by striking paragraph (2) and inserting the 
                following:
            ``(2) Required non-federal members.--The Secretary, in 
        consultation with such other heads of Federal agencies as may 
        be appropriate, shall appoint to the Advisory Committee under 
        paragraph (1) at least 13 individuals to perform the duties 
        described in subsections (b) and (c), including--
                    ``(A) at least 2 non-Federal professionals with 
                expertise in pediatric medical disaster planning, 
                preparedness, response, or recovery;
                    ``(B) at least 2 representatives from State, local, 
                tribal, or territorial agencies with expertise in 
                pediatric disaster planning, preparedness, response, or 
                recovery;
                    ``(C) at least 4 members representing health care 
                professionals, which may include members with expertise 
                in pediatric emergency medicine; pediatric trauma, 
                critical care, or surgery; the treatment of pediatric 
                patients affected by chemical, biological, 
                radiological, or nuclear agents and emerging infectious 
                diseases; pediatric mental or behavioral health related 
                to children affected by a public health emergency; or 
                pediatric primary care; and
                    ``(D) other members as the Secretary determines 
                appropriate, of whom--
                            ``(i) at least one such member shall 
                        represent a children's hospital;
                            ``(ii) at least one such member shall be an 
                        individual with expertise in schools or child 
                        care settings;
                            ``(iii) at least one such member shall be 
                        an individual with expertise in children and 
                        youth with special health care needs; and
                            ``(iv) at least one such member shall be an 
                        individual with expertise in the needs of 
                        parents or family caregivers, including the 
                        parents or caregivers of children with 
                        disabilities.
            ``(3) Federal members.--The Advisory Committee under 
        paragraph (1) shall include the following Federal members or 
        their designees:
                    ``(A) The Assistant Secretary for Preparedness and 
                Response.
                    ``(B) The Director of the Biomedical Advanced 
                Research and Development Authority.
                    ``(C) The Director of the Centers for Disease 
                Control and Prevention.
                    ``(D) The Commissioner of Food and Drugs.
                    ``(E) The Director of the National Institutes of 
                Health.
                    ``(F) The Assistant Secretary of the Administration 
                for Children and Families.
                    ``(G) The Administrator of the Health Resources and 
                Services Administration.
                    ``(H) The Administrator of the Federal Emergency 
                Management Agency.
                    ``(I) The Administrator of the Administration for 
                Community Living.
                    ``(J) The Secretary of Education.
                    ``(K) Representatives from such Federal agencies 
                (such as the Substance Abuse and Mental Health Services 
                Administration and the Department of Homeland Security) 
                as the Secretary determines appropriate to fulfill the 
                duties of the Advisory Committee under subsections (b) 
                and (c).
            ``(4) Term of appointment.--Each member of the Advisory 
        Committee appointed under paragraph (2) shall serve for a term 
        of 3 years, except that the Secretary may adjust the terms of 
        the Advisory Committee appointees serving on the date of 
        enactment of the Pandemic and All-Hazards Preparedness and 
        Advancing Innovation Act of 2018, or appointees who are 
        initially appointed after such date of enactment, in order to 
        provide for a staggered term of appointment for all members.
            ``(5) Consecutive appointments; maximum terms.--A member 
        appointed under paragraph (2) may serve not more than 3 terms 
        on the Advisory Committee, and not more than 2 of which may be 
        served consecutively.'';
            (3) in subsection (e), by adding at the end ``At least one 
        meeting per year shall be an in-person meeting.'';
            (4) by redesignating subsection (f) as subsection (g);
            (5) by inserting after subsection (e) the following:
    ``(f) Coordination.--The Secretary shall coordinate activities 
authorized under this section and section 2811C, in accordance with 
section 2811C(d).''; and
            (6) in subsection (g), as so redesignated, by striking 
        ``2018'' and inserting ``2023''.

SEC. 106. NATIONAL DISASTER MEDICAL SYSTEM.

    (a) Purpose of System.--Clause (ii) of section 2812(a)(3)(A) of the 
Public Health Service Act (42 U.S.C. 300hh-11(a)(3)(A)) is amended to 
read as follows:
                            ``(ii) be present at locations, and for 
                        limited periods of time, specified by the 
                        Secretary on the basis that the Secretary has 
                        determined that a location is at risk of a 
                        public health emergency during the time 
                        specified, or there is a significant potential 
                        for a public health emergency.''.
    (b) Review of the National Disaster Medical System.--Section 
2812(b)(2) of the Public Health Service Act (42 U.S.C. 300hh-11(b)(2)) 
is amended to read as follows:
            ``(2) Joint review and medical surge capacity strategic 
        plan.--
                    ``(A) Review.--Not later than 180 days after the 
                date of enactment of the Pandemic and All-Hazards 
                Preparedness and Advancing Innovation Act of 2018, the 
                Secretary, in coordination with the Secretary of 
                Homeland Security, the Secretary of Defense, and the 
                Secretary of Veterans Affairs, shall conduct a joint 
                review of the National Disaster Medical System. Such 
                review shall include--
                            ``(i) an evaluation of medical surge 
                        capacity, as described in section 2803(a);
                            ``(ii) an assessment of the available 
                        workforce of the intermittent disaster-response 
                        personnel described in subsection (c);
                            ``(iii) the capacity of the workforce 
                        described in clause (ii) to respond to all 
                        hazards, including capacity to simultaneously 
                        respond to multiple public health emergencies 
                        and to respond to a nationwide public health 
                        emergency;
                            ``(iv) the effectiveness of efforts to 
                        recruit, retain, and train such workforce; and
                            ``(v) gaps that may exist in such workforce 
                        and recommendations for addressing such gaps.
                    ``(B) Updates.--As part of the National Health 
                Security Strategy under section 2802, the Secretary 
                shall update the findings from the review under 
                subparagraph (A) and provide recommendations to modify 
                the policies of the National Disaster Medical System as 
                necessary.''.
    (c) Direct Hire Authority.--Section 2812(c)(1) of the Public Health 
Service Act (42 U.S.C. 300hh-11(c)(1)) is amended by inserting ``(or, 
for the period beginning on the date of the enactment of the Pandemic 
and All-Hazards Preparedness Reauthorization Act of 2018 and ending on 
September 30, 2021, without regard to those provisions of title 5, 
United States Code, governing appointments in the competitive 
service)'' after ``in accordance with applicable civil service laws and 
regulations''.
    (d) Service Benefit; Notification of Shortage.--Section 2812(c) (42 
U.S.C. 300hh-11(c)) is amended by adding at the end the following:
            ``(3) Service benefit.--Individuals appointed to serve 
        under this subsection shall be considered public safety 
        officers under part L of title I of the Omnibus Crime Control 
        and Safe Streets Act of 1968. The Secretary shall provide 
        notification to eligible individuals of any effect such 
        designation may have on other benefits for which such 
        individuals are eligible, including benefits from private 
        entities.
            ``(4) Notification.--Not later than 30 days after the date 
        on which the Secretary determines the number of intermittent 
        disaster-response personnel of the National Disaster Medical 
        System is insufficient to address a public health emergency or 
        potential public health emergency, the Secretary shall submit 
        to the congressional committees of jurisdiction a notification 
        detailing--
                    ``(A) the impact such shortage could have on 
                meeting public health needs and emergency medical 
                personnel needs during a public health emergency; and
                    ``(B) any identified measures to address such 
                shortage.''.
    (e) Death Benefits.--Section 1204(9) of the Omnibus Crime Control 
and Safe Streets Act of 1968 (34 U.S.C. 10284(9)) is amended--
            (1) in subparagraph (C), by striking ``or'' at the end;
            (2) in subparagraph (D), by striking the period at the end 
        and inserting ``; or''; and
            (3) by adding at the end the following:
                    ``(E) an individual appointed to assist the 
                National Disaster Medical System pursuant to section 
                2812(c)(1) of the Public Health Service Act.''.
    (f) Authorization of Appropriations.--Section 2812(g) of the Public 
Health Service Act (42 U.S.C. 300hh-11(g)) is amended by striking 
``$52,700,000 for each of fiscal years 2014 through 2018'' and 
inserting ``$57,400,000 for each of fiscal years 2019 through 2023''.

SEC. 107. VOLUNTEER MEDICAL RESERVE CORPS.

    Section 2813 of the Public Health Service Act (42 U.S.C. 300hh-15)) 
is amended--
            (1) in subsection (a), by amending the second sentence to 
        read as follows: ``The Secretary may appoint a Director to head 
        the Corps and oversee the activities of the Corps chapters that 
        exist at the State, local, and tribal levels.''; and
            (2) in subsection (i), by striking ``$11,200,000 for each 
        of fiscal years 2014 through 2018'' and inserting ``$6,000,000 
        for each of fiscal years 2019 through 2023''.

SEC. 108. CONTINUING THE ROLE OF THE DEPARTMENT OF VETERANS AFFAIRS.

    Section 8117(g) of title 38, United States Code, is amended by 
striking ``$155,300,000 for each of fiscal years 2014 through 2018'' 
and inserting ``$126,800,000 for each of fiscal years 2019 through 
2023''.

SEC. 109. AUTHORIZING THE NATIONAL ADVISORY COMMITTEE ON SENIORS AND 
              DISASTERS.

    Subtitle B of title XXVIII of the Public Health Service Act (42 
U.S.C. 300hh et seq.), as amended by section 102, is further amended by 
inserting after section 2811B the following:

``SEC. 2811C. NATIONAL ADVISORY COMMITTEE ON SENIORS AND DISASTERS.

    ``(a) Establishment.--The Secretary, in consultation with the 
Secretary of Homeland Security and the Secretary of Veterans Affairs, 
shall establish an advisory committee to be known as the National 
Advisory Committee on Seniors and Disasters (referred to in this 
section as the `Advisory Committee').
    ``(b) Duties.--
            ``(1) In general.--The Advisory Committee shall--
                    ``(A) provide advice and consultation with respect 
                to the activities carried out pursuant to section 2814, 
                as applicable and appropriate;
                    ``(B) evaluate and provide input with respect to 
                the medical and public health needs of seniors related 
                to the preparation for, response to, and recovery from 
                all-hazards emergencies; and
                    ``(C) provide advice and consultation with respect 
                to State emergency preparedness and response activities 
                and seniors, including related drills and exercises 
                pursuant to the preparedness goals under section 
                2802(b).
            ``(2) Additional duties.--The Advisory Committee may 
        provide advice and recommendations to the Secretary with 
        respect to seniors and the medical and public health grants and 
        cooperative agreements as applicable to preparedness and 
        response activities under this title and title III.
            ``(3) Membership.--
                    ``(A) In general.--The Secretary, in consultation 
                with such other heads of agencies as appropriate, shall 
                appoint not more than 15 members to the Advisory 
                Committee. In appointing such members, the Secretary 
                shall ensure that the total membership of the Advisory 
                Committee is an odd number.
                    ``(B) Required members.--The members appointed 
                under paragraph (1) shall include--
                            ``(i) the Assistant Secretary for 
                        Preparedness and Response;
                            ``(ii) the Director of the Biomedical 
                        Advanced Research and Development Authority;
                            ``(iii) the Director of the Centers for 
                        Disease Control and Prevention;
                            ``(iv) the Commissioner of Food and Drugs;
                            ``(v) the Director of the National 
                        Institutes of Health;
                            ``(vi) the Administrator of the Centers for 
                        Medicare & Medicaid Services;
                            ``(vii) the Administrator of the 
                        Administration for Community Living;
                            ``(viii) the Administrator of the Federal 
                        Emergency Management Agency;
                            ``(ix) the Under Secretary for Health of 
                        the Department of Veterans Affairs;
                            ``(x) at least 2 non-Federal health care 
                        professionals with expertise in medical 
                        disaster planning, preparedness, response, or 
                        recovery;
                            ``(xi) at least 2 representatives of State, 
                        local, territorial, or tribal agencies with 
                        expertise in disaster planning, preparedness, 
                        response, or recovery; and
                            ``(xii) representatives of such other 
                        Federal agencies (such as the Department of 
                        Energy and the Department of Homeland Security) 
                        as the Secretary determines necessary to 
                        fulfill the duties of the Advisory Committee.
    ``(c) Meetings.--The Advisory Committee shall meet not less 
frequently than biannually.
    ``(d) Advisory Committee Coordination.--
            ``(1) In general.--The Secretary shall coordinate 
        activities authorized under this section and section 2811B, and 
        make efforts to reduce unnecessary or duplication of meetings, 
        recommendations, and reporting under such sections. Members of 
        the advisory committees under this section and section 2811B, 
        or their designees, shall meet periodically, and not less than 
        annually, to--
                    ``(A) review the recommendations developed by such 
                committees to coordinate, as appropriate, the 
                implementation of recommendations, in order to reduce 
                gaps, overlap, and duplication of effort in Federal 
                programs or by Federal grantees; and
                    ``(B) align preparedness and response programs or 
                activities to address the dual or overlapping needs of 
                children and seniors and any challenges in preparing 
                for and responding to such needs.
            ``(2) Notification.--The Secretary shall notify the 
        congressional committees of jurisdiction upon the convening of 
        each meeting under paragraph (1), and provide minutes from such 
        meeting not later than 90 days after the meeting.
    ``(e) Sunset.--The Advisory Committee shall terminate on September 
30, 2023.''.

SEC. 110. NATIONAL ADVISORY COMMITTEE ON INDIVIDUALS WITH DISABILITIES 
              IN ALL-HAZARDS EMERGENCIES.

    Subtitle B of title XXVIII of the Public Health Service Act (42 
U.S.C. 300hh et seq.), as amended by sections 102 and 109, is further 
amended by inserting after section 2811C the following:

``SEC. 2811D. NATIONAL ADVISORY COMMITTEE ON INDIVIDUALS WITH 
              DISABILITIES IN ALL-HAZARDS EMERGENCIES.

    ``(a) Establishment.--Not later than 90 days after the date of this 
section, the Secretary shall establish a national advisory committee to 
be known as the National Advisory Committee on Individuals with 
Disabilities in All-Hazards Emergencies (referred to in this section as 
the `Advisory Committee').
    ``(b) Duties.--The Advisory Committee shall--
            ``(1) provide advice and consultation with respect to 
        activities carried out pursuant to section 2814, as applicable 
        and appropriate;
            ``(2) evaluate and provide input with respect to the public 
        health, accessibility, and medical needs of individuals with 
        disabilities as they relate to preparation for, response to, 
        and recovery from all-hazards emergencies; and
            ``(3) provide advice and consultation with respect to State 
        emergency preparedness and response activities, including 
        related drills and exercises pursuant to the preparedness goals 
        under section 2802(b).
    ``(c) Report.--Not later than February 1, 2020, the Advisory 
Committee shall submit to the Secretary, the Committee on Energy and 
Commerce of the House of Representatives, the Committee on Homeland 
Security of the House of Representatives, the Committee on Veterans' 
Affairs of the House of Representatives, the Committee on Health, 
Education, Labor, and Pensions of the Senate, the Committee on 
Veterans' Affairs of the Senate, and the Committee on Homeland Security 
and Governmental Affairs of the Senate a report that evaluates the 
extent to which individuals with disabilities are thoroughly included 
in disaster preparedness planning and disaster recovery. Such report 
shall--
            ``(1) include recommendations that offer specific 
        improvements that could be made across local, State, tribal, 
        territorial, and Federal efforts to improve outcomes in areas 
        that include--
                    ``(A) preparedness;
                    ``(B) planning;
                    ``(C) exercises and drills;
                    ``(D) alerts, warning, and notifications;
                    ``(E) evacuation;
                    ``(F) sheltering;
                    ``(G) health maintenance;
                    ``(H) accessing emergency programs and services;
                    ``(I) medical care (including mental health care);
                    ``(J) temporary housing;
                    ``(K) mitigation; and
                    ``(L) community resilience; and
            ``(2) assess the strength of existing policies to 
        incorporate such individuals as well as the efficacy of 
        implementation.
    ``(d) Composition.--
            ``(1) In general.--The Secretary, in consultation with such 
        other heads of agencies and departments as may be appropriate, 
        shall appoint not to exceed 25 members to the Advisory 
        Committee.
            ``(2) Required members.--In carrying out paragraph (1), the 
        Secretary shall appoint to the Advisory Committee such 
        individuals as may be appropriate to perform the duties 
        described in subsections (b), which shall include--
                    ``(A) the Assistant Secretary for Preparedness and 
                Response (or their designee);
                    ``(B) the Director of the Administration for 
                Community Living (or their designee);
                    ``(C) the Director of the Biomedical Advanced 
                Research and Development Authority (or their designee);
                    ``(D) the Director of the Centers for Disease 
                Control and Prevention (or their designee);
                    ``(E) the Commissioner of Food and Drugs (or their 
                designee);
                    ``(F) the Director of the National Institutes of 
                Health (or their designee);
                    ``(G) the Administrator of the Federal Emergency 
                Management Agency (or their designee);
                    ``(H) the Director of Office of Disability 
                Integration and Coordination (or their designee);
                    ``(I) the Officer for Civil Rights and Civil 
                Liberties of the Department of Homeland Security (or 
                their designee);
                    ``(J) the Chair of the National Council on 
                Disability (or their designee);
                    ``(K) the Chair of the United States Access Board 
                (or their designee);
                    ``(L) the Director of the Disability Rights Section 
                of the Department of Justice (or their designee);
                    ``(M) the Secretary of the Department of Education 
                (or their designee);
                    ``(N) the Secretary of the Department of 
                Transportation (or their designee);
                    ``(O) the Secretary of the Department of Housing 
                and Urban Development (or their designee);
                    ``(P) a representative from the Department of 
                Veterans Affairs Health Administration's Office of 
                Emergency Management;
                    ``(Q) the Director of the Bureau of Prisons (or 
                their designee);
                    ``(R) at least four representatives who are 
                individuals with disabilities that have substantive 
                expertise in disability inclusive emergency management 
                policy and operations;
                    ``(S) at least two non-Federal health care 
                professionals with expertise in disability 
                accessibility before, during, and after disasters, 
                medical and mass care disaster planning, preparedness, 
                response, or recovery; and
                    ``(T) at least two representatives from State, 
                local, territorial, or tribal agencies with expertise 
                in disability-inclusive disaster planning, 
                preparedness, response, or recovery.
    ``(e) Meetings.--The Advisory Committee shall meet not less than 
biannually.
    ``(f) Disability Defined.--For purposes of this section, the term 
`disability' has the meaning given such term in section 3 of the 
Americans with Disabilities Act of 1990.
    ``(g) Termination of Committee.--
            ``(1) In general.--The Advisory Committee shall terminate 
        on September 30, 2023.
            ``(2) Recommendation.--Not later than March 30, 2023, the 
        Secretary shall submit to Congress 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 researching 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 sections 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 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 infants, 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 manmade threats.
            (2) Components.--The study conducted pursuant to paragraph 
        (1) shall include an assessment, in relation to disaster 
        medical assistance teams, of--
                    (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 Department of Health 
                and Human Services uses to determine--
                            (i) the training needs of such teams; and
                            (ii) whether such teams are mission ready;
                    (C) how to improve the determinations described in 
                subparagraph (B);
                    (D) the extent to which the provision of additional 
                resources (including personnel, training, and 
                equipment) has addressed mission readiness concerns; 
                and
                    (E) the extent to which the Assistant Secretary 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 General shall submit to 
        the Committee on Energy and Commerce of the House of 
        Representatives and the Committee on Health, Education, Labor 
        and Pensions 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 Defined.--In this section, the 
term ``disaster medical assistance team'' means a disaster medical 
assistance team operating pursuant to the National Disaster Medical 
System established under section 2812 of the Public Health Service 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 following 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 Program.--
            ``(1) In general.--The Secretary shall award grants to not 
        more than 20 eligible high-acuity trauma centers to enable 
        military trauma teams to provide, 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 performance period.--
        Notwithstanding section 1552 of title 31, United States Code, 
        or any other provision of law, funds available to the Secretary 
        for obligation 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 Placement 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.
            ``(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 renewed 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 trauma 
                        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 trauma 
                        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 providing 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 providers into such trauma center, 
        including expenditures for malpractice insurance, office space, 
        information technology, specialty education and supervision, 
        trauma programs, research, and State license fees for such 
        military trauma care providers.
    ``(d) Rule of Construction.--Nothing in this section 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 Defense 
        a report for such year that includes information 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;
                    ``(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 effect 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 trauma 
                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 centers.
    ``(f) Definitions.--For purposes of this part:
            ``(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 agreement with the 
                Secretary of Defense to enable military trauma care 
                providers to provide trauma care and related acute care 
                at such trauma center.
                    ``(B) Such trauma center utilizes a risk-adjusted 
                benchmarking system to measure performance 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 providers to maintain 
                or improve the trauma clinical capability of such 
                trauma center.
            ``(2) Eligible high-acuity trauma center.--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 agreement with the 
                Secretary of Defense to enable military trauma teams to 
                provide trauma care and related acute care at such 
                trauma center.
                    ``(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-adjusted 
                benchmarking system to measure performance 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 programs 
                        and fellowships in critical trauma specialties 
                        and subspecialties, and provides education and 
                        supervision of military trauma team members 
                        according to those specialties and 
                        subspecialties; and
                            ``(iii) that undertakes research in the 
                        prevention and treatment of traumatic injury.
                    ``(E) Such trauma center serves as a disaster 
                response leader for its community, such as by 
                participating in a partnership for State and regional 
                hospital preparedness established under section 319C-2.
            ``(3) Major trauma.--The term `major trauma' 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 providers.
            ``(5) Military trauma care provider.--The term `military 
        trauma care provider' means a member 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, 
        combat 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 subsection (a); 
        and
            ``(2) $5,000,000 shall be for carrying out subsection 
        (b).''.

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 
                response 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 SUPPLY.

    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 recommendations related to maintaining an adequate 
national blood supply, including challenges associated with continuous 
recruitment of blood donors, ensuring adequacy of blood supply in the 
case of public health emergencies, and implementation of safety 
measures and innovation.

   TITLE II--OPTIMIZING STATE AND LOCAL ALL-HAZARDS PREPAREDNESS AND 
                                RESPONSE

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 significant 
                        potential for a public health emergency, to 
                        allow the Secretary to rapidly respond to the 
                        immediate needs resulting from such public 
                        health emergency or potential public health 
                        emergency''; and
                            (ii) by inserting after the first sentence 
                        the following: ``The Secretary shall plan for 
                        the expedited distribution of amounts in the 
                        Fund to appropriate agencies and entities.'';
                    (B) by redesignating paragraph (2) as paragraph 
                (3);
                    (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 territorial entities 
                and public and private health care entities that the 
                Secretary determines may be affected by a public health 
                emergency or potential public health emergency referred 
                to in paragraph (1) (including communication of such 
                entities with relevant international entities, as 
                applicable);
                    ``(B) to make grants, provide for awards, enter 
                into contracts, and conduct supportive investigations 
                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 applicable, 
                advanced research and development of security 
                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-3), that are applicable to such 
                a public health emergency or potential public health 
                emergency;
                    ``(D) to strengthen biosurveillance capabilities 
                and laboratory capacity to identify, collect, and 
                analyze information regarding such a public health 
                emergency or potential public health emergency, 
                including the systems under section 319D;
                    ``(E) to support initial emergency operations and 
                assets related to preparation and deployment of 
                intermittent disaster-response personnel under section 
                2812, and the Medical Reserve Corps under section 2813; 
                and
                    ``(F) to carry out other activities, as the 
                Secretary determines applicable and appropriate.''; 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 Secretary, in coordination 
        with the Assistant Secretary for Preparedness and Response, 
        shall conduct a review of the Fund under this subsection, and 
        provide recommendations to the Committee on Health, Education, 
        Labor, and Pensions and the Committee on Appropriations of the 
        Senate and the Committee on Energy and Commerce and the 
        Committee on Appropriations of the House of Representatives on 
        policies to improve such Fund for the uses described in 
        paragraph (2).
            ``(5) GAO review and report.--The Comptroller 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 Reauthorization Act 
        of 2018, the Comptroller General shall submit to the Committee 
        on Energy and Commerce of the House of Representatives and the 
        Committee on Health, Education, Labor, and Pensions of the 
        Senate a report on such review, including recommendations 
        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''.

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 following 
                new clause:
                            ``(x) a description of--
                                    ``(I) the measures the entity will 
                                have in place to prioritize nursing 
                                facilities and skilled nursing 
                                facilities with respect to public 
                                health emergency preparedness in the 
                                same manner as such plan will 
                                prioritize hospitals, while ensuring 
                                that, in prioritizing nursing 
                                facilities, skilled nursing facilities, 
                                and hospitals, the entity will retain 
                                the discretion to prioritize among such 
                                facilities; and
                                    ``(II) the plans that each electric 
                                utility company within the entity's 
                                jurisdiction has in place to ensure 
                                that each such company will remain 
                                functioning or return to functioning as 
                                soon as practicable during power 
                                outages 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 preparedness 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 pursuant to paragraph (3) (subject 
        to the authority of the Secretary to make awards pursuant to 
        paragraphs (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 of this Act and apply with respect 
to cooperative agreements 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 preparedness 
        for'' and inserting ``health care preparedness for and response 
        to'';
            (3) in subsection (b)(1)(A)--
                    (A) in the matter preceding clause (i)--
                            (i) by striking ``partnership'' and 
                        inserting ``coalition''; and
                            (ii) by striking ``consisting of'' and 
                        inserting ``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:
                            ``(iv) an emergency medical service 
                        organization; and
                            ``(v) an emergency management organization; 
                        and'';
            (4) in subsection (c), by inserting after ``preparedness'' 
        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 inserting 
                ``coalition''; and
                    (C) in paragraph (2)(C), by striking ``medical 
                preparedness'' and inserting ``preparedness and 
                response'';
            (6) in subsection (f), by striking ``partnership'' and 
        inserting ``coalition'';
            (7) in subsection (g)(2)--
                    (A) by striking ``Partnerships'' and inserting 
                ``Coalitions'';
                    (B) by striking ``partnerships'' and inserting 
                ``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 paragraph 
                        (2), the requirements'';
                            (ii) by striking ``An entity'' and 
                        inserting ``A coalition'';
                            (iii) by striking ``such partnership'' and 
                        inserting ``such coalition''; and
                            (iv) by adding at the end the following: 
                        ``In submitting reports pursuant to this 
                        paragraph, an entity shall include information 
                        on the progress (if any) that the entity has 
                        made towards the implementation of section 
                        319C-3.'';
                    (B) by redesignating paragraph (2) as paragraph 
                (3); and
                    (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 section--
                    ``(A) paragraph (5)(A) of section 319C-1(g) shall 
                be applied--
                            ``(i) by substituting `for the immediately 
                        preceding fiscal year' with the following: `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 fiscal 
                        years immediately following a fiscal year in 
                        which an entity experienced a failure described 
                        in subparagraph (A) or (B) of paragraph (5) by 
                        the entity, an amount equal to 10 percent of 
                        the amount the entity was eligible to receive 
                        for each such fiscal 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 entity 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 been made in each such 
                        year by virtue of clauses (i) and (ii). 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 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 entity 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 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 clauses (i), (ii), and (iii).'.''; 
                        and
            (9) in subsection (j)(2), in the paragraph heading, by 
        striking ``Partnerships'' and inserting ``Coalitions''.

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 Secretary shall conduct an evaluation of the evidence-based 
        benchmarks and objective standards required under subsection 
        (g). Such evaluation shall be submitted to the congressional 
        committees of jurisdiction 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 benchmarks and 
                objective standards, and associated metrics and 
                targets;
                    ``(B) a discussion of changes to any evidence-based 
                benchmarks and objective standards, and the effect of 
                such changes on the ability to track whether entities 
                are meeting or making progress toward the goals under 
                this section and, to the extent practicable, the 
                applicable 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 objective standards; and
                    ``(D) recommendations, as applicable and 
                appropriate, to improve evidence-based benchmarks and 
                objective standards to more accurately 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)''.

SEC. 205. AUTHORIZATION OF APPROPRIATIONS FOR REVITALIZING THE CENTERS 
              FOR DISEASE CONTROL 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 REGISTRATION OF VOLUNTEER HEALTH PROFESSIONALS.

    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 PREPAREDNESS 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 section 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 hospitals, 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 advance of, and immediately following a public 
health emergency, including threats posed by one or more chemical, 
biological, radiological, and nuclear agents, including emerging 
infectious diseases.
    ``(b) Guidelines.--The Assistant Secretary for Preparedness and 
Response, in consultation with the Director of the Centers for Disease 
Control and Prevention, the Administrator of the Centers for Medicare & 
Medicaid Services, the Administrator of the Health Resources and 
Services Administration, the Commissioner of Food and Drugs, the 
Assistant Secretary for Mental Health and Substance Use, the Assistant 
Secretary of Labor for Occupational Safety and Health, the Secretary of 
Veterans Affairs, the heads of such other Federal agencies as the 
Secretary determines to be appropriate, and State, local, tribal, 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 relating to 
        practices and protocols for all-hazards public health emergency 
        preparedness and response for hospitals and health care 
        facilities to provide appropriate patient care during, in 
        advance of, or immediately following, a public health 
        emergency, resulting from one or more chemical, biological, 
        radiological, or nuclear agents, including emerging infectious 
        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 patients affected by 
                such emergency, including--
                            ``(i) the manner in which the system will 
                        coordinate with and integrate the health care 
                        coalitions and entities described in section 
                        319C-2(b); and
                            ``(ii) informing and educating appropriate 
                        first responders and health care supply chain 
                        partners of the regional emergency preparedness 
                        and response capabilities and medical surge 
                        capacity of such hospitals and health care 
                        facilities in the community;
                    ``(B) physical and technological infrastructure, 
                laboratory capacity, staffing, blood supply, and other 
                supply chain needs, taking into account 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 
                experience among the health care workforce, behavioral 
                health, psychological resilience, and training 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 systems in different States or 
                regions; and
                    ``(E) the needs of children and other at-risk 
                individuals;
            ``(2) make such guidelines available on the public website 
        of the Department of Health and Human Services in a manner that 
        does not compromise national security; and
            ``(3) update such guidelines as appropriate, including 
        based on input received pursuant to subsections (c) and (f), to 
        address new and emerging public health threats.
    ``(c) Considerations.--In identifying, developing, and updating 
guidelines under subsection (b), the Assistant 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 subject matter experts 
        (including experts with relevant expertise in chemical, 
        biological, radiological, or nuclear 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 facilities (including hospitals, 
        primary care clinics, community health centers, mental health 
        facilities, ambulatory care facilities, and dental health 
        facilities), pharmacies, emergency medical providers, trauma 
        care providers, environmental health agencies, public health 
        laboratories, poison control centers, blood banks, and other 
        experts that the Assistant Secretary determines appropriate, to 
        meet the goals under section 2802(b)(3);
            ``(3) consider feedback related to financial implications 
        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 applicable; and
            ``(4) consider financial requirements and potential 
        incentives for entities to prepare for, and respond to, public 
        health emergencies as part of the regional health care 
        emergency preparedness and response system.
    ``(d) Technical Assistance.--The Assistant Secretary for 
Preparedness and Response, in consultation with the Director of the 
Centers for Disease Control and Prevention and the Assistant Secretary 
of Labor for Occupational Safety and Health, may provide technical 
assistance and consultation towards meeting the guidelines described in 
subsection (b).
    ``(e) Demonstration Project for Regional Health Care Preparedness 
and Response Systems.--
            ``(1) In general.--The Assistant Secretary for Preparedness 
        and Response may establish a demonstration 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 
        response capabilities, improve specialty care expertise for 
        all-hazards response, and coordinate medical preparedness and 
        response across State, local, tribal, territorial, and regional 
        jurisdictions.
            ``(2) Sunset.--The authority under this subsection 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 Senate 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 which hospitals and health care 
        facilities have implemented the recommended guidelines under 
        subsection (b), including an analysis and evaluation of any 
        challenges hospitals or health care facilities experienced in 
        implementing such guidelines.
            ``(2) Content.--The Comptroller General shall include in 
        the report under paragraph (1)--
                    ``(A) data on the preparedness and response 
                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, public health emergencies; and
                    ``(B) recommendations to reduce gaps in incentives 
                for regional health partners, including hospitals and 
                health care facilities, to improve capacity and medical 
                surge capabilities to prepare for, and respond to, 
                public health emergencies, consistent with subsection 
                (a), which may include consideration of facilities 
                participating in programs under section 319C-2, 
                programs under the Centers for Medicare & Medicaid 
                Services (including innovative health care delivery and 
                payment models), and input from private sector 
                financial institutions.
            ``(3) Consultation.--In carrying out paragraphs (1) and 
        (2), the Comptroller General shall consult with the heads of 
        appropriate Federal agencies, including--
                    ``(A) the Assistant Secretary for Preparedness and 
                Response;
                    ``(B) the Director of the Centers for Disease 
                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 agencies as 
                the Secretary determines appropriate.''.

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 EMERGENCIES.

    (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 arrangement 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 appropriate 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 arrangement 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 centers, and medical 
                facilities regarding emergency preparedness planning;
                    (B) to identify and prioritize options to implement 
                policies for hospitals, long-term care facilities, 
                dialysis centers, and other medical facilities 
                nationwide that address future threats;
                    (C) to review all Federal grant programs that 
                affect the preparedness of hospitals, long-term care 
                facilities, dialysis centers, or other medical 
                facilities for public health emergencies and provide 
                recommendations for improving such preparedness by--
                            (i) improving such existing Federal grant 
                        programs; or
                            (ii) creating new Federal grant programs;
                    (D) to review, identify, and recommend best 
                practices for improving emergency preparedness at 
                hospitals, long-term care facilities, dialysis centers, 
                and other medical facilities;
                    (E) to identify and recommend best sources and 
                guidelines for alterative or emergency power systems, 
                including renewable sources, battery storage, and 
                generators; and
                    (F) to identify and recommend best practices and 
                guidelines for emergency preparedness planning related 
                to access to clean water at hospitals, long-term care 
                facilities, dialysis centers, and other medical 
                facilities.
    (b) Report.--
            (1) In general.--The arrangement under subsection (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 results 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 facilities, 
                dialysis centers, and other medical facilities 
                nationwide for public health emergencies, including 
                natural disasters.

SEC. 209. LIMITATION ON LIABILITY FOR VOLUNTEER HEALTH CARE 
              PROFESSIONALS.

    (a) In General.--Title II of the Public Health Service 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 occurs--
            ``(1) during the period of the disaster;
            ``(2) in the State or States for which the disaster 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 services that 
        are within the scope of the license, registration, 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 provided 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 flagrant indifference to 
        the rights or safety of the individual harmed by the health 
        care professional; or
            ``(2) the health care professional provided such health 
        care services under the influence (as determined 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 professionals 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 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 declared by 
                the President under the Robert T. Stafford Disaster 
                Relief and Emergency Assistance Act; or
                    ``(C) a public health emergency that is determined 
                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 
                        covered by such determination; and
                            ``(ii) excluding any period covered by a 
                        renewal of such determination.
            ``(2) The term `harm' includes physical, nonphysical, 
        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.
            ``(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 treatment 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 several States, 
        the District of Columbia, the Commonwealth 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 services 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 1128B(f) of the Social 
                Security Act) or State health benefits program; and
                    ``(ii) excludes--
                            ``(I) reasonable reimbursement or allowance 
                        for expenses actually incurred;
                            ``(II) receipt of paid leave; and
                            ``(III) receipt of items to be used 
                        exclusively for providing the health care 
                        services 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 occurred 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 Congress that--
            (1) health care professionals should be encouraged, to 
        register with the Emergency System for Advance Registration of 
        Volunteer Health Professionals (ESARVHP), and States should 
        employ online registration with the promptest processing 
        possible of such registrations to foster the rapid deployment 
        and utilization of volunteer health care professionals 
        following a disaster;
            (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 professionals serving 
        disaster victims as soon as is reasonably practical following a 
        disaster.

 TITLE III--ACCELERATING MEDICAL COUNTERMEASURE ADVANCED RESEARCH AND 
                              DEVELOPMENT

SEC. 301. STRATEGIC NATIONAL STOCKPILE AND SECURITY COUNTERMEASURE 
              PROCUREMENT.

    (a) In General.--
            (1) Coordination with the aspr.--Subsection (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 
        Preparedness 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--
                    (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 pursuant 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 Homeland 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 Security 
and Government Affairs of the Senate and the Committee 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.--Paragraph (1) of section 319F-
2(g) of the Public Health Service Act (42 U.S.C. 247d-6b(g)) is amended 
to read as follows:
            ``(1) Authorization of appropriations.--In addition to 
        amounts appropriated to the special reserve 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 
        appropriation, to be obligated at a rate of not less than 
        $710,000,000 per year. Amounts appropriated pursuant to this 
        paragraph are authorized to remain available until expended.''.

SEC. 302. BIOMEDICAL ADVANCED RESEARCH AND DEVELOPMENT AUTHORITY.

    (a) Preparing for Pandemic Influenza, Antimicrobial Resistance, and 
Other Significant Threats.--Section 319L(c)(4) of the Public Health 
Service Act (247d-7e(c)(4)) is amended by adding at the end the 
following:
                    ``(F) Strategic initiatives.--The Secretary, acting 
                through the Director of BARDA, may implement strategic 
                initiatives, including by building on existing programs 
                and by awarding 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 national 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 infrastructure). Such initiatives shall 
                accelerate and support the advanced research, 
                development, and procurement of, countermeasures and 
                products, as applicable, to address areas including--
                            ``(i) chemical, biological, radiological, 
                        or nuclear threats, including emerging 
                        infectious diseases, for which insufficient 
                        approved, licensed, or authorized 
                        countermeasures 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 rendered 
                        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, 
                        manufacturing, and appropriate stockpiling of 
                        qualified pandemic or epidemic products, and 
                        products, technologies, or processes to support 
                        the advanced research and development of such 
                        countermeasures (including multiuse platform 
                        technologies for diagnostics, vaccines, and 
                        therapeutics; virus seeds; clinical trial lots; 
                        novel virus strains; and antigen and adjuvant 
                        material); and
                            ``(iii) threats that may result primarily 
                        or secondarily from a chemical, biological, 
                        radiological, or nuclear agent, or emerging 
                        infectious disease, and which may present 
                        increased treatment complications 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 transactions other 
                        than a contract, grant, or cooperative 
                        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 
                                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 following new 
        subsections:
    ``(d) Pandemic Influenza Program.--The Secretary, acting through 
the Director of BARDA, shall establish and implement a program that--
            ``(1) supports research and development activities for 
        qualified pandemic or epidemic products (as defined in section 
        319F-3(i)), including by developing innovative technologies to 
        enhance rapid response 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
            ``(3) sustains and replenishes pandemic stockpiles of bulk 
        antigen and adjuvant material, including annually testing the 
        potency and shelf-life potential 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 research and development, and manufacturing 
infrastructure, activities with respect to an emerging infectious 
disease.''.
    (d) Funding.--Subsection (f) of section 319L of the Public Health 
Service Act (42 U.S.C. 247d-7e), as redesignated 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:
            ``(3) Funding for pandemic influenza program.--
                    ``(A) In general.--To carry out the purposes 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 disease program.--
                    ``(A) In general.--To carry out the purposes 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).''.

SEC. 303. REPORT ON THE DEVELOPMENT OF VACCINES TO PREVENT FUTURE 
              EPIDEMICS.

    Not later than one year after the date of the enactment 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 related to the provision of any 
funding or technical assistance to such entities.

                   TITLE IV--MISCELLANEOUS PROVISIONS

SEC. 401. CYBERSECURITY.

    (a) National Health Security Strategy.--Section 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 
        addressing cybersecurity threats to the public health and 
        health care system, including--
                    ``(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 mitigation to 
                prevent harm to human health in case of a cybersecurity 
                incident.''.
    (b) Coordination of Preparedness for and Response to All-Hazards 
Public Health Emergencies.--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 paragraph (5); and
            (2) by inserting after paragraph (3) the following:
            ``(4) have lead responsibility within the Department of 
        Health and Human Services for ensuring the ability of the 
        health care sector to provide continuity 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--
            (1) by redesignating paragraph (3) as paragraph (4); and
            (2) by inserting after paragraph (2) the following:
            ``(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 qualification submissions.''.
    (b) Emergency Use Instructions.--Subparagraph (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 
inserting ``subsection (a)(1)(C)''.
    (c) Products Held for Emergency Use.--Section 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 section 564A'' 
        before the period at the end.

SEC. 403. FORMAL STRATEGY RELATING TO CHILDREN SEPARATED FROM PARENTS 
              AND GUARDIANS AS A RESULT OF ZERO TOLERANCE POLICY.

    Not later than 14 days after the date of the enactment 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 previous work 
        of the Committee, which began in 2014, regarding the oversight 
        of, and care for, unaccompanied alien children in the custody 
        of the Department.

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.--
            ``(1) In general.--The Secretary of Health and Human 
        Services, in coordination with the Secretary 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 intentionally 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 departments and 
                agencies to replace and enhance biological threat 
                detection systems in use, including recommendation for 
                the transfer of biological threat detection technology 
                among Federal departments and agencies.
            ``(2) Considerations.--In carrying out paragraph (1), the 
        Secretary of Health and Human Services shall take into 
        consideration the capabilities of the system with respect to 
        each of the following:
                    ``(A) Rapidly detecting, identifying, 
                characterizing, and confirming the presence of 
                biological threat agents.
                    ``(B) Recovering live biological agents from 
                collection devices.
                    ``(C) Determining the geographical distribution of 
                biological agents.
                    ``(D) Determining the extent of environmental 
                contamination and persistence of biological agents.
                    ``(E) Providing advanced molecular diagnostics to 
                State, local, tribal, and territorial public health and 
                other laboratories that support biological threat 
                detection activities.
    ``(b) Collaboration.--The Secretary of Health and Human Services, 
in consultation with Secretary of Defense, 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 collaborate 
with State, local, tribal, and territorial public health laboratories 
and other users of current and future biological threat detection 
systems to develop--
            ``(1) biological threat detection requirements, including--
                    ``(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 standards 
                        and the development and deployment of 
                        biological threat detection systems; and
                            ``(ii) metrics for, collaborative 
                        assessment of, and deployment of biosafety 
                        standards;
            ``(2) a standardized integration strategy for--
                    ``(A) the level to which biological threat 
                detection 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 laboratory 
        training requirements for--
                    ``(A) supporting and participating in biological 
                threat detection systems; and
                    ``(B) addressing flexibility at the jurisdictional 
                level allowing for adoption of technology based on need 
                and assessment of the efficacy and local utility of 
                technology by the jurisdiction;
            ``(4) guidelines for a coordinated public health response 
        addressing all aspect of a response, including clinical and 
        epidemiological guidelines for utilizing information produced 
        by biological threat detection systems and responding to 
        intentionally introduced, accidentally released, and naturally 
        occurring infectious diseases; and
            ``(5) a coordinated remediation plan with Federal 
        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)--
                    (A) by inserting ``including programs to address 
                emerging infectious mosquito-borne diseases,'' after 
                ``subdivisions for control programs,''; and
                    (B) by inserting ``or improving existing control 
                programs'' before the period at the end;
            (2) in subsection (b)--
                    (A) in paragraph (1), by inserting ``, including 
                improvement,'' after ``operation'';
                    (B) in paragraph (2)--
                            (i) in subparagraph (A)--
                                    (I) in clause (ii), by striking 
                                ``or'' at the end;
                                    (II) in clause (iii), by striking 
                                the semicolon at the end and inserting 
                                ``, including an emerging infectious 
                                mosquito-borne disease that presents a 
                                serious public health threat; or''; and
                                    (III) by adding at the end the 
                                following:
                            ``(iv) a public health emergency due to the 
                        incidence or prevalence of a mosquito-borne 
                        disease that presents a serious public health 
                        threat;''; and
                            (ii) by amending subparagraph (D) to read 
                        as follows:
                    ``(D)(i) is located in a State that has received 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 control 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 
                                potentially impacted human population;
                                    ``(II) the size or density of a 
                                mosquito population that requires 
                                heightened control; or
                                    ``(III) the severity of the 
                                mosquito-borne disease, such that 
                                expected serious adverse health 
                                outcomes for the human population 
                                justify the waiver.''; and
                    (D) by amending paragraph (6) to read as follows:
            ``(6) Number of grants.--A political subdivision or a 
        consortium of political subdivisions may not receive more than 
        one grant under paragraph (1).''; and
            (3) in subsection (d), by striking ``Amounts appropriated 
        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 ``, including 
        mosquito and other vector-borne diseases,'' after ``infectious 
        diseases''; and
            (2) by amending subsection (b) to read as follows:
    ``(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 surveillance 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 defined) and such 
                territories), including--
                            (i) how such infrastructure and programs 
                        are organized and implemented at the Federal, 
                        State and local levels, including with respect 
                        to departments and agencies of the States, and 
                        local organizations (including special 
                        districts) involved in such control programs;
                            (ii) the role of the private sector in such 
                        activities;
                            (iii) how the authority for mosquito 
                        control impacts such activities; and
                            (iv) the funding sources for such 
                        infrastructure and programs, including Federal, 
                        State, and local funding sources;
                    (B) how mosquito-borne and other vector-borne 
                disease surveillance and control is integrated into 
                Federal, State, and local preparedness plans and 
                actions, including how zoonotic surveillance is 
                integrated into infectious disease surveillance to 
                support real-time situational surveillance and 
                awareness;
                    (C) Federal, State, and local laboratory capacity 
                for emerging vector-borne diseases, including mosquito-
                borne and other zoonotic diseases; and
                    (D) any regulatory challenges for developing and 
                utilizing vector-control technologies and platforms as 
                part of mosquito control strategies.
            (2) Consultations.--In conducting the study under paragraph 
        (1), the Comptroller General of the United States shall consult 
        with--
                    (A) State and local public health officials 
                involved in mosquito and other vector-borne disease 
                surveillance and control efforts;
                    (B) researchers and manufacturers of mosquito 
                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 Pensions of the Senate and the Committee on Energy 
        and Commerce of the House of Representatives a report 
        containing--
                    (A) the results of the study conducted under 
                paragraph (1); and
                    (B) any relevant recommendations of the Comptroller 
                General for preparedness and response efforts with 
                respect to Zika virus and other mosquito-borne 
                diseases.

SEC. 406. ADDITIONAL STRATEGIES FOR COMBATING ANTIBIOTIC RESISTANCE.

    Part B of title III of the Public Health Service Act (42 U.S.C. 243 
et seq.) is amended by inserting after section 319E the following:

``SEC. 319E-1. ADVISORY COUNCIL ON COMBATING ANTIBIOTIC-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 Executive Order 13676 of September 18, 2014 (79 
        Fed. Reg. 56931; relating to combating antibiotic-resistant 
        bacteria).
            ``(3) National strategy.--The term `National Strategy' 
        means the National Strategy for Combating Antibiotic-Resistant 
        Bacteria issued by the White House in September 2014, and any 
        subsequent update to such strategy or a successor strategy.
    ``(b) Advisory Council.--The Advisory Council shall provide advice, 
information, and recommendations to the Secretary regarding programs 
and policies intended to support and evaluate the implementation of 
Executive Order 13676 of September 18, 2014 (79 Fed. Reg. 56931; 
relating to combating antibiotic-resistant bacteria), including the 
National Strategy, and the Action Plan.
    ``(c) Meetings and Duties.--
            ``(1) Meetings.--The Advisory Council shall meet as the 
        Chair determines appropriate but not less than twice per year, 
        and, to the extent practicable, in conjunction with meetings of 
        the task force described in section 319E.
            ``(2) Recommendations.--The Advisory Council shall make 
        recommendations to the Secretary, in consultation with the 
        Secretary of Agriculture and the Secretary of Defense, 
        regarding programs and policies intended to--
                    ``(A) preserve the effectiveness of antibiotics by 
                optimizing their use;
                    ``(B) advance research to develop improved methods 
                for combating antibiotic resistance and conducting 
                antimicrobial stewardship, as defined in section 
                319E(h)(3);
                    ``(C) strengthen surveillance of antibiotic-
                resistant bacterial infections;
                    ``(D) prevent the transmission of antibiotic-
                resistant bacterial infections;
                    ``(E) advance the development of rapid point-of-
                care and agricultural diagnostics;
                    ``(F) further research on new treatments for 
                bacterial infections;
                    ``(G) develop alternatives to antibiotics for 
                animal health purposes;
                    ``(H) maximize the dissemination of up-to-date 
                information on the appropriate and proper use of 
                antibiotics to the general public and human and animal 
                health care providers; and
                    ``(I) improve international coordination of efforts 
                to combat antibiotic resistance.
            ``(3) Coordination.--The Advisory Council shall, to the 
        greatest extent practicable, coordinate activities carried out 
        by the Council with the Transatlantic Taskforce on 
        Antimicrobial Resistence.''.

SEC. 407. ADDITIONAL PURPOSES FOR GRANTS FOR CERTAIN TRAUMA CENTERS.

    Section 1241(a)(2) of the Public Health Service Act (42 U.S.C. 
300d-41(a)(2)) is amended to read as follows:
            ``(2) to further the core missions of such trauma centers, 
        including by addressing costs associated with patient 
        stabilization and transfer, trauma education and outreach, 
        coordination with local and regional trauma systems, essential 
        personnel and other fixed costs, expenses associated with 
        employee and non-employee physician services, trauma staff 
        recruitment and retention, ensuring surge capacity, trauma-
        related emotional and mental health services, and other 
        investments needed to implement and maintain Regional Health 
        Care Emergency Preparedness and Response Systems.''.
                                 <all>