Title: Public Health Emergency Response and Accountability Act
Policy area: Health

Summary:
Public Health Emergency Response and Accountability Act
This bill modifies funding mechanisms and establishes reporting requirements relating to public health emergencies that are infectious disease outbreaks, bioterrorist attacks, or disasters.
Specifically, the bill establishes a formula-based funding mechanism for the Public Health Emergency Fund to automatically provide funding in the event of these types of emergencies. The amounts provided by the bill are designated as an emergency requirement pursuant to the Statutory Pay-As-You-Go Act of 2010 (PAYGO) and the Senate PAYGO rule. (This excludes the budget effects from being counted for the purposes of enforcing the PAYGO rules.)
The bill also puts in place additional reporting requirements concerning these types of public health emergencies. Upon determination of such an emergency, the Department of Health and Human Services must convene a group of federal officials to prepare monthly reports for Congress on emergency response efforts. In addition, the Government Accountability Office (GAO) must issue a report on the governmental response to such an emergency within six months of the emergency's termination.
The GAO must also report on the capacity of the public health system to respond effectively to infectious disease outbreaks and how funds for public health emergencies have been expended within the last two years.
Finally, the bill exempts the Public Health Emergency Fund from sequestration. (Sequestration is a process of automatic, usually across-the-board spending reductions under which budgetary resources are permanently cancelled to enforce specific budget policy goals.)

[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 2467 Introduced in Senate (IS)]

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117th CONGRESS
  1st Session
                                S. 2467

 To provide for a Public Health Emergency Fund, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             July 26, 2021

  Mr. Cassidy introduced the following bill; which was read twice and 
  referred to the Committee on Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
 To provide for a Public Health Emergency Fund, 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 ``Public Health Emergency Response and 
Accountability Act''.

SEC. 2. PUBLIC HEALTH EMERGENCIES.

    (a) In General.--Section 319 of the Public Health Service Act (42 
U.S.C. 247d) is amended--
            (1) in subsection (a), by striking ``after consultation'' 
        and inserting ``in consultation with the Assistant Secretary 
        for Preparedness and Response and'';
            (2) by redesignating subsections (b) through (f) as 
        subsections (c) through (g), respectively;
            (3) by inserting after subsection (a), the following:
    ``(b) Reporting Requirements.--
            ``(1) In general.--Upon the determination of a public 
        health emergency under subsection (a) that is an infectious 
        disease outbreak, a bioterrorist attack, or a disaster, the 
        Secretary shall request the Assistant Secretary for 
        Preparedness and Response to convene a group of Federal public 
        health and other Federal officials that shall prepare monthly 
        reports related to such emergency for the period described in 
        paragraph (3) and submit such reports to Congress.
            ``(2) Contents.--The reports prepared under paragraph (1) 
        shall include--
                    ``(A) in the first monthly report, the proposed 
                budget of the response to the emergency, and, in each 
                subsequent report, updates to such budget;
                    ``(B) a description of how the Secretary plans to 
                use best practices and lessons learned from previous 
                public health emergency responses;
                    ``(C) a description of how collaboration among 
                public health agencies and departments will be 
                achieved, strategies for public communication, and 
                acquisition and distribution of supplies;
                    ``(D) an identification of additional authorities 
                needed, if any, to respond to the emergency; and
                    ``(E) in the first monthly report, the 
                justification for triggering the public health 
                emergency response.
            ``(3) Period.--The period described in this paragraph is 
        the period beginning not later than 30 days after the 
        determination of a public health emergency under subsection (a) 
        that is an infectious disease outbreak, a bioterrorist attack, 
        or a disaster, and ending 30 days after the determination of 
        such emergency terminates in accordance with such 
        subsection.''; and
            (4) in subsection (c) (as so redesignated)--
                    (A) in paragraph (3), by striking ``Committee on 
                Commerce'' and inserting ``Committee on Energy and 
                Commerce''; and
                    (B) by adding at the end the following:
            ``(6) Funding.--
                    ``(A) Definitions.--In this paragraph:
                            ``(i) Public health emergency relief.--The 
                        term `public health emergency relief' means the 
                        expenditures to address a public health 
                        emergency determined under subsection (a) that 
                        is an infectious disease outbreak, a 
                        bioterrorist attack, or a disaster from--
                                    ``(I) amounts made available by 
                                emergency supplemental appropriations 
                                to appropriations accounts of the 
                                Department of Health and Human Services 
                                to address a public health emergency 
                                that is an infectious disease outbreak, 
                                a bioterrorist attack, or a disaster 
                                (excluding funds transferred to the 
                                Department from the appropriations 
                                account for the `Federal Emergency 
                                Management Agency, Disaster Relief 
                                Fund' or pursuant to the Oil Pollution 
                                Act of 1990); and
                                    ``(II) any amounts expended from 
                                the Public Health Emergency Fund under 
                                this subsection.
                            ``(ii) Target amount.--The term `target 
                        amount' means the amount that is the rolling 
                        annual average of expenditures for public 
                        health emergency relief over the full 14 fiscal 
                        years immediately preceding the fiscal year for 
                        which the determination of a public health 
                        emergency is made under subsection (a) that is 
                        an infectious disease outbreak, a bioterrorist 
                        attack, or a disaster, excluding the highest 
                        and lowest years.
                    ``(B) Appropriations.--
                            ``(i) In general.--Subject to clause (iv), 
                        upon the determination of each public health 
                        emergency under subsection (a) that is an 
                        infectious disease outbreak, a bioterrorist 
                        attack, or a disaster, there is appropriated to 
                        the Public Health Emergency Fund, out of any 
                        money in the Treasury not otherwise 
                        appropriated, for the fiscal year of the 
                        determination, an amount determined under 
                        subparagraph (C), to remain available until 
                        expended, which may be used in accordance with 
                        subparagraph (D).
                            ``(ii) Reporting.--The reporting 
                        requirements contained in subsection (b) shall 
                        apply with respect to amounts appropriated 
                        under clause (i).
                            ``(iii) Emergency designations.--
                                    ``(I) In general.--Amounts 
                                appropriated under clause (i) are 
                                designated as an emergency requirement 
                                pursuant to section 4(g) of the 
                                Statutory Pay-As-You-Go Act of 2010 (2 
                                U.S.C. 933(g)).
                                    ``(II) Designation in the senate.--
                                In the Senate, amounts appropriated 
                                under clause (i) are designated as an 
                                emergency requirement pursuant to 
                                section 403(a) of S. Con. Res. 13 
                                (111th Congress), the concurrent 
                                resolution on the budget for fiscal 
                                year 2010.
                            ``(iv) Limitation.--Clause (i) shall not 
                        apply if the amount available for expenditure 
                        in the Public Health Emergency Fund, as of the 
                        date of the determination as a public health 
                        emergency under subsection (a) that is an 
                        infectious disease outbreak, a bioterrorist 
                        attack, or a disaster, is equal to or greater 
                        than the target amount.
                    ``(C) Formula.--
                            ``(i) In general.--Subject to clause (ii), 
                        the amount determined under this subparagraph 
                        shall be equal to the difference between the 
                        target amount and the amount available for 
                        expenditure in the Public Health Emergency 
                        Fund, as of the date of the determination of 
                        the public health emergency under subsection 
                        (a).
                            ``(ii) Report by omb.--Not later than 30 
                        days after the date of enactment of this 
                        paragraph, the Director of the Office of 
                        Management and Budget shall submit to the 
                        Committee on Appropriations and the Committee 
                        on the Budget of the Senate and the Committee 
                        on Appropriations and the Committee on the 
                        Budget of the House of Representatives, a 
                        report on the rolling average calculated for 
                        purposes of determining the target amount.
                    ``(D) Use of funds.--
                            ``(i) In general.--Amounts appropriated to 
                        the Public Health Emergency Fund under 
                        subparagraph (B) shall be used by the Secretary 
                        in accordance with the proposed budget 
                        described in subsection (b)(2) for any public 
                        health emergency determined under subsection 
                        (a) that is an infectious disease outbreak, a 
                        bioterrorist attack, or a disaster that has not 
                        terminated under such subsection. Such funds 
                        shall be used--
                                    ``(I) to provide assistance for 
                                immediate Federal, State, local, or 
                                international response needs with 
                                respect to any public health emergency 
                                determined under subsection (a) that is 
                                an infectious disease outbreak, a 
                                bioterrorist attack, or a disaster; and
                                    ``(II) for activities determined 
                                appropriate by the Secretary to improve 
                                preparedness and response to protect 
                                human health for all populations in any 
                                public health emergency determined 
                                under subsection (a) that is an 
                                infectious disease outbreak, a 
                                bioterrorist attack, or a disaster.
                            ``(ii) Availability.--Amounts appropriated 
                        to the Public Health Emergency Fund under 
                        subparagraph (B) shall remain available for the 
                        uses described in this subparagraph so long as 
                        any public health emergency is determined under 
                        subsection (a) that is an infectious disease 
                        outbreak, a bioterrorist attack, or a disaster, 
                        and the determination for any such emergency 
                        has not terminated under such subsection.
                            ``(iii) Authority.--In expending funds 
                        appropriated under subparagraph (B) and 
                        carrying out activities under this 
                        subparagraph, the Secretary shall have the 
                        authority to--
                                    ``(I) transfer funds and enter into 
                                contracts;
                                    ``(II) utilize flexible hiring 
                                mechanisms, including direct hiring 
                                authority and personal service 
                                contracts; exemptions from certain 
                                administrative restrictions (such as 
                                travel, information technology, 
                                printing and supplies); motor vehicle 
                                authority; and flexible compensation 
                                for responders, including overtime and 
                                danger pay; and
                                    ``(III) utilize flexible 
                                transaction mechanisms.''.
    (b) Exemption of the Public Health Emergency Fund From 
Sequestration.--
            (1) In general.--Section 255(g)(1)(A) of the Balanced 
        Budget and Emergency Deficit Control Act of 1985 is amended by 
        inserting ``Public Health Emergency Fund (009-91-9913).'' after 
        the item relating to ``Postal Service Fund (18-4020-0-3-
        372).''.
            (2) Application.--The amendment made by paragraph (1) shall 
        apply to any sequestration order issued under such Act on or 
        after the date of enactment of this section.
    (c) GAO Reports.--
            (1) In general.--Not later than 180 days after the date of 
        enactment of this Act, the Comptroller General of the United 
        States, in consultation with relevant Federal, State, and local 
        government entities, shall prepare and submit to the 
        appropriate committees of Congress, a report--
                    (A) reviewing the capacity of the United States 
                public health system, including the public health 
                workforce, to respond effectively to infectious disease 
                outbreaks;
                    (B) identifying areas of potential improvement in 
                coordination between Federal, State, and local 
                government entities to respond more effectively to 
                infectious disease outbreaks;
                    (C) making recommendations on how to provide or 
                allocate most effectively resources for public health 
                emergency response, specifically considering how to 
                utilize most effectively the emergency fund established 
                under section 319 of the Public Health Service Act (42 
                U.S.C. 247d); and
                    (D) containing an audit of how funds for public 
                health emergencies have been expended within the 2 
                years preceding the date of the report.
            (2) Post-emergency report.--
                    (A) In general.--Not later than 6 months after the 
                termination of a determination of a public health 
                emergency under section 319 of the Public Health 
                Service Act (42 U.S.C. 247d) that is an infectious 
                disease outbreak, a bioterrorist attack, or a disaster, 
                the Comptroller General of the United States shall 
                review response efforts by Federal, State, and local 
                government entities, as well as any other relevant 
                entities engaged in response efforts, and submit a 
                report to the appropriate committees of Congress to 
                determine--
                            (i) the compliance of such efforts with 
                        best practices identified in the report under 
                        paragraph (1);
                            (ii) the effectiveness of such best 
                        practices;
                            (iii) the cost of such efforts;
                            (iv) the areas of potential continued 
                        improvement in coordination between Federal, 
                        State, and local government entities to respond 
                        more effectively to infectious disease 
                        outbreaks; and
                            (v) how to incorporate additional best 
                        practices which may be incorporated in future 
                        response efforts.
                    (B) Audit.--The report under subparagraph (A) shall 
                include an audit indicating how funds used for public 
                health emergencies determined under section 319 of the 
                Public Health Service Act have been expended during the 
                2 years preceding the submission of the report under 
                such subparagraph.

SEC. 3. APPLICABILITY.

    Nothing in this Act, or an amendment made by this Act, shall affect 
the applicability of the Robert T. Stafford Disaster Relief and 
Emergency Assistance Act (42 U.S.C. 5121 et seq.) or the Oil Pollution 
Act of 1990 (33 U.S.C. 2701 et seq.) in the case of a public health 
emergency.
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