II Calendar No. 268 118th CONGRESS 1st Session S. 1798 [Report No. 118–124] IN THE SENATE OF THE UNITED STATES June 1, 2023 Mr. Peters (for himself and Mr. Cornyn ) introduced the following bill; which was read twice and referred to the Committee on Homeland Security and Governmental Affairs December 11, 2023 Reported by Mr. Peters , with an amendment Strike out all after the enacting clause and insert the part printed in italic A BILL To establish a Countering Weapons of Mass Destruction Office and an Office of Health Security in the Department of Homeland Security, and for other purposes.

1. Short title; table of contents (a) Short title This Act may be cited as the Offices of Countering Weapons of Mass Destruction and Health Security Act of 2023 . (b) Table of contents The table of contents for this Act is as follows: Sec. 1. Short title; table of contents. TITLE I—Countering Weapons of Mass Destruction Office Sec. 101. Countering Weapons of Mass Destruction Office. Sec. 102. Rule of construction. TITLE II—Office of Health Security Sec. 201. Office of Health Security. Sec. 202. Confidentiality of medical quality assurance records. Sec. 203. Technical and conforming amendments. I Countering Weapons of Mass Destruction Office 101. Countering Weapons of Mass Destruction Office (a) Homeland Security Act of 2002 Title XIX of the Homeland Security Act of 2002 ( 6 U.S.C. 590 et seq. ) is amended— (1) in section 1901 ( 6 U.S.C. 591 )— (A) in subsection (c), by striking paragraphs (1) and (2) and inserting the following: (1) matters and strategies pertaining to— (A) weapons of mass destruction; and (B) non-medical aspects of chemical, biological, radiological, nuclear, and other related emerging threats; (2) coordinating the efforts of the Department to counter— (A) weapons of mass destruction; and (B) non-medical aspects of chemical, biological, radiological, nuclear, and other related emerging threats; and (3) enhancing the ability of Federal, State, local, and Tribal partners to prevent, detect, protect against, and mitigate the impacts of terrorist attacks in the United States to counter— (A) weapons of mass destruction; and (B) non-medical aspects of use of unauthorized chemical, biological, radiological, and nuclear materials, devices, or agents and other related emerging threats. ; and (B) by striking subsection (e); (2) by amending section 1921 ( 6 U.S.C. 591g ) to read as follows: 1921. Mission of the Office The Office shall be responsible for— (1) coordinating the efforts of the Department and with other Federal departments and agencies to counter— (A) weapons of mass destruction; and (B) chemical, biological, radiological, nuclear, and other related emerging threats; and (2) enhancing the ability of Federal, State, local, and Tribal partners to prevent, detect, protect against, and mitigate the impacts of attacks using— (A) weapons of mass destruction against the United States; and (B) unauthorized chemical, biological, radiological, nuclear materials, devices, or agents and other related emerging threats against the United States. ; (3) in section 1922 ( 6 U.S.C. 591h )— (A) by striking subsection (b); and (B) by redesignating subsection (c) as subsection (b); (4) in section 1923 ( 6 U.S.C. 592 )— (A) by redesignating subsections (a) and (b) as subsections (b) and (d), respectively; (B) by inserting before subsection (b), as so redesignated, the following: (a) Office responsibilities (1) In general For the purposes of coordinating the efforts of the Department to counter weapons of mass destruction and chemical, biological, radiological, nuclear, and other related emerging threats, the Office shall— (A) provide expertise and guidance to Department leadership and components on non-medical aspects of chemical, biological, radiological, nuclear, and other related emerging threats, subject to the research, development, testing, and evaluation coordination requirement described in subparagraph (G); (B) in coordination with the Office for Strategy, Policy, and Plans, lead development of policies and strategies to counter weapons of mass destruction and chemical, biological, radiological, nuclear, and other related emerging threats on behalf of the Department; (C) identify, assess, and prioritize capability gaps relating to the strategic and mission objectives of the Department for weapons of mass destruction and chemical, biological, radiological, nuclear, and other related emerging threats; (D) in coordination with the Office of Intelligence and Analysis, support components of the Department, and Federal, State, local, and Tribal partners by providing intelligence and information analysis and reports on weapons of mass destruction and chemical, biological, radiological, nuclear, and other related emerging threats; (E) in consultation with the Science and Technology Directorate, assess risk to the United States from weapons of mass destruction and chemical, biological, radiological, nuclear, and other related emerging threats; (F) lead development and prioritization of Department requirements to counter weapons of mass destruction and chemical, biological, radiological, nuclear, and other related emerging threats, subject to the research, development, testing, and evaluation coordination requirement described in subparagraph (G), which requirements shall be— (i) developed in coordination with end users; and (ii) reviewed by the Joint Requirements Council, as directed by the Secretary; (G) in coordination with the Science and Technology Directorate, direct, fund, and coordinate capability development activities to counter weapons of mass destruction and chemical, biological, radiological, nuclear, and other related emerging threats research, development, test, and evaluation matters, including research, development, testing, and evaluation expertise, threat characterization, technology maturation, prototyping, and technology transition; (H) acquire, procure, and deploy capabilities to counter weapons of mass destruction and chemical, biological, radiological, nuclear, and other related emerging threats, and serve as the lead advisor of the Department on component acquisition, procurement, and deployment of counter-weapons of mass destruction capabilities; (I) in coordination with the Office of Health Security, support components of the Department, and Federal, State, local, and Tribal partners on chemical, biological, radiological, nuclear, and other related emerging threats health matters; (J) provide expertise on weapons of mass destruction and non-medical aspects of chemical, biological, radiological, nuclear, and other related emerging threats to Departmental and Federal partners to support engagements and efforts with international partners subject to the research, development, testing, and evaluation coordination requirement under subparagraph (G); and (K) carry out any other duties assigned to the Office by the Secretary. (2) Detection and reporting For purposes of the detection and reporting responsibilities of the Office for weapons of mass destruction and chemical, biological, radiological, nuclear, and other related emerging threats, the Office shall— (A) in coordination with end users, including State, local, and Tribal partners, as appropriate— (i) carry out a program to test and evaluate technology, in consultation with the Science and Technology Directorate, to detect and report on weapons of mass destruction and chemical, biological, radiological, nuclear, and other related emerging threats, in coordination with other Federal agencies, as appropriate, and establish performance metrics to evaluate the effectiveness of individual detectors and detection systems in detecting those weapons of mass destruction or chemical, biological, radiological, nuclear, or other related emerging threats— (I) under realistic operational and environmental conditions; and (II) against realistic adversary tactics and countermeasures; (B) in coordination with end users, conduct, support, coordinate, and encourage a transformational program of research and development to generate and improve technologies to detect, protect against, and report on the illicit entry, transport, assembly, or potential use within the United States of weapons of mass destruction and chemical, biological, radiological, nuclear, and other related emerging threats, and coordinate with the Under Secretary for Science and Technology on research and development efforts relevant to the mission of the Office and the Under Secretary for Science and Technology; (C) before carrying out operational testing under subparagraph (A), develop a testing and evaluation plan that articulates the requirements for the user and describes how these capability needs will be tested in developmental test and evaluation and operational test and evaluation; (D) as appropriate, develop, acquire, and deploy equipment to detect and report on weapons of mass destruction and chemical, biological, radiological, nuclear, and other related emerging threats in support of Federal, State, local, and Tribal governments; (E) support and enhance the effective sharing and use of appropriate information on weapons of mass destruction and chemical, biological, radiological, nuclear, and other related emerging threats generated by elements of the intelligence community (as defined in section 3 of the National Security Act of 1947 ( 50 U.S.C. 3003 )), law enforcement agencies, other Federal agencies, State, local, and Tribal governments, and foreign governments, as well as provide appropriate information to those entities; (F) consult, as appropriate, with relevant Departmental components and offices, the Department of Health and Human Services, and other Federal partners, on weapons of mass destruction and non-medical aspects of chemical, biological, radiological, nuclear, and other related emerging threats and efforts to mitigate, prepare, and respond to all threats in support of the State, local, and Tribal communities; and (G) perform other duties as assigned by the Secretary. ; (C) in subsection (b), as so redesignated— (i) in the subsection heading, by striking Mission and inserting Radiological and nuclear responsibilities ; (ii) in paragraph (1)— (I) by inserting deploy, after acquire, ; and (II) by striking deployment and inserting operations ; (iii) by striking paragraphs (6) through (10); (iv) redesignating paragraphs (11) and (12) as paragraphs (6) and (7), respectively; (v) in paragraph (6), as so redesignated— (I) by striking subparagraph (B); (II) by striking activities— and all that follows through to ensure and inserting activities to ensure ; and (III) by striking attacks; and and inserting attacks; (vi) in paragraph (7)(C)(v), as so redesignated— (I) in the matter preceding subclause (I), by inserting except as otherwise provided, before require ; and (II) in subclause (II)— (aa) in the matter preceding item (aa), by striking death or disability and inserting death, disability, or a finding of good cause as determined by the Assistant Secretary (including extreme hardship, extreme need, or the needs of the Office) and for which the Assistant Secretary may grant a waiver of the repayment obligation ; and (bb) in item (bb), by adding and at the end; (vii) by striking paragraph (13); and (viii) by redesignating paragraph (14) as paragraph (8); and (D) by inserting after subsection (b), as so redesignated, the following: (c) Chemical and biological responsibilities The Office— (1) shall be responsible for coordinating with other Federal efforts to enhance the ability of Federal, State, local, and Tribal governments to prevent, detect, mitigate, and protect against the importation, possession, storage, transportation, development, or use of unauthorized chemical and biological materials, devices, or agents against the United States; and (2) shall— (A) serve as a primary entity responsible for the efforts of the Department to develop, acquire, deploy, and support the operations of a national biological detection system and improve that system over time; (B) enhance the chemical and biological detection efforts of Federal, State, local, and Tribal governments and provide guidance, tools, and training to help ensure a managed, coordinated response; and (C) collaborate with the Department of Health and Human Services, the Office of Health Security of the Department, the Defense Advanced Research Projects Agency, and the National Aeronautics and Space Administration, and other relevant Federal stakeholders, and receive input from industry, academia, and the national laboratories on chemical and biological surveillance efforts. ; (5) in section 1924 ( 6 U.S.C. 593 ), by striking section 11011 of the Strom Thurmond National Defense Authorization Act for Fiscal Year 1999 ( 5 U.S.C. 3104 note). and inserting section 4092 of title 10, United States Code, except that the authority shall be limited to facilitate the recruitment of experts in the chemical, biological, radiological, or nuclear specialties. ; (6) in section 1927(a)(1)(C) ( 6 U.S.C. 596a(a)(1)(C) )— (A) in clause (i), by striking required under section 1036 of the National Defense Authorization Act for Fiscal Year 2010 ; (B) in clause (ii), by striking and at the end; (C) in clause (iii), by striking the period at the end and inserting ; and ; and (D) by adding at the end the following: (iv) includes any other information regarding national technical nuclear forensics activities carried out under section 1923. ; (7) in section 1928 ( 6 U.S.C. 596b )— (A) in subsection (a), by striking high-risk urban areas and inserting jurisdictions designated under subsection (c) ; (B) in subsection (c)(1), by striking from among high-risk urban areas under section 2003 and inserting based on the capability and capacity of the jurisdiction, as well as the relative threat, vulnerability, and consequences from terrorist attacks and other high-consequence events utilizing nuclear or other radiological materials ; and (C) by striking subsection (d) and inserting the following: (d) Report Not later than 2 years after the date of enactment of the Offices of Countering Weapons of Mass Destruction and Health Security Act of 2023 , the Secretary shall submit to the appropriate congressional committees an update on the STC program. ; and (8) by adding at the end the following: 1929. Accountability (a) Departmentwide strategy (1) In general Not later than 180 days after the date of enactment of Offices of Countering Weapons of Mass Destruction and Health Security Act of 2023 , and every 4 years thereafter, the Secretary shall create a Departmentwide strategy and implementation plan to counter weapons of mass destruction and chemical, biological, radiological, nuclear, and other related emerging threats, which should— (A) have clearly identified authorities, specified roles, objectives, benchmarks, accountability, and timelines; (B) incorporate the perspectives of non-Federal and private sector partners; and (C) articulate how the Department will contribute to relevant national-level strategies and work with other Federal agencies. (2) Consideration The Secretary shall appropriately consider weapons of mass destruction and chemical, biological, radiological, nuclear, and other related emerging threats when creating the strategy and implementation plan required under paragraph (1). (3) Report The Office shall submit to the appropriate congressional committees a report on the updated Departmentwide strategy and implementation plan required under paragraph (1). (b) Departmentwide biodefense review and strategy (1) In general Not later than 180 days after the date of enactment of the Offices of Countering Weapons of Mass Destruction and Health Security Act of 2023 , the Secretary, in consultation with appropriate stakeholders representing Federal, State, local, Tribal, academic, private sector, and nongovernmental entities, shall conduct a Departmentwide review of biodefense activities and strategies. (2) Review The review required under paragraph (1) shall— (A) identify with specificity the biodefense lines of effort of the Department, including relating to biodefense roles, responsibilities, and capabilities of components and offices of the Department; (B) assess how such components and offices coordinate internally and with public and private partners in the biodefense enterprise; (C) identify any policy, resource, capability, or other gaps in the Department’s ability to assess, prevent, protect against, and respond to biological threats; and (D) identify any organizational changes or reforms necessary for the Department to effectively execute its biodefense mission and role, including with respect to public and private partners in the biodefense enterprise. (3) Strategy Not later than 1 year after completion of the review required under paragraph (1), the Secretary shall issue a biodefense strategy for the Department that— (A) is informed by such review and is aligned with section 1086 of the National Defense Authorization Act for Fiscal Year 2017 ( 6 U.S.C. 104 ; relating to the development of a national biodefense strategy and associated implementation plan, including a review and assessment of biodefense policies, practices, programs, and initiatives) or any successor strategy; and (B) shall— (i) describe the biodefense mission and role of the Department, as well as how such mission and role relates to the biodefense lines of effort of the Department; (ii) clarify, as necessary, biodefense roles, responsibilities, and capabilities of the components and offices of the Department involved in the biodefense lines of effort of the Department; (iii) establish how biodefense lines of effort of the Department are to be coordinated within the Department; (iv) establish how the Department engages with public and private partners in the biodefense enterprise, including other Federal agencies, national laboratories and sites, and State, local, and Tribal entities, with specificity regarding the frequency and nature of such engagement by Department components and offices with State, local, and Tribal entities; and (v) include information relating to— (I) milestones and performance metrics that are specific to the biodefense mission and role of the Department described in clause (i); and (II) implementation of any operational changes necessary to carry out clauses (iii) and (iv). (4) Periodic update Beginning not later than 5 years after the issuance of the biodefense strategy and implementation plans required under paragraph (3), and not less often than once every 5 years thereafter, the Secretary shall review and update, as necessary, such strategy and plans. (5) Congressional oversight Not later than 30 days after the issuance of the biodefense strategy and implementation plans required under paragraph (3), the Secretary shall brief the Committee on Homeland Security and Governmental Affairs of the Senate and the Committee on Homeland Security of the House of Representatives regarding such strategy and plans. (c) Employee morale Not later than 180 days after the date of enactment of the Offices of Countering Weapons of Mass Destruction and Health Security Act of 2023 , the Office shall submit to and brief the appropriate congressional committees on a strategy and plan to continuously improve morale within the Office. (d) Comptroller General Not later than 1 year after the date of enactment of the Offices of Countering Weapons of Mass Destruction and Health Security Act of 2023 , the Comptroller General of the United States shall conduct a review of and brief the appropriate congressional committees on— (1) the efforts of the Office to prioritize the programs and activities that carry out the mission of the Office, including research and development; (2) the consistency and effectiveness of stakeholder coordination across the mission of the Department, including operational and support components of the Department and State and local entities; and (3) the efforts of the Office to manage and coordinate the lifecycle of research and development within the Office and with other components of the Department, including the Science and Technology Directorate. (e) National Academies of Sciences, Engineering, and Medicine (1) Study The Secretary shall enter into an agreement with the National Academies of Sciences, Engineering, and Medicine to conduct a consensus study and report to the Secretary and the appropriate congressional committees on— (A) the role of the Department in preparing, detecting, and responding to biological and health security threats to the homeland; (B) recommendations to improve departmental biosurveillance efforts against biological threats, including any relevant biological detection methods and technologies; and (C) the feasibility of different technological advances for biodetection compared to the cost, risk reduction, and timeliness of those advances. (2) Briefing Not later than 1 year after the date on which the Secretary receives the report required under paragraph (1), the Secretary shall brief the appropriate congressional committees on— (A) the implementation of the recommendations included in the report; and (B) the status of biological detection at the Department, and, if applicable, timelines for the transition to updated technology. (f) Advisory Council (1) Establishment Not later than 180 days after the date of enactment of the Offices of Countering Weapons of Mass Destruction and Health Security Act of 2023 , the Secretary shall establish an advisory body to advise on the ongoing coordination of the efforts of the Department to counter weapons of mass destruction and chemical, biological, radiological, nuclear, and other related emerging threats, to be known as the Advisory Council for Countering Weapons of Mass Destruction (in this subsection referred to as the Advisory Council ). (2) Membership The members of the Advisory Council shall— (A) be appointed by the Assistant Secretary; and (B) to the extent practicable, represent a geographic (including urban and rural) and substantive cross section of officials, from State, local, and Tribal governments, academia, the private sector, national laboratories, and nongovernmental organizations, including, as appropriate— (i) members selected from the emergency management field and emergency response providers; (ii) State, local, and Tribal government officials; (iii) experts in the public and private sectors with expertise in chemical, biological, radiological, and nuclear materials, devices, or agents; (iv) representatives from the national laboratories; and (v) such other individuals as the Assistant Secretary determines to be appropriate. (3) Responsibilities The Advisory Council shall— (A) advise the Assistant Secretary on all aspects of countering weapons of mass destruction and chemical, biological, radiological, nuclear, and other related emerging threats; (B) incorporate State, local, and Tribal government, national laboratories, and private sector input in the development of the strategy and implementation plan of the Department for countering weapons of mass destruction and chemical, biological, radiological, nuclear, and other related emerging threats; and (C) provide advice on performance criteria for a national biological detection system and review the testing protocol for biological detection prototypes. (4) Consultation To ensure input from and coordination with State, local, and Tribal governments, the Assistant Secretary shall regularly consult and work with the Advisory Council on the administration of Federal assistance provided by the Department, including with respect to the development of requirements of Office programs, as appropriate. (5) Voluntary service The members of the Advisory Council shall serve on the Advisory Council on a voluntary basis. (6) FACA The Federal Advisory Committee Act (5 U.S.C. App.) shall not apply to the Advisory Council. . (b) Countering Weapons of Mass Destruction Act of 2018 Section 2 of the Countering Weapons of Mass Destruction Act of 2018 ( Public Law 115–387 ; 132 Stat. 5162) is amended— (1) in subsection (b)(2) ( 6 U.S.C. 591 note), by striking 1927 and inserting 1926 ; and (2) in subsection (g) ( 6 U.S.C. 591 note)— (A) in the matter preceding paragraph (1), by striking one year after the date of the enactment of this Act, and annually thereafter, and inserting June 30 of each year, ; and (B) in paragraph (2), by striking Security, including research and development activities and inserting Security . (c) Security and Accountability for Every Port Act of 2006 The Security and Accountability for Every Port Act of 2006 ( 6 U.S.C. 901 et seq. ) is amended— (1) in section 1(b) ( Public Law 109–347 ; 120 Stat 1884), by striking the item relating to section 502; and (2) by striking section 502 ( 6 U.S.C. 592a ). 102. Rule of construction Nothing in this Act or the amendments made by this Act may be construed as modifying any existing authority under any provision of law not expressly amended by this Act. II Office of Health Security 201. Office of Health Security (a) Establishment The Homeland Security Act of 2002 ( 6 U.S.C. 101 et seq. ) is amended— (1) in section 103 ( 6 U.S.C. 113 )— (A) in subsection (a)(2)— (i) by striking the Assistant Secretary for Health Affairs, ; and (ii) by striking Affairs, or and inserting Affairs or ; and (B) in subsection (d), by adding at the end the following: (6) A Chief Medical Officer. ; (2) by adding at the end the following: XXIII Office of Health Security ; (3) by redesignating section 1931 ( 6 U.S.C. 597 ) as section 2301 and transferring such section to appear after the heading for title XXIII, as added by paragraph (2); (4) in section 2301, as so redesignated— (A) in the section heading, by striking Chief Medical Officer and inserting Office of Health Security ; (B) by striking subsections (a) and (b) and inserting the following: (a) In general There is established in the Department an Office of Health Security. (b) Head of Office of Health Security The Office of Health Security shall be headed by a chief medical officer, who shall— (1) be the Assistant Secretary for Health Security and the Chief Medical Officer of the Department; (2) be a licensed physician possessing a demonstrated ability in and knowledge of medicine and public health; (3) be appointed by the President; and (4) report directly to the Secretary. ; (C) in subsection (c)— (i) in the matter preceding paragraph (1), by striking medical issues related to natural disasters, acts of terrorism, and other man-made disasters and inserting medical activities of the Department and all workforce-focused health and safety activities of the Department ; (ii) in paragraph (1), by striking , the Administrator of the Federal Emergency Management Agency, the Assistant Secretary, and other Department officials and inserting and all other Department officials ; (iii) in paragraph (4), by striking and at the end; (iv) by redesignating paragraph (5) as paragraph (13); and (v) by inserting after paragraph (4) the following: (5) overseeing all medical activities of the Department, including the delivery, advisement, and support of direct patient care and the organization, management, and staffing of component operations that deliver direct patient care; (6) advising the head of each component of the Department that delivers direct patient care regarding the recruitment and appointment of a component chief medical officer and deputy chief medical officer or the employee who functions in the capacity of chief medical officer and deputy chief medical officer; (7) advising the Secretary and the head of each component of the Department that delivers direct patient care regarding knowledge and skill standards for medical personnel and the assessment of that knowledge and skill; (8) in coordination with the Chief Privacy Officer of the Department and the Chief Information Officer of the Department, advising the Secretary and the head of each component of the Department that delivers patient care regarding the collection, storage, and oversight of medical records; (9) with respect to any psychological health counseling or assistance program of the Department, including such a program of a law enforcement, operational, or support component of the Department, advising the head of each such component with such a program regarding— (A) ensuring such program includes safeguards against adverse action, including automatic referrals for a fitness for duty examination, by such component with respect to any employee solely because such employee self-identifies a need for psychological health counseling or assistance or receives such counseling or assistance; (B) increasing the availability and number of local psychological health professionals with experience providing psychological support services to personnel; (C) establishing a behavioral health curriculum for employees at the beginning of their careers to provide resources early regarding the importance of psychological health; (D) establishing periodic management training on crisis intervention and such component’s psychological health counseling or assistance program; (E) improving any associated existing employee peer support programs, including by making additional training and resources available for peer support personnel in the workplace across such component; (F) developing and implementing a voluntary alcohol treatment program that includes a safe harbor for employees who seek treatment; (G) prioritizing, as appropriate, expertise in the provision of psychological health counseling and assistance for certain populations of the workforce, such as employees serving in positions within law enforcement, to help improve outcomes for those employees receiving that counseling or assistance; and (H) including, when appropriate, collaborating and partnering with key employee stakeholders and, for those components with employees with an exclusive representative, the exclusive representative with respect to such a program; (10) in consultation with the Chief Information Officer of the Department— (A) identifying methods and technologies for managing, updating, and overseeing patient records; and (B) setting standards for technology used by the components of the Department regarding the collection, storage, and oversight of medical records; (11) advising the Secretary and the head of each component of the Department that delivers direct patient care regarding contracts for the delivery of direct patient care, other medical services, and medical supplies; (12) coordinating with the Countering Weapons of Mass Destruction Office and other components of the Department as directed by the Secretary, Federal agencies including the Department of Agriculture, the Department of Health and Human Services, the Department of State, and the Department of Transportation, State, local, and Tribal governments, and the medical community; and ; and (D) by adding at the end the following: (d) Assistance and agreements The Secretary, acting through the Chief Medical Officer, in support of the medical activities of the Department, may— (1) provide technical assistance, training, and information to State, local, and Tribal governments and nongovernmental organizations; (2) enter into agreements with other Federal agencies; and (3) accept services from personnel of components of the Department and other Federal agencies on a reimbursable or nonreimbursable basis. (e) Office of Health Security Privacy Officer There shall be a Privacy Officer in the Office of Health Security with primary responsibility for privacy policy and compliance within the Office, who shall— (1) report directly to the Chief Medical Officer; and (2) ensure privacy protections are integrated into all Office of Health Security activities, subject to the review and approval of the Chief Privacy Officer of the Department to the extent consistent with the authority of the Chief Privacy Officer of the Department under section 222. (f) Accountability (1) Strategy and implementation plan Not later than 180 days after the date of enactment of this section, and every 4 years thereafter, the Secretary shall create a Departmentwide strategy and implementation plan to address medical activities of, and the workforce health and safety matters under the purview of, the Department. (2) Briefing Not later than 90 days after the date of enactment of this section, the Secretary shall brief the appropriate congressional committees on the organizational transformations of the Office of Health Security, including how best practices were used in the creation of the Office of Health Security. ; (5) by redesignating section 710 ( 6 U.S.C. 350 ) as section 2302 and transferring such section to appear after section 2301, as so redesignated; (6) in section 2302, as so redesignated— (A) in the section heading, by striking medical support and inserting safety ; (B) in subsection (a), by striking Under Secretary for Management each place that term appears and inserting Chief Medical Officer ; and (C) in subsection (b)— (i) in the matter preceding paragraph (1), by striking Under Secretary for Management, in coordination with the Chief Medical Officer, and inserting Chief Medical Officer ; and (ii) in paragraph (3), by striking as deemed appropriate by the Under Secretary, ; (7) by redesignating section 528 ( 6 U.S.C. 321q ) as section 2303 and transferring such section to appear after section 2302, as so redesignated; (8) in section 2303, as so redesignated— (A) in subsection (a), by striking Assistant Secretary for the Countering Weapons of Mass Destruction Office and inserting Chief Medical Officer ; and (B) in subsection (b)— (i) in paragraph (1), by striking Homeland Security Presidential Directive 9-Defense of the United States Agriculture and Food and inserting National Security Memorandum 16—Strengthening the Security and Resilience of the United States Food and Agriculture ; and (ii) in paragraph (6), by inserting the Department of Agriculture and other before appropriate ; (9) by redesignating section 1932 ( 6 U.S.C. 597a ) as section 2304 and transferring such section to appear after section 2303, as so redesignated; (10) in section 2304(f)(2)(B), as so redesignated, by striking Office of the Assistant Secretary for Preparedness and Response and inserting Administration for Strategic Preparedness and Response ; and (11) by inserting after section 2304, as so redesignated, the following: 2305. Rules of construction Nothing in this title shall be construed to— (1) override or otherwise affect the requirements described in section 888; (2) require the advice of the Chief Medical Officer on the appointment of Coast Guard officers or the officer from the Public Health Service of the Department of Health and Human Services assigned to the Coast Guard; (3) provide the Chief Medical Officer with authority to take any action that would diminish the interoperability of the Coast Guard medical system with the medical systems of the other branches of the Armed Forces of the United States; or (4) affect or diminish the authority of the Secretary of Health and Human Services or to grant to the Chief Medical Officer any authority that is vested in, or delegated to, the Secretary of Health and Human Services. . (b) Transition and transfers (1) Transition The individual appointed pursuant to section 1931 of the Homeland Security Act of 2002 ( 6 U.S.C. 597 ) of the Department of Homeland Security, as in effect on the day before the date of enactment of this Act, and serving as the Chief Medical Officer of the Department of Homeland Security on the day before the date of enactment of this Act, shall continue to serve as the Chief Medical Officer of the Department on and after the date of enactment of this Act without the need for reappointment. (2) Transfer The Secretary of Homeland Security shall transfer to the Chief Medical Officer of the Department of Homeland Security— (A) all functions, personnel, budget authority, and assets of the Under Secretary for Management relating to workforce health and safety, as in existence on the day before the date of enactment of this Act; (B) all functions, personnel, budget authority, and assets of the Assistant Secretary for the Countering Weapons of Mass Destruction Office relating to the Chief Medical Officer, including the Medical Operations Directorate of the Countering Weapons of Mass Destruction Office, as in existence on the day before the date of enactment of this Act; and (C) all functions, personnel, budget authority, and assets of the Assistant Secretary for the Countering Weapons of Mass Destruction Office associated with the efforts pertaining to the program coordination activities relating to defending the food, agriculture, and veterinary defenses of the Office, as in existence on the day before the date of enactment of this Act. 202. Confidentiality of medical quality assurance records Title XXIII of the Homeland Security Act of 2002, as added by this Act, is amended by adding at the end the following: 2306. Confidentiality of medical quality assurance records (a) Definitions In this section: (1) Health care provider The term health care provider means an individual who— (A) is— (i) an employee of the Department; (ii) a detailee to the Department from another Federal agency; (iii) a personal services contractor of the Department; or (iv) hired under a contract for services; (B) performs health care services as part of duties of the individual in that capacity; and (C) has a current, valid, and unrestricted license or certification— (i) that is issued by a State, the District of Columbia, or a commonwealth, territory, or possession of the United States; and (ii) that is for the practice of medicine, osteopathic medicine, dentistry, nursing, emergency medical services, or another health profession. (2) Medical quality assurance program The term medical quality assurance program means any activity carried out on or after the date of enactment of this section by the Department to assess the quality of medical care, including activities conducted by individuals, committees, or other review bodies responsible for quality assurance, credentials, infection control, incident reporting, the delivery, advisement, and support of direct patient care and assessment (including treatment procedures, blood, drugs, and therapeutics), medical records, health resources management review, and identification and prevention of medical, mental health, or dental incidents and risks. (3) Medical quality assurance record of the Department The term medical quality assurance record of the Department means the proceedings, records (including patient records that the Department creates and maintains as part of a system of records), minutes, and reports that— (A) emanate from quality assurance program activities described in paragraph (2); and (B) are produced or compiled by the Department as part of a medical quality assurance program. (b) Confidentiality of records A medical quality assurance record of the Department that is created as part of a medical quality assurance program— (1) is confidential and privileged; and (2) except as provided in subsection (d), may not be disclosed to any person or entity. (c) Prohibition on disclosure and testimony Except as otherwise provided in this section— (1) no part of any medical quality assurance record of the Department may be subject to discovery or admitted into evidence in any judicial or administrative proceeding; and (2) an individual who reviews or creates a medical quality assurance record of the Department or who participates in any proceeding that reviews or creates a medical quality assurance record of the Department may not be permitted or required to testify in any judicial or administrative proceeding with respect to such record or with respect to any finding, recommendation, evaluation, opinion, or action taken by such individual in connection with such record. (d) Authorized disclosure and testimony (1) In general Subject to paragraph (2), a medical quality assurance record of the Department may be disclosed, and a person described in subsection (c)(2) may give testimony in connection with the record, only as follows: (A) To a Federal agency or private organization, if such medical quality assurance record of the Department or testimony is needed by the Federal agency or private organization to— (i) perform licensing or accreditation functions related to Department health care facilities, a facility affiliated with the Department, or any other location authorized by the Secretary for the performance of health care services; or (ii) perform monitoring, required by law, of Department health care facilities, a facility affiliated with the Department, or any other location authorized by the Secretary for the performance of health care services. (B) To an administrative or judicial proceeding concerning an adverse action related to the credentialing of or health care provided by a present or former health care provider by the Department. (C) To a governmental board or agency or to a professional health care society or organization, if such medical quality assurance record of the Department or testimony is needed by the board, agency, society, or organization to perform licensing, credentialing, or the monitoring of professional standards with respect to any health care provider who is or was a health care provider for the Department. (D) To a hospital, medical center, or other institution that provides health care services, if such medical quality assurance record of the Department or testimony is needed by such institution to assess the professional qualifications of any health care provider who is or was a health care provider for the Department and who has applied for or been granted authority or employment to provide health care services in or on behalf of the institution. (E) To an employee, a detailee, or a contractor of the Department who has a need for such medical quality assurance record of the Department or testimony to perform official duties or duties within the scope of their contract. (F) To a criminal or civil law enforcement agency or instrumentality charged under applicable law with the protection of the public health or safety, if a qualified representative of the agency or instrumentality makes a written request that such medical quality assurance record of the Department or testimony be provided for a purpose authorized by law. (G) In an administrative or judicial proceeding commenced by a criminal or civil law enforcement agency or instrumentality described in subparagraph (F), but only with respect to the subject of the proceeding. (2) Personally identifiable information (A) In general With the exception of the subject of a quality assurance action, personally identifiable information of any person receiving health care services from the Department or of any other person associated with the Department for purposes of a medical quality assurance program that is disclosed in a medical quality assurance record of the Department shall be deleted from that record before any disclosure of the record is made outside the Department. (B) Application The requirement under subparagraph (A) shall not apply to the release of information that is permissible under section 552a of title 5, United States Code (commonly known as the Privacy Act of 1974 ). (e) Disclosure for certain purposes Nothing in this section shall be construed— (1) to authorize or require the withholding from any person or entity de-identified aggregate statistical information regarding the results of medical quality assurance programs, under de-identification standards developed by the Secretary in consultation with the Secretary of Health and Human Services, as appropriate, that is released in a manner in accordance with all other applicable legal requirements; or (2) to authorize the withholding of any medical quality assurance record of the Department from a committee of either House of Congress, any joint committee of Congress, or the Comptroller General of the United States if the record pertains to any matter within their respective jurisdictions. (f) Prohibition on disclosure of information, record, or testimony A person or entity having possession of or access to a medical quality assurance record of the Department or testimony described in this section may not disclose the contents of the record or testimony in any manner or for any purpose except as provided in this section. (g) Exemption from Freedom of Information Act A medical quality assurance record of the Department shall be exempt from disclosure under section 552(b)(3) of title 5, United States Code. (h) Limitation on civil liability A person who participates in the review or creation of, or provides information to a person or body that reviews or creates, a medical quality assurance record of the Department shall not be civilly liable under this section for that participation or for providing that information if the participation or provision of information was— (1) provided in good faith based on prevailing professional standards at the time the medical quality assurance program activity took place; and (2) made in accordance with any other applicable legal requirement, including Federal privacy laws and regulations. (i) Application to information in certain other records Nothing in this section shall be construed as limiting access to the information in a record created and maintained outside a medical quality assurance program, including the medical record of a patient, on the grounds that the information was presented during meetings of a review body that are part of a medical quality assurance program. (j) Penalty Any person who willfully discloses a medical quality assurance record of the Department other than as provided in this section, knowing that the record is a medical quality assurance record of the Department shall be fined not more than $3,000 in the case of a first offense and not more than $20,000 in the case of a subsequent offense. (k) Relationship to Coast Guard The requirements of this section shall not apply to any medical quality assurance record of the Department that is created by or for the Coast Guard as part of a medical quality assurance program. (l) Continued protection Disclosure under subsection (d) does not permit redisclosure except to the extent the further disclosure is authorized under subsection (d) or is otherwise authorized to be disclosed under this section. (m) Relationship to other law This section shall continue in force and effect, except as otherwise specifically provided in any Federal law enacted after the date of enactment of this Act. (n) Rule of construction Nothing in this section shall be construed to supersede the requirements of— (1) the Health Insurance Portability and Accountability Act of 1996 ( Public Law 104–191 ; 110 Stat. 1936) and its implementing regulations; (2) the Health Information Technology for Economic and Clinical Health Act( 42 U.S.C. 17931 et seq. ) and its implementing regulations; or (3) sections 921 through 926 of the Public Health Service Act (42 U.S.C. 299b–21 through 299b–26) and their implementing regulations. . 203. Technical and conforming amendments The Homeland Security Act of 2002 ( 6 U.S.C. 101 et seq. ) is amended— (1) in the table of contents in section 1(b) ( Public Law 107–296 ; 116 Stat. 2135)— (A) by striking the items relating to sections 528 and 529 and inserting the following: Sec. 528. Transfer of equipment during a public health emergency. ; (B) by striking the items relating to sections 710, 711, 712, and 713 and inserting the following: Sec. 710. Employee engagement. Sec. 711. Annual employee award program. Sec. 712. Acquisition professional career program. ; (C) by inserting after the item relating to section 1928 the following: Sec. 1929. Accountability. ; (D) by striking the items relating to subtitle C of title XIX and sections 1931 and 1932; and (E) by adding at the end the following: TITLE XXIII—Office of Health Security Sec. 2301. Office of Health Security. Sec. 2302. Workforce health and safety. Sec. 2303. Coordination of Department of Homeland Security efforts related to food, agriculture, and veterinary defense against terrorism. Sec. 2304. Medical countermeasures. Sec. 2305. Rules of construction. Sec. 2306. Confidentiality of medical quality assurance records. ; (2) by redesignating section 529 ( 6 U.S.C. 321r ) as section 528; (3) in section 704(e)(4) ( 6 U.S.C. 344(e)(4) ), by striking section 711(a) and inserting section 710(a)) ; (4) by redesignating sections 711, 712, and 713 as sections 710, 711, and 712, respectively; (5) in section 1923(d)(3) ( 6 U.S.C. 592(d)(3) )— (A) in the paragraph heading, by striking Hawaiian native-serving and inserting Native Hawaiian-serving ; and (B) by striking Hawaiian native-serving and inserting ‘Native Hawaiian-serving ; and (6) by striking the subtitle heading for subtitle C of title XIX.

1. Short title; table of contents (a) Short title This Act may be cited as the Offices of Countering Weapons of Mass Destruction and Health Security Act of 2023 . (b) Table of contents The table of contents for this Act is as follows: Sec. 1. Short title; table of contents. TITLE I—Countering Weapons of Mass Destruction Office Sec. 101. Countering Weapons of Mass Destruction Office. Sec. 102. Rule of construction. TITLE II—Office of Health Security Sec. 201. Office of Health Security. Sec. 202. Confidentiality of medical quality assurance records. Sec. 203. Technical and conforming amendments. I Countering Weapons of Mass Destruction Office 101. Countering Weapons of Mass Destruction Office (a) Homeland Security Act of 2002 Title XIX of the Homeland Security Act of 2002 ( 6 U.S.C. 590 et seq. ) is amended— (1) in section 1901 ( 6 U.S.C. 591 )— (A) in subsection (c), by striking paragraphs (1) and (2) and inserting the following: (1) matters and strategies pertaining to— (A) weapons of mass destruction; and (B) non-medical aspects of chemical, biological, radiological, nuclear, and other related emerging threats; (2) coordinating the efforts of the Department to counter— (A) weapons of mass destruction; and (B) non-medical aspects of chemical, biological, radiological, nuclear, and other related emerging threats; and (3) enhancing the ability of Federal, State, local, and Tribal partners to prevent, detect, protect against, and mitigate the impacts of terrorist attacks in the United States to counter— (A) weapons of mass destruction; and (B) non-medical aspects of use of unauthorized chemical, biological, radiological, and nuclear materials, devices, or agents and other related emerging threats. ; and (B) by striking subsection (e); (2) by amending section 1921 ( 6 U.S.C. 591g ) to read as follows: 1921. Mission of the Office The Office shall be responsible for— (1) coordinating the efforts of the Department and with other Federal departments and agencies to counter— (A) weapons of mass destruction; and (B) chemical, biological, radiological, nuclear, and other related emerging threats; and (2) enhancing the ability of Federal, State, local, and Tribal partners to prevent, detect, protect against, and mitigate the impacts of attacks using— (A) weapons of mass destruction against the United States; or (B) unauthorized chemical, biological, radiological, nuclear materials, devices, or agents or other related emerging threats against the United States. ; (3) in section 1922 ( 6 U.S.C. 591h )— (A) by striking subsection (b); and (B) by redesignating subsection (c) as subsection (b); (4) in section 1923 ( 6 U.S.C. 592 )— (A) by redesignating subsections (a) and (b) as subsections (b) and (d), respectively; (B) by inserting before subsection (b), as so redesignated, the following: (a) Office responsibilities (1) In general For the purposes of coordinating the efforts of the Department to counter weapons of mass destruction and chemical, biological, radiological, nuclear, and other related emerging threats, the Office shall— (A) provide expertise and guidance to Department leadership and components on non-medical aspects of chemical, biological, radiological, nuclear, and other related emerging threats, subject to the research, development, testing, and evaluation coordination requirement described in subparagraph (G); (B) in coordination with the Office of Strategy, Policy, and Plans, lead development of policies and strategies to counter weapons of mass destruction and chemical, biological, radiological, nuclear, and other related emerging threats on behalf of the Department; (C) identify, assess, and prioritize capability gaps relating to the strategic and mission objectives of the Department for weapons of mass destruction and chemical, biological, radiological, nuclear, and other related emerging threats; (D) in coordination with the Office of Intelligence and Analysis, support components of the Department, and Federal, State, local, and Tribal partners by providing intelligence and information analysis and reports on weapons of mass destruction and chemical, biological, radiological, nuclear, and other related emerging threats; (E) in consultation with the Science and Technology Directorate, assess risk to the United States from weapons of mass destruction and chemical, biological, radiological, nuclear, and other related emerging threats; (F) lead development and prioritization of Department requirements to counter weapons of mass destruction and chemical, biological, radiological, nuclear, and other related emerging threats, subject to the research, development, testing, and evaluation coordination requirement described in subparagraph (G), which requirements shall be— (i) developed in coordination with end users; and (ii) reviewed by the Joint Requirements Council, as directed by the Secretary; (G) in coordination with the Science and Technology Directorate, direct, fund, and coordinate capability development activities to counter weapons of mass destruction and chemical, biological, radiological, nuclear, and other related emerging threats research, development, test, and evaluation matters, including research, development, testing, and evaluation expertise, threat characterization, technology maturation, prototyping, and technology transition; (H) acquire, procure, and deploy capabilities to counter weapons of mass destruction and chemical, biological, radiological, nuclear, and other related emerging threats, and serve as the lead advisor of the Department on component acquisition, procurement, and deployment of counter-weapons of mass destruction capabilities; (I) in coordination with the Office of Health Security, support components of the Department, and Federal, State, local, and Tribal partners on chemical, biological, radiological, nuclear, and other related emerging threats health matters; (J) provide expertise on weapons of mass destruction and non-medical aspects of chemical, biological, radiological, nuclear, and other related emerging threats to Departmental and Federal partners to support engagements and efforts with international partners subject to the research, development, testing, and evaluation coordination requirement under subparagraph (G); and (K) carry out any other duties assigned to the Office by the Secretary. (2) Detection and reporting For purposes of the detection and reporting responsibilities of the Office for weapons of mass destruction and chemical, biological, radiological, nuclear, and other related emerging threats, the Office shall— (A) in coordination with end users, including State, local, and Tribal partners, as appropriate— (i) carry out a program to test and evaluate technology, in consultation with the Science and Technology Directorate, to detect and report on weapons of mass destruction and chemical, biological, radiological, nuclear, and other related emerging threats, in coordination with other Federal agencies, as appropriate, and establish performance metrics to evaluate the effectiveness of individual detectors and detection systems in detecting those weapons of mass destruction or chemical, biological, radiological, nuclear, or other related emerging threats— (I) under realistic operational and environmental conditions; and (II) against realistic adversary tactics and countermeasures; (B) in coordination with end users, conduct, support, coordinate, and encourage a transformational program of research and development to generate and improve technologies to detect, protect against, and report on the illicit entry, transport, assembly, or potential use within the United States of weapons of mass destruction and chemical, biological, radiological, nuclear, and other related emerging threats, and coordinate with the Under Secretary for Science and Technology on research and development efforts relevant to the mission of the Office and the Under Secretary for Science and Technology; (C) before carrying out operational testing under subparagraph (A), develop a testing and evaluation plan that articulates the requirements for the user and describes how these capability needs will be tested in developmental test and evaluation and operational test and evaluation; (D) as appropriate, develop, acquire, and deploy equipment to detect and report on weapons of mass destruction and chemical, biological, radiological, nuclear, and other related emerging threats in support of Federal, State, local, and Tribal governments; (E) support and enhance the effective sharing and use of appropriate information on weapons of mass destruction and chemical, biological, radiological, nuclear, and other related emerging threats generated by elements of the intelligence community, law enforcement agencies, other Federal agencies, State, local, and Tribal governments, and foreign governments, as well as provide appropriate information to those entities; (F) consult, as appropriate, with relevant Departmental components and offices, the Department of Health and Human Services, and other Federal partners, on weapons of mass destruction and non-medical aspects of chemical, biological, radiological, nuclear, and other related emerging threats and efforts to mitigate, prepare, and respond to all threats in support of the State, local, and Tribal communities; and (G) perform other duties as assigned by the Secretary. ; (C) in subsection (b), as so redesignated— (i) in the subsection heading, by striking Mission and inserting Radiological and nuclear responsibilities ; (ii) in paragraph (1)— (I) by inserting deploy, after acquire, ; and (II) by striking deployment and inserting operation ; (iii) by striking paragraphs (6) through (10); (iv) redesignating paragraphs (11) and (12) as paragraphs (6) and (7), respectively; (v) in paragraph (6), as so redesignated— (I) by striking subparagraph (B); (II) by striking activities— and all that follows through to ensure and inserting activities to ensure ; and (III) by striking attacks; and and inserting attacks; ; (vi) in paragraph (7)(C)(v), as so redesignated— (I) in the matter preceding subclause (I), by inserting except as otherwise provided, before require ; and (II) in subclause (II)— (aa) in the matter preceding item (aa), by striking death or disability and inserting death, disability, or a finding of good cause as determined by the Assistant Secretary (including extreme hardship, extreme need, or the needs of the Office) and for which the Assistant Secretary may grant a waiver of the repayment obligation ; and (bb) in item (bb), by adding and at the end; (vii) by striking paragraph (13); and (viii) by redesignating paragraph (14) as paragraph (8); and (D) by inserting after subsection (b), as so redesignated, the following: (c) Chemical and biological responsibilities The Office— (1) shall be responsible for coordinating with other Federal efforts to enhance the ability of Federal, State, local, and Tribal governments to prevent, detect, mitigate, and protect against the importation, possession, storage, transportation, development, or use of unauthorized chemical and biological materials, devices, or agents against the United States; and (2) shall— (A) serve as a primary entity responsible for the efforts of the Department to develop, acquire, deploy, and support the operations of a national biological detection system and improve that system over time; (B) enhance the chemical and biological detection efforts of Federal, State, local, and Tribal governments and provide guidance, tools, and training to help ensure a managed, coordinated response; and (C) collaborate with the Department of Health and Human Services, the Office of Health Security of the Department, the Defense Advanced Research Projects Agency, the National Aeronautics and Space Administration, and other relevant Federal stakeholders, and receive input from industry, academia, and the national laboratories on chemical and biological surveillance efforts. ; (5) in section 1924 ( 6 U.S.C. 593 ), by striking section 11011 of the Strom Thurmond National Defense Authorization Act for Fiscal Year 1999 ( 5 U.S.C. 3104 note). and inserting section 4092 of title 10, United States Code, except that the authority shall be limited to facilitate the recruitment of experts in the chemical, biological, radiological, or nuclear specialties. ; (6) in section 1927(a)(1)(C) ( 6 U.S.C. 596a(a)(1)(C) )— (A) in clause (i), by striking required under section 1036 of the National Defense Authorization Act for Fiscal Year 2010 ; (B) in clause (ii), by striking and at the end; (C) in clause (iii), by striking the period at the end and inserting ; and ; and (D) by adding at the end the following: (iv) includes any other information regarding national technical nuclear forensics activities carried out under section 1923. ; (7) in section 1928 ( 6 U.S.C. 596b )— (A) in subsection (a), by striking high-risk urban areas and inserting jurisdictions designated under subsection (c) ; (B) in subsection (c)(1), by striking from among high-risk urban areas under section 2003 and inserting based on the capability and capacity of the jurisdiction, as well as the relative threat, vulnerability, and consequences from terrorist attacks and other high-consequence events utilizing nuclear or other radiological materials ; and (C) by striking subsection (d) and inserting the following: (d) Report Not later than 2 years after the date of enactment of the Offices of Countering Weapons of Mass Destruction and Health Security Act of 2023 , the Secretary shall submit to the appropriate congressional committees an update on the STC program. ; and (8) by inserting after section 1928 ( 6 U.S.C. 596b ) the following: 1929. Accountability (a) Departmentwide strategy (1) In general Not later than 180 days after the date of enactment of Offices of Countering Weapons of Mass Destruction and Health Security Act of 2023 , and every 4 years thereafter, the Secretary shall create a Departmentwide strategy and implementation plan to counter weapons of mass destruction and chemical, biological, radiological, nuclear, and other related emerging threats, which should— (A) have clearly identified authorities, specified roles, objectives, benchmarks, accountability, and timelines; (B) incorporate the perspectives of non-Federal and private sector partners; and (C) articulate how the Department will contribute to relevant national-level strategies and work with other Federal agencies. (2) Consideration The Secretary shall appropriately consider weapons of mass destruction and chemical, biological, radiological, nuclear, and other related emerging threats when creating the strategy and implementation plan required under paragraph (1). (3) Report The Office shall submit to the appropriate congressional committees a report on the updated Departmentwide strategy and implementation plan required under paragraph (1). (b) Departmentwide biodefense review and strategy (1) In general Not later than 180 days after the date of enactment of the Offices of Countering Weapons of Mass Destruction and Health Security Act of 2023 , the Secretary, in consultation with appropriate stakeholders representing Federal, State, local, Tribal, academic, private sector, and nongovernmental entities, shall conduct a Departmentwide review of biodefense activities and strategies. (2) Review The review required under paragraph (1) shall— (A) identify with specificity the biodefense lines of effort of the Department, including biodefense lines of effort relating to biodefense roles, responsibilities, and capabilities of components and offices of the Department; (B) assess how such components and offices coordinate internally and with public and private partners in the biodefense enterprise; (C) identify any policy, resource, capability, or other gaps in the Department’s ability to assess, prevent, protect against, and respond to biological threats; (D) identify any organizational changes or reforms necessary for the Department to effectively execute its biodefense mission and role, including with respect to public and private partners in the biodefense enterprise; and (E) assess the risk of high-risk gain-of-function research to the homeland security of the United States and identify the gaps in the response of the Department to that risk. (3) Strategy Not later than 1 year after completion of the review required under paragraph (1), the Secretary shall issue a biodefense strategy for the Department that— (A) is informed by such review and is aligned with section 1086 of the National Defense Authorization Act for Fiscal Year 2017 ( 6 U.S.C. 104 ; relating to the development of a national biodefense strategy and associated implementation plan, including a review and assessment of biodefense policies, practices, programs, and initiatives) or any successor strategy; and (B) shall— (i) describe the biodefense mission and role of the Department, as well as how such mission and role relates to the biodefense lines of effort of the Department; (ii) clarify, as necessary, biodefense roles, responsibilities, and capabilities of the components and offices of the Department involved in the biodefense lines of effort of the Department; (iii) establish how biodefense lines of effort of the Department are to be coordinated within the Department; (iv) establish how the Department engages with public and private partners in the biodefense enterprise, including other Federal agencies, national laboratories and sites, and State, local, and Tribal entities, with specificity regarding the frequency and nature of such engagement by Department components and offices with State, local, and Tribal entities; and (v) include information relating to— (I) milestones and performance metrics that are specific to the biodefense mission and role of the Department described in clause (i); and (II) implementation of any operational changes necessary to carry out clauses (iii) and (iv). (4) Periodic update Beginning not later than 5 years after the issuance of the biodefense strategy and implementation plans required under paragraph (3), and not less often than once every 5 years thereafter, the Secretary shall review and update, as necessary, such strategy and plans. (5) Congressional oversight Not later than 30 days after the issuance of the biodefense strategy and implementation plans required under paragraph (3), the Secretary shall brief the Committee on Homeland Security and Governmental Affairs of the Senate and the Committee on Homeland Security of the House of Representatives regarding such strategy and plans. (c) Employee morale Not later than 180 days after the date of enactment of the Offices of Countering Weapons of Mass Destruction and Health Security Act of 2023 , the Office shall submit to and brief the appropriate congressional committees on a strategy and plan to continuously improve morale within the Office. (d) Comptroller General Not later than 1 year after the date of enactment of the Offices of Countering Weapons of Mass Destruction and Health Security Act of 2023 , the Comptroller General of the United States shall conduct a review of and brief the appropriate congressional committees on— (1) the efforts of the Office to prioritize the programs and activities that carry out the mission of the Office, including research and development; (2) the consistency and effectiveness of stakeholder coordination across the mission of the Office, including operational and support components of the Department and State and local entities; and (3) the efforts of the Office to manage and coordinate the lifecycle of research and development within the Office and with other components of the Department, including the Science and Technology Directorate. (e) National Academies of Sciences, Engineering, and Medicine (1) Study The Secretary shall enter into an agreement with the National Academies of Sciences, Engineering, and Medicine to conduct a consensus study and report to the Secretary and the appropriate congressional committees on— (A) the role of the Department in preparing, detecting, and responding to biological and health security threats to the homeland; (B) recommendations to improve departmental biosurveillance efforts against biological threats, including any relevant biological detection methods and technologies; and (C) the feasibility of different technological advances for biodetection compared to the cost, risk reduction, and timeliness of those advances. (2) Briefing Not later than 1 year after the date on which the Secretary receives the report required under paragraph (1), the Secretary shall brief the appropriate congressional committees on— (A) the implementation of the recommendations included in the report; and (B) the status of biological detection at the Department, and, if applicable, timelines for the transition to updated technology. (f) Advisory Council (1) Establishment Not later than 180 days after the date of enactment of the Offices of Countering Weapons of Mass Destruction and Health Security Act of 2023 , the Secretary shall establish an advisory body to advise on the ongoing coordination of the efforts of the Department to counter weapons of mass destruction and chemical, biological, radiological, nuclear, and other related emerging threats, to be known as the Advisory Council for Countering Weapons of Mass Destruction (in this subsection referred to as the Advisory Council ). (2) Membership The members of the Advisory Council shall— (A) be appointed by the Assistant Secretary; and (B) to the extent practicable, represent a geographic (including urban and rural) and substantive cross section of officials from State, local, and Tribal governments, academia, the private sector, national laboratories, and nongovernmental organizations, including, as appropriate— (i) members selected from the emergency management field and emergency response providers; (ii) State, local, and Tribal government officials; (iii) experts in the public and private sectors with expertise in chemical, biological, radiological, or nuclear materials, devices, or agents; (iv) representatives from the national laboratories; and (v) such other individuals as the Assistant Secretary determines to be appropriate. (3) Responsibilities The Advisory Council shall— (A) advise the Assistant Secretary on all aspects of countering weapons of mass destruction and chemical, biological, radiological, nuclear, and other related emerging threats; (B) incorporate State, local, and Tribal government, national laboratories, and private sector input in the development of the strategy and implementation plan of the Department for countering weapons of mass destruction and chemical, biological, radiological, nuclear, and other related emerging threats; and (C) provide advice on performance criteria for a national biological detection system and review the testing protocol for biological detection prototypes. (4) Consultation To ensure input from and coordination with State, local, and Tribal governments, the Assistant Secretary shall regularly consult and work with the Advisory Council on the administration of Federal assistance provided by the Department, including with respect to the development of requirements of Office programs, as appropriate. (5) Voluntary service The members of the Advisory Council shall serve on the Advisory Council on a voluntary basis. (6) FACA Chapter 10 of title 5, United States Code, shall not apply to the Advisory Council. (7) Qualifications Each member of the Advisory Council shall— (A) be impartial in any advice provided to the Advisory Council; and (B) not seek to advance any political position or predetermined conclusion as a member of the Advisory Council. . (b) Countering Weapons of Mass Destruction Act of 2018 Section 2 of the Countering Weapons of Mass Destruction Act of 2018 ( Public Law 115–387 ; 132 Stat. 5162) is amended— (1) in subsection (b)(2) ( 6 U.S.C. 591 note), by striking 1927 and inserting 1926 ; and (2) in subsection (g) ( 6 U.S.C. 591 note)— (A) in the matter preceding paragraph (1), by striking one year after the date of the enactment of this Act, and annually thereafter, and inserting June 30 of each year, ; and (B) in paragraph (2), by striking Security, including research and development activities and inserting Security . (c) Security and Accountability for Every Port Act of 2006 The Security and Accountability for Every Port Act of 2006 ( Public Law 109–347 ; 120 Stat 1884) is amended— (1) in section 1(b), by striking the item relating to section 502; and (2) by striking section 502 ( 6 U.S.C. 592a ). 102. Rule of construction Nothing in this title or the amendments made by this title may be construed as modifying any existing authority under any provision of law not expressly amended by this title. II Office of Health Security 201. Office of Health Security (a) Establishment The Homeland Security Act of 2002 ( 6 U.S.C. 101 et seq. ) is amended— (1) in section 103 ( 6 U.S.C. 113 )— (A) in subsection (a)(2)— (i) by striking the Assistant Secretary for Health Affairs, ; and (ii) by striking Affairs, or and inserting Affairs or ; and (B) in subsection (d), by adding at the end the following: (6) A Chief Medical Officer. ; (2) by adding at the end the following: XXIII Office of Health Security ; (3) by redesignating section 1931 ( 6 U.S.C. 597 ) as section 2301 and transferring such section to appear after the heading for title XXIII, as added by paragraph (2); (4) in section 2301, as so redesignated— (A) in the section heading, by striking Chief Medical Officer and inserting Office of Health Security ; (B) by striking subsections (a) and (b) and inserting the following: (a) In general There is established in the Department an Office of Health Security. (b) Head of Office of Health Security The Office of Health Security shall be headed by a chief medical officer, who shall— (1) be the Assistant Secretary for Health Security and the Chief Medical Officer of the Department; (2) be a licensed physician possessing a demonstrated ability in and knowledge of medicine and public health; (3) be appointed by the President; and (4) report directly to the Secretary. ; (C) in subsection (c)— (i) in the matter preceding paragraph (1), by striking medical issues related to natural disasters, acts of terrorism, and other man-made disasters and inserting medical activities of the Department and all workforce-focused health and safety activities of the Department ; (ii) in paragraph (1), by striking , the Administrator of the Federal Emergency Management Agency, the Assistant Secretary, and other Department officials and inserting and all other Department officials ; (iii) in paragraph (4), by striking and at the end; (iv) by redesignating paragraph (5) as paragraph (13); and (v) by inserting after paragraph (4) the following: (5) overseeing all medical activities of the Department, including the delivery, advisement, and support of direct patient care and the organization, management, and staffing of component operations that deliver direct patient care; (6) advising the head of each component of the Department that delivers direct patient care regarding the recruitment and appointment of a component chief medical officer and deputy chief medical officer or the employees who function in the capacity of chief medical officer and deputy chief medical officer; (7) advising the Secretary and the head of each component of the Department that delivers direct patient care regarding knowledge and skill standards for medical personnel and the assessment of that knowledge and skill; (8) in coordination with the Chief Privacy Officer of the Department and the Chief Information Officer of the Department, advising the Secretary and the head of each component of the Department that delivers patient care regarding the collection, storage, and oversight of medical records; (9) with respect to any psychological health counseling or assistance program of the Department, including such a program of a law enforcement, operational, or support component of the Department, advising the head of each such component with such a program regarding— (A) ensuring such program includes safeguards against adverse actions by such component with respect to any employee solely because the employee identifies a need for psychological health counseling or assistance or receives such assistance; (B) ensuring such program includes safeguards regarding automatic referrals for employment-related examinations or inquires that are based solely on an employee who self identifies a need for psychological health counseling or assistance or receives such counseling or assistance, except that such safeguards shall not prevent a component referral to evaluate the ability of an employee to meet established medical or psychological standards by such component or to evaluate the national security eligibility of the employee; (C) increasing the availability and number of local psychological health professionals with experience providing psychological support services to personnel; (D) establishing a behavioral health curriculum for employees at the beginning of their careers to provide resources early regarding the importance of psychological health; (E) establishing periodic management training on crisis intervention and such component’s psychological health counseling or assistance program; (F) improving any associated existing employee peer support programs, including by making additional training and resources available for peer support personnel in the workplace across such component; (G) developing and implementing a voluntary alcohol treatment program that includes a safe harbor for employees who seek treatment; (H) prioritizing, as appropriate, expertise in the provision of psychological health counseling and assistance for certain populations of the workforce, such as employees serving in positions within law enforcement, to help improve outcomes for those employees receiving that counseling or assistance; and (I) including, when appropriate, collaborating and partnering with key employee stakeholders and, for those components with employees with an exclusive representative, the exclusive representative with respect to such a program; (10) in consultation with the Chief Information Officer of the Department— (A) identifying methods and technologies for managing, updating, and overseeing patient records; and (B) setting standards for technology used by the components of the Department regarding the collection, storage, and oversight of medical records; (11) advising the Secretary and the head of each component of the Department that delivers direct patient care regarding contracts for the delivery of direct patient care, other medical services, and medical supplies; (12) coordinating with— (A) the Countering Weapons of Mass Destruction Office; (B) other components of the Department as directed by the Secretary; (C) Federal agencies, including the Department of Agriculture, the Department of Health and Human Services, the Department of State, and the Department of Transportation; (D) State, local, and Tribal governments; and (E) the medical community; and ; and (D) by adding at the end the following: (d) Assistance and agreements The Secretary, acting through the Chief Medical Officer, in support of the medical activities of the Department, may— (1) provide technical assistance, training, and information to State, local, and Tribal governments and nongovernmental organizations; (2) enter into agreements with other Federal agencies; and (3) accept services from personnel of components of the Department and other Federal agencies on a reimbursable or nonreimbursable basis. (e) Office of Health Security Privacy Officer There shall be a Privacy Officer in the Office of Health Security with primary responsibility for privacy policy and compliance within the Office, who shall— (1) report directly to the Chief Medical Officer; and (2) ensure privacy protections are integrated into all Office of Health Security activities, subject to the review and approval of the Chief Privacy Officer of the Department to the extent consistent with the authority of the Chief Privacy Officer of the Department under section 222. (f) Accountability (1) Strategy and implementation plan Not later than 180 days after the date of enactment of this subsection, and every 4 years thereafter, the Secretary shall create a Departmentwide strategy and implementation plan to address medical activities of, and the workforce health and safety matters under the purview of, the Department. (2) Briefing Not later than 90 days after the date of enactment of this subsection, the Secretary shall brief the appropriate congressional committees on the organizational transformations of the Office of Health Security, including how best practices were used in the creation of the Office of Health Security. ; (5) by redesignating section 710 ( 6 U.S.C. 350 ) as section 2302 and transferring such section to appear after section 2301, as so redesignated; (6) in section 2302, as so redesignated— (A) in the section heading, by striking medical support and inserting safety ; (B) in subsection (a), by striking Under Secretary for Management each place that term appears and inserting Chief Medical Officer ; and (C) in subsection (b)— (i) in the matter preceding paragraph (1), by striking Under Secretary for Management, in coordination with the Chief Medical Officer, and inserting Chief Medical Officer ; and (ii) in paragraph (3), by striking as deemed appropriate by the Under Secretary, ; (7) by redesignating section 528 ( 6 U.S.C. 321q ) as section 2303 and transferring such section to appear after section 2302, as so redesignated; (8) in section 2303, as so redesignated— (A) in subsection (a), by striking Assistant Secretary for the Countering Weapons of Mass Destruction Office and inserting Chief Medical Officer ; and (B) in subsection (b)— (i) in paragraph (1), by striking Homeland Security Presidential Directive 9–Defense of the United States Agriculture and Food and inserting National Security Memorandum 16—Strengthening the Security and Resilience of the United States Food and Agriculture ; and (ii) in paragraph (6), by inserting the Department of Agriculture and other before appropriate ; (9) by redesignating section 1932 ( 6 U.S.C. 597a ) as section 2304 and transferring such section to appear after section 2303, as so redesignated; (10) in section 2304(f)(2)(B), as so redesignated, by striking Office of the Assistant Secretary for Preparedness and Response and inserting Administration for Strategic Preparedness and Response ; and (11) by inserting after section 2304, as so redesignated, the following: 2305. Rules of construction Nothing in this title shall be construed to— (1) override or otherwise affect the requirements described in section 888; (2) require the advice of the Chief Medical Officer on the appointment of Coast Guard officers or the officer from the Public Health Service of the Department of Health and Human Services assigned to the Coast Guard; (3) provide the Chief Medical Officer with authority to take any action that would diminish the interoperability of the Coast Guard medical system with the medical systems of the other branches of the Armed Forces of the United States; or (4) affect or diminish the authority of the Secretary of Health and Human Services or to grant to the Chief Medical Officer any authority that is vested in, or delegated to, the Secretary of Health and Human Services. . (b) Transition and transfers (1) Transition The individual appointed pursuant to section 1931 of the Homeland Security Act of 2002 ( 6 U.S.C. 597 ) of the Department of Homeland Security, as in effect on the day before the date of enactment of this Act, and serving as the Chief Medical Officer of the Department of Homeland Security on the day before the date of enactment of this Act, shall continue to serve as the Chief Medical Officer of the Department on and after the date of enactment of this Act without the need for reappointment. (2) Transfer The Secretary of Homeland Security shall transfer to the Chief Medical Officer of the Department of Homeland Security— (A) all functions, personnel, budget authority, and assets of the Under Secretary for Management relating to workforce health and safety, as in existence on the day before the date of enactment of this Act; (B) all functions, personnel, budget authority, and assets of the Assistant Secretary for the Countering Weapons of Mass Destruction Office relating to the Chief Medical Officer, including the Medical Operations Directorate of the Countering Weapons of Mass Destruction Office, as in existence on the day before the date of enactment of this Act; and (C) all functions, personnel, budget authority, and assets of the Assistant Secretary for the Countering Weapons of Mass Destruction Office associated with the efforts pertaining to the program coordination activities relating to defending the food, agriculture, and veterinary defenses of the Office, as in existence on the day before the date of enactment of this Act. 202. Confidentiality of medical quality assurance records Title XXIII of the Homeland Security Act of 2002, as added by this Act, is amended by adding at the end the following: 2306. Confidentiality of medical quality assurance records (a) Definitions In this section: (1) Health care provider The term health care provider means an individual who— (A) is— (i) an employee of the Department; (ii) a detailee to the Department from another Federal agency; (iii) a personal services contractor of the Department; or (iv) hired under a contract for services with the Department; (B) performs health care services as part of duties of the individual in that capacity; and (C) has a current, valid, and unrestricted license or certification— (i) that is issued by a State; and (ii) that is for the practice of medicine, osteopathic medicine, dentistry, nursing, emergency medical services, or another health profession. (2) Medical quality assurance program The term medical quality assurance program means any activity carried out on or after the date of enactment of this section by the Department to assess the quality of medical care, including activities conducted by individuals, committees, or other review bodies responsible for quality assurance, credentials, infection control, incident reporting, the delivery, advisement, and support of direct patient care and assessment (including treatment procedures, blood, drugs, and therapeutics), medical records, health resources management review, or identification and prevention of medical, mental health, or dental incidents and risks. (3) Medical quality assurance record of the Department The term medical quality assurance record of the Department means the proceedings, records (including patient records that the Department creates and maintains as part of a system of records), minutes, and reports that— (A) emanate from quality assurance program activities described in paragraph (2); and (B) are produced or compiled by the Department as part of a medical quality assurance program. (b) Confidentiality of records A medical quality assurance record of the Department that is created as part of a medical quality assurance program— (1) is confidential and privileged; and (2) except as provided in subsection (d), may not be disclosed to any person or entity. (c) Prohibition on disclosure and testimony Except as otherwise provided in this section— (1) no part of any medical quality assurance record of the Department may be subject to discovery or admitted into evidence in any judicial or administrative proceeding; and (2) an individual who reviews or creates a medical quality assurance record of the Department or who participates in any proceeding that reviews or creates a medical quality assurance record of the Department may not be permitted or required to testify in any judicial or administrative proceeding with respect to such record or with respect to any finding, recommendation, evaluation, opinion, or action taken by such individual in connection with such record. (d) Authorized disclosure and testimony (1) In general Subject to paragraph (2), a medical quality assurance record of the Department may be disclosed, and a person described in subsection (c)(2) may give testimony in connection with the record, only as follows: (A) To a Federal agency or private organization, if such medical quality assurance record of the Department or testimony is needed by the Federal agency or private organization to— (i) perform licensing or accreditation functions related to Department health care facilities, a facility affiliated with the Department, or any other location authorized by the Secretary for the performance of health care services; or (ii) perform monitoring, required by law, of Department health care facilities, a facility affiliated with the Department, or any other location authorized by the Secretary for the performance of health care services. (B) To an administrative or judicial proceeding concerning an adverse action related to the credentialing of or health care provided by a present or former health care provider by the Department. (C) To a governmental board or agency or to a professional health care society or organization, if such medical quality assurance record of the Department or testimony is needed by the board, agency, society, or organization to perform licensing, credentialing, or the monitoring of professional standards with respect to any health care provider who is or was a health care provider for the Department. (D) To a hospital, medical center, or other institution that provides health care services, if such medical quality assurance record of the Department or testimony is needed by such institution to assess the professional qualifications of any health care provider who is or was a health care provider for the Department and who has applied for or been granted authority or employment to provide health care services in or on behalf of the institution. (E) To an employee, a detailee, or a contractor of the Department who has a need for such medical quality assurance record of the Department or testimony to perform official duties or duties within the scope of their employment or contract. (F) To a criminal or civil law enforcement agency or instrumentality charged under applicable law with the protection of the public health or safety, if a qualified representative of the agency or instrumentality makes a written request that such medical quality assurance record of the Department or testimony be provided for a purpose authorized by law. (G) In an administrative or judicial proceeding commenced by a criminal or civil law enforcement agency or instrumentality described in subparagraph (F), but only with respect to the subject of the proceeding. (2) Personally identifiable information (A) In general With the exception of the subject of a quality assurance action, personally identifiable information of any person receiving health care services from the Department or of any other person associated with the Department for purposes of a medical quality assurance program that is disclosed in a medical quality assurance record of the Department shall be deleted from that record before any disclosure of the record is made outside the Department. (B) Application The requirement under subparagraph (A) shall not apply to the release of information that is permissible under section 552a of title 5, United States Code (commonly known as the Privacy Act of 1974 ). (e) Disclosure for certain purposes Nothing in this section shall be construed— (1) to authorize or require the withholding from any person or entity de-identified aggregate statistical information regarding the results of medical quality assurance programs, under de-identification standards developed by the Secretary in consultation with the Secretary of Health and Human Services, as appropriate, that is released in a manner in accordance with all other applicable legal requirements; or (2) to authorize the withholding of any medical quality assurance record of the Department from a committee of either House of Congress, any joint committee of Congress, or the Comptroller General of the United States if the record pertains to any matter within their respective jurisdictions. (f) Prohibition on disclosure of information, records, or testimony A person or entity having possession of or access to a medical quality assurance record of the Department or testimony described in this section may not disclose the contents of the record or testimony in any manner or for any purpose except as provided in this section. (g) Exemption from Freedom of Information Act A medical quality assurance record of the Department shall be exempt from disclosure under section 552(b)(3) of title 5, United States Code. (h) Limitation on civil liability A person who participates in the review or creation of, or provides information to a person or body that reviews or creates, a medical quality assurance record of the Department shall not be civilly liable under this section for that participation or for providing that information if the participation or provision of information was— (1) provided in good faith based on prevailing professional standards at the time the medical quality assurance program activity took place; and (2) made in accordance with any other applicable legal requirement, including Federal privacy laws and regulations. (i) Application to information in certain other records Nothing in this section shall be construed as limiting access to the information in a record created and maintained outside a medical quality assurance program, including the medical record of a patient, on the grounds that the information was presented during meetings of a review body that are part of a medical quality assurance program. (j) Penalty Any person who willfully discloses a medical quality assurance record of the Department other than as provided in this section, knowing that the record is a medical quality assurance record of the Department shall be fined not more than $3,000 in the case of a first offense and not more than $20,000 in the case of a subsequent offense. (k) Relationship to Coast Guard The requirements of this section shall not apply to any medical quality assurance record of the Department that is created by or for the Coast Guard as part of a medical quality assurance program. (l) Continued protection Disclosure under subsection (d) does not permit redisclosure except to the extent the further disclosure is authorized under subsection (d) or is otherwise authorized to be disclosed under this section. (m) Relationship to other law This section shall continue in force and effect, except as otherwise specifically provided in any Federal law enacted after the date of enactment of this Act. (n) Rule of construction Nothing in this section shall be construed to supersede the requirements of— (1) the Health Insurance Portability and Accountability Act of 1996 ( Public Law 104–191 ; 110 Stat. 1936) and its implementing regulations; (2) part 1 of subtitle D of title XIII of the Health Information Technology for Economic and Clinical Health Act ( 42 U.S.C. 17931 et seq. ) and its implementing regulations; or (3) sections 921 through 926 of the Public Health Service Act (42 U.S.C. 299b–21 through 299b–26) and their implementing regulations. . 203. Technical and conforming amendments The Homeland Security Act of 2002 ( 6 U.S.C. 101 et seq. ) is amended— (1) in the table of contents in section 1(b) ( Public Law 107–296 ; 116 Stat. 2135)— (A) by striking the items relating to sections 528 and 529 and inserting the following: Sec. 528. Transfer of equipment during a public health emergency. ; (B) by striking the items relating to sections 710, 711, 712, and 713 and inserting the following: Sec. 710. Employee engagement. Sec. 711. Annual employee award program. Sec. 712. Acquisition professional career program. ; (C) by inserting after the item relating to section 1928 the following: Sec. 1929. Accountability. ; (D) by striking the items relating to subtitle C of title XIX and sections 1931 and 1932; and (E) by adding at the end the following: TITLE XXIII—Office of Health Security Sec. 2301. Office of Health Security. Sec. 2302. Workforce health and safety. Sec. 2303. Coordination of Department of Homeland Security efforts related to food, agriculture, and veterinary defense against terrorism. Sec. 2304. Medical countermeasures. Sec. 2305. Rules of construction. Sec. 2306. Confidentiality of medical quality assurance records. ; (2) by redesignating section 529 ( 6 U.S.C. 321r ) as section 528; (3) in section 704(e)(4) ( 6 U.S.C. 344(e)(4) ), by striking section 711(a) and inserting section 710(a)) ; (4) by redesignating sections 711, 712, and 713 as sections 710, 711, and 712, respectively; (5) in section subsection (d)(3) of section 1923(d)(3) ( 6 U.S.C. 592 ), as so redesignated— (A) in the paragraph heading, by striking Hawaiian native-serving and inserting Native Hawaiian-serving ; and (B) by striking Hawaiian native-serving and inserting ‘Native Hawaiian-serving ; and (6) by striking the subtitle heading for subtitle C of title XIX.

December 11, 2023 Reported with an amendment