AMENDMENTS TO THE PUBLIC HEALTH SERVICE ACT.

SEC. 102. AMENDMENTS TO THE PUBLIC HEALTH SERVICE ACT. Part B of title III of the Public Health Service Act (42 U.S.C. 243 et seq.) is amended by striking section 319 and inserting the following: “SEC. 319. PUBLIC HEALTH EMERGENCIES. “(a) Emergencies.—If the Secretary determines, after consultation with such public health officials as may be necessary, that— “(1) a disease or disorder presents a public health emergency; or “(2) a public health emergency, including significant outbreaks of infectious diseases or bioterrorist attacks, otherwise exists, the Secretary may take such action as may be appropriate to respond to the public health emergency, including making grants and entering into contracts and conducting and supporting investigations into the cause, treatment, or prevention of a disease or disorder as described in paragraphs (1) and (2). “(b) Public Health Emergency Fund.— “(1) In general.—There is established in the Treasury a fund to be designated as the ‘Public Health Emergency Fund’ 114 STAT. 2316to be made available to the Secretary without fiscal year limitation to carry out subsection (a) only if a public health emergency has been declared by the Secretary under such subsection. There is authorized to be appropriated to the Fund such sums as may be necessary. “(2) Report.—Not later than 90 days after the end of each fiscal year, the Secretary shall prepare and submit to the Committee on Health, Education, Labor, and Pensions and the Committee on Appropriations of the Senate and the Committee on Commerce and the Committee on Appropriations of the House of Representatives a report describing— “(A) the expenditures made from the Public Health Emergency Fund in such fiscal year; and “(B) each public health emergency for which the expenditures were made and the activities undertaken with respect to each emergency which was conducted or supported by expenditures from the Fund. “(c) Supplement Not Supplant.—Funds appropriated under this section shall be used to supplement and not supplant other Federal, State, and local public funds provided for activities under this section. “SEC. 319A. NATIONAL NEEDS TO COMBAT THREATS TO PUBLIC HEALTH. “(a) Capacities.— “(1) In general.—Not later than 1 year after the date of the enactment of this section, the Secretary, and such Administrators, Directors, or Commissioners, as may be appropriate, and in collaboration with State and local health officials, shall establish reasonable capacities that are appropriate for national, State, and local public health systems and the personnel or work forces of such systems. Such capacities shall be revised every 10 years, or more frequently as the Secretary determines to be necessary. “(2) Basis.—The capacities established under paragraph (1) shall improve, enhance or expand the capacity of national, State and local public health agencies to detect and respond effectively to significant public health threats, including major outbreaks of infections disease, pathogens resistant to antimicrobial agents and acts of bioterrorism. Such capacities may include the capacity to— “(A) recognize the clinical signs and epidemiological characteristic of significant outbreaks of infectious disease; “(B) identify disease-causing pathogens rapidly and accurately; “(C) develop and implement plans to provide medical care for persons infected with disease-causing agents and to provide preventive care as needed for individuals likely to be exposed to disease-causing agents; “(D) communicate information relevant to significant public health threats rapidly to local, State and national health agencies, and health care providers; or “(E) develop or implement policies to prevent the spread of infectious disease or antimicrobial resistance. “(b) Supplement Not Supplant.—Funds appropriated under this section shall be used to supplement and not supplant other 114 STAT. 2317Federal, State, and local public funds provided for activities under this section. “(c) Technical Assistance.—The Secretary shall provide technical assistance to the States to assist such States in fulfilling the requirements of this section. “(d) Authorization of Appropriations.—There are authorized to be appropriated to carry out this section $4,000,000 for fiscal year 2001, and such sums as may be necessary for each subsequent fiscal year through 2006. “SEC. 319B. ASSESSMENT OF PUBLIC HEALTH NEEDS. “(a) Program Authorized.—Not later than 1 year after the date of the enactment of this section and every 10 years thereafter, the Secretary shall award grants to States, or consortia of two or more States or political subdivisions of States, to perform, in collaboration with local public health agencies, an evaluation to determine the extent to which the States or local public health agencies can achieve the capacities applicable to State and local public health agencies described in subsection (a) of section 319A The Secretary shall provide technical assistance to States, or consortia of two or more States or political subdivisions of States, in addition to awarding such grants. “(b) Procedure.— “(1) In general.—A State, or a consortium of two or more States or political subdivisions of States, may contract with an outside entity to perform the evaluation described in subsection (a). “(2) Methods.—To the extent practicable, the evaluation described in subsection (a) shall be completed by using methods, to be developed by the Secretary in collaboration with State and local health officials, that facilitate the comparison of evaluations conducted by a State to those conducted by other States receiving funds under this section. “(c) Report.—Not later than 1 year after the date on which a State, or a consortium of two or more States or political subdivisions of States, receives a grant under this subsection, such State, or a consortium of two or more States or political subdivisions of States, shall prepare and submit to the Secretary a report describing the results of the evaluation described in subsection (a) with respect to such State, or consortia of two or more States or political subdivisions of States. “(d) Supplement not Supplant.—Funds appropriated under this section shall be used to supplement and not supplant other Federal, State, and local public funds provided for activities under this section. “(e) Authorization of Appropriations.—There are authorized to be appropriated to carry out this section $45,000,000 for fiscal year 2001, and such sums as may be necessary for each subsequent fiscal year through 2003. “SEC. 319C. GRANTS TO IMPROVE STATE AND LOCAL PUBLIC HEALTH AGENCIES. “(a) Program Authorized.—The Secretary shall award competitive grants to eligible entities to address core public health capacity needs using the capacities developed under section 319A, with a particular focus on building capacity to identify, detect, monitor, and respond to threats to the public health.114 STAT. 2318 “(b) Eligible Entities.—A State or political subdivision of a State, or a consortium of two or more States or political subdivisions of States, that has completed an evaluation under section 319B(a), or an evaluation that is substantially equivalent as determined by the Secretary under section 319B(a), shall be eligible for grants under subsection (a). “(c) Use of Funds.—An eligible entity that receives a grant under subsection (a), may use funds received under such grant to— “(1) train public health personnel; “(2) develop, enhance, coordinate, or improve participation in an electronic network by which disease detection and public health related information can be rapidly shared among national, regional, State, and local public health agencies and health care providers; “(3) develop a plan for responding to public health emergencies, including significant outbreaks of infectious diseases or bioterrorism attacks, which is coordinated with the capacities of applicable national, State, and local health agencies and health care providers; and “(4) enhance laboratory capacity and facilities. “(d) Report.—No later than January 1, 2005, the Secretary shall prepare and submit to the Committee on Health, Education, Labor, and Pensions and the Committee on Appropriations of the Senate and the Committee on Commerce and the Committee on Appropriations of the House of Representatives a report that describes the activities carried out under sections 319A, 319B, and 319C. “(e) Supplement Not Supplant.—Funds appropriated under this section shall be used to supplement and not supplant other Federal, State, and local public funds provided for activities under this section. “(f) Authorization of Appropriations.—There are authorized to be appropriated to carry out this section $50,000,000 for fiscal year 2001, and such sums as may be necessary for each subsequent fiscal year through 2006. “SEC. 319D. REVITALIZING THE CENTERS FOR DISEASE CONTROL AND PREVENTION. “(a) Findings.—Congress finds that the Centers for Disease Control and Prevention have an essential role in defending against and combatting public health threats of the 21st century and requires secure and modern facilities that are sufficient to enable such Centers to conduct this important mission. “(b) Authorization of Appropriations.—For the purposes of achieving the mission of the Centers for Disease Control and Prevention described in subsection (a), for constructing new facilities and renovating existing facilities of such Centers, including laboratories, laboratory support buildings, health communication facilities, office buildings and other facilities and infrastructure, for better conducting the capacities described in section 319A, and for supporting related public health activities, there are authorized to be appropriated $180,000,000 for fiscal year 2001, and such sums as may be necessary for each subsequent fiscal year through 2010. “SEC. 319E. COMBATING ANTIMICROBIAL RESISTANCE. “(a) Task Force.—114 STAT. 2319 “(1) In general.—The Secretary shall establish an Antimicrobial Resistance Task Force to provide advice and recommendations to the Secretary and coordinate Federal programs relating to antimicrobial resistance. The Secretary may appoint or select a committee, or other organization in existence as of the date of the enactment of this section, to serve as such a task force, if such committee, or other organization meets the requirements of this section. “(2) Members of task force.—The task force described in paragraph (1) shall be composed of representatives from such Federal agencies, and shall seek input from public health constituencies, manufacturers, veterinary and medical professional societies and others, as determined to be necessary by the Secretary, to develop and implement a comprehensive plan to address the public health threat of antimicrobial resistance. “(3) Agenda.— “(A) In general.—The task force described in paragraph (1) shall consider factors the Secretary considers appropriate, including— “(i) public health factors contributing to increasing antimicrobial resistance; “(ii) public health needs to detect and monitor antimicrobial resistance; “(iii) detection, prevention, and control strategies for resistant pathogens; “(iv) the need for improved information and data collection; “(v) the assessment of the risk imposed by pathogens presenting a threat to the public health; and “(vi) any other issues which the Secretary determines are relevant to antimicrobial resistance. “(B) Detection and Control.—The Secretary, in consultation with the task force described in paragraph (1) and State and local public health officials, shall— “(i) develop, improve, coordinate or enhance participation in a surveillance plan to detect and monitor emerging antimicrobial resistance; and “(ii) develop, improve, coordinate or enhance participation in an integrated information system to assimilate, analyze, and exchange antimicrobial resistance data between public health departments. “(4) Meetings.—The task force described under paragraph (1) shall convene not less than twice a year, or more frequently as the Secretary determines to be appropriate. “(b) Research and Development of New Antimicrobial Drugs and Diagnostics.—The Secretary and the Director of Agricultural Research Services, consistent with the recommendations of the task force established under subsection (a), shall conduct and support research, investigations, experiments, demonstrations, and studies in the health sciences that are related to— “(1) the development of new therapeutics, including vaccines and antimicrobials, against resistant pathogens; “(2) the development or testing of medical diagnostics to detect pathogens resistant to antimicrobials; “(3) the epidemiology, mechanisms, and pathogenesis of antimicrobial resistance;114 STAT. 2320 “(4) the sequencing of the genomes of priority pathogens as determined by the Director of the National Institutes of Health in consultation with the task force established under subsection (a); and “(5) other relevant research areas. “(c) Education of Medical and Public Health Personnel.—The Secretary, after consultation with the Assistant Secretary for Health, the Surgeon General, the Director of the Centers for Disease Control and Prevention, the Administrator of the Health Resources and Services Administration, the Director of the Agency for Healthcare Research and Quality, members of the task force described in subsection (a), professional organizations and societies, and such other public health officials as may be necessary, shall— “(1) develop and implement educational programs to increase the awareness of the general public with respect to the public health threat of antimicrobial resistance and the appropriate use of antibiotics; “(2) develop and implement educational programs to instruct health care professionals in the prudent use of antibiotics; and “(3) develop and implement programs to train laboratory personnel in the recognition or identification of resistance in pathogens. “(d) Grants.— “(1) In general.—The Secretary shall award competitive grants to eligible entities to enable such entities to increase the capacity to detect, monitor, and combat antimicrobial resistance. “(2) Eligible entities.—Eligible entities for grants under paragraph (1) shall be State or local public health agencies, Indian tribes or tribal organizations, or other public or private nonprofit entities. “(3) Use of funds.—An eligible entity receiving a grant under paragraph (1) shall use funds from such grant for activities that are consistent with the factors identified by the task force under subsection (a)(3), which may include activities that— “(A) provide training to enable such entity to identify patterns of resistance rapidly and accurately; “(B) develop, improve, coordinate or enhance participation in information systems by which data on resistant infections can be shared rapidly among relevant national, State, and local health agencies and health care providers; and “(C) develop and implement policies to control the spread of antimicrobial resistance. “(e) Grants for Demonstration Programs.— “(1) In general.—The Secretary shall award competitive grants to eligible entities to establish demonstration programs to promote judicious use of antimicrobial drugs or control the spread of antimicrobial-resistant pathogens. “(2) Eligible entities.—Eligible entities for grants under paragraph (1) may include hospitals, clinics, institutions of long-term care, professional medical societies, or other public or private nonprofit entities.114 STAT. 2321 “(3) Technical assistance.—The Secretary shall provide appropriate technical assistance to eligible entities that receive grants under paragraph (1). “(f) Supplement Not Supplant.—Funds appropriated under this section shall be used to supplement and not supplant other Federal, State, and local public funds provided for activities under this section. “(g) Authorization of Appropriations.—There are authorized to be appropriated to carry out this section, $40,000,000 for fiscal year 2001, and such sums as may be necessary for each subsequent fiscal year through 2006. “SEC. 319F. PUBLIC HEALTH COUNTERMEASURES TO A BIOTERRORIST ATTACK “(a) Working Group on Preparedness for Acts of Bioterrorism.—The Secretary, in coordination with the Secretary of Defense, shall establish a joint interdepartmental working group on preparedness and readiness for the medical and public health effects of a bioterrorist attack on the civilian population. Such joint working group shall— “(1) coordinate research on pathogens likely to be used in a bioterrorist attack on the civilian population as well as therapies to treat such pathogens; “(2) coordinate research and development into equipment to detect pathogens likely to be used in a bioterrorist attack on the civilian population and protect against infection from such pathogens; “(3) develop shared standards for equipment to detect and to protect against infection from pathogens likely to be used in a bioterrorist attack on the civilian population; and “(4) coordinate the development, maintenance, and procedures for the release of, strategic reserves of vaccines, drugs, and medical supplies which may be needed rapidly after a bioterrorist attack upon the civilian population. “(b) Working Group on the Public Health and Medical Consequences of Bioterrorism.— “(1) In general.—The Secretary, in collaboration with the Director of the Federal Emergency Management Agency, the Attorney General, and the Secretary of Agriculture, shall establish a joint interdepartmental working group to address the public health and medical consequences of a bioterrorist attack on the civilian population. “(2) Functions.—Such working group shall— “(A) assess the priorities for and enhance the preparedness of public health institutions, providers of medical care, and other emergency service personnel to detect, diagnose, and respond to a bioterrorist attack; and “(B) in the recognition that medical and public health professionals are likely to provide much of the first response to such an attack, develop, coordinate, enhance, and assure the quality of joint planning and training programs that address the public health and medical consequences of a bioterrorist attack on the civilian population between— “(i) local firefighters, ambulance personnel, police and public security officers, or other emergency response personnel; and114 STAT. 2322 “(ii) hospitals, primary care facilities, and public health agencies. “(3) Working group membership.—In establishing such working group, the Secretary shall act through the Assistant Secretary for Health and the Director of the Centers for Disease Control and Prevention. “(4) Coordination.—The Secretary shall ensure coordination and communication between the working groups established in this subsection and subsection (a). “(c) Grants.— “(1) In general.—The Secretary, in coordination with the working group established under subsection (b), shall, on a competitive basis and following scientific or technical review, award grants to or enter into cooperative agreements with eligible entities to enable such entities to increase their capacity to detect, diagnose, and respond to acts of bioterrorism upon the civilian population. “(2) Eligibility.—To be an eligible entity under this subsection, such entity must be a State, political subdivision of a State, a consortium of two or more States or political subdivisions of States, or a hospital, clinic, or primary care facility. “(3) Use of funds.—An entity that receives a grant under this subsection shall use such funds for activities that are consistent with the priorities identified by the working group under subsection (b), including— “(A) training health care professionals and public health personnel to enhance the ability of such personnel to recognize the symptoms and epidemiological characteristics of exposure to a potential bioweapon; “(B) addressing rapid and accurate identification of potential bioweapons; “(C) coordinating medical care for individuals exposed to bioweapons; and “(D) facilitating and coordinating rapid communication of data generated from a bioterrorist attack between national, State, and local health agencies, and health care providers. “(4) Coordination.—The Secretary, in awarding grants under this subsection, shall— “(A) notify the Director of the Office of Justice Programs, and the Director of the National Domestic Preparedness Office annually as to the amount and status of grants awarded under this subsection; and “(B) coordinate grants awarded under this subsection with grants awarded by the Office of Emergency Preparedness and the Centers for Disease Control and Prevention for the purpose of improving the capacity of health care providers and public health agencies to respond to bioterrorist attacks on the civilian population. “(5) Activities.—An entity that receives a grant under this subsection shall, to the greatest extent practicable, coordinate activities carried out with such funds with the activities of a local Metropolitan Medical Response System. “(d) Federal Assistance.—The Secretary shall ensure that the Department of Health and Human Services is able to provide such assistance as may be needed to State and local health agencies to enable such agencies to respond effectively to bioterrorist attacks.114 STAT. 2323 “(e) Education.—The Secretary, in collaboration with members of the working group described in subsection (b), and professional organizations and societies, shall— “(1) develop and implement educational programs to instruct public health officials, medical professionals, and other personnel working in health care facilities in the recognition and care of victims of a bioterrorist attack; and “(2) develop and implement programs to train laboratory personnel in the recognition and identification of a potential bioweapon. “(f) Future Resource Development.—The Secretary shall consult with the working group described in subsection (a), to develop priorities for and conduct research, investigations, experiments, demonstrations, and studies in the health sciences related to— “(1) the epidemiology and pathogenesis of potential bioweapons; “(2) the development of new vaccines or other therapeutics against pathogens likely to be used in a bioterrorist attack; “(3) the development of medical diagnostics to detect potential bioweapons; and “(4) other relevant research areas. “(g) General Accounting Office Report.—Not later than 180 days after the date of the enactment of this section, the Comptroller General shall submit to the Committee on Health, Education, Labor, and Pensions and the Committee on Appropriations of the Senate and the Committee on Commerce and the Committee on Appropriations of the House of Representatives a report that describee— “(1) Federal activities primarily related to research on, preparedness for, and the management of the public health and medical consequences of a bioterrorist attack against the civilian population; “(2) the coordination of the activities described in paragraph (1); “(3) the amount of Federal funds authorized or appropriated for the activities described in paragraph (1); and “(4) the effectiveness of such efforts in preparing national, State, and local authorities to address the public health and medical consequences of a potential bioterrorist attack against the civilian population. “(h) Supplement Not Supplant.—Funds appropriated under this section shall be used to supplement and not supplant other Federal, State, and local public funds provided for activities under this section. “(i) Authorization of Appropriations.—There are authorized to be appropriated to carry out this section $215,000,000 for fiscal year 2001, and such sums as may be necessary for each subsequent fiscal year through 2006. “SEC. 319G. DEMONSTRATION PROGRAM TO ENHANCE BIOTERRORISM TRAINING, COORDINATION, AND READINESS. “(a) In general.—The Secretary shall make grants to not more than three eligible entities to carry out demonstration programs to improve the detection of pathogens likely to be used in a bioterrorist attack, the development of plans and measures to respond to bioterrorist attacks, and the training of personnel 114 STAT. 2324involved with the various responsibilities and capabilities needed to respond to acts of bioterrorism upon the civilian population. Such awards shall be made on a competitive basis and pursuant to scientific and technical review. “(b) Eligible Entities.—Eligible entities for grants under subsection (a) are States, political subdivisions of States, and public or private non-profit organizations. “(c) Specific Criteria.—In making grants under subsection (a), the Secretary shall take into account the following factors: “(1) Whether the eligible entity involved is proximate to, and collaborates with, a major research university with expertise in scientific training, identification of biological agents, medicine, and life sciences. “(2) Whether the entity is proximate to, and collaborates with, a laboratory that has expertise in the identification of biological agents. “(3) Whether the entity demonstrates, in the application for the program, support and participation of State and local governments and research institutions in the conduct of the program. “(4) Whether the entity is proximate to, and collaborates with, or is, an academic medical center that has the capacity to serve an uninsured or underserved population, and is equipped to educate medical personnel. “(5) Such other factors as the Secretary determines to be appropriate. “(d) Duration of Award.—The period during which payments are made under a grant under subsection (a) may not exceed 5 years. The provision of such payments shall be subject to annual approval by the Secretary of the payments and subject to the availability of appropriations for the fiscal year involved to make the payments. “(e) Supplement Not Supplant.—Grants under subsection (a) shall be used to supplement, and not supplant, other Federal, State, or local public funds provided for the activities described in such subsection. “(f) General Accounting Office Report.—Not later than 180 days after the conclusion of the demonstration programs carried out under subsection (a), the Comptroller General of the United States shall submit to the Committee on Health, Education, Labor, and Pensions and the Committee on Appropriations of the Senate, and the Committee on Commerce and the Committee on Appropriations of the House of Representatives, a report that describes the ability of grantees under such subsection to detect pathogens likely to be used in a bioterrorist attack, develop plans and measures for dealing with such threats, and train personnel involved with the various responsibilities and capabilities needed to deal with bioterrorist threats. “(g) Authorization of Appropriations.—There is authorized to be appropriated to carry out this section $6,000,000 for fiscal year 2001, and such sums as may be necessary through fiscal year 2006.”.