GRANTS TO IMPROVE STATE, LOCAL, AND HOSPITAL PREPAREDNESS FOR AND RESPONSE TO BIOTERRORISM AND OTHER PUBLIC HEALTH EMERGENCIES.

SEC. 131. GRANTS TO IMPROVE STATE, LOCAL, AND HOSPITAL PREPAREDNESS FOR AND RESPONSE TO BIOTERRORISM AND OTHER PUBLIC HEALTH EMERGENCIES. (a) In General.—Part B of title III of the Public Health Service Act (42 U.S.C. 243 et seq.) is amended by inserting after section 319C the following sections: “SEC. 319C-1. GRANTS TO IMPROVE STATE, LOCAL, AND HOSPITAL PREPAREDNESS FOR AND RESPONSE TO BIOTERRORISM AND OTHER PUBLIC HEALTH EMERGENCIES. “(a) In General.—To enhance the security of the United States with respect to bioterrorism and other public health emergencies, the Secretary shall make awards of grants or cooperative agreements to eligible entities to enable such entities to conduct the activities described in subsection (d). “(b) Eligible Entities.— “(1) In general.—To be eligible to receive an award under subsection (a), an entity shall— “(A) (i) be a State; and “(ii) prepare and submit to the Secretary an application at such time, and in such manner, and containing such information as the Secretary may require, including an assurance that the State— “(I) has completed an evaluation under section 319B(a), or an evaluation that is substantially equivalent to an evaluation described in such section (as determined by the Secretary); “(II) has prepared, or will (within 60 days of receiving an award under this section) prepare, a Bioterrorism and Other Public Health Emergency Preparedness and Response Plan in accordance with subsection (c); “(III) has established a means by which to obtain public comment and input on the plan prepared under subclause (II), and on the implementation of such plan, 116 STAT. 618that shall include an advisory committee or other similar mechanism for obtaining comment from the public at large as well as from other State and local stakeholders; “(IV) will use amounts received under the award in accordance with the plan prepared under subclause (II), including making expenditures to carry out the strategy contained in the plan; and “(V) with respect to the plan prepared under subclause (II), will establish reasonable criteria to evaluate the effective performance of entities that receive funds under the award and include relevant benchmarks in the plan; or “(B) “(i) be a political subdivision of a State or a consortium of 2 or more such subdivisions; and “(ii) prepare and submit to the Secretary an application at such time, and in such manner, and containing such information as the Secretary may require. “(2) Coordination with statewide plans.—An award under subsection (a) to an eligible entity described in paragraph (1)(B) may not be made unless the application of such entity is in coordination with, and consistent with, applicable Statewide plans described in subsection (d)(1). “(c) Bioterrorism and Other Public Health Emergency Preparedness and Response Plan.—Not later than 60 days after receiving amounts under an award under subsection (a), an eligible entity described in subsection (b)(1)(A) shall prepare and submit to the Secretary a Bioterrorism and Other Public Health Emergency Preparedness and Response Plan. Recognizing the assessment of public health needs conducted under section 319B, such plan shall include a description of activities to be carried out by the entity to address the needs identified in such assessment (or an equivalent assessment). “(d) Use of Funds.—An award under subsection (a) may be expended for activities that may include the following and similar activities: “(1) To develop Statewide plans (including the development of the Bioterrorism and Other Public Health Emergency Preparedness and Response Plan required under subsection (c)), and community-wide plans for responding to bioterrorism and other public health emergencies that are coordinated with the capacities of applicable national, State, and local health agencies and health care providers, including poison control centers. “(2) To address deficiencies identified in the assessment conducted under section 319B. “(3) To purchase or upgrade equipment (including stationary or mobile communications equipment), supplies, pharmaceuticals or other priority countermeasures to enhance preparedness for and response to bioterrorism or other public health emergencies, consistent with the plan described in subsection (c). “(4) To conduct exercises to test the capability and timeliness of public health emergency response activities. “(5) To develop and implement the trauma care and burn center care components of the State plans for the provision of emergency medical services. 116 STAT. 619 “(6) To improve training or workforce development to enhance public health laboratories. “(7) To train public health and health care personnel to enhance the ability of such personnel— “(A) to detect, provide accurate identification of, and recognize the symptoms and epidemiological characteristics of exposure to a biological agent that may cause a public health emergency; and “(B) to provide treatment to individuals who are exposed to such an agent. “(8) To develop, enhance, coordinate, or improve participation in systems by which disease detection and information about biological attacks and other public health emergencies can be rapidly communicated among national, State, and local health agencies, emergency response personnel, and health care providers and facilities to detect and respond to a bioterrorist attack or other public health emergency, including activities to improve information technology and communications equipment available to health care and public health officials for use in responding to a biological threat or attack or other public health emergency. “(9) To enhance communication to the public of information on bioterrorism and other public health emergencies, including through the use of 2-1-1 call centers. “(10) To address the health security needs of children and other vulnerable populations with respect to bioterrorism and other public health emergencies. “(11) To provide training and develop, enhance, coordinate, or improve methods to enhance the safety of workers and workplaces in the event of bioterrorism. “(12) To prepare and plan for contamination prevention efforts related to public health that may be implemented in the event of a bioterrorist attack, including training and planning to protect the health and safety of workers conducting the activities described in this paragraph. “(13) To prepare a plan for triage and transport management in the event of bioterrorism or other public health emergencies. “(14) To enhance the training of health care professionals to recognize and treat the mental health consequences of bioterrorism or other public health emergencies. “(15) To enhance the training of health care professionals to assist in providing appropriate health care for large numbers of individuals exposed to a bioweapon. “(16) To enhance training and planning to protect the health and safety of personnel, including health care professionals, involved in responding to a biological attack. “(17) To improve surveillance, detection, and response activities to prepare for emergency response activities including biological threats or attacks, including training personnel in these and other necessary functions and including early warning and surveillance networks that use advanced information technology to provide early detection of biological threats or attacks. “(18) To develop, enhance, and coordinate or improve the ability of existing telemedicine programs to provide health care 116 STAT. 620 information and advice as part of the emergency public health response to bioterrorism or other public health emergencies. Nothing in this subsection may be construed as establishing new regulatory authority or as modifying any existing regulatory authority. “(e) Priorities in Use of Grants.— “(1) In general.— “(A) Priorities.—Except as provided in subparagraph (B), the Secretary shall, in carrying out the activities described in this section, address the following hazards in the following priority: “(i) Bioterrorism or acute outbreaks of infectious diseases. “(ii) Other public health threats and emergencies. “(B) Determination of the secretary.—In the case of the hazard involved, the degree of priority that would apply to the hazard based on the categories specified in clauses (i) and (ii) of subparagraph (A) may be modified by the Secretary if the following conditions are met: “(i) The Secretary determines that the modification is appropriate on the basis of the following factors: “(I) The extent to which eligible entities are adequately prepared for responding to hazards within the category specified in clause (i) of subparagraph (A). “(II) There has been a significant change in the assessment of risks to the public health posed by hazards within the category specified in clause (ii) of such subparagraph. “(ii) Prior to modifying the priority, the Secretary notifies the appropriate committees of the Congress of the determination of the Secretary under clause (i) of this subparagraph. “(2) Areas of emphasis within categories.—The Secretary shall determine areas of emphasis within the category of hazards specified in clause (i) of paragraph (1)(A), and shall determine areas of emphasis within the category of hazards specified in clause (ii) of such paragraph, based on an assessment of the risk and likely consequences of such hazards and on an evaluation of Federal, State, and local needs, and may also take into account the extent to which receiving an award under subsection (a) will develop capacities that can be used for public health emergencies of varying types. “(f) Certain Activities.—In administering activities under section 319C(c)(4) or similar activities, the Secretary shall, where appropriate, give priority to activities that include State or local government financial commitments, that seek to incorporate multiple public health and safety services or diagnostic databases into an integrated public health entity, and that cover geographic areas lacking advanced diagnostic and laboratory capabilities. “(g) Coordination with Local Medical Response System.—An eligible entity and local Metropolitan Medical Response Systems shall, to the extent practicable, ensure that activities carried out under an award under subsection (a) are coordinated with activities that are carried out by local Metropolitan Medical Response Systems. 116 STAT. 621 “(h) Coordination of Federal Activities.—In making awards under subsection (a), the Secretary shall— “(1) annually notify the Director of the Federal Emergency Management Agency, the Director of the Office of Justice Programs, and the Director of the National Domestic Preparedness Office, as to the amount, activities covered under, and status of such awards; and “(2) coordinate such awards with other activities conducted or supported by the Secretary to enhance preparedness for bioterrorism and other public health emergencies. “(i) Definition.—For purposes of this section, the term ‘eligible entity’ means an entity that meets the conditions described in subparagraph (A) or (B) of subsection (b)(1). “(j) Funding.— “(1) Authorizations of appropriations.— “(A) Fiscal year 2003.— “(i) Authorizations.—For the purpose of carrying out this section, there is authorized to be appropriated $1,600,000,000 for fiscal year 2003, of which— “(I) $1,080,000,000 is authorized to be appropriated for awards pursuant to paragraph (3) (subject to the authority of the Secretary to make awards pursuant to paragraphs (4) and (5)); and “(II) $520,000,000 is authorized to be appropriated— “(aa) for awards under subsection (a) to States, notwitstanding the eligibility conditions under subsection (b), for the purpose of enhancing the preparedness of hospitals (including children’s hospitals), clinics, health centers, and primary care facilities for bioterrorism and other public health emergencies; and “(bb) for Federal, State, and local planning and administrative activities related to such purpose. “(ii) Contingent additional authorization.—If a significant change in circumstances warrants an increase in the amount authorized to be appropriated under clause (i) for fiscal year 2003, there are authorized to be appropriated such sums as may be necessary for such year for carrying out this section, in addition to the amount authorized in clause (i). “(B) Other fiscal years.—For the purpose of carrying out this section, there are authorized to be appropriated such sums as may be necessary for each of the fiscal years 2004 through 2006. “(2) Supplement not supplant.—Amounts appropriated under paragraph (1) shall be used to supplement and not supplant other State and local public funds provided for activities under this section. “(3) State bioterrorism and other public health emergency preparedness and response block grant for fiscal year 2003.— 116 STAT. 622 “(A) In general.—For fiscal year 2003, the Secretary shall, in an amount determined in accordance with subparagraphs (B) through (D), make an award under subsection (a) to each State, notwithstanding the eligibility conditions described in subsection (b), that submits to the Secretary an application for the award that meets the criteria of the Secretary for the receipt of such an award and that meets other implementation conditions established by the Secretary for such awards. No other awards may be made under subsection (a) for such fiscal year, except as provided in paragraph (1)(A)(i)(II) and paragraphs (4) and (5). “(B) Base amount.—In determining the amount of an award pursuant to subparagraph (A) for a State, the Secretary shall first determine an amount the Secretary considers appropriate for the State (referred to in this paragraph as the ‘base amount’), except that such amount may not be greater than the minimum amount determined under subparagraph (D). “(C) Increase on basis of population.—After determining the base amount for a State under subparagraph (B), the Secretary shall increase the base amount by an amount equal to the product of— “(i) the amount appropriated under paragraph (1)(A)(i)(I) for the fiscal year, less an amount equal to the sum of all base amounts determined for the States under subparagraph (B), and less the amount, if any, reserved by the Secretary under paragraphs (4) and (5); and “(ii) subject to paragraph (4)(C), the percentage constituted by the ratio of an amount equal to the population of the State over an amount equal to the total population of the States (as indicated by the most recent data collected by the Bureau of the Census). “(D) Minimum amount.—Subject to the amount appropriated under paragraph (1)(A)(i)(I), an award pursuant to subparagraph (A) for a State shall be the greater of the base amount as increased under subparagraph (C), or the minimum amount under this subparagraph. The minimum amount under this subparagraph is— “(i) in the case of each of the several States, the District of Columbia, and the Commonwealth of Puerto Rico, an amount equal to the lesser of— “(I) $5,000,000; or “(II) if the amount appropriated under paragraph (1)(A)(i)(I) is less than $667,000,000, an amount equal to 0.75 percent of the amount appropriated under such paragraph, less the amount, if any, reserved by the Secretary under paragraphs (4) and (5); or “(ii) in the case of each of American Samoa, Guam, the Commonwealth of the Northern Mariana Islands, and the Virgin Islands, an amount determined by the Secretary to be appropriate, except that such amount may not exceed the amount determined under clause (i). 116 STAT. 623 “(4) Certain political subdivisions.— “(A) In general.—For fiscal year 2003, the Secretary may, before making awards pursuant to paragraph (3) for such year, reserve from the amount appropriated under paragraph (1)(A)(i)(I) for the year an amount determined necessary by the Secretary to make awards under subsection (a) to political subdivisions that have a substantial number of residents, have a substantial local infrastructure for responding to public health emergencies, and face a high degree of risk from bioterrorist attacks or other public health emergencies. Not more than three political subdivisions may receive awards pursuant to this subparagraph. “(B) Coordination with statewide plans.—An award pursuant to subparagraph (A) may not be made unless the application of the political subdivision involved is in coordination with, and consistent with, applicable Statewide plans described in subsection (c). “(C) Relationship to formula grants.—In the case of a State that will receive an award pursuant to paragraph (3), and in which there is located a political subdivision that will receive an award pursuant to subparagraph (A), the Secretary shall, in determining the amount under paragraph (3)(C) for the State, subtract from the population of the State an amount equal to the population of such political subdivision. “(D) Continuity of funding.—In determining whether to make an award pursuant to subparagraph (A) to a political subdivision, the Secretary may consider, as a factor indicating that the award should be made, that the political subdivision received public health funding from the Secretary for fiscal year 2002. “(5) Significant unmet needs; degree of risk.— “(A) In general.—For fiscal year 2003, the Secretary may, before making awards pursuant to paragraph (3) for such year, reserve from the amount appropriated under paragraph (1)(A)(i)(I) for the year an amount determined necessary by the Secretary to make awards under subsection (a) to eligible entities that— “(i) have a significant need for funds to build capacity to identify, detect, monitor, and respond to a bioterrorist or other threat to the public health, which need will not be met by awards pursuant to paragraph (3); and “(ii) face a particularly high degree of risk of such a threat. “(B) Recipients of grants.—Awards pursuant to subparagraph (A) may be supplemental awards to States that receive awards pursuant to paragraph (3), or may be awards to eligible entities described in subsection (b)(1)(B) within such States. “(C) Finding with respect to district of columbia.—The Secretary shall consider the District of Columbia to have a significant unmet need for purposes of subparagraph (A), and to face a particularly high degree of risk for such purposes, on the basis of the concentration of entities of national significance located within the District. 116 STAT. 624 “(6) Funding of local entities.—For fiscal year 2003, the Secretary shall in making awards under this section ensure that appropriate portions of such awards are made available to political subdivisions, local departments of public health, hospitals (including children’s hospitals), clinics, health centers, or primary care facilities, or consortia of such entities. “SEC. 319C-2. PARTNERSHIPS FOR COMMUNITY AND HOSPITAL PREPAREDNESS. “(a) Grants.—The Secretary shall make awards of grants or cooperative agreements to eligible entities to enable such entities to improve community and hospital preparedness for bioterrorism and other public health emergencies. “(b) Eligibility.—To be eligible for an award under subsection (a), an entity shall— “(1) be a partnership consisting of— “(A) one or more hospitals (including children’s hospitals), clinics, health centers, or primary care facilities; and “(B) “(i) one or more political subdivisions of States; “(ii) one or more States; or “(iii) one or more States and one or more political subdivisions of States; and “(2) prepare, in consultation with the Chief Executive Officer of the State, District, or territory in which the hospital, clinic, health center, or primary care facility described in paragraph (1)(A) is located, and submit to the Secretary, an application at such time, in such manner, and containing such information as the Secretary may require. “(c) Regional Coordination.—In making awards under subsection (a), the Secretary shall give preference to eligible entities that submit applications that, in the determination of the Secretary, will— “(1) enhance coordination— “(A) among the entities described in subsection (b)(1)(A); and “(B) between such entities and the entities described in subsection (b)(1)(B); and “(2) serve the needs of a defined geographic area. “(d) Consistency of Planned Activities.—An entity described in subsection (b)(1) shall utilize amounts received under an award under subsection (a) in a manner that is coordinated and consistent, as determined by the Secretary, with an applicable State Bioterrorism and Other Public Health Emergency Preparedness and Response Plan. “(e) Use of Funds.—An award under subsection (a) may be expended for activities that may include the following and similar activities— “(1) planning and administration for such award; “(2) preparing a plan for triage and transport management in the event of bioterrorism or other public health emergencies; “(3) enhancing the training of health care professionals to improve the ability of such professionals to recognize the symptoms of exposure to a potential bioweapon, to make appropriate diagnosis, and to provide treatment to those individuals so exposed; 116 STAT. 625 “(4) enhancing the training of health care professionals to recognize and treat the mental health consequences of bioterrorism or other public health emergencies; “(5) enhancing the training of health care professionals to assist in providing appropriate health care for large numbers of individuals exposed to a bioweapon; “(6) enhancing training and planning to protect the health and safety of personnel involved in responding to a biological attack; “(7) developing and implementing the trauma care and burn center care components of the State plans for the provision of emergency medical services; or “(8) conducting such activities as are described in section 319C-1(d) that are appropriate for hospitals (including children’s hospitals), clinics, health centers, or primary care facilities. “(f) Limitation on Awards.—A political subdivision of a State shall not participate in more than one partnership described in subsection (b)(1). “(g) Priorities in Use of Grants.— “(1) In general.— “(A) Priorities.—Except as provided in subparagraph (B), the Secretary shall, in carrying out the activities described in this section, address the following hazards in the following priority: “(i) Bioterrorism or acute outbreaks of infectious diseases. “(ii) Other public health threats and emergencies. “(B) Determination of the secretary.—In the case of the hazard involved, the degree of priority that would apply to the hazard based on the categories specified in clauses (i) and (ii) of subparagraph (A) may be modified by the Secretary if the following conditions are met: “(i) The Secretary determines that the modification is appropriate on the basis of the following factors: “(I) The extent to which eligible entities are adequately prepared for responding to hazards within the category specified in clause (i) of subparagraph (A). “(II) There has been a significant change in the assessment of risks to the public health posed by hazards within the category specified in clause (ii) of such subparagraph. “(ii) Prior to modifying the priority, the Secretary notifies the appropriate committees of the Congress of the determination of the Secretary under clause (i) of this subparagraph. “(2) Areas of emphasis within categories.—The Secretary shall determine areas of emphasis within the category of hazards specified in clause (i) of paragraph (1)(A), and shall determine areas of emphasis within the category of hazards specified in clause (ii) of such paragraph, based on an assessment of the risk and likely consequences of such hazards and on an evaluation of Federal, State, and local needs, and may also take into account the extent to which receiving an award under subsection (a) will develop capacities that can be used for public health emergencies of varying types. 116 STAT. 626 “(h) Coordination with Local Medical Response System.—An eligible entity and local Metropolitan Medical Response Systems shall, to the extent practicable, ensure that activities carried out under an award under subsection (a) are coordinated with activities that are carried out by local Metropolitan Medical Response Systems. “(i) Authorization of Appropriations.—For the purpose of carrying out this section, there are authorized to be appropriated such sums as may be necessary for each of fiscal years 2004 through 2006.”. (b) Certain Grants.—Section 319C of the Public Health Service Act (42 U.S.C. 247d-3) is amended by striking subsection (f).