[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 1995 Introduced in Senate (IS)]
<DOC>
118th CONGRESS
1st Session
S. 1995
To support public health infrastructure.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
June 14, 2023
Mrs. Murray (for herself, Mr. Merkley, Mr. Schatz, Mr. Casey, Mr.
Blumenthal, Ms. Klobuchar, Ms. Smith, Ms. Baldwin, Ms. Warren, Mr.
Reed, Mr. Menendez, Mr. Van Hollen, Ms. Duckworth, and Mr. Brown)
introduced the following bill; which was read twice and referred to the
Committee on Health, Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To support public health infrastructure.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Public Health Infrastructure Saves
Lives Act''.
SEC. 2. CORE PUBLIC HEALTH INFRASTRUCTURE FOR STATE, TERRITORIAL,
LOCAL, AND TRIBAL HEALTH DEPARTMENTS.
(a) Program.--The Secretary of Health and Human Services (referred
to in this Act as the ``Secretary''), acting through the Director of
the Centers for Disease Control and Prevention, shall establish a core
public health infrastructure program to strengthen the public health
system of the United States, consisting of awarding grants under
subsection (b).
(b) Grants.--
(1) Award.--For the purpose of addressing core public
health infrastructure needs, the Secretary--
(A) shall award a grant to each State or
territorial health department, and to local health
departments that serve 500,000 people or more; and
(B) shall award grants on a competitive basis to
State, territorial, or local health departments.
(2) Allocation.--Of the total amount of funds awarded as
grants under this subsection for a fiscal year--
(A) not less than 50 percent shall be for grants to
health departments under paragraph (1)(A); and
(B) not less than 30 percent shall be for grants to
State, territorial, or local health departments under
paragraph (1)(B).
(c) Use of Funds.--The Secretary may award a grant to an entity
under subsection (b)(1) only if the entity agrees to use the full
amount of the grant to address core public health infrastructure needs,
including those identified in the accreditation process under
subsection (h).
(d) Formula Grants to Health Departments.--In making grants under
subsection (b)(1)(A), the Secretary shall award funds to each health
department in accordance with--
(1) a formula based on population size, burden of
preventable disease and disability, and poverty rate, with
special consideration given to territories; and
(2) application requirements established by the Secretary,
including a requirement that the health department submit a
plan by the end of year 1 of the grant that demonstrates to the
satisfaction of the Secretary that the health department will--
(A) address its highest priority core public health
infrastructure needs; and
(B) for State health departments, allocate at least
25 percent of the grant funds to local health
departments within the State to support the local
jurisdiction's contribution to core public health
infrastructure.
(e) Competitive Grants to State, Territorial, and Local Health
Departments.--In making grants under subsection (b)(1)(B), the
Secretary shall give priority to applicants demonstrating core public
health infrastructure needs for all public health agencies in the
applicant's jurisdiction to be certified by the accreditation process
under subsection (h), or for an entity for which a waiver has been
received under subparagraph (A) or (B) of subsection (h)(2), that has
otherwise demonstrated the applicant has core public health
infrastructure needs for all public health agencies.
(f) Permitted Use.--The Secretary may make available a subset of
the funds available for grants under subsection (b)(1) for purposes of
awarding planning grants to health departments eligible to receive a
grant under subsection (b)(1)(B). Recipients of such a planning grant
may use such award to assess core public health infrastructure needs.
(g) Maintenance of Effort.--The Secretary may award a grant to an
entity under subsection (b) only if the entity demonstrates to the
satisfaction of the Secretary that--
(1) funds received through the grant will be expended only
to supplement, and not supplant, non-Federal and Federal funds
otherwise available to the entity for the purpose of addressing
core public health infrastructure needs; and
(2) with respect to activities for which the grant is
awarded, the entity will maintain expenditures of non-Federal
amounts for such activities at a level not less than the level
of such expenditures maintained by the entity for the fiscal
year preceding the fiscal year for which the entity receives
the grant.
(h) Support of a National Public Health Accreditation Program.--
(1) In general.--The Secretary, acting through the Director
of the Centers for Disease Control and Prevention, shall--
(A) support continued development, and periodic
review and updating of standards for accreditation of
State, territorial, local, or Tribal health departments
for the purpose of advancing the quality and
performance of such departments with an emphasis on
core public health infrastructure;
(B) implement a program to accredit such health
departments in accordance with such standards; and
(C) beginning in fiscal year 2027, ensure that any
entity receiving a grant under subsection (b) is
accredited as described in subparagraph (A) or meets
another standard of accountability specific to public
health infrastructure, subject to paragraph (2).
(2) Waivers.--The Secretary may waive the requirement under
paragraph (1)(C) with respect to--
(A) any individual entity until fiscal year 2029;
or
(B) after fiscal year 2029, any individual entity
that demonstrates that it would be a significant
hardship to comply with such requirement.
(3) Cooperative agreement.--The Secretary may enter into a
cooperative agreement with a private nonprofit entity to carry
out this subsection.
(i) Report.--The Secretary shall submit to the Committee on Health,
Education, Labor, and Pensions of the Senate and the Committee on
Energy and Commerce of the House of Representatives an annual report on
progress being made to accredit entities under subsection (h). Such
report shall include--
(1) a strategy, including goals and objectives, for
accrediting entities under subsection (h) and achieving the
purpose described in subsection (h)(1);
(2) a list of funding recipients and the amounts received,
including directly funded entities under subsection (b)(1), as
well as local health departments that receive funding in
accordance with subsection (d)(2)(B);
(3) data reported by grantees funded under this section
pursuant to a minimum data set required by the Secretary, which
shall include each grantee's activities, standardized financial
reporting, and resource allocation data; and
(4) identification of gaps in research related to core
public health infrastructure and recommendations of priority
areas for such research.
(j) Tribal Set-Aside.--Of the amount appropriated under subsection
(a) for a fiscal year, the Secretary shall reserve 3 percent for
purposes of, acting through the Director of the Centers for Disease
Control and Prevention and in consultation with the Director of the
Indian Health Service, awarding grants under this section to Tribal
health departments and to epidemiology centers established under
section 214 of the Indian Health Care Improvement Act (25 U.S.C.
1621m).
SEC. 3. CORE PUBLIC HEALTH INFRASTRUCTURE AND ACTIVITIES FOR CDC.
(a) In General.--The Secretary, acting through the Director of the
Centers for Disease Control and Prevention, shall expand and improve
the core public health infrastructure and activities of the Centers for
Disease Control and Prevention to address unmet and emerging public
health needs and provide technical assistance to grantees funded under
this provision, including the administration of the grants under
section 2(b)(1).
(b) Report.--The Secretary shall submit to Congress an annual
report on the activities funded through this section.
SEC. 4. CORE PUBLIC HEALTH INFRASTRUCTURE DEFINED.
For purposes of this Act, the term ``core public health
infrastructure'' means all of the following elements, and the workforce
needed to establish and maintain such elements:
(1) Assessment (including surveillance, epidemiology, and
laboratory capacity).--The ability to track the health of a
community through data, case finding, and laboratory tests with
particular attention to those most at risk.
(2) All hazards preparedness and response.--The capacity to
respond to emergencies of all kinds.
(3) Policy development and support.--The ability to
translate public health science into appropriate policy and
regulation.
(4) Communications.--The ability to reach the public
effectively with timely, science-based information to mitigate
the impact of public health threats, with particular attention
to hard-to-reach populations.
(5) Community partnership development.--The capacity to
harness and align community resources and organizations to
advance the health of all members of the community.
(6) Organizational competencies (leadership and
governance).--The ability to lead internal and external
stakeholders to consensus and action.
(7) Accountability and performance management (including
quality improvement, information technology, human resources,
financial management, and law).--The ability to apply business
practices, including a standardized approach to financial
reporting, that ensure efficient use of resources, achieve
desired outcomes, and foster a continuous learning environment.
(8) Equity.--Utilizing all of the preceding elements, the
capacity to address and correct health disparities (including
disparities related to race, ethnicity, national origin,
socioeconomic status, primary language, sex (including sexual
orientation and gender identity), disability status, and other
factors), advance health equity in all communities, and
implement culturally and linguistically appropriate programs
and interventions.
SEC. 5. FUNDING.
(a) In General.--To carry out this Act, there are hereby
appropriated, out of amounts in the Treasury not otherwise
appropriated, the following to be made available until expended:
(1) For fiscal year 2024, $750,000,000.
(2) For fiscal year 2025, $1,000,000,000.
(3) For fiscal year 2026, $2,000,000,000.
(4) For fiscal year 2027, $3,000,000,000.
(5) For fiscal year 2028 and each subsequent fiscal year,
$4,500,000,000.
(b) Core Public Health Infrastructure and Activities.--Of the
amounts made available under this section for a fiscal year, not more
than $350,000,000 shall be used to carry out section 3.
(c) Supplement.--Amounts made available under this section shall be
used to supplement, and not supplant, amounts otherwise made available
for the purposes described in this Act.
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