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111th Congress                                                   Report
                        HOUSE OF REPRESENTATIVES
 2d Session                                                     111-634

======================================================================



 
            VETERINARY PUBLIC HEALTH AMENDMENTS ACT OF 2010

                                _______
                                

 September 28, 2010.--Committed to the Committee of the Whole House on 
            the State of the Union and ordered to be printed

                                _______
                                

 Mr. Waxman, from the Committee on Energy and Commerce, submitted the 
                               following

                              R E P O R T

                        [To accompany H.R. 2999]

      [Including cost estimate of the Congressional Budget Office]

      The Committee on Energy and Commerce, to whom was 
referred the bill (H.R. 2999) to amend the Public Health 
Service Act to enhance and increase the number of veterinarians 
trained in veterinary public health, having considered the 
same, report favorably thereon with an amendment and recommend 
that the bill as amended do pass.

                                CONTENTS

                                                                   Page
Amendment........................................................     2
Purpose and Summary..............................................     2
Background and Need for Legislation..............................     2
Committee Consideration..........................................     3
Committee Votes..................................................     3
Committee Oversight Findings and Recommendations.................     3
New Budget Authority, Entitlement Authority, and Tax Expenditures     4
Statement of General Performance Goals and Objectives............     4
Constitutional Authority Statement...............................     4
Earmarks and Tax and Tariff Benefits.............................     4
Federal Advisory Committee Statement.............................     4
Applicability of Law to the Legislative Branch...................     4
Federal Mandates Statement.......................................     4
Committee Cost Estimate..........................................     4
Congressional Budget Office Cost Estimate........................     5
Section-by-Section Analysis of the Legislation...................     6
Explanation of Amendments........................................     6
Changes in Existing Law Made by the Bill, as Reported............     6

                               Amendment

    The amendment is as follows:
    Strike all after the enacting clause and insert the 
following:

SECTION 1. SHORT TITLE.

  This Act may be cited as the ``Veterinary Public Health Amendments 
Act of 2010''.

SEC. 2. INCLUSION OF VETERINARY PUBLIC HEALTH IN CERTAIN PUBLIC HEALTH 
                    WORKFORCE PROVISIONS.

  (a) Public Health Workforce Grants.--Subsections (b)(1)(A) and (d)(6) 
of section 765 of the Public Health Service Act (42 U.S.C. 295) are 
amended by inserting ``veterinary public health,'' after ``preventive 
medicine,'' each place it appears.
  (b) Public Health Workforce Loan Repayment Program.--
          (1) In general.--Subparagraphs (A) and (B) of section 
        776(b)(1) of the Public Health Service Act (42 U.S.C. 295f-
        1(b)(1)) are amended by striking ``public health or health 
        professions degree or certificate'' each place it appears and 
        inserting ``public health (including veterinary public health) 
        or health professions degree or certificate''.
          (2) Technical correction.--Subparagraph (A) of section 
        776(b)(1) of the Public Health Service Act (42 U.S.C. 295f-
        1(b)(1)) is amended by adding ``or'' at the end.
  (c) Definition.--Section 799B of the Public Health Service Act (42 
U.S.C. 295p) is amended by adding at the end the following:
          ``(27) Veterinary public health.--The term `veterinary public 
        health' includes veterinarians engaged in one or more of the 
        following areas to the extent such areas have an impact on 
        human health: biodefense and emergency preparedness, emerging 
        and reemerging infectious diseases, environmental health, 
        ecosystem health, pre- and post-harvest food protection, 
        regulatory medicine, diagnostic laboratory medicine, veterinary 
        pathology, biomedical research, the practice of food animal 
        medicine in rural areas, and government practice.''.

                          Purpose and Summary

    H.R. 2999, the ``Veterinary Public Health Workforce and 
Education Act'', was introduced on June 23, 2009, by Rep. Tammy 
Baldwin (D-WI), and referred to the Committee on Energy and 
Commerce.
    The goal of H.R. 2999 is to help increase the number of 
veterinary public health professionals. The bill provides 
resources toward that end.

                  Background and Need for Legislation

    Veterinary medicine is an important component of our public 
health system.\1\ Veterinarians protect human health through 
early detection and response to disease events that can be 
linked to newly-emerging infectious diseases, such as SARS or 
West Nile Virus. They can also assist in the response to 
threats, such as the 2009 H1N1 (flu) outbreak.
---------------------------------------------------------------------------
    \1\World Health Organization Study Group on Future Trends in 
Veterinary Public Health, Future Trends in Veterinary Public Health 
(2002).
---------------------------------------------------------------------------
    There are critical shortages of veterinarians working in 
public health disciplines. A February 2009 report from the 
Government Accountability Office warns that ``there is a 
growing shortage of veterinarians nationwide, particularly of 
veterinarians who care for animals raised for food, serve in 
rural communities, and have training in public health.''\2\ 
Furthermore, the report states that the ``veterinarian shortage 
is expected to worsen'' even as ``the demand for veterinarians 
is expected to increase.''
---------------------------------------------------------------------------
    \2\Government Accountability Office, Veterinarian Workforce: 
Actions Are Needed to Ensure Sufficient Capacity for Protecting Public 
and Animal Health (Feb. 4, 2009) (GAO-09-178).
---------------------------------------------------------------------------
    Since 1967, the Health Resources and Services 
Administration (HRSA) and its precedent organizations, have 
administered programs supporting health professionals, 
including public health professionals. Section 765 of the 
Public Health Service Act (PHSA) currently provides authority 
for the Secretary of the Department of Health and Human 
Services (HHS) to award grants to, or enter into contracts 
with, training institutions to increase the number of 
individuals in the public health workforce; to enhance the 
quality of the workforce; and to enhance the ability of the 
workforce to meet national, state, and local needs. 
Additionally, the Patient Protection and Affordable Care Act 
(P.L. 111-148) authorized a new loan repayment program in PHSA 
Section 776 to support public health professionals that serve 
in federal, state, local, and tribal public health agencies. 
While veterinary public health professionals are not excluded 
from participation in these programs, their participation is 
not explicitly required or permitted.

                        Committee Consideration

    H.R. 2999, the ``Veterinary Public Health Amendments Act of 
2010'', was introduced by Ms. Baldwin of Wisconsin on June 23, 
2009, and referred to the Committee on Energy and Commerce. The 
bill was subsequently referred to the Subcommittee on Health on 
June 24, 2009. On September 15, 2010, the Subcommittee held a 
legislative hearing on the bill. The Subcommittee met in open 
markup session to consider H.R. 2999 on September 16, 2010. An 
amendment in the nature of a substitute (manager's amendment) 
by Ms. Baldwin was adopted by a voice vote. Subsequently, H.R. 
2999 was favorably forwarded to the full Committee, amended, by 
a voice vote.
    On September 23, 2010, the Committee on Energy and Commerce 
met in open markup session to consider H.R. 2999 as approved by 
the Subcommittee on Health. An amendment offered by Ms. Baldwin 
was adopted by a voice vote. Subsequently the Committee ordered 
H.R. 2999 favorably reported to the House, amended, by a voice 
vote.

                            Committee Votes

    Clause 3(b) of rule XIII of the Rules of the House of 
Representatives requires the Committee to list each record vote 
on the motion to report legislation and amendments thereto. A 
motion by Mr. Waxman ordering H.R. 2999 reported to the House, 
amended, was approved by a voice vote. There were no record 
votes taken during consideration of this bill.

            Committee Oversight Findings and Recommendations

    In compliance with clause 3(c)(1) of rule XIII and clause 
2(b)(1) of rule X of the Rules of the House of Representatives, 
the oversight findings and recommendations of the Committee are 
reflected in the descriptive portions of this report, including 
the finding that there are shortages of veterinarians working 
in public health disciplines.

   New Budget Authority, Entitlement Authority, and Tax Expenditures

    Regarding compliance with clause 3(c)(2) of rule XIII of 
the Rules of the House of Representatives, the Committee finds 
that H.R. 2999 would result in no new budget authority, 
entitlement authority, or tax expenditures or revenues.

         Statement of General Performance Goals and Objectives

    In accordance with clause 3(c)(4) of rule XIII of the Rules 
of the House of Representatives, the performance goals and 
objectives of the Committee are reflected in the descriptive 
portions of this report, including the goal of increasing the 
number of veterinary public health professionals.

                   Constitutional Authority Statement

    Pursuant to clause 3(d)(1) of rule XIII of the Rules of the 
House of Representatives, the Committee finds that the 
constitutional authority for H.R. 2999 is provided under 
article I, section 8, clauses 3 and 18 of the Constitution of 
the United States.

                  Earmarks and Tax and Tariff Benefits

    H.R. 2999 does not contain any congressional earmarks, 
limited tax benefits, or limited tariff benefits as defined in 
clause 9 of rule XXI of the Rules of the House of 
Representatives.

                  Federal Advisory Committee Statement

    The Committee finds that the legislation does not establish 
or authorize the establishment of an advisory committee within 
the definition of 5 U.S.C. App., section 5(b) of the Federal 
Advisory Committee Act.

             Applicability of Law to the Legislative Branch

    Section 102(b)(3) of Public Law 104-1 requires a 
description of the application of this bill to the legislative 
branch where the bill relates to terms and conditions of 
employment or access to public services and accommodations. 
H.R. 2999 contains no such provisions.

                       Federal Mandates Statement

    Section 423 of the Congressional Budget and Impoundment 
Control Act of 1974 (as amended by section 101(a)(2) of the 
Unfunded Mandates Reform Act, Public Law 104-4) requires a 
statement on whether the provisions of the report include 
unfunded mandates. In compliance with this requirement the 
Committee adopts as its own the analysis of federal mandates 
prepared by the Director of the Congressional Budget Office 
regarding H.R. 2999.

                        Committee Cost Estimate

    Pursuant to clause 3(d)(2) of rule XIII of the Rules of the 
House of Representatives, the Committee adopts as its own the 
cost estimate of H.R. 2999 prepared by the Director of the 
Congressional Budget Office pursuant to section 402 of the 
Congressional Budget Act of 1974.

               Congressional Budget Office Cost Estimate

    With respect to the requirements of clause 3(c)(3) of rule 
XIII of the Rules of the House of Representatives and section 
402 of the Congressional Budget Act of 1974, the Committee has 
received the following cost estimate for H.R. 2999 from the 
Director of Congressional Budget Office:

                                                September 24, 2010.
Hon. Henry A. Waxman,
Chairman, Committee on Energy and Commerce,
House of Representatives, Washington, DC.
    Dear Mr. Chairman: The Congressional Budget Office has 
prepared the enclosed cost estimate for H.R. 2999, Veterinary 
Public Health Amendments Act of 2010.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Lisa Ramirez-
Branum, who can be reached at 226-9010.
            Sincerely,
                                              Douglas W. Elmendorf.
    Enclosure.

H.R. 2999--Veterinary Public Health Amendments Act of 2010

    Under current law, the Health Resources and Services 
Administration is authorized to provide loans or grants to 
certain individuals or entities with the goal of increasing and 
improving the public health workforce. H.R. 2999 would amend 
the Public Health Service Act by providing access to those 
programs for certain veterinary health professionals and 
educational organizations. The bill would allow entities that 
provide education and training in veterinary public health to 
apply for and receive grant assistance from the Public Health 
Workforce Grant program. In addition, the bill would allow 
certain individuals that will receive or have received a degree 
in veterinary public health to apply for and receive loan 
assistance under the Public Health Workforce Loan Repayment 
program.
    Based on the cost of changes in eligibility for grants and 
assistance in similar programs, CBO estimates that implementing 
H.R. 2999 would have a negligible impact on federal spending 
over the next five years; any additional spending would be 
subject to the availability of appropriated funds. Enacting 
this legislation would not affect direct spending or revenues; 
therefore, pay-as-you-go procedures do not apply.
    H.R. 2999 contains no intergovernmental or private-sector 
mandates as defined in the Unfunded Mandates Reform Act. State 
and local governments, including public institutions of higher 
education that provide education and training in veterinary 
public health, would benefit from expanded eligibility 
authorized in the bill.
    The CBO staff contact for this estimate is Lisa Ramirez-
Branum. This estimate was approved by Holly Harvey, Deputy 
Assistant Director for Budget Analysis.

             Section-by-Section Analysis of the Legislation


Section 1. Short title

    Section 1 designates that the short title may be cited as 
the ``Veterinary Public Health Amendments Act of 2010''.

Section 2. Inclusion of veterinary public health in certain public 
        health workforce provisions

    Section 2 clarifies that ``veterinary public health'' 
professionals are intended to be included among the health 
professionals for purposes of two PHSA sections. The first 
provision, PHSA section 765, currently provides authority for 
the Secretary of HHS to award grants and contracts to eligible 
entities to increase the number of individuals in the public 
health workforce, to enhance the quality of the health 
workforce, and to enhance the ability of the health workforce 
to meet national, state, and local needs. The second provision, 
PHSA section 776, provides for a loan repayment program for 
public health professionals. Section 2 of the Act clarifies 
that veterinary public health professionals are considered 
public health professionals for the purposes of both PHSA 
section 765 and PHSA section 776.
    Section 2 also defines ``veterinary public health'' to 
include veterinarians engaged in one or more of the following 
areas to the extent such areas have an impact on human health: 
biodefense and emergency preparedness, emerging and reemerging 
infectious diseases, environmental health, ecosystem health, 
pre-harvest and post-harvest food protection, regulatory 
medicine, diagnostic laboratory medicine, veterinary pathology, 
biomedical research, practice of food animal medicine in rural 
areas, and government practice.

                       Explanation of Amendments

    During the Subcommittee on Health markup of H.R. 2999, Ms. 
Baldwin of Wisconsin offered an amendment in the nature of a 
substitute (manager's amendment), which was adopted by a voice 
vote. During full Committee consideration of H.R. 2999, Ms. 
Baldwin offered a technical amendment to the bill as amended by 
the Subcommittee on Health, also adopted by a voice vote. The 
substance of each amendment is reflected in the section-by-
section analysis contained in this report.

         Changes in Existing Law Made by the Bill, as Reported

  In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (existing law 
proposed to be omitted is enclosed in black brackets, new 
matter is printed in italic, existing law in which no change is 
proposed is shown in roman):

PUBLIC HEALTH SERVICE ACT

           *       *       *       *       *       *       *



TITLE VII--HEALTH PROFESSIONS EDUCATION

           *       *       *       *       *       *       *


PART E--HEALTH PROFESSIONS AND PUBLIC HEALTH WORKFORCE

           *       *       *       *       *       *       *


                   Subpart 2--Public Health Workforce

SEC. 765. GENERAL PROVISIONS.

  (a) * * *
  (b) Eligibility.--To be eligible to receive a grant or 
contract under subsection (a) an entity shall--
          (1) be--
                  (A) a health professions school, including an 
                accredited school or program of public health, 
                health administration, preventive medicine, 
                veterinary public health, or dental public 
                health or a school providing health management 
                programs;

           *       *       *       *       *       *       *

  (d) Activities.--Amounts provided under a grant or contract 
awarded under this section may be used for--
          (1) * * *

           *       *       *       *       *       *       *

          (6) the retraining of existing public health workers 
        as well as for increasing the supply of new 
        practitioners to address priority public health, 
        preventive medicine, veterinary public health, public 
        health dentistry, and health administration needs;

           *       *       *       *       *       *       *


Subpart 3--Recruitment and Retention Programs

           *       *       *       *       *       *       *


SEC. 776. PUBLIC HEALTH WORKFORCE LOAN REPAYMENT PROGRAM.

  (a) * * *
  (b) Eligibility.--To be eligible to participate in the 
Program, an individual shall--
          (1)(A) be accepted for enrollment, or be enrolled, as 
        a student in an accredited academic educational 
        institution in a State or territory in the final year 
        of a course of study or program leading to a [public 
        health or health professions degree or certificate] 
        public health (including veterinary public health) or 
        health professions degree or certificate; and have 
        accepted employment with a Federal, State, local, or 
        tribal public health agency, or a related training 
        fellowship, as recognized by the Secretary, to commence 
        upon graduation; or
          (B)(i) have graduated, during the preceding 10-year 
        period, from an accredited educational institution in a 
        State or territory and received a [public health or 
        health professions degree or certificate] public health 
        (including veterinary public health) or health 
        professions degree or certificate; and

           *       *       *       *       *       *       *


PART F--GENERAL PROVISIONS

           *       *       *       *       *       *       *


SEC. 799B. DEFINITIONS.

  For purposes of this title:
          (1) * * *

           *       *       *       *       *       *       *

          (27) Veterinary public health.--The term ``veterinary 
        public health'' includes veterinarians engaged in one 
        or more of the following areas to the extent such areas 
        have an impact on human health: biodefense and 
        emergency preparedness, emerging and reemerging 
        infectious diseases, environmental health, ecosystem 
        health, pre- and post-harvest food protection, 
        regulatory medicine, diagnostic laboratory medicine, 
        veterinary pathology, biomedical research, the practice 
        of food animal medicine in rural areas, and government 
        practice.

           *       *       *       *       *       *       *