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Title II — Improving preparedness and response

S. 2852 · 115th Congress · May 15, 2018 · Lineage

II Improving preparedness and response

Sec. 201 Improving benchmarks and standards for preparedness and response

(a)
Evaluating measurable evidence-Based benchmarks and objective standards— Section 319C–1 (42 U.S.C. 247d–3a) is amended by inserting after subsection (j) the following:

“(k) Evaluation

“(1) In general—Not later than 2 years after the date of enactment of the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 and every 2 years thereafter, the Secretary shall conduct an evaluation of the evidence-based benchmarks and objective standards required under subsection (g). Such evaluation shall be submitted to the congressional committees of jurisdiction together with the National Health Security Strategy under section 2802, at such time as such strategy is submitted.

“(2) Content—The evaluation under this paragraph shall include—

“(A) a review of evidence-based benchmarks and objective standards, and associated metrics and targets;

“(B) a discussion of changes to any evidence-based benchmarks and objective standards, and the effect of such changes on the ability to track whether entities are meeting or making progress toward the goals under this section and, to the extent practicable, the applicable goals of the National Health Security Strategy under section 2802;

“(C) a description of amounts received by eligible entities, as described in subsection (b) and section 319C–2(b), and amounts received by sub-recipients and the effect of such funding on meeting evidence-based benchmarks and objective standards; and

“(D) recommendations, as applicable and appropriate, to improve evidence-based benchmarks and objective standards to more accurately assess the ability of entities receiving awards under this section to better achieve the goals under this section and section 2802.”

(b)
Evaluating the partnership for State and regional hospital preparedness— Section 319C–2(i)(1) (42 U.S.C. 247–3b(i)(1)) is amended by striking “section 319C–1(g), (i), and (j)” and inserting “section 319C–1(g), (i), (j), and (k)”.

Sec. 202 Amendments to preparedness and response programs

(a)
Cooperative agreement applications for improving State and local public health security— Section 319C–1 (42 U.S.C. 247d–3a) is amended—
(1)
in subsection (a), by inserting “, acting through the Director of the Centers for Disease Control and Prevention,” after “the Secretary”; and
(2)
in subsection (b)(2)(A)—
(A)
in clause (vi), by inserting “, including public health agencies with specific expertise that may be relevant to public health security, such as environmental health agencies,” after “stakeholders”;
(B)
by redesignating clauses (vii) through (ix) as clauses (viii) through (x); and
(C)
by inserting after clause (vi) the following:

“(vii) a description of how, as applicable, such entity may integrate information to account for individuals with behavioral health needs following a public health emergency;”

(b)
Partnership for State and regional hospital preparedness To improve surge capacity— Section 319C–2 (42 U.S.C. 247d–3b) is amended—
(1)
in subsection (a)—
(A)
by inserting “, acting through the Assistant Secretary for Preparedness and Response,” after “The Secretary”; and
(B)
by striking “preparedness for public health emergencies” and inserting “preparedness for, and response to, public health emergencies in accordance with subsection (c)”; and
(2)
in subsection (b)(1)(A)—
(A)
in clause (iii), by redesignating subclauses (I) through (III) as items (aa) through (cc), respectively, and adjusting the margins accordingly;
(B)
by redesignating clauses (i) through (iii) as subclauses (I) through (III) respectively, and adjusting the margins accordingly;
(C)
by striking “partnership consisting of—” and inserting “partnership—

“(i) consisting of—”

(D)
by adding at the end the following:

“(ii) that may include one or more emergency medical service organizations or emergency management organizations; and”

(c)
Public health security grants authorization of appropriations— Section 319C–1(h)(1)(A) (42 U.S.C. 247d–3a(h)(1)(A)) is amended by striking “$641,900,000 for fiscal year 2014” and all that follows through the period at the end and inserting “$685,000,000 for each of fiscal years 2019 through 2023 for awards pursuant to paragraph (3) (subject to the authority of the Secretary to make awards pursuant to paragraphs (4) and (5)).”.
(d)
Partnership for State and regional hospital preparedness authorization of appropriations— Section 319C–2(j) (42 U.S.C. 247d–3b(j)) is amended—
(1)
by amending paragraph (1) to read as follows:

“(1) In general

“(A) Authorization of appropriations—For purposes of carrying out this section and section 319C–3, in accordance with subparagraph (B), there is authorized to be appropriated $385,000,000 for each of fiscal years 2019 through 2023.

“(B) Reservations of amounts for regional systems

“(i) In general—Subject to clause (ii), of the amount appropriated under subparagraph (A) for a fiscal year, the Secretary may reserve up to 5 percent for the purpose of carrying out section 319C–3.

“(ii) Reservations contingent on continued appropriations—If the amount appropriated under subparagraph (A) for fiscal year 2019 or a subsequent fiscal year is less than or equal the amount so appropriated for the previous fiscal year, the amount that may be reserved under clause (i) shall be reduced such that the amount remaining for the purpose of carrying out this section is not less than the amount available for such purpose for the previous fiscal year.”

(2)
in paragraph (2), by striking “paragraph (1) for a fiscal year” and inserting “paragraph (1)(A) for a fiscal year and not reserved for the purpose described in paragraph (1)(B)(i)”; and
(3)
in paragraph (3)(A), by striking “paragraph (1) and not reserved under paragraph (2)” and inserting “paragraph (1)(A) and not reserved under paragraph (1)(B)(i) or (2)”.

Sec. 203 Regional health care emergency preparedness and response systems

(a)
In general— Part B of title III (42 U.S.C. 243 et seq.) is amended by inserting after section 319C–2 the following:

“319C–3. Guidelines for regional health care emergency preparedness and response systems

“(a) Purpose—It is the purpose of this section to identify and provide guidelines for regional systems of hospitals, health care facilities, and other public and private sector entities, with varying levels of capability to treat patients and increase medical surge capacity during, and in advance of, a public health emergency, including threats posed by one or more chemical, biological, radiological, and nuclear agents, including emerging infectious diseases.

“(b) Guidelines—The Assistant Secretary for Preparedness and Response, in consultation with the Director of the Centers for Disease Control and Prevention, the Administrator of the Centers for Medicare & Medicaid Services, the Administrator of the Health Resources and Services Administration, the Commissioner of Food and Drugs, the Assistant Secretary for Mental Health and Substance Use, the Assistant Secretary of Labor for Occupational Safety and Health, the Secretary of Veterans Affairs, heads of such other Federal agencies as the Secretary determines to be appropriate, and State, local, tribal, and territorial public health officials, shall, not later than 2 years after the date of enactment of this section—

“(1) identify and develop a set of guidelines relating to practices and protocols for all-hazards public health emergency preparedness and response for hospitals and health care facilities to provide appropriate patient care during, in advance of, or immediately following, a public health emergency, resulting from one or more chemical, biological, radiological, or nuclear agents, including emerging infectious diseases (which may include existing practices, such as trauma care and medical surge capacity and capabilities), with respect to—

“(A) a regional approach to identifying hospitals and health care facilities based on varying capabilities and capacity to treat patients affected by such emergency, including—

“(i) the manner in which the system will coordinate with and integrate the partnerships established under section 319C–2(b); and

“(ii) informing and educating appropriate first responders and health care supply chain partners of the regional emergency preparedness and response capabilities and medical surge capacity of such hospitals and health care facilities in the community;

“(B) physical and technological infrastructure, laboratory capacity, staffing, blood supply, and other supply chain needs, taking into account resiliency, geographic considerations, and rural considerations;

“(C) protocols or best practices for the safety and personal protection of workers who handle human remains and health care workers (including with respect to protective equipment and supplies, waste management processes, and decontamination), sharing of specialized experience among the health care workforce, behavioral health, psychological resilience, and training of the workforce, as applicable;

“(D) in a manner that allows for disease containment (within the meaning of section 2802(b)(2)(B)), coordinated medical triage, treatment, and transportation of patients, based on patient medical need (including patients in rural areas), to the appropriate hospitals or health care facilities within the regional system or, as applicable and appropriate, between systems in different States or regions; and

“(E) the needs of children and other at-risk individuals;

“(2) make such guidelines available on the internet website of the Department of Health and Human Services in a manner that does not compromise national security; and

“(3) update such guidelines as appropriate, including based on input received pursuant to subsections (c), (e), and (f), to address new and emerging public health threats.

“(c) Considerations—In identifying, developing, and updating guidelines under subsection (b), the Assistant Secretary for Preparedness and Response shall—

“(1) include input from hospitals and health care facilities, including health care coalitions under section 319C–2, State, local, tribal, and territorial public health departments, and health care or subject matter experts, including experts with relevant expertise in chemical, biological, radiological, or nuclear threats, and emerging infectious disease as the Assistant Secretary determines appropriate, to meet the goals under section 2802(b)(3);

“(2) consult and engage with appropriate health care providers and professionals, including physicians, nurses, first responders, health care facilities (including hospitals, primary care clinics, community health centers, mental health facilities, ambulatory care facilities, and dental health facilities), pharmacies, emergency medical providers, trauma care providers, environmental health agencies, public health laboratories, poison control centers, blood banks, and other experts that the Assistant Secretary determines appropriate, to meet the goals under section 2802(b)(3);

“(3) consider feedback related to financial implications for hospitals, health care facilities, public health agencies, laboratories, and other entities engaged in regional preparedness planning to implement and follow such guidelines, as applicable; and

“(4) consider financial requirements and potential incentives for entities to prepare for, and respond to, public health emergencies as part of the regional health care emergency preparedness and response system.

“(d) Technical assistance—The Assistant Secretary for Preparedness and Response, in consultation with the Director of the Centers for Disease Control and Prevention and the Assistant Secretary of Labor for Occupational Safety and Health, may provide technical assistance and consultation towards meeting the guidelines described in subsection (b).

“(e) Demonstration project for regional health care preparedness and response systems

“(1) In general—The Assistant Secretary for Preparedness and Response may establish a demonstration project pursuant to the development and implementation of guidelines under subsection (b) to improve medical surge capacity for all hazards, build and integrate regional medical response capabilities, improve specialty care expertise for all-hazards response, and coordinate medical preparedness and response across State, local, tribal, territorial, and regional jurisdictions.

“(2) Sunset—The authority under this subsection shall expire on September 30, 2023.

“(f) GAO report to Congress

“(1) Report—Not later than 3 years after the date of enactment of this section, the Comptroller General of the United States (referred to in this subsection as the “Comptroller General”) shall submit to the Committee on Health, Education, Labor, and Pensions and the Committee on Finance of the Senate and the Committee on Energy and Commerce and the Committee on Ways and Means of the House of Representatives, a report on the extent to which hospitals and health care facilities have implemented the recommended guidelines under subsection (b), including an analysis and evaluation of any challenges hospitals or health care facilities experienced in implementing such guidelines.

“(2) Content—The Comptroller General shall include in the report under paragraph (1)—

“(A) data on the preparedness and response capabilities that have been informed by the guidelines under subsection (b) to improve regional emergency health care preparedness and response capability, including hospital and health care facility capacity and medical surge capabilities to prepare for, and respond to, public health emergencies; and

“(B) recommendations to reduce gaps in incentives for regional health partners, including hospitals and health care facilities to improve capacity and medical surge capabilities to prepare for, and respond to, public health emergencies, consistent with subsection (a), which may include consideration of facilities participating in programs under section 319C–2, programs under the Centers for Medicare & Medicaid Services (including innovative health care delivery and payment models), and input from private sector financial institutions.

“(3) Consultation—In carrying out paragraphs (1) and (2), the Comptroller General shall consult with the heads of appropriate Federal agencies, including—

“(A) the Assistant Secretary for Preparedness and Response;

“(B) the Director of the Centers for Disease Control and Prevention;

“(C) the Administrator of the Centers for Medicare & Medicaid Services;

“(D) the Assistant Secretary for Mental Health and Substance Use;

“(E) the Assistant Secretary of Labor for Occupational Safety and Health;

“(F) the Secretary of Veterans Affairs; and

“(G) the heads of such other Federal agencies as the Secretary determines appropriate.”

(b)
Annual reports— Section 319C–2(i)(1) (42 U.S.C. 247d–3b(i)(1)) is amended by inserting after the first sentence the following “The reports submitted under this paragraph shall also include progress towards the implementation of section 319C–3.”.
(c)
National health security strategy incorporation of regionalized emergency preparedness and response— Section 2802(b)(3) (42 U.S.C. 300hh–1(b)(3)) is amended—
(1)
in the matter preceding subparagraph (A), by striking “including mental health” and inserting “including pharmacies, mental health facilities,”; and
(2)
by amending subparagraph (G) to read as follows:

“(G) Optimizing a coordinated and flexible approach to the emergency response and medical surge capacity of hospitals, other health care facilities, critical care, trauma care (which may include trauma centers), and emergency medical systems, which may include the implementation of guidelines for regional health care emergency preparedness and response systems under section 319C–3.”

(d)
Improving State and local public health security—
(1)
State and local security— Section 319C–1(e) (42 U.S.C. 247d–3a(e)) is amended by striking “, and local emergency plans.” and inserting “, local emergency plans, and any regional health care emergency preparedness and response system established pursuant to the applicable guidelines under section 319C–3.”.
(2)
Partnerships— Section 319C–2(d)(1)(A) (42 U.S.C. 247d–3b(d)(1)(A)) is amended—
(A)
in clause (i), by striking “; and” and inserting “;”;
(B)
by redesignating clause (ii) as clause (iii); and
(C)
inserting after clause (i), the following:

“(ii) among one or more facilities in a regional health care emergency system under section 319C–3; and”

Sec. 204 Public health and health care system situational awareness and biosurveillance capabilities

(a)
Facilities, capacities, and biosurveillance capabilities— Section 319D (42 U.S.C. 247d–4) is amended—
(1)
in the section heading, by striking “Revitalizing” and inserting “Facilities and capacities of”;
(2)
in subsection (a)—
(A)
in the subsection heading, by striking “Facilities; capacities” and inserting “In general”;
(B)
in paragraph (1), by striking “and improved” and inserting “, improved, and appropriately maintained”;
(C)
in paragraph (3), in the matter preceding subparagraph (A), by striking “expand, enhance, and improve” and inserting “expand, improve, enhance, and appropriately maintain”; and
(D)
by adding at the end the following:

“(4) Study of resources for facilities and capacities—Not later than June 1, 2022, the Comptroller General of the United States shall conduct a study on Federal spending in fiscal years 2013 through 2018 for activities authorized under this subsection. Such study shall include a review and assessment of obligations and expenditures directly related to each activity under paragraphs (2) and (3), including a specific accounting of, and delineation between, obligations and expenditures incurred for the construction, renovation, equipping, and security upgrades of facilities and associated contracts under this subsection, and the obligations and expenditures incurred to establish and improve the situational awareness and biosurveillance network under subsection (b), and shall identify the agency or agencies incurring such obligations and expenditures.”

(3)
in subsection (b)—
(A)
in the subsection heading, by striking “national” and inserting “Establishment of systems of public health ”;
(B)
in paragraph (1)(B), by inserting “immunization information systems,” after “centers,”;
(C)
in paragraph (2)—
(i)
by inserting “develop a plan to, and” after “The Secretary shall”; and
(ii)
by inserting “and in a form readily usable for analytical approaches” after “in a secure manner”; and
(D)
by amending paragraph (3) to read as follows:

“(3) Standards

“(A) In general—Not later than 1 year after the date of the enactment of the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018, the Secretary, in cooperation with health care providers, State, local, tribal, and territorial public health officials, and relevant Federal agencies (including the Office of the National Coordinator for Health Information Technology and the National Institute of Standards and Technology), shall, as necessary, adopt technical and reporting standards, including standards for interoperability as defined by section 3000, for networks under paragraph (1) and update such standards as necessary. Such standards shall be made available on the internet website of the Department of Health and Human Services, in a manner that does not compromise national security.

“(B) Deference to standards development organizations—In adopting and implementing standards under this subsection and subsection (c), the Secretary shall give deference to standards published by standards development organizations and voluntary consensus-based standards entities.”

(4)
in subsection (c)—
(A)
in paragraph (1)—
(i)
by striking “Not later than 2 years after the date of enactment of the Pandemic and All-Hazards Preparedness Reauthorization Act of 2013, the Secretary” and inserting “The Secretary”;
(ii)
by inserting “, and improve as applicable and appropriate,” after “shall establish”;
(iii)
by striking “of rapid” and inserting “of, rapid”; and
(iv)
by striking “such connectivity” and inserting “such interoperability”;
(B)
by amending paragraph (2) to read as follows:

“(2) Coordination and consultation—In establishing and improving the network under paragraph (1) the Secretary shall—

“(A) facilitate coordination among agencies within the Department of Health and Human Services that provide or have the potential to provide information and data to, and analyses for, the situational awareness and biosurveillance network under paragraph (1), including coordination among relevant agencies related to health care services, the facilitation of health information exchange (including the Office of the National Coordinator for Health Information Technology), and public health emergency preparedness and response; and

“(B) consult with the Secretary of Agriculture, the Secretary of Commerce (and the Director of the National Institute of Standards and Technology), the Secretary of Defense, the Secretary of Homeland Security, and the Secretary of Veterans Affairs, and the heads of other Federal agencies, as the Secretary determines appropriate.”

(C)
in paragraph (3)—
(i)
by redesignating subparagraphs (A) through (E) as clauses (i) through (v), respectively, and adjusting the margins accordingly;
(ii)
in clause (iv), as so redesignated—
(I)
by inserting “immunization information programs,” after “poison control,”; and
(II)
by striking “and clinical laboratories” and inserting “, clinical laboratories, and public environmental health agencies”;
(iii)
by striking “The network” and inserting the following:

“(A) In general—The network”

(iv)
by adding at the end the following:

“(B) Review—Not later than 2 years after the date of the enactment of the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 and every 6 years thereafter, the Secretary shall conduct a review of the elements described in subparagraph (A). Such review shall include a discussion of the addition of any elements pursuant to clause (v), including elements added to advancing new technologies, and identify any challenges in the incorporation of elements under subparagraph (A). The Secretary shall provide such review to the congressional committees of jurisdiction.”

(D)
in paragraph (5)—
(i)
by redesignating subparagraphs (A) through (D) as clauses (i) through (iv), respectively, and adjusting the margins accordingly;
(ii)
by striking “In establishing” and inserting the following:

“(A) In general—In establishing”

(iii)
by adding at the end the following:

“(B) Public meeting

“(i) In general—Not later than 180 days after the date of enactment of the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018, the Secretary shall convene a public meeting for purposes of discussing and providing input on the potential goals, functions, and uses of the network described in paragraph (1) and incorporating the elements described in paragraph (3)(A).

“(ii) Experts—The public meeting shall include representatives of relevant Federal agencies (including representatives from the Office of the National Coordinator for Health Information Technology and the National Institute of Standards and Technology), State, local, tribal, and territorial public health officials, stakeholders with expertise in biosurveillance and situational awareness, and stakeholders with expertise in capabilities relevant to biosurveillance and situational awareness, such as experts in informatics and data analytics (including experts in prediction and forecasting), and other representatives as the Secretary determines appropriate.

“(iii) Topics—Such public meeting shall include a discussion of—

“(I) data elements, including minimal or essential data elements, that are voluntarily provided for such network, which may include elements from public health and public and private health care entities, to the extent practicable;

“(II) standards and implementation specifications that may improve the collection, analysis, and interpretation of data during a public health emergency;

“(III) strategies to encourage the access, exchange, and use of information;

“(IV) considerations for State, local, tribal, and territorial capabilities and infrastructure related to data exchange and interoperability;

“(V) privacy and security protections provided at the Federal, State, local, tribal, and territorial levels, and by nongovernmental stakeholders; and

“(VI) opportunities for the incorporation of innovative technologies to improve the network.”

(iv)
in subparagraph (A), as so designated by clause (ii)—
(I)
in clause (i), as so redesignated—
(aa)
by striking “as determined” and inserting “as adopted”; and
(bb)
by inserting “and the National Institute of Standards and Technology” after “Office of the National Coordinator for Health Information Technology”;
(II)
in clause (iii), as so redesignated, by striking “; and” and inserting a semicolon;
(III)
in clause (iv), as so redesignated, by striking the period and inserting “; and”; and
(IV)
by adding at the end the following:

“(v) pilot test standards and implementation specifications, consistent with the process described in section 3002(b)(3)(C), which State, local, tribal, and territorial public health entities may utilize, on a voluntary basis, as a part of the network.”

(E)
by redesignating paragraph (6) as paragraph (7);
(F)
by inserting after paragraph (5) the following:

“(6) Strategy and implementation plan

“(A) In general—Not later than 18 months after the date of enactment of the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018, the Secretary shall submit to the appropriate committees of Congress a coordinated strategy and an accompanying implementation plan that—

“(i) is informed by the public meeting under paragraph (5)(B);

“(ii) includes a review and assessment of existing capabilities of the network and related infrastructure, including input provided by the public meeting under paragraph (5)(B);

“(iii) identifies and demonstrates the measurable steps the Secretary will carry out to—

“(I) develop, implement, and evaluate the network described in paragraph (1), utilizing elements described in paragraph (3)(A);

“(II) modernize and enhance biosurveillance activities, including strategies to include innovative technologies and analytical approaches (including prediction and forecasting for pandemics and all-hazards) from public and private entities;

“(III) improve information sharing, coordination, and communication among disparate biosurveillance systems supported by the Department of Health and Human Services, including the identification of methods to improve accountability, better utilize resources and workforce capabilities, and incorporate innovative technologies within and across agencies; and

“(IV) test and evaluate capabilities of the interoperable network of systems to improve situational awareness and biosurveillance capabilities;

“(iv) includes performance measures and the metrics by which performance measures will be assessed with respect to the measurable steps under clause (iii); and

“(v) establishes dates by which each measurable step under clause (iii) will be implemented.”

“(B) Annual budget plan—Not later than 2 years after the date of enactment of the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 and on an annual basis thereafter, in accordance with the strategy and implementation plan under this paragraph, the Secretary shall, taking into account recommendations provided by the National Biodefense Science Board, develop a budget plan based on the strategy and implementation plan under this section. Such budget plan shall include—

“(i) a summary of resources previously expended to establish, improve, and utilize the nationwide public health situational awareness and biosurveillance network under paragraph (1);

“(ii) estimates of costs and resources needed to establish and improve the network under paragraph (1) according to the strategy and implementation plan under subparagraph (A);

“(iii) the identification of gaps and inefficiencies in nationwide public health situational awareness and biosurveillance capabilities, resources, and authorities needed to address such gaps; and

“(iv) a strategy to minimize and address such gaps and improve inefficiencies.”

(G)
in paragraph (7), as so redesignated—
(i)
in subparagraph (A), by inserting “(taking into account zoonotic disease, including gaps in scientific understanding of the interactions between human, animal, and environmental health)” after “human health”;
(ii)
in subparagraph (B)—
(I)
by inserting “and gaps in surveillance programs” after “surveillance programs”; and
(II)
by striking “; and” and inserting a semicolon;
(iii)
in subparagraph (C)—
(I)
by inserting “, animal health organizations related to zoonotic disease,” after “health care entities”; and
(II)
by striking the period and inserting “; and”; and
(iv)
by adding at the end the following:

“(D) provide recommendations to the Secretary on policies and procedures to complete the steps described in this paragraph in a manner that is consistent with section 2802.”

(H)
by adding at the end the following:

“(8) Situational awareness and biosurveillance as a national security priority—The Secretary, on a periodic basis as applicable and appropriate, shall meet with the Director of National Intelligence to inform the development and capabilities of the nationwide public health situational awareness and biosurveillance network.”

(5)
in subsection (d)—
(A)
in paragraph (1)—
(i)
by inserting “environmental health agencies,” after “public health agencies,”; and
(ii)
by inserting “immunization programs,” after “poison control centers,”; and
(B)
in paragraph (2)—
(i)
in subparagraph (B), by striking “and” at the end;
(ii)
in subparagraph (C), by striking the period and inserting “; and”; and
(iii)
by adding after subparagraph (C) the following:

“(D) an implementation plan that may include measurable steps to achieve the purposes described in paragraph (1).”

(C)
by striking paragraph (5) and inserting the following:

“(5) Technical assistance—The Secretary may provide technical assistance to States, localities, tribes, and territories or a consortium of States, localities, tribes, and territories receiving an award under this subsection regarding interoperability and the technical standards set forth by the Secretary.”

(6)
by redesignating subsections (f) and (g) as subsections (h) and (i), respectively; and
(7)
by inserting after subsection (e) the following:

“(f) Timeline—The Secretary shall accomplish the purposes under subsections (b) and (c) no later than September 30, 2023, and shall provide a justification to Congress for any missed or delayed implementation of measurable steps identified under subsection (c)(6)(A)(iii).

“(g) Independent evaluation—Not later than 3 years after the date of enactment of the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018, the Comptroller General of the United States shall conduct an independent evaluation, and submit to the Secretary and the appropriate committees of Congress a report concerning the activities conducted under subsections (b) and (c), and provide recommendations, as applicable and appropriate, on necessary improvements to the biosurveillance and situational awareness network.”

(b)
Authorization of appropriations— Subsection (h) of section 319D (42 U.S.C. 247d–4), as redesignated by subsection (a)(6), is amended by striking “$138,300,000 for each of fiscal years 2014 through 2018” and inserting “$161,800,000 for each of fiscal years 2019 through 2023”.

Sec. 205 Strengthening and supporting the public health emergency rapid response fund

Section 319 of the Public Health Service Act (42 U.S.C. 247d) is amended—
(1)
in subsection (b)—
(A)
in paragraph (1)—
(i)
in the first sentence, by inserting “or if the Secretary determines there is the significant potential for a public health emergency, to allow the Secretary to rapidly respond to the immediate needs resulting from such public health emergency or potential public health emergency” before the period; and
(ii)
by inserting “The Secretary shall plan for the expedited distribution of funds to appropriate agencies and entities.” after the first sentence;
(B)
by redesignating paragraph (2) as paragraph (3);
(C)
by inserting after paragraph (1) the following:

“(2) Uses—The Secretary may use amounts in the Fund established under paragraph (1), to—

“(A) facilitate coordination between and among Federal, State, local, tribal, and territorial entities and public and private health care entities that the Secretary determines may be affected by a public health emergency or potential public health emergency (including communication of such entities with relevant international entities, as applicable);

“(B) make grants, provide for awards, enter into contracts, and conduct supportive investigations pertaining to a public health emergency or potential public health emergency, including further supporting programs under section 319C–1 or 319C–2;

“(C) facilitate and accelerate, as applicable, advanced research and development of security countermeasures (as defined in section 319F–2), qualified countermeasures (as defined in section 319F–1), or qualified pandemic or epidemic products (as defined in section 319F–3), that are applicable to the public health emergency or potential public health emergency under paragraph (1);

“(D) strengthen biosurveillance capabilities and laboratory capacity to identify, collect, and analyze information on such public health emergency or potential public health emergency, including the systems under section 319D;

“(E) support initial emergency operations and assets related to preparation and deployment of intermittent disaster response personnel expenses under section 2812, and the Medical Reserve Corps under section 2813; and

“(F) other activities, as the Secretary determines applicable and appropriate.”

(D)
by inserting after paragraph (3), as so redesignated, the following:

“(4) Review—Not later than 2 years after the date of enactment of the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018, the Secretary, in coordination with the Assistant Secretary for Preparedness and Response, shall conduct a review of the Fund under this section, and provide recommendations to the Committee on Health, Education, Labor, and Pensions and the Committee on Appropriations of the Senate and the Committee on Energy and Commerce and the Committee on Appropriations of the House of Representatives on policies to improve such Fund for the uses described in paragraph (2).

“(5) GAO report—Not later than 4 years after the date of enactment of the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018, the Comptroller General of the United States shall conduct a review of the Fund under this section, including the uses and the resources available in the Fund.”

(2)
in subsection (c)—
(A)
by inserting “rapidly respond to public health emergencies or potential public health emergencies and” after “used to”; and
(B)
by striking “section.” and inserting “Act or funds otherwise provided for emergency response.”.

Sec. 206 Improving preparedness for and response to all-hazards by public health emergency volunteers

Section 319I (42 U.S.C. 247d–7b) is amended:
(1)
in subsection (a), by adding at the end the following: “Such health care professionals may include members of the National Disaster Medical System, members of the Medical Reserve Corps, and individual health care professionals.”;
(2)
in subsection (i) by adding at the end “In order to inform the development of such mechanisms by States, the Secretary shall make available information and material provided by States that have developed mechanisms to waive the application of licensing requirements to applicable health professionals seeking to provide medical services during a public health emergency. Such information shall be made publicly available in a manner that does not jeopardize national security.”; and
(3)
in subsection (k) by striking “$2014 through 2018” and inserting “2019 through 2023”.