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Title IV — Public Health Infrastructure Improvements

H.R. 14 · 116th Congress · Oct 30, 2020 · Lineage

IV Public Health Infrastructure Improvements

A Public Health Infrastructure Modernization

Sec. 4001 Public health data system transformation

Subtitle C of title XXVIII of the Public Health Service Act (42 U.S.C. 300hh–31 et seq.) is amended by adding at the end the following:

“2822. Public health data system transformation

“(a) Expanding CDC and public health department capabilities

“(1) In general—The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall—

“(A) conduct activities to expand, enhance, and improve public health data systems used by the Centers for Disease Control and Prevention, related to the interoperability and improvement of such systems (including with respect to preparedness for, prevention and detection of, and response to public health emergencies); and

“(B) award grants or cooperative agreements to State, local, Tribal, or territorial public health departments for the expansion and modernization of public health data systems, to assist public health departments in—

“(i) assessing current data infrastructure capabilities and gaps to improve consistency in data collection, storage, and analysis, and as appropriate to improve dissemination of public health-related information;

“(ii) improving secure public health data collection, transmission, exchange, maintenance, and analysis;

“(iii) improving the secure exchange of data between the Centers for Disease Control and Prevention, State, local, Tribal, and territorial public health departments, public health organizations, and health care providers, including—

“(I) between public health officials in multiple jurisdictions within a State; and

“(II) by simplifying and supporting reporting by health care providers pursuant to State law, including through the use of health information technology;

“(iv) enhancing the interoperability of public health data systems (including systems created or accessed by public health departments) with health information technology, including with health information technology certified under section 3001(c)(5);

“(v) supporting and training public health data systems, data science, and informatics personnel;

“(vi) supporting earlier disease and health condition detection, such as through near real-time data monitoring, to support rapid public health responses;

“(vii) supporting activities within the applicable jurisdiction related to the expansion and modernization of electronic case reporting; and

“(viii) developing and disseminating information related to the use and importance of public health data.

“(2) Data standards—In carrying out paragraph (1), the Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall, as appropriate and in coordination with the Office of the National Coordinator for Health Information Technology, designate data and technology standards (including standards for interoperability) for public health data systems, with deference given to standards published by consensus-based standards development organizations with public input and voluntary consensus-based standards bodies.

“(3) Public-private partnerships—The Secretary may develop and utilize public-private partnerships for technical assistance, training, and related implementation support for State, local, Tribal, and territorial public health departments, and the Centers for Disease Control and Prevention, on the expansion and modernization of electronic case reporting and public health data systems, as applicable.

“(b) Requirements

“(1) Health information technology standards—The Secretary may not award a grant or cooperative agreement under subsection (a)(1)(B) unless the applicant uses or agrees to use standards endorsed by the National Coordinator for Health Information Technology pursuant to section 3001(c)(1) or adopted by the Secretary under section 3004.

“(2) Waiver—The Secretary may waive the requirement under paragraph (1) with respect to an applicant if the Secretary determines that the activities under subsection (a)(1)(B) cannot otherwise be carried out within the applicable jurisdiction.

“(3) Application—A State, local, Tribal, or territorial health department applying for a grant or cooperative agreement under this section shall submit an application to the Secretary at such time and in such manner as the Secretary may require. Such application shall include information describing—

“(A) the activities that will be supported by the grant or cooperative agreement; and

“(B) how the modernization of the public health data systems involved will support or impact the public health infrastructure of the health department, including a description of remaining gaps, if any, and the actions needed to address such gaps.

“(c) Strategy and implementation plan—Not later than 180 days after the date of enactment of this section, the Secretary, acting through the Director of the Centers for Disease Control and Prevention, 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 a coordinated strategy and an accompanying implementation plan that identifies and describes the measures the Secretary will utilize to—

“(1) update and improve public health data systems used by the Centers for Disease Control and Prevention; and

“(2) carry out the activities described in this section to support the improvement of State, local, Tribal, and territorial public health data systems.

“(d) Consultation—In carrying out this section, the Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall consult with State, local, Tribal, and territorial public health departments, professional medical and public health associations, associations representing hospitals or other health care entities, health information technology experts, and other appropriate public or private entities.

“(e) Report to Congress—Not later than 1 year after the date of enactment of this section, the Secretary shall submit a report to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives that includes—

“(1) a description of any barriers to—

“(A) public health authorities implementing interoperable public health data systems and electronic case reporting;

“(B) the exchange of information pursuant to electronic case reporting; or

“(C) reporting by health care providers using such public health data systems, as appropriate, and pursuant to State law;

“(2) an assessment of the potential public health impact of implementing electronic case reporting and interoperable public health data systems; and

“(3) a description of the activities carried out pursuant to this section.

“(f) Electronic case reporting—In this section, the term electronic case reporting means the automated identification, generation, and bilateral exchange of reports of health events among electronic health record or health information technology systems and public health authorities.

“(g) Authorization of appropriations—To carry out this section, there is authorized to be appropriated $100,000,000 for each of fiscal years 2021 through 2025.”

B Modernizing infectious disease data collection

Sec. 4011 Modernizing infectious disease data collection

(a)
Improving infectious disease data collection— Section 319D of the Public Health Service Act (42 U.S.C. 247d–4) is amended—
(1)
in subsection (c)—
(A)
in paragraph (3)(A)(iv), by inserting “(such as commercial, academic, and other hospital laboratories)” after “clinical laboratories”;
(B)
in paragraph (5)—
(i)
in subparagraph (A)—
(I)
in the matter preceding clause (i), by striking “and operating” and inserting “, operating, and updating”;
(II)
in clause (iv), by striking “and” at the end;
(III)
in clause (v), by striking the period and inserting “; and”; and
(IV)
by adding at the end the following:

“(vi) integrate and update applicable existing Centers for Disease Control and Prevention data systems and networks in collaboration with State, local, tribal, and territorial public health officials, including public health surveillance and disease detection systems.”

(ii)
in subparagraph (B)—
(I)
in clause (i), by inserting “and 60 days after the date of enactment of the Commitment to Defeat the Virus and Keep America Healthy Act” after “Innovation Act of 2019”;
(II)
in clause (ii), by inserting “epidemiologists, clinical microbiologists, pathologists and laboratory experts, experts in health information technology, privacy, and data security” after “forecasting);”; and
(III)
in clause (iii)—
(aa)
in subclause (V), by striking “and” at the end;
(bb)
in subclause (VI), by striking the period; and
(cc)
by adding at the end the following:

“(VII) strategies to integrate laboratory and epidemiology systems and capabilities to conduct rapid and accurate laboratory tests;

“(VIII) strategies to improve the collection and reporting of appropriate, aggregated, deidentified demographic data to inform responses to public health emergencies, including identification of at-risk populations and to address health disparities; and

“(IX) strategies to improve the electronic exchange of health information between State and local health departments and health care providers and facilities to improve public health surveillance.”

(C)
in paragraph (6)—
(i)
in subparagraph (A)—
(I)
in clause (iii)—
(aa)
in subclause (III), by striking “and” at the end;
(bb)
in subclause (IV), by inserting “, including the ability to conduct and report on rapid and accurate laboratory testing during a public health emergency” before the semicolon; and
(cc)
by adding at the end the following:

“(V) improve coordination and collaboration, as appropriate, with other Federal departments; and

“(VI) implement applicable lessons learned from recent public health emergencies to address gaps in situational awareness and biosurveillance capabilities, including an evaluation of ways to improve the collection and reporting of aggregated, deidentified demographic data to inform public health preparedness and response”

(II)
in clause (iv), by striking “and” at the end;
(III)
in clause (v), by striking the period and inserting “including a description of how such steps will further the goal of improving awareness of and timely responses to emerging infectious disease threats; and”; and
(IV)
by adding at the end the following:

“(vi) identifies and demonstrates measurable steps the Secretary will take to further develop and integrate infectious disease detection, including expanding capabilities to conduct rapid and accurate diagnostic laboratory testing during a public health emergency, and improve coordination and collaboration with State, local, Tribal, and territorial public health officials, clinical laboratories (including commercial, hospital and academic laboratories), and other entities with expertise in public health surveillance.”

(ii)
by redesignating subparagraph (B) as subparagraph (C); and
(iii)
by inserting after subparagraph (A), the following:

“(B) Reports

“(i) In general—Not later than 1 month after date of enactment of the Commitment to Defeat the Virus and Keep America Healthy Act, and as provided for in clause (ii), 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, a report on the status of the Department of Health and Human Services’ biosurveillance modernization and assessment progress with respect to emerging infectious disease threats.

“(ii) Additional reports—During the 2-year period beginning on the date of enactment of the Commitment to Defeat the Virus and Keep America Healthy Act, the Secretary shall provide additional reports under clause (i) every 90 days after the submission of the initial report under such clause. The Secretary shall provide such reports annually thereafter. The Secretary may provide such additional reports less frequently, but not less frequently than every 180 days, during an ongoing public health emergency or another significant infectious disease outbreak.”

(2)
in subsection (d)—
(A)
in paragraph (2)(C), by inserting “, including any public-private partnerships entered into to improve such capacity” before the semicolon; and
(B)
in paragraph (3)—
(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 at the end the following:

“(D) may establish, enhance, or maintain a system or network for the collection of data to provide for early detection of infectious disease outbreaks, near real-time access to relevant electronic data and integration of electronic data and information from public health and other appropriate sources, such as laboratories, hospitals, and epidemiology systems, to enhance the capability to conduct rapid and accurate diagnostic laboratory tests to provide for disease detection.”

(3)
in subsection (f)(1)(A), by inserting “pathologists, clinical microbiologists, laboratory professionals, epidemiologists,” after “forecasting),”; and
(4)
in subsection (h), by adding at the end the following: “Such evaluation shall include identification of any gaps in biosurveillance and situational awareness capabilities identified related to recent public health emergencies, any immediate steps taken to address such gaps, and any long-term plans to address such gaps, including steps related to activities authorized under this section.”.
(b)
National health security strategy— Section 2802(b)(2) of the Public Health Service Act (42 U.S.C. 300hh–1(b)(2)) is amended—
(1)
in subparagraph (A), by inserting “such as by integrating laboratory and epidemiology systems and capability to conduct rapid and accurate laboratory tests,” after “detection, identification,”; and
(2)
in subparagraph (B), by inserting “laboratory testing,” after “services and supplies,”.
(c)
Epidemiology-Laboratory capacity grants— Section 2821(a) of the Public Health Service Act (42 U.S.C. 300hh–31(a)) is amended—
(1)
in paragraph (3), by striking “and”;
(2)
in paragraph (4), by striking the period and inserting “; and”; and
(3)
by adding at the end the following:

“(5) supporting activities of State and local public health departments related to biosurveillance and disease detection, which may include activities related to section 319D, as appropriate.”

C Diagnostic Testing for Public Health Labs

Sec. 4021 Grants for public health laboratories to acquire high-throughput diagnostic equipment

Section 2821 of the Public Health Service Act (42 U.S.C. 300hh–31) is amended—
(1)
by redesignating subsection (b) as subsection (c);
(2)
by inserting after subsection (a) the following new subsection:

“(b) Grants for public health laboratories To acquire high-Throughput diagnostic equipment

“(1) Grants—The Secretary shall award grants to eligible entities to assist such entities in purchasing high-throughput diagnostic equipment and related supplies and in hiring and training staff to use such equipment.

“(2) Eligibility—To be eligible for a grant under paragraph (1), an entity shall—

“(A) be—

“(i) a State, local, or Tribal public health laboratory;

“(ii) a laboratory within a public health laboratory network coordinated or managed by the Centers for Disease Control and Prevention;

“(iii) a laboratory not described in clause (i) or (ii) that the Secretary determines (at the Secretary’s discretion) provides population-based testing for the prevention and control of infectious, communicable, genetic, or chronic diseases; or

“(iv) a consortium of 2 or more entities described in any of clauses (i) through (iii); and

“(B) submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may reasonably require.

“(3) Use of funds—Amounts received through a grant under this subsection shall be used—

“(A) to purchase high-throughput diagnostic equipment and such materials as are necessary to administer, store, and process applicable tests, including diagnostic and serological tests; and

“(B) to hire and train staff to use such equipment.

“(4) Amount of grant—The amount of a grant under paragraph (1) may not exceed $2,000,000, except in the case of eligible entity described in paragraph (2)(A)(iv).

“(5) High-throughput diagnostic equipment defined—In this subsection, the term high-throughput diagnostic equipment means legally marketed equipment and supplies capable of performing multichannel analysis for use in clinical laboratory diagnostic testing.”

(3)
in subsection (c), as so redesignated—
(A)
by redesignating paragraphs (1), (2), and (3) as subparagraphs (A), (B), and (C), respectively, and moving the margin of each such redesignated subparagraph 2 ems to the right;
(B)
by striking “There are authorized to be appropriated to carry out this section” and inserting the following:

“(1) In general—There are authorized to be appropriated to carry out subsection (a)”

(C)
by adding at the end the following new paragraph:

“(2) Authorization of appropriations

“(A) In general—For the purpose of carrying out subsection (b), there is authorized to be appropriated $250,000,000 for fiscal year 2021, to remain available until expended.

“(B) Administrative expenses—Of the amount made available to carry out subsection (b) for any fiscal year, the Secretary may not use more than 5 percent of such amount for the expenses of administering subsection (b).”

D Rapid Testing for Communities

Sec. 4031 Grants for same-day point-of-care clinical laboratory diagnostic testing in communities

Section 2821 of the Public Health Service Act (42 U.S.C. 300hh–31) is amended—
(1)
by redesignating subsection (c), as redesignated by section 4021, as subsection (d);
(2)
by inserting after subsection (b), as added by section 4021, the following new subsection:

“(c) Grants for same-Day point-of-Care clinical laboratory diagnostic testing in communities

“(1) Grants—The Secretary shall award grants to eligible entities to assist such entities in acquiring legally marketed equipment and supplies capable of performing same-day clinical laboratory diagnostic testing in a point-of-care setting.

“(2) Eligibility—To be eligible for a grant under paragraph (1), an entity shall—

“(A) be—

“(i) a hospital;

“(ii) a primary care facility;

“(iii) a clinic;

“(iv) a physician; or

“(v) another type of health care provider as the Secretary may define; and

“(B) submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may reasonably require.

“(3) Use of funds—Amounts received through a grant under this subsection shall be used to purchase legally marketed rapid diagnostic equipment and such materials as are necessary to administer, store, and process same-day clinical laboratory diagnostic testing in a point-of-care setting, including diagnostic and serological tests.

“(4) Amount of grant—The amount of a grant under paragraph (1) may not exceed $20,000.

“(5) Priority in making awards—In awarding grants under paragraph (1), the Secretary shall give priority to eligible entities providing services to—

“(A) medically underserved populations (as defined in section 330(b)(3)) in rural areas; and

“(B) all other areas.”

(3)
by adding at the end of subsection (d), as redesignated, the following new paragraph:

“(3) Authorization of Appropriations

“(A) In general—For the purpose of carrying out subsection (c), there is authorized to be appropriated $500,000,000 for fiscal year 2021, to remain available until expended.

“(B) Administrative expenses—Of the amount made available to carry out subsection (c) for any fiscal year, the Secretary may not use more than 5 percent of such amount for the expenses of administering this section.”

E Public Health Workforce Loan Repayment

Sec. 4041 Public Health Workforce Loan Repayment Program

Part D of title III of the Public Health Service Act (42 U.S.C. 254b et seq.), as amended by section 2031, is further amended by adding at the end the following new subpart:

“XIV Public Health Workforce

“340K. Loan Repayment Program

“(a) Establishment—The Secretary of Health and Human Services shall establish a program to be known as the Public Health Workforce Loan Repayment Program (referred to in this section as the “Program”) to assure an adequate supply of and encourage recruitment of public health professionals to eliminate critical public health workforce shortages in local, State, and Tribal public health agencies.

“(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 and have accepted employment with a local, State, 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; and

“(ii) be employed by, or have accepted employment with, a local, State, or Tribal public health agency or a related training fellowship, as recognized by the Secretary;

“(2) be a United States citizen;

“(3)

“(A) submit an application to the Secretary to participate in the Program; and

“(B) execute a written contract as required in subsection (c); and

“(4) not have received, for the same service, a reduction of loan obligations under section 428J, 428K, 428L, 455(m), or 460 of the Higher Education Act of 1965 (20 U.S.C. 1078–10, 1078–11, 1078–12, 1087e(m), and 1087j).

“(c) Contract—The written contract referred to in subsection (b)(3)(B) between the Secretary and an individual shall contain—

“(1) an agreement on the part of the Secretary that the Secretary will repay, on behalf of the individual, loans incurred by the individual in the pursuit of the relevant degree or certificate in accordance with the terms of the contract;

“(2) an agreement on the part of the individual that the individual will serve in the full-time employment of a local, State, or Tribal public health agency or a related fellowship program in a position related to the course of study or program for which the contract was awarded for a period of time equal to the greater of—

“(A) 3 years; or

“(B) such longer period of time as determined appropriate by the Secretary and the individual;

“(3) an agreement, as appropriate, on the part of the individual to relocate to a priority service area (as determined by the Secretary) in exchange for an additional loan repayment incentive amount to be determined by the Secretary;

“(4) a provision that any financial obligation of the United States arising out of a contract entered into under this section and any obligation of the individual that is conditioned thereon, is contingent on funds being appropriated for loan repayments under this section;

“(5) a statement of the damages to which the United States is entitled, under this section for the individual’s breach of the contract; and

“(6) such other statements of the rights and liabilities of the Secretary and of the individual as the Secretary determines appropriate, not inconsistent with this section.

“(d) Payments

“(1) In general—A loan repayment provided for an individual under a written contract referred to in subsection (b)(3)(B) shall consist of payment, in accordance with paragraph (2), on behalf of the individual of the principal, interest, and related expenses on government and commercial loans received by the individual regarding the undergraduate or graduate education of the individual (or both), which loans were made for tuition expenses incurred by the individual.

“(2) Payments for years served—For each year of service that an individual contracts to serve pursuant to subsection (c)(2), the Secretary may pay not more than $35,000 on behalf of the individual for loans described in paragraph (1). With respect to participants under the Program whose total eligible loans are less than $105,000, the Secretary shall pay an amount that does not exceed ⅓ of the eligible loan balance for each year of such service of such individual.

“(3) Tax liability—For the purpose of providing reimbursements for tax liability resulting from payments under paragraph (2) on behalf of an individual, the Secretary shall, in addition to such payments, make payments to the individual in an amount not to exceed 39 percent of the total amount of loan repayments made for the taxable year involved.

“(e) Postponing obligated service—With respect to an individual receiving a degree or certificate from a health professions or other related school, the date of the initiation of the period of obligated service may be postponed as approved by the Secretary.

“(f) Breach of contract—An individual who fails to comply with the contract entered into under subsection (c) shall be subject to the same financial penalties as provided for under section 338E of the Public Health Service Act (42 U.S.C. 254o) for breaches of loan repayment contracts under section 338B of such Act (42 U.S.C. section 254l–1).

“(g) Authorization of appropriations—There is authorized to be appropriated to carry out this section—

“(1) $100,000,000 for fiscal year 2021; and

“(2) $75,000,000 for each of fiscal years 2022 through 2026.”

F Vaccine Awareness and Disease Prevention

Sec. 4051 Improving awareness of disease prevention

(a)
In general— The Public Health Service Act is amended by striking section 313 of such Act (42 U.S.C. 245) and inserting the following:

“313. Public awareness campaign on the importance of vaccinations

“(a) In general—The Secretary, acting through the Director of the Centers for Disease Control and Prevention and in coordination with other offices and agencies, as appropriate, shall award competitive grants or contracts to one or more public or private entities to carry out a national, evidence-based campaign to increase awareness and knowledge of the safety and effectiveness of vaccines for the prevention and control of diseases, combat misinformation about vaccines, and disseminate scientific and evidence-based vaccine-related information, with the goal of increasing rates of vaccination across all ages, as applicable, particularly in communities with low rates of vaccination, to reduce and eliminate vaccine-preventable diseases.

“(b) Consultation—In carrying out the campaign under this section, the Secretary shall consult with appropriate public health and medical experts, including the National Academy of Medicine and medical and public health associations and nonprofit organizations, in the development, implementation, and evaluation of the evidence-based public awareness campaign.

“(c) Requirements—The campaign under this section shall—

“(1) be a nationwide, evidence-based media and public engagement initiative;

“(2) include the development of resources for communities with low rates of vaccination, including culturally and linguistically appropriate resources, as applicable;

“(3) include the dissemination of vaccine information and communication resources to public health departments, health care providers, and health care facilities, including such providers and facilities that provide prenatal and pediatric care;

“(4) be complementary to, and coordinated with, any other Federal, State, local, or Tribal efforts, as appropriate; and

“(5) assess the effectiveness of communication strategies to increase rates of vaccination.

“(d) Additional activities—The campaign under this section may—

“(1) include the use of television, radio, the internet, and other media and telecommunications technologies;

“(2) include the use of in-person activities;

“(3) be focused to address specific needs of communities and populations with low rates of vaccination; and

“(4) include the dissemination of scientific and evidence-based vaccine-related information, such as—

“(A) advancements in evidence-based research related to diseases that may be prevented by vaccines and vaccine development;

“(B) information on vaccinations for individuals and communities, including individuals for whom vaccines are not recommended by the Advisory Committee for Immunization Practices, and the effects of low vaccination rates within a community on such individuals;

“(C) information on diseases that may be prevented by vaccines; and

“(D) information on vaccine safety and the systems in place to monitor vaccine safety.

“(e) Evaluation—The Secretary shall—

“(1) establish benchmarks and metrics to quantitatively measure and evaluate the awareness campaign under this section;

“(2) conduct qualitative assessments regarding the awareness campaign under this section; and

“(3) prepare and submit to the Committee on Health, Education, Labor, and Pensions of the Senate and Committee on Energy and Commerce of the House of Representatives an evaluation of the awareness campaign under this section.

“(f) Supplement not supplant—Funds appropriated under this section shall be used to supplement and not supplant other Federal, State, and local public funds provided for activities described in this section.

“(g) Authorization of appropriations—There are authorized to be appropriated to carry out this section and subsections (k) and (n) of section 317 $10,000,000 for each of fiscal years 2021 through 2025.”

(b)
Grants To address vaccine-Preventable diseases— Section 317 of the Public Health Service Act (42 U.S.C. 247b) is amended—
(1)
in subsection (k)(1)—
(A)
in subparagraph (C), by striking “; and” and inserting a semicolon;
(B)
in subparagraph (D), by striking the period and inserting a semicolon; and
(C)
by adding at the end the following:

“(E) planning, implementation, and evaluation of activities to address vaccine-preventable diseases, including activities to—

“(i) identify communities at high risk of outbreaks related to vaccine-preventable diseases, including through improved data collection and analysis;

“(ii) pilot innovative approaches to improve vaccination rates in communities and among populations with low rates of vaccination;

“(iii) reduce barriers to accessing vaccines and evidence-based information about the health effects of vaccines;

“(iv) partner with community organizations and health care providers to develop and deliver evidence-based interventions, including culturally and linguistically appropriate interventions, to increase vaccination rates;

“(v) improve delivery of evidence-based, vaccine-related information to parents and others; and

“(vi) improve the ability of State, local, Tribal, and territorial public health departments to engage communities at high risk for outbreaks related to vaccine-preventable diseases, in coordination, as appropriate, with local educational agencies, as defined in section 8101 of the Elementary and Secondary Education Act of 1965; and

“(F) research related to strategies for improving awareness of scientific and evidence-based, vaccine-related information, including for communities with low rates of vaccination, in order to understand barriers to vaccination, improve vaccination rates, and assess the public health outcomes of such strategies.”

(2)
by adding at the end the following:

“(n) Vaccination data—The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall expand and enhance, and, as appropriate, establish and improve, programs and conduct activities to collect, monitor, and analyze vaccination coverage data to assess levels of protection from vaccine-preventable diseases, including by assessing factors contributing to underutilization of vaccines and variations of such factors, and identifying communities at high risk of outbreaks associated with vaccine-preventable diseases.”

(c)
Supplemental grant funds— Section 330(d)(1) of the Public Health Service Act (42 U.S.C. 254b) is amended—
(1)
in subparagraph (F), by striking “and” at the end;
(2)
in subparagraph (G), by striking the period and inserting “; and”; and
(3)
by adding at the end the following:

“(H) improving access to recommended immunizations.”

(d)
Update of 2015 NVAC report— The National Vaccine Advisory Committee established under section 2105 of the Public Health Service Act (42 U.S.C. 300aa–5) shall, as appropriate, update the report entitled, “Assessing the State of Vaccine Confidence in the United States: Recommendations from the National Vaccine Advisory Committee”, approved by the National Vaccine Advisory Committee on June 10, 2015, with respect to factors affecting childhood vaccination.

G Protecting the Health of America’s Older Adults During COVID–19 & Beyond

Sec. 4061 National COVID–19 Resource Center for Older Adults

(a)
In general— The Secretary of Health and Human Services (in this subtitle referred to as the “Secretary”) shall establish within the Office of the Assistant Secretary for Health a National COVID–19 Resource Center for Older Adults (in this section referred to as the “Center”) to identify, curate, and disseminate, promising and proven practices and tools for the care of older adults in their homes, community-based care settings, hospitals, and nursing and acute care facilities.
(b)
Involvement by Federal departments and all levels of government— The Center shall—
(1)
be advised by a team of senior officials from—
(A)
agencies across the Department of Health and Human Services, including the Administration for Community Living (including the Administration on Aging), the Centers for Disease Control and Prevention, the Centers for Medicare & Medicaid Services, the Health Resources and Services Administration, the Indian Health Service, and the Office of Minority Health in the Office of the Secretary; and
(B)
other Federal departments, including the Department of Housing and Urban Development and the Department of Veterans Affairs; and
(2)
collaborate with State and local governments, Indian tribes and Tribal organizations, and nonprofit organizations.
(c)
Activities— The Center shall perform the following activities:
(1)
Develop a set of best practices for older adult health and well-being during and beyond the period of the COVID–19 pandemic, including such best practices with respect to the following focus areas:
(A)
Providing specialized services to overcome the risks associated with social isolation, such as additional resources for home-delivered meals and other nutrition programs to provide not only food but also face-to-face interactions.
(B)
Streamlining and improving access to screening, testing, and health care services and resources, and prioritizing venues older adults can reach.
(C)
Expanding the use of telemedicine, including the provision of technology to execute televisits that safely and comprehensively address older adults’ health care needs.
(D)
Supporting family caregivers, including those with additional responsibilities for homebound individuals.
(E)
Reducing disparities among underserved populations.
(F)
Developing cross-sector collaborative efforts.
(2)
Create and disseminate tools, technical assistance, training, and funding to State, local, Tribal, and territorial governments to adopt best practices developed under subparagraphs (E) and (F) of paragraph (1).
(3)
Establish mechanisms for providing training and technical assistance to State, local, Tribal, and territorial governments to ensure that complementary cross-sector activities are replicated at the State, local, Tribal, and territorial levels.
(4)
Facilitate the development of learning networks of practitioners at the hospital, nursing facility, and community levels to disseminate the best practices developed under paragraph (1) and ensure implementation of such best practices to reduce morbidity and mortality of older adults affected by COVID–19.
(5)
Identify and disseminate approaches that strengthen public health and health care system capacity to serve older Americans with regard to health issues during and beyond the COVID–19 pandemic.

Sec. 4062 Healthy Aging Program

(a)
In general— The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall establish a Healthy Aging Program for the purpose of promoting the health and well-being of older adults by—
(1)
improving the coordination of public health interventions that promote the health and well-being of older adults;
(2)
disseminating and implementing evidence-based best practices and programs with respect to promoting the health and well-being of older adults; and
(3)
coordinating multisectoral efforts to promote the health and well-being of older adults across governmental and nongovernmental health and related agencies.
(b)
Activities— For the purpose described in subsection (a), the Secretary shall design the Healthy Aging Program to carry out the following activities:
(1)
Regularly assess the health-related needs of older adults and promote policies addressing those needs through evidence-based public health interventions to promote overall health and well-being among older adults and reduce health care costs.
(2)
Identify disparities in health among vulnerable populations of older adults.
(3)
Identify gaps in existing public health programs and policies that focus on older adults.
(4)
Promote public health partnerships with aging and other sector stakeholders to ensure nonduplication of efforts and increase efficiency by working collaboratively across sectors.
(5)
Work with multisectoral agencies to improve emergency preparedness plans and activities for vulnerable older adult populations.
(6)
Coordinate efforts to promote the health of older adults with the Administration for Community Living, other Federal departments and agencies, and nonprofit organizations.
(7)
Identify resources and evidence-based programs available to local and State health departments, including resources and programs that could be coordinated across sectors, to address the health and well-being of older adults.
(c)
Grants to health departments— The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall award grants or cooperative agreements to eligible health departments to carry out any of the following activities:
(1)
Improving availability of data on the older adult population, including through data-sharing with elder affairs agencies.
(2)
Linking the health care sector with the community services sector (including aging services and supports) to coordinate and promote community-based prevention services.
(3)
Ensuring that State and local emergency preparedness plans and activities address the special needs of older adults, particularly the most vulnerable populations.
(4)
Training State and local public health personnel to implement or adapt evidence-based and innovative health promotion and disease prevention programs and policies.
(5)
Improving community conditions and addressing social determinants to promote health and well-being and foster independence among older adults, such as efforts to advance age-friendly communities and dementia-friendly communities.
(d)
Technical assistance— The Secretary shall (directly or through grants, cooperative agreements, or contracts) provide technical assistance to eligible health departments in carrying out activities described in subsection (c).
(e)
Evaluations— The Secretary shall (directly or through grants, cooperative agreements, or contracts) provide for the evaluation of activities carried out under subsections (a), (b), and (c) in order to determine the extent to which such activities have been effective in carrying out the purpose described in subsection (a), including the effects of such activities on addressing health disparities.
(f)
Definition— In this section, the term eligible health department means a health department of a State, the District of Columbia, the Commonwealth of Puerto Rico, the United States Virgin Islands, Guam, American Samoa, the Commonwealth of the Northern Mariana Islands, a Tribe (as defined in section 4 of the Indian Self-Determination and Education Assistance Act (25 U.S.C. 5304)), or a large city (as defined by the Director of the Centers for Disease Control and Prevention for purposes of this section).

Sec. 4063 Authorization of appropriations

There is authorized to be appropriated—
(1)
$10,000,000 for the period of fiscal years 2021 through 2025 to carry out section 4061, to remain available until September 30, 2025; and
(2)
$20,000,000 for each of fiscal years 2021 through 2025 to carry out section 4062, including for grants under section 4062(c), to remain available until September 30, 2025.

H Expanding Capacity for Health Outcomes

Sec. 4071 Expanding capacity for health outcomes

Title III of the Public Health Service Act is amended by inserting after section 330M (42 U.S.C. 254c–19) the following:

“330N. Expanding capacity for health outcomes

“(a) Definitions—In this section:

“(1) Eligible entity—The term eligible entity—

“(A) means an entity that provides, or supports the provision of, health care services—

“(i) in rural areas, frontier areas, health professional shortage areas, or medically underserved areas; or

“(ii) to medically underserved populations or Native Americans, including Indian Tribes, Tribal organizations, or urban Indian organizations; and

“(B) may include entities leading, or capable of leading, a technology-enabled collaborative learning and capacity building model or engaging in technology-enabled collaborative training of participants in such model.

“(2) Health professional shortage area—The term health professional shortage area means a health professional shortage area designated under section 332.

“(3) Indian tribe—The terms Indian Tribe and Tribal organization have the meanings given the terms Indian tribe and tribal organization in section 4 of the Indian Self-Determination and Education Assistance Act.

“(4) Medically underserved population—The term medically underserved population has the meaning given the term in section 330(b)(3).

“(5) Native Americans—The term Native Americans has the meaning given such term in section 736 and includes Indian Tribes and Tribal organizations.

“(6) Technology-enabled collaborative learning and capacity building model—The term technology-enabled collaborative learning and capacity building model means a distance health education model that connects health care professionals, and particularly specialists, with multiple other health care professionals through simultaneous interactive videoconferencing for the purpose of facilitating case-based learning, disseminating best practices, and evaluating outcomes.

“(7) Urban Indian organization—The “urban Indian organization” has the meaning given the term Urban Indian organization in section 4 of the Indian Health Care Improvement Act.

“(b) Program established—The Secretary shall, as appropriate, award grants to evaluate, develop, and, as appropriate, expand the use of technology-enabled collaborative learning and capacity building models, to improve retention of health care providers and increase access to health care services, such as those to address chronic diseases and conditions, infectious diseases, mental health, substance use disorders, prenatal and maternal health, pediatric care, pain management, palliative care, and other specialty care in rural areas, frontier areas, health professional shortage areas, or medically underserved areas and for medically underserved populations or Native Americans, including Indian Tribes and Tribal organizations.

“(c) Use of funds

“(1) In general—Grants awarded under subsection (b) shall be used for—

“(A) the development and acquisition of instructional programming, and the training of health care providers and other professionals that provide or assist in the provision of services through models described in subsection (b), such as training on best practices for data collection and leading or participating in such technology-enabled activities consistent with technology-enabled collaborative learning and capacity building models;

“(B) information collection and evaluation activities to study the impact of such models on patient outcomes and health care providers, and to identify best practices for the expansion and use of such models; or

“(C) other activities consistent with achieving the objectives of the grants awarded under this section, as determined by the Secretary.

“(2) Other uses—In addition to any of the uses under paragraph (1), grants awarded under subsection (b) may be used for—

“(A) equipment to support the use and expansion of technology-enabled collaborative learning and capacity building models, including for hardware and software that enables distance learning, health care provider support, and the secure exchange of electronic health information; or

“(B) support for health care providers and other professionals that provide or assist in the provision of services through such models.

“(d) Length of grants—Grants awarded under subsection (b) shall be for a period of up to 5 years.

“(e) Grant requirements—The Secretary may require entities awarded a grant under this section to collect information on the effect of the use of technology-enabled collaborative learning and capacity building models, such as on health outcomes, access to health care services, quality of care, and provider retention in areas and populations described in subsection (b). The Secretary may award a grant or contract to assist in the coordination of such models, including to assess outcomes associated with the use of such models in grants awarded under subsection (b), including for the purpose described in subsection (c)(1)(B).

“(f) Application—An eligible entity that seeks to receive a grant under subsection (b) shall submit to the Secretary an application, at such time, in such manner, and containing such information as the Secretary may require. Such application shall include plans to assess the effect of technology-enabled collaborative learning and capacity building models on patient outcomes and health care providers.

“(g) Access to broadband—In administering grants under this section, the Secretary may coordinate with other agencies to ensure that funding opportunities are available to support access to reliable, high-speed internet for grantees.

“(h) Technical assistance—The Secretary shall provide (either directly through the Department of Health and Human Services or by contract) technical assistance to eligible entities, including recipients of grants under subsection (b), on the development, use, and evaluation of technology-enabled collaborative learning and capacity building models in order to expand access to health care services provided by such entities, including for medically underserved areas and to medically underserved populations or Native Americans, including Indian Tribes and Tribal organizations.

“(i) Research and evaluation—The Secretary, in consultation with stakeholders with appropriate expertise in such models, shall develop a strategic plan to research and evaluate the evidence for such models. The Secretary shall use such plan to inform the activities carried out under this section.

“(j) Report by Secretary—Not later than 4 years after the date of enactment of this section, the Secretary shall prepare and 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, and post on the internet website of the Department of Health and Human Services, a report including, at minimum—

“(1) a description of any new and continuing grants awarded to entities under subsection (b) and the specific purpose and amounts of such grants;

“(2) an overview of—

“(A) the evaluations conducted under subsection (b);

“(B) technical assistance provided under subsection (h); and

“(C) activities conducted by entities awarded grants under subsection (b); and

“(3) a description of any significant findings or developments related to patient outcomes or health care providers and best practices for eligible entities expanding, using, or evaluating technology-enabled collaborative learning and capacity building models, including through the activities described in subsection (h).

“(k) Authorization of appropriations—There is authorized to be appropriated to carry out this section, $20,000,000 for each of fiscal years 2021 through 2025.”

I Community Readiness

Sec. 4081 Grants for research on, or establishing, wastewater surveillance and other early warning systems

Subtitle C of title XXVIII of the Public Health Service Act (42 U.S.C. 300hh–31 et seq.) is amended by adding at the end the following:

“2823. Grants for research on, or establishing, wastewater surveillance and other early warning systems

“(a) In general—The Secretary, in consultation with the Administrator of the Environmental Protection Agency, may award grants to eligible entities to conduct research on, or to establish, a wastewater surveillance or other early warning system through—

“(1) wastewater testing;

“(2) temperature tracking to monitor axillary body temperature; and

“(3) other methods deemed permissible by the Secretary and Administrator.

“(b) Permissible uses of funds—A grant recipient under this section may use grant funds to support the activities described in subsection (a), including by—

“(1) paying for data-centric services that can detect infectious diseases before positive cases or hospitalizations;

“(2) entering into contracts with private companies to implement early warning detection methods; or

“(3) funding research to study early warning detection methods.

“(c) Priority—In selecting grant recipients under this section, the Secretary shall give priority to eligible entities proposing to conduct research on, or to establish, wastewater surveillance or other early warning system in one or more areas that—

“(1) are (or include one or more areas that are) a hot spot; or

“(2) a higher percentage of vulnerable populations than the national average.

“(d) Federal privacy requirements—Nothing in this section shall be construed to supersede any Federal privacy or confidentiality requirement, including the regulations promulgated under section 264(c) of the Health Insurance Portability and Accountability Act of 1996 and section 543 of this Act.

“(e) Definitions—In this section:

“(1) The term Administrator means the Administrator of the Environmental Protection Agency.

“(2) The term eligible entity means—

“(A) a State government;

“(B) a local government;

“(C) a Tribal government;

“(D) an entity that conducts health research; and

“(E) an academic institution.

“(3) The term emergency period has the meaning given to that term in section 1135(g)(1)(B) of the Social Security Act.

“(4) The term hot spot means a geographic area where the rate of infection with a particular pathogen exceeds the national average.

“(5) The term local government means a county, municipality, town, township, village, parish, borough, or other unit of general local government.

“(6) The term Secretary means the Secretary of Health and Human Services.

“(7) The term State means each of the several States, the District of Columbia, the Commonwealth of Puerto Rico, American Samoa, Guam, the Commonwealth of the Northern Mariana Islands, the Virgin Islands, and the Trust Territory of the Pacific Islands.

“(8) The term vulnerable population means people at increased risk of severe illness.

“(f) Authorization of appropriations—To carry out this section, there are authorized to be appropriated $18,000,000 for each of fiscal years 2021 through 2025.”