Comprehensive TB Elimination Act of 2019

II 116TH CONGRESS 1ST SESSION S. 834 To amend the Public Health Service Act to enhance the national strategy for combating and eliminating tuberculosis, and for other purposes. IN THE SENATE OF THE UNITED STATES MARCH 14, 2019 Mr. BROWN introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions A BILL To amend the Public Health Service Act to enhance the national strategy for combating and eliminating tuber- culosis, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Comprehensive TB 4 Elimination Act of 2019’’. 5 SEC. 2. NATIONAL STRATEGY FOR COMBATING AND ELIMI- 6 NATING TUBERCULOSIS. 7 (a) IN GENERAL.—Section 317E of the Public 8 Health Service Act (42 U.S.C. 247b–6) is amended— 9 (1) in subsection (a)— 10 VerDate Sep 11 2014 00:22 Mar 29, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S834.IS S834 pamtmann on DSKBFK8HB2PROD with BILLS 2 •S 834 IS (A) by striking ‘‘The Secretary’’ and in- 1 serting the following: 2 ‘‘(1) GRANTS.—The Secretary’’; and 3 (B) by adding at the end the following: 4 ‘‘(2) PRIORITY.—In making grants under this 5 subsection, the Secretary may give priority to award- 6 ing grants to State health departments proposing to 7 focus on the prevention, control, and elimination of 8 tuberculosis in high-risk populations, including for- 9 eign-born, homeless, incarcerated, HIV-tuberculosis 10 coinfected, and medically underserved populations.’’; 11 (2) in subsection (b)— 12 (A) in paragraph (3)— 13 (i) in subparagraph (C), by redesig- 14 nating clauses (i) and (ii) as subclauses (I) 15 and (II), respectively, and adjusting the 16 margins accordingly; and 17 (ii) by redesignating subparagraphs 18 (A) through (F) as clauses (i) through (vi), 19 respectively, and adjusting the margins ac- 20 cordingly; 21 (B) by redesignating paragraphs (1) 22 through (8) as subparagraphs (A) through (H), 23 respectively, and adjusting the margins accord- 24 ingly; 25 VerDate Sep 11 2014 00:22 Mar 29, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S834.IS S834 pamtmann on DSKBFK8HB2PROD with BILLS 3 •S 834 IS (C) in the matter preceding subparagraph 1 (A), as so redesignated, by striking ‘‘With re- 2 spect to’’ and inserting the following: 3 ‘‘(1) IN GENERAL.—With respect to’’; 4 (D) by striking subparagraph (B), as so 5 redesignated, and inserting the following: 6 ‘‘(B) Research, investigations, experiments, 7 demonstrations, and studies in the health 8 sciences that are related to— 9 ‘‘(i) the development of new tools, in- 10 cluding vaccines and antimicrobial drugs, 11 to prevent and treat tuberculosis; 12 ‘‘(ii) novel therapeutics for special 13 populations, including pediatric popu- 14 lations, immunosuppressed individuals, and 15 pregnant women; 16 ‘‘(iii) the development or testing of 17 medical diagnostics to detect tuberculosis; 18 ‘‘(iv) research to address the epidemi- 19 ology, mechanisms, and pathogenesis of tu- 20 berculosis; 21 ‘‘(v) public health interventions to ad- 22 dress the prevention, treatment, and con- 23 trol of tuberculosis, such as directly ob- 24 VerDate Sep 11 2014 00:22 Mar 29, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S834.IS S834 pamtmann on DSKBFK8HB2PROD with BILLS 4 •S 834 IS served therapy and non-pharmaceutical 1 intervention; 2 ‘‘(vi) methods to enhance detection 3 and response to outbreaks of tuberculosis, 4 including multidrug resistant tuberculosis; 5 and 6 ‘‘(vii) other relevant research areas.’’; 7 (E) in subparagraph (C), as so redesig- 8 nated— 9 (i) by redesignating clause (vi), as so 10 redesignated, as clause (vii); 11 (ii) in clause (v), as so redesignated, 12 by striking ‘‘; and’’ and inserting ‘‘;’’; and 13 (iii) by inserting after clause (v), as so 14 redesignated, the following: 15 ‘‘(vi) the intensification of efforts to 16 prevent, detect, and treat latent tuber- 17 culosis; and’’; 18 (F) in subparagraph (D), as so redesig- 19 nated, by inserting before the period the fol- 20 lowing: ‘‘, including public awareness campaigns 21 and development of educational, risk, and 22 media communications.’’; 23 (G) in subparagraph (F), as so redesig- 24 nated, by striking ‘‘paragraphs (1) through 25 VerDate Sep 11 2014 00:22 Mar 29, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S834.IS S834 pamtmann on DSKBFK8HB2PROD with BILLS 5 •S 834 IS (4)’’ and inserting ‘‘subparagraphs (A) through 1 (D)’’; and 2 (H) by adding at the end the following: 3 ‘‘(2) SELECTION.—In carrying out the activities 4 described in paragraph (1), the Secretary— 5 ‘‘(A) is encouraged to give priority to pro- 6 grammatically relevant research so that new 7 tools can be utilized in public health practice; 8 and 9 ‘‘(B) may seek input from the Biomedical 10 Advanced Research and Development Authority 11 in identifying novel candidates to utilize in the 12 efforts under this subsection to prevent, diag- 13 nose, and control tuberculosis.’’; 14 (3) by redesignating subsections (c) through (h) 15 as subsections (d) through (i), respectively; 16 (4) by inserting after subsection (b) the fol- 17 lowing— 18 ‘‘(c) GRANTS FOR COORDINATION OF PROGRAMS AND 19 SERVICES FOR PREVENTION, DIAGNOSIS, AND TREAT- 20 MENT.— 21 ‘‘(1) GRANTS.—The Secretary, acting through 22 the Administrator of the Health Resources and Serv- 23 ices Administration, may award grants to State and 24 local governments and Federally qualified health 25 VerDate Sep 11 2014 00:22 Mar 29, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S834.IS S834 pamtmann on DSKBFK8HB2PROD with BILLS 6 •S 834 IS centers for coordinating the programs and services 1 of such States, governments, and centers to ensure 2 timely and appropriate prevention, risk-based screen- 3 ing, diagnosis, and treatment of latent and active tu- 4 berculosis. 5 ‘‘(2) DEFINITION.—In this subsection, the term 6 ‘Federally qualified health center’ has the meaning 7 given to such term in section 1861(aa) of the Social 8 Security Act.’’; 9 (5) in subsections (d), (e), and (f), as so redes- 10 ignated, by striking ‘‘(a) or (b)’’ each place it ap- 11 pears and inserting ‘‘(a), (b), or (c)’’; 12 (6) in subsection (g)(4), as so redesignated, by 13 adding at the end the following: 14 ‘‘(C) REPORT TO CONGRESS.—The Sec- 15 retary is encouraged to make the reports under 16 subparagraph (A), or other publications rel- 17 evant to domestic tuberculosis surveillance, pub- 18 licly available on the internet website of the 19 Centers for Disease Control and Prevention and 20 to disseminate such information to stake- 21 holders.’’; 22 (7) in subsection (h), as so redesignated— 23 (A) in paragraph (1)— 24 VerDate Sep 11 2014 00:22 Mar 29, 2019 Jkt 089200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S834.IS S834 pamtmann on DSKBFK8HB2PROD with BILLS 7 •S 834 IS (i) by striking ‘‘research into new 1 tools under subsection (b)(2)’’ and insert- 2 ing ‘‘the research, investigations, experi- 3 ments, demonstrations, and studies in 4 health science under subsection (b)(1)(B)’’; 5 and 6 (ii) by inserting ‘‘ensuring access to 7 the products developed as a result of such 8 research, investigations, experiments, dem- 9 onstrations, and studies and’’ after ‘‘advice 10 regarding’’; and 11 (B) in paragraph (3)— 12 (i) by redesignating subparagraphs 13 (D) and (E) as subparagraphs (E) and 14 (F), respectively; and 15 (ii) by inserting after subparagraph 16 (C) the following: 17 ‘‘(D) members of the Biomedical Advanced 18 Research and Development Authority;’’; and 19 (8) in subsection (i)(1)(A), as so redesignated, 20 by striking ‘‘$200,000,000’’ and all that follows 21 through the period and inserting ‘‘$142,200,000 for 22 fiscal year 2020, $195,700,000 for fiscal year 2021, 23 $225,000,000 for fiscal year 2022, $236,250,000 for 24 VerDate Sep 11 2014 00:22 Mar 29, 2019 Jkt 089200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S834.IS S834 pamtmann on DSKBFK8HB2PROD with BILLS 8 •S 834 IS fiscal year 2023, $248,062,500 for fiscal year 2024, 1 and $260,465,625 for fiscal year 2025.’’. 2 (b) NIH TUBERCULOSIS ACTIVITIES.—Section 3 424C(b) of the Public Health Service Act (42 U.S.C. 4 285b–7c(b)) is amended by striking paragraph (1) and in- 5 serting the following: 6 ‘‘(1) enhancing basic, clinical, and operational 7 research on tuberculosis, including with respect to— 8 ‘‘(A) drug-resistant tuberculosis; 9 ‘‘(B) infection with tuberculosis and la- 10 tency and progression of tuberculosis; and 11 ‘‘(C) pediatric tuberculosis;’’. 12 SEC. 3. GAO STUDY. 13 Not later than 2 years after the date of enactment 14 of this Act, the Comptroller General of the United States 15 shall issue a report on the coordination of efforts in the 16 United States to— 17 (1) prevent, control, and eliminate tuberculosis; 18 and 19 (2) implement the activities under section 317E 20 of the Public Health Service Act (42 U.S.C. 247b– 21 6), as amended by this Act, and the National Action 22 Plan for Combating Multidrug-Resistant Tuber- 23 culosis, issued in December 2015. 24 Æ VerDate Sep 11 2014 00:22 Mar 29, 2019 Jkt 089200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6301 E:\BILLS\S834.IS S834 pamtmann on DSKBFK8HB2PROD with BILLS