Public Health Emergency Response and Accountability Act

II 116TH CONGRESS 2D SESSION S. 3309 To provide for a Public Health Emergency Fund, and for other purposes. IN THE SENATE OF THE UNITED STATES FEBRUARY 13, 2020 Mr. CASSIDY (for himself, Mr. SCHATZ, Mr. RUBIO, Mr. DURBIN, Ms. SMITH, and Mr. KING) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions A BILL To provide for a Public Health Emergency Fund, 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 ‘‘Public Health Emer- 4 gency Response and Accountability Act’’. 5 SEC. 2. PUBLIC HEALTH EMERGENCIES. 6 (a) IN GENERAL.—Section 319 of the Public Health 7 Service Act (42 U.S.C. 247d) is amended— 8 (1) in subsection (a), by striking ‘‘after con- 9 sultation’’ and inserting ‘‘in consultation with the 10 VerDate Sep 11 2014 16:04 Feb 17, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S3309.IS S3309 pamtmann on DSKBC07HB2PROD with BILLS 2 •S 3309 IS Assistant Secretary for Preparedness and Response 1 and’’; 2 (2) by redesignating subsections (b) through (f) 3 as subsections (c) through (g), respectively; 4 (3) by inserting after subsection (a), the fol- 5 lowing: 6 ‘‘(b) REPORTING REQUIREMENTS.— 7 ‘‘(1) IN GENERAL.—Upon the determination of 8 a public health emergency under subsection (a) that 9 is an infectious disease outbreak, a bioterrorist at- 10 tack, or a disaster, the Secretary shall request the 11 Assistant Secretary for Preparedness and Response 12 to convene a group of Federal public health and 13 other Federal officials that shall prepare monthly re- 14 ports related to such emergency for the period de- 15 scribed in paragraph (3) and submit such reports to 16 Congress. 17 ‘‘(2) CONTENTS.—The reports prepared under 18 paragraph (1) shall include— 19 ‘‘(A) in the first monthly report, the pro- 20 posed budget of the response to the emergency, 21 and, in each subsequent report, updates to such 22 budget; 23 ‘‘(B) a description of how the Secretary 24 plans to use best practices and lessons learned 25 VerDate Sep 11 2014 16:04 Feb 17, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S3309.IS S3309 pamtmann on DSKBC07HB2PROD with BILLS 3 •S 3309 IS from previous public health emergency re- 1 sponses; 2 ‘‘(C) a description of how collaboration 3 among public health agencies and departments 4 will be achieved, strategies for public commu- 5 nication, and acquisition and distribution of 6 supplies; 7 ‘‘(D) an identification of additional au- 8 thorities needed, if any, to respond to the emer- 9 gency; and 10 ‘‘(E) in the first monthly report, the jus- 11 tification for triggering the public health emer- 12 gency response. 13 ‘‘(3) PERIOD.—The period described in this 14 paragraph is the period beginning not later than 30 15 days after the determination of a public health emer- 16 gency under subsection (a) that is an infectious dis- 17 ease outbreak, a bioterrorist attack, or a disaster, 18 and ending 30 days after the determination of such 19 emergency terminates in accordance with such sub- 20 section.’’; and 21 (4) in subsection (c) (as so redesignated)— 22 (A) in paragraph (3), by striking ‘‘Com- 23 mittee on Commerce’’ and inserting ‘‘Com- 24 mittee on Energy and Commerce’’; and 25 VerDate Sep 11 2014 16:04 Feb 17, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S3309.IS S3309 pamtmann on DSKBC07HB2PROD with BILLS 4 •S 3309 IS (B) by adding at the end the following: 1 ‘‘(6) FUNDING.— 2 ‘‘(A) DEFINITIONS.—In this paragraph: 3 ‘‘(i) PUBLIC HEALTH EMERGENCY RE- 4 LIEF.—The term ‘public health emergency 5 relief’ means the expenditures to address a 6 public health emergency determined under 7 subsection (a) that is an infectious disease 8 outbreak, a bioterrorist attack, or a dis- 9 aster from— 10 ‘‘(I) amounts made available by 11 emergency supplemental appropria- 12 tions to appropriations accounts of 13 the Department of Health and 14 Human Services to address a public 15 health emergency that is an infectious 16 disease outbreak, a bioterrorist attack, 17 or a disaster (excluding funds trans- 18 ferred to the Department from the ap- 19 propriations account for the ‘Federal 20 Emergency Management Agency, Dis- 21 aster Relief Fund’ or pursuant to the 22 Oil Pollution Act of 1990); and 23 VerDate Sep 11 2014 16:04 Feb 17, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S3309.IS S3309 pamtmann on DSKBC07HB2PROD with BILLS 5 •S 3309 IS ‘‘(II) any amounts expended from 1 the Public Health Emergency Fund 2 under this subsection. 3 ‘‘(ii) TARGET AMOUNT.—The term 4 ‘target amount’ means the amount that is 5 the rolling annual average of expenditures 6 for public health emergency relief over the 7 full 14 fiscal years immediately preceding 8 the fiscal year for which the determination 9 of a public health emergency is made 10 under subsection (a) that is an infectious 11 disease outbreak, a bioterrorist attack, or a 12 disaster, excluding the highest and lowest 13 years. 14 ‘‘(B) APPROPRIATIONS.— 15 ‘‘(i) IN GENERAL.—Subject to clause 16 (iv), upon the determination of each public 17 health emergency under subsection (a) that 18 is an infectious disease outbreak, a bioter- 19 rorist attack, or a disaster, there is appro- 20 priated to the Public Health Emergency 21 Fund, out of any money in the Treasury 22 not otherwise appropriated, for the fiscal 23 year of the determination, an amount de- 24 termined under subparagraph (C), to re- 25 VerDate Sep 11 2014 16:04 Feb 17, 2020 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S3309.IS S3309 pamtmann on DSKBC07HB2PROD with BILLS 6 •S 3309 IS main available until expended, which may 1 be used in accordance with subparagraph 2 (D). 3 ‘‘(ii) REPORTING.—The reporting re- 4 quirements contained in subsection (b) 5 shall apply with respect to amounts appro- 6 priated under clause (i). 7 ‘‘(iii) EMERGENCY DESIGNATIONS.— 8 ‘‘(I) IN GENERAL.—Amounts ap- 9 propriated under clause (i) are des- 10 ignated as an emergency requirement 11 pursuant to section 4(g) of the Statu- 12 tory Pay-As-You-Go Act of 2010 (2 13 U.S.C. 933(g)). 14 ‘‘(II) DESIGNATION IN THE SEN- 15 ATE.—In the Senate, amounts appro- 16 priated under clause (i) are des- 17 ignated as an emergency requirement 18 pursuant to section 403(a) of S. Con. 19 Res. 13 (111th Congress), the concur- 20 rent resolution on the budget for fis- 21 cal year 2010. 22 ‘‘(iv) LIMITATION.—Clause (i) shall 23 not apply if the amount available for ex- 24 penditure in the Public Health Emergency 25 VerDate Sep 11 2014 16:04 Feb 17, 2020 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S3309.IS S3309 pamtmann on DSKBC07HB2PROD with BILLS 7 •S 3309 IS Fund, as of the date of the determination 1 as a public health emergency under sub- 2 section (a) that is an infectious disease 3 outbreak, a bioterrorist attack, or a dis- 4 aster, is equal to or greater than the target 5 amount. 6 ‘‘(C) FORMULA.— 7 ‘‘(i) IN GENERAL.—Subject to clause 8 (ii), the amount determined under this 9 subparagraph shall be equal to the dif- 10 ference between the target amount and the 11 amount available for expenditure in the 12 Public Health Emergency Fund, as of the 13 date of the determination of the public 14 health emergency under subsection (a). 15 ‘‘(ii) REPORT BY OMB.—Not later 16 than 30 days after the date of enactment 17 of this paragraph, the Director of the Of- 18 fice of Management and Budget shall sub- 19 mit to the Committee on Appropriations 20 and the Committee on the Budget of the 21 Senate and the Committee on Appropria- 22 tions and the Committee on the Budget of 23 the House of Representatives, a report on 24 VerDate Sep 11 2014 16:04 Feb 17, 2020 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S3309.IS S3309 pamtmann on DSKBC07HB2PROD with BILLS 8 •S 3309 IS the rolling average calculated for purposes 1 of determining the target amount. 2 ‘‘(D) USE OF FUNDS.— 3 ‘‘(i) IN GENERAL.—Amounts appro- 4 priated to the Public Health Emergency 5 Fund under subparagraph (B) shall be 6 used by the Secretary in accordance with 7 the proposed budget described in sub- 8 section (b)(2) for any public health emer- 9 gency determined under subsection (a) that 10 is an infectious disease outbreak, a bioter- 11 rorist attack, or a disaster that has not 12 terminated under such subsection. Such 13 funds shall be used— 14 ‘‘(I) to provide assistance for im- 15 mediate Federal, State, local, or inter- 16 national response needs with respect 17 to any public health emergency deter- 18 mined under subsection (a) that is an 19 infectious disease outbreak, a bioter- 20 rorist attack, or a disaster; and 21 ‘‘(II) for activities determined ap- 22 propriate by the Secretary to improve 23 preparedness and response to protect 24 human health for all populations in 25 VerDate Sep 11 2014 16:04 Feb 17, 2020 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S3309.IS S3309 pamtmann on DSKBC07HB2PROD with BILLS 9 •S 3309 IS any public health emergency deter- 1 mined under subsection (a) that is an 2 infectious disease outbreak, a bioter- 3 rorist attack, or a disaster. 4 ‘‘(ii) AVAILABILITY.—Amounts appro- 5 priated to the Public Health Emergency 6 Fund under subparagraph (B) shall re- 7 main available for the uses described in 8 this subparagraph so long as any public 9 health emergency is determined under sub- 10 section (a) that is an infectious disease 11 outbreak, a bioterrorist attack, or a dis- 12 aster, and the determination for any such 13 emergency has not terminated under such 14 subsection. 15 ‘‘(iii) AUTHORITY.—In expending 16 funds appropriated under subparagraph 17 (B) and carrying out activities under this 18 subparagraph, the Secretary shall have the 19 authority to— 20 ‘‘(I) transfer funds and enter 21 into contracts; 22 ‘‘(II) utilize flexible hiring mech- 23 anisms, including direct hiring author- 24 ity and personal service contracts; ex- 25 VerDate Sep 11 2014 16:04 Feb 17, 2020 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S3309.IS S3309 pamtmann on DSKBC07HB2PROD with BILLS 10 •S 3309 IS emptions from certain administrative 1 restrictions (such as travel, informa- 2 tion technology, printing and sup- 3 plies); motor vehicle authority; and 4 flexible compensation for responders, 5 including overtime and danger pay; 6 and 7 ‘‘(III) utilize flexible transaction 8 mechanisms.’’. 9 (b) EXEMPTION OF THE PUBLIC HEALTH EMER- 10 GENCY FUND FROM SEQUESTRATION.— 11 (1) IN GENERAL.—Section 255(g)(1)(A) of the 12 Balanced Budget and Emergency Deficit Control 13 Act of 1985 is amended by inserting ‘‘Public Health 14 Emergency Fund (009–91–9913).’’ after the item 15 relating to ‘‘Postal Service Fund (18–4020–0–3– 16 372).’’. 17 (2) APPLICATION.—The amendment made by 18 paragraph (1) shall apply to any sequestration order 19 issued under such Act on or after the date of enact- 20 ment of this section. 21 (c) GAO REPORTS.— 22 (1) IN GENERAL.—Not later than 180 days 23 after the date of enactment of this Act, the Comp- 24 troller General of the United States, in consultation 25 VerDate Sep 11 2014 16:04 Feb 17, 2020 Jkt 099200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S3309.IS S3309 pamtmann on DSKBC07HB2PROD with BILLS 11 •S 3309 IS with relevant Federal, State, and local government 1 entities, shall prepare and submit to the appropriate 2 committees of Congress, a report— 3 (A) reviewing the capacity of the United 4 States public health system, including the pub- 5 lic health workforce, to respond effectively to in- 6 fectious disease outbreaks; 7 (B) identifying areas of potential improve- 8 ment in coordination between Federal, State, 9 and local government entities to respond more 10 effectively to infectious disease outbreaks; 11 (C) making recommendations on how to 12 provide or allocate most effectively resources for 13 public health emergency response, specifically 14 considering how to utilize most effectively the 15 emergency fund established under section 319 16 of the Public Health Service Act (42 U.S.C. 17 247d); and 18 (D) containing an audit of how funds for 19 public health emergencies have been expended 20 within the 2 years preceding the date of the re- 21 port. 22 (2) POST-EMERGENCY REPORT.— 23 (A) IN GENERAL.—Not later than 6 24 months after the termination of a determination 25 VerDate Sep 11 2014 16:04 Feb 17, 2020 Jkt 099200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S3309.IS S3309 pamtmann on DSKBC07HB2PROD with BILLS 12 •S 3309 IS of a public health emergency under section 319 1 of the Public Health Service Act (42 U.S.C. 2 247d) that is an infectious disease outbreak, a 3 bioterrorist attack, or a disaster, the Comp- 4 troller General of the United States shall review 5 response efforts by Federal, State, and local 6 government entities, as well as any other rel- 7 evant entities engaged in response efforts, and 8 submit a report to the appropriate committees 9 of Congress to determine— 10 (i) the compliance of such efforts with 11 best practices identified in the report 12 under paragraph (1); 13 (ii) the effectiveness of such best prac- 14 tices; 15 (iii) the cost of such efforts; 16 (iv) the areas of potential continued 17 improvement in coordination between Fed- 18 eral, State, and local government entities 19 to respond more effectively to infectious 20 disease outbreaks; and 21 (v) how to incorporate additional best 22 practices which may be incorporated in fu- 23 ture response efforts. 24 VerDate Sep 11 2014 16:04 Feb 17, 2020 Jkt 099200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\S3309.IS S3309 pamtmann on DSKBC07HB2PROD with BILLS 13 •S 3309 IS (B) AUDIT.—The report under subpara- 1 graph (A) shall include an audit indicating how 2 funds used for public health emergencies deter- 3 mined under section 319 of the Public Health 4 Service Act have been expended during the 2 5 years preceding the submission of the report 6 under such subparagraph. 7 SEC. 3. APPLICABILITY. 8 Nothing in this Act, or an amendment made by this 9 Act, shall affect the applicability of the Robert T. Stafford 10 Disaster Relief and Emergency Assistance Act (42 U.S.C. 11 5121 et seq.) or the Oil Pollution Act of 1990 (33 U.S.C. 12 2701 et seq.) in the case of a public health emergency. 13 Æ VerDate Sep 11 2014 16:04 Feb 17, 2020 Jkt 099200 PO 00000 Frm 00013 Fmt 6652 Sfmt 6301 E:\BILLS\S3309.IS S3309 pamtmann on DSKBC07HB2PROD with BILLS