Border Health Security Act of 2020

II 116TH CONGRESS 2D SESSION S. 3436 To establish grant programs to improve the health of border area residents and for all hazards preparedness in the border area including bioter- rorism, infectious disease, and noncommunicable emerging threats, and for other purposes. IN THE SENATE OF THE UNITED STATES MARCH 11, 2020 Mr. UDALL (for himself, Mr. HEINRICH, Mrs. GILLIBRAND, Ms. MCSALLY, Ms. SINEMA, and Mr. CORNYN) introduced the following bill; which was read twice and referred to the Committee on Foreign Relations A BILL To establish grant programs to improve the health of border area residents and for all hazards preparedness in the border area including bioterrorism, infectious disease, and noncommunicable emerging threats, 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 ‘‘Border Health Secu- 4 rity Act of 2020’’. 5 SEC. 2. FINDINGS. 6 Congress makes the following findings: 7 VerDate Sep 11 2014 19:53 Mar 23, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S3436.IS S3436 pamtmann on DSKBC07HB2PROD with BILLS 2 •S 3436 IS (1) The United States-Mexico border is an 1 interdependent and dynamic region of approximately 2 15,000,000 residents and millions of border cross- 3 ings each year, with significant and unique public 4 health challenges. 5 (2) These challenges include low rates of health 6 insurance coverage, poor access to health care serv- 7 ices, lack of education or access to information, pov- 8 erty, and high rates of dangerous diseases, such as 9 tuberculosis and West Nile virus, as well as other 10 noncommunicable diseases such as cardiovascular 11 disease, asthma, diabetes, and obesity. 12 (3) As the 2020 dengue outbreak in Mexico and 13 many parts of Latin America illustrates, diseases do 14 not respect international boundaries, and a strong 15 public health effort at and along the borders is cru- 16 cial to not only protect and improve the health of 17 Americans but also to help secure the country 18 against threats to biosecurity and other emerging 19 threats. 20 (4) For 20 years, the United States-Mexico 21 Border Health Commission has served as a crucial 22 binational institution to address these unique and 23 truly cross-border health issues. 24 VerDate Sep 11 2014 19:53 Mar 23, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S3436.IS S3436 pamtmann on DSKBC07HB2PROD with BILLS 3 •S 3436 IS (5) In 2016, 66 percent of Canadians lived 1 within 100 miles of the United States border. The 2 2003 epidemic of severe acute respiratory syndrome 3 caused more than 250 illnesses in the Greater To- 4 ronto Area, just 80 miles from New York. 5 (6) The recent coronavirus outbreak has high- 6 lighted the need for continued coordination of re- 7 sources, effective communication, and information 8 sharing between countries to address emerging pub- 9 lic health crises. 10 SEC. 3. UNITED STATES-MEXICO BORDER HEALTH COMMIS- 11 SION ACT AMENDMENTS. 12 The United States-Mexico Border Health Commis- 13 sion Act (22 U.S.C. 290n et seq.) is amended— 14 (1) in section 3— 15 (A) in paragraph (1), by striking ‘‘; and’’ 16 and inserting ‘‘;’’; 17 (B) in paragraph (2)(B), by striking the 18 period and inserting a semicolon; and 19 (C) by adding at the end the following: 20 ‘‘(3) to evaluate the Commission’s progress in 21 carrying out the duties described in paragraphs (1) 22 and (2) and report on such progress and make rec- 23 ommendations, as appropriate, to the Secretary of 24 VerDate Sep 11 2014 19:53 Mar 23, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S3436.IS S3436 pamtmann on DSKBC07HB2PROD with BILLS 4 •S 3436 IS Health and Human Services and Congress regarding 1 such duties; 2 ‘‘(4) to cooperate with the Canada-United 3 States Pan Border Public Health Preparedness 4 Council (referred to in this Act as the ‘Council’), as 5 appropriate; and 6 ‘‘(5) to serve as an independent and objective 7 body to both recommend and implement initiatives 8 that solve border health issues.’’; 9 (2) in section 5(b), by striking ‘‘should be the 10 leader’’ and inserting ‘‘shall be the Chair’’; 11 (3) by redesignating section 8 as section 12; 12 (4) by striking section 7 and inserting the fol- 13 lowing: 14 ‘‘SEC. 7. BORDER HEALTH GRANTS. 15 ‘‘(a) ELIGIBLE ENTITY DEFINED.—In this section, 16 the term ‘eligible entity’ means a State, public institution 17 of higher education, local government, Indian Tribe, Trib- 18 al organization, urban Indian organization, nonprofit 19 health organization, trauma center, critical access hospital 20 or other hospital that serves rural or other vulnerable com- 21 munities and populations, faith-based entity, or commu- 22 nity health center receiving assistance under section 330 23 of the Public Health Service Act (42 U.S.C. 254b), that 24 VerDate Sep 11 2014 19:53 Mar 23, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S3436.IS S3436 pamtmann on DSKBC07HB2PROD with BILLS 5 •S 3436 IS is located in the United States-Mexico border area or the 1 United States-Canada border area. 2 ‘‘(b) AUTHORIZATION.—From amounts appropriated 3 under section 11, the Secretary, in consultation with mem- 4 bers of the Commission and Council and in coordination 5 with the Office of Global Affairs, shall award grants to 6 eligible entities to improve the health of residents of the 7 United States-Mexico and United States-Canada border 8 areas with appropriate priority given to grants that ad- 9 dress recommendations outlined by the strategic plan and 10 operational work plan of the Commission and the Council 11 under section 9. 12 ‘‘(c) APPLICATION.—An eligible entity that desires a 13 grant under subsection (b) shall submit an application to 14 the Secretary at such time, in such manner, and con- 15 taining such information as the Secretary may require. 16 ‘‘(d) USE OF FUNDS.—An eligible entity that receives 17 a grant under subsection (b) shall use the grant funds for 18 any of the following: 19 ‘‘(1) Programs relating to any one or more of 20 the following: 21 ‘‘(A) Maternal and child health. 22 ‘‘(B) Primary care and preventative health. 23 ‘‘(C) Infectious disease testing, monitoring, 24 and surveillance. 25 VerDate Sep 11 2014 19:53 Mar 23, 2020 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S3436.IS S3436 pamtmann on DSKBC07HB2PROD with BILLS 6 •S 3436 IS ‘‘(D) Public health and public health infra- 1 structure. 2 ‘‘(E) Health promotion, health literacy, 3 and health education. 4 ‘‘(F) Oral health. 5 ‘‘(G) Behavioral and mental health. 6 ‘‘(H) Substance abuse prevention and 7 harm reduction. 8 ‘‘(I) Health conditions that have a high 9 prevalence in the United States-Mexico border 10 area or United States-Canada border area. 11 ‘‘(J) Medical and health services research. 12 ‘‘(K) Workforce training and development. 13 ‘‘(L) Community health workers and 14 promotoras. 15 ‘‘(M) Health care infrastructure problems 16 in the United States-Mexico border area or 17 United States-Canada border area (including 18 planning and construction grants). 19 ‘‘(N) Health disparities in the United 20 States-Mexico border area or United States- 21 Canada border area. 22 ‘‘(O) Environmental health. 23 ‘‘(P) Bioterrorism and zoonosis. 24 VerDate Sep 11 2014 19:53 Mar 23, 2020 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S3436.IS S3436 pamtmann on DSKBC07HB2PROD with BILLS 7 •S 3436 IS ‘‘(Q) Outreach and enrollment services 1 with respect to Federal programs (including 2 programs authorized under titles XIX and XXI 3 of the Social Security Act (42 U.S.C. 1396 et 4 seq., 42 U.S.C. 1397aa et seq.)). 5 ‘‘(R) Trauma care. 6 ‘‘(S) Health research with an emphasis on 7 infectious disease, such as measles, and press- 8 ing issues related to noncommunicable diseases. 9 ‘‘(T) Epidemiology and health research. 10 ‘‘(U) Cross-border health surveillance co- 11 ordinated with Mexican Health Authorities or 12 Canadian Health Authorities. 13 ‘‘(V) Chronic diseases, such as diabetes 14 and obesity, particularly childhood obesity. 15 ‘‘(W) Community-based participatory re- 16 search on border health issues. 17 ‘‘(X) Domestic violence and violence pre- 18 vention. 19 ‘‘(Y) Cross-border public health prepared- 20 ness. 21 ‘‘(2) Other programs as the Secretary deter- 22 mines appropriate. 23 ‘‘(e) SUPPLEMENT, NOT SUPPLANT.—Amounts pro- 24 vided to an eligible entity awarded a grant under sub- 25 VerDate Sep 11 2014 19:53 Mar 23, 2020 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S3436.IS S3436 pamtmann on DSKBC07HB2PROD with BILLS 8 •S 3436 IS section (b) shall be used to supplement and not supplant 1 other funds available to the eligible entity to carry out the 2 activities described in subsection (d). 3 ‘‘SEC. 8. GRANTS FOR EARLY WARNING INFECTIOUS DIS- 4 EASE SURVEILLANCE IN THE BORDER AREA. 5 ‘‘(a) ELIGIBLE ENTITY DEFINED.—In this section, 6 the term ‘eligible entity’ means a State, local government, 7 Indian Tribe, Tribal organization, urban Indian organiza- 8 tion, trauma center, regional trauma center coordinating 9 entity, or public health entity. 10 ‘‘(b) AUTHORIZATION.—From funds appropriated 11 under section 11, the Secretary shall award grants for 12 Early Warning Infectious Disease Surveillance to eligible 13 entities for infectious disease surveillance activities in the 14 United States-Mexico border area or United States-Can- 15 ada border area. 16 ‘‘(c) APPLICATION.—An eligible entity that desires a 17 grant under this section shall submit an application to the 18 Secretary at such time, in such manner, and containing 19 such information as the Secretary may require. 20 ‘‘(d) USES OF FUNDS.—An eligible entity that re- 21 ceives a grant under subsection (b) shall use the grant 22 funds, in coordination with State and local all hazards pro- 23 grams, to— 24 VerDate Sep 11 2014 19:53 Mar 23, 2020 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S3436.IS S3436 pamtmann on DSKBC07HB2PROD with BILLS 9 •S 3436 IS ‘‘(1) develop and implement infectious disease 1 surveillance plans and networks and public health 2 emergency and readiness assessments and prepared- 3 ness plans, and purchase items necessary for such 4 plans; 5 ‘‘(2) coordinate infectious disease surveillance 6 planning and interjurisdictional risk assessments in 7 the region with appropriate United States-based 8 agencies and organizations and appropriate authori- 9 ties in Mexico or Canada; 10 ‘‘(3) improve infrastructure, including surge ca- 11 pacity, syndromic surveillance, and isolation and de- 12 contamination capacity, and policy preparedness, in- 13 cluding for mutual assistance and for the sharing of 14 information and resources; 15 ‘‘(4) improve laboratory capacity, in order to 16 maintain and enhance capability and capacity to de- 17 tect potential infectious disease, whether naturally 18 occurring or the result of terrorism; 19 ‘‘(5) create and maintain a health alert net- 20 work, including risk communication and information 21 dissemination that is culturally competent and takes 22 into account the needs of at-risk populations, includ- 23 ing individuals with disabilities; 24 VerDate Sep 11 2014 19:53 Mar 23, 2020 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S3436.IS S3436 pamtmann on DSKBC07HB2PROD with BILLS 10 •S 3436 IS ‘‘(6) educate and train clinicians, epidemiolo- 1 gists, laboratories, and emergency management per- 2 sonnel; 3 ‘‘(7) implement electronic data and infrastruc- 4 ture inventory systems to coordinate the triage, 5 transportation, and treatment of multicasualty inci- 6 dent victims; 7 ‘‘(8) provide infectious disease testing in the 8 United States-Mexico border area or United States- 9 Canada border area; and 10 ‘‘(9) carry out such other activities identified by 11 the Secretary, members of the Commission, members 12 of the Council, State or local public health authori- 13 ties, representatives of border health offices, or au- 14 thorities at the United States-Mexico or United 15 States-Canada borders. 16 ‘‘SEC. 9. PLANS, REPORTS, AUDITS, AND BY-LAWS. 17 ‘‘(a) STRATEGIC PLAN.— 18 ‘‘(1) IN GENERAL.—Not later than 2 years 19 after the date of enactment of this section, and every 20 5 years thereafter, the Commission (including the 21 participation of members representing both the 22 United States and Mexican sections) and the Coun- 23 cil (including the participation of members rep- 24 resenting both the United States and Canada) shall 25 VerDate Sep 11 2014 19:53 Mar 23, 2020 Jkt 099200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S3436.IS S3436 pamtmann on DSKBC07HB2PROD with BILLS 11 •S 3436 IS each prepare a binational strategic plan to guide the 1 operations of the Commission and the Council and 2 submit such plan to the Secretary and Congress. 3 ‘‘(2) REQUIREMENTS.—The binational strategic 4 plan under paragraph (1) shall include— 5 ‘‘(A) health-related priority areas deter- 6 mined most important by the full membership 7 of the Commission or Council, as applicable; 8 ‘‘(B) recommendations for goals, objec- 9 tives, strategies, and actions designed to ad- 10 dress such priority areas; and 11 ‘‘(C) a proposed evaluation framework with 12 output and outcome indicators appropriate to 13 gauge progress toward meeting the objectives 14 and priorities of the Commission or Council, as 15 applicable. 16 ‘‘(b) WORK PLAN.—Not later than January 1, 2023, 17 and every 2 years thereafter, the Commission and the 18 Council shall develop and approve an operational work 19 plan and budget based on the strategic plan under sub- 20 section (a). 21 ‘‘(c) GAO REVIEW.—Not later than January 1, 22 2024, and every 2 years thereafter, the Comptroller Gen- 23 eral of the United States shall conduct an evaluation of 24 the activities conducted by the Commission and the Coun- 25 VerDate Sep 11 2014 19:53 Mar 23, 2020 Jkt 099200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S3436.IS S3436 pamtmann on DSKBC07HB2PROD with BILLS 12 •S 3436 IS cil based on the operational work plans described in sub- 1 section (b) for the previous year and the output and out- 2 come indicators included in the strategic plan described 3 in subsection (a). The evaluation shall include a request 4 for written evaluations from members of the Commission 5 and the Council about barriers and facilitators to exe- 6 cuting successfully the work plans of the Commission and 7 the Council. 8 ‘‘(d) BIANNUAL REPORTING.—The Commission and 9 Council shall each issue a biannual report to the Secretary 10 that provides independent policy recommendations related 11 to border health issues. Not later than 3 mo [Text truncated for display. Full text available on Congress.gov.]