,i  #aac? ,,congress  #b;d ,session  ,h4
 ,r4 #ebba  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,july #bh1 #bjad ,mr4 
,h9ojosa 7= himself1 ,mr4 ,vela1 ,mr4   
,mi*aud1 ,mr4 ,cuell>1 ,ms4 ,eddie      
,b]nice ,johnson ( ,texas1 & ,mr4       
,grijalva7 introduc$ ! foll[+ bill2 :i* 
0 ref]r$ to ! ,committee on ,en]gy &    
,comm]ce1 & 9 addition to ! ,committee  
on ,=eign ,affairs1 = a p]iod to be     
subsequ5tly det]m9$ by ! ,speak]1 9 ea* 
case = consid]ation ( su* provisions z  
fall )9 ! jurisdiction ( ! committee    
conc]n$  ,a ,,bill  ,to e/abli% grant   
programs to improve ! heal? ( bord] area
 resid5ts & = all haz>ds prep>$ness 9 ! 
bord] area includ+ biot]rorism1         
infecti\s disease1 & noncommunicable    
em]g+ ?reats1 & = o!r purposes4  #a4    
,%ort title ,?is ,act may be cit$ z !   
,bord] ,heal? ,security ,act ( #bjad4   
#b4 ,f9d+s ,congress makes ! foll[+     
f9d+s3  7#a7 ,! ,unit$ ,/ates-,mexico   
bord] is an int]dep5d5t & dynamic region
 ( m ?an #ae1jjj1jjj p ) significant &  

unique public heal? *all5ges4  7#b7 ,^! 
*all5ges include l[ rates ( heal?       
insurance cov]age1 poor access to heal? 
c>e s]vices1 high unemploym5t rates1 l[ 
educational atta9m5t1 & high rates (    
dang]\s diseases1 su* z tub]culosis1    
diabetes1 obesity1 & o!r                
non-communicable diseases4  7#c7 ,z !   
#bjji novel influ5za ,a 7,h#a,n#a7      
p&emic illu/rat$1 diseases d n respect  
int]national b\nd>ies1 & a /rong public 
heal? ef=t at & along ! bord]s is       
crucial to n only protect & improve !   
heal? ( ,am]icans b also to help secure 
! c\ntry aga9/ ?reats to biosecurity &  
o!r em]g+ ?reats4  7#d7 ,= #aa ye>s1 !  
,unit$ ,/ates-,mexico ,bord] ,heal?     
,commission has s]v$ z a crucial        
b9ational in/itution to address ^!      
unique & truly cross-bord] heal? issues4
  7#e7 ,m ?an #ge p]c5t ( ,canadians    
live )9 #ajj miles ( ! ,unit$ ,/ates    
bord]4 ,! #bjjc epidemic ( sev]e acute  
respiratory syndrome caus$ m ?an #bej   
illnesses 9 ! ,great] ,toronto ,area1 j 

#hj miles f ,new ,york4  #c4 ,unit$     
,/ates-,mexico ,bord] ,heal? ,commission
 ,act am5dm5ts ,! ,unit$ ,/ates-,mexico 
,bord] ,heal? ,commission ,act 7#bb     
,u4,s4,c4 #bijn et seq47 is am5d$--     
7#a7 9 section #c--  7,a7 9 p>agraph    
7#a71 by /rik+ 2 & & ins]t+ 22  7,b7 9  
p>agraph 7#b71 by /rik+ ! p]iod & ins]t+
 a semicolon2 &  7,c7 by add+ at ! end !
 foll[+3  7#c7 to coop]ate ) !          
,canada-,unit$ ,/ates ,pan-,bord]       
,public ,heal? ,prep>$ness ,c\ncil      
7ref]r$ to 9 ?is ,act z ! ,c\ncil71 z   
appropriate2 &  7#d7 to s]ve z an       
indep5d5t & objective body to bo?       
recomm5d & implem5t initiatives t solve 
bord] heal? issues4  2  7#b7 9 section  
#e--  7,a7 9 subsection 7b71 by /rik+   
%\ld be ! lead] & ins]t+ %all be !      
,*air2 &  7,b7 by add+ at ! end !       
foll[+3  7d7 ,provid+ advice &          
recomm5dations ,memb]s ( ! ,commission &
 ! ,c\ncil may at any "t provide advice 
or recomm5dations to ! ,secret>y1       
,congress1 or any ,memb] ( ,congress    

conc]n+ issues t are consid]$ by !      
,commission or ,c\ncil4 ,su* advice or  
recomm5dations may be provid$ reg>dless 
( :e!r a reque/ = su* is made &         
reg>dless ( :e!r ! memb] or individual  
is au?oriz$ to provide su* advice or    
recomm5dations by ! ,commission or      
,c\ncil or any o!r ,f$]al (ficial4  2   
7#c7 by r$esignat+ section #h z section 
#ab2  7#d7 by /rik+ section #g & ins]t+ 
! foll[+3  #g4 ,bord] heal? grants  7a7 
,eligible entity def9$ ,9 ?is section1 !
 t]m eligible entity means a ,/ate1     
public in/itution ( high] education1    
local gov]nm5t1 ,indian tribe1 tribal   
organization1 urban ,indian             
organization1 nonpr(it heal?            
organization1 trauma c5t]1 critical     
access hospital or o!r hospital t s]ves 
rural or o!r vuln]able communities &    
populations1 fai?-bas$ entity1 or       
community heal? c5t] receiv+ assi/ance  
"u section #ccj ( ! ,public ,heal?      
,s]vice ,act 7#db ,u4,s4,c4 #bed;b71 t  
is locat$ 9 ! ,unit$ ,/ates-,mexico     

bord] area or ! ,unit$ ,/ates-,canada   
bord] area4  7b7 ,au?orization ,f am\nts
 appropriat$ "u section #aa1 !          
,secret>y1 9 consultation ) memb]s ( !  
,commission & ,c\ncil & 9 coord9ation ) 
! ,(fice ( ,global ,affairs1 %all aw>d  
grants to eligible entities to address  
priorities & recomm5dations outl9$ by ! 
/rategic plan & op]ational "w plan ( !  
,commission & ! ,c\ncil1 z au?oriz$ "u  
section #i1 to improve ! heal? ( ,unit$ 
,/ates-,mexico bord] area & ,unit$      
,/ates-,canada bord] area resid5ts4  7c7
 ,application ,an eligible entity t     
desires a grant "u subsection 7b7 %all  
submit an application to ! ,secret>y at 
su* "t1 9 su* mann]1 & conta9+ su*      
in=mation z ! ,secret>y may require4    
7d7 ,use ( funds ,an eligible entity t  
receives a grant "u subsection 7b7 %all 
use ! grant funds = any ( ! foll[+3     
7#a7 ,programs relat+ to any #a or m ( !
 foll[+3  7,a7 ,mat]nal & *ild heal?4   
7,b7 ,prim>y c>e & prev5tative heal?4   
7,c7 ,infecti\s disease te/+1 monitor+1 

& surveillance4  7,d7 ,public heal? &   
public heal? infra/ructure4  7,e7 ,heal?
 promotion4  7,f7 ,oral heal?4  7,g7    
,behavioral & m5tal heal?4  7,h7        
,sub/ance abuse prev5tion & h>m         
r$uction4  7,i7 ,heal? conditions t h a 
high preval5ce 9 ! ,unit$ ,/ates-,mexico
 bord] area or ,unit$ ,/ates-,canada    
bord] area4  7,j7 ,m$ical & heal?       
s]vices rese>*4  7,k7 ,work=ce tra9+ &  
developm5t4  7,l7 ,community heal?      
work]s & promotoras4  7,m7 ,heal? c>e   
infra/ructure problems 9 ! ,unit$       
,/ates-,mexico bord] area or ,unit$     
,/ates-,canada bord] area 7includ+      
plann+ & con/ruction grants74  7,n7     
,heal? disp>ities 9 ! ,unit$            
,/ates-,mexico bord] area or ,unit$     
,/ates-,canada bord] area4  7,o7        
,environm5tal heal?4  7,p7 ,heal?       
education4  7,q7 ,outrea* & enrollm5t   
s]vices ) respect to ,f$]al programs    
7includ+ programs au?oriz$ "u titles    
,,xix & ,,xxi ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acif et seq4 & #acig;aa

 et seq4774  7,r7 ,trauma c>e4  7,s7    
,heal? rese>* ) an emphasis on infecti\s
 disease & press+ issues relat$ to      
noncommunicable diseases4  7,t7         
,epidemiology & heal? rese>*4  7,u7     
,cross-bord] heal? surveillance         
coord9at$ ) ,mexican ,heal? ,au?orities 
or ,canadian ,heal? ,au?orities4  7,v7  
,obesity1 p>ticul>ly *ildhood obesity4  
7,w7 ,crisis communication1 dome/ic     
viol5ce1 heal? lit]acy1 or canc]4  7,x7 
,community-bas$ p>ticipatory rese>* on  
bord] heal? issues4  7,y7 ,viol5ce      
prev5tion4  7,z7 ,cross-bord] public    
heal? prep>$ness4  7#b7 ,o!r programs   
det]m9$ appropriate by ! ,secret>y4  7e7
 ,supplem5t1 n supplant ,am\nts provid$ 
to an eligible entity aw>d$ a grant "u  
subsection 7b7 %all be us$ to supplem5t 
& n supplant o!r funds available to !   
eligible entity to c>ry out ! activities
 describ$ 9 subsection 7d74  #h4 ,grants
 = ,e>ly ,w>n+ ,infecti\s ,disease      
,surveillance 7,,ewids7 9 ! bord] area  
7a7 ,eligible entity def9$ ,9 ?is       

section1 ! t]m eligible entity means a  
,/ate1 local gov]nm5t1 ,indian tribe1   
tribal organization1 urban ,indian      
organization1 trauma c5t]1 regional     
trauma c5t] coord9at+ entity1 or public 
heal? entity4  7b7 ,au?orization ,f     
funds appropriat$ "u section #aa1 !     
,secret>y %all aw>d grants = ,e>ly ,w>n+
 ,infecti\s ,disease ,surveillance      
7,,ewids7 to eligible entities =        
infecti\s disease surveillance          
activities 9 ! ,unit$ ,/ates-,mexico    
bord] area or ,unit$ ,/ates-,canada     
bord] area4  7c7 ,application ,an       
eligible entity t desires a grant "u ?is
 section %all submit an application to !
 ,secret>y at su* "t1 9 su* mann]1 &    
conta9+ su* in=mation z ! ,secret>y may 
require4  7d7 ,uses ( funds ,an eligible
 entity t receives a grant "u subsection
 7b7 %all use ! grant funds1 9          
coord9ation ) ,/ate & local all haz>ds  
programs1 to--  7#a7 develop & implem5t 
infecti\s disease surveillance plans &  
networks & public heal? em]g5cy &       

read9ess assessm5ts & prep>$ness plans1 
& pur*ase items necess>y = su* plans2   
7#b7 coord9ate infecti\s disease        
surveillance plann+ & int]jurisdictional
 risk assessm5ts 9 ! region )           
appropriate ,unit$ ,/ates-bas$ ag5cies &
 organizations & appropriate au?orities 
9 ,mexico or ,canada2  7#c7 improve     
infra/ructure1 includ+ surge capacity1  
syndromic surveillance1 &               
isolation_/decontam9ation capacity1 &   
policy prep>$ness1 includ+ = mutual     
assi/ance & = ! %>+ ( in=mation &       
res\rces2  7#d7 improve laboratory      
capacity1 9 ord] to ma9ta9 & enhance    
capability & capacity to detect pot5tial
 infecti\s disease1 :e!r naturally      
occurr+ or ! result ( t]rorism2  7#e7   
create & ma9ta9 a heal? al]t network1   
includ+ risk communication & in=mation  
dissem9ation t is culturally compet5t & 
takes into acc\nt ! ne$s ( at-risk      
populations1 includ+ individuals )      
disabilities2  7#f7 educate & tra9      
cl9icians1 epidemiologi/s1 laboratories1

 & em]g5cy managem5t p]sonnel2  7#g7    
implem5t electronic data & infra/ructure
 inv5tory sy/ems to coord9ate ! triage1 
transportation1 & treatm5t (            
multicasualty incid5t victims2  7#h7    
provide infecti\s disease te/+ 9 !      
,unit$ ,/ates-,mexico bord] area or     
,unit$ ,/ates-,canada bord] area2 &     
7#i7 c>ry out su* o!r activities        
id5tifi$ by ! ,secret>y1 memb]s ( !     
,commission1 memb]s ( ! ,c\ncil1 ,/ate  
or local public heal? au?orities1       
repres5tatives ( bord] heal? (fices1 or 
au?orities at ! ,unit$ ,/ates-,mexico or
 ,unit$ ,/ates-,canada bord]s4  #i4     
,plans1 reports1 audits1 & by-laws  7a7 
,/rategic plan  7#a7 ,9 g5]al ,n lat]   
?an #b ye>s aft] ! date ( enactm5t ( ?is
 section1 & e #e ye>s !reaft]1 !        
,commission 7includ+ ! p>ticipation (   
memb]s repres5t+ bo? ! ,unit$ ,/ates &  
,mexican sections7 & ! ,c\ncil 7includ+ 
! p>ticipation ( memb]s repres5t+ bo? ! 
,unit$ ,/ates & ,canada7 %all ea* prep>e
 a b9ational /rategic plan to guide !   

op]ations ( ! ,commission & ! ,c\ncil & 
submit su* plan to ! ,secret>y &        
,congress4  7#b7 ,requirem5ts ,!        
b9ational /rategic plan "u p>agraph 7#a7
 %all include--  7,a7 heal?-relat$      
priority areas det]m9$ mo/ important by 
! full memb]%ip ( ! ,commission or      
,c\ncil1 z applicable2  7,b7            
recomm5dations = goals1 objectives1     
/rategies1 & actions design$ to address 
su* priority areas2 &  7,c7 a propos$   
evaluation framework ) output & outcome 
indicators appropriate to gauge progress
 t[>d meet+ ! objectives & priorities ( 
! ,commission or ,c\ncil1 z applicable4 
7b7 ,"w plan ,n lat] ?an ,janu>y #a1    
#bjaf1 & e #b ye>s !reaft]1 !           
,commission & ! ,c\ncil %all develop &  
approve an op]ational "w plan & budget  
bas$ on ! /rategic plan "u subsection   
7a74  7c7 ,,gao review ,n lat] ?an      
,janu>y #a1 #bjag1 & e #b ye>s !reaft]1 
! ,comptroll] ,g5]al ( ! ,unit$ ,/ates  
%all conduct an evaluation ( !          
activities conduct$ by ! ,commission & !

 ,c\ncil bas$ on ! op]ational "w plans  
describ$ 9 subsection 7b7 = ! previ\s   
ye> & ! output & outcome indicators     
includ$ 9 ! /rategic plan describ$ 9    
subsection 7a74 ,! evaluation %all      
include a reque/ = writt5 evaluations f 
memb]s ( ! ,commission & ! ,c\ncil ab\t 
b>ri]s & facilitators to execut+        
successfully ! "w plans ( ! ,commission 
& ! ,c\ncil4  7d7 ,biannual report+ ,!  
,commission & ,c\ncil %all ea* issue a  
biannual report to ! ,secret>y t        
provides indep5d5t policy recomm5dations
 relat$ to bord] heal? issues4 ,n lat]  
?an #c mon?s foll[+ receipt ( ea* su*   
biannual report1 ! ,secret>y %all       
provide to ,congress ! report & any     
/udies or o!r mat]ials produc$          
indep5d5tly by ! ,commission & ,c\ncil4 
7e7 ,audits ,! ,secret>y %all annually  
prep>e an audit$ f9ancial report to     
acc\nt = all appropriat$ assets exp5d$  
by ! ,commission & ,c\ncil to address   
bo? ! /rategic & op]ational "w plans = !
 ye> involv$4  7f7 ,by-,laws ,n lat] ?an

 #f mon?s aft] ! date ( enactm5t ( ?is  
section1 ! ,commission & ,c\ncil %all   
develop & approve bylaws to provide     
fully = compliance ) ! requirem5ts ( ?is
 section4  7g7 ,transmittal to congress 
,! ,commission & ,c\ncil %all submit    
copies ( ! op]ational "w plan & by-laws 
to ,congress4 ,! ,comptroll] ,g5]al ( ! 
,unit$ ,/ates %all submit a copy ( ea*  
evaluation complet$ "u subsection 7c7 to
 ,congress4  #aj4 ,coord9ation  7a7 ,9  
g5]al ,to ! ext5t practicable &         
appropriate1 plans1 sy/ems1 & activities
 to be fund$ 7or support$7 "u ?is ,act =
 all haz>d prep>$ness1 & g5]al bord]    
heal?1 %all be coord9at$ ) ,f$]al1      
,/ate1 & local au?orities 9 ,mexico1    
,canada1 & ! ,unit$ ,/ates4  7b7        
,coord9ation ( heal? s]vices &          
surveillance ,! ,secret>y1 act+ ?r\gh ! 
,assi/ant ,secret>y = ,prep>$ness &     
,response1 :5 appropriate1 may coord9ate
 ) ! ,secret>y ( ,homel& ,security 9    
e/abli%+ a heal? al]t sy/em t--  7#a7   
al]ts cl9icians & public heal? (ficials 

( em]g+ disease clu/]s & syndromes along
 ! ,unit$ ,/ates-,mexico bord] area &   
,unit$ ,/ates-,canada bord] area2 &     
7#b7 w>ns ( heal? ?reats1 extreme wea!r 
conditions1 disa/]s ( mass scale1       
biot]rorism1 & o!r em]g+ ?reats along ! 
,unit$ ,/ates-,mexico bord] area &      
,unit$ ,/ates-,canada bord] area4  #aa4 
,au?orization ( appropriations ,!re is  
au?oriz$ to be appropriat$ to c>ry out  
?is ,act #g1jjj1jjj = fiscal ye> #bjae &
 ea* succe$+ ye>1 subject to !          
availability ( appropriations = su*     
purpose1 ( :i* #d1fej1jjj %all be made  
available to fund op]ationally feasible 
functions1 activities1 & grants )       
respect to ! ,unit$ ,/ates-,mexico bord]
 & ! bord] heal? activities "u          
coop]ative agreem5ts ) ! bord] heal?    
(fices ( ! ,/ates ( ,cali=nia1 ,arizona1
 ,new ,mexico1 & ,texas1 & #b1cej1jjj   
%all be allocat$ = ! adm9i/ration (     
,unit$ ,/ates activities "u ?is ,act on 
! ,unit$ ,/ates-,canada bord] & ! bord] 
heal? au?orities1 act+ ?r\gh !          

,canada-,unit$ ,/ates ,pan-,bord]       
,public ,heal? ,prep>$ness ,c\ncil4  2 &
  7#e7 9 section #ab 7z s r$esignat$7-- 
7,a7 by r$esignat+ p>agraphs 7#c7 & 7#d7
 z p>agraphs 7#d7 & 7#f71 respectively2 
7,b7 by ins]t+ aft] p>agraph 7#b71 !    
foll[+3  7#c7 ,indians2 indian tribe2   
tribal organization2 urban indian       
organization ,! t]ms ,indian1 ,indian   
tribe1 tribal organization1 & urban     
,indian organization h ! mean+s giv5 su*
 t]ms 9 section #d ( ! ,indian ,heal?   
,c>e ,improvem5t ,act 7#be ,u4,s4,c4    
#afjc74  2 &  7,c7 by ins]t+ aft]       
p>agraph 7#d71 z s r$esignat$1 ! foll[+3
  7#e7 ,unit$ ,/ates-,canada bord] area 
,! t]m ,unit$ ,/ates-,canada bord] area 
means ! area locat$ 9 ! ,unit$ ,/ates & 
,canada )9 #ajj kilomet]s ( ! bord]     
betwe5 ! ,unit$ ,/ates & ,canada4  4