,,ii #aacth ,,congress #b;d ,session ,s4 #bbfh ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,april #bi1 #bjad,mr4 ,udall of ,new ,mexico 7for himself1 ,mr4 ,heinrich1 and ,mrs4 ,gillibrand7 introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to establish grant programs to improve the health of border area residents and for all hazards preparedness in the border area including bioterrorism1 infectious disease1 and noncommunicable emerging threats1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,border ,health ,security ,act of #bjac4 #b4 ,findings ,congress makes the following findings3 7#a7 ,the ,united ,states-,mexico border is an interdependent and dynamic region of more than #ae1jjj1jjj people with significant and unique public health challenges4 7#b7 ,these challenges include low rates of health insurance coverage1 poor access to health care services1 high unemployment rates1 low educational attainment1 and high rates of dangerous diseases1 such as tuberculosis1 diabetes1 obesity1 and other non-communicable diseases4 7#c7 ,as the #bjji novel influenza ,a 7,h#a,n#a7 pandemic illustrated1 diseases do not respect international boundaries1 and a strong public health effort at and along the borders is crucial to not only protect and improve the health of ,americans but also to help secure the country against threats to biosecurity and other emerging threats4 7#d7 ,for #aa years1 the ,united ,states-,mexico ,border ,health ,commission has served as a crucial binational institution to address these unique and truly cross-border health issues4 7#e7 ,more than #ge percent of ,canadians live within #ajj miles of the ,united ,states border4 ,the #bjjc epidemic of severe acute respiratory syndrome caused more than #bej illnesses in the ,greater ,toronto ,area1 just #hj miles from ,new ,york4 #c4 ,united ,states-,mexico ,border ,health ,commission ,act amendments ,the ,united ,states-,mexico ,border ,health ,commission ,act 7#bb ,u4,s4,c4 #bijn et seq47 is amended-- 7#a7 in section #c-- 7,a7 in paragraph 7#a71 by striking 2 and and inserting 22 7,b7 in paragraph 7#b71 by striking the period and inserting a semicolon2 and 7,c7 by adding at the end the following3 7#c7 to cooperate with the ,canada-,united ,states ,pan ,border ,public ,health ,preparedness ,council 7referred to in this ,act as the ,council71 as appropriate2 and 7#d7 to serve as an independent and objective body to both recommend and implement initiatives that solve border health issues4 2 7#b7 in section #e-- 7,a7 in subsection 7b71 by striking should be the leader and inserting shall be the ,chair2 and 7,b7 by adding at the end the following3 7d7 ,providing advice and recommendations ,members of the ,commission and the ,council may at any time provide advice or recommendations to the ,secretary1 ,congress1 or any ,member of ,congress concerning issues that are considered by the ,commission or ,council4 ,such advice or recommendations may be provided regardless of whether a request for such is made and regardless of whether the member or individual is authorized to provide such advice or recommendations by the ,commission or ,council or any other ,federal official4 2 7#c7 by redesignating section #h as section #ab2 7#d7 by striking section #g and inserting the following3 #g4 ,border health grants 7a7 ,eligible entity defined ,in this section1 the term eligible entity means a ,state1 public institution of higher education1 local government1 ,indian tribe1 tribal organization1 urban ,indian organization1 nonprofit health organization1 trauma center1 critical access hospital or other hospital that serves rural or other vulnerable communities and populations1 faith-based entity1 or community health center receiving assistance under section #ccj of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;b71 that is located in the ,united ,states-,mexico border area or the ,united ,states-,canada border area4 7b7 ,authorization ,from amounts appropriated under section #aa1 the ,secretary1 in consultation with members of the ,commission and ,council and in coordination with the ,office of ,global ,affairs1 shall award grants to eligible entities to address priorities and recommendations outlined by the strategic plan and operational work plan of the ,commission and the ,council1 as authorized under section #i1 to improve the health of ,united ,states-,mexico border area and ,united ,states-,canada border area residents4 7c7 ,application ,an eligible entity that desires a grant under subsection 7b7 shall submit an application to the ,secretary at such time1 in such manner1 and containing such information as the ,secretary may require4 7d7 ,use of funds ,an eligible entity that receives a grant under subsection 7b7 shall use the grant funds for any of the following3 7#a7 ,programs relating to any one or more of the following3 7,a7 ,maternal and child health4 7,b7 ,primary care and preventative health4 7,c7 ,infectious disease testing1 monitoring1 and surveillance4 7,d7 ,public health and public health infrastructure4 7,e7 ,health promotion4 7,f7 ,oral health4 7,g7 ,behavioral and mental health4 7,h7 ,substance abuse prevention and harm reduction4 7,i7 ,health conditions that have a high prevalence in the ,united ,states-,mexico border area or ,united ,states-,canada border area4 7,j7 ,medical and health services research4 7,k7 ,workforce training and development4 7,l7 ,community health workers and promotoras4 7,m7 ,health care infrastructure problems in the ,united ,states-,mexico border area or ,united ,states-,canada border area 7including planning and construction grants74 7,n7 ,health disparities in the ,united ,states-,mexico border area or ,united ,states-,canada border area4 7,o7 ,environmental health4 7,p7 ,health education4 7,q7 ,outreach and enrollment services with respect to ,federal programs 7including programs authorized under titles ,,xix and ,,xxi of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq4 and #acig;aa et seq4774 7,r7 ,trauma care4 7,s7 ,health research with an emphasis on infectious disease and pressing issues related to noncommunicable diseases4 7,t7 ,epidemiology and health research4 7,u7 ,cross-border health surveillance coordinated with ,mexican ,health ,authorities or ,canadian ,health ,authorities4 7,v7 ,obesity1 particularly childhood obesity4 7,w7 ,crisis communication1 domestic violence1 health literacy1 or cancer4 7,x7 ,community-based participatory research on border health issues4 7,y7 ,violence prevention4 7,z7 ,cross-border public health preparedness4 7#b7 ,other programs determined appropriate by the ,secretary4 7e7 ,supplement1 not supplant ,amounts provided to an eligible entity awarded a grant under subsection 7b7 shall be used to supplement and not supplant other funds available to the eligible entity to carry out the activities described in subsection 7d74 #h4 ,grants for ,early ,warning ,infectious ,disease ,surveillance 7,,ewids7 in the border area 7a7 ,eligible entity defined ,in this section1 the term eligible entity means a ,state1 local government1 ,indian tribe1 tribal organization1 urban ,indian organization1 trauma center1 regional trauma center coordinating entity1 or public health entity4 7b7 ,authorization ,from funds appropriated under section #aa1 the ,secretary shall award grants for ,early ,warning ,infectious ,disease ,surveillance 7,,ewids7 to eligible entities for infectious disease surveillance activities in the ,united ,states-,mexico border area or ,united ,states-,canada border area4 7c7 ,application ,an eligible entity that desires a grant under this section shall submit an application to the ,secretary at such time1 in such manner1 and containing such information as the ,secretary may require4 7d7 ,uses of funds ,an eligible entity that receives a grant under subsection 7b7 shall use the grant funds1 in coordination with ,state and all local hazards programs1 to-- 7#a7 develop and implement infectious disease surveillance plans and networks and public health emergency and readiness assessments and preparedness plans1 and purchase items necessary for such plans2 7#b7 coordinate infectious disease surveillance planning and interjurisdictional risk assessments in the region with appropriate ,united ,states-based agencies and organizations and appropriate authorities in ,mexico or ,canada2 7#c7 improve infrastructure1 including surge capacity1 syndromic surveillance1 and isolation_/decontamination capacity1 and policy preparedness1 including for mutual assistance and for the sharing of information and resources2 7#d7 improve laboratory capacity1 in order to maintain and enhance capability and capacity to detect potential infectious disease1 whether naturally occurring or the result of terrorism2 7#e7 create and maintain a health alert network1 including risk communication and information dissemination that is culturally competent and takes into account the needs of at-risk populations1 including individuals with disabilities2 7#f7 educate and train clinicians1 epidemiologists1 laboratories1 and emergency management personnel2 7#g7 implement electronic data and infrastructure inventory systems to coordinate the triage1 transportation1 and treatment of multicasualty incident victims2 7#h7 provide infectious disease testing in the ,united ,states-,mexico border area or ,united ,states-,canada border area2 and 7#i7 carry out such other activities identified by the ,secretary1 members of the ,commission1 members of the ,council1 ,state or local public health authorities1 representatives of border health offices1 or authorities at the ,united ,states-,mexico or ,united ,states-,canada borders4 #i4 ,plans1 reports1 audits1 and by-laws 7a7 ,strategic plan 7#a7 ,in general ,not later than #b years after the date of enactment of this section1 and every #e years thereafter1 the ,commission 7including the participation of members representing both the ,united ,states and ,mexican sections7 and the ,council 7including the participation of members representing both the ,united ,states and ,canada7 shall each prepare a binational strategic plan to guide the operations of the ,commission and the ,council and submit such plan to the ,secretary and ,congress4 7#b7 ,requirements ,the binational strategic plan under paragraph 7#a7 shall include-- 7,a7 health-related priority areas determined most important by the full membership of the ,commission or ,council1 as applicable2 7,b7 recommendations for goals1 objectives1 strategies1 and actions designed to address such priority areas2 and 7,c7 a proposed evaluation framework with output and outcome indicators appropriate to gauge progress toward meeting the objectives and priorities of the ,commission or ,council1 as applicable4 7b7 ,work plan ,not later than ,january #a1 #bjae1 and every #b years thereafter1 the ,commission and the ,council shall develop and approve an operational work plan and budget based on the strategic plan under subsection 7a74 7c7 ,,gao review ,not later than ,january #a1 #bjaf1 and every #b years thereafter1 the ,comptroller ,general of the ,united ,states shall conduct an evaluation of the activities conducted by the ,commission and the ,council based on the operational work plans described in subsection 7b7 for the previous year and the output and outcome indicators included in the strategic plan described in subsection 7a74 ,the evaluation shall include a request for written evaluations from members of the ,commission and the ,council about barriers and facilitators to executing successfully the work plans of the ,commission and the ,council4 7d7 ,biannual reporting ,the ,commission and ,council shall each issue a biannual report to the ,secretary that provides independent policy recommendations related to border health issues4 ,not later than #c months following receipt of each such biannual report1 the ,secretary shall provide to ,congress the report and any studies or other materials produced independently by the ,commission and ,council4 7e7 ,audits ,the ,secretary shall annually prepare an audited financial report to account for all appropriated assets expended by the ,commission and ,council to address both the strategic and operational work plans for the year involved4 7f7 ,by-,laws ,not later than #f months after the date of enactment of this section1 the ,commission and ,council shall develop and approve bylaws to provide fully for compliance with the requirements of this section4 7g7 ,transmittal to congress ,the ,commission and ,council shall submit copies of the operational work plan and by-laws to ,congress4 ,the ,comptroller ,general of the ,united ,states shall submit a copy of each evaluation completed under subsection 7c7 to ,congress4 #aj4 ,coordination 7a7 ,in general ,to the extent practicable and appropriate1 plans1 systems1 and activities to be funded 7or supported7 under this ,act for all hazard preparedness1 and general border health1 shall be coordinated with ,federal1 ,state1 and local authorities in ,mexico1 ,canada1 and the ,united ,states4 7b7 ,coordination of health services and surveillance ,the ,secretary1 acting through the ,assistant ,secretary for ,preparedness and ,response1 when appropriate1 may coordinate with the ,secretary of ,homeland ,security in establishing a health alert system that-- 7#a7 alerts clinicians and public health officials of emerging disease clusters and syndromes along the ,united ,states-,mexico border area and ,united ,states-,canada border area2 and 7#b7 warns of health threats1 extreme weather conditions1 disasters of mass scale1 bioterrorism1 and other emerging threats along the ,united ,states-,mexico border area and ,united ,states-,canada border area4 #aa4 ,authorization of appropriations ,there is authorized to be appropriated to carry out this ,act #g1jjj1jjj for fiscal year #bjad and each succeeding year1 subject to the availability of appropriations for such purpose1 of which #d1fej1jjj shall be made available to fund operationally feasible functions1 activities1 and grants with respect to the ,united ,states-,mexico border and the border health activities under cooperative agreements with the border health offices of the ,states of ,california1 ,arizona1 ,new ,mexico1 and ,texas1 and #b1cej1jjj shall be allocated for the administration of ,united ,states activities under this ,act on the ,united ,states-,canada border and the border health authorities1 acting through the ,canada-,united ,states ,pan-,border ,public ,health ,preparedness ,council4 2 and 7#e7 in section #ab 7as so redesignated7-- 7,a7 by redesignating paragraphs 7#c7 and 7#d7 as paragraphs 7#d7 and 7#f71 respectively2 7,b7 by inserting after paragraph 7#b71 the following3 7#c7 ,indians2 indian tribe2 tribal organization2 urban indian organization ,the terms ,indian1 ,indian tribe1 tribal organization1 and urban ,indian organization have the meanings given such terms in section #d of the ,indian ,health ,care ,improvement ,act 7#be ,u4,s4,c4 #afjc74 2 and 7,c7 by inserting after paragraph 7#d71 as so redesignated1 the following3 7#e7 ,united ,states-,canada border area ,the term ,united ,states-,canada border area means the area located in the ,united ,states and ,canada within #ajj kilometers of the border between the ,united ,states and ,canada4 4