,,ii #aadth ,,congress #b;d ,session ,s4 #bhdc ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,april #ba1 #bjaf ,mr4 ,nelson 7for himself1 ,mr4 ,reid1 ,mr4 ,schumer1 ,ms4 ,hirono1 ,ms4 ,warren1 ,mr4 ,franken1 ,mr4 ,durbin1 ,mrs4 ,feinstein1 ,mr4 ,menendez1 ,mr4 ,reed1 and ,mrs4 ,gillibrand7 introduced the following bill2 which was read twice and referred to the ,committee on ,appropriations ,a ,,bill ,to provide emergency supplemental appropriations to address the ,zika crisis4 ,that the following sums are appropriated1 out of any money in the ,treasury not otherwise appropriated1 for the ,departments of ,health and ,human ,services and the ,department of ,state1 and related agencies for the fiscal year ending ,september #cj1 #bjaf1 and for other purposes1 namely3 ,title ,i ,department of ,health and ,human ,services ,centers for ,disease ,control and ,prevention ,,cdc-,wide ,activities and ,program ,support 7,including ,transfer of ,funds7,for an additional amount for ,,cdc-,wide ,activities and ,program ,support1 #gdc1jjj1jjj1 to remain available until expended1 to prevent1 prepare for1 and respond to ,zika virus1 other vector-borne diseases1 or other infectious diseases and related health outcomes1 domestically and internationally2 and to carry out titles ,,ii1 ,,iii1 and ,,xvii of the ,public ,health ,service 7referred to in this title as the ,,phs ,act7 with respect to domestic preparedness and global health3 ,provided1 ,that products purchased with these funds may1 at the discretion of the ,secretary of ,health and ,human ,services1 be deposited in the ,strategic ,national ,stockpile under section #cai;,f-#b of the ,,phs ,act3 ,provided further1 ,that funds may be used for purchase and insurance of official motor vehicles in foreign countries3 ,provided further1 ,that the provisions in section #cag,s of the ,,phs ,act shall apply to the use of funds appropriated in this paragraph as determined by the ,director of the ,centers for ,disease ,control and ,prevention 7,,cdc7 to be appropriate3 ,provided further1 ,that funds appropriated in this paragraph may be used for grants for the construction1 alteration1 or renovation of nonfederally owned facilities to improve preparedness and response capability at the ,state and local level3 ,provided further1 ,that funds appropriated in this paragraph may be used for acquisition of real property 7including long-term ground leases7 and equipment1 and construction1 demolition1 or renovation of facilities1 including construction on leased land3 ,provided further1 ,that funds appropriated in this paragraph may be transferred by the ,director of ,,cdc to other accounts of the ,,cdc for the purposes provided in this paragraph3 ,provided further1 ,that such transfer authority is in addition to any other transfer authority provided by law3 ,provided further1 ,that1 upon a determination that all or part of the funds transferred from this appropriation are not necessary for the purposes provided herein1 such amounts may be transferred back to this appropriation3 ,provided further1 ,that the amount appropriated in this paragraph is designated by the ,congress as an emergency requirement pursuant to section #bea7;b77#b77;,a7 of the ,balanced ,budget and ,emergency ,deficit ,control ,act of #aihe1 as amended3 ,provided further1 ,that such amount shall be available only if the ,president designates such amount as an emergency requirement pursuant to section #bea7;b77#b77;,a74 ,departmental ,management ,public ,health and ,social ,services ,emergency ,fund 7,including ,transfer of ,funds7,for an additional amount for ,public ,health and ,social ,services ,emergency ,fund1 #bcc1jjj1jjj1 to remain available until expended1 to prevent1 prepare for1 and respond to ,zika virus1 other vector-borne diseases1 or other infectious diseases and related health outcomes1 domestically and internationally2 to develop necessary countermeasures and vaccines1 including the development and purchase of vaccines1 therapeutics1 diagnostics1 necessary medical supplies1 and administrative activities2 for carrying out titles ,,ii1 ,,iii1 and ,,xvii of the ,,phs ,act with respect to domestic preparedness and global health2 and for carrying out title ,,iii of the ,,phs ,act and title ,v of the ,social ,security ,act to provide health care and related services in areas affected by ,zika virus3 ,provided1 ,that funds appropriated in this paragraph may be used to procure security countermeasures 7as defined in section #cai;,f-#b7;c77#a77;,b7 of the ,,phs ,act1 as amended by this ,act73 ,provided further1 ,that paragraphs 7#a7 and 7#g77;,c7 of subsection 7c7 of section #cai;,f-#b of the ,,phs ,act1 but no other provisions of such section1 shall apply to such security countermeasures procured with funds appropriated in this paragraph3 ,provided further1 ,that products purchased with funds appropriated in this paragraph may1 at the discretion of the ,secretary of ,health and ,human ,services1 be deposited in the ,strategic ,national ,stockpile under section #cai;,f-#b of the ,,phs ,act3 ,provided further1 ,that funds appropriated in this paragraph may be transferred to the fund authorized by section #cai;,f-#d of the ,,phs ,act3 ,provided further1 ,that funds appropriated in this paragraph may1 for purposes of providing primary health services in areas affected by ,zika virus1 other vector-borne diseases1 or other infectious diseases1 be used to assign ,national ,health ,service ,corps 7,,nhsc7 members to ,puerto ,rico and other ,territories1 notwithstanding the assignment priorities and limitations in or under sections #ccc7;a77#a77;,d71 #ccc7;b71 or #ccc;,a7a7 of the ,,phs ,act1 and to make ,,nhsc ,loan ,repayment ,program awards under section #cch;,b of such ,act3 ,provided further1 ,that funds may be awarded for projects of regional and national significance in ,puerto ,rico and other ,territories authorized under section #eja of the ,social ,security ,act1 notwithstanding section #ejb of such ,act3 ,provided further1 ,that funds may be used for the alteration or renovation of nonfederally owned facilities to improve preparedness and response capability at the ,state and local level3 ,provided further1 ,that funds appropriated in this paragraph may be transferred to other appropriations of the ,department of ,health and ,human ,services1 as determined by the ,secretary to be appropriate1 to be used for the purposes specified in this paragraph3 ,provided further1 ,that any transfers of these funds shall be made in consultation with the ,office of ,management and ,budget3 ,provided further1 ,that the transfer authority provided in this paragraph is in addition to any other transfer authority provided by law3 ,provided further1 ,that1 upon a determination that all or part of the funds transferred from this appropriation are not necessary for the purposes provided herein1 such amounts may be transferred back to this appropriation3 ,provided further1 ,that the amount appropriated in this paragraph is designated by the ,congress as an emergency requirement pursuant to section #bea7;b77#b77;,a7 of the ,balanced ,budget and ,emergency ,deficit ,control ,act of #aihe1 as amended3 ,provided further1 ,that such amount shall be available only if the ,president designates such amount as an emergency requirement pursuant to section #bea7;b77#b77;,a74 ,national ,institutes of ,health ,national ,institute of ,allergy and ,infectious ,diseases ,for an additional amount for ,national ,institute of ,allergy and ,infectious ,diseases1 #bgg1jjj1jjj1 to remain available until expended1 to prevent1 prepare for1 and respond to ,zika virus1 other vector-borne diseases1 or other infectious diseases and related health outcomes1 domestically and internationally1 including expenses related to carrying out section #cja and title ,,iv of the ,,phs ,act3 ,provided1 ,that such funds may be transferred by the ,director of the ,national ,institutes of ,health 7,,nih7 to other accounts of the ,,nih for the purposes provided in this paragraph3 ,provided further1 ,that such transfer authority is in addition to any other transfer authority provided by law3 ,provided further1 ,that1 upon a determination that all or part of the funds transferred from this appropriation are not necessary for the purposes provided herein1 such amounts may be transferred back to this appropriation3 ,provided further1 ,that the amount appropriated in this paragraph is designated by the ,congress as an emergency requirement pursuant to section #bea7;b77#b77;,a7 of the ,balanced ,budget and ,emergency ,deficit ,control ,act of #aihe1 as amended3 ,provided further1 ,that such amount shall be available only if the ,president designates such amount as an emergency requirement pursuant to section #bea7;b77#b77;,a74 ,food and ,drug ,administration ,salaries and ,expenses ,for an additional amount for ,salaries and ,expenses1 #aj1jjj1jjj1 to remain available until expended1 to prevent1 prepare for1 and respond to ,zika virus1 other vector-borne diseases1 or other infectious diseases and related health outcomes1 domestically and internationally1 and to develop necessary medical countermeasures and vaccines1 including the review1 regulation1 and post market surveillance of vaccines and therapies1 and administrative activities3 ,provided1 ,that such amount is designated by the ,congress as an emergency requirement pursuant to section #bea7;b77#b77;,a7 of the ,balanced ,budget and ,emergency ,deficit ,control ,act of #aihe1 as amended3 ,provided further1 ,that such amount shall be available only if the ,president designates such amount as an emergency requirement pursuant to section #bea7;b77#b77;,a74 ,general ,provisions--,this ,act 7,including ,transfer of ,funds7 #aja4 ,for purposes of preventing1 preparing for1 and responding to ,zika virus1 other vector-borne diseases1 or other infectious diseases and related health outcomes domestically and internationally1 the ,secretary of ,health and ,human ,services may use funds provided in this ,act-- 7#a7 to acquire1 lease1 construct1 alter1 renovate1 equip1 furnish1 or manage facilities outside of the ,united ,states1 as necessary to conduct such programs1 in consultation with the ,secretary of ,state1 either directly for the use of the ,united ,states ,government or for the use1 pursuant to grants1 direct assistance1 or cooperative agreements1 of public or nonprofit private institutions or agencies in participating foreign countries2 and 7#b7 to enter into contracts with individuals for the provision of personal services 7as described in section #ajd of part #cg of title #dh1 ,code of ,federal ,regulations 7#dh ,c4,f4,r4 #cg4ajd771 within the ,united ,states and abroad3 ,provided1 ,that such individuals may not be deemed employees of the ,united ,states for the purpose of any law administered by the ,office of ,personnel ,management4 #ajb4 ,section #ccjd of title #e1 ,united ,states ,code1 is amended by adding at the end the following3 7g7 ,the heads of the ,department of ,health and ,human ,services1 ,department of ,state1 and the ,agency for ,international ,development may appoint1 without regard to the provisions of sections #ccji through #ccai1 candidates needed for positions to perform critical work in direct response to a public health threat requiring an immediate response for which-- 7#a7 public notice has been given2 and 7#b7 the ,secretary of ,health and ,human ,services has determined that such a public health threat exists4 4 #ajc4 ,funds appropriated by this title may be used to reimburse accounts administered by the ,department of ,health and ,human ,services for obligations incurred for ,zika virus response prior to the enactment of this ,act4 ,transfer ,authority #ajd4 ,funds appropriated to the ,department of ,health and ,human ,services in this ,act may be transferred to and merged with other ,federal accounts for purposes specified in this ,act following consultation with the ,office of ,management and ,budget3 ,provided1 ,that such transfer authority shall be in addition to any other transfer authority provided by law3 ,provided further1 ,that1 upon a determination that all or part of the funds transferred from an appropriation are not necessary1 such amounts may be transferred back to that appropriation4 #aje4 ,section #cai;,f-#b7;c77#a77;,b7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;d-#f;b7c77#a77;,b77 is amended-- 7#a7 in clause 7i77,,iii77bb71 by striking 2 or and inserting a semicolon2 7#b7 in clause 7ii71 by striking the period and inserting 2 or2 and 7#c7 by adding the following new clause3 7iii7 7,i7 the ,secretary determines to be a necessary countermeasure to diagnose1 mitigate1 prevent1 or treat harm from any infectious disease that may pose a threat to the public health2 and 7,,ii7 7aa7 is approved or cleared under chapter ,v of the ,federal ,food1 ,drug1 and ,cosmetic ,act1 or licensed under section #cea of this ,act2 or 7bb7 is a countermeasure for which the ,secretary determines that sufficient and satisfactory clinical experience or research data 7including data1 if available1 from pre-clinical and clinical trials7 support a reasonable conclusion that the countermeasure will qualify for approval or licensing within #aj years after the date of a determination under subclause 7,i74 4 #ajf4 7a7 ,in general 7#a7 ,for purposes of title ,,xix of the ,social ,security ,act1 for the one year period beginning with the first day of the first full fiscal quarter following enactment of this section1 the ,federal medical assistance percentage 7,,fmap7 under section #aije7;b7 of such ,act for the ,territories specified in paragraph 7#b7 shall be raised from #ee percent to #fe percent4 ,any net increase in payment to such a territory under section #aijc7;a7 of such ,act1 which is attributable to such raised ,,fmap1 shall be disregarded in applying sections #aajh7;f7 and #aajh7;g7 of such ,act to the territory4 7#b7 ,the ,territories specified in this paragraph are the ,commonwealth of ,puerto ,rico1 the ,united ,states ,virgin ,islands1 ,guam1 ,american ,samoa1 and the ,northern ,mariana ,islands4 7b7 ,availability of appropriations for implementing increased ,,fmap ,with respect to the amount needed for purposes of implementing the raised ,,fmap under subsection 7a7 for each of fiscal years #bjaf and #bjag1 such amount is designated by the ,congress as an emergency requirement pursuant to section #bea7;b77#b77;,a7 of the ,balanced ,budget and ,emergency ,deficit ,control ,act of #aihe1 as amended1 and such amount shall be available only if the ,president designates such amount as an emergency requirement pursuant to section #bea7;b77#b77;,a74 ,title ,,ii ,department of ,state and ,other ,international ,programs ,administration of ,foreign ,affairs ,diplomatic and ,consular ,programs ,for an additional amount for ,diplomatic and ,consular ,programs1 #ad1eid1jjj1 to remain available until ,september #cj1 #bjag1 for necessary expenses to support response efforts related to the ,zika virus and related health outcomes1 other vector-borne diseases1 or other infectious diseases3 ,provided1 ,that up to #b1dai1jjj may be made available for medical evacuation costs of any other ,department or agency of the ,united ,states under the ,chief of ,mission authority1 and may be transferred to any other appropriation of such ,department or agency for such costs3 ,provided further1 ,that such amount is designated by the ,congress as an emergency requirement pursuant to section #bea7;b77#b77;,a7 of the ,balanced ,budget and ,emergency ,deficit ,control ,act of #aihe1 as amended3 ,provided further1 ,that such amount shall be available only if the ,president designates such amount as an emergency requirement pursuant to section #bea7;b77#b77;,a74 ,administration of ,foreign ,affairs ,emergencies in the ,diplomatic and ,consular ,service ,for an additional amount for ,emergencies in the ,diplomatic and ,consular ,services1 #d1jjj1jjj for necessary expenses to support response efforts related to the ,zika virus and related health outcomes1 other vector-borne diseases1 or other infectious diseases1 to remain available until expended3 ,provided1 ,that such amount is designated by the ,congress as an emergency requirement pursuant to section #bea7;b77#b77;,a7 of the ,balanced ,budget and ,emergency ,deficit ,control ,act of #aihe1 as amended3 ,provided further1 ,that such amount shall be available only if the ,president designates such amount as an emergency requirement pursuant to section #bea7;b77#b77;,a74 ,administration of ,foreign ,affairs ,repatriation ,loans ,program ,account ,for an additional amount for ,repatriation ,loans ,program ,account for the cost of direct loans1 #a1jjj1jjj1 to support the response efforts related to the ,zika virus and related health outcomes1 other vector-borne diseases1 or other infectious diseases1 to remain available until expended3 ,provided1 ,that such costs1 including the cost of modifying such loans1 shall be as defined in section #ejb of the ,congressional ,budget ,act of #aigd3 ,provided further1 ,that such funds are available to subsidize an additional amount of gross obligations for the principal amount of direct loans not to exceed #a1hhj1djf3 ,provided further1 ,that such amount is designated by the ,congress as an emergency requirement pursuant to section #bea7;b77#b77;,a7 of the ,balanced ,budget and ,emergency ,deficit ,control ,act of #aihe1 as amended3 ,provided further1 ,that such amount shall be available only if the ,president designates such amount as an emergency requirement pursuant to section #bea7;b77#b77;,a74 ,other ,global ,health ,programs ,for an additional amount for ,global ,health ,programs1 #cbe1jjj1jjj1 to remain available until expended1 for necessary expenses for assistance or research to prevent1 treat1 or otherwise respond to the ,zika virus and related health outcomes1 other vector-borne diseases1 or other infectious diseases3 ,provided1 ,that funds appropriated under this heading may be made available for multi-year funding commitments to incentivize the development of global health technologies3 ,provided further1 ,that such amount is designated by the ,congress as an emergency requirement pursuant to section #bea7;b77#b77;,a7 of the ,balanced ,budget and ,emergency ,deficit ,control ,act of #aihe1 as amended3 ,provided further1 ,that such amount shall be available only if the ,president designates such amount as an emergency requirement pursuant to section #bea7;b77#b77;,a74 ,international ,assistance ,programs ,international ,security ,assistance ,nonproliferation1 ,anti-,terrorism1 ,demining and ,related ,programs ,for an additional amount for ,nonproliferation1 ,anti-,terrorism1 ,demining and ,related ,programs1 #h1jjj1jjj1 to remain available until ,september #cj1 #bjag1 for necessary expenses to support response and research efforts related to the ,zika virus and related health outcomes1 other vector-borne diseases1 or other infectious diseases3 ,provided1 ,that such amount is designated by the ,congress as an emergency requirement pursuant to section #bea7;b77#b77;,a7 of the ,balanced ,budget and ,emergency ,deficit ,control ,act of #aihe1 as amended3 ,provided further1 ,that such amount shall be available only if the ,president designates such amount as an emergency requirement pursuant to section #bea7;b77#b77;,a74 ,multilateral ,assistance ,international ,organizations and ,programs ,for an additional amount for ,international ,organizations and ,programs1 #ac1ejj1jjj1 to remain available until ,september #cj1 #bjag1 for necessary expenses to support response and research efforts related to the ,zika virus and related health outcomes1 other vector-borne diseases1 or other infectious diseases3 ,provided1 ,that such amount is designated by the ,congress as an emergency requirement pursuant to section #bea7;b77#b77;,a7 of the ,balanced ,budget and ,emergency ,deficit ,control ,act of #aihe1 as amended3 ,provided further1 ,that such amount shall be available only if the ,president designates such amount as an emergency requirement pursuant to section #bea7;b77#b77;,a74 ,agency for ,international ,development ,operating ,expenses ,for an additional amount for ,operating ,expenses1 #aj1jjj1jjj1 to remain available until ,september #cj1 #bjag1 for necessary expenses to support response efforts related to the ,zika virus and related health outcomes1 other vector-borne diseases1 or other infectious diseases3 ,provided1 ,that such amount is designated by the ,congress as an emergency requirement pursuant to section #bea7;b77#b77;,a7 of the ,balanced ,budget and ,emergency ,deficit ,control ,act of #aihe1 as amended3 ,provided further1 ,that such amount shall be available only if the ,president designates such amount as an emergency requirement pursuant to section #bea7;b77#b77;,a74 ,general ,provisions--,department of ,state and ,other ,international ,programs ,use of ,ebola ,balances for ,other ,infectious ,diseases #bja4 ,unobligated balances of amounts appropriated under title ,,ix of the ,department of ,state1 ,foreign ,operations1 and ,related ,programs ,appropriations ,act1 #bjae 7division ,j of ,public ,law #aac-bce7 shall also be available for necessary expenses for operations1 assistance1 or research to prevent1 treat1 or otherwise respond to the ,zika virus and related health outcomes1 other vector-borne diseases1 or other infectious diseases3 ,provided1 ,that amounts repurposed pursuant to this section are designated by the ,congress as an emergency requirement pursuant to section #bea7;b77#b77;,a7 of the ,balanced ,budget and ,emergency ,deficit ,control ,act of #aihe1 as amended3 ,provided further1 ,that such amounts shall be available only if the ,president designates such amounts as an emergency requirement pursuant to section #bea7;b77#b77;,a74 ,transfer ,authority #bjb4 7a7 ,funds appropriated by this ,act under the headings ,global ,health ,programs1 ,nonproliferation1 ,anti-,terrorism1 ,demining and ,related ,programs1 ,international ,organizations and ,programs1 and ,operating ,expenses may be transferred to1 and merged with1 funds appropriated by this ,act under such headings to carry out the purposes of this ,act4 7b7 ,funds appropriated by this ,act under the headings ,diplomatic and ,consular ,programs1 ,emergencies in the ,diplomatic and ,consular ,service1 and ,repatriation ,loan ,programs may be transferred to1 and merged with1 funds appropriated by this ,act under such headings to carry out the purposes of this ,act4 7c7 ,the transfer authorities provided by this section are in addition to any other transfer authority provided by law4 7d7 ,upon a determination that all or part of the funds transferred pursuant to the authorities provided by this section are not necessary for such purposes1 such amounts may be transferred back to such appropriations4 ,reimbursement ,authority #bjc4 ,funds appropriated by this ,act may be used to reimburse accounts administered by the ,united ,states ,agency for ,international ,development and the ,department of ,state for obligations incurred for ,zika virus response prior to the enactment of this ,act4 ,availability of ,funds for ,international ,operations #bjd4 ,section #cjg7;a7 of the ,foreign ,assistance ,act of #aifa 7#bb ,u4,s4,c4 #bbbg7;a77 shall not apply to funds appropriated by this ,act4 ,notwithstanding ,authority #bje4 ,funds appropriated or otherwise made available under this ,act and prior ,acts making appropriations for the ,department of ,state1 ,foreign ,operations1 and ,related ,programs that are made available to support ,zika virus response and related activities may be made available notwithstanding any other provision of law4 ,personal ,service ,contractors #bjf4 ,funds available in this ,act to support response efforts related to the ,zika virus and related health outcomes1 other vector-borne diseases1 or other infectious diseases may be used to enter into contracts with individuals for the provision of personal services 7as described in section #ajd of part #cg of title #dh1 ,code of ,federal ,regulations 7#dh ,c4,f4,r4 #cg4ajd77 in the ,united ,states or abroad3 ,provided1 ,that such individuals may not be deemed employees of the ,united ,states for the purpose of any law administered by the ,office of ,personnel ,management4