,,ii #aaeth ,,congress #b;d ,session ,s4 #bhea ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,may #ae1 #bjah ,mr4 ,casey 7for himself and ,mr4 ,burr7 introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to improve regional health care emergency preparedness and response systems1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,regional ,health ,care ,emergency ,preparedness and ,response ,systems ,act4 #b4 ,regional ,health ,care ,emergency ,preparedness and ,response ,systems 7a7 ,in general ,part ,b of title ,,iii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdc et seq47 is amended by inserting after section #cai;,c-#b the following3 #cai;,c-#c4 ,guidelines for ,regional ,health ,care ,emergency ,preparedness and ,response ,systems 7a7 ,purpose ,it is the purpose of this section to identify and provide guidelines for regional systems of hospitals1 health care facilities1 and other public and private sector entities1 with varying levels of capability to treat patients and increase medical surge capacity during1 and in advance of1 a public health emergency1 including threats posed by one or more chemical1 biological1 radiological1 and nuclear agents1 including emerging infectious diseases4 7b7 ,guidelines ,the ,assistant ,secretary for ,preparedness and ,response1 in consultation with the ,director of the ,centers for ,disease ,control and ,prevention1 the ,administrator of the ,centers for ,medicare ,medicaid ,services1 the ,administrator of the ,health ,resources and ,services ,administration1 the ,commissioner of ,food and ,drugs1 the ,assistant ,secretary for ,mental ,health and ,substance ,use1 the ,assistant ,secretary of ,labor for ,occupational ,safety and ,health1 the ,secretary of ,veterans ,affairs1 heads of such other ,federal agencies as the ,secretary determines to be appropriate1 and ,state1 local1 tribal1 and territorial public health officials1 shall1 not later than #b years after the date of enactment of this section-- 7#a7 identify and develop a set of guidelines relating to practices and protocols for all-hazards public health emergency preparedness and response for hospitals and health care facilities to provide appropriate patient care during1 in advance of1 or immediately following1 a public health emergency1 resulting from one or more chemical1 biological1 radiological1 or nuclear agents1 including emerging infectious diseases 7which may include existing practices1 such as trauma care and medical surge capacity and capabilities71 with respect to-- 7,a7 a regional approach to identifying hospitals and health care facilities based on varying capabilities and capacity to treat patients affected by such emergency1 including-- 7i7 the manner in which the system will coordinate with and integrate the partnerships established under section #cai;,c-#b7;b72 and 7ii7 informing and educating appropriate first responders and health care supply chain partners of the regional emergency preparedness and response capabilities and medical surge capacity of such hospitals and health care facilities in the community2 7,b7 physical and technological infrastructure1 laboratory capacity1 staffing1 blood supply1 and other supply chain needs1 taking into account resiliency1 geographic considerations1 and rural considerations2 7,c7 protocols or best practices for the safety and personal protection of workers who handle human remains and health care workers 7including with respect to protective equipment and supplies1 waste management processes1 and decontamination71 sharing of specialized experience among the health care workforce1 behavioral health1 psychological resilience1 and training of the workforce1 as applicable2 7,d7 in a manner that allows for disease containment 7within the meaning of section #bhjb7;b77#b77;,b771 coordinated medical triage1 treatment1 and transportation of patients1 based on patient medical need 7including patients in rural areas71 to the appropriate hospitals or health care facilities within the regional system or1 as applicable and appropriate1 between systems in different ,states or regions2 and 7,e7 the needs of children and other at-risk individuals2 7#b7 make such guidelines available on the internet website of the ,department of ,health and ,human ,services in a manner that does not compromise national security2 and 7#c7 update such guidelines as appropriate1 including based on input received pursuant to subsections 7c71 7e71 and 7f71 to address new and emerging public health threats4 7c7 ,considerations ,in identifying1 developing1 and updating guidelines under subsection 7b71 the ,assistant ,secretary for ,preparedness and ,response shall-- 7#a7 include input from hospitals and health care facilities1 including health care coalitions under section #cai;,c-#b1 ,state1 local1 tribal1 and territorial public health departments1 and health care or subject matter experts1 including experts with relevant expertise in chemical1 biological1 radiological1 or nuclear threats1 and emerging infectious disease as the ,assistant ,secretary determines appropriate1 to meet the goals under section #bhjb7;b77#c72 7#b7 consult and engage with appropriate health care providers and professionals1 including physicians1 nurses1 first responders1 health care facilities 7including hospitals1 primary care clinics1 community health centers1 mental health facilities1 ambulatory care facilities1 and dental health facilities71 pharmacies1 emergency medical providers1 trauma care providers1 environmental health agencies1 public health laboratories1 poison control centers1 blood banks1 and other experts that the ,assistant ,secretary determines appropriate1 to meet the goals under section #bhjb7;b77#c72 7#c7 consider feedback related to financial implications for hospitals1 health care facilities1 public health agencies1 laboratories1 and other entities engaged in regional preparedness planning to implement and follow such guidelines1 as applicable2 and 7#d7 consider financial requirements and potential incentives for entities to prepare for1 and respond to1 public health emergencies as part of the regional health care emergency preparedness and response system4 7d7 ,technical assistance ,the ,assistant ,secretary for ,preparedness and ,response1 in consultation with the ,director of the ,centers for ,disease ,control and ,prevention and the ,assistant ,secretary of ,labor for ,occupational ,safety and ,health1 may provide technical assistance and consultation towards meeting the guidelines described in subsection 7b74 7e7 ,demonstration project for ,regional ,health ,care ,preparedness and ,response ,systems 7#a7 ,in general ,the ,assistant ,secretary for ,preparedness and ,response may establish a demonstration project pursuant to the development and implementation of guidelines under subsection 7b7 to improve medical surge capacity for all hazards1 build and integrate regional medical response capabilities1 improve specialty care expertise for all-hazards response1 and coordinate medical preparedness and response across ,state1 local1 tribal1 territorial1 and regional jurisdictions4 7#b7 ,sunset ,the authority under this subsection shall expire on ,september #cj1 #bjbc4 7f7 ,,gao report to ,congress 7#a7 ,report ,not later than #c years after the date of enactment of this section1 the ,comptroller ,general of the ,united ,states 7referred to in this subsection as the ,comptroller ,general7 shall submit to the ,committee on ,health1 ,education1 ,labor1 and ,pensions and the ,committee on ,finance of the ,senate and the ,committee on ,energy and ,commerce and the ,committee on ,ways and ,means of the ,house of ,representatives1 a report on the extent to which hospitals and health care facilities have implemented the recommended guidelines under subsection 7b71 including an analysis and evaluation of any challenges hospitals or health care facilities experienced in implementing such guidelines4 7#b7 ,content ,the ,comptroller ,general shall include in the report under paragraph 7#a7-- 7,a7 data on the preparedness and response capabilities that have been informed by the guidelines under subsection 7b7 to improve regional emergency health care preparedness and response capability1 including hospital and health care facility capacity and medical surge capabilities to prepare for1 and respond to1 public health emergencies2 and 7,b7 recommendations to reduce gaps in incentives for regional health partners1 including hospitals and health care facilities to improve capacity and medical surge capabilities to prepare for1 and respond to1 public health emergencies1 consistent with subsection 7a71 which may include consideration of facilities participating in programs under section #cai;,c-#b1 programs under the ,centers for ,medicare ,medicaid ,services 7including innovative health care delivery and payment models71 and input from private sector financial institutions4 7#c7 ,consultation ,in carrying out paragraphs 7#a7 and 7#b71 the ,comptroller ,general shall consult with the heads of appropriate ,federal agencies1 including-- 7,a7 the ,assistant ,secretary for ,preparedness and ,response2 7,b7 the ,director of the ,centers for ,disease ,control and ,prevention2 7,c7 the ,administrator of the ,centers for ,medicare ,medicaid ,services2 7,d7 the ,assistant ,secretary for ,mental ,health and ,substance ,use2 7,e7 the ,assistant ,secretary of ,labor for ,occupational ,safety and ,health2 7,f7 the ,secretary of ,veterans ,affairs2 and 7,g7 the heads of such other ,federal agencies as the ,secretary determines appropriate4 4 7b7 ,annual reports ,section #cai;,c-#b7;i77#a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;d-#c;b7i77#a77 is amended by inserting after the first sentence the following ,the reports submitted under this paragraph shall also include progress towards the implementation of section #cai;,c-#c44 7c7 ,national ,health ,security ,strategy ,incorporation of ,regionalized ,emergency ,preparedness and ,response ,section #bhjb7;b77#c7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;hh-#a7;b77#c77 is amended-- 7#a7 in the matter preceding subparagraph 7,a71 by striking including mental health and inserting 8including pharmacies1 mental health facilities102 and 7#b7 by amending subparagraph 7,g7 to read as follows3 7,g7 ,optimizing a coordinated and flexible approach to the emergency response and medical surge capacity of hospitals1 other health care facilities1 critical care1 trauma care 7which may include trauma centers71 and emergency medical systems1 which may include the implementation of guidelines for regional health care emergency preparedness and response systems under section #cai;,c-#c4 4 7d7 ,improving ,state and local public health security 7#a7 ,state and local security ,section #cai;,c-#a7;e7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;d-#c;a7e77 is amended by striking 1 and local emergency plans4 and inserting 1 local emergency plans1 and any regional health care emergency preparedness and response system established pursuant to the applicable guidelines under section #cai;,c-#c44 7#b7 ,partnerships ,section #cai;,c-#b7;d77#a77;,a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;d-#c;b7d77#a77;,a77 is amended-- 7,a7 in clause 7i71 by striking 2 and and inserting 22 7,b7 by redesignating clause 7ii7 as clause 7iii72 and 7,c7 inserting after clause 7i71 the following3 7ii7 among one or more facilities in a regional health care emergency system under section #cai;,c-#c2 and 4