,,ii  #aaf? ,,congress  #a/ ,session    
,s4 #bcjd  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,july #bi1 #bjai,mr4   
,br[n introduc$ ! foll[+ bill2 :i* 0    
read twice & ref]r$ to ! ,committee on  
,heal?1 ,education1 ,labor1 & ,p5sions  
,a ,,bill  ,to am5d ! ,public ,heal?    
,s]vice ,act to enhance ef=ts to address
 antibiotic resi/ance1 & = o!r purposes4
  #a4 ,%ort title ,?is ,act may be cit$ 
z ! ,/rategies ,to ,address ,antibiotic 
,resi/ance ,act or ! ,,/a> ,act4  #b4   
,combat+ antimicrobial resi/ance        
,section #cai;,e ( ! ,public ,heal?     
,s]vice ,act 7#db ,u4,s4,c4 #bdg;d-#e7  
is am5d$--  7#a7 9 subsection 7a7--     
7,a7 9 p>agraph 7#a71 9 ! fir/ s5t5ce1  
by /rik+ & coord9ate ,f$]al programs    
relat+ to antimicrobial resi/ance &     
ins]t+ relat+ to antimicrobial          
resi/ance1 coord9ate ,f$]al programs    
relat+ to antimicrobial resi/ance1 &    
implem5t ! objectives ( ! ,national     
,action ,plan = ,combat+                
,antibiotic-,resi/ant ,bact]ia1 publi%$ 

9 ,m>* #bjae 9 response to ,executive   
,ord] #acfgf ( ,septemb] #ah1 #bjad 7#gi
 ,f$4 ,reg4 #efica2 relat+ to combat+   
antibiotic-resi/ant bact]ia7 7ref]r$ to 
9 ?is section z ! ,action ,plan72  7,b7 
by am5d+ p>agraph 7#b7 to read z foll[s3
  7#b7 ,memb]s ( task =ce ,! task =ce   
describ$ 9 p>agraph 7#a7 %all be        
co-*air$ by ! ,secret>y ( ,heal? &      
,human ,s]vices1 ! ,secret>y (          
,agriculture1 & ! ,secret>y ( ,def5se1 &
 %all be compos$ ( repres5tatives (     
relevant ,f$]al ag5cies & su* executive 
dep>tm5ts1 ag5cies1 or (fices z !       
co-*airs may designate4  2  7,c7 by     
am5d+ p>agraph 7#d7 to read z foll[s3   
7#d7 ,meet+s ,at lea/ twice a ye>1 !    
task =ce describ$ 9 p>agraph 7#a7 %all h
 a public meet+ to assess progress &    
ob/acles to implem5t+ ! objectives ( !  
,action ,plan4 ,! task =ce may discuss &
 review bas$ on ne$ or conc]n ! foll[+  
7among o!r issues73  7,a7 ,f$]al        
activities to sl[ ! em]g5ce (           
antimicrobial-resi/ant bact]ia & prev5t 

! spread ( resi/ant infections4 ,su*    
activities may include optimal use (    
vacc9es & o!r infection control measures
 to prev5t infections1 implem5tation (  
heal? c>e policies & antimicrobial      
/ew>d%ip programs t improve pati5t      
outcomes1 regional ef=ts to control     
transmission across community & heal?   
c>e sett+s1 & public aw>5ess campaigns4 
7,b7 ,f$]al activities to /r5g!n        
national ,"o-,heal? surveillance ef=ts1 
:i* are ef=ts address+ ! int]actions    
betwe5 human1 animal1 & environm5tal    
heal?1 to combat antibiotic resi/ance4  
,"o-,heal? surveillance ef=ts to combat 
antibiotic resi/ance may include enhanc$
 data %>+ & coord9ation ( surveillance &
 laboratory sy/ems across human & animal
 sett+s1 & enhanc$ monitor+ ( sales1    
usage1 resi/ance1 & managem5t practices 
( antibiotic drugs along !              
food-production *a94 ,su* surveillance &
 laboratory sy/ems may include !        
,national ,heal?c>e ,safety ,network1 ! 
,em]g+ ,infections ,program1 ! ,national

 ,antimicrobial ,resi/ance ,monitor+    
,sy/em1 ! ,national ,animal ,heal?      
,monitor+ ,sy/em1 ! ,national ,animal   
,heal? ,laboratory ,network1 ! ,vet]9>y 
,laboratory ,inve/igation & ,response   
,network1 & ! ,antibiotic ,resi/ance    
,laboratory ,network4  7,c7 ,f$]al ef=ts
 to advance ! developm5t & use ( rapid &
 innovative diagno/ic te/s =            
id5tification & *>act]ization (         
antibiotic-resi/ant bact]ia4 ,su* ef=ts 
may include developm5t ( new diagno/ic  
te/s & expansion ( _! availability & use
 to improve treatm5t1 infection control1
 & outbreak response4  7,d7 ,f$]al ef=ts
 to accel]ate basic & appli$ rese>* &   
developm5t = new antibiotic drugs1 o!r  
!rapeutics1 prev5tion ef=ts1 & vacc9es4 
,su* ef=ts may include support = basic &
 appli$ rese>*1 provision ( sci5tific   
s]vices & guidance to rese>*]s1 & fo/]+ 
( public-private p>tn]%ips4  7,e7 ,f$]al
 ef=ts to improve int]national          
collaboration & capacities =            
antibiotic-resi/ance prev5tion1         

surveillance1 & control & antibiotic    
rese>* & developm5t4 ,su* ef=ts may     
include collaborations ) =eign m9i/ries 
( heal? & agriculture1 ! ,_w ,heal?     
,organization1 ! ,food & ,agriculture   
,organization1 ! ,_w ,organization =    
,animal ,heal?1 & o!r mult9ational      
organizations4  2 &  7,d7 by add+ at !  
end ! foll[+3  7#e7 ,availability (     
in=mation ,! task =ce describ$ 9        
p>agraph 7#a71 to ! ext5t p]mitt$ by    
law1 %all--  7,a7 provide ! ,presid5tial
 ,advisory ,c\ncil on ,combat+          
,antibiotic-,resi/ant ,bact]ia describ$ 
9 section #eje ( ! ,p&emic &            
,all-,haz>ds ,prep>$ness & ,advanc+     
,innovation ,act ( #bjai ) su* in=mation
 z may be requir$ = c>ry+ out !         
functions ( su* ,advisory ,c\ncil1      
includ+ in=mation on progress 9 advanc+ 
! ,action ,plan1 meet+ m9utes1 & o!r key
 in=mation ( ! task =ce2 &  7,b7 ensure 
t all in=mation describ$ 9 subp>agraph  
7,a7 is made available on ! websites ( !
 ,dep>tm5t ( ,heal? & ,human ,s]vices1 !

 ,dep>tm5t ( ,agriculture1 & ! ,dep>tm5t
 ( ,def5se4  2  7#b7 9 subsection 7h7-- 
7,a7 9 ! head+1 by /rik+ ,in=mation     
relat$ to2  7,b7 by /rik+ ,! ,secret>y &
 ins]t+ ! foll[+3  7#a7 ,dissem9ation ( 
in=mation ,! ,secret>y  2 &  7,c7 by    
add+ at ! end ! foll[+3  7#b7 ,enc\rag+ 
antimicrobial /ew>d%ip programs ,!      
,secret>y %all enc\rage heal? c>e       
facilities to e/abli% antimicrobial     
/ew>d%ip programs t are consi/5t )      
docum5ts issu$ by ! ,c5t]s = ,disease   
,control & ,prev5tion relat+ to ! core  
elem5ts ( antimicrobial /ew>d%ip        
programs4  7#c7 ,def9ition (            
antimicrobial /ew>d%ip ,= purposes ( ?is
 section1 ! t]m antimicrobial /ew>d%ip  
means coord9at$ int]v5tions design$ to  
improve & evaluate ! appropriate use (  
antimicrobial ag5ts1 includ+ promot+ !  
use ( antimicrobial drugs only :5       
cl9ically indicat$1 &1 :5 antimicrobial 
drugs are cl9ically indicat$1 promot+ ! 
selection ( ! optimal antimicrobial drug
 regim51 includ+ ?r\gh factors su* z    

dosage1 duration ( !rapy1 & r\te (      
adm9i/ration4  2  7#c7 9 subsection 7m71
 by /rik+ #dj1jjj1jjj & all t foll[s    
?r\gh ! p]iod at ! end & ins]t+ su* sums
 z may be necess>y = ea* ( fiscal ye>s  
#bjbj ?r\gh #bjbf42 &  7#d7 by add+ at !
 end ! foll[+3  7n7 ,annual report on   
implem5t+ ! ,action ,plan objectives ,n 
lat] ?an #a ye> aft] ! date ( ! enactm5t
 ( ! ,/rategies ,to ,address ,antibiotic
 ,resi/ance ,act1 & annually !reaft]1 ! 
,secret>y1 9 coop]ation ) ! ,secret>y ( 
,agriculture1 ! ,secret>y ( ,def5se1 & !
 task =ce describ$ 9 subsection 7a71    
%all submit to ! ,committee on ,heal?1  
,education1 ,labor1 & ,p5sions ( !      
,s5ate & ! ,committee on ,en]gy &       
,comm]ce ( ! ,h\se ( ,repres5tatives1 & 
make available on ! websites ( !        
,dep>tm5t ( ,heal? & ,human ,s]vices1 ! 
,dep>tm5t ( ,agriculture1 & ! ,dep>tm5t 
( ,def5se1 a report on ! progress made 9
 implem5t+ ! objectives ( ! ,action     
,plan4  4  #c4 ,additional /rategies =  
combat+ antibiotic resi/ance ,"p ,b (   

title ,,iii ( ! ,public ,heal? ,s]vice  
,act 7#db ,u4,s4,c4 #bdc et seq47 is    
am5d$ by ins]t+ aft] section #cai;,e !  
foll[+3  #cai;,e-#a4 ,surveillance &    
report+ ( antibiotic use & resi/ance    
7a7 ,9 g5]al ,! ,secret>y1 act+ ?r\gh ! 
,director ( ! ,c5t]s = ,disease ,control
 & ,prev5tion1 %all use ! ,national     
,heal?c>e ,safety ,network & o!r        
appropriate surveillance sy/ems to      
assess--  7#a7 appropriate conditions1  
outcomes1 & measures causally relat$ to 
antibact]ial resi/ance1 includ+ types ( 
infections1 ! causes = infections1 &    
:e!r infections are acquir$ 9 a         
community or hospital sett+1 increas$   
l5g?s ( hospital /ay1 increas$ co/s1 &  
rates ( mortality2 &  7#b7 *anges 9     
bact]ial resi/ance to drugs 9 relation  
to pati5t outcomes1 includ+ *anges 9    
p]c5t resi/ance1 preval5ce (            
antibiotic-resi/ant infections1 & o!r   
su* *anges4  7b7 ,antibiotic use data ,!
 ,secret>y1 act+ ?r\gh ! ,director ( !  
,c5t]s = ,disease ,control & ,prev5tion1

 %all "w ) ,f$]al ag5cies 7includ+ !    
,dep>tm5t ( ,vet]ans ,affairs1 !        
,dep>tm5t ( ,def5se1 & ! ,c5t]s =       
,m$ic>e  ,m$icaid ,s]vices71 private    
v5dors1 heal? c>e organizations1 ph>macy
 b5efit manag]s1 & o!r entities z       
appropriate to obta9 reliable &         
comp>able human antibiotic drug         
consumption data 7includ+1 z available &
 appropriate1 volume antibiotic         
di/ribution data & antibiotic use data1 
includ+ prescription data7 by ,/ate or  
metropolitan areas4  7c7 ,antibiotic    
resi/ance tr5d data ,! ,secret>y1 act+  
?r\gh ! ,director ( ! ,c5t]s = ,disease 
,control & ,prev5tion1 %all int5sify &  
exp& ef=ts to collect antibiotic        
resi/ance data & enc\rage adoption ( !  
antibiotic resi/ance & use module )9 !  
,national ,heal?c>e ,safety ,network    
among all heal? c>e facilities across ! 
cont9uum ( c>e1 includ+1 z appropriate1 
acute c>e hospitals1 dialysis           
facilities1 nurs+ homes1 ambulatory     
surgical c5t]s1 & o!r ambulatory heal?  

c>e sett+s 9 :i* antimicrobial          
m$ications are r\t9ely prescrib$4 ,!    
,secret>y %all seek to collect su* data 
f electronic m$ication adm9i/ration     
reports & laboratory sy/ems to produce !
 reports describ$ 9 subsection 7d74  7d7
 ,public availability ( data ,!         
,secret>y1 act+ ?r\gh ! ,director ( !   
,c5t]s = ,disease ,control & ,prev5tion1
 %all1 = ! purposes ( improv+ ! monitor+
 ( important tr5ds 9 pati5t outcomes 9  
relation to antibact]ial resi/ance--    
7#a7 make ! data d]iv$ f surveillance "u
 ?is section publicly available ?r\gh   
reports issu$ on a regul> basis t is n  
less ?an annually2 &  7#b7 exam9e       
opportunities to make su* data available
 9 ne> real "t4  #cai;,e-#b4 ,detect+   
network ( antibiotic resi/ance regional 
laboratories  7a7 ,9 g5]al ,! ,secret>y1
 act+ ?r\gh ! ,director ( ! ,c5t]s =    
,disease ,control & ,prev5tion1 %all    
e/abli% n less ?an #g ,antibiotic       
,resi/ance ,surveillance & ,laboratory  
,network sites1 build+ ^u ! intramural &

 extramural programs & laboratories ( ! 
,c5t]s = ,disease ,control & ,prev5tion1
 to int5sify1 /r5g!n1 & exp& ! national 
capacity to--  7#a7 monitor ! em]g5ce & 
*anges 9 ! patt]ns ( antibiotic-resi/ant
 bact]ia2  7#b7 describe1 confirm1 &1 z 
necess>y1 facilitate a response to1     
local or regional outbreaks ( resi/ant  
bact]ia2  7#c7 assess & describe        
antibiotic resi/ance patt]ns to in=m    
public heal? & improve prev5tion        
practices2  7#d7 obta9 isolates (       
pa?og5s1 & 9 p>ticul>1 bact]ia t %[ new 
or atypical patt]ns ( resi/ance adv]sely
 affect+ public heal?2  7#e7 assi/ 9    
/udy+ ! epidemiology ( infections f su* 
pa?og5s2  7#f7 evaluate commonly us$    
antibiotic susceptibility te/+ me?ods to
 improve ! accuracy ( resi/ance te/+ &  
report+2  7#g7 z necess>y1 develop or   
evaluate novel diagno/ic te/s capable ( 
detect+ new or em]g+ resi/ance 9        
bact]ia2  7#h7 l9k data g5]at$ by       
regional laboratory networks "u exi/+   
public heal? surveillance networks &    

relevant gov]nm5t ag5cies2 &  7#i7      
provide laboratory assi/ance & ref]5ce  
te/+ ( antibiotic-resi/ant bact]ia to   
enhance infection control & facilitate  
outbreak detection & response 9 heal?   
c>e & community sett+s4  7b7 ,geographic
 di/ribution ,! sites e/abli%$ "u       
subsection 7a7 %all be geographically   
di/ribut$ across ! ,unit$ ,/ates4  7c7  
,nonduplication ( curr5t national       
capacity ,! sites e/abli%$ "u subsection
 7a7 may be bas$ 9 academic c5t]s1 heal?
 dep>tm5ts1 & exi/+ surveillance &      
laboratory sites4  #cai;,e-#c4 ,cl9ical 
trials network on antibact]ial resi/ance
  7a7 ,9 ,g5]al ,! ,secret>y1 act+ ?r\gh
 ! ,director ( ! ,national ,in/itute (  
,all]gy & ,infecti\s ,diseases1 %all    
ma9ta9 a ,cl9ical ,trials ,network on   
,antibact]ial ,resi/ance to enhance1    
/r5g!n1 & exp& rese>* on cl9ical sci5ce1
 antibact]ial & diagno/ic developm5t1 & 
optimal usage /rategies ) respect to    
address+ antibact]ial resi/ance4 ,su*   
,network %all1 at a m9imum--  7#a7      

facilitate rese>* to bett] und]/&       
resi/ance me*anisms & h[ to prev5t1     
control1 & treat resi/ant organisms2    
7#b7 advance cl9ical trial ef=ts to     
develop antibiotics diagno/ics1 &       
evaluate & optimize ! usage ( su*       
antibiotics diagno/ics2  7#c7 conduct   
cl9ical rese>* to develop natural       
hi/ories ( resi/ant infecti\s diseases2 
7#d7 exam9e pati5t outcomes ) curr5tly  
available antibiotic !rapy & validate & 
improve ^u biom>k]s & o!r surrogate     
endpo9ts2 &  7#e7 /udy %ort] treatm5t   
duration & e>ly cessation ( antibiotic  
!rapy = treatm5t efficacy & ! effect on 
developm5t ( resi/ance4  7b7            
,au?orization ( appropriations ,!re are 
au?oriz$ to be appropriat$ to c>ry out  
?is section su* sums z may be necess>y =
 ea* ( fiscal ye>s #bjbj ?r\gh #bjbf4   
#cai;,e-#d4 ,regional prev5tion         
collaborative ef=ts  7a7 ,9 g5]al ,!    
,secret>y1 act+ ?r\gh ! ,director ( !   
,c5t]s = ,disease ,control & ,prev5tion1
 %all "w ) ,/ate & local heal? dep>tm5ts

 to support ! expansion ( collaborative 
ef=ts by gr\ps ( heal? c>e facilities t 
focus on prev5t+ ! spread (             
antibiotic-resi/ant bact]ia t pose a    
s]i\s ?reat to public heal?1 & t are    
design$ to int]rupt & prev5t !          
transmission ( significant              
antibiotic-resi/ant pa?og5s be+         
transmitt$ across heal? c>e sett+s 9 a  
geographic region4 ,su* collaborative   
ef=ts %all--  7#a7 id5tify significant  
drug resi/ant pa?og5s be+ transmitt$    
across heal? c>e sett+s locally2  7#b7  
implem5t evid5ce-bas$ int]v5tions to    
int]rupt ! transmission (               
antibiotic-resi/ant /ra9s ( bact]ia &   
prev5t ! infections caus$ by su*        
bact]ia1 includ+ evid5ce-bas$           
transmission prev5tion guidel9es1       
rigor\s h&-hygi5e protocols1 & infection
 control & prev5tion measures2  7#c7    
assess compliance & id5tify b>ri]s to   
adh]5ce to su* measures2  7#d7 evaluate 
! impact ( su* measures1 to ! ext5t     
possible1 on hospital readmissions 9    

heal? c>e facilities across ! cont9uum (
 c>e1 rates ( heal? c>e associat$       
infections1 or any o!r relevant measures
 t *>act]ize ! heal? or economic impact 
( ! collaborative ef=ts2 &  7#e7 provide
 recomm5dations = improv$ outcomes &    
compliance ) su* measures4  7b7         
,prev5tion epic5t]s  7#a7 ,expansion ,! 
,secret>y1 act+ ?r\gh ! ,director ( !   
,c5t]s = ,disease ,control & ,prev5tion1
 may int5sify & exp& academic public    
heal? p>tn]%ips ?r\gh ! ,prev5tion      
,epic5t]s ,program to provide ! regional
 prev5tion collaboration ef=ts describ$ 
9 subsection 7a7 ) tools1 /rategies1 &  
evid5ce-bas$ int]v5tions4  7#b7         
,evaluations & rese>* ,! ,director ( !  
,c5t]s = ,disease ,control & ,prev5tion 
& ! epic5t]s p>ticipat+ 9 ! ,prev5tion  
,epic5t]s ,program %all "w ) entities1  
includ+ ! entities p>ticipat+ 9 !       
regional prev5tion collaborative ef=ts1 
to--  7,a7 evaluate new & exi/+         
int]v5tions to prev5t or limit infection
 rates 9 heal? c>e facilities across !  

cont9uum ( c>e & 9 community sett+s2    
7,b7 facilitate public heal? rese>* on !
 prev5tion & control ( resi/ant         
organisms2 &  7,c7 assess ! feasibility1
 co/-effectiv5ess1 & appropriat5ess (   
surveillance & prev5tion programs 9     
diff]+ heal? c>e & in/itutional sett+s4 
7c7 ,educational mat]ials ,! ,secret>y1 
act+ ?r\gh ! ,director ( ! ,c5t]s =     
,disease ,control & ,prev5tion1 %all use
 ! evaluations1 rese>*1 & assessm5ts    
describ$ 9 subsection 7b7 to create &   
dissem9ate educational mat]ials focus$  
on infection prev5tion & control = use 9
 heal? c>e facilities across ! cont9uum 
( c>e & 9 community sett+s4  4  #d4     
,protection ( confid5tial & national    
security in=mation ,?is ,act1 & !       
am5dm5ts made by ?is ,act1 %all n be    
con/ru$ to p]mit ! disclosure ( any     
trade secret1 confid5tial comm]cial     
in=mation1 or mat]ial inconsi/5t )      
national security1 t is o!rwise         
prohibit$ by law4