,,ii  #aaf? ,,congress  #b;d ,session   
,s4 #cdcf  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,m>* #aa1 #bjbj,mr4    
,udall 7= himself1 ,mr4 ,he9ri*1 ,mrs4  
,gillibr&1 ,ms4 ,mc,sally1 ,ms4 ,s9ema1 
& ,mr4 ,cornyn7 introduc$ ! foll[+ bill2
 :i* 0 read twice & ref]r$ to !         
,committee on ,=eign ,relations  ,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 ( #bjbj4  #b4 ,f9d+s ,congress     
makes ! foll[+ f9d+s3 7#a7 ,! ,unit$    
,/ates-,mexico bord] is an int]dep5d5t &
 dynamic region ( approximately         
#ae1jjj1jjj resid5ts & millions ( bord] 
cross+s ea* ye>1 ) significant & unique 
public heal? *all5ges4  7#b7 ,^!        
*all5ges include l[ rates ( heal?       
insurance cov]age1 poor access to heal? 
c>e s]vices1 lack ( education or access 

to in=mation1 pov]ty1 & high rates (    
dang]\s diseases1 su* z tub]culosis &   
,we/ ,nile virus1 z well z o!r          
noncommunicable diseases su* z          
c>diovascul> disease1 a/hma1 diabetes1 &
 obesity4  7#c7 ,z ! #bjbj d5gue        
outbreak 9 ,mexico & _m p>ts ( ,lat9    
,am]ica illu/rates1 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 ,= #bj 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 ,9 #bjaf1 #ff p]c5t ( ,canadians 
liv$ )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  7#f7 ,! rec5t  
coronavirus outbreak has highlight$ !   

ne$ = cont9u$ coord9ation ( res\rces1   
effective communication1 & in=mation %>+
 betwe5 c\ntries to address em]g+ public
 heal? crises4  #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$-- 7#a7
 9 section #c-- 7,a7 9 p>agraph 7#a71 by
 /rik+ 2 & & ins]t+ 22  7,b7 9 p>agraph 
7#b77;,b71 by /rik+ ! p]iod & ins]t+ a  
semicolon2 &  7,c7 by add+ at ! end !   
foll[+3  7#c7 to evaluate !             
,commission's progress 9 c>ry+ out !    
duties describ$ 9 p>agraphs 7#a7 & 7#b7 
& report on su* progress & make         
recomm5dations1 z appropriate1 to !     
,secret>y ( ,heal? & ,human ,s]vices &  
,congress reg>d+ su* duties2  7#d7 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#e7 to s]ve
 z an indep5d5t & objective body to bo? 
recomm5d & implem5t initiatives t solve 

bord] heal? issues4  2  7#b7 9 section  
#e7;b71 by /rik+ %\ld be ! lead] &      
ins]t+ %all be ! ,*air2  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 improve !
 heal? ( resid5ts ( ! ,unit$            
,/ates-,mexico & ,unit$ ,/ates-,canada  
bord] areas ) appropriate priority giv5 
to grants t address recomm5dations      
outl9$ by ! /rategic plan & op]ational  
"w plan ( ! ,commission & ! ,c\ncil "u  
section #i4  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 "o 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? promotion1  
heal? lit]acy1 & heal? education4  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 ,biot]rorism 
& zoonosis4  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 seq41 #db      
,u4,s4,c4 #acig;aa et seq4774  7,r7     
,trauma c>e4  7,s7 ,heal? rese>* ) an   
emphasis on infecti\s disease1 su* z    
measles1 & 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  
,*ronic diseases1 su* z diabetes &      
obesity1 p>ticul>ly *ildhood obesity4   
7,w7 ,community-bas$ p>ticipatory rese>*
 on bord] heal? issues4  7,x7 ,dome/ic  
viol5ce & viol5ce prev5tion4  7,y7      
,cross-bord] public heal? prep>$ness4   
7#b7 ,o!r programs z ! ,secret>y        
det]m9es appropriate4  7e7 ,supplem5t1 n
 supplant ,am\nts provid$ 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 
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 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    
#bjbc1 & 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 #bjbd1 & 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 includ+ ) respect to infecti\s   
disease1 %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 #aj1ejj1jjj = fiscal ye> #bjba 
& ea* succe$+ ye>1 subject to !         
availability ( appropriations = su*     
purpose1 ( :i* #g1jjj1jjj %all be made  
available to fund op]ationally feasible 
functions1 activities1 & grants )       
respect to ! ,unit$ ,/ates-,mexico bord]
 & ! bord] heal? activities "u          
coop]ative agreem5ts ) ! bord] heal?    
(fices ( ! ,/ates ( ,cali=nia1 ,arizona1
 ,new ,mexico1 & ,texas1 & #c1ejj1jjj   
%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