,,ii #aafth ,,congress #b;d ,session ,s4 #dgdj ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,september #bi1 #bjbj,mrs4 ,murray 7for herself1 ,mr4 ,casey1 ,mr4 ,menendez1 ,mr4 ,van ,hollen1 ,ms4 ,duckworth1 ,mr4 ,brown1 ,mr4 ,merkley1 ,mr4 ,bennet1 ,ms4 ,warren1 ,mr4 ,markey1 ,ms4 ,hirono1 ,ms4 ,baldwin1 ,ms4 ,rosen1 ,mr4 ,schatz1 ,ms4 ,klobuchar1 ,mr4 ,reed1 ,ms4 ,smith1 ,mr4 ,blumenthal1 and ,mr4 ,durbin7 introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to support public health infrastructure4 #a4 ,short title ,this ,act may be cited as the ,public ,health ,infrastructure ,saves ,lives ,act4 #b4 ,core public health infrastructure for ,state1 territorial1 local1 and tribal health departments 7a7 ,program ,the ,secretary of ,health and ,human ,services 7referred to in this ,act as the ,secretary71 acting through the ,director of the ,centers for ,disease ,control and ,prevention1 shall establish a core public health infrastructure program to strengthen the public health system of the ,united ,states1 including the ,nation's ability to respond to the ,,covid-#ai pandemic1 consisting of awarding grants under subsection 7b74 7b7 ,grants 7#a7 ,award ,for the purpose of addressing core public health infrastructure needs1 the ,secretary-- 7,a7 shall award a grant to each ,state or territorial health department1 and to local health departments that serve #ejj1jjj people or more2 and 7,b7 shall award grants on a competitive basis to ,state1 territorial1 local1 or tribal health departments4 7#b7 ,allocation ,of the total amount of funds awarded as grants under this subsection for a fiscal year-- 7,a7 not less than #ej percent shall be for grants to health departments under paragraph 7#a77;,a72 and 7,b7 not less than #cj percent shall be for grants to ,state1 territorial1 local1 or tribal health departments under paragraph 7#a77;,b74 7c7 ,use of ,funds ,the ,secretary may award a grant to an entity under subsection 7b77#a7 only if the entity agrees to use the full amount of the grant to address core public health infrastructure needs1 including those identified in the accreditation process under subsection 7h74 7d7 ,formula grants to health departments ,in making grants under subsection 7b77#a77;,a71 the ,secretary shall award funds to each health department in accordance with-- 7#a7 a formula-- 7,a7 based on population size1 burden of preventable disease and disability1 and poverty rate1 with special consideration given to territories2 and 7,b7 which1 in the event of an award made during the public health emergency declared under section #cai of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;d7 in response to ,,covid-#ai1 shall consider the ,,covid-#ai burden of each jurisdiction2 and 7#b7 application requirements established by the ,secretary1 including a requirement that the health department submit a plan by the end of year #a of the grant that demonstrates to the satisfaction of the ,secretary that the health department will-- 7,a7 address its highest priority core public health infrastructure needs2 7,b7 in the case of such a plan submitted during the public health emergency described in paragraph 7#a77;,b71 identify the core public health infrastructure needs that are the highest priority for strengthening the response to ,,covid-#ai and similar public health threats and other public health emergencies2 and 7,c7 for ,state health departments1 allocate at least #be percent of the grant funds to local health departments within the ,state to support the local jurisdiction's contribution to core public health infrastructure4 7e7 ,competitive grants to ,state1 territorial1 local1 and tribal health departments ,in making grants under subsection 7b77#a77;,b71 the ,secretary shall give priority to applicants demonstrating core public health infrastructure needs for all public health agencies in the applicant's jurisdiction to be certified by the accreditation process under subsection 7h71 or for an entity for which a waiver has been received under subparagraph 7,a7 or 7,b7 of subsection 7h77#b71 that has otherwise demonstrated the applicant has core public health infrastructure needs for all public health agencies4 7f7 ,permitted use ,the ,secretary may make available a subset of the funds available for grants under subsection 7b77#a7 for purposes of awarding planning grants to health departments eligible to receive a grant under subsection 7b77#a77;,b74 ,recipients of such a planning grant may use such award to assess core public health infrastructure needs4 7g7 ,maintenance of effort ,the ,secretary may award a grant to an entity under subsection 7b7 only if the entity demonstrates to the satisfaction of the ,secretary that-- 7#a7 funds received through the grant will be expended only to supplement1 and not supplant1 non-,federal and ,federal funds otherwise available to the entity for the purpose of addressing core public health infrastructure needs2 and 7#b7 with respect to activities for which the grant is awarded1 the entity will maintain expenditures of non-,federal amounts for such activities at a level not less than the level of such expenditures maintained by the entity for the fiscal year preceding the fiscal year for which the entity receives the grant4 7h7 ,support of a national ,public ,health ,accreditation ,program 7#a7 ,in general ,the ,secretary1 acting through the ,director of the ,centers for ,disease ,control and ,prevention1 shall-- 7,a7 support continued development1 and periodic review and updating of standards for accreditation of ,state1 territorial1 local1 or tribal health departments for the purpose of advancing the quality and performance of such departments with an emphasis on core public health infrastructure2 7,b7 implement a program to accredit such health departments in accordance with such standards2 and 7,c7 beginning in fiscal year #bjbd1 ensure that any entity receiving a grant under subsection 7b7 is accredited as described in subparagraph 7,a7 or meets another standard of accountability specific to public health infrastructure1 subject to paragraph 7#b74 7#b7 ,waivers ,the ,secretary may waive the requirement under paragraph 7#a77;,c7 with respect to-- 7,a7 any individual entity until fiscal year #bjbf2 or 7,b7 after fiscal year #bjbf1 any individual entity that demonstrates that it would be a significant hardship to comply with such requirement4 7#c7 ,cooperative agreement ,the ,secretary may enter into a cooperative agreement with a private nonprofit entity to carry out this subsection4 7i7 ,report ,the ,secretary shall submit to the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate and the ,committee on ,energy and ,commerce of the ,house of ,representatives an annual report on progress being made to accredit entities under subsection 7h71 including-- 7#a7 a strategy1 including goals and objectives1 for accrediting entities under subsection 7h7 and achieving the purpose described in subsection 7h77#a72 and 7#b7 identification of gaps in research related to core public health infrastructure and recommendations of priority areas for such research4 #c4 ,core public health infrastructure and activities for ,,cdc 7a7 ,in general ,the ,secretary1 acting through the ,director of the ,centers for ,disease ,control and ,prevention1 shall expand and improve the core public health infrastructure and activities of the ,centers for ,disease ,control and ,prevention to address unmet and emerging public health needs and provide technical assistance to grantees funded under this provision1 including the administration of the grants under section #b7;b77#a74 7b7 ,report ,the ,secretary shall submit to ,congress an annual report on the activities funded through this section4 #d4 ,core ,public ,health ,infrastructure defined ,for purposes of this ,act1 the term core public health infrastructure means all of the following elements1 and the workforce needed to establish and maintain such elements3 7#a7 ,assessment 7including surveillance1 epidemiology1 and laboratory capacity7 ,the ability to track the health of a community through data1 case finding1 and laboratory tests with particular attention to those most at risk4 7#b7 ,all hazards preparedness and response ,the capacity to respond to emergencies of all kinds4 7#c7 ,policy development and support ,the ability to translate public health science into appropriate policy and regulation4 7#d7 ,communications ,the ability to reach the public effectively with timely1 science-based information to mitigate the impact of public health threats1 with particular attention to hard-to-reach populations4 7#e7 ,community partnership development ,the capacity to harness and align community resources and organizations to advance the health of all members of the community4 7#f7 ,organizational competencies 7leadership and governance1 health equity7 ,the ability to lead internal and external stakeholders to consensus and action4 7#g7 ,accountability and performance management 7including quality improvement1 information technology1 human resources1 financial management1 and law7 ,the ability to apply business practices that ensure efficient use of resources1 achieve desired outcomes1 and foster a continuous learning environment4 7#h7 ,equity ,utilizing all of the preceding elements1 the capacity to address and correct health disparities 7including disparities related to race1 ethnicity1 national origin1 socioeconomic status1 primary language1 sex 7including sexual orientation and gender identity71 disability status1 and other factors71 advance health equity in all communities1 and implement culturally and linguistically appropriate programs and interventions4 #e4 ,funding 7a7 ,in general ,to carry out this ,act1 there are hereby appropriated1 out of amounts in the ,treasury not otherwise appropriated1 the following to be made available until expended3 7#a7 ,for fiscal year #bjba1 #gej1jjj1jjj4 7#b7 ,for fiscal year #bjbb1 #a1jjj1jjj1jjj4 7#c7 ,for fiscal year #bjbc1 #b1jjj1jjj1jjj4 7#d7 ,for fiscal year #bjbd1 #c1jjj1jjj1jjj4 7#e7 ,for fiscal year #bjbe and each subsequent fiscal year1 #d1ejj1jjj1jjj4 7b7 ,core public health infrastructure and activities ,of the amounts made available under this section for a fiscal year1 not more than #cej1jjj1jjj shall be used to carry out section #c4 7c7 ,supplement ,amounts made available under this section shall be used to supplement1 and not supplant1 amounts otherwise made available for the purposes described in this ,act4