,,ii #aagth ,,congress #b;d ,session ,s4 #cifh ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,march #cj1 #bjbb,ms4 ,warren 7for herself1 ,mr4 ,heinrich1 ,ms4 ,smith1 ,ms4 ,klobuchar1 ,mr4 ,booker1 ,ms4 ,baldwin1 and ,mr4 ,sanders7 introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to improve ,state1 local1 and ,tribal public health security4 #a4 ,short title ,this ,act may be cited as the ,,cdc ,tribal ,public ,health ,security and ,preparedness ,act4 #b4 ,improving ,state1 local1 and ,tribal public health security ,section #cai;,c-#a of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;d-#c;a7 is amended-- 7#a7 in the section heading1 by striking and local and inserting 1 local1 and ,tribal2 7#b7 in subsection 7b7-- 7,a7 in paragraph 7#a7-- 7i7 in subparagraph 7,b71 by striking or at the end2 7ii7 in subparagraph 7,c71 by striking and at the end and inserting or2 and 7iii7 by adding at the end the following3 7,d7 be an ,indian ,tribe1 a ,tribal organization1 or a consortium of ,indian ,tribes or ,tribal organizations2 and 2 and 7,b7 in paragraph 7#b7-- 7i7 in subparagraph 7,a77viii7-- 7,i7 by inserting and ,tribal after with ,state2 7,,ii7 by striking 7as defined in section #haja of the ,elementary and ,secondary ,education ,act of #aife7 and inserting and ,tribal educational agencies 7as defined in sections #haja and #facb1 respectively1 of the ,elementary and ,secondary ,education ,act of #aife72 and 7,,iii7 by inserting and ,tribal after and ,state2 7ii7 in subparagraph 7,g71 by inserting 7including ,indian ,tribes1 ,tribal organizations1 and urban ,indian organizations7 after stakeholders2 and 7iii7 in subparagraph 7,h71 by inserting 1 ,indian ,tribes1 and urban ,indian organizations after public health2 7#c7 in subsection 7e71 by inserting ,indian ,tribes1 ,tribal organizations1 urban ,indian organizations1 after local emergency plans12 7#d7 in subsection 7h7-- 7,a7 by amending subparagraph 7,a7 of paragraph 7#a7 to read as follows3 7,a7 ,in general ,for the purpose of carrying out this section1 there is authorized to be appropriated #gej1jjj1jjj for each of fiscal years #bjbc through #bjbe for awards pursuant to paragraph 7#c7 7subject to the authority of the ,secretary to make awards pursuant to paragraphs 7#d7 and 7#e77 and paragraph 7#h71 of which not less than #e percent shall be reserved each fiscal year for awards under paragraph 7#h74 2 7,b7 in the heading of paragraph 7#c71 by inserting for ,states after amount2 and 7,c7 by adding at the end the following3 7#h7 ,tribal eligible entities 7,a7 ,determination of funding amount 7i7 ,in general ,the ,secretary shall award at least #aj cooperative agreements under this section1 in amounts not less than the minimum amount determined under clause 7ii71 to eligible entities described in subsection 7b77#a77;,d7 that submit to the ,secretary an application that meets the criteria of the ,secretary for the receipt of such an award and that meets other reasonable implementation conditions established by the ,secretary1 in consultation with ,indian ,tribes1 for such awards4 7ii7 ,minimum amount ,in determining the minimum amount of an award pursuant to clause 7i71 the ,secretary1 in consultation with ,indian ,tribes1 shall first determine an amount the ,secretary considers appropriate for the eligible entity4 7,b7 ,available until expended ,amounts provided to a ,tribal eligible entity under a cooperative agreement under this section for a fiscal year and remaining unobligated at the end of such year shall remain available to such entity during the entirety of the performance period1 for the purposes for which said funds were provided4 7,c7 ,no matching requirement ,subparagraphs 7,b7 and 7,c7 of paragraph 7#a7 shall not apply with respect to cooperative agreements awarded under this section to eligible entities described in subsection 7b77#a77;,d74 2 and 7#e7 by adding at the end the following3 7l7 ,special rules related to ,tribal eligible entities 7#a7 ,modifications ,after consultation with ,indian ,tribes1 the ,secretary may make necessary and appropriate modifications with respect to subsections 7b77#b71 7g71 and 7i7 to facilitate the use of the cooperative agreement program by eligible entities described in subsection 7b77#a77;,d74 7#b7 ,waivers 7,a7 ,in general ,except as provided in subparagraph 7,b71 the ,secretary shall waive or specify alternative requirements for any provision of this section 7including regulations7 that the ,secretary administers in connection with this section if the ,secretary1 after consultation with ,indian ,tribes1 finds that the waiver or alternative requirement is appropriate for the effective delivery and administration of this program with respect to eligible entities described in subsection 7b77#a77;,d74 7,b7 ,exception ,the ,secretary may not waive or specify alternative requirements under subparagraph 7,a7 relating to labor standards or the environment4 7#c7 ,consultation ,the ,secretary shall consult with ,indian ,tribes and ,tribal organizations on the design of this program with respect to such ,tribes and organizations to ensure the effectiveness of the program in enhancing the security of ,indian ,tribes with respect to public health emergencies4 7#d7 ,reporting 7,a7 ,in general ,not later than #b years after the date of enactment of this subsection1 and as an addendum to the biennial evaluations required under subsection 7k71 the ,secretary1 in coordination with the ,director of the ,indian ,health ,service1 shall-- 7i7 conduct a review of the implementation of this section with respect to eligible entities described in subsection 7b77#a77;,d71 including any factors that may have limited its success2 7ii7 compile a report containing-- 7,i7 a description of the results of the review described in clause 7i72 7,,ii7 a breakdown of the eligible entities described in subsection 7b77#a77;,d7 that-- 7aa7 received an award under this section2 7bb7 received an award under this section and a waiver as described in paragraph 7#b72 and 7cc7 applied under this section but did not receive an award2 7,,iii7 a list of any requirements of this section for which the ,secretary provided a waiver or alternative requirement1 and the reasoning for issuing a waiver or alternative requirement2 and 7,,iv7 recommendations to ,congress for program modifications necessary to improve the implementation of the program with respect to eligible entities described in subsection 7b77#a77;,d72 and 7iii7 submit the report described in clause 7ii7 to-- 7,i7 the ,committee on ,indian ,affairs1 the ,committee on ,health1 ,education1 ,labor1 and ,pensions1 and the ,committee on ,appropriations of the ,senate2 and 7,,ii7 the ,subcommittee on ,indigenous ,people of the ,committee on ,natural ,resources1 the ,committee on ,energy and ,commerce1 and the ,committee on ,appropriations of the ,house of ,representatives4 7,b7 ,analysis of ,tribal public health emergency infrastructure limitation ,the ,secretary shall include in the initial report submitted under subparagraph 7,a7 a description of any public health emergency infrastructure limitation encountered by eligible entities described in subsection 7b77#a77;,d74 4