,i #aahth ,,congress #ast ,session ,h4 ,r4 #eede ,,in ,,the ,,house ,,of ,,representatives ,september #ah1 #bjbc,ms4 ,meng 7for herself1 ,mr4 ,blumenauer1 and ,mr4 ,la,hood7 introduced the following bill2 which was referred to the ,committee on ,foreign ,affairs ,a ,,bill ,to authorize an ,action ,plan for ,united ,states foreign assistance to developing countries to increase access to sustainable safe water1 sanitation1 and hygiene in healthcare facilities1 promote stronger health systems and sustainable health infrastructure1 build capacity of health workers1 and promote the safety of health workers and patients1 especially women and girls1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,global ,,wash in ,healthcare ,facilities ,act of #bjbc4 #b4 ,findings ,congress finds the following3 7#a7 ,water1 sanitation1 and hygiene 7,,wash7 is critical to health security1 preparedness and response efforts1 including for the prevention of ,,covid-#ai and future pandemics4 7#b7 ,,wash in healthcare facilities is necessary to ensure health security1 including reducing preventable maternal1 newborn1 and child deaths and reducing the spread of infectious diseases such as cholera1 diarrhea1 and sepsis4 7#c7 ,globally1 #a out of every #e healthcare facilities have no basic water services1 and #a in #b do not have adequate facilities to wash hands1 leaving #c1hej1jjj1jjj people1 including health care workers and patients1 at greater risk of infections4 7#d7 ,in least-developed countries1 about half of healthcare facilities lack basic water services1 #gi percent have no sanitation services1 and #fh percent lack basic hygiene services4 7#e7 ,healthcare acquired infections arise from poor hygiene1 contribute to patient morbidity and mortality1 increase the risk of antimicrobial resistance1 and contribute to increased costs for patients1 their families and healthcare systems4 7#f7 ,an estimated #ae percent of patients in low- and middle-income countries acquire one or more infections during a typical hospital stay4 ,infections associated with unclean births account for #bf percent of neonatal deaths and #aa percent of maternal deaths2 together they account for more than #a1jjj1jjj deaths each year4 #c4 ,statement of policy2 sense of congress 7a7 ,statement of policy objectives ,it is in the national security interest of the ,united ,states to increase access to sustainable and safe water1 sanitation1 and hygiene in healthcare facilities1 through global health1 maternal1 newborn and child health1 and global water programs1 activities1 and initiatives that-- 7#a7 increase access to safe water in healthcare facilities2 7#b7 enable handwashing at all points of care2 7#c7 increase access to toilets in healthcare facilities1 including non-sewered sanitation solutions and a variety of technologies for sanitation and healthcare waste treatment2 7#d7 provide for the safe segregation1 treatment1 and disposal of healthcare waste and increased infection and prevention control measures2 7#e7 promote ,,wash social and behavior change to ensure the safety of health workers and patients to improve infection prevention and control measures2 7#f7 improve the ability of patients and healthcare workers1 including persons with disabilities to access water1 sanitation1 and hygiene1 including for their menstrual health and hygiene needs in primary1 secondary1 and tertiary healthcare facilities2 7#g7 promote health facility administration management and monitoring of water1 sanitation1 and hygiene services in healthcare facilities for infection prevention and control and quality of care outcomes1 including-- 7,a7 ensuring operations and maintenance of water and sanitation infrastructure2 and 7,b7 providing support to patients to adopt consistent sanitation1 hygiene1 and menstrual health behaviors2 7#h7 integrate water1 sanitation1 and hygiene services into pandemic preparedness and response and global health security initiatives1 including preventive measures that help to contain infectious disease outbreaks at their source and support resilient health facilities to ensure continuous primary care during an outbreak2 and 7#i7 provide technical support to partner governments1 particularly ,ministries of ,health1 to improve wash systems and to incorporate safe water1 sanitation1 and hygiene into national plans1 strategies1 and budgets for new and existing healthcare facilities4 7b7 ,sense of congress ,it is the sense of ,congress that the ,administrator of the ,united ,states ,agency for ,international ,development1 in implementing the ,global ,,wash in ,healthcare ,facilities ,action ,plan described in section #e1 should-- 7#a7 coordinate in consultation with the ,,usaid ,assistant ,administrator for ,global ,health1 the ,senior ,coordinator for ,gender ,equality and ,women's ,empowerment1 and the ,global ,water ,coordinator1 to expand safe water1 sanitation1 and hygiene in healthcare facilities2 7#b7 promote assistance to and build the capacity of national governments to include water1 sanitation1 and hygiene indicators in national health systems monitoring and budgets2 7#c7 coordinate implementation of existing ,united ,states ,government strategies related to ,,wash in healthcare facilities1 including the ,united ,states ,global ,water ,strategy and ,united ,states ,international ,activities to ,advance ,global ,health ,security and ,diplomacy ,strategy and ,report to achieve the objectives of section #c7;a72 7#d7 include policies that promote the privacy1 safety1 and dignity of women and girls1 and disability access in design1 implementation1 and evaluation1 in accordance with existing ,,usaid policies for people with disabilities2 7#e7 promote the development of resilient water1 sanitation1 and hygiene systems in healthcare facilities2 and 7#f7 prioritize high priority countries where the needs are greatest4 #d4 ,definitions ,in this ,act3 7#a7 ,appropriate congressional committees ,the term appropriate congressional committees means-- 7,a7 the ,committee on ,foreign ,affairs and the ,committee on ,appropriations of the ,house of ,representatives2 and 7,b7 the ,committee on ,foreign ,relations and the ,committee on ,appropriations of the ,senate4 7#b7 ,sustainable ,the term sustainable means the ability of a target country1 community1 implementing partner1 or intended beneficiary to maintain1 over time1 the programs authorized and outcomes achieved pursuant to this ,act4 7#c7 ,healthcare facility ,the term healthcare facility means a hospital1 clinic1 health center1 or other location established for the purpose of providing health care4 7#d7 ,healthcare worker ,the term healthcare worker includes doctors1 nurses1 lab technicians1 pharmacists1 janitors1 healthcare administrators1 and other individuals working at or in partnership with healthcare facilities4 7#e7 ,high priority country ,the term high priority country means a country designated pursuant to section #acf7;h7 of the ,foreign ,assistance ,act of #aifa 7#bb ,u4,s4,c4 #baea;h7h77 and any country identified by ,,usaid as a high priority country for the purposes of this ,act4 7#f7 ,key stakeholders ,the term key stakeholders means-- 7,a7 communities directly affected by the lack of access to safe water1 sanitation or hygiene2 7,b7 other appropriate nongovernmental organizations2 and 7,c7 agencies or departments of countries affected by the lack of access to safe water1 sanitation1 or hygiene4 7#g7 ,,usaid ,the term ,,usaid means the ,united ,states ,agency for ,international ,development4 7#h7 ,,wash ,the term ,,wash means water1 sanitation1 and hygiene4 #e4 ,global wash in healthcare facilities action plan 7a7 ,action plan required ,the ,administrator of the ,united ,states ,agency for ,international ,development1 in coordination with the ,director of the ,centers for ,disease ,control and ,prevention and the ,secretary of ,state1 shall develop and implement an action plan1 to be known as the ,global ,,wash in ,healthcare ,facilities ,action ,plan1 to accomplish the policy objectives listed in section #c7;a74 ,such action plan shall-- 7#a7 set specific1 timebound1 and measurable goals1 and identify relevant performance metrics drawing from existing and complementary strategies and plans2 7#b7 describe monitoring and evaluation plans that reflect best practices relating to transparency1 accountability1 localized sustainability1 country capacity1 budgetary support and ownership1 water1 sanitation1 and hygiene1 including appropriate use of gender disaggregated data2 7#c7 establish clear and transparent criteria for ,,wash in healthcare facilities in target countries1 drawn from existing water1 sanitation and hygiene1 need for strong health systems1 infection prevention and control1 pandemic preparedness and response1 maternal1 newborn and child health1 and nutrition programs high priority countries and assessments1 and for selecting regions and intended beneficiaries of assistance2 7#d7 describe linkages and coordination with other relevant policies1 strategies1 plans and initiatives including those related to gender1 resilience1 global health1 and pandemic preparedness and response2 7#e7 describe measures and approaches to address the issues of infection prevention and control1 menstrual health and hygiene1 safe and equitable access to ,,wash for health workers1 gaps in current data1 monitoring and evaluation analysis and capacity1 consistent with the policy objectives described in section #c7;a72 7#f7 support partner governments to strengthen supply chains and1 as appropriate1 establish and maintain strategic stockpiles of critical water1 sanitation1 hygiene and menstrual health products1 clean1 operational and maintenance inputs1 and related hardware for resilient healthcare2 7#g7 address women's and girls' specific needs for water1 sanitation1 and hygiene access in healthcare facilities1 in particular1 personal safety1 privacy1 dignity1 and menstrual health and hygiene and maternal health2 7#h7 support the long-term sustainability of water1 sanitation1 and hygiene access in healthcare facilities especially at points of care1 through health systems resiliency approaches including capacity building2 7#i7 leverage new and existing water1 sanitation1 and hygiene technologies1 including non-sewered sanitation solutions1 and a variety of technologies for sanitation and healthcare waste treatment2 7#aj7 in support of sustainably increased ,,wash access in healthcare facilities and increased local ownership1 identify criteria1 and methodology for graduating countries from ,united ,states assistance provided for the policy objectives listed in section #c7;a72 and 7#aa7 anticipate resource needs to implement the ,action ,plan1 including such amounts to be transferred by the ,secretary of ,state to the ,administrator of ,,usaid pursuant to section #f7;a74 7b7 ,inclusion in other strategies1 policies1 plans1 and initiatives ,the ,administrator may include the ,action ,plan required by subsection 7a7 as a component of the ,,usaid ,agency-,specific ,plan for the ,united ,states ,international ,activities to ,advance ,global ,health ,security and ,diplomacy ,strategy required by the ,global ,health ,security and ,international ,pandemic1 ,preparedness and ,response ,act 7subtitle ,d of title ,,lv of the ,national ,defense ,authorization ,act for ,fiscal ,year #bjbc71 or as a component of other ,,usaid strategies1 policies1 plans or initiatives1 as appropriate4 7c7 ,action plan submission ,not later than #a year after the date of the enactment of this ,act1 the ,administrator of ,,usaid shall submit to the appropriate congressional committees a report consisting of-- 7#a7 the ,global ,,wash in ,healthcare ,facilities ,action ,plan required under subsection 7a72 and 7#b7 a description of the manner in which the ,administrator intends to advance the policy objectives listed in section #c7;a7 through such action plan4 #f4 ,assistance to implement the global wash in healthcare facilities action plan 7a7 ,authorization of appropriations ,amounts appropriated pursuant to the authorization under section #eefd of the ,national ,defense ,authorization ,act for ,fiscal ,year #bjbc are also authorized to be made available during fiscal years #bjbd through #bjbg to carry out the ,global ,,wash in ,health ,care ,facilities ,action ,plan described in section #e in support of the ,united ,states ,international ,activities to ,advance the ,global ,,wash in ,healthcare ,facilities ,action ,plan4 7b7 ,authorization of transfers ,subject to the availability of funds appropriated pursuant to the authorization under section #eefd of the ,national ,defense ,authorization ,act for ,fiscal ,year #bjbc and in accordance with subsection 7a71 the ,secretary of ,state is authorized to transfer to the ,administrator of the ,,usaid such sums as may be necessary to implement the ,global ,,wash in ,health ,care ,facilities ,action ,plan described in section #e of this ,act4 7c7 ,monitoring and evaluation ,the ,administrator shall seek to ensure that assistance to implement the ,global ,,wash in ,healthcare ,facilities ,action ,plan is provided under established parameters for a rigorous accountability system to monitor and evaluate progress and impact of the action plan1 including by reporting to the appropriate congressional committees and the public on an annual basis1 in accordance with section #g4 #g4 ,reports 7a7 ,initial report ,not later than #a year after the date of the submission of the ,global ,,wash in ,healthcare ,facilities ,action ,plan required under section #e1 the ,administrator shall submit to the appropriate congressional committees a report that describes the status of the implementation of the ,action ,plan4 7b7 ,content ,the report required under subsection 7a7 shall-- 7#a7 contain a summary of the ,global ,,wash in ,healthcare ,facilities ,action ,plan as an appendix2 7#b7 describe the progress made in implementing the ,action ,plan2 7#c7 identify the indicators and measure results over time1 as well as the mechanisms for reporting such results in an open and transparent manner1 including disaggregated data on healthcare facilities with basic or safe access to water1 sanitation and hygiene defined by the ,world ,health ,organization and ,,unicef2 7#d7 contain a transparent and detailed accounting of ,,usaid spending to implement the ,global ,,wash in ,healthcare ,facilities ,action ,plan and related activities2 7#e7 describe how the ,global ,,wash in ,healthcare ,facilities ,action ,plan leverages other ,united ,states global health programs including but not limited to maternal and child health1 health systems1 and global health security2 7#f7 describe the impact of the ,global ,,wash in ,healthcare ,facilities ,action ,plan on other global health programs1 including progress in the promotion of infection prevention and control1 strengthening global health security and pandemic preparedness1 prevention and response and reducing preventable maternal and child deaths2 7#g7 assess efforts to coordinate ,united ,states global health programs1 activities1 and initiatives with key stakeholders2 7#h7 assess ,united ,states ,government-facilitated private investment in related sectors and the impact of private sector investment in target countries and communities2 7#i7 assess the increased access to safe sanitation and hand washing stations in healthcare facilities1 including to address menstrual health and hygiene needs2 7#aj7 incorporate a plan for regularly sharing lessons learned with a wide range of stakeholders1 including local civil society organizations in an open1 transparent manner and through biennial stakeholder consultation2 and 7#aa7 establish mechanisms for receiving feedback from stakeholders and incorporating feedback into updates of relevant congressionally mandated strategies and action plans4 7c7 ,subsequent reports ,for the five-year period beginning on the date of the submission of the initial report required under subsection 7a71 the ,administrator shall annually submit to the appropriate congressional committees a report on the status of the implementation of the action plan1 the progress made in achieving the elements described in section #e1 and any changes to the action plan since the date of the submission of the most recent prior report4 7d7 ,inclusion in other reports ,the ,administrator may include the report required by subsection 7a7 as a component of the ,united ,states ,international ,activities to ,advance ,global ,health ,security and ,diplomacy ,strategy report or as a component of other ,,usaid reports1 as appropriate4 7e7 ,public availability of information ,the information referred to in subsections 7a7 and 7b7 shall be timely made available on the public website of ,,usaid in a consolidated1 downloadable1 and machine-searchable format4