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Multimodal Art Projection 472

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# Public Law 116–20 116th Congress Making supplemental appropriations for the fiscal year ending September 30, 2019, and for other purposes. Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, The following sums in this Act are appropriated, out of any money in the Treasury not otherwise appropriated, for the fiscal year ending September 30, 2019, and for other purposes, namely: For an additional amount for the ‘‘Office of the Secretary’’, $3,005,442,000, which shall remain available until December 31, 2020, for necessary expenses related to losses of crops (including milk, on-farm stored commodities, crops prevented from planting in 2019, and harvested adulterated wine grapes), trees, bushes, and vines, as a consequence of Hurricanes Michael and Florence, other hurricanes, floods, tornadoes, typhoons, volcanic activity, snowstorms, and wildfires occurring in calendar years 2018 and 2019 under such terms and conditions as determined by the Sec- retary: Provided , That the Secretary may provide assistance for such losses in the form of block grants to eligible states and terri- tories and such assistance may include compensation to producers, as determined by the Secretary, for forest restoration and poultry and livestock losses: Provided further , That of the amounts provided under this heading, tree assistance payments may be made under section 1501(e) of the Agricultural Act of 2014 (7 U.S.C. 9081(e)) to eligible orchardists or nursery tree growers (as defined in such section) of pecan trees with a tree mortality rate that exceeds 7.5 percent (adjusted for normal mortality) and is less than 15 percent (adjusted for normal mortality), to be available until expended, for losses incurred during the period beginning January 1, 2018, and ending December 31, 2018: Provided further , That in the case of producers impacted by volcanic activity that resulted in the loss of crop land, or access to crop land, the Secretary shall consider all measures available, as appropriate, to bring replacement land into production: Provided further , That of the ## DEPARTMENT OF AGRICULTURE ## AGRICULTURAL PROGRAMS ## PROCESSING, RESEARCH AND MARKETING ## OFFICE OF THE SECRETARY # An Act ## TITLE I June 6, 2019 [H.R. 2157] Additional Supplemental Appropriations for Disaster Relief Act, 2019. Determination. Time period.

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Reports. amounts provided under this heading, not more than $7,000,000 shall be available to make payments to agricultural producers whose Whole Farm Revenue Protection indemnity payments were reduced following 2018 crop year losses due to assistance received through state-legislated agriculture disaster assistance programs: Provided further , That the total amount of payments received under this heading and applicable policies of crop insurance under the Federal Crop Insurance Act (7 U.S.C. 1501 et seq.) or the Noninsured Crop Disaster Assistance Program (NAP) under section 196 of the Federal Agriculture Improvement and Reform Act of 1996 (7 U.S.C. 7333) shall not exceed 90 percent of the loss as determined by the Secretary: Provided further , That the total amount of payments received under this heading for producers who did not obtain a policy or plan of insurance for an insurable commodity for the applicable crop year under the Federal Crop Insurance Act (7 U.S.C. 1501 et seq.) for the crop incurring the losses or did not file the required paperwork and pay the service fee by the applicable State filing deadline for a noninsurable commodity for the applicable crop year under NAP for the crop incurring the losses shall not exceed 70 percent of the loss as determined by the Secretary: Provided further , That in the case of a crop under this heading for which the Federal Crop Insurance Corporation offers a revenue insurance policy under section 508 of the Federal Crop Insurance Act (7 U.S.C. 1508), the Secretary shall use the greater of the projected price or the harvest price for such crop to determine the expected value of such crop: Provided further , That producers receiving payments under this heading, as determined by the Sec- retary, shall be required to purchase crop insurance where crop insurance is available for the next two available crop years, excluding tree insurance policies, and producers receiving payments under this heading shall be required to purchase coverage under NAP where crop insurance is not available in the next two available crop years, as determined by the Secretary: Provided further , That, not later than 120 days after the end of fiscal year 2019, the Secretary shall submit a report to the Congress specifying the type, amount, and method of such assistance by state and territory: Provided further , That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Con- trol Act of 1985. For an additional amount for the ‘‘Emergency Forest Restora- tion Program’’, for necessary expenses related to the consequences of Hurricanes Michael and Florence and wildfires occurring in cal- endar year 2018, tornadoes and floods occurring in calendar year 2019, and other natural disasters, $480,000,000, to remain available until expended: Provided , That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Con- trol Act of 1985. ## EMERGENCY FOREST RESTORATION PROGRAM ## FARM SERVICE AGENCY

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For an additional amount for ‘‘Central Utah Project Completion Account’’, $350,000, to be deposited into the Utah Reclamation Mitigation and Conservation Account for use by the Utah Reclama- tion Mitigation and Conservation Commission, to remain available until expended, for expenses necessary in carrying out fire remedi- ation activities related to wildfires in 2018: Provided , That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. For an additional amount for ‘‘Water and Related Resources’’, $15,500,000, to remain available until expended, for fire remediation and suppression emergency assistance related to wildfires in 2017 and 2018: Provided , That such amount is designated by the Con- gress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Con- trol Act of 1985. For an additional amount, to be deposited in the Federal Buildings Fund, $91,200,000, to remain available until expended, for necessary expenses related to the consequences of Hurricane Florence for repair and alteration of buildings under the custody and control of the Administrator of General Services, and real property management and related activities not otherwise provided for: Provided , That such amount may be used to reimburse the Fund for obligations incurred for this purpose prior to the date of the enactment of this Act: Provided further , That such amount is designated by the Congress as being for an emergency require- ment pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. ## DEPARTMENT OF THE INTERIOR ## CENTRAL UTAH PROJECT ## CENTRAL UTAH PROJECT COMPLETION ACCOUNT ## BUREAU OF RECLAMATION ## WATER AND RELATED RESOURCES ## GENERAL SERVICES ADMINISTRATION ## REAL PROPERTY ACTIVITIES ## FEDERAL BUILDINGS FUND ## TITLE V Reimbursement.

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For an additional amount for ‘‘Operations and Support’’ for necessary expenses related to the consequences of Hurricanes Michael, Florence, and Lane, Tropical Storm Gordon, and Typhoon Mangkhut, $48,977,000; of which $46,977,000 shall remain avail- able until September 30, 2020, and of which $2,000,000 shall remain available until September 30, 2023, for environmental compliance and restoration: Provided , That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Con- trol Act of 1985. For an additional amount for ‘‘Procurement, Construction, and Improvements’’ for necessary expenses related to the consequences of Hurricanes Michael, Florence, and Lane, Tropical Storm Gordon, and Typhoon Mangkhut, $476,755,000, to remain available until September 30, 2023: Provided , That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. SEC. 601. In implementing section 20601 of Public Law 115– 123, the Administrator shall include the costs associated with addressing pre-disaster condition, undamaged components, codes and standards, and industry standards in the cost of repair when calculating the percentage in section 206.226(f) of title 44, Code of Federal Regulations: Provided , That amounts repurposed under this section that were previously designated by the Congress, respectively, as an emergency requirement or as being for disaster relief pursuant to the Balanced Budget and Emergency Deficit Control Act are designated by the Congress as being for an emer- gency requirement pursuant to section 251(b)(2)(A)(i) of the Bal- anced Budget and Emergency Deficit Control Act of 1985 or as being for disaster relief pursuant to section 251(b)(2)(D) of the Balanced Budget and Emergency Deficit Control Act of 1985. SEC. 602. Notwithstanding any other provision of law, funds made available under each heading in this title shall only be used for the purposes specifically described under that heading. ## DEPARTMENT OF HOMELAND SECURITY ## SECURITY, ENFORCEMENT, AND INVESTIGATIONS ## PROCUREMENT, CONSTRUCTION, AND IMPROVEMENTS ## GENERAL PROVISIONS—THIS TITLE ## OPERATIONS AND SUPPORT ## TITLE VI ## COAST GUARD

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For an additional amount for ‘‘Construction’’ for necessary expenses related to the consequences of Hurricanes Florence, Lane, and Michael, and flooding associated with major declared disaster DR–4365, and calendar year 2018 earthquakes, $82,400,000, to remain available until expended: Provided , That of this amount $50,000,000 shall be used to restore and rebuild national wildlife refuges and increase the resiliency and capacity of coastal habitat and infrastructure to withstand storms and reduce the amount of damage caused by such storms: Provided further , That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. For an additional amount for the ‘‘Historic Preservation Fund’’ for necessary expenses related to the consequences of Hurricanes Florence and Michael, and Typhoon Yutu, $50,000,000, to remain available until September 30, 2022, including costs to States and territories necessary to complete compliance activities required by section 306108 of title 54, United States Code (formerly section 106 of the National Historic Preservation Act) and costs needed to administer the program: Provided , That grants shall only be available for areas that have received a major disaster declaration pursuant to the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5121 et seq.): Provided further , That individual grants shall not be subject to a non-Federal matching requirement: Provided further , That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. For an additional amount for ‘‘Construction’’ for necessary expenses related to the consequences of Hurricanes Florence and Michael, Typhoons Yutu and Mangkhut, and calendar year 2018 wildfires, earthquakes, and volcanic eruptions, $78,000,000, to remain available until expended: Provided , That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. ## DEPARTMENT OF THE INTERIOR ## UNITED STATES FISH AND WILDLIFE SERVICE ## NATIONAL PARK SERVICE ## HISTORIC PRESERVATION FUND ## TITLE VII ## CONSTRUCTION ## CONSTRUCTION

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Reports. Cost estimates. For an additional amount for ‘‘Surveys, Investigations, and Research’’ for necessary expenses related to the consequences of Hurricanes Florence and Michael, and calendar year 2018 wildfires, earthquake damage associated with emergency declaration EM– 3410, and in those areas impacted by a major disaster declared pursuant to the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5121 et seq.) with respect to calendar year 2018 wildfires or volcanic eruptions, $98,500,000, to remain available until expended: Provided , That of this amount, $72,310,000 is for costs related to the repair and replacement of equipment and facilities damaged by disasters in 2018: Provided further , That, not later than 90 days after enactment of this Act, the Survey shall submit a report to the Committees on Appropria- tions that describes the potential options to replace the facility damaged by the 2018 volcano disaster along with cost estimates and a description of how the Survey will provide direct access for monitoring volcanic activity and the potential threat to at- risk communities: Provided further , That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. For an additional amount for ‘‘Technical Assistance’’ for finan- cial management expenses related to the consequences of Typhoon Yutu, $2,000,000, to remain available until expended: Provided , That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. For an additional amount for ‘‘Salaries and Expenses’’ for nec- essary expenses related to the consequences of major disasters declared pursuant to the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5121 et seq.) in 2018, $1,000,000, to remain available until expended: Provided , That such amount is designated by the Congress as being for an emer- gency requirement pursuant to section 251(b)(2)(A)(i) of the Bal- anced Budget and Emergency Deficit Control Act of 1985. For an additional amount for ‘‘Science and Technology’’ for necessary expenses related to improving preparedness of the water ## UNITED STATES GEOLOGICAL SURVEY ## SURVEYS, INVESTIGATIONS, AND RESEARCH ## DEPARTMENTAL OFFICES ## ASSISTANCE TO TERRITORIES ## OFFICE OF INSPECTOR GENERAL ## ENVIRONMENTAL PROTECTION AGENCY ## SCIENCE AND TECHNOLOGY ## INSULAR AFFAIRS ## SALARIES AND EXPENSES

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sector, $600,000, to remain available until expended: Provided , That such amount is designated by the Congress as being for an emer- gency requirement pursuant to section 251(b)(2)(A)(i) of the Bal- anced Budget and Emergency Deficit Control Act of 1985. ## LEAKING UNDERGROUND STORAGE TANK TRUST FUND PROGRAM For an additional amount for ‘‘Leaking Underground Storage Tank Fund’’ for necessary expenses related to the consequences of Hurricanes Florence and Michael, calendar year 2018 earth- quakes, and Typhoon Yutu, $1,500,000, to remain available until expended: Provided , That such amount is designated by the Con- gress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Con- trol Act of 1985. For additional amounts for ‘‘State and Tribal Assistance Grants’’ for necessary expenses related to the consequences of Hurri- canes Florence and Michael and calendar year 2018 earthquakes for the hazardous waste financial assistance grants program, $1,500,000, to remain available until expended; for necessary expenses related to the consequences of Typhoon Yutu for the hazardous waste financial assistance grants program and for other solid waste management activities, $56,000,000, to remain available until expended, provided that none of these funds shall be subject to section 3011(b) of the Solid Waste Disposal Act; and for grants under section 106 of the Federal Water Pollution Control Act, $5,000,000, to remain available until expended, to address impacts of Hurricane Florence, Hurricane Michael, Typhoon Yutu, and cal- endar year 2018 wildfires, notwithstanding subsections (b), (e), and (f), of such section: Provided , That such amounts are designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. For an additional amount for ‘‘State and Tribal Assistance Grants’’, $349,400,000 to remain available until expended, of which $53,300,000 shall be for capitalization grants for the Clean Water State Revolving Funds under title VI of the Federal Water Pollution Control Act, and of which $296,100,000 shall be for capitalization grants under section 1452 of the Safe Drinking Water Act: Provided , That notwithstanding section 604(a) of the Federal Water Pollution Control Act and section 1452(a)(1)(D) of the Safe Drinking Water Act, funds appropriated herein shall be provided to States or Terri- tories in EPA Regions 4, 9, and 10 in amounts determined by the Administrator for wastewater treatment works and drinking water facilities impacted by Hurricanes Florence and Michael, Typhoon Yutu, and calendar year 2018 wildfires and earthquakes: Provided further , That notwithstanding the requirements of section 603(i) of the Federal Water Pollution Control Act and section 1452(d) of the Safe Drinking Water Act, for the funds appropriated herein, each State shall use not less than 20 percent but not more than 30 percent of the amount of its capitalization grants to provide additional subsidization to eligible recipients in the form of forgiveness of principal, negative interest loans or grants or any combination of these: Provided further , That the Administrator shall retain $10,400,000 of the funds appropriated herein for grants ## STATE AND TRIBAL ASSISTANCE GRANTS Determination.

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for drinking water facilities and waste water treatment plants impacted by Typhoon Yutu: Provided further , That the funds appro- priated herein shall be used for eligible projects whose purpose is to reduce flood or fire damage risk and vulnerability or to enhance resiliency to rapid hydrologic change or natural disaster at treat- ment works as defined by section 212 of the Federal Water Pollution Control Act or any eligible facilities under section 1452 of the Safe Drinking Water Act, and for other eligible tasks at such treatment works or facilities necessary to further such purposes: Provided further , That the Administrator of the Environmental Protection Agency may retain up to $1,000,000 of the funds appro- priated herein for management and oversight: Provided further , That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. For an additional amount for ‘‘Forest and Rangeland Research’’ for necessary expenses related to the consequences of Hurricanes Florence and Michael, and the calendar year 2018 wildfires, $1,000,000, to remain available until expended for the forest inven- tory and analysis program: Provided , That such amount is des- ignated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. For an additional amount for ‘‘State and Private Forestry’’ for necessary expenses related to the consequences of Hurricanes Florence and Michael, and the calendar year 2018 wildfires, $12,000,000, to remain available until expended: Provided , That such amount is designated by the Congress as being for an emer- gency requirement pursuant to section 251(b)(2)(A)(i) of the Bal- anced Budget and Emergency Deficit Control Act of 1985. For an additional amount for ‘‘National Forest System’’ for necessary expenses related to the consequences of Hurricanes Flor- ence and Michael, and the calendar year 2018 wildfires, $84,960,000, to remain available until expended: Provided , That of this amount $21,000,000 shall be used for hazardous fuels management activities: Provided further , That such amount is des- ignated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. ## DEPARTMENT OF AGRICULTURE ## RELATED AGENCIES ## FOREST SERVICE ## FOREST AND RANGELAND RESEARCH ## STATE AND PRIVATE FORESTRY ## NATIONAL FOREST SYSTEM

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For an additional amount for ‘‘Capital Improvement and Maintenance’’ for necessary expenses related to the consequences of Hurricanes Florence and Michael, and the calendar year 2018 wildfires, $36,040,000, to remain available until expended: Provided , That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. For an additional amount for ‘‘Wildland Fire Management’’, $720,271,000, to remain available through September 30, 2022, for urgent wildland fire suppression operations: Provided , That such funds shall be solely available to be transferred to and merged with other appropriations accounts from which funds were pre- viously transferred for wildland fire suppression in fiscal year 2018 to fully repay those amounts: Provided further , That such amount is designated by the Congress as an emergency requirement pursu- ant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. ## DEPARTMENT OF HEALTH AND HUMAN SERVICES ## NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES For an additional amount for ‘‘National Institute of Environ- mental Health Sciences’’ for necessary expenses in carrying out activities set forth in section 311(a) of the Comprehensive Environ- mental Response, Compensation, and Liability Act of 1980 (42 U.S.C. 9660(a)) and section 126(g) of the Superfund Amendments and Reauthorization Act of 1986 related to the consequences of major disasters declared pursuant to the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5121 et seq.) in 2018, $1,000,000, to remain available until expended: Provided , That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. SEC. 701. Not later than 45 days after the date of enactment of this Act, the agencies receiving funds appropriated by this title shall provide a detailed operating plan of anticipated uses of funds made available in this title by State and Territory, and by program, project, and activity, to the Committees on Appropriations: Pro- vided , That no such funds shall be obligated before the operating plans are provided to the Committees: Provided further , That such plans shall be updated, including obligations to date, and submitted to the Committees on Appropriations every 60 days until all such funds are expended. ## CAPITAL IMPROVEMENT AND MAINTENANCE ## WILDLAND FIRE MANAGEMENT ## (INCLUDING TRANSFER OF FUNDS) ## NATIONAL INSTITUTES OF HEALTH ## GENERAL PROVISION—THIS TITLE Deadline. Operating plans. Time period.

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For an additional amount for ‘‘Training and Employment Serv- ices’’, $50,000,000, for the dislocated workers assistance national reserve for necessary expenses directly related to the consequences of Hurricanes Florence and Michael, Typhoon Mangkhut, Super Typhoon Yutu, wildfires and earthquakes occurring in calendar year 2018, and tornadoes and floods occurring in calendar year 2019 (referred to under this heading as ‘‘covered disaster or emer- gency’’), to remain available through September 30, 2020: Provided , That the Secretary of Labor may transfer up to $1,000,000 of such funds to any other Department of Labor account for reconstruc- tion and recovery needs, including worker protection activities: Pro- vided further , That these sums may be used to replace grant funds previously obligated to the impacted areas: Provided further , That of the amount provided, up to $500,000, to remain available until expended, shall be transferred to ‘‘Office of Inspector General’’ for oversight of activities responding to such covered disaster or emer- gency: Provided further , That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Con- trol Act of 1985. ## PAYMENTS TO STATES FOR THE CHILD CARE AND DEVELOPMENT BLOCK GRANT For an additional amount for ‘‘Payments to States for the Child Care and Development Block Grant’’, $30,000,000, to remain available through September 30, 2021, for necessary expenses directly related to the consequences of Hurricanes Florence and Michael, Typhoon Mangkhut, Super Typhoon Yutu, and wildfires and earthquakes occurring in calendar year 2018 and tornadoes and floods occurring in calendar year 2019 in those areas for which a major disaster or emergency has been declared under section 401 or 501 of the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5170 and 5191): Provided , That the Sec- retary shall allocate such funds based on assessed need notwith- standing sections 658J and 658O of the Child Care and Develop- ment Block Grant Act of 1990: Provided further , That such funds may be used for costs of renovating, repairing, or rebuilding child care facilities without regard to section 658F(b) or 658G of such Act and with amounts allocated for such purposes excluded from the calculation of percentages under subsection 658E(c)(3) of such Act: Provided further , That notwithstanding section 658J(c) of such Act, funds allotted to a State and used for renovating, repairing, or rebuilding child care facilities may be obligated by the State ## EMPLOYMENT AND TRAINING ADMINISTRATION ## DEPARTMENT OF HEALTH AND HUMAN SERVICES ## ADMINISTRATION FOR CHILDREN AND FAMILIES ## DEPARTMENT OF LABOR ## TRAINING AND EMPLOYMENT SERVICES ## (INCLUDING TRANSFER OF FUNDS) ## TITLE VIII

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in that fiscal year or the succeeding three fiscal years: Provided further , That Federal interest provisions will not apply to the ren- ovation or rebuilding of privately-owned family child care homes, and the Secretary shall develop parameters on the use of funds for family child care homes: Provided further , That the Secretary shall not retain Federal interest after a period of 10 years in any facility renovated, repaired, or rebuilt with funds appropriated under this paragraph: Provided further , That funds appropriated in this paragraph shall not be available for costs that are reimbursed by the Federal Emergency Management Agency, under a contract for insurance, or by self-insurance: Provided further , That obligations incurred for the purposes provided herein prior to the date of enactment of this Act may be charged to funds appropriated under this heading: Provided further , That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. For an additional amount for ‘‘Children and Families Services Programs’’, $90,000,000, to remain available through September 30, 2021, for necessary expenses directly related to the consequences of Hurricanes Florence and Michael, Typhoon Mangkhut, Super Typhoon Yutu, and wildfires and earthquakes occurring in calendar year 2018 and tornadoes and floods occurring in calendar year 2019 in those areas for which a major disaster or emergency has been declared under section 401 or 501 of the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5170 and 5191): Provided , That $55,000,000 shall be for Head Start programs, including making payments under the Head Start Act: Provided further , That none of funds provided in the previous proviso shall be included in the calculation of the ‘‘base grant’’ in subsequent fiscal years, as such term is defined in sections 640(a)(7)(A), 641A(h)(1)(B), or 645(d)(3) of the Head Start Act: Pro- vided further , That funds provided in the second previous proviso are not subject to the allocation requirements of section 640(a) of the Head Start Act: Provided further , That $5,000,000 shall be for payments to States, territories, and tribes for activities authorized under subpart 1 of part B of title IV of the Social Security Act, with such funds allocated based on assessed need notwithstanding section 423 of such Act and paid without regard to percentage limitations in subsections (a) or (e) in section 424 of such Act: Provided further , That $25,000,000 shall be for pay- ments to States, territories, and tribes authorized under the Community Services Block Grant Act, with such funds allocated based on assessed need notwithstanding sections 674(b), 675A, and 675B of such Act: Provided further , That notwithstanding section 676(b)(8) of the Community Services Block Grant Act, each State, territory, or tribe may allocate funds to eligible entities based on assessed need: Provided further , That funds appropriated in this paragraph shall not be available for costs that are reimbursed by the Federal Emergency Management Agency, under a contract for insurance, or by self-insurance: Provided further , That up to $5,000,000, to remain available until expended, shall be available for Federal administrative expenses: Provided further , That obliga- tions incurred for the purposes provided herein prior to the date ## CHILDREN AND FAMILIES SERVICES PROGRAMS Time period.

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of enactment of this Act may be charged to funds appropriated under this heading: Provided further , That such amount is des- ignated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. ## PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY FUND For an additional amount for the ‘‘Public Health and Social Services Emergency Fund’’, $201,000,000, to remain available through September 30, 2020, for necessary expenses directly related to the consequences of Hurricanes Florence and Michael, Typhoon Mangkhut, Super Typhoon Yutu, and wildfires and earthquakes occurring in calendar year 2018 and tornadoes and floods occurring in calendar year 2019 in those areas for which a major disaster or emergency has been declared under section 401 or 501 of the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5170 and 5191) (referred to under this heading as ‘‘cov- ered disaster or emergency’’), including activities authorized under section 319(a) of the Public Health Service Act (referred to in this Act as the ‘‘PHS Act’’): Provided , That of the amount provided, $80,000,000 shall be transferred to ‘‘Health Resources and Services Administration—Primary Health Care’’ for expenses directly related to a covered disaster or emergency for disaster response and recovery, for the Health Centers Program under section 330 of the PHS Act, including alteration, renovation, construction, equip- ment, and other capital improvement costs as necessary to meet the needs of areas affected by a covered disaster or emergency: Provided further , That the time limitation in section 330(e)(3) of the PHS Act shall not apply to funds made available under the preceding proviso: Provided further , That of the amount provided, not less than $20,000,000 shall be transferred to ‘‘Centers for Dis- ease Control and Prevention—CDC-Wide Activities and Program Support’’ for response, recovery, mitigation, and other expenses directly related to a covered disaster or emergency: Provided further , That of the amount provided, not less than $100,000,000 shall be transferred to ‘‘Substance Abuse and Mental Health Services Administration—Health Surveillance and Program Support’’ for grants, contracts, and cooperative agreements for behavioral health treatment, treatment of substance use disorders, crisis counseling, and other related helplines, and for other similar programs to provide support to individuals impacted by a covered disaster or emergency: Provided further , That of the amount provided, up to $1,000,000, to remain available until expended, shall be transferred to ‘‘Office of the Secretary—Office of Inspector General’’ for oversight of activities responding to such covered disasters or emergencies: Provided further , That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Con- trol Act of 1985. ## OFFICE OF THE SECRETARY ## (INCLUDING TRANSFERS OF FUNDS)

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For an additional amount for the ‘‘Emergency Conservation Program’’, for necessary expenses related to the consequences of Hurricanes Michael and Florence and wildfires occurring in cal- endar year 2018, tornadoes and floods occurring in calendar year 2019, and other natural disasters, $558,000,000, to remain available until expended: Provided , That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Con- trol Act of 1985. For an additional amount for ‘‘Watershed and Flood Prevention Operations’’, for necessary expenses for the Emergency Watershed Protection Program related to the consequences of Hurricanes Michael and Florence and wildfires occurring in calendar year 2018, tornadoes and floods occurring in calendar year 2019, and other natural disasters, $435,000,000, to remain available until expended: Provided , That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Con- trol Act of 1985. For an additional amount for the cost of grants for rural commu- nity facilities programs as authorized by section 306 and described in section 381E(d)(1) of the Consolidated Farm and Rural Develop- ment Act, for necessary expenses related to the consequences of Hurricanes Michael and Florence and wildfires occurring in cal- endar year 2018, tornadoes and floods occurring in calendar year 2019, and other natural disasters, $150,000,000, to remain available until expended: Provided , That sections 381E–H and 381N of the Consolidated Farm and Rural Development Act are not applicable to the funds made available under this heading: Provided further , That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. SEC. 101. In addition to amounts otherwise made available, out of the funds made available under section 18 of the Food and Nutrition Act of 2008, $25,200,000 shall be available for the Secretary to provide a grant to the Commonwealth of the Northern Mariana Islands for disaster nutrition assistance in response to the Presidentially declared major disasters and emergencies: Pro- vided , That funds made available to the Commonwealth of the Northern Mariana Islands under this section shall remain available for obligation by the Commonwealth until September 30, 2020: Provided further , That such amount is designated by the Congress as being for an emergency requirement pursuant to section ## EMERGENCY CONSERVATION PROGRAM ## NATURAL RESOURCES CONSERVATION SERVICE ## WATERSHED AND FLOOD PREVENTION OPERATIONS ## RURAL COMMUNITY FACILITIES PROGRAM ACCOUNT ## GENERAL PROVISIONS—THIS TITLE ## RURAL DEVELOPMENT

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For an additional amount for ‘‘Hurricane Education Recovery’’ for necessary expenses related to the consequences of Hurricanes Florence and Michael, Typhoon Mangkhut, Super Typhoon Yutu, and wildfires, earthquakes, and volcanic eruptions occurring in calendar year 2018 and tornadoes and floods occurring in calendar year 2019 in those areas for which a major disaster or emergency has been declared under section 401 or 501 of the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5170 and 5191) (referred to under this heading as ‘‘covered disaster or emergency’’), $165,000,000, to remain available through Sep- tember 30, 2020, for assisting in meeting the educational needs of individuals affected by a covered disaster or emergency: Provided , That such assistance may be provided through any of the programs authorized under this heading in title VIII of subdivision 1 of division B of Public Law 115–123 (as amended by Public Law 115–141), as determined by the Secretary of Education, and subject to the terms and conditions that applied to those programs, except that references to dates and school years in Public Law 115–123 shall be deemed to be the corresponding dates and school years for the covered disaster or emergency: Provided further , That the Secretary of Education may determine the amounts to be used for each such program and shall notify the Committees on Appro- priations of the House of Representatives and the Senate of these amounts not later than 7 days prior to obligation: Provided further , That $2,000,000 of the funds made available under this heading, to remain available until expended, shall be transferred to the Office of the Inspector General of the Department of Education for oversight of activities supported with funds appropriated under this heading, and up to $1,000,000 of the funds made available under this heading shall be for program administration: Provided further , That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. SEC. 801. Not later than 30 days after enactment of this Act, the Secretaries of Labor, Health and Human Services, and Edu- cation shall provide a detailed spend plan of anticipated uses of funds made available in this title, including estimated personnel and administrative costs, to the Committees on Appropriations: Provided , That such plans shall be updated and submitted to the Committees on Appropriations every 60 days until all funds are expended or expire. SEC. 802. (a) Section 1108(g)(5) of the Social Security Act (42 U.S.C. 1308(g)(5)) is amended— (1) in subparagraph (A), by striking ‘‘and (E)’’ and inserting ‘‘(E), and (F)’’; (2) in subparagraph (C), in the matter preceding clause (i), by striking ‘‘and (E)’’ and inserting ‘‘and (F)’’; (3) by redesignating subparagraph (E) as subparagraph (F); ## DEPARTMENT OF EDUCATION ## HURRICANE EDUCATION RECOVERY ## (INCLUDING TRANSFER OF FUNDS) ## GENERAL PROVISIONS—THIS TITLE Determination. Determination. Notification. Deadline. Deadline. Spend plan. Cost estimates. Time period.

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Time period. Northern Mariana Islands. Time period. Guam. American Samoa. Deadline. Guam. American Samoa. Plans. Deadline. Spend plan. Funding estimates. (5) in subparagraph (F) (as redesignated by paragraph (3) of this section)— (b) The amounts provided by the amendments made by sub- section (a) are designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. For an additional amount for ‘‘Salaries and Expenses’’, $10,000,000, to remain available until expended, for audits and investigations related to Hurricanes Florence, Lane, and Michael, Typhoons Yutu and Mangkhut, the calendar year 2018 wildfires, earthquakes, and volcano eruptions, and other disasters declared pursuant to the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5121 et seq.): Provided , That, not later than 90 days after the date of enactment of this Act, the Govern- ment Accountability Office shall submit to the Committees on Appropriations of the House of Representatives and the Senate (4) by inserting after subparagraph (D), the following: ‘‘(E) Subject to subparagraph (F), for the period begin- ning January 1, 2019, and ending September 30, 2019, the amount of the increase otherwise provided under subparagraph (A) for the Northern Mariana Islands shall be further increased by $36,000,000.’’; and (A) by striking ‘‘title XIX, during’’ and inserting ‘‘title XIX— (B) by striking ‘‘and (D)’’ and inserting ‘‘, (D), and (E)’’; (C) by striking ‘‘and the Virgin Islands’’ each place it appears and inserting ‘‘, the Virgin Islands, and the Northern Mariana Islands’’; (D) by striking the period at the end and inserting ‘‘; and’’; and (E) by adding at the end the following: ‘‘(ii) for the period beginning January 1, 2019, and ending September 30, 2019, with respect to pay- ments to Guam and American Samoa from the addi- tional funds provided under subparagraph (A), the Sec- retary shall increase the Federal medical assistance percentage or other rate that would otherwise apply to such payments to 100 percent.’’; and (6) by adding at the end the following: ‘‘(G) Not later than September 30, 2019, Guam and American Samoa shall each submit a plan to the Secretary outlining the steps each such territory shall take to collect and report reliable data to the Transformed Medicaid Statistical Information System (T–MSIS) (or a successor system).’’. ## GOVERNMENT ACCOUNTABILITY OFFICE ‘‘(i) during’’; ## LEGISLATIVE BRANCH ## SALARIES AND EXPENSES ## TITLE IX

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a spend plan specifying funding estimates for audits and investiga- tions of any such declared disasters occurring in 2018 and identi- fying funding estimates or carryover balances, if any, that may be available for audits and investigations of any other such declared disasters: Provided further , That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. For an additional amount for ‘‘Military Construction, Navy and Marine Corps’’, $600,000,000, to remain available until Sep- tember 30, 2023, for planning and design, and construction expenses related to the consequences of Hurricanes Florence and Michael on Navy and Marine Corps installations: Provided , That none of the funds shall be available for obligation until the Committees on Appropriations of the House of Representatives and the Senate receive a master plan for the installations: Provided further , That, not later than 60 days after enactment of this Act, the Secretary of the Navy, or his designee, shall submit to the Committees on Appropriations of the House of Representatives and the Senate a detailed expenditure plan for funds provided under this heading: Provided further , That such funds may be obligated or expended for planning and design and military construction projects not other- wise authorized by law: Provided further , That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. For an additional amount for ‘‘Military Construction, Air Force’’, $1,000,000,000, to remain available until September 30, 2023, for planning and design, and construction expenses related to the con- sequences of Hurricane Michael and floods occurring in calendar year 2019: Provided , That none of the funds shall be available for obligation until the Committees on Appropriations of the House of Representatives and the Senate receive a basing plan and future mission requirements for installations significantly damaged by Hurricane Michael: Provided further , That, not later than 60 days after enactment of this Act, the Secretary of the Air Force, or his designee, shall submit to the Committees on Appropriations of the House of Representatives and the Senate a detailed expendi- ture plan for funds provided under this heading: Provided further , That such funds may be obligated or expended for planning and design and military construction projects not otherwise authorized by law: Provided further , That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Con- trol Act of 1985. ## MILITARY CONSTRUCTION, NAVY AND MARINE CORPS ## DEPARTMENT OF DEFENSE ## MILITARY CONSTRUCTION, AIR FORCE ## TITLE X Deadline. Expenditure plans. Deadline. Expenditure plan.

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Deadline. Expenditure plan. Determination. Notice. Expenditure plan. For an additional amount for ‘‘Military Construction, Army National Guard’’, $42,400,000, to remain available until September 30, 2023, for necessary expenses related to the consequences of Hurricanes Florence and Michael: Provided , That none of the funds shall be available for obligation until the Committees on Appropria- tions of the House of Representatives and the Senate receive form 1391 for each specific request: Provided further , That, not later than 60 days after enactment of this Act, the Director of the Army National Guard, or his designee, shall submit to the Commit- tees on Appropriations of the House of Representatives and the Senate a detailed expenditure plan for funds provided under this heading: Provided further , That such funds may be obligated or expended for planning and design and military construction projects not otherwise authorized by law: Provided further , That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. For an additional amount for ‘‘Medical Facilities’’, $3,000,000, to remain available until September 30, 2023, for necessary expenses related to the consequences of Hurricanes Florence and Michael and Typhoons Mangkhut and Yutu: Provided , That the Secretary of Veterans Affairs, upon determination that such action is necessary to address needs as a result of the consequences of Hurricanes Florence and Michael and Typhoons Mangkhut and Yutu, may transfer such funds to any discretionary account of the Department of Veterans Affairs: Provided further , That before a transfer may take place, the Secretary of Veterans Affairs shall submit notice thereof to the Committees on Appropriations of the House of Representatives and the Senate: Provided further , That none of these funds shall be available for obligation until the Secretary of Veterans Affairs submits to the Committees on Appro- priations of the House of Representatives and the Senate a detailed expenditure plan for funds provided under this heading: Provided further , That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. SEC. 1001. Notwithstanding any other provision of law, funds made available under each heading within the ‘‘Department of Defense’’ in this title shall only be used for the purposes specifically described under that heading. ## MILITARY CONSTRUCTION, ARMY NATIONAL GUARD ## DEPARTMENT OF VETERANS AFFAIRS ## GENERAL PROVISION—THIS TITLE ## VETERANS HEALTH ADMINISTRATION ## (INCLUDING TRANSFER OF FUNDS) ## MEDICAL FACILITIES

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For an additional amount for the ‘‘Public Transportation Emer- gency Relief Program’’ as authorized under section 5324 of title 49, United States Code, $10,542,000 to remain available until expended, for transit systems affected by major declared disasters occurring in calendar year 2018: Provided , That not more than three-quarters of 1 percent of the funds for public transportation emergency relief shall be available for administrative expenses and ongoing program management oversight as authorized under sec- tions 5334 and 5338(f)(2) of such title and shall be in addition to any other appropriations for such purpose: Provided further , That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. Of the amounts made available for ‘‘Federal Aviation Adminis- tration—Operations’’ in division B of the Bipartisan Budget Act of 2018 (Public Law 115–123), up to $18,000,000 shall also be available for necessary expenses related to the consequences of major declared disasters occurring in calendar year 2018: Provided , That amounts repurposed under this heading that were previously designated by the Congress as an emergency requirement pursuant to the Balanced Budget and Emergency Deficit Control Act of 1985 are designated by the Congress as an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. For an additional amount for the Emergency Relief Program as authorized under section 125 of title 23, United States Code, $1,650,000,000, to remain available until expended: Provided , That such amount is designated by the Congress as being for an emer- gency requirement pursuant to section 251(b)(2)(A)(i) of the Bal- anced Budget and Emergency Deficit Control Act of 1985. ## DEPARTMENT OF TRANSPORTATION ## FEDERAL TRANSIT ADMINISTRATION ## PUBLIC TRANSPORTATION EMERGENCY RELIEF PROGRAM ## FEDERAL AVIATION ADMINISTRATION ## (AIRPORT AND AIRWAY TRUST FUND) ## FEDERAL HIGHWAY ADMINISTRATION ## EMERGENCY RELIEF PROGRAM ## TITLE XI ## OPERATIONS

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Determination. Certification. Review. ## DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT For an additional amount for ‘‘Community Development Fund’’, $2,431,000,000, to remain available until expended, for necessary expenses for activities authorized under title I of the Housing and Community Development Act of 1974 (42 U.S.C. 5301 et seq.) related to disaster relief, long-term recovery, restoration of infra- structure and housing, economic revitalization, and mitigation in the most impacted and distressed areas resulting from a major disaster that occurred in 2018 or 2019 (except as otherwise provided under this heading) pursuant to the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5121 et seq.): Provided , That funds shall be awarded directly to the State, unit of general local government, or Indian tribe (as such term is defined in section 102 of the Housing and Community Development Act of 1974) at the discretion of the Secretary: Provided further , That of the amounts made available under this heading $431,000,000 shall be allocated to meet unmet infrastructure needs for grantees that received allocations for disasters that occurred in 2017 under this heading of division B of Public Law 115–56 and title XI of subdivision 1 of division B of Public Law 115–123, of which $331,442,114 shall be allocated to those grantees affected by Hurri- cane Maria: Provided further , That of the amounts provided in the previous proviso, the Secretary’s determination of unmet needs for infrastructure shall not take into account mitigation-specific allocations: Provided further , That any amounts allocated pursuant to the previous two provisos to any such grantee shall not be available for draw down and expenditure by a grantee that has entered into alternative procedures under section 428 of the Stafford Act as of the date of enactment of this Act until such grantee has reached a final agreement on all fixed cost estimates within the timeline provided by the Federal Emergency Management Agency: Provided further , That prior to making any grant of funds provided in the previous three provisos, the Secretary must receive from the grantee information that allows the Secretary to certify that such grantee has in place proficient financial controls and procurement processes and has established adequate procedures to prevent any duplication of benefits as defined by section 312 of the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5155), to ensure timely expenditure of funds, to maintain comprehensive websites regarding all disaster recovery activities assisted with these funds, and to detect and prevent waste, fraud, and abuse of funds: Provided further , That of the amounts made available under this heading in Public Law 115– 123 and transferred to the Office of Inspector General, no less than $6,000,000 shall be for necessary costs of overseeing and auditing funds made available to grantees affected by Hurricane Maria, including a review of grant expenditure rates: Provided further , That any funds made available under this heading and under the same heading in Public Law 115–254 that remain avail- able, after the funds under such headings have been allocated ## COMMUNITY PLANNING AND DEVELOPMENT ## COMMUNITY DEVELOPMENT FUND ## (INCLUDING TRANSFERS OF FUNDS)

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for necessary expenses for activities authorized under such headings, shall be allocated to grantees, for mitigation activities in the most impacted and distressed areas resulting from a major disaster that occurred in 2018: Provided further , That such alloca- tions shall be made in the same proportion that the amount of funds each grantee received under this Act and the same heading in division I of Public Law 115–254 bears to the amount of all funds provided to all grantees that received allocations for disasters that occurred in 2018: Provided further , That of the amounts made available under the text preceding the first proviso under this heading and under the same heading in Public Law 115–254, the Secretary shall allocate to all such grantees an aggregate amount not less than 33 percent of the sum of such amounts of funds within 120 days after the enactment of this Act based on the best available data, and shall allocate no less than 100 percent of such funds by no later than 180 days after the enactment of this Act: Provided further , That the Secretary shall not prohibit the use of funds made available under this heading and the same heading in Public Law 115–254 for non-Federal share as authorized by section 105(a)(9) of the Housing and Community Development Act of 1974 (42 U.S.C. 5305(a)(9)): Provided further , That of the amounts made available under this heading, grantees may establish grant programs to assist small businesses for working capital pur- poses to aid in recovery: Provided further , That as a condition of making any grant, the Secretary shall certify in advance that such grantee has in place proficient financial controls and procure- ment processes and has established adequate procedures to prevent any duplication of benefits as defined by section 312 of the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5155), to ensure timely expenditure of funds, to maintain com- prehensive websites regarding all disaster recovery activities assisted with these funds, and to detect and prevent waste, fraud, and abuse of funds: Provided further , That with respect to any such duplication of benefits, the Secretary shall act in accordance with section 1210 of Public Law 115–254 (132 Stat. 3442) and section 312 of the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5155): Provided further , That the Sec- retary shall require grantees to maintain on a public website information containing common reporting criteria established by the Department that permits individuals and entities awaiting assistance and the general public to see how all grant funds are used, including copies of all relevant procurement documents, grantee administrative contracts and details of ongoing procurement processes, as determined by the Secretary: Provided further , That prior to the obligation of funds a grantee shall submit a plan to the Secretary for approval detailing the proposed use of all funds, including criteria for eligibility and how the use of these funds will address long-term recovery and restoration of infrastruc- ture and housing, economic revitalization, and mitigation in the most impacted and distressed areas: Provided further , That such funds may not be used for activities reimbursed by, or for which funds have been made available by, the Federal Emergency Manage- ment Agency or the Army Corps of Engineers, in excess of the authorized amount of the project or its components: Provided fur- ther , That funds allocated under this heading shall not be considered relevant to the non-disaster formula allocations made pursuant to section 106 of the Housing and Community Development Act Certification. Website. Public information. Criteria. Determination. Plan. Criteria.

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132 Stat. 3531. Waiver authority. Federal Register, publication. Notice. Deadline. of 1974 (42 U.S.C. 5306): Provided further , That a State, unit of general local government, or Indian tribe may use up to 5 percent of its allocation for administrative costs: Provided further , That the first proviso under this heading in the Supplemental Appropriations for Disaster Relief Requirements Act, 2018 (division I of Public Law 115–254) is amended by striking ‘‘State or unit of general local government’’ and inserting ‘‘State, unit of general local government, or Indian tribe (as such term is defined in section 102 of the Housing and Community Development Act of 1974 (42 U.S.C. 5302))’’: Provided further , That the sixth proviso under this heading in the Supplemental Appropriations for Disaster Relief Requirements Act, 2018 (division I of Public Law 115–254) is amended by striking ‘‘State or subdivision thereof’’ and inserting ‘‘State, unit of general local government, or Indian tribe (as such term is defined in section 102 of the Housing and Community Development Act of 1974 (42 U.S.C. 5302))’’: Provided further , That in administering the funds under this heading, the Secretary of Housing and Urban Development may waive, or specify alternative requirements for, any provision of any statute or regulation that the Secretary administers in connection with the obligation by the Secretary or the use by the recipient of these funds (except for requirements related to fair housing, nondiscrimination, labor standards, and the environment), if the Secretary finds that good cause exists for the waiver or alternative requirement and such waiver or alternative requirement would not be inconsistent with the overall purpose of title I of the Housing and Community Development Act of 1974: Provided further , That, notwithstanding the preceding proviso, recipients of funds provided under this heading that use such funds to supplement Federal assistance provided under section 402, 403, 404, 406, 407, 408(c)(4), or 502 of the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5121 et seq.) may adopt, without review or public comment, any environmental review, approval, or permit performed by a Federal agency, and such adoption shall satisfy the responsibil- ities of the recipient with respect to such environmental review, approval or permit: Provided further , That, notwithstanding section 104(g)(2) of the Housing and Community Development Act of 1974 (42 U.S.C. 5304(g)(2)), the Secretary may, upon receipt of a request for release of funds and certification, immediately approve the release of funds for an activity or project assisted under this heading if the recipient has adopted an environmental review, approval or permit under the preceding proviso or the activity or project is categorically excluded from review under the National Environ- mental Policy Act of 1969 (42 U.S.C. 4321 et seq.): Provided further , That the Secretary shall publish via notice in the Federal Register any waiver, or alternative requirement, to any statute or regulation that the Secretary administers pursuant to title I of the Housing and Community Development Act of 1974 no later than 5 days before the effective date of such waiver or alternative requirement: Provided further , That of the amounts made available under this heading, up to $5,000,000 shall be made available for capacity building and technical assistance, including assistance on con- tracting and procurement processes, to support States, units of general local government, or Indian tribes (and their subrecipients) that receive allocations pursuant to this heading, received disaster recovery allocations under the same heading in Public Law 115– 254, or may receive similar allocations for disaster recovery in

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future appropriations Acts: Provided further , That of the amounts made available under this heading and under the same heading in Public Law 115–254, up to $2,500,000 shall be transferred, in aggregate, to ‘‘Department of Housing and Urban Development— Program Office Salaries and Expenses—Community Planning and Development’’ for necessary costs, including information technology costs, of administering and overseeing the obligation and expendi- ture of amounts under this heading: Provided further , That the amount specified in the preceding proviso shall be combined with funds appropriated under the same heading and for the same purpose in Public Law 115–254 and the aggregate of such amounts shall be available for any of the same such purposes specified under this heading or the same heading in Public Law 115–254 without limitation: Provided further , That such amount is des- ignated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985: Provided further , That amounts repurposed under this heading that were previously des- ignated by the Congress as an emergency requirement pursuant to the Balanced Budget and Emergency Deficit Control Act are designated by the Congress as an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. SEC. 1101. (a) Amounts previously made available for activities authorized under title I of the Housing and Community Develop- ment Act of 1974 (42 U.S.C. 5301 et seq.) related to disaster relief, long-term recovery, restoration of infrastructure and housing, economic revitalization, and mitigation in the most impacted and distressed areas resulting from a major disaster, including funds provided under section 145 of division C of Public Law 114–223, section 192 of division C of Public Law 114–223 (as added by section 101(3) of division A of Public Law 114–254), section 421 of division K of Public Law 115–31, and any mitigation funding provided under the heading ‘‘Department of Housing and Urban Development—Community Planning and Development—Commu- nity Development Fund’’ of Public Law 115–123, that were allocated in response to Hurricane Matthew, may be used interchangeably and without limitation for the same activities in the most impacted and distressed areas related to Hurricane Florence. In addition, any funds provided under the heading ‘‘Department of Housing and Urban Development—Community Planning and Development— Community Development Fund’’ in this Act or in division I of Public Law 115–254 that are allocated in response to Hurricane Florence may be used interchangeably and without limitation for the same activities in the most impacted and distressed areas related to Hurricane Matthew. Until HUD publishes the Federal Register Notice implementing this provision, grantees may submit for HUD approval revised plans for the use of funds related to Hurricane Matthew that expand the eligible beneficiaries of existing programs contained in such previously approved plans to include those impacted by Hurricane Florence. Approval of any such revised plans shall include the execution of revised grant terms and condi- tions as necessary. Once the implementing Notice is published, ## GENERAL PROVISION—THIS TITLE Revised plans.

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42 USC 5322. Federal Register, publication. Deadline. Reviews. Deadlines. Certification. any additional action plan revisions shall follow the requirements contained therein. (b) Amounts made available for administrative costs for activi- ties authorized under title I of the Housing and Community Development Act of 1974 (42 U.S.C. 5301 et seq.) related to disaster relief, long-term recovery, restoration of infrastructure and housing, economic revitalization, and mitigation in the most impacted and distressed areas under this Act or any future Act, and amounts previously provided under section 420 of division L of Public Law 114–113, section 145 of division C of Public Law 114–223, section 192 of division C of Public Law 114–223 (as added by section 101(3) of division A of Public Law 114–254), section 421 of division K of Public Law 115–31, and under the heading ‘‘Department of Housing and Urban Development—Community Planning and Development—Community Development Fund’’ of division B of Public Law 115–56, Public Law 115–123, and Public Law 115– 254, shall be available for eligible administrative costs of the grantee related to any disaster relief funding identified in this subsection without regard to the particular disaster appropriation from which such funds originated. (c) The additional uses pursuant to this section for amounts that were previously designated by the Congress, respectively, as an emergency requirement or as being for disaster relief pursuant to the Balanced Budget and Emergency Deficit Control Act are designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985 or as being for disaster relief pursuant to section 251(b)(2)(D) of the Balanced Budget and Emergency Deficit Control Act of 1985. SEC. 1102. Of all amounts made available for mitigation activi- ties under the heading ‘‘Department of Housing and Urban Develop- ment—Community Development Fund’’ in Public Law 115–123, the Secretary shall publish in the Federal Register the allocations to all eligible grantees, and the necessary administrative requirements applicable to such allocations within 90 days after enactment of this Act: (1) For any plans or amendments addressing the use of any funds provided under Public Law 115–123 and received by the Secretary prior to December 22, 2018, the Secretary shall review pending amendments within 15 days of enactment of this Act and pending plans within 30 days of enactment of this Act; (2) After the date of enactment of this Act, the Secretary may not apply the statutory waiver or alternative requirement authority provided by Public Law 115–123 to extend or other- wise alter existing statutory and regulatory provisions gov- erning the timeline for review of required grantee plans: Provided , That any amounts allocated pursuant to this section to any such grantee shall not be available for draw down and expenditure by a grantee that has entered into alternative proce- dures under section 428 of the Stafford Act as of the date of enactment of this Act until such grantee has reached a final agree- ment on all fixed cost estimates within the timeline provided by the Federal Emergency Management Agency: Provided further , That prior to making any grant of funds allocated pursuant to this section, the Secretary must receive from the grantee information that allows the Secretary to certify that such grantee has in place

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Grants. Puerto Rico. Study. Survey. Puerto Rico. 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Con- trol Act of 1985. SEC. 102. For purposes of administering title I of subdivision 1 of division B of the Bipartisan Budget Act of 2018 (Public Law 115–123), losses to agricultural producers resulting from hurricanes shall also include losses incurred from Tropical Storm Cindy, losses of peach and blueberry crops in calendar year 2017 due to extreme cold, and blueberry productivity losses in calendar year 2018 due to extreme cold and hurricane damage in calendar year 2017: Pro- vided , That the amounts provided by this section are designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985: Provided further , That amounts repurposed under this section that were previously designated by the Congress as an emergency requirement pursuant to the Bal- anced Budget and Emergency Deficit Control Act of 1985 are des- ignated by the Congress as an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. SEC. 103. (a)(1) Except as provided in paragraph (2), a person or legal entity is not eligible to receive a payment under the Market Facilitation Program established pursuant to the Commodity Credit Corporation Charter Act (15 U.S.C. 714 et seq.) if the average adjusted gross income of such person or legal entity is greater than $900,000. (2) Paragraph (1) shall not apply to a person or legal entity if at least 75 percent of the adjusted gross income of such person or legal entity is derived from farming, ranching, or forestry related activities. (b) In this section, the term ‘‘average adjusted gross income’’ has the meaning given the term defined in section 760.1502 of title 7 Code of Federal Regulations (as in effect July 18, 2018). (c) The amount provided by this section is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Con- trol Act of 1985. SEC. 104. In addition to other amounts made available by section 309 of division A of the Additional Supplemental Appropria- tions for Disaster Relief Requirements Act, 2017 (Public Law 115– 72; 131 Stat. 1229), there is appropriated to the Secretary, out of any moneys in the Treasury not otherwise appropriated, for the fiscal year ending September 30, 2019, $600,000,000 to provide a grant to the Commonwealth of Puerto Rico for disaster nutrition assistance in response to a major disaster or emergency designated by the President under the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5121 et seq.): Provided , That the funds made available to the Commonwealth of Puerto Rico under this section shall remain available for obligation by the Commonwealth until September 30, 2020, and shall be in addition to funds otherwise made available: Provided further , That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985 (2 U.S.C. 901(b)(2)(A)(i)). SEC. 105. There is hereby appropriated $5,000,000, to remain available until September 30, 2020, for the Secretary of Agriculture to conduct an independent study, including a survey of participants,

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proficient financial controls and procurement processes and has established adequate procedures to prevent any duplication of bene- fits as defined by section 312 of the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5155), to ensure timely expenditure of funds, to maintain comprehensive websites regarding all disaster recovery activities assisted with these funds, and to detect and prevent waste, fraud, and abuse of funds: Provided further , That amounts repurposed under this heading that were previously designated by the Congress as an emergency requirement pursuant to the Balanced Budget and Emergency Deficit Control Act of 1985 are designated by the Congress as an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. SEC. 1201. Each amount appropriated or made available by this Act is in addition to amounts otherwise appropriated for the fiscal year involved. SEC. 1202. No part of any appropriation contained in this Act shall remain available for obligation beyond the current fiscal year unless expressly so provided herein. SEC. 1203. Unless otherwise provided for by this Act, the addi- tional amounts appropriated by this Act to appropriations accounts shall be available under the authorities and conditions applicable to such appropriations accounts for fiscal year 2019. SEC. 1204. Each amount designated in this Act by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Con- trol Act of 1985 shall be available (or rescinded or transferred, if applicable) only if the President subsequently so designates all such amounts and transmits such designations to the Congress. SEC. 1205. For purposes of this Act, the consequences or impacts of any hurricane shall include damages caused by the storm at any time during the entirety of its duration as a cyclone, as defined by the National Hurricane Center. SEC. 1206. Any amount appropriated by this Act, designated by the Congress as an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Con- trol Act of 1985 and subsequently so designated by the President, and transferred pursuant to transfer authorities provided by this Act shall retain such designation. SEC. 1207. (a) Section 1309(a) of the National Flood Insurance Act of 1968 (42 U.S.C. 4016(a)) is amended by striking ‘‘June 14, 2019’’ and inserting ‘‘September 30, 2019’’. (b) Section 1319 of the National Flood Insurance Act of 1968 (42 U.S.C. 4026) is amended by striking ‘‘June 14, 2019’’ and inserting ‘‘September 30, 2019’’. (c) If this Act is enacted after June 14, 2019, the amendments made by subsections (a) and (b) shall take effect as if enacted on June 14, 2019. ## GENERAL PROVISIONS—THIS ACT ## TITLE XII President. President. Effective date. 42 USC 4016 note.

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This Act may be cited as the ‘‘Additional Supplemental Appro- priations for Disaster Relief Act, 2019’’. Approved June 6, 2019.

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to compare the impact of the additional benefits provided by section 309 of Public Law 115–72 to the food insecurity, health status, and well-being of low-income residents in Puerto Rico without such additional benefits: Provided , That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. SEC. 106. In addition to amounts otherwise made available, out of the funds made available under section 18 of the Food and Nutrition Act of 2008, $18,000,000 shall be available for the Secretary to provide a grant to American Samoa for disaster nutri- tion assistance in response to the presidentially declared major disasters and emergencies: Provided , That funds made available to the territory under this section shall remain available for obliga- tion by the territory until September 30, 2020: Provided further , That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. SEC. 107. Beginning not later than the 2020 reinsurance year, the Federal Crop Insurance Corporation shall offer coverage under the wholefarm revenue protection insurance policy (or a successor policy or plan of insurance) for hemp (as defined in section 297A of the Agricultural Marketing Act of 1946 (7 U.S.C. 1639o)): Pro- vided , That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. SEC. 108. Notwithstanding any other provision of law, any rural community impacted by major declared disaster DR–4407 may have the governor in the affected state, or the governor’s designee, certify the area’s population as a rural area with respect to eligibility for loans, grants, and technical assistance under rural development programs funded by the Department of Agriculture until data from the 2020 United States Census is available: Pro- vided , That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. ## ECONOMIC DEVELOPMENT ASSISTANCE PROGRAMS (INCLUDING TRANSFERS OF FUNDS) ## DEPARTMENT OF COMMERCE ## ECONOMIC DEVELOPMENT ADMINISTRATION ## TITLE II 7 USC 1508 note. Pursuant to section 703 of the Public Works and Economic Development Act (42 U.S.C. 3233), for an additional amount for ‘‘Economic Development Assistance Programs’’ for necessary expenses related to flood mitigation, disaster relief, long-term recovery, and restoration of infrastructure in areas that received a major disaster designation as a result of Hurricanes Florence, Michael, and Lane, Typhoons Yutu and Mangkhut, and of wildfires, volcanic eruptions, earthquakes, and other natural disasters occur- ring in calendar year 2018, and tornadoes and floods occurring in calendar year 2019 under the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5121 et seq.), $^{Certification. }$

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Spending plan. Deadline. Spending plan. Deadline. $600,000,000, to remain available until expended: Provided , That such amount is designated by the Congress as being for an emer- gency requirement pursuant to section 251(b)(2)(A)(i) of the Bal- anced Budget and Emergency Deficit Control Act of 1985: Provided further , That within the amount appropriated, up to 2 percent of funds may be transferred to the ‘‘Salaries and Expenses’’ account for administration and oversight activities: Provided further , That within the amount appropriated, $1,000,000 shall be transferred to the ‘‘Office of Inspector General’’ account for carrying out inves- tigations and audits related to the funding provided under this heading. ## NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION For an additional amount for ‘‘Operations, Research, and Facili- ties’’ for necessary expenses related to the consequences of Hurri- canes Florence and Michael, Typhoon Yutu, and of wildfires, $120,570,000, to remain available until September 30, 2020, as follows: (1) $3,000,000 for repair and replacement of observing assets, real property, and equipment; (4) $25,000,000 to improve: (a) hurricane intensity fore- casting, including through deployment of unmanned ocean observing platforms and enhanced data assimilation; (b) flood prediction, forecasting, and mitigation capabilities; and (c) wild- fire prediction, detection, and forecasting; and (5) $50,000,000 for Title IX Fund grants as authorized under section 906(c) of division O of Public Law 114–113: Provided , That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Con- trol Act of 1985: Provided further , That the National Oceanic and Atmospheric Administration shall submit a spending plan to the Committees on Appropriations of the House of Representatives and the Senate for funding provided under subsection (4) of this heading within 45 days after the date of enactment of this Act. For an additional amount for ‘‘Procurement, Acquisition and Construction’’, $25,000,000, to remain available until September 30, 2021, for improvements to operational and research weather supercomputing infrastructure and satellite ground services used for hurricane intensity and track prediction; flood prediction, fore- casting, and mitigation; and wildfire prediction, detection, and fore- casting: Provided , That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Con- trol Act of 1985: Provided further , That the National Oceanic and Atmospheric Administration shall submit a spending plan to the Committees on Appropriations of the House of Representatives and the Senate within 45 days after the date of enactment of this Act. ## OPERATIONS, RESEARCH, AND FACILITIES (2) $11,000,000 for marine debris assessment and removal; (3) $31,570,000 for mapping, charting, and geodesy services; ## PROCUREMENT, ACQUISITION AND CONSTRUCTION

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For an additional amount for ‘‘Fishery Disaster Assistance’’ for necessary expenses associated with the mitigation of fishery disasters, $150,000,000, to remain available until expended: Pro- vided , That funds shall be used for mitigating the effects of commer- cial fishery failures and fishery resource disasters declared by the Secretary of Commerce, including those declared by the Secretary to be a direct result of Hurricanes Florence and Michael and Typhoons Yutu and Mangkhut: Provided further , That such amount is designated by the Congress as being for an emergency require- ment pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. For an additional amount for ‘‘Salaries and Expenses’’ for nec- essary expenses related to the consequences of Hurricanes Florence and Michael and Typhoon Yutu, $1,336,000: Provided , That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. For an additional amount for ‘‘Buildings and Facilities’’ for necessary expenses related to the consequences of Hurricanes Flor- ence and Michael and Typhoon Yutu, $28,400,000, to remain avail- able until expended: Provided , That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. For an additional amount for ‘‘Payment to the Legal Services Corporation’’ to carry out the purposes of the Legal Services Cor- poration Act by providing for necessary expenses related to the consequences of Hurricanes Florence, Michael, and Lane, Typhoons Yutu and Mangkhut, calendar year 2018 wildfires, volcanic erup- tions, and earthquakes, and calendar year 2019 tornadoes and floods, $15,000,000: Provided , That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985: Provided further , That none of the funds appropriated in this Act to the Legal Services Corporation shall be expended for any purpose prohibited or limited by, or contrary to any of the provisions of, sections 501, 502, 503, 504, ## PAYMENT TO THE LEGAL SERVICES CORPORATION ## FISHERY DISASTER ASSISTANCE ## DEPARTMENT OF JUSTICE ## UNITED STATES MARSHALS SERVICE ## SALARIES AND EXPENSES ## FEDERAL PRISON SYSTEM ## BUILDINGS AND FACILITIES ## RELATED AGENCIES ## LEGAL SERVICES CORPORATION

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505, and 506 of Public Law 105–119, and all funds appropriated in this Act to the Legal Services Corporation shall be subject to the same terms and conditions set forth in such sections, except that all references in sections 502 and 503 to 1997 and 1998 shall be deemed to refer instead to 2018 and 2019, respectively, and except that sections 501 and 503 of Public Law 104–134 (ref- erenced by Public Law 105–119) shall not apply to the amount made available under this heading: Provided further , That, for the purposes of this Act, the Legal Services Corporation shall be considered an agency of the United States Government. For an additional amount for ‘‘Operation and Maintenance, Marine Corps’’, $381,000,000, for necessary expenses related to the consequences of Hurricanes Michael and Florence: Provided , That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. For an additional amount for ‘‘Operation and Maintenance, Air Force’’, $670,000,000, for necessary expenses related to the consequences of Hurricanes Michael and Florence and floods occur- ring in calendar year 2019: Provided , That such amount is des- ignated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. SEC. 301. Notwithstanding any other provision of law, funds made available under each heading in this title shall only be used for the purposes specifically described under that heading. For an additional amount for ‘‘Investigations’’ for necessary expenses related to the completion, or initiation and completion, of flood and storm damage reduction, including shore protection, studies which are currently authorized or which are authorized after the date of enactment of this Act, to reduce risk from future floods and hurricanes, at full Federal expense, $35,000,000, to remain available until expended, for high priority studies of projects in States and insular areas that were impacted by Hurricanes Florence and Michael, Typhoon Mangkhut, Super Typhoon Yutu, and Tropical Storm Gita: Provided , That such amount is designated ## OPERATION AND MAINTENANCE, MARINE CORPS ## DEPARTMENT OF DEFENSE ## OPERATION AND MAINTENANCE, AIR FORCE ## GENERAL PROVISION—THIS TITLE ## CORPS OF ENGINEERS—CIVIL ## DEPARTMENT OF THE ARMY ## TITLE III ## TITLE IV ## INVESTIGATIONS

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by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985: Provided further , That the Assistant Secretary of the Army for Civil Works shall provide a monthly report directly to the Committees on Appropriations of the House and the Senate detailing the allocation and obligation of these funds, including new studies selected to be initiated using funds provided under this heading, beginning not later than 60 days after the date of enactment of this Act. For an additional amount for ‘‘Construction’’ for necessary expenses, $740,000,000, to remain available until expended, to con- struct flood and storm damage reduction, including shore protection, projects which are currently authorized or which are authorized after the date of enactment of this Act, and flood and storm damage reduction, including shore protection, projects which have signed Chief’s Reports as of the date of enactment of this Act or which are studied using funds provided under the heading ‘‘Investigations’’ if the Secretary determines such projects to be technically feasible, economically justified, and environmentally acceptable, in States and insular areas that were impacted by Hurricanes Florence and Michael, Typhoon Mangkhut, Super Typhoon Yutu, and Tropical Storm Gita: Provided , That projects receiving funds provided under the first proviso in ‘‘Title IV—Corps of Engineers—Civil—Depart- ment of the Army—Construction’’ in Public Law 115–123 shall not be eligible for funding provided under this heading: Provided further , That for projects receiving funds provided under this heading, the provisions of Section 902 of the Water Resources Development Act of 1986 shall not apply to these funds: Provided further , That the completion of ongoing construction projects receiving funds provided under this heading shall be at full Federal expense with respect to such funds: Provided further , That using funds provided under this heading, the non-Federal cash contribu- tion for projects other than ongoing construction projects shall be financed in accordance with the provisions of section 103(k) of Public Law 99–662 over a period of 30 years from the date of completion of the project or separable element: Provided further , That up to $25,000,000 of the funds made available under this heading shall be used for continuing authorities projects to reduce the risk of flooding and storm damage: Provided further , That any projects using funds appropriated under this heading shall be initiated only after non-Federal interests have entered into binding agreements with the Secretary requiring, where applicable, the non-Federal interests to pay 100 percent of the operation, maintenance, repair, replacement, and rehabilitation costs of the project and to hold and save the United States free from damages due to the construction or operation and maintenance of the project, except for damages due to the fault or negligence of the United States or its contractors: Provided further , That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985: Provided further , That the Assistant Secretary of the Army for Civil Works shall provide a monthly report directly to the Committees on Appropriations ## CONSTRUCTION Reports. Reports.

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Reports. Reports. Reports. of the House of Representatives and the Senate detailing the alloca- tion and obligation of these funds, beginning not later than 60 days after the date of enactment of this Act. For an additional amount for ‘‘Mississippi River and Tribu- taries’’ for necessary expenses to address emergency situations at Corps of Engineers projects and rehabilitate and repair damages to Corps of Engineers projects, caused by natural disasters, $575,000,000, to remain available until expended: Provided , That such amount is designated by the Congress as being for an emer- gency requirement pursuant to section 251(b)(2)(A)(i) of the Bal- anced Budget and Emergency Deficit Control Act of 1985: Provided further , That the Assistant Secretary of the Army for Civil Works shall provide a monthly report directly to the Committees on Appro- priations of the House of Representatives and the Senate detailing the allocation and obligation of these funds, beginning not later than 60 days after the date of enactment of this Act. For an additional amount for ‘‘Operation and Maintenance’’ for necessary expenses to dredge Federal navigation projects in response to, and repair damages to Corps of Engineers Federal projects caused by, natural disasters, $908,000,000, to remain avail- able until expended, of which such sums as are necessary to cover the Federal share of eligible operation and maintenance costs for coastal harbors and channels, and for inland harbors shall be derived from the Harbor Maintenance Trust Fund: Provided , That such amount is designated by the Congress as being for an emer- gency requirement pursuant to section 251(b)(2)(A)(i) of the Bal- anced Budget and Emergency Deficit Control Act of 1985: Provided further , That the Assistant Secretary of the Army for Civil Works shall provide a monthly report directly to the Committees on Appro- priations of the House of Representatives and the Senate detailing the allocation and obligation of these funds, beginning not later than 60 days after the date of enactment of this Act. For an additional amount for ‘‘Flood Control and Coastal Emer- gencies’’, as authorized by section 5 of the Act of August 18, 1941 (33 U.S.C. 701n), for necessary expenses to prepare for flood, hurri- cane and other natural disasters and support emergency operations, repairs, and other activities in response to such disasters, as author- ized by law, $1,000,000,000, to remain available until expended: Provided , That funding utilized for authorized shore protection projects shall restore such projects to the full project profile at full Federal expense: Provided further , That such amount is des- ignated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985: Provided further , That the Assistant Secretary of the Army for Civil Works shall provide a monthly report to the Committees on Appropriations of the House of Representatives and the Senate detailing the allocation and obligation of these funds, beginning not later than 60 days after the date of enactment of this Act. ## MISSISSIPPI RIVER AND TRIBUTARIES ## OPERATION AND MAINTENANCE ## FLOOD CONTROL AND COASTAL EMERGENCIES

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# Public Law 116–22 116th Congress To reauthorize certain programs under the Public Health Service Act and the Federal Food, Drug, and Cosmetic Act with respect to public health security and all-hazards preparedness and response, and for other purposes. Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, ## SECTION 1. SHORT TITLE; TABLE OF CONTENTS. (a) SHORT TITLE.—This Act may be cited as the ‘‘Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019’’. (b) TABLE OF CONTENTS.—The table of contents for this Act is as follows: Sec. 1. Short title; table of contents. Sec. 2. References in Act. ## TITLE I—STRENGTHENING THE NATIONAL HEALTH SECURITY STRATEGY Sec. 101. National Health Security Strategy. Sec. 201. Improving benchmarks and standards for preparedness and response. Sec. 202. Amendments to preparedness and response programs. Sec. 203. Regional health care emergency preparedness and response systems. Sec. 204. Military and civilian partnership for trauma readiness. Sec. 205. Public health and health care system situational awareness and bio- surveillance capabilities. Sec. 206. Strengthening and supporting the public health emergency rapid re- sponse fund. Sec. 207. Improving all-hazards preparedness and response by public health emer- gency volunteers. Sec. 208. Clarifying State liability law for volunteer health care professionals. Sec. 209. Report on adequate national blood supply. Sec. 210. Report on the public health preparedness and response capabilities and capacities of hospitals, long-term care facilities, and other health care facilities. Sec. 301. Strengthening and assessing the emergency response workforce. Sec. 302. Health system infrastructure to improve preparedness and response. Sec. 303. Considerations for at-risk individuals. Sec. 304. Improving emergency preparedness and response considerations for chil- dren. Sec. 305. National advisory committees on disasters. Sec. 306. Guidance for participation in exercises and drills. Sec. 401. Assistant Secretary for Preparedness and Response. Sec. 402. Public Health Emergency Medical Countermeasures Enterprise. Sec. 403. Strategic National Stockpile. Sec. 404. Preparing for pandemic influenza, antimicrobial resistance, and other sig- nificant threats. ## TITLE II—IMPROVING PREPAREDNESS AND RESPONSE ## TITLE III—REACHING ALL COMMUNITIES ## TITLE IV—PRIORITIZING A THREAT-BASED APPROACH # An Act June 24, 2019 [S. 1379] Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019. 42 USC 201 note.

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## ‘‘PART I—MILITARY AND CIVILIAN PARTNER- SHIP FOR TRAUMA READINESS GRANT PRO- GRAM ## ‘‘SEC. 1291. MILITARY AND CIVILIAN PARTNERSHIP FOR TRAUMA READINESS GRANT PROGRAM. ‘‘(a) MILITARY TRAUMA TEAM PLACEMENT PROGRAM.— ‘‘(1) IN GENERAL.—The Secretary, acting through the Assist- ant Secretary for Preparedness and Response and in consulta- tion with the Secretary of Defense, shall award grants to not more than 20 eligible high-acuity trauma centers to enable military trauma teams to provide, on a full-time basis, trauma care and related acute care at such trauma centers. ‘‘(2) LIMITATIONS.—In the case of a grant awarded under paragraph (1) to an eligible high-acuity trauma center, such grant— ‘‘(3) AVAILABILITY OF FUNDS.—Notwithstanding section 1552 of title 31, United States Code, or any other provision of law, funds available to the Secretary for obligation for a grant under this subsection shall remain available for expendi- ture for 100 days after the last day of the performance period of such grant. ‘‘(b) MILITARY TRAUMA CARE PROVIDER PLACEMENT PROGRAM.— ‘‘(1) IN GENERAL.—The Secretary, acting through the Assist- ant Secretary for Preparedness and Response and in consulta- tion with the Secretary of Defense, shall award grants to eligible trauma centers to enable military trauma care providers to provide trauma care and related acute care at such trauma centers. ‘‘(2) LIMITATIONS.—In the case of a grant awarded under paragraph (1) to an eligible trauma center, such grant— ‘‘(c) GRANT REQUIREMENTS.— ‘‘(1) DEPLOYMENT AND PUBLIC HEALTH EMERGENCIES.—As a condition of receipt of a grant under this section, a grant recipient shall agree to allow military trauma care providers providing care pursuant to such grant to— ‘‘(A) shall be for a period of at least 3 years and not more than 5 years (and may be renewed at the end of such period); and ‘‘(B) shall be in an amount that does not exceed $1,000,000 per year. ‘‘(A) shall be for a period of at least 1 year and not more than 3 years (and may be renewed at the end of such period); and ‘‘(B) shall be in an amount that does not exceed, in a year— ‘‘(i) $100,000 for each military trauma care pro- vider that is a physician at such eligible trauma center; and ‘‘(ii) $50,000 for each other military trauma care provider at such eligible trauma center. ‘‘(A) be deployed by the Secretary of Defense for mili- tary operations, for training, or for response to a mass casualty incident; and ‘‘(B) be deployed by the Secretary of Defense, in con- sultation with the Secretary of Health and Human Services, 42 USC 300d–91. Consultation. Time periods. Consultation. Time period. Consultation.

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Consultation. ‘‘(d) RULE OF CONSTRUCTION.—Nothing in this section shall be construed to affect any other provision of law that preempts State licensing requirements for health care professionals, including with respect to military trauma care providers. for response to a public health emergency pursuant to section 319. ‘‘(2) USE OF FUNDS.—Grants awarded under this section to an eligible trauma center may be used to train and incor- porate military trauma care providers into such trauma center, including incorporation into operational exercises and training drills related to public health emergencies, expenditures for malpractice insurance, office space, information technology, spe- cialty education and supervision, trauma programs, research, and applicable license fees for such military trauma care pro- viders. ‘‘(e) REPORTING REQUIREMENTS.— ‘‘(1) REPORT TO THE SECRETARY AND THE SECRETARY OF DEFENSE.—Each eligible trauma center or eligible high-acuity trauma center awarded a grant under subsection (a) or (b) for a year shall submit to the Secretary and the Secretary of Defense a report for such year that includes information on— ‘‘(A) the number and types of trauma cases managed by military trauma teams or military trauma care providers pursuant to such grant during such year; ‘‘(B) the ability to maintain the integration of the mili- tary trauma providers or teams of providers as part of the trauma center, including the financial effect of such grant on the trauma center; ‘‘(C) the educational effect on resident trainees in cen- ters where military trauma teams are assigned; ‘‘(D) any research conducted during such year sup- ported by such grant; and ‘‘(E) any other information required by the Secretaries for the purpose of evaluating the effect of such grant. ‘‘(2) REPORT TO CONGRESS.—Not less than once every 2 years, the Secretary, in consultation with the Secretary of Defense, shall submit a report to the congressional committees of jurisdiction that includes information on the effect of placing military trauma care providers in trauma centers awarded grants under this section on— ‘‘(A) maintaining military trauma care providers’ readi- ness and ability to respond to and treat battlefield injuries; ‘‘(B) providing health care to civilian trauma patients in urban and rural settings; ‘‘(C) the capability of trauma centers and military trauma care providers to increase medical surge capacity, including as a result of a large-scale event; ‘‘(D) the ability of grant recipients to maintain the integration of the military trauma providers or teams of providers as part of the trauma center; ‘‘(E) efforts to incorporate military trauma care pro- viders into operational exercises and training and drills for public health emergencies; and ‘‘(F) the capability of military trauma care providers to participate as part of a medical response during or

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in advance of a public health emergency, as determined by the Secretary, or a mass casualty incident. ‘‘(f) DEFINITIONS.—For purposes of this part: ‘‘(1) ELIGIBLE HIGH-ACUITY TRAUMA CENTER.—The term ‘eligible high-acuity trauma center’ means a Level I trauma center that satisfies each of the following: ‘‘(A) Such trauma center has an agreement with the Secretary of Defense to enable military trauma teams to provide trauma care and related acute care at such trauma center. ‘‘(B) At least 20 percent of patients treated at such trauma center in the most recent 3-month period for which data are available are treated for a major trauma at such trauma center. ‘‘(C) Such trauma center utilizes a risk-adjusted benchmarking system and metrics to measure performance, quality, and patient outcomes. ‘‘(D) Such trauma center is an academic training center— ‘‘(ii) that maintains residency programs and fellow- ships in critical trauma specialties and subspecialties, and provides education and supervision of military trauma team members according to those specialties and subspecialties; and ‘‘(iii) that undertakes research in the prevention and treatment of traumatic injury. ‘‘(E) Such trauma center serves as a medical and public health preparedness and response leader for its community, such as by participating in a partnership for State and regional hospital preparedness established under section 319C–2 or 319C–3. ‘‘(2) ELIGIBLE TRAUMA CENTER.—The term ‘eligible trauma center’ means a Level I, II, or III trauma center that satisfies each of the following: ‘‘(A) Such trauma center has an agreement with the Secretary of Defense to enable military trauma care pro- viders to provide trauma care and related acute care at such trauma center. ‘‘(B) Such trauma center utilizes a risk-adjusted benchmarking system and metrics to measure performance, quality, and patient outcomes. ‘‘(C) Such trauma center demonstrates a need for integrated military trauma care providers to maintain or improve the trauma clinical capability of such trauma center. ‘‘(3) MAJOR TRAUMA.—The term ‘major trauma’ means an injury that is greater than or equal to 15 on the injury severity score. ‘‘(4) MILITARY TRAUMA TEAM.—The term ‘military trauma team’ means a complete military trauma team consisting of military trauma care providers. ‘‘(5) MILITARY TRAUMA CARE PROVIDER.—The term ‘military trauma care provider’ means a member of the Armed Forces who furnishes emergency, critical care, and other trauma acute ‘‘(i) affiliated with a medical school;

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Deadline. Time period. Review. Assessment. Deadline. care services (including a physician, surgeon, physician assist- ant, nurse, nurse practitioner, respiratory therapist, flight para- medic, combat medic, or enlisted medical technician) or other military trauma care provider as the Secretary determines appropriate. ‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—To carry out this section, there is authorized to be appropriated $11,500,000 for each of fiscal years 2019 through 2023.’’. ## SEC. 205. PUBLIC HEALTH AND HEALTH CARE SYSTEM SITUATIONAL AWARENESS AND BIOSURVEILLANCE CAPABILITIES. (a) FACILITIES, CAPACITIES, AND BIOSURVEILLANCE CAPABILI- TIES.—Section 319D (42 U.S.C. 247d–4) is amended— (1) in the section heading, by striking ‘‘ REVITALIZING ’’ and inserting ‘‘ FACILITIES AND CAPACITIES OF ’’; (2) in subsection (a)— (A) in the subsection heading, by striking ‘‘FACILITIES; CAPACITIES’’ and inserting ‘‘IN GENERAL’’; (B) in paragraph (1), by striking ‘‘and improved’’ and inserting ‘‘, improved, and appropriately maintained’’; (C) in paragraph (3), in the matter preceding subpara- graph (A), by striking ‘‘expand, enhance, and improve’’ and inserting ‘‘expand, improve, enhance, and appropriately maintain’’; and ‘‘(4) STUDY OF RESOURCES FOR FACILITIES AND CAPACITIES.— Not later than June 1, 2022, the Comptroller General of the United States shall conduct a study on Federal spending in fiscal years 2013 through 2018 for activities authorized under this subsection. Such study shall include a review and assess- ment of obligations and expenditures directly related to each activity under paragraphs (2) and (3), including a specific accounting of, and delineation between, obligations and expenditures incurred for the construction, renovation, equip- ping, and security upgrades of facilities and associated contracts under this subsection, and the obligations and expenditures incurred to establish and improve the situational awareness and biosurveillance network under subsection (b), and shall identify the agency or agencies incurring such obligations and expenditures.’’; (3) in subsection (b)— (A) in the subsection heading, by striking ‘‘NATIONAL’’ and inserting ‘‘ESTABLISHMENT OF SYSTEMS OF PUBLIC HEALTH’’; (B) in paragraph (1)(B), by inserting ‘‘immunization information systems,’’ after ‘‘centers,’’; (D) by amending paragraph (3) to read as follows: ‘‘(3) STANDARDS.— ‘‘(A) IN GENERAL.—Not later than 1 year after the date of the enactment of the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019, the (D) by adding at the end the following: (C) in paragraph (2)— (i) by inserting ‘‘develop a plan to, and’’ after ‘‘The Secretary shall’’; and (ii) by inserting ‘‘and in a form readily usable for analytical approaches’’ after ‘‘in a secure manner’’; and

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Secretary, in cooperation with health care providers, State, local, Tribal, and territorial public health officials, and relevant Federal agencies (including the Office of the National Coordinator for Health Information Technology and the National Institute of Standards and Technology), shall, as necessary, adopt technical and reporting stand- ards, including standards for interoperability as defined by section 3000, for networks under paragraph (1) and update such standards as necessary. Such standards shall be made available on the internet website of the Depart- ment of Health and Human Services, in a manner that does not compromise national security. ‘‘(B) DEFERENCE TO STANDARDS DEVELOPMENT ORGANIZATIONS.—In adopting and implementing standards under this subsection and subsection (c), the Secretary shall give deference to standards published by standards development organizations and voluntary consensus-based standards entities.’’; (4) in subsection (c)— (A) in paragraph (1)— (i) by striking ‘‘Not later than 2 years after the date of enactment of the Pandemic and All-Hazards Preparedness Reauthorization Act of 2013, the Sec- retary’’ and inserting ‘‘The Secretary’’; (ii) by inserting ‘‘, and improve as applicable and appropriate,’’ after ‘‘shall establish’’; (iii) by striking ‘‘of rapid’’ and inserting ‘‘of, rapid’’; and (iv) by striking ‘‘such connectivity’’ and inserting ‘‘such interoperability’’; (B) by amending paragraph (2) to read as follows: ‘‘(2) COORDINATION AND CONSULTATION.—In establishing and improving the network under paragraph (1), the Secretary shall— ‘‘(A) facilitate coordination among agencies within the Department of Health and Human Services that provide, or have the potential to provide, information and data to, and analyses for, the situational awareness and bio- surveillance network under paragraph (1), including coordination among relevant agencies related to health care services, the facilitation of health information exchange (including the Office of the National Coordinator for Health Information Technology), and public health emergency preparedness and response; and ‘‘(B) consult with the Secretary of Agriculture, the Sec- retary of Commerce (and the Director of the National Institute of Standards and Technology), the Secretary of Defense, the Secretary of Homeland Security, the Secretary of Veterans Affairs, and the heads of other Federal agen- cies, as the Secretary determines appropriate.’’; (C) in paragraph (3)— (i) by redesignating subparagraphs (A) through (E) as clauses (i) through (v), respectively, and adjusting the margins accordingly; (ii) in clause (iv), as so redesignated— (I) by inserting ‘‘immunization information systems,’’ after ‘‘poison control,’’; and Web posting.

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Deadline. Time periods. Deadline. ‘‘(B) REVIEW.—Not later than 2 years after the date of the enactment of the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019 and every 6 years thereafter, the Secretary shall conduct a review of the elements described in subparagraph (A). Such review shall include a discussion of the addition of any elements pursuant to clause (v), including elements added to advancing new technologies, and identify any challenges in the incorporation of elements under subparagraph (A). The Secretary shall provide such review to the congres- sional committees of jurisdiction.’’; (II) by striking ‘‘and clinical laboratories’’ and inserting ‘‘, clinical laboratories, and public environmental health agencies’’; (iii) by striking ‘‘The network’’ and inserting the following: ‘‘(A) IN GENERAL.—The network’’; and (iv) by adding at the end the following: (D) in paragraph (5)— (i) by redesignating subparagraphs (A) through (D) as clauses (i) through (iv), respectively, and adjusting the margins accordingly; (ii) by striking ‘‘In establishing’’ and inserting the following: ‘‘(A) IN GENERAL.—In establishing’’; (iii) by adding at the end the following: ‘‘(B) PUBLIC MEETING.— ‘‘(i) IN GENERAL.—Not later than 180 days after the date of enactment of the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019, the Secretary shall convene a public meeting for pur- poses of discussing and providing input on the potential goals, functions, and uses of the network described in paragraph (1) and incorporating the elements described in paragraph (3)(A). ‘‘(ii) EXPERTS.—The public meeting shall include representatives of relevant Federal agencies (including representatives from the Office of the National Coordi- nator for Health Information Technology and the National Institute of Standards and Technology); State, local, Tribal, and territorial public health officials; stakeholders with expertise in biosurveillance and situational awareness; stakeholders with expertise in capabilities relevant to biosurveillance and situational awareness, such as experts in informatics and data analytics (including experts in prediction, modeling, or forecasting); and other representatives as the Sec- retary determines appropriate. ‘‘(iii) TOPICS.—Such public meeting shall include a discussion of— ‘‘(I) data elements, including minimal or essen- tial data elements, that are voluntarily provided for such network, which may include elements from public health and public and private health care entities, to the extent practicable; ‘‘(II) standards and implementation specifica- tions that may improve the collection, analysis,

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‘‘(6) STRATEGY AND IMPLEMENTATION PLAN.— ‘‘(A) IN GENERAL.—Not later than 18 months after the date of enactment of the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019, the Secretary shall submit to the congressional committees of jurisdiction a coordinated strategy and an accompanying implementation plan that— and interpretation of data during a public health emergency; ‘‘(III) strategies to encourage the access, exchange, and use of information; ‘‘(IV) considerations for State, local, Tribal, and territorial capabilities and infrastructure related to data exchange and interoperability; ‘‘(V) privacy and security protections provided at the Federal, State, local, Tribal, and territorial levels, and by nongovernmental stakeholders; and ‘‘(VI) opportunities for the incorporation of innovative technologies to improve the network.’’; and (iv) in subparagraph (A), as so designated by clause (ii)— (I) in clause (i), as so redesignated— (aa) by striking ‘‘as determined’’ and inserting ‘‘as adopted’’; and (bb) by inserting ‘‘and the National Institute of Standards and Technology’’ after ‘‘Office of the National Coordinator for Health Information Technology’’; (II) in clause (iii), as so redesignated, by striking ‘‘; and’’ and inserting a semicolon; (III) in clause (iv), as so redesignated, by striking the period and inserting ‘‘; and’’; and (IV) by adding at the end the following: ‘‘(v) pilot test standards and implementation speci- fications, consistent with the process described in sec- tion 3002(b)(3)(C), which State, local, Tribal, and terri- torial public health entities may utilize, on a voluntary basis, as a part of the network.’’; (E) by redesignating paragraph (6) as paragraph (7); (F) by inserting after paragraph (5) the following: ‘‘(i) is informed by the public meeting under para- graph (5)(B); ‘‘(ii) includes a review and assessment of existing capabilities of the network and related infrastructure, including input provided by the public meeting under paragraph (5)(B); ‘‘(iii) identifies and demonstrates the measurable steps the Secretary will carry out to— ‘‘(I) develop, implement, and evaluate the net- work described in paragraph (1), utilizing elements described in paragraph (3)(A); ‘‘(II) modernize and enhance biosurveillance activities, including strategies to include innova- tive technologies and analytical approaches (including prediction and forecasting for pandemics and all-hazards) from public and private entities; Deadline. Review. Assessment.

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Evaluation. Deadline. Summary. Cost estimates. Strategy. ‘‘(B) ANNUAL BUDGET PLAN.—Not later than 2 years after the date of enactment of the Pandemic and All-Haz- ards Preparedness and Advancing Innovation Act of 2019 and on an annual basis thereafter, in accordance with the strategy and implementation plan under this para- graph, the Secretary shall, taking into account rec- ommendations provided by the National Biodefense Science Board, develop a budget plan based on the strategy and implementation plan under this section. Such budget plan shall include— ‘‘(III) improve information sharing, coordina- tion, and communication among disparate bio- surveillance systems supported by the Department of Health and Human Services, including the identification of methods to improve accountability, better utilize resources and workforce capabilities, and incorporate innovative technologies within and across agencies; and ‘‘(IV) test and evaluate capabilities of the inter- operable network of systems to improve situational awareness and biosurveillance capabilities; ‘‘(iv) includes performance measures and the metrics by which performance measures will be assessed with respect to the measurable steps under clause (iii); and ‘‘(v) establishes dates by which each measurable step under clause (iii) will be implemented. ‘‘(i) a summary of resources previously expended to establish, improve, and utilize the nationwide public health situational awareness and biosurveillance net- work under paragraph (1); ‘‘(ii) estimates of costs and resources needed to establish and improve the network under paragraph (1) according to the strategy and implementation plan under subparagraph (A); ‘‘(iii) the identification of gaps and inefficiencies in nationwide public health situational awareness and biosurveillance capabilities, resources, and authorities needed to address such gaps; and ‘‘(iv) a strategy to minimize and address such gaps and improve inefficiencies.’’; (G) in paragraph (7), as so redesignated— (i) in subparagraph (A), by inserting ‘‘(taking into account zoonotic disease, including gaps in scientific understanding of the interactions between human, animal, and environmental health)’’ after ‘‘human health’’; (ii) in subparagraph (B)— (I) by inserting ‘‘and gaps in surveillance pro- grams’’ after ‘‘surveillance programs’’; and (II) by striking ‘‘; and’’ and inserting a semi- colon; (iii) in subparagraph (C)— (I) by inserting ‘‘, animal health organizations related to zoonotic disease,’’ after ‘‘health care enti- ties’’; and

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‘‘(D) provide recommendations to the Secretary on poli- cies and procedures to complete the steps described in this paragraph in a manner that is consistent with section 2802.’’; and ‘‘(8) SITUATIONAL AWARENESS AND BIOSURVEILLANCE AS A NATIONAL SECURITY PRIORITY.—The Secretary, on a periodic basis as applicable and appropriate, shall meet with the Director of National Intelligence to inform the development and capabilities of the nationwide public health situational awareness and biosurveillance network.’’; (5) in subsection (d)— ‘‘(D) an implementation plan that may include measur- able steps to achieve the purposes described in paragraph (1).’’; and (C) by striking paragraph (5) and inserting the fol- lowing: ‘‘(5) TECHNICAL ASSISTANCE.—The Secretary may provide technical assistance to States, localities, Tribes, and territories or a consortium of States, localities, Tribes, and territories receiving an award under this subsection regarding interoper- ability and the technical standards set forth by the Secretary.’’; (6) by redesignating subsections (f) and (g) as subsections (i) and (j), respectively; and (7) by inserting after subsection (e) the following: ‘‘(f) PERSONNEL AUTHORITIES.— ‘‘(1) SPECIALLY QUALIFIED PERSONNEL.—In addition to any other personnel authorities, to carry out subsections (b) and (c), the Secretary may— ‘‘(A) appoint highly qualified individuals to scientific or professional positions at the Centers for Disease Control and Prevention, not to exceed 30 such employees at any time (specific to positions authorized by this subsection), with expertise in capabilities relevant to biosurveillance and situational awareness, such as experts in informatics and data analytics (including experts in prediction, mod- eling, or forecasting), and other related scientific or tech- nical fields; and ‘‘(B) compensate individuals appointed under subpara- graph (A) in the same manner and subject to the same terms and conditions in which individuals appointed under (II) by striking the period and inserting ‘‘; and’’; and (iv) by adding at the end the following: (H) by adding at the end the following: (A) in paragraph (1)— (i) by inserting ‘‘environmental health agencies,’’ after ‘‘public health agencies,’’; and (ii) by inserting ‘‘immunization programs,’’ after ‘‘poison control centers,’’; (B) in paragraph (2)— (i) in subparagraph (B), by striking ‘‘and’’ at the end; (ii) in subparagraph (C), by striking the period and inserting ‘‘; and’’; and (iii) by adding after subparagraph (C) the fol- lowing: Recommenda- tions.

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Deadline. Deadline. Reports. Recommenda- tions. Coordination. ‘‘(g) TIMELINE.—The Secretary shall accomplish the purposes under subsections (b) and (c) no later than September 30, 2023, and shall provide a justification to the congressional committees of jurisdiction for any missed or delayed implementation of measur- able steps identified under subsection (c)(6)(A)(iii). ‘‘(h) INDEPENDENT EVALUATION.—Not later than 3 years after the date of enactment of the Pandemic and All-Hazards Prepared- ness and Advancing Innovation Act of 2019, the Comptroller Gen- eral of the United States shall conduct an independent evaluation and submit to the Secretary and the congressional committees of jurisdiction a report concerning the activities conducted under subsections (b) and (c), and provide recommendations, as applicable and appropriate, on necessary improvements to the biosurveillance and situational awareness network.’’. (b) AUTHORIZATION OF APPROPRIATIONS.—Subsection (i) of sec- tion 319D (42 U.S.C. 247d–4), as redesignated by subsection (a)(6), is amended by striking ‘‘$138,300,000 for each of fiscal years 2014 through 2018’’ and inserting ‘‘$161,800,000 for each of fiscal years 2019 through 2023’’. (c) BIOLOGICAL THREAT DETECTION REPORT.—The Secretary of Health and Human Services shall, in coordination with the Sec- retary of Defense and the Secretary of Homeland Security, not later than 180 days after the date of enactment of this Act, report to the Committee on Energy and Commerce, the Committee on Armed Services, and the Committee on Homeland Security of the House of Representatives and the Committee on Health, Education, Labor, and Pensions, the Committee on Armed Services, and the Committee on Homeland Security and Governmental Affairs of the Senate on the state of Federal biological threat detection efforts, including the following: 9903 of title 5, United States Code, are compensated, with- out regard to the provisions of chapter 51 and subchapter III of chapter 53 of such title relating to classification and General Schedule pay rates. ‘‘(2) LIMITATIONS.—The Secretary shall exercise the authority under paragraph (1) in a manner that is consistent with the limitations described in section 319F–1(e)(2). (1) An identification of technological, operational, and pro- grammatic successes and failures of domestic detection pro- grams supported by Federal departments and agencies for intentionally introduced or accidentally released biological threat agents and naturally occurring infectious diseases. (2) A description of Federal efforts to facilitate the exchange of information related to the information described in paragraph (1) among Federal departments and agencies that utilize biological threat detection technology. (3) A description of the capabilities of detection systems in use by Federal departments and agencies including the capability to— (A) rapidly detect, identify, characterize, and confirm the presence of biological threat agents; (B) recover live biological agents from collection devices; (C) determine the geographical distribution of biological agents; (D) determine the extent of environmental contamina- tion and persistence of biological agents; and

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‘‘(9) ZOONOTIC DISEASE, FOOD, AND AGRICULTURE.— Improving coordination among Federal, State, local, Tribal, and territorial entities (including through consultation with the Sec- retary of Agriculture) to prevent, detect, and respond to out- breaks of plant or animal disease (including zoonotic disease) that could compromise national security resulting from a delib- erate attack, a naturally occurring threat, the intentional adulteration of food, or other public health threats, taking into account interactions between animal health, human health, and animals’ and humans’ shared environment as directly related to public health emergency preparedness and response capabilities, as applicable. ‘‘(10) GLOBAL HEALTH SECURITY.—Assessing current or potential health security threats from abroad to inform domestic public health preparedness and response capabilities.’’. ## TITLE II—IMPROVING PREPAREDNESS AND RESPONSE ## SEC. 201. IMPROVING BENCHMARKS AND STANDARDS FOR PREPARED- NESS AND RESPONSE. (a) EVALUATING MEASURABLE EVIDENCE-BASED BENCHMARKS AND OBJECTIVE STANDARDS.—Section 319C–1 (42 U.S.C. 247d–3a) is amended by inserting after subsection (j) the following: (C) in paragraph (3)— (i) by striking ‘‘2009’’ and inserting ‘‘2022’’; (ii) by inserting ‘‘(including gaps in the environ- mental health and animal health workforces, as applicable), describing the status of such workforce’’ after ‘‘gaps in such workforce’’; (iii) by striking ‘‘and identifying strategies’’ and inserting ‘‘identifying strategies’’; and (iv) by inserting before the period at the end ‘‘, and identifying current capabilities to meet the requirements of section 2803’’; and (2) in subsection (b)— (A) in paragraph (2)— (i) in subparagraph (A), by striking ‘‘and investiga- tion’’ and inserting ‘‘investigation, and related informa- tion technology activities’’; (ii) in subparagraph (B), by striking ‘‘and decon- tamination’’ and inserting ‘‘decontamination, relevant health care services and supplies, and transportation and disposal of medical waste’’; and (iii) by adding at the end the following: ‘‘(E) Response to environmental hazards.’’; (B) in paragraph (3)— (i) in the matter preceding subparagraph (A), by striking ‘‘including mental health’’ and inserting ‘‘including pharmacies, mental health facilities,’’; and (ii) in subparagraph (F), by inserting ‘‘or exposures to agents that could cause a public health emergency’’ before the period; (C) in paragraph (5), by inserting ‘‘and other applicable compacts’’ after ‘‘Compact’’; and (D) by adding at the end the following: Coordination. Consultation. Assessment.

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## SEC. 206. STRENGTHENING AND SUPPORTING THE PUBLIC HEALTH EMERGENCY RAPID RESPONSE FUND. (E) provide advanced molecular diagnostics to State, local, Tribal, and territorial public health and other labora- tories that support biological threat detection activities. (4) A description of Federal interagency coordination related to biological threat detection. (5) A description of efforts by Federal departments and agencies that utilize biological threat detection technology to collaborate with State, local, Tribal, and territorial public health laboratories and other users of biological threat detection sys- tems, including collaboration regarding the development of— (A) biological threat detection requirements or stand- ards; (B) a standardized integration strategy; (C) training requirements or guidelines; (D) guidelines for a coordinated public health response, including preparedness capabilities, and, as applicable, for coordination with public health surveillance systems; and (E) a coordinated environmental remediation plan, as applicable. (6) Recommendations related to research, advanced research, development, and procurement for Federal depart- ments and agencies to improve and enhance biological threat detection systems, including recommendations on the transfer of biological threat detection technology among Federal depart- ments and agencies, as necessary and appropriate. Section 319 (42 U.S.C. 247d) is amended— (1) in subsection (b)— (A) in paragraph (1)— (i) in the first sentence, by inserting ‘‘or if the Secretary determines there is the significant potential for a public health emergency, to allow the Secretary to rapidly respond to the immediate needs resulting from such public health emergency or potential public health emergency’’ before the period; and (ii) by inserting ‘‘The Secretary shall plan for the expedited distribution of funds to appropriate agencies and entities.’’ after the first sentence; (B) by redesignating paragraph (2) as paragraph (3); (C) by inserting after paragraph (1) the following: ‘‘(2) USES.—The Secretary may use amounts in the Fund established under paragraph (1), to— ‘‘(A) facilitate coordination between and among Fed- eral, State, local, Tribal, and territorial entities and public and private health care entities that the Secretary deter- mines may be affected by a public health emergency or potential public health emergency referred to in paragraph (1) (including communication of such entities with relevant international entities, as applicable); ‘‘(B) make grants, provide for awards, enter into con- tracts, and conduct supportive investigations pertaining to a public health emergency or potential public health emergency, including further supporting programs under section 319C–1, 319C–2, or 319C–3; Recommenda- tions.

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Deadline. Coordination. Recommenda- tions. Review. Recommenda- tions. ## SEC. 207. IMPROVING ALL-HAZARDS PREPAREDNESS AND RESPONSE BY PUBLIC HEALTH EMERGENCY VOLUNTEERS. (a) IN GENERAL.—Section 319I (42 U.S.C. 247d–7b) is amended— ‘‘(C) facilitate and accelerate, as applicable, advanced research and development of security countermeasures (as defined in section 319F–2), qualified countermeasures (as defined in section 319F–1), or qualified pandemic or epi- demic products (as defined in section 319F–3), that are applicable to the public health emergency or potential public health emergency under paragraph (1); ‘‘(D) strengthen biosurveillance capabilities and labora- tory capacity to identify, collect, and analyze information regarding such public health emergency or potential public health emergency, including the systems under section 319D; ‘‘(E) support initial emergency operations and assets related to preparation and deployment of intermittent dis- aster response personnel under section 2812 and the Med- ical Reserve Corps under section 2813; and ‘‘(F) carry out other activities, as the Secretary deter- mines applicable and appropriate.’’; and (D) by inserting after paragraph (3), as so redesignated, the following: ‘‘(4) REVIEW.—Not later than 2 years after the date of enactment of the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019, the Secretary, in coordina- tion with the Assistant Secretary for Preparedness and Response, shall conduct a review of the Fund under this section and provide recommendations to the Committee on Health, Education, Labor, and Pensions and the Committee on Appro- priations of the Senate and the Committee on Energy and Commerce and the Committee on Appropriations of the House of Representatives on policies to improve such Fund for the uses described in paragraph (2). ‘‘(5) GAO REPORT.—Not later than 4 years after the date of enactment of the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019, the Comptroller General of the United States shall— ‘‘(A) conduct a review of the Fund under this section, including its uses and the resources available in the Fund; and ‘‘(B) submit to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives a report on such review, including recommendations related to such review, as applicable.’’; and (2) in subsection (c)— (A) by inserting ‘‘rapidly respond to public health emer- gencies or potential public health emergencies and’’ after ‘‘used to’’; and (B) by striking ‘‘section.’’ and inserting ‘‘Act or funds otherwise provided for emergency response.’’. (1) in the section heading, by striking ‘‘ HEALTH PROFES- SIONS VOLUNTEERS ’’ and inserting ‘‘ VOLUNTEER HEALTH PROFESSIONAL ’’;

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(2) in subsection (a), by adding at the end the following: ‘‘Such health care professionals may include members of the National Disaster Medical System, members of the Medical Reserve Corps, and individual health care professionals.’’; (3) in subsection (i), by adding at the end the following: ‘‘In order to inform the development of such mechanisms by States, the Secretary shall make available information and material provided by States that have developed mechanisms to waive the application of licensing requirements to applicable health professionals seeking to provide medical services during a public health emergency. Such information shall be made publicly available in a manner that does not compromise national security.’’; and (4) in subsection (k), by striking ‘‘2014 through 2018’’ and inserting ‘‘2019 through 2023’’. (b) ALL-HAZARDS PUBLIC HEALTH EMERGENCY PREPAREDNESS AND RESPONSE PLAN.—Section 319C–1(b)(2)(A)(iv) (42 U.S.C. 247d– 3a(b)(2)(A)(iv)) is amended to read as follows: ‘‘(iv) a description of the mechanism the entity will implement to utilize the Emergency Management Assist- ance Compact, or other mutual aid agreement, for medical and public health mutual aid, and, as appropriate, the activities such entity will implement pursuant to section 319I to improve enrollment and coordination of volunteer health care professionals seeking to provide medical serv- ices during a public health emergency, which may include— ## SEC. 208. CLARIFYING STATE LIABILITY LAW FOR VOLUNTEER HEALTH CARE PROFESSIONALS. (a) IN GENERAL.—Title II (42 U.S.C. 202 et seq.) is amended by inserting after section 224 the following: ## ‘‘SEC. 225. HEALTH CARE PROFESSIONALS ASSISTING DURING A PUBLIC HEALTH EMERGENCY. ‘‘(a) LIMITATION ON LIABILITY.—Notwithstanding any other provision of law, a health care professional who is a member of the Medical Reserve Corps under section 2813 or who is included in the Emergency System for Advance Registration of Volunteer Health Professionals under section 319I and who— ‘‘(1) is responding— ‘‘(A) to a public health emergency determined under section 319(a), during the initial period of not more than 90 days (as determined by the Secretary) of the public health emergency determination (excluding any period cov- ered by a renewal of such determination); or ‘‘(B) to a major disaster or an emergency as declared by the President under section 401 of the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. ‘‘(I) providing a public method of communication for purposes of volunteer coordination (such as a phone number); ‘‘(II) providing for optional registration to partici- pate in volunteer services during processes related to State medical licensing, registration, or certification or renewal of such licensing, registration, or certifi- cation; or ‘‘(III) other mechanisms as the State determines appropriate;’’. Public information. 42 USC 234. Time period. Determination.

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shall be subject only to the State liability laws of the State in which such act or omission occurred, in the same manner and to the same extent as a similar health care professional who is a resident of such State would be subject to such State laws, except with respect to the licensure, registration, and certification of such individual. ‘‘(b) VOLUNTEER PROTECTION ACT.—Nothing in this section shall be construed to affect an individual’s right to protections under the Volunteer Protection Act of 1997. ‘‘(c) PREEMPTION.—This section shall supersede the laws of any State that would subject a health care professional described in subsection (a) to the liability laws of any State other than the State liability laws to which such individual is subject pursuant to such subsection. 5170) or under section 201 of the National Emergencies Act (50 U.S.C. 1621) during the initial period of such dec- laration; ‘‘(2) is alleged to be liable for an act or omission— ‘‘(A) during the initial period of a determination or declaration described in paragraph (1) and related to the treatment of individuals in need of health care services due to such public health emergency, major disaster, or emergency; ‘‘(B) in the State or States for which such determination or declaration is made; ‘‘(C) in the health care professional’s capacity as a member of the Medical Reserve Corps or a professional included in the Emergency System for Advance Registra- tion of Volunteer Health Professionals under section 319I; and ‘‘(D) in the course of providing services that are within the scope of the license, registration, or certification of the professional, as defined by the State of licensure, reg- istration, or certification; and ‘‘(3) prior to the rendering of such act or omission, was authorized by the State’s authorization of deploying such State’s Emergency System for Advance Registration of Volunteer Health Professionals described in section 319I or the Medical Reserve Corps established under section 2813, to provide health care services, ‘‘(d) DEFINITIONS.—In this section: ‘‘(1) The term ‘health care professional’ means an individual licensed, registered, or certified under Federal or State laws or regulations to provide health care services. ‘‘(2) The term ‘health care services’ means any services provided by a health care professional, or by any individual working under the supervision of a health care professional, that relate to— ‘‘(A) the diagnosis, prevention, or treatment of any human disease or impairment; or ‘‘(B) the assessment or care of the health of human beings. ‘‘(e) EFFECTIVE DATE.— ‘‘(1) IN GENERAL.—This section shall take effect 90 days after the date of the enactment of the Pandemic and All- Hazards Preparedness and Advancing Innovation Act of 2019.

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‘‘(2) APPLICATION.—This section shall apply to a claim for harm only if the act or omission that caused such harm occurred on or after the effective date described in paragraph (1).’’. (b) GAO STUDY.—Not later than one year after the date of enactment of this Act, the Comptroller General of the United States shall conduct a review of— (1) the number of health care providers who register under the Emergency System for Advance Registration of Volunteer Health Professionals under section 319I of the Public Health Service Act (42 U.S.C. 247d–7b) in advance to provide services during a public health emergency; (2) the number of health care providers who are credentialed to provide services during the period of a public health emergency declaration, including those who are credentialed though programs established in the Emergency System for Advance Registration of Volunteer Health Profes- sionals under such section 319I and those credentialed by authorities within the State in which the emergency occurred; (3) the average time to verify the credentials of a health care provider during the period of a public health emergency declaration, including the average time pursuant to the Emer- gency System for Advance Registration of Volunteer Health Professionals under such section 319I and for an individual’s credentials to be verified by an authority within the State; and (4) the Emergency System for Advance Registration of Vol- unteer Health Professionals program in States, including whether physician or medical groups, associations, or other relevant provider organizations utilize such program for pur- poses of volunteering during public health emergencies. ## SEC. 209. REPORT ON ADEQUATE NATIONAL BLOOD SUPPLY. Not later than 1 year after the date of the enactment of this Act, the Secretary of Health and Human Services shall submit to Congress a report containing recommendations related to maintaining an adequate national blood supply, including— (1) challenges associated with the continuous recruitment of blood donors (including those newly eligible to donate); (2) ensuring the adequacy of the blood supply in the case of public health emergencies; (3) implementation of the transfusion transmission moni- toring system; and (4) other measures to promote safety and innovation, such as the development, use, or implementation of new technologies, processes, and procedures to improve the safety and reliability of the blood supply. ## SEC. 210. REPORT ON THE PUBLIC HEALTH PREPAREDNESS AND RESPONSE CAPABILITIES AND CAPACITIES OF HOSPITALS, LONG-TERM CARE FACILITIES, AND OTHER HEALTH CARE FACILITIES. (a) STUDY.— (1) IN GENERAL.—Not later than one year after the date of enactment of this Act, the Secretary of Health and Human Services shall enter into an agreement with an appropriate entity to conduct a study regarding the public health prepared- ness and response capabilities and medical surge capacities of hospitals, long-term care facilities, and other health care Deadline. Review. Recommenda- tions. Contracts.

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Recommenda- tions. facilities to prepare for, and respond to, public health emer- gencies, including natural disasters. (2) CONSULTATION.—In conducting the study under para- graph (1), the entity shall consult with Federal, State, local, Tribal, and territorial public health officials (as appropriate), and health care providers and facilities with experience in public health preparedness and response activities. (3) EVALUATION.—The study under paragraph (1) shall include— (A) an evaluation of the current benchmarks and objec- tive standards, as applicable, related to programs that sup- port hospitals, long-term care facilities, and other health care facilities, and their effect on improving public health preparedness and response capabilities and medical surge capacities, including the Hospital Preparedness Program, the Public Health Emergency Preparedness cooperative agreements, and the Regional Health Care Emergency Preparedness and Response Systems under section 319C– 3 of the Public Health Service Act (as added by section 203); (B) the identification of gaps in preparedness, including with respect to such benchmarks and objective standards, such as those identified during recent public health emer- gencies, for hospitals, long-term care facilities, and other health care facilities to address future potential public health threats; (C) an evaluation of coordination efforts between the recipients of Federal funding for programs described in subparagraph (A) and entities with expertise in emergency power systems and other critical infrastructure partners during a public health emergency, to ensure a functioning critical infrastructure, to the greatest extent practicable, during a public health emergency; (D) an evaluation of coordination efforts between the recipients of Federal funding for programs described in subparagraph (A) and environmental health agencies with expertise in emergency preparedness and response plan- ning for hospitals, long-term care facilities, and other health care facilities; and (E) an evaluation of current public health preparedness and response capabilities and medical surge capacities related to at-risk individuals during public health emer- gencies, including an identification of gaps in such preparedness as they relate to such individuals. (b) REPORT.— (1) IN GENERAL.—The agreement under subsection (a) shall require the entity to submit to the Secretary of Health and Human Services and the congressional committees of jurisdic- tion, not later than 3 years after the date of enactment of this Act, a report on the results of the study conducted pursuant to this section. (2) CONTENTS.—The report under paragraph (1) shall— (A) describe the findings and conclusions of the evalua- tion conducted pursuant to subsection (a); and (B) provide recommendations for improving public health preparedness and response capability and medical

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## SEC. 301. STRENGTHENING AND ASSESSING THE EMERGENCY RESPONSE WORKFORCE. (a) NATIONAL DISASTER MEDICAL SYSTEM.— (1) STRENGTHENING THE NATIONAL DISASTER MEDICAL SYSTEM.—Clause (ii) of section 2812(a)(3)(A) (42 U.S.C. 300hh– 11(a)(3)(A)) is amended to read as follows: (2) REVIEW OF THE NATIONAL DISASTER MEDICAL SYSTEM.— Section 2812(b)(2) (42 U.S.C. 300hh–11(b)(2)) is amended to read as follows: ‘‘(2) JOINT REVIEW AND MEDICAL SURGE CAPACITY STRATEGIC PLAN.— surge capacity for hospitals, long-term care facilities, and other health care facilities, including— (i) improving the existing benchmarks and objec- tive standards for the Federal grant programs described in subsection (a)(3)(A) or developing new benchmarks and standards for such programs; and (ii) identifying best practices for improving public health preparedness and response programs and med- ical surge capacity at hospitals, long-term care facili- ties, and other health care facilities, including rec- ommendations for the evaluation under subparagraphs (C) and (D) of subsection (a)(3). ## TITLE III—REACHING ALL COMMUNITIES ‘‘(ii) be present at locations, and for limited periods of time, specified by the Secretary on the basis that the Secretary has determined that a location is at risk of a public health emergency during the time specified, or there is a significant potential for a public health emergency.’’. ‘‘(A) REVIEW.—Not later than 180 days after the date of enactment of the Pandemic and All-Hazards Prepared- ness and Advancing Innovation Act of 2019, the Secretary, in coordination with the Secretary of Homeland Security, the Secretary of Defense, and the Secretary of Veterans Affairs, shall conduct a joint review of the National Disaster Medical System. Such review shall include— ‘‘(i) an evaluation of medical surge capacity, as described in section 2803(a); ‘‘(ii) an assessment of the available workforce of the intermittent disaster response personnel described in subsection (c); ‘‘(iii) the capacity of the workforce described in clause (ii) to respond to all hazards, including capacity to simultaneously respond to multiple public health emergencies and the capacity to respond to a nation- wide public health emergency; ‘‘(iv) the effectiveness of efforts to recruit, retain, and train such workforce; and ‘‘(v) gaps that may exist in such workforce and recommendations for addressing such gaps. ‘‘(B) UPDATES.—As part of the National Health Security Strategy under section 2802, the Secretary shall update Deadline. Coordination. Evaluation. Recommenda- tions. Recommenda- tions.

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Deadline. Determination. Time period. (c) STRENGTHENING THE EPIDEMIC INTELLIGENCE SERVICE.— Section 317F (42 U.S.C. Sec. 247b–7) is amended— the findings from the review under subparagraph (A) and provide recommendations to modify the policies of the National Disaster Medical System as necessary.’’. (3) NOTIFICATION OF SHORTAGE.—Section 2812(c) (42 U.S.C. 300hh–11(c)) is amended by adding at the end the following: ‘‘(3) NOTIFICATION.—Not later than 30 days after the date on which the Secretary determines the number of intermittent disaster-response personnel of the National Disaster Medical System is insufficient to address a public health emergency or potential public health emergency, the Secretary shall submit to the congressional committees of jurisdiction a notification detailing— ‘‘(A) the impact such shortage could have on meeting public health needs and emergency medical personnel needs during a public health emergency; and ‘‘(B) any identified measures to address such shortage. ‘‘(4) CERTAIN APPOINTMENTS.— ‘‘(A) IN GENERAL.—If the Secretary determines that the number of intermittent disaster response personnel within the National Disaster Medical System under this section is insufficient to address a public health emergency or potential public health emergency, the Secretary may appoint candidates directly to personnel positions for inter- mittent disaster response within such system. The Sec- retary shall provide updates on the number of vacant or unfilled positions within such system to the congressional committees of jurisdiction each quarter for which this authority is in effect. ‘‘(B) SUNSET.—The authority under this paragraph shall expire on September 30, 2021.’’. (4) AUTHORIZATION OF APPROPRIATIONS.—Section 2812(g) (42 U.S.C. 300hh–11(g)) is amended by striking ‘‘$52,700,000 for each of fiscal years 2014 through 2018’’ and inserting ‘‘$57,400,000 for each of fiscal years 2019 through 2023’’. (b) VOLUNTEER MEDICAL RESERVE CORPS.— (1) IN GENERAL.—Section 2813(a) (42 U.S.C. 42 U.S.C. 300hh–15(a)) is amended by striking the second sentence and inserting ‘‘The Secretary may appoint a Director to head the Corps and oversee the activities of the Corps chapters that exist at the State, local, Tribal, and territorial levels.’’. (2) AUTHORIZATION OF APPROPRIATIONS.—Section 2813(i) (42 U.S.C. 300hh–15(i)) is amended by striking ‘‘2014 through 2018’’ and inserting ‘‘2019 through 2023’’. (1) in subsection (a)— (A) in paragraph (1)— (i) by inserting ‘‘or preparedness and response activities, including rapid response to public health emergencies and significant public health threats’’ after ‘‘conduct prevention activities’’; and (ii) by striking ‘‘$35,000’’ and inserting ‘‘$50,000’’; and (B) in paragraph (2)(B), by striking ‘‘3 years’’ and inserting ‘‘2 years’’; and (2) in subsection (c)—

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(d) SERVICE BENEFIT FOR NATIONAL DISASTER MEDICAL SYSTEM VOLUNTEERS.— (A) by striking ‘‘For the purpose of carrying out this section’’ and inserting the following: ‘‘(1) IN GENERAL.—For the purpose of carrying out this section, except as described in paragraph (2)’’; and (B) by adding at the end the following: ‘‘(2) EPIDEMIC INTELLIGENCE SERVICE PROGRAM.—For pur- poses of carrying out this section with respect to qualified health professionals serving in the Epidemic Intelligence Service, as authorized under section 317G, there is authorized to be appropriated $1,000,000 for each of fiscal years 2019 through 2023.’’. (1) IN GENERAL.—Section 2812(c) (42 U.S.C. 300hh–11(c)), as amended by subsection (a)(3), is further amended by adding at the end the following: ‘‘(5) SERVICE BENEFIT.—Individuals appointed to serve under this subsection shall be considered eligible for benefits under part L of title I of the Omnibus Crime Control and Safe Streets Act of 1968. The Secretary shall provide notifica- tion to any eligible individual of any effect such designation may have on other benefits for which such individual is eligible, including benefits from private entities.’’. (2) PUBLIC SAFETY OFFICER BENEFITS.—Section 1204(9) of title I of the Omnibus Crime Control and Safe Streets Act of 1968 (34 U.S.C. 10284(9)) is amended— (A) in subparagraph (C)(ii), by striking ‘‘or’’ at the end; (B) in subparagraph (D), by striking the period and inserting ‘‘; or’’; and (C) by inserting after subparagraph (D) the following: ‘‘(E) an individual appointed to the National Disaster Medical System under section 2812 of the Public Health Service Act (42 U.S.C. 300hh–11) who is performing official duties of the Department of Health and Human Services, if those official duties are— ‘‘(i) related to responding to a public health emer- gency or potential public health emergency, or other activities for which the Secretary of Health and Human Services has activated such National Disaster Medical System; and ‘‘(ii) determined by the Secretary of Health and Human Services to be hazardous.’’. (3) SUNSET.—The amendments made by paragraphs (1) and (2) shall cease to have force or effect on October 1, 2021. (e) MISSION READINESS REPORT TO CONGRESS.— (1) REPORT.—Not later than one year after the date of enactment of this section, the Comptroller General of the United States (referred to in this subsection as the ‘‘Comptroller Gen- eral’’) shall submit to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives, a report on the medical surge capacity of the United States in the event of a public health emergency, including the capacity and capability of the current health care workforce to prepare for, and respond to, the full range of public health emergencies Time periods. Appropriation authorization. Notification. Determination. 34 USC 10284 note. Recommenda- tions.

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Recommenda- tions. Determination. or potential public health emergencies, and recommendations to address any gaps identified in such workforce. (2) CONTENTS.—The Comptroller General shall include in the report under paragraph (1)— (A) the number of health care providers who have volunteered to provide health care services during a public health emergency, including members of the National Dis- aster Medical System, the Disaster Medical Assistant Teams, the Medical Reserve Corps, and other volunteer health care professionals in the verification network pursu- ant to section 319I of the Public Health Service Act (42 U.S.C. 247d–7b); (B) the capacity of the workforce described in subpara- graph (A) to respond to a public health emergency or poten- tial public health emergency, including the capacity to respond to multiple concurrent public health emergencies and the capacity to respond to a nationwide public health emergency; (C) the preparedness and response capabilities and mission readiness of the workforce described in subpara- graph (A) taking into account areas of health care expertise and considerations for at-risk individuals (as defined in section 2802(b)(4)(B) of the Public Health Service Act (42 U.S.C. 300hh–1(b)(4)(B))); (D) an assessment of the effectiveness of efforts to recruit, retain, and train such workforce; and (E) identification of gaps that may exist in such workforce and recommendations for addressing such gaps, the extent to which the Assistant Secretary for Prepared- ness and Response plans to address such gaps, and any recommendations from the Comptroller General to address such gaps. ## SEC. 302. HEALTH SYSTEM INFRASTRUCTURE TO IMPROVE PREPARED- NESS AND RESPONSE. (a) COORDINATION OF PREPAREDNESS.—Section 2811(b)(5) (42 U.S.C. 300hh–10(b)(5)) is amended by adding at the end the fol- lowing: ‘‘Such logistical support shall include working with other relevant Federal, State, local, Tribal, and territorial public health officials and private sector entities to identify the critical infrastruc- ture assets, systems, and networks needed for the proper func- tioning of the health care and public health sectors that need to be maintained through any emergency or disaster, including entities capable of assisting with, responding to, and mitigating the effect of a public health emergency, including a public health emergency determined by the Secretary pursuant to section 319(a) or an emergency or major disaster declared by the President under the Robert T. Stafford Disaster Relief and Emergency Assistance Act or the National Emergencies Act, including by establishing methods to exchange critical information and deliver products con- sumed or used to preserve, protect, or sustain life, health, or safety, and sharing of specialized expertise.’’. (b) MANUFACTURING CAPACITY.—Section 2811(d)(2)(C) (42 U.S.C. 300hh–10(d)(2)(C)) is amended by inserting ‘‘, and ancillary medical supplies to assist with the utilization of such counter- measures or products,’’ after ‘‘products’’.

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Deadlines. Review. Recommenda- tions. ‘‘(k) EVALUATION.— ‘‘(1) IN GENERAL.—Not later than 2 years after the date of enactment of the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019 and every 2 years there- after, the Secretary shall conduct an evaluation of the evidence- based benchmarks and objective standards required under sub- section (g). Such evaluation shall be submitted to the congres- sional committees of jurisdiction together with the National Health Security Strategy under section 2802, at such time as such strategy is submitted. ‘‘(2) CONTENT.—The evaluation under this paragraph shall include— ‘‘(A) a review of evidence-based benchmarks and objec- tive standards, and associated metrics and targets; ‘‘(B) a discussion of changes to any evidence-based benchmarks and objective standards, and the effect of such changes on the ability to track whether entities are meeting or making progress toward the goals under this section and, to the extent practicable, the applicable goals of the National Health Security Strategy under section 2802; ‘‘(C) a description of amounts received by eligible enti- ties described in subsection (b) and section 319C–2(b), and amounts received by subrecipients and the effect of such funding on meeting evidence-based benchmarks and objec- tive standards; and ‘‘(D) recommendations, as applicable and appropriate, to improve evidence-based benchmarks and objective stand- ards to more accurately assess the ability of entities receiving awards under this section to better achieve the goals under this section and section 2802.’’. (b) EVALUATING THE PARTNERSHIP FOR STATE AND REGIONAL HOSPITAL PREPAREDNESS.—Section 319C–2(i)(1) (42 U.S.C. 247– 3b(i)(1)) is amended by striking ‘‘section 319C–1(g), (i), and (j)’’ and inserting ‘‘section 319C–1(g), (i), (j), and (k)’’. ## SEC. 202. AMENDMENTS TO PREPAREDNESS AND RESPONSE PRO- GRAMS. (a) COOPERATIVE AGREEMENT APPLICATIONS FOR IMPROVING STATE AND LOCAL PUBLIC HEALTH SECURITY.—Section 319C–1 (42 U.S.C. 247d–3a) is amended— (1) in subsection (a), by inserting ‘‘, acting through the Director of the Centers for Disease Control and Prevention,’’ after ‘‘the Secretary’’; and (2) in subsection (b)(2)(A)— (A) in clause (vi), by inserting ‘‘, including public health agencies with specific expertise that may be relevant to public health security, such as environmental health agen- cies,’’ after ‘‘stakeholders’’; (B) by redesignating clauses (vii) through (ix) as clauses (viii) through (x); (D) in clause (ix), as so redesignated, by striking ‘‘; and’’ and inserting a semicolon; and (C) by inserting after clause (vi) the following: ‘‘(vii) a description of how, as applicable, such entity may integrate information to account for individ- uals with behavioral health needs following a public health emergency;’’;

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(c) EVALUATION OF BARRIERS TO RAPID DELIVERY OF MEDICAL COUNTERMEASURES.— (1) RAPID DELIVERY STUDY.—The Assistant Secretary for Preparedness and Response may conduct a study on issues that have the potential to adversely affect the handling and rapid delivery of medical countermeasures to individuals during public health emergencies occurring in the United States. (2) NOTICE TO CONGRESS.—Not later than 9 months after the date of the enactment of this Act, the Assistant Secretary for Preparedness and Response shall notify the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate if the Assistant Secretary for Preparedness and Response does not plan to conduct the study under paragraph (1) and shall provide such committees a summary explanation for such decision. (3) REPORT TO CONGRESS.—Not later than 1 year after the Assistant Secretary for Preparedness and Response con- ducts the study under paragraph (1), such Assistant Secretary shall submit a report to the Committee on Energy and Com- merce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate con- taining the findings of such study. ## SEC. 303. CONSIDERATIONS FOR AT-RISK INDIVIDUALS. (a) AT-RISK INDIVIDUALS IN THE NATIONAL HEALTH SECURITY STRATEGY.—Section 2802(b)(4)(B) (42 U.S.C. 300hh–1(b)(4)(B)) is amended— (1) by striking ‘‘this section and sections 319C–1, 319F, and 319L,’’ and inserting ‘‘this Act,’’; and (b) COUNTERMEASURE CONSIDERATIONS.—Section 319L(c)(6) (42 U.S.C. 247d–7e(c)(6)) is amended— (2) by inserting ‘‘with relevant characteristics that warrant consideration during the process of researching and developing such countermeasures and products’’ before the period. (c) BIOSURVEILLANCE OF EMERGING PUBLIC HEALTH THREATS.— Section 2814 is amended— (1) in paragraph (7), by striking ‘‘; and’’ and inserting a semicolon; (2) in paragraph (8), by striking the period and inserting ‘‘; and’’; and ‘‘(9) facilitate coordination to ensure that, in implementing the situational awareness and biosurveillance network under section 319D, the Secretary considers incorporating data and information from Federal, State, local, Tribal, and territorial public health officials and entities relevant to detecting emerging public health threats that may affect at-risk individ- uals, such as pregnant and postpartum women and infants, including adverse health outcomes of such populations related to such emerging public health threats.’’. ## SEC. 304. IMPROVING EMERGENCY PREPAREDNESS AND RESPONSE CONSIDERATIONS FOR CHILDREN. Part B of title III (42 U.S.C. 243 et seq.) is amended by inserting after section 319D the following: (2) by striking ‘‘special’’ and inserting ‘‘access or functional’’. (1) by striking ‘‘elderly’’ and inserting ‘‘older adults’’; and (3) by adding at the end the following: Deadline. Summary.

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42 USC 247d–4b. ## ‘‘SEC. 319D–1. CHILDREN’S PREPAREDNESS UNIT. ‘‘(a) ENHANCING EMERGENCY PREPAREDNESS FOR CHILDREN.— The Secretary, acting through the Director of the Centers for Dis- ease Control and Prevention (referred to in this subsection as the ‘Director’), shall maintain an internal team of experts, to be known as the Children’s Preparedness Unit (referred to in this subsection as the ‘Unit’), to work collaboratively to provide guidance on the considerations for, and the specific needs of, children before, during, and after public health emergencies. The Unit shall inform the Director regarding emergency preparedness and response efforts pertaining to children at the Centers for Disease Control and Prevention. ‘‘(b) EXPERTISE.—The team described in subsection (a) shall include one or more pediatricians, which may be a developmental- behavioral pediatrician, and may also include behavioral scientists, child psychologists, epidemiologists, biostatisticians, health commu- nications staff, and individuals with other areas of expertise, as the Secretary determines appropriate. ‘‘(c) DUTIES.—The team described in subsection (a) may— ‘‘(1) assist State, local, Tribal, and territorial emergency planning and response activities related to children, which may include developing, identifying, and sharing best practices; ‘‘(2) provide technical assistance, training, and consultation to Federal, State, local, Tribal, and territorial public health officials to improve preparedness and response capabilities with respect to the needs of children, including providing such tech- nical assistance, training, and consultation to eligible entities in order to support the achievement of measurable evidence- based benchmarks and objective standards applicable to sec- tions 319C–1 and 319C–2; ‘‘(3) improve the utilization of methods to incorporate the needs of children in planning for and responding to a public health emergency, including public awareness of such methods; ‘‘(4) coordinate with, and improve, public-private partner- ships, such as health care coalitions pursuant to sections 319C– 2 and 319C–3, to address gaps and inefficiencies in emergency preparedness and response efforts for children; ‘‘(5) provide expertise and input during the development of guidance and clinical recommendations to address the needs of children when preparing for, and responding to, public health emergencies, including pursuant to section 319C–3; and ‘‘(6) carry out other duties related to preparedness and response activities for children, as the Secretary determines appropriate.’’. ## SEC. 305. NATIONAL ADVISORY COMMITTEES ON DISASTERS. (a) REAUTHORIZING THE NATIONAL ADVISORY COMMITTEE ON CHILDREN AND DISASTERS.—Section 2811A (42 U.S.C. 300hh–10a) is amended— (1) in subsection (b)(2), by inserting ‘‘, mental and behav- ioral,’’ after ‘‘medical’’; (2) in subsection (d)— (A) in paragraph (1), by striking ‘‘15’’ and inserting ‘‘25’’; and (B) by striking paragraph (2) and inserting the fol- lowing:

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‘‘(2) REQUIRED NON-FEDERAL MEMBERS.—The Secretary, in consultation with such other heads of Federal agencies as may be appropriate, shall appoint to the Advisory Committee under paragraph (1) at least 13 individuals, including— ‘‘(A) at least 2 non-Federal professionals with expertise in pediatric medical disaster planning, preparedness, response, or recovery; ‘‘(B) at least 2 representatives from State, local, Tribal, or territorial agencies with expertise in pediatric disaster planning, preparedness, response, or recovery; ‘‘(C) at least 4 members representing health care professionals, which may include members with expertise in pediatric emergency medicine; pediatric trauma, critical care, or surgery; the treatment of pediatric patients affected by chemical, biological, radiological, or nuclear agents, including emerging infectious diseases; pediatric mental or behavioral health related to children affected by a public health emergency; or pediatric primary care; and ‘‘(D) other members as the Secretary determines appro- priate, of whom— ‘‘(3) FEDERAL MEMBERS.—The Advisory Committee under paragraph (1) shall include the following Federal members or their designees (who may be nonvoting members, as deter- mined by the Secretary): ‘‘(A) The Assistant Secretary for Preparedness and Response. ‘‘(B) The Director of the Biomedical Advanced Research and Development Authority. ‘‘(C) The Director of the Centers for Disease Control and Prevention. ‘‘(F) The Assistant Secretary of the Administration for Children and Families. ‘‘(G) The Administrator of the Health Resources and Services Administration. ‘‘(H) The Administrator of the Federal Emergency Management Agency. ‘‘(I) The Administrator of the Administration for Community Living. ‘‘(K) Representatives from such Federal agencies (such as the Substance Abuse and Mental Health Services Administration and the Department of Homeland Security) as the Secretary determines appropriate to fulfill the duties of the Advisory Committee under subsections (b) and (c). ‘‘(i) at least one such member shall represent a children’s hospital; ‘‘(ii) at least one such member shall be an indi- vidual with expertise in schools or child care settings; ‘‘(iii) at least one such member shall be an indi- vidual with expertise in children and youth with special health care needs; and ‘‘(iv) at least one such member shall be an indi- vidual with expertise in the needs of parents or family caregivers, including the parents or caregivers of chil- dren with disabilities. ‘‘(D) The Commissioner of Food and Drugs. ‘‘(E) The Director of the National Institutes of Health. ‘‘(J) The Secretary of Education. Consultation. Appointments.

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42 USC 300hh–10c. Consultation. Consultations. Evaluation. Recommenda- tions. Consultation. Appointments. ‘‘(4) TERM OF APPOINTMENT.—Each member of the Advisory Committee appointed under paragraph (2) shall serve for a term of 3 years, except that the Secretary may adjust the terms of the Advisory Committee appointees serving on the date of enactment of the Pandemic and All-Hazards Prepared- ness and Advancing Innovation Act of 2019, or appointees who are initially appointed after such date of enactment, in order to provide for a staggered term of appointment for all members. ‘‘(5) CONSECUTIVE APPOINTMENTS; MAXIMUM TERMS.—A member appointed under paragraph (2) may serve not more than 3 terms on the Advisory Committee, and not more than two of such terms may be served consecutively.’’; (3) in subsection (e), by adding at the end ‘‘At least one meeting per year shall be an in-person meeting.’’; (4) by redesignating subsection (f) as subsection (g); (5) by inserting after subsection (e) the following: ‘‘(f) COORDINATION.—The Secretary shall coordinate duties and activities authorized under this section in accordance with section 2811D.’’; and (6) in subsection (g), as so redesignated, by striking ‘‘2018’’ and inserting ‘‘2023’’. (b) AUTHORIZING THE NATIONAL ADVISORY COMMITTEE ON SEN- IORS AND DISASTERS.—Subtitle B of title XXVIII (42 U.S.C. 300hh et seq.) is amended by inserting after section 2811A the following: ## ‘‘SEC. 2811B. NATIONAL ADVISORY COMMITTEE ON SENIORS AND DISASTERS. ‘‘(a) ESTABLISHMENT.—The Secretary, in consultation with the Secretary of Homeland Security and the Secretary of Veterans Affairs, shall establish an advisory committee to be known as the National Advisory Committee on Seniors and Disasters (referred to in this section as the ‘Advisory Committee’). ‘‘(b) DUTIES.—The Advisory Committee shall— ‘‘(1) provide advice and consultation with respect to the activities carried out pursuant to section 2814, as applicable and appropriate; ‘‘(2) evaluate and provide input with respect to the medical and public health needs of seniors related to preparation for, response to, and recovery from all-hazards emergencies; and ‘‘(3) provide advice and consultation with respect to State emergency preparedness and response activities relating to sen- iors, including related drills and exercises pursuant to the preparedness goals under section 2802(b). ‘‘(c) ADDITIONAL DUTIES.—The Advisory Committee may provide advice and recommendations to the Secretary with respect to seniors and the medical and public health grants and cooperative agree- ments as applicable to preparedness and response activities under this title and title III. ‘‘(d) MEMBERSHIP.— ‘‘(1) IN GENERAL.—The Secretary, in consultation with such other heads of agencies as appropriate, shall appoint not more than 17 members to the Advisory Committee. In appointing such members, the Secretary shall ensure that the total mem- bership of the Advisory Committee is an odd number.

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‘‘(2) REQUIRED MEMBERS.—The Advisory Committee shall include Federal members or their designees (who may be non- voting members, as determined by the Secretary) and non- Federal members, as follows: ‘‘(A) The Assistant Secretary for Preparedness and Response. ‘‘(B) The Director of the Biomedical Advanced Research and Development Authority. ‘‘(C) The Director of the Centers for Disease Control and Prevention. ‘‘(F) The Administrator of the Centers for Medicare & Medicaid Services. ‘‘(G) The Administrator of the Administration for Community Living. ‘‘(H) The Administrator of the Federal Emergency Management Agency. ‘‘(I) The Under Secretary for Health of the Department of Veterans Affairs. ‘‘(J) At least 2 non-Federal health care professionals with expertise in geriatric medical disaster planning, preparedness, response, or recovery. ‘‘(K) At least 2 representatives of State, local, Tribal, or territorial agencies with expertise in geriatric disaster planning, preparedness, response, or recovery. ‘‘(L) Representatives of such other Federal agencies (such as the Department of Energy and the Department of Homeland Security) as the Secretary determines nec- essary to fulfill the duties of the Advisory Committee. ‘‘(e) MEETINGS.—The Advisory Committee shall meet not less frequently than biannually. At least one meeting per year shall be an in-person meeting. ‘‘(f) COORDINATION.—The Secretary shall coordinate duties and activities authorized under this section in accordance with section 2811D. ‘‘(g) SUNSET.— ‘‘(1) IN GENERAL.—The Advisory Committee shall terminate on September 30, 2023. ‘‘(2) EXTENSION OF COMMITTEE.—Not later than October 1, 2022, the Secretary shall submit to Congress a recommenda- tion on whether the Advisory Committee should be extended.’’. (c) NATIONAL ADVISORY COMMITTEE ON INDIVIDUALS WITH DISABILITIES AND DISASTERS.—Subtitle B of title XXVIII (42 U.S.C. 300hh et seq.), as amended by subsection (b), is further amended by inserting after section 2811B the following: ## ‘‘SEC. 2811C. NATIONAL ADVISORY COMMITTEE ON INDIVIDUALS WITH DISABILITIES AND DISASTERS. ‘‘(a) ESTABLISHMENT.—The Secretary, in consultation with the Secretary of Homeland Security, shall establish a national advisory committee to be known as the National Advisory Committee on Individuals with Disabilities and Disasters (referred to in this sec- tion as the ‘Advisory Committee’). ‘‘(b) DUTIES.—The Advisory Committee shall— ‘‘(D) The Commissioner of Food and Drugs. ‘‘(E) The Director of the National Institutes of Health. Deadline. Recommenda- tion. 42 USC 300hh–10d. Consultation. Consultations.

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Evaluation. Consultation. Appointments. Determination. ‘‘(1) provide advice and consultation with respect to activi- ties carried out pursuant to section 2814, as applicable and appropriate; ‘‘(2) evaluate and provide input with respect to the medical, public health, and accessibility needs of individuals with disabilities related to preparation for, response to, and recovery from all-hazards emergencies; and ‘‘(3) provide advice and consultation with respect to State emergency preparedness and response activities, including related drills and exercises pursuant to the preparedness goals under section 2802(b). ‘‘(c) MEMBERSHIP.— ‘‘(1) IN GENERAL.—The Secretary, in consultation with such other heads of agencies and departments as appropriate, shall appoint not more than 17 members to the Advisory Committee. In appointing such members, the Secretary shall ensure that the total membership of the Advisory Committee is an odd number. ‘‘(2) REQUIRED MEMBERS.—The Advisory Committee shall include Federal members or their designees (who may be non- voting members, as determined by the Secretary) and non- Federal members, as follows: ‘‘(A) The Assistant Secretary for Preparedness and Response. ‘‘(B) The Administrator of the Administration for Community Living. ‘‘(C) The Director of the Biomedical Advanced Research and Development Authority. ‘‘(D) The Director of the Centers for Disease Control and Prevention. ‘‘(G) The Administrator of the Federal Emergency Management Agency. ‘‘(J) The Under Secretary for Health of the Department of Veterans Affairs. ‘‘(K) At least 2 non-Federal health care professionals with expertise in disability accessibility before, during, and after disasters, medical and mass care disaster planning, preparedness, response, or recovery. ‘‘(L) At least 2 representatives from State, local, Tribal, or territorial agencies with expertise in disaster planning, preparedness, response, or recovery for individuals with disabilities. ‘‘(M) At least 2 individuals with a disability with exper- tise in disaster planning, preparedness, response, or recovery for individuals with disabilities. ‘‘(d) MEETINGS.—The Advisory Committee shall meet not less frequently than biannually. At least one meeting per year shall be an in-person meeting. ‘‘(e) DISABILITY DEFINED.—For purposes of this section, the term ‘disability’ has the meaning given such term in section 3 of the Americans with Disabilities Act of 1990. ‘‘(E) The Commissioner of Food and Drugs. ‘‘(F) The Director of the National Institutes of Health. ‘‘(H) The Chair of the National Council on Disability. ‘‘(I) The Chair of the United States Access Board.

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‘‘(f) COORDINATION.—The Secretary shall coordinate duties and activities authorized under this section in accordance with section 2811D. ‘‘(g) SUNSET.— ‘‘(1) IN GENERAL.—The Advisory Committee shall terminate on September 30, 2023. ‘‘(2) RECOMMENDATION.—Not later than October 1, 2022, the Secretary shall submit to Congress a recommendation on whether the Advisory Committee should be extended.’’. (d) ADVISORY COMMITTEE COORDINATION.—Subtitle B of title XXVIII (42 U.S.C. 300hh et seq.), as amended by subsection (c), is further amended by inserting after section 2811C the following: ## ‘‘SEC. 2811D. ADVISORY COMMITTEE COORDINATION. ‘‘(a) IN GENERAL.—The Secretary shall coordinate duties and activities authorized under sections 2811A, 2811B, and 2811C, and make efforts to reduce unnecessary or duplicative reporting, or unnecessary duplicative meetings and recommendations under such sections, as practicable. Members of the advisory committees authorized under such sections, or their designees, shall annually meet to coordinate any recommendations, as appropriate, that may be similar, duplicative, or overlapping with respect to addressing the needs of children, seniors, and individuals with disabilities during public health emergencies. If such coordination occurs through an in-person meeting, it shall not be considered the required in-person meetings under any of sections 2811A(e), 2811B(e), or 2811C(d). ‘‘(b) COORDINATION AND ALIGNMENT.—The Secretary, acting through the employee designated pursuant to section 2814, shall align preparedness and response programs or activities to address similar, dual, or overlapping needs of children, seniors, and individ- uals with disabilities, and any challenges in preparing for and responding to such needs. ‘‘(c) NOTIFICATION.—The Secretary shall annually notify the congressional committees of jurisdiction regarding the steps taken to coordinate, as appropriate, the recommendations under this sec- tion, and provide a summary description of such coordination.’’. ## SEC. 306. GUIDANCE FOR PARTICIPATION IN EXERCISES AND DRILLS. Not later than 2 years after the date of enactment of this Act, the Secretary of Health and Human Services shall issue final guidance regarding the ability of personnel funded by programs authorized under this Act (including the amendments made by this Act) to participate in drills and operational exercises related to all-hazards medical and public health preparedness and response. Such drills and operational exercises may include activities that incorporate medical surge capacity planning, medical counter- measure distribution and administration, and preparing for and responding to identified threats for that region. Such personnel may include State, local, Tribal, and territorial public health depart- ment or agency personnel funded under this Act (including the amendments made by this Act). The Secretary shall consult with the Department of Homeland Security, the Department of Defense, the Department of Veterans Affairs, and other applicable Federal departments and agencies as necessary and appropriate in the development of such guidance. The Secretary shall make the guid- ance available on the internet website of the Department of Health and Human Services. Deadline. 42 USC 300hh–10e. Recommenda- tions. Deadline. Summary. 42 USC 300hh note. Deadline. Consultation. Web posting.

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Coordination. Assessment. 42 USC 300hh–10a. Establishment. ## TITLE IV—PRIORITIZING A THREAT- BASED APPROACH ## SEC. 401. ASSISTANT SECRETARY FOR PREPAREDNESS AND RESPONSE. Section 2811(b) (42 U.S.C. 300hh–10(b)) is amended— (1) in the matter preceding paragraph (1), by inserting ‘‘utilize experience related to public health emergency prepared- ness and response, biodefense, medical countermeasures, and other relevant topics to’’ after ‘‘shall’’; and (2) in paragraph (4), by adding at the end the following: ‘‘(I) THREAT AWARENESS.—Coordinate with the Director of the Centers for Disease Control and Prevention, the Director of National Intelligence, the Secretary of Home- land Security, the Assistant to the President for National Security Affairs, the Secretary of Defense, and other rel- evant Federal officials, such as the Secretary of Agriculture, to maintain a current assessment of national security threats and inform preparedness and response capabilities based on the range of the threats that have the potential to result in a public health emergency.’’. ## SEC. 402. PUBLIC HEALTH EMERGENCY MEDICAL COUNTERMEASURES ENTERPRISE. (a) IN GENERAL.—Title XXVIII is amended by inserting after section 2811 (42 U.S.C. 300hh–10) the following: ## ‘‘SEC. 2811–1. PUBLIC HEALTH EMERGENCY MEDICAL COUNTER- MEASURES ENTERPRISE. ‘‘(a) IN GENERAL.—The Secretary shall establish the Public Health Emergency Medical Countermeasures Enterprise (referred to in this section as the ‘PHEMCE’). The Assistant Secretary for Preparedness and Response shall serve as chair of the PHEMCE. ‘‘(b) MEMBERS.—The PHEMCE shall include each of the fol- lowing members, or the designee of such members: ‘‘(1) The Assistant Secretary for Preparedness and Response. ‘‘(2) The Director of the Centers for Disease Control and Prevention. ‘‘(3) The Director of the National Institutes of Health. ‘‘(4) The Commissioner of Food and Drugs. ‘‘(5) The Secretary of Defense. ‘‘(6) The Secretary of Homeland Security. ‘‘(7) The Secretary of Agriculture. ‘‘(8) The Secretary of Veterans Affairs. ‘‘(9) The Director of National Intelligence. ‘‘(10) Representatives of any other Federal agency, which may include the Director of the Biomedical Advanced Research and Development Authority, the Director of the Strategic National Stockpile, the Director of the National Institute of Allergy and Infectious Diseases, and the Director of the Office of Public Health Preparedness and Response, as the Secretary determines appropriate. ‘‘(c) FUNCTIONS.— ‘‘(1) IN GENERAL.—The functions of the PHEMCE shall include the following:

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(b) PUBLIC HEALTH EMERGENCY MEDICAL COUNTERMEASURES ENTERPRISE STRATEGY AND IMPLEMENTATION PLAN.—Section 2811(d) (42 U.S.C. 300hh–10(d)) is amended— ## SEC. 403. STRATEGIC NATIONAL STOCKPILE. (a) IN GENERAL.—Section 319F–2(a) (42 U.S.C. 247d–6b(a)) is amended— ‘‘(A) Utilize a process to make recommendations to the Secretary regarding research, advanced research, development, procurement, stockpiling, deployment, dis- tribution, and utilization with respect to countermeasures, as defined in section 319F–2(c), including prioritization based on the health security needs of the United States. Such recommendations shall be informed by, when avail- able and practicable, the National Health Security Strategy pursuant to section 2802, the Strategic National Stockpile needs pursuant to section 319F–2, and assessments of cur- rent national security threats, including chemical, biological, radiological, and nuclear threats, including emerging infectious diseases. In the event that members of the PHEMCE do not agree upon a recommendation, the Secretary shall provide a determination regarding such recommendation. ‘‘(B) Identify national health security needs, including gaps in public health preparedness and response related to countermeasures and challenges to addressing such needs (including any regulatory challenges), and support alignment of countermeasure procurement with rec- ommendations to address such needs under subparagraph (A). ‘‘(C) Assist the Secretary in developing strategies related to logistics, deployment, distribution, dispensing, and use of countermeasures that may be applicable to the activities of the strategic national stockpile under sec- tion 319F–2(a). ‘‘(D) Provide consultation for the development of the strategy and implementation plan under section 2811(d). ‘‘(2) INPUT.—In carrying out subparagraphs (B) and (C) of paragraph (1), the PHEMCE shall solicit and consider input from State, local, Tribal, and territorial public health depart- ments or officials, as appropriate.’’. (1) in paragraph (1)— (A) by striking ‘‘Not later than 180 days after the date of enactment of this subsection, and every year there- after’’ and inserting ‘‘Not later than March 15, 2020, and biennially thereafter’’; and (B) by striking ‘‘Director of the Biomedical’’ and all that follows through ‘‘Food and Drugs’’ and inserting ‘‘Public Health Emergency Medical Countermeasures Enterprise established under section 2811–1’’; and (2) in paragraph (2)(J)(v), by striking ‘‘one-year period’’ and inserting ‘‘2-year period’’. (1) by redesignating paragraphs (2) and (3) as paragraphs (3) and (4), respectively; and (2) in paragraph (1)— (A) by inserting ‘‘the Assistant Secretary for Prepared- ness and Response and’’ after ‘‘collaboration with’’; Recommenda- tions. Assessments. Determination. Recommenda- tions. Strategies. Consultation.

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Consultation. Assessment. Deadlines. Assessment. (B) by inserting ‘‘and optimize’’ after ‘‘provide for’’; (C) by inserting ‘‘and, as informed by existing rec- ommendations of, or consultations with, the Public Health Emergency Medical Countermeasure Enterprise estab- lished under section 2811–1, make necessary additions or modifications to the contents of such stockpile or stockpiles based on the review conducted under paragraph (2)’’ before the period of the first sentence; and (D) by striking the second sentence; (3) by inserting after paragraph (1) the following: ‘‘(2) THREAT-BASED REVIEW.— ‘‘(A) IN GENERAL.—The Secretary shall conduct an annual threat-based review (taking into account at-risk individuals) of the contents of the stockpile under para- graph (1), including non-pharmaceutical supplies, and, in consultation with the Public Health Emergency Medical Countermeasures Enterprise established under section 2811–1, review contents within the stockpile and assess whether such contents are consistent with the recommenda- tions made pursuant to section 2811–1(c)(1)(A). Such review shall be submitted on June 15, 2019, and on March 15 of each year thereafter, to the Committee on Health, Edu- cation, Labor, and Pensions and the Committee on Appro- priations of the Senate and the Committee on Energy and Commerce and the Committee on Appropriations of the House of Representatives, in a manner that does not com- promise national security. ‘‘(B) ADDITIONS, MODIFICATIONS, AND REPLENISH- MENTS.—Each annual threat-based review under subpara- graph (A) shall, for each new or modified countermeasure procurement or replenishment, provide— ‘‘(i) information regarding— ‘‘(I) the quantities of the additional or modified countermeasure procured for, or contracted to be procured for, the stockpile; ‘‘(II) planning considerations for appropriate manufacturing capacity and capability to meet the goals of such additions or modifications (without disclosing proprietary information), including consideration of the effect such additions or modi- fications may have on the availability of such prod- ucts and ancillary medical supplies in the health care system; ‘‘(III) the presence or lack of a commercial market for the countermeasure at the time of procurement; ‘‘(IV) the emergency health security threat or threats such countermeasure procurement is intended to address, including whether such procurement is consistent with meeting emergency health security needs associated with such threat or threats; ‘‘(V) an assessment of whether the emergency health security threat or threats described in sub- clause (IV) could be addressed in a manner that better utilizes the resources of the stockpile and permits the greatest possible increase in the level

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(b) EXCEPTION RELATING TO APPLICATION OF CERTAIN REQUIRE- MENTS.— (1) IN GENERAL.—Section 319C–1(g) (42 U.S.C. 247d–3a(g)) is amended— (2) EFFECTIVE DATE.—The amendments made by paragraph (1) shall apply with respect to cooperative agreements awarded on or after the date of enactment of this Act. (c) PARTNERSHIP FOR STATE AND REGIONAL HOSPITAL PREPAREDNESS TO IMPROVE SURGE CAPACITY.—Section 319C–2 (42 U.S.C. 247d–3b) is amended— (E) by adding at the end the following: ‘‘(xi) a description of how the entity will partner with health care facilities, including hospitals and nursing homes and other long-term care facilities, to promote and improve public health preparedness and response; and ‘‘(xii) a description of how, as appropriate and prac- ticable, the entity will include critical infrastructure partners, such as utility companies within the entity’s jurisdiction, in planning pursuant to this subparagraph to help ensure that critical infrastructure will remain functioning during, or return to function as soon as practicable after, a public health emergency;’’. (A) in paragraph (5)— (i) in the matter preceding subparagraph (A), by striking ‘‘Beginning with fiscal year 2009’’ and inserting ‘‘Beginning with fiscal year 2019’’; and (ii) in subparagraph (A)— (I) by striking ‘‘for the immediately preceding fiscal year’’ and inserting ‘‘for either of the 2 imme- diately preceding fiscal years’’; and (II) by striking ‘‘2008’’ and inserting ‘‘2018’’; and (B) in paragraph (6), by amending subparagraph (A) to read as follows: ‘‘(A) IN GENERAL.—The amounts described in this para- graph are the following amounts that are payable to an entity for activities described in this section or section 319C–2: ‘‘(i) For no more than one of each of the first 2 fiscal years immediately following a fiscal year in which an entity experienced a failure described in subparagraph (A) or (B) of paragraph (5), an amount equal to 10 percent of the amount the entity was eligible to receive for the respective fiscal year. ‘‘(ii) For no more than one of the first 2 fiscal years immediately following the third consecutive fiscal year in which an entity experienced such a failure, in lieu of applying clause (i), an amount equal to 15 percent of the amount the entity was eligible to receive for the respective fiscal year.’’. (1) in subsection (a)— (A) by inserting ‘‘, acting through the Assistant Sec- retary for Preparedness and Response,’’ after ‘‘The Sec- retary’’; and (B) by striking ‘‘preparedness for public health emer- gencies’’ and inserting ‘‘preparedness for, and response to, Time periods. 42 USC 247d–3a note.

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(4) in paragraph (3), as so redesignated— (A) in subparagraph (A), by inserting ‘‘and the Public Health Emergency Medical Countermeasures Enterprise established under section 2811–1’’ before the semicolon; (B) in subparagraph (C), by inserting ‘‘, and the avail- ability, deployment, dispensing, and administration of countermeasures’’ before the semicolon; ‘‘(E) devise plans for effective and timely supply-chain management of the stockpile, in consultation with the Director of the Centers for Disease Control and Prevention, the Assistant Secretary for Preparedness and Response, the Secretary of Transportation, the Secretary of Homeland Security, the Secretary of Veterans Affairs, and the heads of other appropriate Federal agencies; State, local, Tribal, and territorial agencies; and the public and private health care infrastructure, as applicable, taking into account the manufacturing capacity and other available sources of prod- ucts and appropriate alternatives to supplies in the stock- pile;’’; (D) in subparagraph (G), by striking ‘‘; and’’ and inserting a semicolon; (E) in subparagraph (H), by striking the period and inserting a semicolon; and of emergency preparedness to address such threats; ‘‘(VI) whether such countermeasure is replen- ishing an expiring or expired countermeasure, is a different countermeasure with the same indica- tion that is replacing an expiring or expired countermeasure, or is a new addition to the stock- pile; ‘‘(VII) a description of how such additions or modifications align with projected investments under previous countermeasures budget plans under section 2811(b)(7), including expected life- cycle costs, expenditures related to countermeasure procurement to address the threat or threats described in subclause (IV), replenishment dates (including the ability to extend the maximum shelf life of a countermeasure), and the manufacturing capacity required to replenish such counter- measure; and ‘‘(VIII) appropriate protocols and processes for the deployment, distribution, or dispensing of the countermeasure at the State and local level, including plans for relevant capabilities of State and local entities to dispense, distribute, and administer the countermeasure; and ‘‘(ii) an assurance, which need not be provided in advance of procurement, that for each counter- measure procured or replenished under this subsection, the Secretary completed a review addressing each item listed under this subsection in advance of such procure- ment or replenishment.’’; (C) by amending subparagraph (E) to read as follows: (F) by adding at the end the following: Consultation.

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Deadline. Time period. Review. Assessments. Analysis. ‘‘(I) ensure that each countermeasure or product under consideration for procurement pursuant to this subsection receives the same consideration regardless of whether such countermeasure or product receives or had received funding under section 319L, including with respect to whether the countermeasure or product is most appropriate to meet the emergency health security needs of the United States; and ‘‘(J) provide assistance, including technical assistance, to maintain and improve State and local public health preparedness capabilities to distribute and dispense med- ical countermeasures and products from the stockpile, as appropriate.’’; and (5) by adding at the end the following: ‘‘(5) GAO REPORT.— ‘‘(A) IN GENERAL.—Not later than 3 years after the date of enactment of the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019, and every 5 years thereafter, the Comptroller General of the United States shall conduct a review of any changes to the contents or management of the stockpile since January 1, 2015. Such review shall include— ‘‘(i) an assessment of the comprehensiveness and completeness of each annual threat-based review under paragraph (2), including whether all newly procured or replenished countermeasures within the stockpile were described in each annual review, and whether, consistent with paragraph (2)(B), the Secretary con- ducted the necessary internal review in advance of such procurement or replenishment; ‘‘(ii) an assessment of whether the Secretary estab- lished health security and science-based justifications, and a description of such justifications for procurement decisions related to health security needs with respect to the identified threat, for additions or modifications to the stockpile based on the information provided in such reviews under paragraph (2)(B), including whether such review was conducted prior to procure- ment, modification, or replenishment; ‘‘(iii) an assessment of the plans developed by the Secretary for the deployment, distribution, and dis- pensing of countermeasures procured, modified, or replenished under paragraph (1), including whether such plans were developed prior to procurement, modi- fication, or replenishment; ‘‘(iv) an accounting of countermeasures procured, modified, or replenished under paragraph (1) that received advanced research and development funding from the Biomedical Advanced Research and Develop- ment Authority; ‘‘(v) an analysis of how such procurement decisions made progress toward meeting emergency health secu- rity needs related to the identified threats for counter- measures added, modified, or replenished under para- graph (1); ‘‘(vi) a description of the resources expended related to the procurement of countermeasures

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(b) ADDITIONAL REPORTING.—In the first threat-based review submitted after the date of enactment of this Act pursuant to paragraph (2) of section 319F–2(a) of the Public Health Service Act (42 U.S.C. 247d–6b(a)), as amended by subsection (a), the Secretary shall include a description of the processes and procedures through which the Director of the Strategic National Stockpile and the Director of the Biomedical Advanced Research and Develop- ment Authority coordinate with respect to countermeasures and products procured under such section 319F–2(a), including such processes and procedures in place to ensure countermeasures and products under consideration for procurement pursuant to such section 319F–2(a) receive the same consideration regardless of whether such countermeasures or products receive or had received funding under section 319L of the Public Health Service Act (42 U.S.C. 247d–7e), and whether such countermeasures and products are the most appropriate to meet the emergency health security needs of the United States. (c) AUTHORIZATION OF APPROPRIATIONS, STRATEGIC NATIONAL STOCKPILE.—Section 319F–2(f)(1) (42 U.S.C. 247d–6b(f)(1)) is amended by striking ‘‘$533,800,000 for each of fiscal years 2014 through 2018’’ and inserting ‘‘$610,000,000 for each of fiscal years 2019 through 2023, to remain available until expended’’. (including additions, modifications, and replenish- ments) in the stockpile, and how such expenditures relate to the ability of the stockpile to meet emergency health security needs; ‘‘(vii) an assessment of the extent to which addi- tions, modifications, and replenishments reviewed under paragraph (2) align with previous relevant reports or reviews by the Secretary or the Comptroller General; ‘‘(viii) with respect to any change in the Federal organizational management of the stockpile, an assess- ment and comparison of the processes affected by such change, including planning for potential counter- measure deployment, distribution, or dispensing capabilities and processes related to procurement decisions, use of stockpiled countermeasures, and use of resources for such activities; and ‘‘(ix) an assessment of whether the processes and procedures described by the Secretary pursuant to sec- tion 403(b) of the Pandemic and All-Hazards Prepared- ness and Advancing Innovation Act of 2019 are suffi- cient to ensure countermeasures and products under consideration for procurement pursuant to subsection (a) receive the same consideration regardless of whether such countermeasures and products receive or had received funding under section 319L, including with respect to whether such countermeasures and products are most appropriate to meet the emergency health security needs of the United States. ‘‘(B) SUBMISSION.—Not later than 6 months after com- pleting a classified version of the review under subpara- graph (A), the Comptroller General shall submit an unclassified version of the review to the congressional committees of jurisdiction.’’. Deadline.

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Determination. ## SEC. 404. PREPARING FOR PANDEMIC INFLUENZA, ANTIMICROBIAL RESISTANCE, AND OTHER SIGNIFICANT THREATS. (a) STRATEGIC INITIATIVES.—Section 319L(c)(4) (247d–7e(c)(4)) is amended by adding at the end the following: (b) PROTECTION OF NATIONAL SECURITY FROM THREATS.—Sec- tion 2811 (42 U.S.C. 300hh–10) is amended by adding at the end the following: ‘‘(f) PROTECTION OF NATIONAL SECURITY FROM THREATS.— ‘‘(1) IN GENERAL.—In carrying out subsection (b)(3), the Assistant Secretary for Preparedness and Response shall imple- ment strategic initiatives or activities to address threats, including pandemic influenza and which may include a chem- ical, biological, radiological, or nuclear agent (including any such agent with a significant potential to become a pandemic), that pose a significant level of risk to public health and national ‘‘(F) STRATEGIC INITIATIVES.—The Secretary, acting through the Director of BARDA, may implement strategic initiatives, including by building on existing programs and by awarding contracts, grants, and cooperative agreements, or entering into other transactions, to support innovative candidate products in preclinical and clinical development that address priority, naturally occurring and man-made threats that, as determined by the Secretary, pose a signifi- cant level of risk to national security based on the characteristics of a chemical, biological, radiological or nuclear threat, or existing capabilities to respond to such a threat (including medical response and treatment capabilities and manufacturing infrastructure). Such initia- tives shall accelerate and support the advanced research, development, and procurement of countermeasures and products, as applicable, to address areas including— ‘‘(i) chemical, biological, radiological, or nuclear threats, including emerging infectious diseases, for which insufficient approved, licensed, or authorized countermeasures exist, or for which such threat, or the result of an exposure to such threat, may become resistant to countermeasures or existing counter- measures may be rendered ineffective; ‘‘(ii) threats that consistently exist or continually circulate and have a significant potential to become a pandemic, such as pandemic influenza, which may include the advanced research and development, manu- facturing, and appropriate stockpiling of qualified pan- demic or epidemic products, and products, technologies, or processes to support the advanced research and development of such countermeasures (including multiuse platform technologies for diagnostics, vac- cines, and therapeutics; virus seeds; clinical trial lots; novel virus strains; and antigen and adjuvant mate- rial); and ‘‘(iii) threats that may result primarily or second- arily from a chemical, biological, radiological, or nuclear agent, or emerging infectious diseases, and which may present increased treatment complications such as the occurrence of resistance to available countermeasures or potential countermeasures, including antimicrobial resistant pathogens.’’.

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security based on the characteristics of such threat. Such initia- tives shall include activities to— ## SEC. 405. REPORTING ON THE FEDERAL SELECT AGENT PROGRAM. Section 351A(k) (42 U.S.C. 262a(k)) is amended— ERAL EXPERTS SECURITY ADVISORY PANEL AND THE FAST TRACK ACTION COMMITTEE ON SELECT AGENT REGULATIONS.— ‘‘(A) accelerate and support the advanced research, development, manufacturing capacity, procurement, and stockpiling of countermeasures, including initiatives under section 319L(c)(4)(F); ‘‘(B) support the development and manufacturing of virus seeds, clinical trial lots, and stockpiles of novel virus strains; and ‘‘(C) maintain or improve preparedness activities, including for pandemic influenza. ‘‘(2) AUTHORIZATION OF APPROPRIATIONS.— ‘‘(A) IN GENERAL.—To carry out this subsection, there is authorized to be appropriated $250,000,000 for each of fiscal years 2019 through 2023. ‘‘(B) SUPPLEMENT, NOT SUPPLANT.—Amounts appro- priated under this paragraph shall be used to supplement and not supplant funds provided under sections 319L(d) and 319F–2(g). ‘‘(C) DOCUMENTATION REQUIRED.—The Assistant Sec- retary for Preparedness and Response, in accordance with subsection (b)(7), shall document amounts expended for purposes of carrying out this subsection, including amounts appropriated under the heading ‘Public Health and Social Services Emergency Fund’ under the heading ‘Office of the Secretary’ under title II of division H of the Consoli- dated Appropriations Act, 2018 (Public Law 115–141) and allocated to carrying out section 319L(c)(4)(F).’’. (1) by striking ‘‘The Secretary’’ and inserting the following: ‘‘(1) IN GENERAL.—The Secretary’’; and (2) by adding at the end the following: ‘‘(2) IMPLEMENTATION OF RECOMMENDATIONS OF THE FED- ‘‘(A) IN GENERAL.—Not later than 1 year after the date of the enactment of the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019, the Secretary shall report to the congressional committees of jurisdiction on the implementation of recommendations of the Federal Experts Security Advisory Panel concerning the select agent program. ‘‘(B) CONTINUED UPDATES.—The Secretary shall report to the congressional committees of jurisdiction annually following the submission of the report under subparagraph (A) until the recommendations described in such subpara- graph are fully implemented, or a justification is provided for the delay in, or lack of, implementation.’’.

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Determinations. Deadline. ## TITLE V—INCREASING COMMUNICA- TION IN MEDICAL COUNTERMEASURE ADVANCED RESEARCH AND DEVELOP- MENT ## SEC. 501. MEDICAL COUNTERMEASURE BUDGET PLAN. Section 2811(b)(7) (42 U.S.C. 300hh–10(b)(7)) is amended— (1) in the matter preceding subparagraph (A), by striking ‘‘March 1’’ and inserting ‘‘March 15’’; (3) by redesignating subparagraphs (D) and (E) as subpara- graphs (E) and (F), respectively; and ## SEC. 502. MATERIAL THREAT AND MEDICAL COUNTERMEASURE NOTIFICATIONS. (a) CONGRESSIONAL NOTIFICATION OF MATERIAL THREAT DETER- MINATION.—Section 319F–2(c)(2)(C) (42 U.S.C. 247d–6b(c)(2)(C)) is amended by striking ‘‘The Secretary and the Homeland Security Secretary shall promptly notify the appropriate committees of Con- gress’’ and inserting ‘‘The Secretary and the Secretary of Homeland Security shall send to Congress, on an annual basis, all current material threat determinations and shall promptly notify the Com- mittee on Health, Education, Labor, and Pensions and the Com- mittee on Homeland Security and Governmental Affairs of the Senate and the Committee on Energy and Commerce and the Com- mittee on Homeland Security of the House of Representatives’’. (b) CONTRACTING COMMUNICATION.—Section 319F– 2(c)(7)(B)(ii)(III) (42 U.S.C. 247d–6b(c)(7)(B)(ii)(III)) is amended by adding at the end the following: ‘‘The Secretary shall notify the (2) in subparagraph (A)— (A) in clause (ii), by striking ‘‘; and’’ and inserting ‘‘;’’; and (B) by striking clause (iii) and inserting the following: ‘‘(iii) procurement, stockpiling, maintenance, and potential replenishment (including manufacturing capabilities) of all products in the Strategic National Stockpile; ‘‘(iv) the availability of technologies that may assist in the advanced research and development of counter- measures and opportunities to use such technologies to accelerate and navigate challenges unique to countermeasure research and development; and ‘‘(v) potential deployment, distribution, and utiliza- tion of medical countermeasures; development of clin- ical guidance and emergency use instructions for the use of medical countermeasures; and, as applicable, potential postdeployment activities related to medical countermeasures;’’; (4) by inserting after subparagraph (C), the following: ‘‘(D) identify the full range of anticipated medical countermeasure needs related to research and development, procurement, and stockpiling, including the potential need for indications, dosing, and administration technologies, and other countermeasure needs as applicable and appro- priate;’’.

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vendor within 90 days of a determination by the Secretary to renew, extend, or terminate such contract.’’. ## SEC. 503. AVAILABILITY OF REGULATORY MANAGEMENT PLANS. Section 565(f) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360bbb–4(f)) is amended— (1) by redesignating paragraphs (3) through (6) as para- graphs (4) through (7), respectively; ‘‘(3) PUBLICATION.—The Secretary shall make available on the internet website of the Food and Drug Administration information regarding regulatory management plans, including— (3) in paragraph (6), as so redesignated, in the matter preceding subparagraph (A)— (4) in paragraph (7)(A), as so redesignated, by striking ‘‘paragraph (3)(A)’’ and inserting ‘‘paragraph (4)(A)’’. ## SEC. 504. THE BIOMEDICAL ADVANCED RESEARCH AND DEVELOP- MENT AUTHORITY AND THE BIOSHIELD SPECIAL RESERVE FUND. (a) BIOSHIELD SPECIAL RESERVE FUND.—Section 319F–2(g)(1) (42 U.S.C. 247d–6b(g)(1)) is amended— (1) by striking ‘‘$2,800,000,000 for the period of fiscal years 2014 through 2018’’ and inserting ‘‘$7,100,000,000 for the period of fiscal years 2019 through 2028, to remain available until expended’’; and (b) THE BIOMEDICAL ADVANCED RESEARCH AND DEVELOPMENT AUTHORITY.—Section 319L(d)(2) (42 U.S.C. 247d–7e(d)(2)) is amended by striking ‘‘$415,000,000 for each of fiscal years 2014 through 2018’’ and inserting ‘‘$611,700,000 for each of fiscal years 2019 through 2023’’. ## SEC. 505. ADDITIONAL STRATEGIES FOR COMBATING ANTIBIOTIC RESISTANCE. (a) ADVISORY COUNCIL.—The Secretary of Health and Human Services (referred to in this section as the ‘‘Secretary’’) may continue the Presidential Advisory Council on Combating Antibiotic-Resist- ant Bacteria, referred to in this section as the ‘‘Advisory Council’’. (b) DUTIES.—The Advisory Council shall advise and provide information and recommendations to the Secretary regarding pro- grams and policies intended to reduce or combat antibiotic-resistant (2) by inserting after paragraph (2) the following: ‘‘(A) the process by which an applicant may submit a request for a regulatory management plan; ‘‘(B) the timeframe by which the Secretary is required to respond to such request; ‘‘(C) the information required for the submission of such request; ‘‘(D) a description of the types of development mile- stones and performance targets that could be discussed and included in such plans; and ‘‘(E) contact information for beginning the regulatory management plan process.’’; (A) by striking ‘‘paragraph (4)(A)’’ and inserting ‘‘para- graph (5)(A)’’; and (B) by striking ‘‘paragraph (4)(B)’’ and inserting ‘‘para- graph (5)(B)’’; and (2) by striking the second sentence. Web posting. 42 USC 247d–5 note. Continuation. Recommenda- tions.

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Coordination. Applicability. Deadline. Recommenda- tion. bacteria that may present a public health threat and improve capabilities to prevent, diagnose, mitigate, or treat such resistance. Such advice, information, and recommendations may be related to improving— (2) research and advanced research on, and the develop- ment of, improved and innovative methods for combating or reducing antibiotic resistance, including new treatments, rapid point-of-care diagnostics, alternatives to antibiotics, including alternatives to animal antibiotics, and antimicrobial steward- ship activities; (3) surveillance of antibiotic-resistant bacterial infections, including publicly available and up-to-date information on resistance to antibiotics; (4) education for health care providers and the public with respect to up-to-date information on antibiotic resistance and ways to reduce or combat such resistance to antibiotics related to humans and animals; (5) methods to prevent or reduce the transmission of anti- biotic-resistant bacterial infections, including stewardship pro- grams; and (6) coordination with respect to international efforts in order to inform and advance United States capabilities to com- bat antibiotic resistance. (c) MEETINGS AND COORDINATION.— (1) MEETINGS.—The Advisory Council shall meet not less than biannually and, to the extent practicable, in coordination with meetings of the Antimicrobial Resistance Task Force estab- lished in section 319E(a) of the Public Health Service Act. (2) COORDINATION.—The Advisory Council shall, to the greatest extent practicable, coordinate activities carried out by the Council with the Antimicrobial Resistance Task Force established under section 319E(a) of the Public Health Service Act (42 U.S.C. 247d–5(a)). (d) FACA.—The Federal Advisory Committee Act (5 U.S.C. App.) shall apply to the activities and duties of the Advisory Council. (e) EXTENSION OF ADVISORY COUNCIL.—Not later than October 1, 2022, the Secretary shall submit to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives a rec- ommendation on whether the Advisory Council should be extended, and in addition, identify whether there are other committees, coun- cils, or task forces that have overlapping or similar duties to that of the Advisory Council, and whether such committees, councils, or task forces should be combined, including with respect to section 319E(a) of the Public Health Service Act (42 U.S.C. 247d–5(a)). ## TITLE VI—ADVANCING TECHNOLOGIES FOR MEDICAL COUNTERMEASURES ## SEC. 601. ADMINISTRATION OF COUNTERMEASURES. Section 319L(c)(4)(D)(iii) (42 U.S.C. 247d–7e(c)(4)(D)(iii)) is amended by striking ‘‘and platform technologies’’ and inserting ‘‘platform technologies, technologies to administer countermeasures, and technologies to improve storage and transportation of counter- measures’’. (1) the effectiveness of antibiotics;

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## SEC. 602. UPDATING DEFINITIONS OF OTHER TRANSACTIONS. Section 319L (42 U.S.C. 247d–7e) is amended— (1) in subsection (a)(3), by striking ‘‘, such as’’ and all that follows through ‘‘Code’’; and ## SEC. 603. MEDICAL COUNTERMEASURE MASTER FILES. (a) IN GENERAL.—The purpose of this section (including section 565B of the Federal Food, Drug, and Cosmetic Act, as added by subsection (b)) is to support and advance the development or manu- facture of security countermeasures, qualified countermeasures, and qualified pandemic or epidemic products by facilitating and encour- aging submission of data and information to support the develop- ment of such products, and through clarifying the authority to cross-reference to data and information previously submitted to the Secretary of Health and Human Services (referred to in this section as the ‘‘Secretary’’), including data and information sub- mitted to medical countermeasure master files or other master files. (b) MEDICAL COUNTERMEASURE MASTER FILES.—Chapter V of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 351 et seq.) is amended by inserting after section 565A the following: ## ‘‘SEC. 565B. MEDICAL COUNTERMEASURE MASTER FILES. ‘‘(a) APPLICABILITY OF REFERENCE.— ‘‘(1) IN GENERAL.—A person may submit data and informa- tion in a master file to the Secretary with the intent to ref- erence, or to authorize, in writing, another person to reference, such data or information to support a medical countermeasure submission (including a supplement or amendment to any such submission), without requiring the master file holder to disclose the data and information to any such persons authorized to reference the master file. Such data and information shall be available for reference by the master file holder or by a person authorized by the master file holder, in accordance with applicable privacy and confidentiality protocols and regula- tions. (2) in subsection (c)(5)(A)— (A) in clause (i), by striking ‘‘under this subsection’’ and all that follows through ‘‘Code’’ and inserting ‘‘(as defined in subsection (a)(3)) under this subsection’’; and (B) in clause (ii)— (i) by amending subclause (I) to read as follows: ‘‘(I) IN GENERAL.—To the maximum extent practicable, competitive procedures shall be used when entering into transactions to carry out projects under this subsection.’’; and (ii) in subclause (II)— (I) by striking ‘‘$20,000,000’’ and inserting ‘‘$100,000,000’’; (II) by striking ‘‘senior procurement executive for the Department (as designated for purpose of section 16(c) of the Office of Federal Procurement Policy Act (41 U.S.C. 414(c)))’’ and inserting ‘‘Assistant Secretary for Financial Resources’’; and (III) by striking ‘‘senior procurement executive under’’ and inserting ‘‘Assistant Secretary for Financial Resources under’’. 21 USC 360bbb–4b note. 21 USC 360bbb–4b.

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Notification. Notification. ‘‘(2) REFERENCE OF CERTAIN MASTER FILES.—In the case that data or information within a medical countermeasure master file is used only to support the conditional approval of an application filed under section 571, such master file may be relied upon to support the effectiveness of a product that is the subject of a subsequent medical countermeasure submission only if such application is supplemented by addi- tional data or information to support review and approval in a manner consistent with the standards applicable to such review and approval for such countermeasure, qualified countermeasure, or qualified pandemic or epidemic product. ‘‘(b) MEDICAL COUNTERMEASURE MASTER FILE CONTENT.— ‘‘(1) IN GENERAL.—A master file under this section may include data or information to support— ‘‘(A) the development of medical countermeasure submissions to support the approval, licensure, classifica- tion, clearance, conditional approval, or authorization of one or more security countermeasures, qualified counter- measures, or qualified pandemic or epidemic products; and ‘‘(B) the manufacture of security countermeasures, qualified countermeasures, or qualified pandemic or epi- demic products. ‘‘(2) REQUIRED UPDATES.—The Secretary may require, as appropriate, that the master file holder ensure that the contents of such master file are updated during the time such master file is referenced for a medical countermeasure submission. ‘‘(c) SPONSOR REFERENCE.— ‘‘(1) IN GENERAL.—Each incorporation of data or informa- tion within a medical countermeasure master file shall describe the incorporated material in a manner in which the Secretary determines appropriate and that permits the review of such information within such master file without necessitating resubmission of such data or information. Master files shall be submitted in an electronic format in accordance with sections 512(b)(4), 571(a)(4), and 745A, as applicable, and as specified in applicable guidance. ‘‘(2) REFERENCE BY A MASTER FILE HOLDER.—A master file holder that is the sponsor of a medical countermeasure submis- sion shall notify the Secretary in writing of the intent to ref- erence the medical countermeasure master file as a part of the submission. ‘‘(3) REFERENCE BY AN AUTHORIZED PERSON.—A person submitting an application for review may, where the Secretary determines appropriate, incorporate by reference all or part of the contents of a medical countermeasure master file, if the master file holder authorizes the incorporation in writing. ‘‘(d) ACKNOWLEDGMENT OF AND RELIANCE UPON A MASTER FILE BY THE SECRETARY.— ‘‘(1) IN GENERAL.—The Secretary shall provide the master file holder with a written notification indicating that the Sec- retary has reviewed and relied upon specified data or informa- tion within a master file and the purposes for which such data or information was incorporated by reference if the Sec- retary has reviewed and relied upon such specified data or information to support the approval, classification, conditional approval, clearance, licensure, or authorization of a security

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(d) PUBLIC HEALTH SECURITY GRANTS AUTHORIZATION OF APPROPRIATIONS.—Section 319C–1(h)(1)(A) (42 U.S.C. 247d– 3a(h)(1)(A)) is amended by striking ‘‘$641,900,000 for fiscal year 2014’’ and all that follows through the period at the end and inserting ‘‘$685,000,000 for each of fiscal years 2019 through 2023 for awards pursuant to paragraph (3) (subject to the authority of the Secretary to make awards pursuant to paragraphs (4) and (5)).’’. (e) PARTNERSHIP FOR STATE AND REGIONAL HOSPITAL PREPAREDNESS AUTHORIZATION OF APPROPRIATIONS.—Section 319C– 2(j) (42 U.S.C. 247d–3b(j)) is amended— public health emergencies in accordance with subsection (c)’’; (2) in subsection (b)(1)(A)— (A) by striking ‘‘partnership consisting of’’ and inserting ‘‘coalition that includes’’; (B) in clause (ii), by striking ‘‘; and’’ and inserting a semicolon; and (C) by adding at the end the following: ‘‘(iv) one or more emergency medical service organiza- tions or emergency management organizations; and’’; (3) in subsection (d)— (A) in paragraph (1)(B), by striking ‘‘partnership’’ each place it appears and inserting ‘‘coalition’’; and (B) in paragraph (2)(C), by striking ‘‘medical prepared- ness’’ and inserting ‘‘preparedness and response’’; (4) in subsection (f), by striking ‘‘partnership’’ and inserting ‘‘coalition’’; (5) in subsection (g)(2)— (A) by striking ‘‘Partnerships’’ and inserting ‘‘Coali- tions’’; (B) by striking ‘‘partnerships’’ and inserting ‘‘coali- tions’’; and (C) by inserting ‘‘and response’’ after ‘‘preparedness’’; and (6) in subsection (i)(1)— (A) by striking ‘‘An entity’’ and inserting ‘‘A coalition’’; and (B) by striking ‘‘such partnership’’ and inserting ‘‘such coalition’’. (1) by amending paragraph (1) to read as follows: ‘‘(1) IN GENERAL.— ‘‘(A) AUTHORIZATION OF APPROPRIATIONS.—For pur- poses of carrying out this section and section 319C–3, in accordance with subparagraph (B), there is authorized to be appropriated $385,000,000 for each of fiscal years 2019 through 2023. ‘‘(B) RESERVATION OF AMOUNTS FOR REGIONAL SYS- TEMS.— ‘‘(i) IN GENERAL.—Subject to clause (ii), of the amount appropriated under subparagraph (A) for a fiscal year, the Secretary may reserve up to 5 percent for the purpose of carrying out section 319C–3. ‘‘(ii) RESERVATION CONTINGENT ON CONTINUED APPROPRIATIONS FOR THIS SECTION.—If for fiscal year 2019 or a subsequent fiscal year, the amount appro- priated under subparagraph (A) is such that, after

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countermeasure, qualified countermeasure, or qualified pan- demic or epidemic product. The Secretary may rely upon the data and information within the medical countermeasure master file for which such written notification was provided in additional applications, as applicable and appropriate and upon the request of the master file holder so notified in writing or by an authorized person of such holder. ‘‘(2) CERTAIN APPLICATIONS.—If the Secretary has reviewed and relied upon specified data or information within a medical countermeasure master file to support the conditional approval of an application under section 571 to subsequently support the approval, clearance, licensure, or authorization of a security countermeasure, qualified countermeasure, or qualified pan- demic or epidemic product, the Secretary shall provide a brief written description to the master file holder regarding the elements of the application fulfilled by the data or information within the master file and how such data or information con- tained in such application meets the standards of evidence under subsection (c) or (d) of section 505, subsection (d) of section 512, or section 351 of the Public Health Service Act (as applicable), which shall not include any trade secret or confidential commercial information. ‘‘(e) RULES OF CONSTRUCTION.—Nothing in this section shall be construed to— ‘‘(1) limit the authority of the Secretary to approve, license, clear, conditionally approve, or authorize drugs, biological prod- ucts, or devices pursuant to, as applicable, this Act or section 351 of the Public Health Service Act (as such applicable Act is in effect on the day before the date of enactment of the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019), including the standards of evidence, and applicable conditions, for approval under the applicable Act; ‘‘(2) alter the standards of evidence with respect to approval, licensure, or clearance, as applicable, of drugs, biological products, or devices under this Act or section 351 of the Public Health Service Act, including, as applicable, the substantial evidence standards under sections 505(d) and 512(d) or this Act and section 351(a) of the Public Health Service Act; or ‘‘(3) alter the authority of the Secretary under this Act or the Public Health Service Act to determine the types of data or information previously submitted by a sponsor or any other person that may be incorporated by reference in an application, request, or notification for a drug, biological product, or device submitted under sections 505(i), 505(b), 505(j), 512(b)(1), 512(b)(2), 512(j), 564, 571, 520(g), 515(c), 513(f)(2), or 510(k) of this Act, or subsection (a) or (k) of section 351 of the Public Health Service Act, including a supplement or amendment to any such submission, and the requirements associated with such reference. ‘‘(f) DEFINITIONS.—In this section: ‘‘(1) The term ‘master file holder’ means a person who submits data and information to the Secretary with the intent to reference or authorize another person to reference such data or information to support a medical countermeasure submis- sion, as described in subsection (a).

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Deadline. Consultation. Deadlines. Publication. ‘‘(2) The term ‘medical countermeasure submission’ means an investigational new drug application under section 505(i), a new drug application under section 505(b), or an abbreviated new drug application under section 505(j) of this Act, a biological product license application under section 351(a) of the Public Health Service Act or a biosimilar biological product license application under section 351(k) of the Public Health Service Act, a new animal drug application under section 512(b)(1) or abbreviated new animal drug application under section 512(b)(2), an application for conditional approval of a new animal drug under section 571, an investigational device application under section 520(g), an application with respect to a device under section 515(c), a request for classification of a device under section 513(f)(2), a notification with respect to a device under section 510(k), or a request for an emergency use authorization under section 564 to support— ‘‘(A) the approval, licensure, classification, clearance, conditional approval, or authorization of a security counter- measure, qualified countermeasure, or qualified pandemic or epidemic product; or ‘‘(B) a new indication to an approved security counter- measure, qualified countermeasure, or qualified pandemic or epidemic product. ‘‘(3) The terms ‘qualified countermeasure’, ‘security counter- measure’, and ‘qualified pandemic or epidemic product’ have the meanings given such terms in sections 319F–1, 319F–2, and 319F–3, respectively, of the Public Health Service Act.’’. (c) STAKEHOLDER INPUT.—Not later than 18 months after the date of enactment of this Act, the Secretary, acting through the Commissioner of Food and Drugs and in consultation with the Assistant Secretary for Preparedness and Response, shall solicit input from stakeholders, including stakeholders developing security countermeasures, qualified countermeasures, or qualified pandemic or epidemic products, and stakeholders developing technologies to assist in the development of such countermeasures with respect to how the Food and Drug Administration can advance the use of tools and technologies to support and advance the development or manufacture of security countermeasures, qualified counter- measures, and qualified pandemic or epidemic products, including through reliance on cross-referenced data and information contained within master files and submissions previously submitted to the Secretary as set forth in section 565B of the Federal Food, Drug, and Cosmetic Act, as added by subsection (b). (d) GUIDANCE.—Not later than 2 years after the date of enact- ment of this Act, the Secretary, acting through the Commissioner of Food and Drugs, shall publish draft guidance about how reliance on cross-referenced data and information contained within master files under section 565B of the Federal Food, Drug, and Cosmetic Act, as added by subsection (b) or submissions otherwise submitted to the Secretary may be used for specific tools or technologies (including platform technologies) that have the potential to support and advance the development or manufacture of security counter- measures, qualified countermeasures, and qualified pandemic or epidemic products. The Secretary, acting through the Commissioner of Food and Drugs, shall publish the final guidance not later than 3 years after the enactment of this Act.

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## SEC. 604. ANIMAL RULE REPORT. (a) STUDY.—The Comptroller General of the United States shall conduct a study on the application of the requirements under sub- sections (c) and (d) of section 565 of the of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360bbb–4) (referred to in this section as the ‘‘animal rule’’) as a component of medical counter- measure advanced development under the Biomedical Advanced Research and Development Authority and regulatory review by the Food and Drug Administration. In conducting such study, the Comptroller General shall examine the following: (1) The extent to which advanced development and review of a medical countermeasure are coordinated between the Bio- medical Advanced Research and Development Authority and the Food and Drug Administration, including activities that facilitate appropriate and efficient design of studies to support approval, licensure, and authorization under the animal rule, consistent with the recommendations in the animal rule guid- ance, issued pursuant to section 565(c) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360bbb–4(c)) and entitled ‘‘Product Development Under the Animal Rule: Guidance for Industry’’ (issued in October 2015), to resolve discrepancies in the design of adequate and well-controlled efficacy studies conducted in animal models related to the provision of substan- tial evidence of effectiveness for the product approved, licensed, or authorized under the animal rule. (2) The consistency of the application of the animal rule among and between review divisions within the Food and Drug Administration. (3) The flexibility pursuant to the animal rule to address variations in countermeasure development and review proc- esses, including the extent to which qualified animal models are adopted and used within the Food and Drug Administration in regulatory decisionmaking with respect to medical counter- measures. (4) The extent to which the guidance issued under section 565(c) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360bbb–4(c)), entitled, ‘‘Product Development Under the Animal Rule: Guidance for Industry’’ (issued in October 2015), has assisted in achieving the purposes described in paragraphs (1), (2), and (3). (b) CONSULTATIONS.—In conducting the study under subsection (a), the Comptroller General of the United States shall consult with— (1) the Federal agencies responsible for advancing, reviewing, and procuring medical countermeasures, including the Office of the Assistant Secretary for Preparedness and Response, the Biomedical Advanced Research and Development Authority, the Food and Drug Administration, and the Depart- ment of Defense; (2) manufacturers involved in the research and develop- ment of medical countermeasures to address biological, chem- ical, radiological, or nuclear threats; and (c) REPORT.—Not later than 3 years after the date of enactment of this Act, the Comptroller General of the United States shall submit to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of (3) other biodefense stakeholders, as applicable. Examination. Recommenda- tions.

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Deadline. the House of Representatives a report containing the results of the study conducted under subsection (a) and recommendations to improve the application and consistency of the requirements under subsections (c) and (d) of section 565 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360bbb–4) to support and expe- dite the research and development of medical countermeasures, as applicable. (d) PROTECTION OF NATIONAL SECURITY.—The Comptroller Gen- eral of the United States shall conduct the study and issue the assessment and report under this section in a manner that does not compromise national security. ## SEC. 605. REVIEW OF THE BENEFITS OF GENOMIC ENGINEERING TECH- NOLOGIES AND THEIR POTENTIAL ROLE IN NATIONAL SECURITY. (a) MEETING.— (1) IN GENERAL.—Not later than 1 year after the date of enactment of this Act, the Secretary of Health and Human Services (referred to in this section as the ‘‘Secretary’’) shall convene a meeting to discuss the potential role advancements in genomic engineering technologies (including genome editing technologies) may have in advancing national health security. Such meeting shall be held in a manner that does not com- promise national security. (2) ATTENDEES.—The attendees of the meeting under para- graph (1)— (3) TOPICS.—The meeting under paragraph (1) shall include a discussion of— (A) shall include— (i) representatives from the Office of the Assistant Secretary for Preparedness and Response, the National Institutes of Health, the Centers for Disease Control and Prevention, and the Food and Drug Administra- tion; and (ii) representatives from academic, private, and nonprofit entities with expertise in genome engineering technologies, biopharmaceuticals, medicine, or bio- defense, and other relevant stakeholders; and (B) may include— (i) other representatives from the Department of Health and Human Services, as the Secretary deter- mines appropriate; and (ii) representatives from the Department of Home- land Security, the Department of Defense, the Depart- ment of Agriculture, and other departments, as the Secretary may request for the meeting. (A) the current state of the science of genomic engineering technologies related to national health security, including— (i) medical countermeasure development, including potential efficiencies in the development pathway and detection technologies; and (ii) the international and domestic regulation of products utilizing genome editing technologies; and (B) national security implications, including—

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(b) REPORT.—Not later than 270 days after the meeting described in subsection (a) is held, the Assistant Secretary for Preparedness and Response shall issue a report to the congressional committees of jurisdiction on the topics discussed at such meeting, and provide recommendations, as applicable, to utilize innovations in genomic engineering (including genome editing) and related tech- nologies as a part of preparedness and response activities to advance national health security. Such report shall be issued in a manner that does not compromise national security. ## SEC. 606. REPORT ON VACCINES DEVELOPMENT. Not later than one year after the date of the enactment of this Act, the Secretary of Health and Human Services shall submit to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives a report describing efforts and activities to coordinate with other countries and international partners during recent public health emergencies with respect to the research and advanced research on, and development of, qualified pandemic or epidemic products (as defined in section 319F–3 of the Public Health Service Act (42 U.S.C. 247d–6d)). Such report may include informa- tion regarding relevant work carried out under section 319L(c)(5)(E) of the Public Health Service Act (42 U.S.C. 247d–7e(c)(5)(E)), through public-private partnerships, and through collaborations with other countries to assist with or expedite the research and development of qualified pandemic or epidemic products. Such report shall not include information that may compromise national security. ## SEC. 607. STRENGTHENING MOSQUITO ABATEMENT FOR SAFETY AND HEALTH. (a) REAUTHORIZATION OF MOSQUITO ABATEMENT FOR SAFETY AND HEALTH PROGRAM.—Section 317S (42 U.S.C. 247b–21) is amended— (i) capabilities of the United States to leverage genomic engineering technologies as a part of the med- ical countermeasure enterprise, including current applicable research, development, and application efforts underway within the Department of Defense; (ii) the potential for state and non-state actors to utilize genomic engineering technologies as a national health security threat; and (iii) security measures to monitor and assess the potential threat that may result from utilization of genomic engineering technologies and related tech- nologies for the purpose of compromising national health security. (1) in subsection (a)(1)(B)— (A) by inserting ‘‘including programs to address emerging infectious mosquito-borne diseases,’’ after ‘‘sub- divisions for control programs,’’; and (B) by inserting ‘‘or improving existing control pro- grams’’ before the period at the end; (2) in subsection (b)— (A) in paragraph (1), by inserting ‘‘, including improve- ment,’’ after ‘‘operation’’; (B) in paragraph (2)— (i) in subparagraph (A)— Recommenda- tions.

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‘‘(6) NUMBER OF GRANTS.—A political subdivision or a consortium of political subdivisions may not receive more than one grant under paragraph (1).’’; and (b) EPIDEMIOLOGY-LABORATORY CAPACITY GRANTS.—Section 2821 (42 U.S.C. 300hh–31) is amended— (1) in subsection (a)(1), by inserting ‘‘, including mosquito and other vector-borne diseases,’’ after ‘‘infectious diseases’’; and ‘‘(iv) a public health emergency due to the incidence or prevalence of a mosquito-borne disease that presents a serious public health threat;’’; and (ii) by amending subparagraph (D) to read as fol- lows: ‘‘(D)(i) is located in a State that has received a grant under subsection (a); or ‘‘(ii) that demonstrates to the Secretary that the control program is consistent with existing State mosquito control plans or policies, or other applicable State preparedness plans.’’; (C) in paragraph (4)(C), by striking ‘‘that extraor- dinary’’ and all that follows through the period at the end and inserting the following: ‘‘that— ‘‘(i) extraordinary economic conditions in the polit- ical subdivision or consortium of political subdivisions involved justify the waiver; or ‘‘(ii) the geographical area covered by a political subdivision or consortium for a grant under paragraph (1) has an extreme mosquito control need due to— (D) by amending paragraph (6) to read as follows: (3) in subsection (f)— (A) in paragraph (1) by striking ‘‘for fiscal year 2003, and such sums as may be necessary for each of fiscal years 2004 through 2007’’ and inserting ‘‘for each of fiscal years 2019 through 2023’’; (B) in paragraph (2), by striking ‘‘the Public Health Security and Bioterrorism Preparedness and Response Act of 2002’’ and inserting ‘‘this Act and other medical and public health preparedness and response laws’’; and (C) in paragraph (3)— (i) in the paragraph heading, by striking ‘‘2004’’ and inserting ‘‘2019’’; and (I) in clause (ii), by striking ‘‘or’’ at the end; (II) in clause (iii), by striking the semicolon at the end and inserting ‘‘, including an emerging infectious mosquito-borne disease that presents a serious public health threat; or’’; and (III) by adding at the end the following: ‘‘(I) the size or density of the potentially impacted human population; ‘‘(II) the size or density of a mosquito popu- lation that requires heightened control; or ‘‘(III) the severity of the mosquito-borne dis- ease, such that expected serious adverse health outcomes for the human population justify the waiver.’’; and (ii) by striking ‘‘2004,’’ and inserting ‘‘2019,’’.

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(2) in subsection (b), by striking ‘‘2010 through 2013’’ and inserting ‘‘2019 through 2023’’. ## TITLE VII—MISCELLANEOUS PROVISIONS ## SEC. 701. REAUTHORIZATIONS AND EXTENSIONS. (a) VETERANS AFFAIRS.—Section 8117(g) of title 38, United States Code, is amended by striking ‘‘2014 through 2018’’ and inserting ‘‘2019 through 2023’’. (b) VACCINE TRACKING AND DISTRIBUTION.—Section 319A(e) (42 U.S.C. 247d–1(e)) is amended by striking ‘‘2014 through 2018’’ and inserting ‘‘2019 through 2023’’. (c) TEMPORARY REASSIGNMENT.—Section 319(e)(8) (42 U.S.C. 247d(e)(8)) is amended by striking ‘‘2018’’ and inserting ‘‘2023’’. (d) STRATEGIC INNOVATION PARTNER.—Section 319L(c)(4)(E)(ix) (42 U.S.C. 247d–7e(c)(4)(E)(ix)) is amended by striking ‘‘2022’’ and inserting ‘‘2023’’. (e) LIMITED ANTITRUST EXEMPTION.— (1) IN GENERAL.—Section 405 of the Pandemic and All- Hazards Preparedness Act (Public Law 109–417; 42 U.S.C. 247d–6a note) is amended— (B) in subsection (b), by striking ‘‘12-year’’ and inserting ‘‘17-year’’; (C) by redesignating such section 405 as section 319L– 1; and (D) by transferring such section 319L–1, as redesig- nated, to the Public Health Service Act (42 U.S.C. 201 et seq.), to appear after section 319L of such Act (42 U.S.C. 247d–7e). (2) CONFORMING AMENDMENTS.— (A) TABLE OF CONTENTS.—The table of contents in sec- tion 1(b) of the Pandemic and All-Hazards Preparedness Act (Public Law 109–417) is amended by striking the item related to section 405. (B) REFERENCE.—Section 319L(c)(4)(A)(iii) (42 U.S.C. 247d–7e) is amended by striking ‘‘section 405 of the Pan- demic and All-Hazards Preparedness Act’’ and inserting ‘‘section 319L–1’’. (f) INAPPLICABILITY OF CERTAIN PROVISIONS.—Subsection (e)(1) of section 319L (42 U.S.C. 247d–7e(e)(1)) is amended— (1) by amending subparagraph (A) to read as follows: (A) in subsection (a)(1)(A)— (i) by striking ‘‘Secretary of Health and Human Services (referred to in this subsection as the ‘Sec- retary’)’’ and inserting ‘‘Secretary’’; (ii) by striking ‘‘of the Public Health Service Act (42 U.S.C. 247d–6b)) (as amended by this Act’’; (iii) by striking ‘‘of the Public Health Service Act (42 U.S.C. 247d–6a)) (as amended by this Act’’; and (iv) by striking ‘‘of the Public Health Service Act (42 U.S.C. 247d–6d)’’; ‘‘(A) NONDISCLOSURE OF INFORMATION.— ‘‘(i) IN GENERAL.—Information described in clause (ii) shall be deemed to be information described in section 552(b)(3) of title 5, United States Code. 42 USC 247d–7f.

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Deadline. (2) by redesignating subparagraph (C) as subparagraph (D); (4) in subparagraph (D), as so redesignated, by striking ‘‘12’’ and inserting ‘‘17’’. ## SEC. 702. LOCATION OF MATERIALS IN THE STOCKPILE. Subsection (d) of section 319F–2 (42 U.S.C. 247d–6b) is amended to read as follows: ‘‘(d) DISCLOSURES.—No Federal agency may disclose under sec- tion 552 of title 5, United States Code any information identifying the location at which materials in the stockpile described in sub- section (a) are stored, or other information regarding the contents or deployment capability of the stockpile that could compromise national security.’’. ## SEC. 703. CYBERSECURITY. (a) STRATEGY FOR PUBLIC HEALTH PREPAREDNESS AND RESPONSE TO CYBERSECURITY THREATS.— (1) STRATEGY.—Not later than 18 months after the date of enactment of this Act, the Secretary of Health and Human Services (referred to in this section as the ‘‘Secretary’’) shall prepare and submit to the relevant committees of Congress a strategy for public health preparedness and response to address cybersecurity threats (as defined in section 102 of Cybersecurity Information Sharing Act of 2015 (6 U.S.C. 1501)) that present a threat to national health security. Such strategy shall include— ‘‘(ii) INFORMATION DESCRIBED.—The information described in this clause is information relevant to pro- grams of the Department of Health and Human Serv- ices that could compromise national security and reveal significant and not otherwise publicly known vulnerabilities of existing medical or public health defenses against chemical, biological, radiological, or nuclear threats, and is comprised of— ‘‘(I) specific technical data or scientific information that is created or obtained during the countermeasure and product advanced research and development carried out under subsection (c); ‘‘(II) information pertaining to the location security, personnel, and research materials and methods of high-containment laboratories con- ducting research with select agents, toxins, or other agents with a material threat determination under section 319F–2(c)(2); or (3) by inserting after subparagraph (B) the following: ‘‘(C) REPORTING.—One year after the date of enactment of the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019, and annually thereafter, the Secretary shall report to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Rep- resentatives on the number of instances in which the Sec- retary has used the authority under this subsection to withhold information from disclosure, as well as the nature of any request under section 552 of title 5, United States Code that was denied using such authority.’’; and ‘‘(III) security and vulnerability assessments.’’;

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(b) COORDINATION OF PREPAREDNESS FOR AND RESPONSE TO ALL-HAZARDS PUBLIC HEALTH EMERGENCIES.—Subparagraph (D) of section 2811(b)(4) (42 U.S.C. 300hh–10(b)(4)) is amended to read as follows: ## SEC. 704. STRATEGY AND REPORT. Not later than 14 days after the date of the enactment of this Act, the Secretary of Health and Human Services, in coordina- tion with the Assistant Secretary for Preparedness and Response and the Assistant Secretary for the Administration on Children and Families or other appropriate office, and in collaboration with other departments, as appropriate, shall submit to the Committee on Energy and Commerce of the House of Representatives, the Committee on Health, Education, Labor, and Pensions of the Senate, and other relevant congressional committees— (A) identifying the duties, functions, and preparedness goals for which the Secretary is responsible in order to prepare for and respond to such cybersecurity threats, including metrics by which to measure success in meeting preparedness goals; (B) identifying gaps in public health capabilities to achieve such preparedness goals; and (C) strategies to address identified gaps and strengthen public health emergency preparedness and response capabilities to address such cybersecurity threats. (2) PROTECTION OF NATIONAL SECURITY.—The Secretary shall make such strategy available to the Committee on Health, Education, Labor, and Pensions of the Senate, the Committee on Energy and Commerce of the House of Representatives, and other congressional committees of jurisdiction, in a manner that does not compromise national security. ‘‘(D) POLICY COORDINATION AND STRATEGIC DIREC- TION.—Provide integrated policy coordination and strategic direction, before, during, and following public health emer- gencies, with respect to all matters related to Federal public health and medical preparedness and execution and deploy- ment of the Federal response for public health emergencies and incidents covered by the National Response Plan described in section 504(a)(6) of the Homeland Security Act of 2002 (6 U.S.C. 314(a)(6)), or any successor plan; and such Federal responses covered by the National Cyber- security Incident Response Plan developed under section 228(c) of the Homeland Security Act of 2002 (6 U.S.C. 149(c)), including public health emergencies or incidents related to cybersecurity threats that present a threat to national health security.’’. (1) a formal strategy, including interdepartmental actions and efforts to reunify children with their parents or guardians, in all cases in which such children have been separated from their parents or guardians as a result of the initiative announced on April 6, 2018, and due to prosecution under section 275(a) of the Immigration and Nationality Act (8 U.S.C. 1325(a)), if the parent or guardian chooses such reunification and the child— (A) was separated from a parent or guardian and placed into a facility funded by the Department of Health and Human Services; Deadline. Coordination. Collaboration.

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Effective date. ## SEC. 705. TECHNICAL AMENDMENTS. (a) PUBLIC HEALTH SERVICE ACT.—Title III (42 U.S.C. 241 et seq.) is amended— (b) PUBLIC HEALTH SECURITY GRANTS.—Section 319C–1(b)(2) (42 U.S.C. 247d–3a(b)(2)) is amended— (c) EMERGENCY USE INSTRUCTIONS.—Subparagraph (A) of sec- tion 564A(e)(2) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360bbb–3a(e)(2)) is amended by striking ‘‘subsection (a)(1)(C)(i)’’ and inserting ‘‘subsection (a)(1)(C)’’. (d) PRODUCTS HELD FOR EMERGENCY USE.—Section 564B(2) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360bbb– 3b) is amended— (e) TRANSPARENCY.—Section 507(c)(3) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 357(c)(3)) is amended— (B) as of the date of the enactment of this Act, remains in the care of the Department of Health and Human Serv- ices; and (C) can be safely reunited with such parent or guardian; and (2) a report on challenges and deficiencies related to the oversight of, and care for, unaccompanied alien children and appropriately reuniting such children with their parents or guardians, and the actions taken to address any challenges and deficiencies related to unaccompanied alien children in the custody of the Department of Health and Human Services, including deficiencies identified and publicly reported by Con- gress, the Government Accountability Office, or the inspectors general of the Department of Health and Human Services or other Federal departments. (1) in paragraphs (1) and (5) of section 319F–1(a) (42 U.S.C. 247d–6a(a)), by striking ‘‘section 319F(h)’’ each place such term appears and inserting ‘‘section 319F(e)’’; and (2) in section 319K(a) (42 U.S.C. 247d–7d(a)), by striking ‘‘section 319F(h)(4)’’ and inserting ‘‘section 319F(e)(4)’’. (1) in subparagraph (C), by striking ‘‘individuals,,’’ and inserting ‘‘individuals,’’; and (2) in subparagraph (F), by striking ‘‘make satisfactory annual improvement and describe’’ and inserting ‘‘makes satis- factory annual improvement and describes’’. (1) in subparagraph (B), by inserting a comma after ‘‘505’’; and (2) in subparagraph (C), by inserting ‘‘or section 564A’’ before the period at the end. (1) by striking ‘‘Nothing in’’ and inserting the following: ‘‘(A) IN GENERAL.—Nothing in’’; (2) by inserting ‘‘or directing’’ after ‘‘authorizing’’; (3) by striking ‘‘disclose any’’ and inserting ‘‘disclose— ‘‘(i) any’’; (4) by striking the period and inserting ‘‘; or’’; and (5) by adding at the end the following: ‘‘(ii) in the case of a drug development tool that may be used to support the development of a qualified countermeasure, security countermeasure, or qualified pandemic or epidemic product, as defined in sections 319F–1, 319F–2, and 319F–3, respectively, of the Public Health Service Act, any information that the

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(2) in paragraph (2), by striking ‘‘paragraph (1) for a fiscal year’’ and inserting ‘‘paragraph (1)(A) for a fiscal year and not reserved for the purpose described in paragraph (1)(B)(i)’’; and (3) in paragraph (3)(A), by striking ‘‘paragraph (1) and not reserved under paragraph (2)’’ and inserting ‘‘paragraph (1)(A) and not reserved under paragraph (1)(B)(i) or (2)’’. ## SEC. 203. REGIONAL HEALTH CARE EMERGENCY PREPAREDNESS AND RESPONSE SYSTEMS. (a) IN GENERAL.—Part B of title III (42 U.S.C. 243 et seq.) is amended by inserting after section 319C–2 the following: ## ‘‘SEC. 319C–3. GUIDELINES FOR REGIONAL HEALTH CARE EMERGENCY PREPAREDNESS AND RESPONSE SYSTEMS. ‘‘(a) PURPOSE.—It is the purpose of this section to identify and provide guidelines for regional systems of hospitals, health care facilities, and other public and private sector entities, with varying levels of capability to treat patients and increase medical surge capacity during, in advance of, and immediately following a public health emergency, including threats posed by one or more chemical, biological, radiological, or nuclear agents, including emerging infectious diseases. ‘‘(b) GUIDELINES.—The Assistant Secretary for Preparedness and Response, in consultation with the Director of the Centers for Disease Control and Prevention, the Administrator of the Cen- ters for Medicare & Medicaid Services, the Administrator of the Health Resources and Services Administration, the Commissioner of Food and Drugs, the Assistant Secretary for Mental Health and Substance Use, the Assistant Secretary of Labor for Occupa- tional Safety and Health, the Secretary of Veterans Affairs, the heads of such other Federal agencies as the Secretary determines to be appropriate, and State, local, Tribal, and territorial public health officials, shall, not later than 2 years after the date of enactment of this section— ‘‘(1) identify and develop a set of guidelines relating to practices and protocols for all-hazards public health emergency preparedness and response for hospitals and health care facili- ties to provide appropriate patient care during, in advance of, or immediately following, a public health emergency, resulting from one or more chemical, biological, radiological, or nuclear agents, including emerging infectious diseases (which may include existing practices, such as trauma care and medical surge capacity and capabilities), with respect to— application of clause (i), the amount remaining for the purpose of carrying out this section would be less than the amount available for such purpose for the previous fiscal year, the amount that may be reserved under clause (i) shall be reduced such that the amount remaining for the purpose of carrying out this section is not less than the amount available for such purpose for the previous fiscal year. ‘‘(iii) SUNSET.—The authority to reserve amounts under clause (i) shall expire on September 30, 2023.’’; ‘‘(A) a regional approach to identifying hospitals and health care facilities based on varying capabilities and capacity to treat patients affected by such emergency, including— 42 USC 247d–3c. Consultation. Deadline.

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Approved June 24, 2019. Secretary determines has a significant potential to affect national security. ‘‘(B) PUBLIC ACKNOWLEDGMENT.—In the case that the Secretary, pursuant to subparagraph (A)(ii), does not make information publicly available, the Secretary shall provide on the internet website of the Food and Drug Administra- tion an acknowledgment of the information that has not been disclosed, pursuant to subparagraph (A)(ii).’’.

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Coordination. Consultation. ‘‘(2) make such guidelines available on the internet website of the Department of Health and Human Services in a manner that does not compromise national security; and ‘‘(3) update such guidelines as appropriate, including based on input received pursuant to subsections (c) and (e) and information resulting from applicable reports required under the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019 (including any amendments made by such Act), to address new and emerging public health threats. ‘‘(c) CONSIDERATIONS.—In identifying, developing, and updating guidelines under subsection (b), the Assistant Secretary for Preparedness and Response shall— ‘‘(1) include input from hospitals and health care facilities (including health care coalitions under section 319C–2), State, local, Tribal, and territorial public health departments, and health care or subject matter experts (including experts with relevant expertise in chemical, biological, radiological, or nuclear threats, including emerging infectious diseases), as the Assistant Secretary determines appropriate, to meet the goals under section 2802(b)(3); ‘‘(2) consult and engage with appropriate health care pro- viders and professionals, including physicians, nurses, first responders, health care facilities (including hospitals, primary care clinics, community health centers, mental health facilities, ambulatory care facilities, and dental health facilities), phar- macies, emergency medical providers, trauma care providers, environmental health agencies, public health laboratories, poi- son control centers, blood banks, tissue banks, and other experts ‘‘(i) the manner in which the system will coordinate with and integrate the partnerships and health care coalitions established under section 319C–2(b); and ‘‘(ii) informing and educating appropriate first responders and health care supply chain partners of the regional emergency preparedness and response capabilities and medical surge capacity of such hos- pitals and health care facilities in the community; ‘‘(B) physical and technological infrastructure, labora- tory capacity, staffing, blood supply, and other supply chain needs, taking into account resiliency, geographic consider- ations, and rural considerations; ‘‘(C) protocols or best practices for the safety and per- sonal protection of workers who handle human remains and health care workers (including with respect to protec- tive equipment and supplies, waste management processes, and decontamination), sharing of specialized experience among the health care workforce, behavioral health, psychological resilience, and training of the workforce, as applicable; ‘‘(D) in a manner that allows for disease containment (within the meaning of section 2802(b)(2)(B)), coordinated medical triage, treatment, and transportation of patients, based on patient medical need (including patients in rural areas), to the appropriate hospitals or health care facilities within the regional system or, as applicable and appro- priate, between systems in different States or regions; and ‘‘(E) the needs of children and other at-risk individuals;

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that the Assistant Secretary determines appropriate, to meet the goals under section 2802(b)(3); ‘‘(3) consider feedback related to financial implications for hospitals, health care facilities, public health agencies, labora- tories, blood banks, tissue banks, and other entities engaged in regional preparedness planning to implement and follow such guidelines, as applicable; and ‘‘(4) consider financial requirements and potential incen- tives for entities to prepare for, and respond to, public health emergencies as part of the regional health care emergency preparedness and response system. ‘‘(d) TECHNICAL ASSISTANCE.—The Assistant Secretary for Preparedness and Response, in consultation with the Director of the Centers for Disease Control and Prevention and the Assistant Secretary of Labor for Occupational Safety and Health, may provide technical assistance and consultation toward meeting the guidelines described in subsection (b). ‘‘(e) DEMONSTRATION PROJECT FOR REGIONAL HEALTH CARE PREPAREDNESS AND RESPONSE SYSTEMS.— ‘‘(1) IN GENERAL.—The Assistant Secretary for Prepared- ness and Response may establish a demonstration project pursuant to the development and implementation of guidelines under subsection (b) to award grants to improve medical surge capacity for all hazards, build and integrate regional medical response capabilities, improve specialty care expertise for all- hazards response, and coordinate medical preparedness and response across State, local, Tribal, territorial, and regional jurisdictions. ‘‘(2) SUNSET.—The authority under this subsection shall expire on September 30, 2023.’’. (b) GAO REPORT TO CONGRESS.— (1) REPORT.—Not later than 3 years after the date of enact- ment of this Act, the Comptroller General of the United States (referred to in this subsection as the ‘‘Comptroller General’’) shall submit to the Committee on Health, Education, Labor, and Pensions and the Committee on Finance of the Senate and the Committee on Energy and Commerce and the Com- mittee on Ways and Means of the House of Representatives, a report on the extent to which hospitals and health care facilities have implemented the recommended guidelines under section 319C–3(b) of the Public Health Service Act (as added by subsection (a)), including an analysis and evaluation of any challenges hospitals or health care facilities experienced in implementing such guidelines. (2) CONTENT.—The Comptroller General shall include in the report under paragraph (1)— (A) data on the preparedness and response capabilities that have been informed by the guidelines under section 319C–3(b) of the Public Health Service Act to improve regional emergency health care preparedness and response capability, including hospital and health care facility capacity and medical surge capabilities to prepare for, and respond to, public health emergencies; and (B) recommendations to reduce gaps in incentives for regional health partners, including hospitals and health care facilities, to improve capacity and medical surge capabilities to prepare for, and respond to, public health Consultation. Grants. Coordination. Analysis. Evaluation. Recommenda- tions.

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(c) ANNUAL REPORTS.—Section 319C–2(i)(1) (42 U.S.C. 247d– 3b(i)(1)) is amended by inserting after the first sentence the fol- lowing: ‘‘In submitting reports under this paragraph, a coalition shall include information on the progress that the coalition has made toward the implementation of section 319C–3 (or barriers to progress, if any).’’. (d) NATIONAL HEALTH SECURITY STRATEGY INCORPORATION OF REGIONALIZED EMERGENCY PREPAREDNESS AND RESPONSE.— Subparagraph (G) of section 2802(b)(3) (42 U.S.C. 300hh–1(b)(3)) is amended to read as follows: ## SEC. 204. MILITARY AND CIVILIAN PARTNERSHIP FOR TRAUMA READI- NESS. Title XII (42 U.S.C. 300d et seq.) is amended by adding at the end the following new part: emergencies, consistent with subsection (a), which may include consideration of facilities participating in programs under section 319C–2 of the Public Health Service Act (42 U.S.C. 247d–3b) or in programs under the Centers for Medicare & Medicaid Services (including innovative health care delivery and payment models), and input from private sector financial institutions. (3) CONSULTATION.—In carrying out paragraphs (1) and (2), the Comptroller General shall consult with the heads of appropriate Federal agencies, including— (A) the Assistant Secretary for Preparedness and Response; (B) the Director of the Centers for Disease Control and Prevention; (C) the Administrator of the Centers for Medicare & Medicaid Services; (D) the Assistant Secretary for Mental Health and Substance Use; (E) the Assistant Secretary of Labor for Occupational Safety and Health; and (F) the Secretary of Veterans Affairs. ‘‘(G) Optimizing a coordinated and flexible approach to the emergency response and medical surge capacity of hospitals, other health care facilities, critical care, trauma care (which may include trauma centers), and emergency medical systems.’’. (e) IMPROVING STATE AND LOCAL PUBLIC HEALTH SECURITY.— (1) STATE AND LOCAL SECURITY.—Section 319C–1(e) (42 U.S.C. 247d–3a(e)) is amended by striking ‘‘, and local emer- gency plans.’’ and inserting ‘‘, local emergency plans, and any regional health care emergency preparedness and response system established pursuant to the applicable guidelines under section 319C–3.’’. (2) PARTNERSHIPS.—Section 319C–2(d)(1)(A) (42 U.S.C. 247d–3b(d)(1)(A)) is amended— (A) in clause (i), by striking ‘‘; and’’ and inserting ‘‘;’’; (B) by redesignating clause (ii) as clause (iii); and (C) by inserting after clause (i) the following: ‘‘(ii) among one or more facilities in a regional health care emergency system under section 319C– 3; and’’.

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# EMERGENCY SUPPLEMENTAL APPROPRIATIONS FOR HUMANITARIAN ASSISTANCE AND SECURITY AT THE SOUTHERN BORDER ACT, 2019

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July 1, 2019 [H.R. 3401] Emergency Supplemental Appropriations for Humanitarian Assistance and Security at the Southern Border Act, 2019. # Public Law 116–26 116th Congress Making emergency supplemental appropriations for the fiscal year ending September 30, 2019, and for other purposes. Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, That the following sums are appropriated, out of any money in the Treasury not otherwise appropriated, for the fiscal year ending September 30, 2019, and for other purposes, namely: For an additional amount for ‘‘Executive Office for Immigration Review’’, $65,000,000, of which $45,000,000 shall be for the hiring of 30 additional Immigration Judge Teams, of which $10,000,000 shall be used for the purchase or lease of immigration judge court- room space and equipment, and of which $10,000,000 shall be used only for services and activities provided by the Legal Orienta- tion Program: Provided , That Immigration Judge Teams shall include appropriate attorneys, law clerks, paralegals, court adminis- trators, and other support staff: Provided further , That such amount is designated by the Congress as being for an emergency require- ment pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. For an additional amount for ‘‘Federal Prisoner Detention’’, for necessary expenses related to United States prisoners in the custody of the United States Marshals Service, to be used only as authorized by section 4013 of title 18, United States Code, $155,000,000, to remain available until expended: Provided , That such amount is designated by the Congress as being for an emer- gency requirement pursuant to section 251(b)(2)(A)(i) of the Bal- anced Budget and Emergency Deficit Control Act of 1985. ## DEPARTMENT OF JUSTICE ## GENERAL ADMINISTRATION ## EXECUTIVE OFFICE FOR IMMIGRATION REVIEW ## UNITED STATES MARSHALS SERVICE ## FEDERAL PRISONER DETENTION # An Act ## TITLE I

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and transferred pursuant to transfer authorities provided by this Act shall retain such designation. SEC. 506. Not later than 180 days after the date of the enact- ment of this Act, the Comptroller General of the United States shall submit a report to the Committees on Appropriations of the House of Representatives and the Senate on the number of asylum officers and immigration judges, including temporary immigration judges, and the corresponding number of support staff necessary— (1) to fairly and effectively make credible fear determina- tions with respect to individuals within family units and unaccompanied alien children; (2) to ensure that the credible fear determination and asylum interview is completed not later than 20 days after the date on which a family unit is apprehended; and (3) to fairly and effectively review appeals of credible fear determinations with respect to individuals within family units and unaccompanied alien children. In addition, the report shall determine if there is any physical infrastructure such as hearing or courtroom space needed to achieve these goals. This Act may be cited as the ‘‘Emergency Supplemental Appro- priations for Humanitarian Assistance and Security at the Southern Border Act, 2019’’. Approved July 1, 2019. Reports. Determination.

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For an additional amount for ‘‘Operation and Maintenance, Army’’, $92,800,000, for necessary expenses to respond to the signifi- cant rise in unaccompanied minors and family unit aliens at the southwest border and related activities: Provided , That such amount is designated by the Congress as being for an emergency require- ment pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. For an additional amount for ‘‘Operation and Maintenance, Marine Corps’’, $13,025,000, for necessary expenses to respond to the significant rise in unaccompanied minors and family unit aliens at the southwest border and related activities: Provided , That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. For an additional amount for ‘‘Operation and Maintenance, Air Force’’, $18,000,000, for necessary expenses to respond to the significant rise in unaccompanied minors and family unit aliens at the southwest border and related activities: Provided , That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. For an additional amount for ‘‘Operation and Maintenance, Army National Guard’’, $21,024,000, for necessary expenses to respond to the significant rise in unaccompanied minors and family unit aliens at the southwest border and related activities: Provided , That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. For an additional amount for ‘‘Operations and Support’’ for necessary expenses to respond to the significant rise in aliens at the southwest border and related activities, $1,015,431,000; of which $819,950,000 shall be available until September 30, 2020: ## OPERATION AND MAINTENANCE, MARINE CORPS ## OPERATION AND MAINTENANCE, ARMY NATIONAL GUARD ## DEPARTMENT OF HOMELAND SECURITY ## DEPARTMENT OF DEFENSE ## OPERATION AND MAINTENANCE ## OPERATION AND MAINTENANCE, ARMY ## U.S. CUSTOMS AND BORDER PROTECTION ## OPERATIONS AND SUPPORT ## TITLE II ## TITLE III

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Deadline. Provided , That of the amounts provided under this heading, $708,000,000 is for establishing and operating migrant care and processing facilities, $111,950,000 is for consumables and medical care, $35,000,000 is for transportation, $110,481,000 is for tem- porary duty and overtime costs including reimbursements, and $50,000,000 is for mission support data systems and analysis: Pro- vided further , That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Con- trol Act of 1985. For an additional amount for ‘‘Procurement, Construction, and Improvements’’ for migrant care and processing facilities, $85,000,000, to remain available until September 30, 2023: Pro- vided , That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. For an additional amount for ‘‘Operations and Support’’ for necessary expenses to respond to the significant rise in aliens at the southwest border and related activities, $208,945,000: Pro- vided , That of the amounts provided under this heading, $35,943,000 is for transportation of unaccompanied alien children, $11,981,000 is for detainee transportation for medical needs, court proceedings, or relocation from U.S. Customs and Border Protection custody, $20,000,000 is for alternatives to detention, $45,000,000 is for detainee medical care, $69,735,000 is for temporary duty, overtime, and other on-board personnel costs including reimburse- ments, $5,000,000 is for the Office of Professional Responsibility for background investigations and facility inspections, and $21,286,000 is for Homeland Security Investigations human traf- ficking investigations: Provided further , That such amount is des- ignated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. For an additional amount for ‘‘Federal Assistance’’, $30,000,000, to remain available until September 30, 2020, for the emergency food and shelter program under title III of the McKinney-Vento Homeless Assistance Act (42 U.S.C. 11331 et seq.) for the purposes of providing assistance to aliens released from the custody of the Department of Homeland Security: Provided , That notwithstanding sections 315 and 316(b) of such Act, funds made available under this section shall be disbursed by the Emergency Food and Shelter Program National Board not later than 30 days after the date on which such funds become available: Provided further , That the ## PROCUREMENT, CONSTRUCTION, AND IMPROVEMENTS ## U.S. IMMIGRATION AND CUSTOMS ENFORCEMENT ## FEDERAL EMERGENCY MANAGEMENT AGENCY ## OPERATIONS AND SUPPORT ## FEDERAL ASSISTANCE

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Emergency Food and Shelter Program National Board shall dis- tribute such funds only to jurisdictions or local recipient organiza- tions serving communities that have experienced a significant influx of such aliens: Provided further , That such funds may be used to reimburse such jurisdictions or local recipient organizations for costs incurred in providing services to such aliens on or after January 1, 2019: Provided further , That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. SEC. 301. Notwithstanding any other provision of law, funds made available under each heading in this title shall only be used for the purposes specifically described under that heading. SEC. 302. Division A of the Consolidated Appropriations Act, 2019 (Public Law 116–6) is amended by adding after section 540 the following: ‘‘SEC. 541. (a) Section 831 of the Homeland Security Act of 2002 (6 U.S.C. 391) shall be applied— ‘‘(1) In subsection (a), by substituting ‘September 30, 2019,’ for ‘September 30, 2017,’; and ‘‘(2) In subsection (c)(1), by substituting ‘September 30, 2019,’ for ‘September 30, 2017’. ‘‘(b) The Secretary of Homeland Security, under the authority of section 831 of the Homeland Security Act of 2002 (6 U.S.C. 391(a)), may carry out prototype projects under section 2371b of title 10, United States Code, and the Secretary shall perform the functions of the Secretary of Defense as prescribed. ‘‘(c) The Secretary of Homeland Security under section 831 of the Homeland Security Act of 2002 (6 U.S.C. 391(d)) may use the definition of nontraditional government contractor as defined in section 2371b(e) of title 10, United States Code.’’. SEC. 303. None of the funds provided in this Act under ‘‘U.S. Customs and Border Protection—Operations and Support’’ for facili- ties shall be available until U.S. Customs and Border Protection establishes policies (via directive, procedures, guidance, and/or memorandum) and training programs to ensure that such facilities adhere to the National Standards on Transport, Escort, Detention, and Search, published in October of 2015: Provided , That not later than 90 days after the date of enactment of this Act, U.S. Customs and Border Protection shall provide a detailed report to the Commit- tees on Appropriations of the Senate and the House of Representa- tives, the Committee on the Judiciary of the Senate, and the House Judiciary Committee regarding the establishment and implementa- tion of such policies and training programs. SEC. 304. No later than 30 days after the date of enactment of this Act, the Secretary of Homeland Security shall provide a report on the number of U.S. Customs and Border Protection Offi- cers assigned to northern border land ports of entry and temporarily assigned to the ongoing humanitarian crisis: Provided , That the report shall outline what resources and conditions would allow a return to northern border staffing levels that are no less than the number committed in the June 12, 2018 Department of Home- land Security Northern Border Strategy: Provided further , That the report shall include the number of officers temporarily assigned ## GENERAL PROVISIONS—THIS TITLE Reimbursement. Effective date. Ante , p. 44. 6 USC 391 note. Policies. Reports. Reports.

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Notification. Deadlines. Assessment. to the southwest border in response to the ongoing humanitarian crisis, the number of days the officers will be away from their northern border assignment, the northern border ports from which officers are being assigned to the southwest border, and efforts being made to limit the impact on operations at each northern border land port of entry where officers have been temporarily assigned to the southwest border. SEC. 305. None of the funds appropriated or otherwise made available by this Act or division A of the Consolidated Appropria- tions Act, 2019 (Public Law 116–6) for the Department of Homeland Security may be used to relocate to the National Targeting Center the vetting of Trusted Traveler Program applications and operations currently carried out at existing locations unless specifically author- ized by a statute enacted after the date of enactment of this Act. SEC. 306. The personnel, supplies, or equipment of any compo- nent of the Department of Homeland Security may be deployed to support activities of the Department of Homeland Security related to the significant rise in aliens at the southwest border and related activities, and for the enforcement of immigration and customs laws, detention and removals of aliens crossing the border unlawfully, and investigations without reimbursement as jointly agreed by the detailing components. ## DEPARTMENT OF HEALTH AND HUMAN SERVICES For an additional amount for ‘‘Refugee and Entrant Assistance’’, $2,881,552,000, to be merged with and available for the same period as funds appropriated in Public Law 115–245 ‘‘for carrying out such sections 414, 501, 462, and 235’’, which shall be available for any purpose funded under such heading in such law: Provided , That if any part of the reprogramming described in the notification submitted by the Secretary of Health and Human Services (the ‘‘Secretary’’) to the Committees on Appropriations of the House of Representatives and the Senate on May 16, 2019 has been executed, such amounts provided by this Act as are necessary shall be used to reverse such reprogramming: Provided further , That amounts allocated by the Secretary for costs of leases of property that include facilities to be used as hard-sided dormitories for which the Secretary intends to seek State licensure for the care of unaccompanied alien children, and that are executed under authorities transferred to the Director of the Office of Refugee Resettlement (ORR) under section 462 of the Homeland Security Act of 2002, shall remain available until expended: Provided further , That ORR shall notify the Committees on Appropriations of the House of Representatives and the Senate within 72 hours of con- ducting a formal assessment of a facility for possible lease or acquisition and within 7 days of any acquisition or lease of real property: Provided further , That not less than $866,000,000 of amounts provided under this heading shall be used for the provision of care in licensed shelters and for expanding the supply of shelters for which State licensure will be sought, of which not less than $27,000,000 shall be available for the purposes of adding shelter ## ADMINISTRATION FOR CHILDREN AND FAMILIES ## REFUGEE AND ENTRANT ASSISTANCE ## TITLE IV

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beds in State-licensed facilities in response to funding opportunity HHS–2017–ACF–ORR–ZU–1132, and of which not less than $185,000,000 shall be available for expansion grants to add beds in State-licensed facilities and open new State-licensed facilities, and for contract costs to acquire, activate, and operate facilities that will include small- and medium-scale hard-sided facilities for which the Secretary intends to seek State licensure in an effort to phase out the need for shelter beds in unlicensed facilities: Provided further , That not less than $100,000,000 of amounts pro- vided under this heading shall be used for post-release services, child advocates, and legal services: Provided further , That not less than $8,000,000 of amounts provided under this heading shall be used for the purposes of hiring additional Federal Field Special- ists and for increasing case management and case coordination services, with the goal of more expeditiously placing unaccompanied alien children with sponsors and reducing the length of stay in ORR custody: Provided further , That not less than $1,000,000 of amounts provided under this heading shall be used for the purposes of hiring project officers and program monitor staff dedicated to pursuing strategic improvements to the Unaccompanied Alien Chil- dren program and for the development of a discharge rate improve- ment plan which shall be submitted to the Committees on Appro- priations of the House of Representatives and the Senate within 120 days of enactment of this Act: Provided further , That of the amounts provided under this heading, $5,000,000 shall be trans- ferred to ‘‘Office of the Secretary—Office of Inspector General’’ and shall remain available until expended for oversight of activities supported with funds appropriated under this heading: Provided further , That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. SEC. 401. The Secretary of Health and Human Services (the ‘‘Secretary’’) shall prioritize use of community-based residential care (including long-term and transitional foster care and small group homes) and shelter care other than large-scale institutional shelter facilities to house unaccompanied alien children in its custody. The Secretary shall prioritize State-licensed and hard-sided dor- mitories. SEC. 402. The Office of Refugee Resettlement shall ensure that its grantees and, to the greatest extent practicable, potential sponsors of unaccompanied alien children are aware of current law regarding the use of information collected as part of the sponsor suitability determination process. SEC. 403. (a) None of the funds provided by this or any prior appropriations Act may be used to reverse changes in procedures made by operational directives issued to providers by the Office of Refugee Resettlement on December 18, 2018, March 23, 2019, and June 10, 2019 regarding the Memorandum of Agreement on Information Sharing executed April 13, 2018. (b) Notwithstanding subsection (a), the Secretary may make changes to such operational directives upon making a determination that such changes are necessary to prevent unaccompanied alien children from being placed in danger, and the Secretary shall pro- vide a written justification to Congress and the Inspector General ## GENERAL PROVISIONS—THIS TITLE Determination.