Border Health Security Act of 2021
This bill modifies the duties and activities of the United States-Mexico Border Health Commission and the Canada-United States Pan-Border Public Health Preparedness Council and makes other changes to address health issues along the U.S. border.
Specifically, the commission must cooperate with the council where appropriate, and both the commission and the council must develop strategic plans, work plans, evaluations, and reports concerning their activities.
The Department of Health and Human Services must award grants to (1) eligible entities in border areas to address recommendations of the commission and the council to improve the health of border area residents; and (2) trauma centers, public health entities, and state, local, or tribal entities for infectious disease surveillance activities in border areas. In addition, the Office of the Assistant Secretary for Preparedness and Response may coordinate with the Department of Homeland Security in establishing a system that alerts clinicians and public health officials to emerging health threats in border areas.
The Government Accountability Office must evaluate commission and council activities every two years.
[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4812 Introduced in House (IH)]
<DOC>
117th CONGRESS
1st Session
H. R. 4812
To establish grant programs to improve the health of residents along
the United States-Mexico and United States-Canada borders and for all
hazards preparedness in the border areas, including with respect to
bioterrorism, infectious disease, and other emerging biothreats, and
for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
July 29, 2021
Ms. Escobar (for herself, Mr. Tony Gonzales of Texas, Mrs. Kirkpatrick,
Mr. Grijalva, Mr. Vargas, Mr. Vicente Gonzalez of Texas, Mr. Cuellar,
and Mr. Vela) introduced the following bill; which was referred to the
Committee on Energy and Commerce, and in addition to the Committee on
Foreign Affairs, for a period to be subsequently determined by the
Speaker, in each case for consideration of such provisions as fall
within the jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To establish grant programs to improve the health of residents along
the United States-Mexico and United States-Canada borders and for all
hazards preparedness in the border areas, including with respect to
bioterrorism, infectious disease, and other emerging biothreats, 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.
This Act may be cited as the ``Border Health Security Act of
2021''.
SEC. 2. FINDINGS.
Congress makes the following findings:
(1) The United States-Mexico border is an interdependent
and dynamic region of approximately 15,000,000 residents and
millions of border crossings each year, with significant and
unique public health challenges.
(2) These challenges include low rates of health insurance
coverage, poor access to health care services, lack of
education or access to information, poverty-related illness,
including undernutrition, and high rates of infectious
diseases, such as tuberculosis, West Nile virus, and Zika
virus, as well as other noncommunicable diseases such as
cardiovascular disease, asthma, diabetes, and obesity.
(3) As the COVID-19 pandemic has illustrated, diseases do
not respect international boundaries, and a strong public
health effort at and along the United States, Mexico, and
Canada borders is crucial to not only protect and improve the
health of Americans but also to help secure the country against
biosecurity and other emerging threats.
(4) For over 20 years, the United States-Mexico Border
Health Commission has served as a crucial binational
institution to address these unique and truly cross-border
health issues.
(5) The COVID-19 pandemic has also highlighted the need for
continued coordination of resources, effective communication,
and information sharing between countries to address emerging
public health crises.
SEC. 3. UNITED STATES-MEXICO BORDER HEALTH COMMISSION ACT AMENDMENTS.
The United States-Mexico Border Health Commission Act (22 U.S.C.
290n et seq.) is amended--
(1) in section 3--
(A) by striking ``It should be the duty'' and
inserting the following:
``(a) In General.--It should be the duty'';
(B) in paragraph (1), by striking ``; and'' and
inserting ``;'';
(C) in paragraph (2)(B), by striking the period and
inserting a semicolon;
(D) by adding at the end the following:
``(3) to evaluate the Commission's progress in carrying out
the duties described in paragraphs (1) and (2) and report on
such progress and make recommendations, as appropriate, to the
Secretary of Health and Human Services and Congress regarding
such duties; and
``(4) to serve as an independent and objective body to both
recommend and implement initiatives that solve border health
issues.''; and
(E) by adding at the end the following:
``(b) United States Section Members.--The members of the United
States section of the Commission, acting independently of the
Commission overall, may--
``(1) provide reports and recommendations to, and consult
with, the Secretary of Health and Human Services and Congress
on the matters described in subsection (a)(3); and
``(2) cooperate with the Canada-United States Pan Border
Public Health Preparedness Council (referred to in this Act as
the `Council'), as appropriate.'';
(2) in section 5(b), by striking ``should be the leader''
and inserting ``shall be the Chair'';
(3) by redesignating section 8 as section 12;
(4) by striking section 7 and inserting the following:
``SEC. 7. BORDER HEALTH GRANTS.
``(a) Eligible Entity Defined.--In this section, the term `eligible
entity' means a State, public institution of higher education, local
government, Indian Tribe, Tribal organization, urban Indian
organization, nonprofit health organization, trauma center, critical
access hospital or other hospital that serves rural or other vulnerable
communities and populations, faith-based entity, or community health
center receiving assistance under section 330 of the Public Health
Service Act (42 U.S.C. 254b), that is located in the United States-
Mexico border area or the United States-Canada border area.
``(b) Authorization.--From amounts appropriated under section 11,
the Secretary, in consultation with members of the Commission and
Council and in coordination with the Office of Global Affairs, shall
award grants to eligible entities to improve the health of residents of
the United States-Mexico and United States-Canada border areas with
appropriate priority given to grants that address recommendations
outlined by the strategic plan and operational work plan of the
Commission and the Council under section 9.
``(c) Application.--An eligible entity that desires a grant under
subsection (b) shall submit an application to the Secretary at such
time, in such manner, and containing such information as the Secretary
may require.
``(d) Use of Funds.--An eligible entity that receives a grant under
subsection (b) shall use the grant funds for any of the following:
``(1) Programs relating to any one or more of the
following:
``(A) Maternal and child health.
``(B) Primary care and preventative health.
``(C) Infectious disease testing, monitoring, and
surveillance.
``(D) Public health and public health
infrastructure.
``(E) Health promotion, health literacy, and health
education.
``(F) Oral health.
``(G) Behavioral and mental health.
``(H) Substance abuse prevention and harm
reduction.
``(I) Health conditions that have a high prevalence
in the United States-Mexico border area or United
States-Canada border area.
``(J) Medical and health services research in
border communities.
``(K) Workforce training and development.
``(L) Community health workers and promotoras.
``(M) Health care infrastructure problems in the
United States-Mexico border area or United States-
Canada border area (including planning and construction
grants).
``(N) Health disparities in the United States-
Mexico border area or United States-Canada border area.
``(O) Environmental health.
``(P) Bioterrorism and zoonosis.
``(Q) Outreach and enrollment services with respect
to Federal programs (including programs authorized
under titles XIX and XXI of the Social Security Act (42
U.S.C. 1396 et seq., 42 U.S.C. 1397aa et seq.)).
``(R) Trauma care.
``(S) Health research with an emphasis on the
prevalence of infectious diseases, such as measles, in
the border areas, as well as other pressing health
issues, such as noncommunicable diseases like diabetes
and obesity.
``(T) Epidemiology and health research.
``(U) Cross-border health surveillance coordinated
with Mexican Health Authorities or Canadian Health
Authorities.
``(V) Community-based participatory research on
border health issues.
``(W) Domestic violence and violence prevention.
``(X) Cross-border public health preparedness.
``(2) Other programs as the Secretary determines
appropriate.
``(e) Supplement, Not Supplant.--Amounts provided to an eligible
entity awarded a grant under subsection (b) shall be used to supplement
and not supplant other funds available to the eligible entity to carry
out the activities described in subsection (d).
``SEC. 8. GRANTS FOR EARLY WARNING INFECTIOUS DISEASE SURVEILLANCE IN
THE BORDER AREA.
``(a) Eligible Entity Defined.--In this section, the term `eligible
entity' means a State, local government, Indian Tribe, Tribal
organization, urban Indian organization, trauma center, regional trauma
center coordinating entity, or public health entity.
``(b) Authorization.--From funds appropriated under section 11, the
Secretary shall award grants for Early Warning Infectious Disease
Surveillance to eligible entities for infectious disease surveillance
activities in the United States-Mexico border area or United States-
Canada border area.
``(c) Application.--An eligible entity that desires a grant under
this section shall submit an application to the Secretary at such time,
in such manner, and containing such information as the Secretary may
require.
``(d) Uses of Funds.--An eligible entity that receives a grant
under subsection (b) shall use the grant funds, in coordination with
State and local all hazards programs, to--
``(1) develop and implement infectious disease surveillance
plans and networks and public health emergency and readiness
assessments and preparedness plans, and purchase items
necessary for such plans;
``(2) coordinate infectious disease surveillance planning
and interjurisdictional risk assessments in the region with
appropriate United States-based agencies and organizations and
appropriate authorities in Mexico or Canada;
``(3) improve infrastructure, including surge capacity,
syndromic surveillance, and isolation and decontamination
capacity, and policy preparedness, including for mutual
assistance and for the sharing of information and resources;
``(4) improve laboratory capacity, in order to maintain and
enhance capability and capacity to detect potential infectious
disease, whether naturally occurring or the result of
terrorism;
``(5) create and maintain a health alert network, including
risk communication and information dissemination that is
culturally competent and takes into account the needs of at-
risk populations;
``(6) educate and train clinicians, epidemiologists,
laboratories, and emergency management personnel;
``(7) implement electronic data and infrastructure
inventory systems to coordinate the triage, transportation, and
treatment of multicasualty incident victims;
``(8) provide infectious disease testing in the United
States-Mexico border area or United States-Canada border area;
and
``(9) carry out such other activities identified by the
Secretary, members of the Commission, members of the Council,
State or local public health authorities, representatives of
border health offices, or authorities at the United States-
Mexico or United States-Canada borders.
``SEC. 9. PLANS, REPORTS, AUDITS, AND BY-LAWS.
``(a) Strategic Plan.--
``(1) In general.--Not later than 2 years after the date of
enactment of this section, and every 5 years thereafter, the
Commission (including the participation of members representing
both the United States and Mexican sections) and the Council
(including the participation of members representing both the
United States and Canada) shall each prepare a binational
strategic plan to guide the operations of the Commission and
the Council and submit such plan to the Secretary and Congress.
``(2) Requirements.--The binational strategic plan under
paragraph (1) shall include--
``(A) health-related priority areas identified by
the full membership of the Commission or Council, as
applicable;
``(B) recommendations for goals, objectives,
strategies, and actions designed to address such
priority areas; and
``(C) a proposed evaluation framework with output
and outcome indicators appropriate to gauge progress
toward meeting the objectives and priorities of the
Commission or Council, as applicable.
``(b) Work Plan.--Not later than January 1, 2024, and every 2 years
thereafter, the Commission and the Council shall develop and approve an
operational work plan and budget based on the strategic plan under
subsection (a).
``(c) GAO Review.--Not later than January 1, 2025, and every 2
years thereafter, the Comptroller General of the United States shall
conduct an evaluation of the activities conducted by the Commission and
the Council based on the operational work plans described in subsection
(b) for the previous year and the output and outcome indicators
included in the strategic plan described in subsection (a). The
evaluation shall include a request for written evaluations from members
of the Commission and the Council about barriers and facilitators to
executing successfully the work plans of the Commission and the
Council.
``(d) Biannual Reporting.--
``(1) By commission and council.--The Commission and
Council shall each issue a biannual report to the Secretary
that--
``(A) provides independent policy recommendations
related to border health issues; and
``(B) details the expenditures of the Commission
and Council over the reporting period.
``(2) By secretary.--Not later than 3 months following
receipt of each such biannual report, the Secretary shall
provide to Congress the report and any studies or other
materials produced independently by the Commission and Council.
``(e) Audits.--The Secretary shall annually prepare an audited
financial report to account for all appropriated assets expended by the
Commission and Council to address both the strategic and operational
work plans for the year involved.
``(f) By-Laws.--Not later than 6 months after the date of enactment
of this section, the Commission and Council shall develop and approve
bylaws to provide fully for compliance with the requirements of this
section.
``(g) Transmittal to Congress.--The Commission and Council shall
submit copies of the operational work plan and by-laws to Congress. The
Comptroller General of the United States shall submit a copy of each
evaluation completed under subsection (c) to Congress.
``SEC. 10. COORDINATION.
``(a) In General.--To the extent practicable and appropriate,
plans, systems, and activities to be funded (or supported) under this
Act for all hazard preparedness, and general border health, including
with respect to infectious disease, shall be coordinated with Federal,
State, and local authorities in Mexico, Canada, and the United States.
``(b) Coordination of Health Services and Surveillance.--
``(c) In General.--The Secretary, acting through the Assistant
Secretary for Preparedness and Response, when appropriate, may
coordinate with the Secretary of Homeland Security in establishing a
health alert system that--
``(1) alerts clinicians and public health officials of
emerging disease clusters and syndromes along the United
States-Mexico border area and United States-Canada border area;
``(2) warns of health threats, extreme weather conditions,
disasters of mass scale, bioterrorism, and other emerging
threats along the United States-Mexico border area and United
States-Canada border area; and
``(3) is coordinated with other systems and agencies to
avoid duplication.
``SEC. 11. AUTHORIZATION OF APPROPRIATIONS.
``There is authorized to be appropriated to carry out this Act
$20,000,000 for fiscal year 2022 and each succeeding year, of which for
each such fiscal year--
``(1) $14,000,000 shall be made available to fund
operationally feasible functions, activities, and grants with
respect to the United States-Mexico border and the border
health activities under cooperative agreements with the border
health offices of the States of California, Arizona, New
Mexico, and Texas; and
``(2) $6,000,000 shall be made available for the
administration of United States activities under this Act on
the United States-Canada border and the border health
authorities, acting through the Canada-United States Pan-Border
Public Health Preparedness Council.''; and
(5) in section 12 (as so redesignated)--
(A) by redesignating paragraphs (3) and (4) as
paragraphs (4) and (6), respectively;
(B) by inserting after paragraph (2), the
following:
``(3) Indians; indian tribe; tribal organization; urban
indian organization.--The terms `Indian', `Indian Tribe',
`Tribal organization', and `urban Indian organization' have the
meanings given such terms in section 4 of the Indian Health
Care Improvement Act (25 U.S.C. 1603).''; and
(C) by inserting after paragraph (4), as so
redesignated, the following:
``(5) United states-canada border area.--The term `United
States-Canada border area' means the area located in the United
States and Canada within 100 kilometers of the border between
the United States and Canada.''.
<all>
Introduced in House
Introduced in House
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Foreign Affairs, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Foreign Affairs, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Subcommittee on Health.
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