42 U.S.C. § 247d–3a — Improving State and local public health security

submitted 82 years ago by Pub. L. 107-188 to r/title-42-THE-PUBLIC-HEALTH-AND-WELFARE · 4,410 words · no verdicts yet

in plain englishAI-generated · not legal advice

The Secretary must give cooperative agreements to states and some local governments to strengthen public health emergency preparedness. States must submit an All-Hazards Preparedness Plan, test readiness yearly, and meet benchmarks or lose funding. The law also sets rules for matching funds, reporting, and evaluating results.

(a) In general. To make the country more secure against public health emergencies, the Secretary — acting through the Director of the CDC — must award cooperative agreements to eligible groups so they can carry out the activities listed in subsection (d). (b) Eligible entities. To qualify for an award, a group must: (1) be a state, be a political subdivision the Secretary decides is eligible (based on criteria in subsection (h)(4)), or be a group of states working together; and (2) submit an application the Secretary requires. That application must include: (A) an "All-Hazards Public Health Emergency Preparedness and Response Plan" describing — the activities the entity will do to meet the goals in section 300hh–1, including for chemical, biological, radiological, or nuclear threats, whether natural, accidental, or deliberate; specific activities for pandemic flu preparedness; strategies that account for the medical and public health needs of at-risk individuals; how the entity will use the Emergency Management Assistance Compact or similar mutual aid agreements, and how it will help volunteer health professionals register and get coordinated during an emergency (for example, by providing a phone number for volunteers or letting them register during state licensing); how the entity will include its State Unit on Aging in planning; how it may partner with other public and private stakeholders, including environmental health agencies; how it may account for people with behavioral health needs; how it will coordinate with state emergency plans, state education agencies, and state child care lead agencies; for entities on the U.S.–Mexico or U.S.–Canada border, border-specific disease detection and response activities; how it will analyze real-time clinical samples for dangerous pathogens, including through poison control centers; how it will partner with hospitals, nursing homes, and other long-term care facilities; how it will give technical assistance to facilities at higher risk of outbreaks, like residential care facilities and group homes; and how it will include infrastructure partners, like utility companies, in its planning. The application must also include: (B) a promise to report to the Secretary at least once a year on meeting the benchmarks in subsection (g); (C) a promise to run a preparedness exercise or drill at least once a year and report back on what it learned and what it fixed; (D) a promise that relevant staff will complete preparedness training; (E) a promise to give the Secretary the data described in section 247d–4(c)(3), as far as that's practical; (F) a promise to educate hospitals in its area about their role in the plan; (G) a promise to hold itself accountable for making yearly improvement, and to describe how it will do that; (H) a description of how the entity gets public comment on its plan, including an advisory committee or similar group; and (I) if relevant, a description of how the entity works with local health departments to agree on how the money is divided. (c) Limitation. Starting in fiscal year 2009, the Secretary cannot give a cooperative agreement to a state unless that state takes part in the Emergency System for Advance Registration of Volunteer Health Professionals under section 247d–7b. (d) Use of funds. (1) Award money must go toward the preparedness goals in section 300hh–1(b), specifically paragraphs (1), (2), (4), (5), and (6). (2) Nothing here creates new regulations or changes existing ones. (e) Coordination with local response capabilities. As much as practical, an entity must coordinate its funded activities with local Metropolitan Medical Response Systems, local health departments, the Cities Readiness Initiative, local emergency plans, and any regional health care emergency system set up under section 247d–3c. (f) Consultation with Homeland Security. When making awards, the Secretary must consult the Secretary of Homeland Security to: (1) make sure public health and medical preparedness work is coordinated with the Metropolitan Medical Response System and similar efforts; (2) avoid funding the same things twice; and (3) study preparedness activities, including drills, to develop best-practice recommendations. (g) Achievement of measurable evidence-based benchmarks and objective standards. (1) By around mid-2007, the Secretary had to create (or adopt) measurable, evidence-based benchmarks and standards to measure how prepared entities are, consulting with state, local, and tribal officials as needed and using existing standards where they fit. These benchmarks must include outcome goals tied to the National Preparedness Goals for all hazards, and must, at minimum, require entities to track their progress and — at least once a year — test and evaluate their preparedness, then report the results to the Secretary. (2) By the same mid-2007 deadline, the Secretary had to create and send states criteria for a good pandemic flu response plan, update those criteria as needed, and fold them into the general benchmarks; this does not require duplicating federal work already done. (3) The Secretary must give states technical help, on request, to meet these requirements — including expert advice on building assessments, setting goals, and measuring improvement. (4) The Secretary must set up a process to notify entities that fail to meet these requirements and give them a chance to fix the problem; an entity that does not fix it faces the funding cuts in paragraph (5). (5) Starting in fiscal year 2019, the Secretary must withhold funding (the amount is set in paragraph (6)) from: (A) any entity that substantially failed to meet the benchmarks in either of the two prior fiscal years (starting with 2018); and (B) any entity that failed to submit a qualifying pandemic flu plan. (6) The withheld amount is: (i) 10% of what the entity was eligible to receive, for up to one of the first two years after a failure; or (ii) if the entity failed three years in a row, 15% instead, for up to one of the first two years after that third failure. Each failure is counted and calculated separately. (7) Money withheld this way gets redirected to awards under section 247d–3b, and entities in states that had money withheld get priority for that redirected money. (8) The Secretary can waive or reduce the withholding, for one entity or for everyone in a given year, if there are good reasons to do so. (h) Funding. (1) Congress can spend $685,000,000 each year from 2019 through 2023 for these awards. Starting in fiscal year 2009, a state or group of states must also put up matching, non-federal money to get an award: at least 5% of the award's value in the first year (that's $1 for every $20 in federal funds), and at least 10% in every year after that ($1 for every $10 in federal funds). This match can be cash or in-kind (like equipment, supplies, or services), fairly valued, but money that already comes from the federal government cannot count toward the match. (2) An entity getting an award must keep spending on public health security at least at the average level it spent over the previous two years; this does not stop the entity from using award money to pay staff who do this work, even if it's not their only job. (3) The Secretary sets each state's award amount using a formula. First, the Secretary sets a "base amount" for the state — an amount that cannot be more than the state's minimum guaranteed amount (explained below). Then the Secretary increases that base amount based on population: take the total money appropriated for the year, subtract all states' base amounts and any money reserved for special awards, and multiply what's left by each state's share of the total U.S. population (based on the latest Census data). Each state's final award is whichever is bigger: its base amount plus the population increase, or its guaranteed minimum. That minimum is: for each state, the District of Columbia, and Puerto Rico, the smaller of $5,000,000, or — if total funding that year is under $667,000,000 — 0.75% of that year's total funding (after subtracting any special reserved amounts); for American Samoa, Guam, the Northern Mariana Islands, and the Virgin Islands, an amount the Secretary decides, capped at the same amount as the states' minimum. (4) For fiscal year 2007 only, the Secretary could set aside money to fund up to three large political subdivisions (cities or counties) that have a lot of residents, strong local infrastructure, and high risk of bioterror attacks or other emergencies — as long as their plans matched the state's overall plan. If a subdivision got its own award, its population was subtracted from the state's population when calculating the state's award, and the Secretary could favor subdivisions that already got public health funding in fiscal year 2006. (5) Also for fiscal year 2007 only, the Secretary could set aside money for entities with a big unmet need to build capacity against bioterror or other threats, and facing high risk — either as extra money for states already getting awards, or as separate awards to eligible political subdivisions. The District of Columbia automatically counted as having a significant unmet need and high risk, because of how many nationally important sites are located there. (6) When making awards, the Secretary must make sure entities pass along appropriate shares of the money to political subdivisions and local health departments, agreed to through a local consensus process. (7) Any award money left unspent at the end of a fiscal year stays available to the entity the next year for the same purpose — but only if the entity is meeting its benchmarks and has submitted its pandemic flu plan as required by subsection (g). (i) Administrative and fiscal responsibility. (1) Each entity must send the Secretary yearly reports on its activities under this section and section 247d–3b, prepared with the health department, in a standardized format the Secretary sets. These reports must accurately describe the entity's activities, show exactly how money was spent and who received it, show how well the entity met its goals, show whether spending matched its application, and get published on a federal website as described in subsection (j). (2) At least once every two years, each entity must audit its own spending under this section, using an independent auditor following the Comptroller General's government auditing standards, and send the audit to the Secretary within 30 days of finishing it. If the Secretary finds — after notice and a hearing — that money was spent improperly, the entity must repay it; if it doesn't, the Secretary can subtract that amount from future funding or recover it another way. The Secretary can also withhold payments, after notice and a hearing, from any entity not using its money properly, until the Secretary is satisfied the problem is fixed and won't happen again. (j) Compilation and availability of data. The Secretary must gather the data entities submit and post it promptly on an appropriate website, in a public-friendly format that shows which activities are working best toward the outcome goals in subsection (g). (k) Evaluation. (1) Starting around two years after June 24, 2019, and every two years after, the Secretary must evaluate the benchmarks and standards from subsection (g), and submit that evaluation to Congress together with the National Health Security Strategy. (2) The evaluation must include: (A) a review of the benchmarks, standards, and how they're measured; (B) a discussion of any changes to them and how those changes affect tracking progress toward this section's goals and the broader National Health Security Strategy goals; (C) a description of how much money went to eligible entities and their subrecipients, and how that funding affected meeting the benchmarks; and (D) recommendations for improving the benchmarks so they better measure how well entities are achieving the goals of this section and section 300hh–1.

the actual law source: uscode.house.gov ↗public domain

(a) In general

To enhance the security of the United States with respect to public health emergencies, the Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall award cooperative agreements to eligible entities to enable such entities to conduct the activities described in subsection (d).

(b) Eligible entities

To be eligible to receive an award under subsection (a), an entity shall—

(1)

(A)

be a State;

(B)

be a political subdivision determined by the Secretary to be eligible for an award under this section (based on criteria described in subsection (h)(4)); or

(C)

be a consortium of States; and

(2)

prepare and submit to the Secretary an application at such time, and in such manner, and containing such information as the Secretary may require, including—

(A)

an All-Hazards Public Health Emergency Preparedness and Response Plan which shall include—

(i)

a description of the activities such entity will carry out under the agreement to meet the goals identified under section 300hh–1 of this title, including with respect to chemical, biological, radiological, or nuclear threats, whether naturally occurring, unintentional, or deliberate;

(ii)

a description of the activities such entity will carry out with respect to pandemic influenza, as a component of the activities carried out under clause (i), and consistent with the requirements of paragraphs (2) and (5) of subsection (g);

(iii)

preparedness and response strategies and capabilities that take into account the medical and public health needs of at-risk individuals in the event of a public health emergency;

(iv)

a description of the mechanism the entity will implement to utilize the Emergency Management Assistance 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 247d–7b of this title to improve enrollment and coordination of volunteer health care professionals seeking to provide medical services during a public health emergency, which may include—

(I)

providing a public method of communication for purposes of volunteer coordination (such as a phone number);

(II)

providing for optional registration to participate in volunteer services during processes related to State medical licensing, registration, or certification or renewal of such licensing, registration, or certification; or

(III)

other mechanisms as the State determines appropriate;

(v)

a description of how the entity will include the State Unit on Aging in public health emergency preparedness;

(vi)

a description of how, as appropriate, the entity may partner with relevant public and private stakeholders, including public health agencies with specific expertise that may be relevant to public health security, such as environmental health agencies, in public health emergency preparedness and response;

(vii)

a description of how, as applicable, such entity may integrate information to account for individuals with behavioral health needs during and following a public health emergency;

(viii)

a description of how the entity, as applicable and appropriate, will coordinate with State emergency preparedness and response plans in public health emergency preparedness, including State education agencies 1 (as defined in section 7801 of title 20), State child care lead agencies (designated under section 9858b of this title), and other relevant State agencies 2

(ix)

in the case of entities that operate on the United States-Mexico border or the United States-Canada border, a description of the activities such entity will carry out under the agreement that are specific to the border area including disease detection, identification, investigation, and preparedness and response activities related to emerging diseases and infectious disease outbreaks whether naturally occurring or due to bioterrorism, consistent with the requirements of this section;

(x)

a description of any activities that such entity will use to analyze real-time clinical specimens for pathogens of public health or bioterrorism significance, including any utilization of poison control centers;

(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;

(xii)

a description of how the entity will provide technical assistance to improve public health preparedness and response, as appropriate, to agencies or other entities that operate facilities within the entity’s jurisdiction in which there is an increased risk of infectious disease outbreaks in the event of a public health emergency declared under section 247d of this title, such as residential care facilities, group homes, and other similar settings; and

(xiii)

a description of how, as appropriate and practicable, 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;

(B)

an assurance that the entity will report to the Secretary on an annual basis (or more frequently as determined by the Secretary) on the evidence-based benchmarks and objective standards established by the Secretary to evaluate the preparedness and response capabilities of such entity under subsection (g);

(C)

an assurance that the entity will conduct, on at least an annual basis, an exercise or drill that meets any criteria established by the Secretary to test the preparedness and response capabilities of such entity, including addressing the needs of at-risk individuals, and that the entity will report back to the Secretary within the application of the following year on the strengths and weaknesses identified through such exercise or drill, and corrective actions taken to address material weaknesses;

(D)

an assurance that the entity will require relevant staff to complete relevant preparedness and response trainings, including trainings related to efficient and effective operation during an incident or event within an Incident Command System;

(E)

an assurance that the entity will provide to the Secretary the data described under section 247d–4(c)(3) of this title as determined feasible by the Secretary;

(F)

an assurance that the entity will conduct activities to inform and educate the hospitals within the jurisdiction of such entity on the role of such hospitals in the plan required under subparagraph (A);

(G)

an assurance that the entity, with respect to the plan described under subparagraph (A), has developed and will implement an accountability system to ensure that such entity makes satisfactory annual improvement and describes such system in the plan under subparagraph (A);

(H)

a description of the means by which to obtain public comment and input on the plan described in subparagraph (A) and on the implementation of such plan, that shall include an advisory committee or other similar mechanism for obtaining comment from the public and from other State, local, and tribal stakeholders; and

(I)

as relevant, a description of the process used by the entity to consult with local departments of public health to reach consensus, approval, or concurrence on the relative distribution of amounts received under this section.

Beginning in fiscal year 2009, the Secretary may not award a cooperative agreement to a State unless such State is a participant in the Emergency System for Advance Registration of Volunteer Health Professionals described in section 247d–7b of this title.

(d) Use of funds

(1) In general

An award under subsection (a) shall be expended for activities to achieve the preparedness goals described under paragraphs (1), (2), (4), (5), and (6) of section 300hh–1(b) of this title.

(2) Effect of section

Nothing in this subsection may be construed as establishing new regulatory authority or as modifying any existing regulatory authority.

(e) Coordination with local response capabilities

An entity shall, to the extent practicable, ensure that activities carried out under an award under subsection (a) are coordinated with activities of relevant Metropolitan Medical Response Systems, local public health departments, the Cities Readiness Initiative, local emergency plans, and any regional health care emergency preparedness and response system established pursuant to the applicable guidelines under section 247d–3c of this title.

(f) Consultation with Homeland Security

In making awards under subsection (a), the Secretary shall consult with the Secretary of Homeland Security to—

(1)

ensure maximum coordination of public health and medical preparedness and response activities with the Metropolitan Medical Response System, and other relevant activities;

(2)

minimize duplicative funding of programs and activities; and

(3)

analyze activities, including exercises and drills, conducted under this section to develop recommendations and guidance on best practices for such activities.

(g) Achievement of measurable evidence-based benchmarks and objective standards

(1) In general

Not later than 180 days after December 19, 2006, the Secretary shall develop or where appropriate adopt, and require the application of, measurable evidence-based benchmarks and objective standards that measure levels of preparedness with respect to the activities described in this section and with respect to activities described in section 247d–3b of this title. In developing such benchmarks and standards, the Secretary shall consult with and seek comments from State, local, and tribal officials and private entities, as appropriate. Where appropriate, the Secretary shall incorporate existing objective standards. Such benchmarks and standards shall—

(A)

include outcome goals representing operational achievements of the National Preparedness Goals developed under section 300hh–1(b) of this title with respect to all-hazards, including chemical, biological, radiological, or nuclear threats; and

(B)

at a minimum, require entities to—

(i)

measure progress toward achieving the outcome goals; and

(ii)

at least annually, test, exercise, and rigorously evaluate the public health and medical emergency preparedness and response capabilities of the entity, and report to the Secretary on such measured and tested capabilities and measured and tested progress toward achieving outcome goals, based on criteria established by the Secretary.

(2) Criteria for pandemic influenza plans

(A) In general

Not later than 180 days after December 19, 2006, the Secretary shall develop and disseminate to the chief executive officer of each State criteria for an effective State plan for responding to pandemic influenza. The Secretary shall periodically update, as necessary and appropriate, such pandemic influenza plan criteria and shall require the integration of such criteria into the benchmarks and standards described in paragraph (1).

(B) Rule of construction

Nothing in this section shall be construed to require the duplication of Federal efforts with respect to the development of criteria or standards, without regard to whether such efforts were carried out prior to or after December 19, 2006.3

(3) Technical assistance

The Secretary shall, as determined appropriate by the Secretary, provide to a State, upon request, technical assistance in meeting the requirements of this section, including the provision of advice by experts in the development of high-quality assessments, the setting of State objectives and assessment methods, the development of measures of satisfactory annual improvement that are valid and reliable, and other relevant areas.

(4) Notification of failures

The Secretary shall develop and implement a process to notify entities that are determined by the Secretary to have failed to meet the requirements of paragraph (1) or (2). Such process shall provide such entities with the opportunity to correct such noncompliance. An entity that fails to correct such noncompliance shall be subject to paragraph (5).

(5) Withholding of amounts from entities that fail to achieve benchmarks or submit influenza plan

Beginning with fiscal year 2019, and in each succeeding fiscal year, the Secretary shall—

(A)

withhold from each entity that has failed substantially to meet the benchmarks and performance measures described in paragraph (1) for either of the 2 immediately preceding fiscal years (beginning with fiscal year 2018), pursuant to the process developed under paragraph (4), the amount described in paragraph (6); and

(B)

withhold from each entity that has failed to submit to the Secretary a plan for responding to pandemic influenza that meets the criteria developed under paragraph (2), the amount described in paragraph (6).

(6) Amounts described

(A) In general

The amounts described in this paragraph are the following amounts that are payable to an entity for activities described in this section or section 247d–3b of this title:

(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.

(B) Separate accounting

Each failure described in subparagraph (A) or (B) of paragraph (5) shall be treated as a separate failure for purposes of calculating amounts withheld under subparagraph (A).

(7) Reallocation of amounts withheld

(A) In general

The Secretary shall make amounts withheld under paragraph (6) available for making awards under section 247d–3b of this title to entities described in subsection (b)(1) of such section.

(B) Preference in reallocation

In making awards under section 247d–3b of this title with amounts described in subparagraph (A), the Secretary shall give preference to eligible entities (as described in section 247d–3b(b)(1) of this title) that are located in whole or in part in States from which amounts have been withheld under paragraph (6).

(8) Waive or reduce withholding

The Secretary may waive or reduce the withholding described in paragraph (6), for a single entity or for all entities in a fiscal year, if the Secretary determines that mitigating conditions exist that justify the waiver or reduction.

(h) Funding

(1) Authorization of appropriations

(A) In general

For the purpose of carrying out this section, there is authorized to be appropriated $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)).

(B) Requirement for State matching funds

Beginning in fiscal year 2009, in the case of any State or consortium of two or more States, the Secretary may not award a cooperative agreement under this section unless the State or consortium of States agree that, with respect to the amount of the cooperative agreement awarded by the Secretary, the State or consortium of States will make available (directly or through donations from public or private entities) non-Federal contributions in an amount equal to—

(i)

for the first fiscal year of the cooperative agreement, not less than 5 percent of such costs ($1 for each $20 of Federal funds provided in the cooperative agreement); and

(ii)

for any second fiscal year of the cooperative agreement, and for any subsequent fiscal year of such cooperative agreement, not less than 10 percent of such costs ($1 for each $10 of Federal funds provided in the cooperative agreement).

As determined by the Secretary, non-Federal contributions required in subparagraph (B) may be provided directly or through donations from public or private entities and may be in cash or in kind, fairly evaluated, including plant, equipment or services. Amounts provided by the Federal government, or services assisted or subsidized to any significant extent by the Federal government, may not be included in determining the amount of such non-Federal contributions.

(2) Maintaining State funding

(A) In general

An entity that receives an award under this section shall maintain expenditures for public health security at a level that is not less than the average level of such expenditures maintained by the entity for the preceding 2 year period.

(B) Rule of construction

Nothing in this section shall be construed to prohibit the use of awards under this section to pay salary and related expenses of public health and other professionals employed by State, local, or tribal public health agencies who are carrying out activities supported by such awards (regardless of whether the primary assignment of such personnel is to carry out such activities).

(3) Determination of amount

(A) In general

The Secretary shall award cooperative agreements under subsection (a) to each State or consortium of 2 or more States that submits to the Secretary an application that meets the criteria of the Secretary for the receipt of such an award and that meets other implementation conditions established by the Secretary for such awards.

(B) Base amount

In determining the amount of an award pursuant to subparagraph (A) for a State, the Secretary shall first determine an amount the Secretary considers appropriate for the State (referred to in this paragraph as the “base amount”), except that such amount may not be greater than the minimum amount determined under subparagraph (D).

After determining the base amount for a State under subparagraph (B), the Secretary shall increase the base amount by an amount equal to the product of—

(i)

the amount appropriated under paragraph (1)(A) for the fiscal year, less an amount equal to the sum of all base amounts determined for the States under subparagraph (B), and less the amount, if any, reserved by the Secretary under paragraphs (4) and (5); and

(ii)

subject to paragraph (4)(C), the percentage constituted by the ratio of an amount equal to the population of the State over an amount equal to the total population of the States (as indicated by the most recent data collected by the Bureau of the Census).

(D) Minimum amount

Subject to the amount appropriated under paragraph (1)(A), an award pursuant to subparagraph (A) for a State shall be the greater of the base amount as increased under subparagraph (C), or the minimum amount under this subparagraph. The minimum amount under this subparagraph is—

(i)

in the case of each of the several States, the District of Columbia, and the Commonwealth of Puerto Rico, an amount equal to the lesser of—

(I)

$5,000,000; or

(II)

if the amount appropriated under paragraph (1)(A) is less than $667,000,000, an amount equal to 0.75 percent of the amount appropriated under such paragraph, less the amount, if any, reserved by the Secretary under paragraphs (4) and (5); or

(ii)

in the case of each of American Samoa, Guam, the Commonwealth of the Northern Mariana Islands, and the Virgin Islands, an amount determined by the Secretary to be appropriate, except that such amount may not exceed the amount determined under clause (i).

(4) Certain political subdivisions

(A) In general

For fiscal year 2007, the Secretary may, before making awards pursuant to paragraph (3) for such year, reserve from the amount appropriated under paragraph (1) for the year an amount determined necessary by the Secretary to make awards under subsection (a) to political subdivisions that have a substantial number of residents, have a substantial local infrastructure for responding to public health emergencies, and face a high degree of risk from bioterrorist attacks or other public health emergencies. Not more than three political subdivisions may receive awards pursuant to this subparagraph.

(B) Coordination with Statewide plans

An award pursuant to subparagraph (A) may not be made unless the application of the political subdivision involved is in coordination with, and consistent with, applicable Statewide plans described in subsection (b).

In the case of a State that will receive an award pursuant to paragraph (3), and in which there is located a political subdivision that will receive an award pursuant to subparagraph (A), the Secretary shall, in determining the amount under paragraph (3)(C) for the State, subtract from the population of the State an amount equal to the population of such political subdivision.

(D) Continuity of funding

In determining whether to make an award pursuant to subparagraph (A) to a political subdivision, the Secretary may consider, as a factor indicating that the award should be made, that the political subdivision received public health funding from the Secretary for fiscal year 2006.

(5) Significant unmet needs; degree of risk

(A) In general

(i)

have a significant need for funds to build capacity to identify, detect, monitor, and respond to a bioterrorist or other threat to the public health, which need will not be met by awards pursuant to paragraph (3); and

(ii)

face a particularly high degree of risk of such a threat.

(B) Recipients of grants

Awards pursuant to subparagraph (A) may be supplemental awards to States that receive awards pursuant to paragraph (3), or may be awards to eligible entities described in subsection (b)(1)(B) within such States.

The Secretary shall consider the District of Columbia to have a significant unmet need for purposes of subparagraph (A), and to face a particularly high degree of risk for such purposes, on the basis of the concentration of entities of national significance located within the District.

(6) Funding of local entities

The Secretary shall, in making awards under this section, ensure that with respect to the cooperative agreement awarded, the entity make available appropriate portions of such award to political subdivisions and local departments of public health through a process involving the consensus, approval or concurrence with such local entities.

(7) Availability of cooperative agreement funds

(A) In general

Amounts provided to an eligible entity under a cooperative agreement under subsection (a) for a fiscal year and remaining unobligated at the end of such year shall remain available to such entity for the next fiscal year for the purposes for which such funds were provided.

(B) Funds contingent on achieving benchmarks

The continued availability of funds under subparagraph (A) with respect to an entity shall be contingent upon such entity achieving the benchmarks and submitting the pandemic influenza plan as described in subsection (g).

(i) Administrative and fiscal responsibility

(1) Annual reporting requirements

Each entity shall prepare and submit to the Secretary annual reports on its activities under this section and section 247d–3b of this title. Each such report shall be prepared by, or in consultation with, the health department. In order to properly evaluate and compare the performance of different entities assisted under this section and section 247d–3b of this title and to assure the proper expenditure of funds under this section and section 247d–3b of this title, such reports shall be in such standardized form and contain such information as the Secretary determines and describes within 180 days of December 19, 2006 (after consultation with the States) to be necessary to—

(A)

secure an accurate description of those activities;

(B)

secure a complete record of the purposes for which funds were spent, and of the recipients of such funds;

(C)

describe the extent to which the entity has met the goals and objectives it set forth under this section or section 247d–3b of this title;

(D)

determine the extent to which funds were expended consistent with the entity’s application transmitted under this section or section 247d–3b of this title; and

(E)

publish such information on a Federal Internet website consistent with subsection (j).

(2) Audits; implementation

(A) In general

Each entity receiving funds under this section or section 247d–3b of this title shall, not less often than once every 2 years, audit its expenditures from amounts received under this section or section 247d–3b of this title. Such audits shall be conducted by an entity independent of the agency administering a program funded under this section or section 247d–3b of this title in accordance with the Comptroller General’s standards for auditing governmental organizations, programs, activities, and functions and generally accepted auditing standards. Within 30 days following the completion of each audit report, the entity shall submit a copy of that audit report to the Secretary.

(B) Repayment

Each entity shall repay to the United States amounts found by the Secretary, after notice and opportunity for a hearing to the entity, not to have been expended in accordance with this section or section 247d–3b of this title and, if such repayment is not made, the Secretary may offset such amounts against the amount of any allotment to which the entity is or may become entitled under this section or section 247d–3b of this title or may otherwise recover such amounts.

The Secretary may, after notice and opportunity for a hearing, withhold payment of funds to any entity which is not using its allotment under this section or section 247d–3b of this title in accordance with such section. The Secretary may withhold such funds until the Secretary finds that the reason for the withholding has been removed and there is reasonable assurance that it will not recur.

(j) Compilation and availability of data

The Secretary shall compile the data submitted under this section and make such data available in a timely manner on an appropriate Internet website in a format that is useful to the public and to other entities and that provides information on what activities are best contributing to the achievement of the outcome goals described in subsection (g).

(k) Evaluation

(1) In general

Not later than 2 years after June 24, 2019, and every 2 years thereafter, the Secretary shall conduct an evaluation of the evidence-based benchmarks and objective standards required under subsection (g). Such evaluation shall be submitted to the congressional committees of jurisdiction together with the National Health Security Strategy under section 300hh–1 of this title, 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 objective 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 300hh–1 of this title;

(C)

a description of amounts received by eligible entities described in subsection (b) and section 247d–3b(b) of this title, and amounts received by subrecipients and the effect of such funding on meeting evidence-based benchmarks and objective standards; and

(D)

recommendations, as applicable and appropriate, to improve evidence-based benchmarks and objective standards to more accurately assess the ability of entities receiving awards under this section to better achieve the goals under this section and section 300hh–1 of this title.

Source credit: (July 1, 1944, ch. 373, title III, § 319C–1, as added Pub. L. 107–188, title I, § 131(a), June 12, 2002, 116 Stat. 617; amended Pub. L. 109–417, title II, § 201, Dec. 19, 2006, 120 Stat. 2837; Pub. L. 113–5, title II, §§ 202(a), (c)(1), 204(b), Mar. 13, 2013, 127 Stat. 173, 175, 179; Pub. L. 114–95, title IX, § 9215(kkk)(1), Dec. 10, 2015, 129 Stat. 2187; Pub. L. 116–22, title II, §§ 201(a), 202(a), (b)(1), (d), 203(e)(1), 207(b), title VII, § 705(b), June 24, 2019, 133 Stat. 907–910, 914, 927, 964; Pub. L. 117–328, div. FF, title II, § 2111(a), Dec. 29, 2022, 136 Stat. 5720.)

history & why it existsrecord from the source credit

1944Enacted · Pub. L. 107-188 · 116 Stat. 617
2006Amended · Pub. L. 109-417 · 120 Stat. 2837
2013Amended · Pub. L. 113-5 · 127 Stat. 173, 175, 179
2015Amended · Pub. L. 114-95 · 129 Stat. 2187
2019Amended · Pub. L. 116-22 · 133 Stat. 907
2022Amended · Pub. L. 117-328 · 136 Stat. 5720

A history note hasn’t been published yet. The record shows enactment by Pub. L. 107-188 on 1944-07-01.

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