42 U.S.C. § 247d–3b — Partnerships for State and regional hospital preparedness to improve surge capacity

(a) In general. The Secretary — acting through the Assistant Secretary for Preparedness and Response — must award competitive grants or cooperative agreements to eligible groups. The goal is to help them boost surge capacity and improve how communities and hospitals prepare for and respond to public health emergencies, as described in subsection (c), including, when appropriate, meeting the needs of children and other at-risk people. (b) Eligibility. A group can qualify for an award in one of two ways. First, it can be a coalition made up of: one or more hospitals (at least one must be a designated trauma center); one or more other local health facilities, like clinics, health centers, primary care facilities, mental health centers, mobile medical units, or nursing homes; one or more political subdivisions, states, or a mix of both; and one or more emergency medical service or emergency management organizations. This kind of coalition must prepare its application together with the state's or territory's top health officials and its Chief Executive Officer, and submit it as the Secretary requires. Second, a group can qualify by being an entity already eligible under section 247d–3a(b)(1) — meaning a state, an eligible political subdivision, or a group of states — and submitting an application with the same information required under section 247d–3a(b)(2), plus a promise to follow the Secretary's applicable guidelines. (c) Use of funds. Award money must go toward the preparedness goals in section 300hh–1(b) — specifically paragraphs (1), (3), (4), (5), and (6) — for all hazards, including chemical, biological, radiological, or nuclear threats. (d) Preferences. The Secretary gives priority to applications that: (1) improve coordination — among the coalition's hospitals and facilities, among facilities in a regional health care system under section 247d–3c, and between hospitals and other local facilities — and that include a large share of the hospitals and health facilities in their area; and (2) among other things, include hospitals that take part in the National Disaster Medical System, are located in a high-risk area (as decided with the Department of Homeland Security), or show a significant unmet need to meet the preparedness goals in section 300hh–1(b)(3). (e) Consistency of planned activities. The Secretary cannot give a cooperative agreement to a coalition unless its application matches the state's All-Hazards Public Health Emergency Preparedness and Response Plan and relevant local plans. (f) Limitation on awards. A political subdivision cannot be part of more than one coalition under this section. (g) Coordination. (1) As much as practical, a coalition must coordinate its funded work with local Metropolitan Medical Response Systems, local Medical Reserve Corps, the local Cities Readiness Initiative, and local emergency plans. (2) Coalitions can, when practical, work with other coalitions nationally to coordinate on the preparedness goals in section 300hh–1(b), paragraphs (1), (3), (4), (5), and (6). (h) Maintenance of funding. (1) An entity getting an award must keep spending on health care preparedness at least at the average level it spent over the prior two years. (2) This does not stop award money from paying salaries and expenses for public health and other professionals doing this work, even if it's not their only assignment. (i) Performance and accountability. (1) The reporting, review, data-publishing, and evaluation rules in subsections (g), (i), (j), and (k) of section 247d–3a apply to entities getting awards under this section the same way they apply under that section. In its reports, a coalition must describe its progress — or any obstacles — toward implementing section 247d–3c. A coalition made up of local groups (under subsection (b)(1)(A)) must share these reports with its state's top health official. (2) The Secretary must use clear, evidence-based measures to check, as much as practical, whether award recipients are meeting the goals of the National Health Security Strategy under section 300hh–1. (j) Authorization of appropriations. (1) Congress can spend $385,000,000 each year from 2019 through 2023 to carry out this section and section 247d–3c. Of that money, the Secretary can reserve up to 5% each year for section 247d–3c's regional systems — but if reserving that money would leave less for this section than was available the year before, the reserved amount is reduced so this section doesn't lose funding. This reservation power ended September 30, 2023. (2) Before making awards described in paragraph (3), the Secretary can set aside an appropriate amount for awards to hospital-and-facility coalitions described in subsection (b)(1)(A). (3) From what's left, the Secretary must make awards to states and political subdivisions described in subsection (b)(2)(A) that completed their applications; the award amount is calculated the same way as under section 247d–3a(h). (4) Any award money left unspent at the end of a fiscal year stays available for the entity the next year for the same purpose, but only if the entity is meeting its benchmarks and submitted its pandemic flu plan as required under subsection (i).