Sec. 2. Core public health infrastructure for State, territorial, local, and tribal health departments
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The Secretary of Health and Human Services (referred to in this Act as the Secretary ), acting through the Director of the Centers for Disease Control and Prevention, shall establish a core public health infrastructure program to strengthen the public health system of the United States, including the Nation's ability to respond to the COVID–19 pandemic, consisting of awarding grants under subsection (b). For the purpose of addressing core public health infrastructure needs, the Secretary— shall award a grant to each State or territorial health department, and to local health departments that serve 500,000 people or more; and shall award grants on a competitive basis to State, territorial, or local health departments.
Of the total amount of funds awarded as grants under this subsection for a fiscal year— not less than 50 percent shall be for grants to health departments under paragraph (1)(A); and not less than 30 percent shall be for grants to State, territorial, or local health departments under paragraph (1)(B). The Secretary may award a grant to an entity under subsection (b)(1) only if the entity agrees to use the full amount of the grant to address core public health infrastructure needs, including those identified in the accreditation process under subsection (h).
In making grants under subsection (b)(1)(A), the Secretary shall award funds to each health department in accordance with— a formula— based on population size, burden of preventable disease and disability, and poverty rate, with special consideration given to territories; and which, in the event of an award made during the public health emergency declared under section 319 of the Public Health Service Act ( 42 U.S.C. 247d ) in response to COVID–19, shall consider the COVID–19 burden of each jurisdiction; and application requirements established by the Secretary, including a requirement that the health department submit a plan by the end of year 1 of the grant that demonstrates to the satisfaction of the Secretary that the health department will— address its highest priority core public health infrastructure needs; in the case of such a plan submitted during the public health emergency described in paragraph (1)(B), identify the core public health infrastructure needs that are the highest priority for strengthening the response to COVID–19 and similar public health threats and other public health emergencies; and for State health departments, allocate at least 25 percent of the grant funds to local health departments within the State to support the local jurisdiction's contribution to core public health infrastructure.
In making grants under subsection (b)(1)(B), the Secretary shall give priority to applicants demonstrating core public health infrastructure needs for all public health agencies in the applicant's jurisdiction to be certified by the accreditation process under subsection (h), or for an entity for which a waiver has been received under subparagraph
(A)or
(B)of subsection (h)(2), that has otherwise demonstrated the applicant has core public health infrastructure needs for all public health agencies. The Secretary may make available a subset of the funds available for grants under subsection (b)(1) for purposes of awarding planning grants to health departments eligible to receive a grant under subsection (b)(1)(B). Recipients of such a planning grant may use such award to assess core public health infrastructure needs. The Secretary may award a grant to an entity under subsection
(b)only if the entity demonstrates to the satisfaction of the Secretary that— funds received through the grant will be expended only to supplement, and not supplant, non-Federal and Federal funds otherwise available to the entity for the purpose of addressing core public health infrastructure needs; and with respect to activities for which the grant is awarded, the entity will maintain expenditures of non-Federal amounts for such activities at a level not less than the level of such expenditures maintained by the entity for the fiscal year preceding the fiscal year for which the entity receives the grant. The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall— support continued development, and periodic review and updating of standards for accreditation of State, territorial, local, or tribal health departments for the purpose of advancing the quality and performance of such departments with an emphasis on core public health infrastructure; implement a program to accredit such health departments in accordance with such standards; and beginning in fiscal year 2025, ensure that any entity receiving a grant under subsection
(b)is accredited as described in subparagraph
(A)or meets another standard of accountability specific to public health infrastructure, subject to paragraph (2). The Secretary may waive the requirement under paragraph (1)(C) with respect to— any individual entity until fiscal year 2027; or after fiscal year 2027, any individual entity that demonstrates that it would be a significant hardship to comply with such requirement. The Secretary may enter into a cooperative agreement with a private nonprofit entity to carry out this subsection. 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 an annual report on progress being made to accredit entities under subsection (h). Such report shall include— a strategy, including goals and objectives, for accrediting entities under subsection
(h)and achieving the purpose described in subsection (h)(1); a list of funding recipients and the amounts received, including directly funded entities under subsection (b)(1), as well as local health departments that receive funding in accordance with subsection (d)(2)(C); data reported by grantees funded under this section pursuant to a minimum data set required by the Secretary, which shall include each grantee's activities, standardized financial reporting, and resource allocation data; and identification of gaps in research related to core public health infrastructure and recommendations of priority areas for such research. Of the amount appropriated under subsection
(a)for a fiscal year, the Secretary shall reserve 3 percent for purposes of, acting through the Director of the Centers for Disease Control and Prevention and in consultation with the Director of the Indian Health Service, awarding grants under this section to Tribal health departments and to epidemiology centers established under section 214 of the Indian Health Care Improvement Act ( 25 U.S.C. 1621m ).
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Sec. 2
Core public health infrastructure for State, territorial, local, and tribal health departments
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