IN THE SENATE OF THE UNITED STATES
June 22, 2011
Mr. Bingaman (for himself and Mrs. Hutchison) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions
To establish grant programs to improve the health of border area residents and for all hazards preparedness in the border area including bioterrorism and infectious disease, and for other purposes.
This Act may be cited as the
Border Health Security Act of
Congress makes the following findings:
The United States-Mexico border is an interdependent and dynamic region of 14,538,209 people with significant and unique public health challenges.
These challenges include low rates of health insurance coverage, poor access to health care services, and high rates of dangerous diseases, such as tuberculosis, diabetes, and obesity.
As the 2009 novel influenza A (H1N1) outbreak illustrates, diseases do not respect international boundaries, therefore, a strong public health effort at and along the U.S.-Mexico border is crucial to not only protect and improve the health of Americans but also to help secure the country against biosecurity threats.
For 11 years, the United States-Mexico Border Health Commission has served as a crucial bi-national institution to address these unique and truly cross-border health issues.
Two initiatives resulting from the United States-Mexico Border Health Commission’s work speak to the importance of an infrastructure that facilitates cross-border communication at the ground level. First, the Early Warning Infectious Disease Surveillance (EWIDS), started in 2004, surveys infectious diseases passing among border States allowing for early detection and intervention. Second, the Ventanillas de Salud program, allows Mexican consulates, in collaboration with United States nonprofit health organizations, to provide information and education to Mexican citizens living and working in the United States through a combination of Mexican state funds and private grants. This program reaches an estimated 1,500,000 people in the United States.
As the United States-Mexico Border Health Commission enters its second decade, and as these issues grow in number and complexity, the Commission requires additional resources and modifications which will allow it to provide stronger leadership to optimize health and quality of life along the United States-Mexico border.
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—
in section 3—
in paragraph (1),
and at the end;
in paragraph (2),
by striking the period and inserting
; and; and
by adding at the end the following:
to serve as an independent and objective body to both recommend and implement initiatives that solve border health issues
in section 5—
(b), by striking
should be the leader and inserting
be the Chair; and
by adding at the end the following:
Providing advice and recommendations to Congress
A member of the Commission may at any time provide advice or recommendations to Congress concerning issues that are considered by the Commission. Such advice or recommendations may be provided whether or not a request for such is made by a member of Congress and regardless of whether the member or individual is authorized to provide such advice or recommendations by the Commission or any other Federal official.
by redesignating section 8 as section 13;
by striking section 7 and inserting the following:
Border health grants
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, 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 border area.
From amounts appropriated under section 12, the Secretary, acting through the Commissioners, shall award grants to eligible entities to address priorities and recommendations outlined by the Commission’s Strategic and Operational Plans, as authorized under section 9, to improve the health of border area residents.
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.
Use of funds
An eligible entity that receives a grant under subsection (b) shall use the grant funds for—
programs relating to—
maternal and child health;
primary care and preventative health;
infectious disease testing and monitoring;
public health and public health infrastructure;
behavioral and mental health;
health conditions that have a high prevalence in the border area;
medical and health services research;
workforce training and development;
community health workers or promotoras;
health care infrastructure problems in the border area (including planning and construction grants);
health disparities in the border area;
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 and 1397aa));
health research with an emphasis on infectious disease;
epidemiology and health research;
cross-border health surveillance coordinated with Mexican Health Authorities;
obesity, particularly childhood obesity;
crisis communication, domestic violence, substance abuse, health literacy, and cancer; or
community-based participatory research on border health issues; or
other programs determined appropriate by the Secretary.
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).
Grants for Early Warning Infectious Disease Surveillance (EWIDS) projects in the border area
Eligible entity defined
In this section, the term eligible entity means a State, local government, Indian tribe, tribal organization, urban Indian organization, trauma centers, regional trauma center coordinating entity, or public health entity.
From funds appropriated under section 12, the Secretary shall award grants under the Early Warning Infectious Disease Surveillance (EWIDS) project to eligible entities for infectious disease surveillance activities in the border area.
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.
Uses of funds
An eligible entity that receives a grant under subsection (b) shall use the grant funds to, in coordination with State and local all hazards programs—
develop and implement infectious disease surveillance plans and readiness assessments and purchase items necessary for such plans;
coordinate infectious disease surveillance planning in the region with appropriate United States-based agencies and organizations as well as appropriate authorities in Mexico or Canada;
improve infrastructure, including surge capacity, syndromic surveillance, laboratory capacity, and isolation/decontamination capacity;
create a health alert network, including risk communication and information dissemination;
educate and train clinicians, epidemiologists, laboratories, and emergency personnel;
implement electronic data systems to coordinate the triage, transportation, and treatment of multi-casualty incident victims;
provide infectious disease testing in the border area; and
carry out such other activities identified by the Secretary, the United States-Mexico Border Health Commission, State and local public health offices, and border health offices at the United States-Mexico or United States-Canada borders.
Plans, reports, audits, and by-laws
Not later than 5 years after the date of enactment of this section, and every 5 years thereafter, the Commission (including the participation of members of both the United States and Mexican sections) shall prepare a binational strategic plan to guide the operations of the Commission and submit such plan to the Secretary and Congress (and the Mexican legislature).
The binational strategic plan under paragraph (1) shall include—
health-related priority areas determined most important by the full membership of the Commission;
recommendations for goals, objectives, strategies and actions designed to address such priority areas; and
a proposed evaluation framework with output and outcome indicators appropriate to gauge progress toward meeting the objectives and priorities of the Commission.
Not later than January 1, 2012, and every other January 1 thereafter, the Commission shall develop and approve an operational work plan and budget based on the strategic plan under subsection (a). At the end of each such work plan cycle, the Government Accountability Office shall conduct an evaluation of the activities conducted by the Commission based on output and outcome indicators included in the strategic plan. The evaluation shall include a request for written evaluations from the commissioners about barriers and facilitators to executing successfully the Commission work plan.
The Commission shall issue a biannual report to the Secretary which provides independent policy recommendations related to border health issues. Not later than 3 months following receipt of each such biannual report, the Secretary shall provide the report and any studies or other material produced independently by the Commission to Congress.
The Secretary shall annually prepare an audited financial report to account for all appropriated assets expended by the Commission to address both the strategic and operational work plans for the year involved.
Not less than 6 months after the date of enactment of this section, the Commission shall develop and approve bylaws to provide fully for compliance with the requirements of this section.
Transmittal to congress
The Commission shall submit copies of the work plan and by-laws to Congress. The Government Accountability Office shall submit a copy of the evaluation to Congress.
Binational health infrastructure and health insurance
The Secretary shall enter into a contract with the Institute of Medicine for the conduct of a study concerning binational health infrastructure (including trauma and emergency care) and health insurance efforts. In conducting such study, the Institute shall solicit input from border health experts and health insurance issuers.
Not later than 1 year after the date on which the Secretary enters into the contract under subsection (a), the Institute of Medicine shall submit to the Secretary and the appropriate committees of Congress a report concerning the study conducted under such contract. Such report shall include the recommendations of the Institute on ways to establish, expand, or improve binational health infrastructure and health insurance efforts.
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, should be coordinated with Federal, State, and local authorities in Mexico and the United States.
Coordination of health services and surveillance
The Secretary may coordinate with the Secretary of Homeland Security in establishing a health alert system that—
alerts clinicians and public health officials of emerging disease clusters and syndromes along the border area; and
is alerted to signs of health threats, disasters of mass scale, or bioterrorism along the border area.
Authorization of appropriations
There is authorized to be appropriated to carry out this Act $31,000,000 for fiscal year 2012 and each succeeding year subject to the availability of appropriations for such purpose. Of the amount appropriated for each fiscal year, at least $1,000,000 shall be made available to fund operationally feasible functions and activities with respect to Mexico. The remaining funds shall be allocated for the administration of United States activities under this Act, border health activities under cooperative agreements with the border health offices of the States of California, Arizona, New Mexico, and Texas, the border health and EWIDS grant programs, and the Institute of Medicine and Government Accountability Office reports.
in section 13 (as so redesignated)—
by redesignating paragraphs (3) and (4) as paragraphs (4) and (5), respectively; and
by inserting after paragraph (2), the following:
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).