All-Hazards Public Health Emergency and Bioterrorism Preparedness and Response Act

109th CONGRESS
2d Session

S. 3042

To amend the Public Health Service Act to improve preparedness for and response to bioterrorism and other public health emergencies, and for other purposes.

IN THE SENATE OF THE UNITED STATES

May 25, 2006

Mr. BAYH (for himself and Mr. SMITH) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions

A BILL

To amend the Public Health Service Act to improve preparedness for and response to bioterrorism and other public health emergencies, 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 `All-Hazards Public Health Emergency and Bioterrorism Preparedness and Response Act'.

TITLE I--ALL-HAZARDS PUBLIC HEALTH EMERGENCY AND BIOTERRORISM PREPAREDNESS AND RESPONSE

SEC. 101. NATIONAL NEEDS TO COMBAT THREATS TO PUBLIC HEALTH.

Section 319A(d) of the Public Health Service Act (42 U.S.C. 247d-1(d)) is amended to read as follows:

`(d) Authorization of Appropriations- There are authorized to be appropriated to carry out this section $5,000,000 for fiscal year 2007 and such sums as may be necessary for each subsequent fiscal year.'.

SEC. 102. ASSESSMENT OF PUBLIC HEALTH NEEDS.

Section 319B of the Public Health Service Act (42 U.S.C. 247d-2) is amended--

(1) in subsection (a), by inserting after the first sentence the following: `Such evaluation shall also include an assessment, using the assessment guidelines described under subsection (d), of each of the specific critical public health threats likely to occur in the State, or consortium of 2 or more States or political subdivision of States performing the evaluation, including threats resulting from natural disasters, outbreaks of disease, or a terrorist attack involving a biological, chemical, or nuclear agent, or catastrophic accident, and the capacity of such State, and localities within the State, or consortium of 2 or more States or political subdivisions of States, to respond to each such threat.';

(2) by striking subsection (e);

(3) by redesignating subsection (d) as subsection (e);

(4) by inserting after subsection (c) the following:

`(d) Assessment Guidelines-

`(1) IN GENERAL- Not later than 180 days after the date of enactment of the All-Hazards Public Health Emergency and Bioterrorism Preparedness and Response Act the Secretary shall establish guidelines for each recipient of a grant under subsection (a) to use to conduct the assessment required under such subsection. The Secretary shall ensure that such guidelines--

`(A) enable such recipient to--

`(i) assess the preparedness of such recipient, and all local jurisdictions within the boundaries of such recipient, as well as businesses, individuals, healthcare providers, and community organizations to respond to the threats described under subsection (a), consistent with the National Response Plan prepared under section 502(6) of the Homeland Security Act of 2002; and

`(ii) evaluate the progress and performance under a grant awarded under this section and section 319C-1 with respect to such preparedness;

`(B) are based on specific, reasonable preparedness goals that may be objectively measured;

`(C) define the responsibilities of the public health entities involved in preparedness and specifically describe the activities that are the responsibility of the Federal Government, the State and local public health authorities, healthcare providers, and other organizations, respectively, consistent with the National Response Plan prepared under section 502(6) of the Homeland Security Act of 2002;

`(D) to the extent practicable and applicable, are harmonized with the standards of the Health Resources and Services Administration and the Joint Commission on Accreditation of Healthcare Organizations; and

`(E) clearly describe a priority system with respect to preparedness activities.

`(2) ANNUAL REVIEW AND UPDATE-

`(A) REVIEW- The Secretary shall review the guidelines described under paragraph (1) on an annual basis.

`(B) UPDATE- Based on the review conducted under subparagraph (A), the Secretary may update the guidelines described under paragraph (1) as the Secretary determines necessary.

`(3) CONSULTATION- In developing and revising the guidelines under this subsection, the Secretary shall consult with State, local, and community public health organizations and expert individuals.'; and

(5) by inserting after subsection (e), as so redesignated, the following:

`(f) Authorization of Appropriations- There are authorized to be appropriated to carry out this section $75,000,000 for fiscal year 2007 and such sums as may be necessary for each subsequent fiscal year.'.

SEC. 103. GRANTS TO IMPROVE STATE, LOCAL, AND HOSPITAL ALL-HAZARDS PUBLIC HEALTH EMERGENCY AND BIOTERRORISM PREPAREDNESS AND RESPONSE.

(a) Additional Requirements- Section 319C-1(b) of the Public Health Service Act (42 U.S.C. 247d-3a(b)) is amended by adding at the end the following:

`(3) OTHER REQUIREMENTS-

`(A) APPLICATION CONTENT- An application under paragraph (1) shall include a letter from the Governor or chief elected official of the eligible entity involved that includes--

`(i) a description of the amount of any funds of the eligible entity involved (without regard to any Federal funds allocated to the eligible entity) allocated to carry out the activities described under the award under this section;

`(ii) includes assurance by the Governor or chief elected official of the eligible entity involved that the eligible entity will conduct periodic simulation exercises to test State and local public health emergency preparedness and, as appropriate, will test existing emergency systems and capacity in conjunction with response to ongoing public health challenges, such as seasonal influenza; and

`(iii) demonstrates understanding by the eligible entity involved of the performance standards that will be used to evaluate the use of the grant funds by such eligible entity under this section.

`(B) REPORT ON USE OF FUNDING- Not later than 60 days after the last day of each grant year in which an eligible entity described in subsection (b)(1)(A) has received amounts under an award under this section, such eligible entity shall submit to the Secretary a report that includes--

`(i) a detailed description of the use of the funds made available under such award, including the amounts made available directly for expenditure by local jurisdictions through a grant, contract, or other arrangement;

`(ii)(I) progress on the efforts to meet the performance standards described in the application under paragraph (1) and the assessment guidelines under section 319B(d);

`(II) an explanation of any failures to meet such performance standards or guidelines; and

`(III) the current capacity of the entity to meet such performance standards and guidelines;

`(iii) the findings of any simulation exercises conducted by the entity, or local jurisdiction within the boundaries of such entity, to test emergency preparedness, and the remediation steps taken or planned in response to such findings; and

`(iv) a detailed description of the State budget expenditures of the entity on public health emergency preparedness for the fiscal year that is the subject of the report.'.

(b) Accountability for Eligible Entities- Section 319C-1 of the Public Health Service Act (42 U.S.C. 247d-3a) is amended--

(1) by striking subsection (c) and inserting the following:

`(c) All-Hazards Public Health Emergency and Bioterrorism Preparedness and Response Plan-

`(1) IN GENERAL- Not later than 60 days after notification of receipt of an award under subsection (a), an eligible entity described in subsection (b)(1)(A) shall prepare and submit to the Secretary an All-Hazards Public Health Emergency and Bioterrorism Preparedness and Response Plan.

`(2) CONTENT OF PLAN- Recognizing the assessment of public health needs and threats conducted under section 319B, an All-Hazards Public Health Emergency and Bioterrorism Preparedness and Response Plan submitted to the Secretary under paragraph (1) shall--

`(A) include an assessment of basic preparedness for the threats described in section 319B(a), using the assessment guidelines established under section 319B(d);

`(B) describe the performance standards under subsection (i), which shall be used to measure the performance of the eligible entity described in subsection (b)(1)(A);

`(C) include a description of activities to be carried out by the eligible entity to address the needs and threats identified in such assessment (or an equivalent assessment);

`(D) include a description of any simulation exercises planned by the entity to test emergency preparedness;

`(E) include a description of the means by which the entity will provide support to, and coordinate with, local jurisdictions in planning and in conducting simulation exercises to test emergency preparedness, performance assessments, and other preparedness activities; and

`(F) include evidence that a majority of local jurisdictions with a majority of the population of the entity concur with the entity's plan.

`(3) APPROVAL OF PLAN PRIOR TO RECEIPT OF FUNDS-

`(A) IN GENERAL- The Secretary shall dispense only 50 percent of the amount of an award under this section for an eligible entity described in subsection (b)(1)(A) unless the Secretary has approved the All-Hazards Public Health Emergency and Bioterrorism Preparedness and Response Plan submitted under paragraph (1) by such entity.

`(B) MODIFICATION- The Secretary may require such entity to modify the All-Hazards Public Health Emergency and Bioterrorism Preparedness and Response Plan of such eligible entity prior to dispensing any amount of an award not dispensed under subparagraph (A).

`(C) APPROVAL OF PLAN- The Secretary shall ensure that the total amount of an award under this section is dispensed not later than 60 days after the date of approval by the Secretary of such All-Hazards Public Health Emergency and Bioterrorism Preparedness and Response Plan.';

(2) in subsection (e)(1)(A), by striking clause (i) and inserting the following:

`(i) Bioterrorism, acute outbreaks of infectious diseases, or other threats identified in an assessment of public health needs pursuant to section 319B(a).';

(3) by redesignating subsections (i) and (j) as subsections (l) and (m), respectively; and

(4) by inserting after subsection (h) the following:

`(i) Performance Standards-

`(1) IN GENERAL-

`(A) ESTABLISHMENT- Not later than 180 days after the date of enactment of the All-Hazards Public Health Emergency and Bioterrorism Preparedness and Response Act, the Secretary shall establish measurable performance standards with respect to basic preparedness for the public health threats described under section 319B(a).

`(B) ANNUAL REVIEW- The Secretary shall review such performance standards on an annual basis, and revise such standards as necessary.

`(2) CONTENT- The Secretary shall ensure that such performance standards--

`(A) provide guidance to each eligible entity described in subsection (b)(1)(A) in evaluating the performance of such entity under a grant under this section;

`(B) include standards related to--

`(i) improving laboratory capacity;

`(ii) measuring the capacity of States and localities to distribute and administer medical resources from the Strategic National Stockpile during a public health emergency;

`(iii) measuring the adequacy of State and local plans to address the needs of special needs populations (including low-income individuals and families, disabled individuals, the homeless, individuals who do not speak English, and the elderly) during a public health emergency;

`(iv) measuring public health surge capacity including planning to assure the ability of the health care system to rapidly expand beyond normal services to meet the increased demand for qualified personnel, medical care, and public health services, which would include the ability to obtain additional resources as needed;

`(v) improving emergency risk communication plans, health information dissemination, and public participation and understanding;

`(vi) improving public health workforce training and recruitment;

`(vii) integrating public health preparedness with State and local emergency management plans;

`(viii) assuring coherent command and control authority at the State and local levels for emergency response; and

`(ix) any other issue as determined appropriate by the Secretary;

`(C) are based on specific, reasonable preparedness goals that may be objectively measured;

`(D) define the responsibilities of the public health entities involved in preparedness and specifically describe the activities that are the responsibility of the Federal Government, the State or local public health authority, healthcare providers, and other organizations, respectively, consistent with the National Response Plan prepared under section 502(6) of the Homeland Security Act of 2002;

`(E) to the extent practicable and applicable, are harmonized with the standards of the Health Resources and Services Administration and the Joint Commission on Accreditation of Healthcare Organizations; and

`(F) clearly describe a priority system with respect to preparedness activities.

`(3) CONSULTATION- In developing and revising the performance standards under this subsection, the Secretary shall consult with State, local, and community public health organizations and expert individuals.

`(j) Biennial Evaluation; Report-

`(1) IN GENERAL- Not later than September 30, 2008, and on a biennial basis thereafter, the Secretary--

`(A) shall conduct an evaluation of each eligible entity described in subsection (b)(1)(A) with respect to--

`(i) preparedness for the threats described under section 319B(a); and

`(ii) the progress and performance of such eligible entity under a grant awarded under this section;

`(B) shall include in such evaluation an assessment of the extent to which the eligible entity meets each performance standard established pursuant to subsection (i); and

`(C) may contract with an entity to conduct such evaluation.

`(2) REPORT- On a biennial basis, the Secretary shall publish by October 1, a report that describes the outcome of each evaluation conducted under paragraph (1).

`(3) DISSEMINATION TO THE PUBLIC- The Secretary shall make available to the public the report described under paragraph (2) to the extent that such availability does not threaten national security, as determined by the Secretary.

`(k) Working Group-

`(1) IN GENERAL- The Secretary shall convene a working group that shall develop successful means for the eligible entity described in subsection (b)(1)(A) to disseminate information regarding best practices of preparing for the threats described under section 319B(a) using the funding awarded under a grant under this section.

`(2) CONSULTATION- In convening the working group under paragraph (1), the Secretary may consult with national and local public health organizations, healthcare providers, and other stakeholders that have expertise in preparedness for bioterrorism and other public health emergencies.'.

(c) Funding- Section 319C-1(m) of the Public Health Service Act (42 U.S.C. 247d-3a(j)), as redesignated by subsection (b), is amended--

(1) in paragraph (1), by striking subparagraph (A) and (B) and inserting the following:

`(A) FISCAL YEAR 2007-

`(i) AUTHORIZATIONS- For the purpose of carrying out this section, there is authorized to be appropriated $1,700,000,000 for fiscal year 2007, of which--

`(I) $950,000,000 is authorized to be appropriated for awards pursuant to paragraph (3) (subject to the authority of the Secretary to make awards pursuant to paragraphs (4) and (5)); and

`(II) $750,000,000 is authorized to be appropriated--

`(aa) for awards under subsection (a) to States, notwithstanding the eligibility conditions under subsection (b), for the purpose of enhancing the preparedness of hospitals (including children's hospitals), clinics, health centers, and primary care facilities for bioterrorism and other public health emergencies; and

`(bb) for Federal, State, and local planning and administrative activities related to such purpose.

`(ii) CONTINGENT ADDITIONAL AUTHORIZATION- If a significant change in circumstances warrants an increase in the amount authorized to be appropriated under clause (i) for fiscal year 2007, there are authorized to be appropriated such sums as may be necessary for such year for carrying out this section, in addition to the amount authorized in clause (i).

`(B) FISCAL YEAR 2008- For the purpose of carrying out this section, there are authorized to be appropriated $1,800,000,000 for fiscal year 2008, of which--

`(i) $950,000,000 is authorized for awards described under subparagraph (A)(i)(I); and

`(ii) $850,000,000 is authorized to be appropriated for awards and activities described under subparagraph (A)(i)(II).

`(C) FISCAL YEAR 2009- For the purpose of carrying out this section, there are authorized to be appropriated $1,800,000,000 of which--

`(i) $950,000,000 is authorized for awards described under subparagraph (A)(i)(I); and

`(ii) $850,000,000 is authorized for awards described under subparagraph (A)(i)(II).

`(D) OTHER FISCAL YEARS- For the purpose of carrying out this section, there are authorized to be appropriated such sums as may be necessary for fiscal year 2010 and each fiscal year thereafter.';

(2) in paragraphs (3), (4), (5), and (6), by--

(A) striking `2003' each place it appears and inserting `2007'; and

(B) striking `2002' each place it appears and inserting `2006'; and

(3) by adding at the end the following:

`(7) OTHER FUNDING REQUIREMENTS-

`(A) WITHHOLDING OF FUNDS-

`(i) IN GENERAL- Beginning in fiscal year 2008, and each fiscal year thereafter, the Secretary may withhold distributions of funding under an award under this section if the Secretary determines--

`(I) that the eligible entity has not sufficiently met the guidelines under section 319B(d) and performance standards described in the application under subsection (b)(3) involved for the previous fiscal year and has not demonstrated that efforts to meet such guidelines and performance standards are in place;

`(II) that such eligible entity has expended such funding for the previous fiscal year on activities inconsistent with the applicable All-Hazards Public Health Emergency and Bioterrorism Preparedness and Response Plan.

`(ii) EXCEPTION- For purposes of applying clause (i), the Secretary may grant a waiver with respect to the designated activities described in clause (i)(II).

`(B) MAXIMUM CARRYOVER AMOUNT-

`(i) IN GENERAL- For each fiscal year, the Secretary shall determine the maximum percentage amount of an award under this section that an eligible entity may carryover to the succeeding fiscal year.

`(ii) AMOUNT EXCEEDED- For each fiscal year, if the percentage amount of an award under this section unexpended by an eligible entity exceeds the maximum percentage permitted by the Secretary under clause (i), the eligible entity shall return to the Secretary the portion of the unexpended amount that exceeds the maximum amount permitted to be carried over by the Secretary.

`(iii) ACTION BY SECRETARY- The Secretary shall redistribute any amount returned to the Secretary under clause (ii) to other eligible entities that demonstrate need and capacity to expend such funds appropriately within the next fiscal year, as determined by the Secretary.

`(iv) WAIVER- An eligible entity may apply to the Secretary for a waiver of the maximum percentage amount under clause (i). Such an application for a waiver shall include an explanation why such requirement should not apply to the eligible entity and the steps taken by such eligible entity to ensure that all funds under an award under this section will be expended appropriately.'.

(d) Conforming Amendments- Section 319C-1 of the Public Health Service Act (42 U.S.C. 247d-3a) is amended--

(1) in subsection (b)(1)(A)(iii)--

(A) in subclause (III), by striking the semicolon and inserting `; and';

(B) in subclause (IV), by striking `; and' and inserting `; or'; and

(2) by striking `Bioterrorism and Other Public Health Emergency Preparedness and Response Plan' each place it appears and inserting `All-Hazards Public Health Emergency and Bioterrorism Preparedness and Response Plan'.

SEC. 104. STUDY OF THE PUBLIC HEALTH EMERGENCY WORKFORCE.

(a) In General-

(1) STUDY- The Secretary of Health and Human Services shall conduct a study that analyzes the size and scope of the healthcare and public health workforces necessary to respond to a range of common public health issues and public health emergencies.

(2) REPORT TO CONGRESS- Not later than 270 days after the date of enactment of this Act, the Secretary of Health and Human Services shall submit to Congress a report that describes the outcomes of the study conducted pursuant to paragraph (1), including any recommendations for legislation.

(b) Authorization of Appropriations- There are authorized to be appropriated $1,000,000 to carry out this section.

SEC. 105. ASSISTANT SECRETARY FOR PUBLIC HEALTH.

(a) In General-

(1) PUBLIC HEALTH SERVICE- Title II of the Public Health Service Act (42 U.S.C. 202 et seq.) is amended by striking section 201 and inserting the following:

`ASSISTANT SECRETARY FOR PUBLIC HEALTH; PUBLIC HEALTH SERVICE

`Sec. 201. There is established within the Department of Health and Human Services the Office of the Assistant Secretary for Public Health. The Public Health Service in such Department shall be administered by the Assistant Secretary for Public Health under the supervision and direction of the Secretary.'.

(2) BIOTERRORISM AND OTHER PUBLIC HEALTH EMERGENCY PREPAREDNESS- Section 2811(a) of the Public Health Service Act (42 U.S.C. 300hh-11(a)) is amended--

(A) by amending the subsection heading to read as follows: `Assistant Secretary for Public Health';

(B) by amending paragraph (1) to read as follows:

`(1) IN GENERAL- The provisions of this title and all other public health preparedness functions of the Department of Health and Human Services shall be administered by the Assistant Secretary for Public Health under the supervision and direction of the Secretary.'; and

(C) in paragraph (2), by striking `Assistant Secretary for Public Health Emergency Preparedness' and inserting `Assistant Secretary for Public Health'.

(b) Conforming Amendments- The Public Health Service Act (42 U.S.C. 201 et seq.) is amended by--

(1) striking `Assistant Secretary for Health' each place it appears and inserting `Assistant Secretary for Public Health'; and

(2) striking `Assistant Secretary for Public Health Emergency Preparedness' each place it appears and inserting `Assistant Secretary for Public Health'.

(1) TRANSFER OF FUNCTIONS- There shall be transferred to the Office of the Assistant Secretary for Public Health established under section 201 of the Public Health Service Act (as amended by subsection (a)) the functions, personnel, assets, and obligations of the Assistant Secretary for Health and the Assistant Secretary for Public Health Emergency Preparedness under the Public Health Service Act (42 U.S.C. 202 et seq.) as in effect on the day before the date of enactment of this Act.

(2) REFERENCES- Any reference in any Federal law, Executive order, rule, regulation, or delegation of authority, or any document of or pertaining to the Assistant Secretary for Health or the Assistant Secretary for Public Health Emergency Preparedness under the Public Health Service Act (42 U.S.C. 202 et seq.) as in effect the day before the date of enactment of this Act, shall be deemed to be a reference to the Assistant Secretary for Public Health under section 201 of the Public Health Service Act (as amended by subsection (a)).

SEC. 106. REQUIREMENT OF PUBLIC HEALTH EMERGENCY CONTINGENCY PLANS.

Subtitle B of title XXVIII of the Public Health Service Act (42 U.S.C. 300hh-11 et seq.) is amended by adding at the end the following:

`SEC. 2812. BIOTERRORISM AND OTHER PUBLIC HEALTH EMERGENCY CONTINGENCY PLANS.

`Notwithstanding any other provision of this Act, beginning with fiscal year 2008, any entity that receives a grant under this Act to provide health-related services, or any other entity as the Secretary determines appropriate, shall, as a condition of receiving such a grant, provide assurance to the Secretary that such entity has a plan for operational continuity in the event of bioterrorism or other public health emergency.'.

SEC. 107. BIOTERRORISM AND PUBLIC HEALTH RESPONSE EMERGENCY FUND.

Subtitle B of title XXVIII of the Public Health Service Act (42 U.S.C. 300hh-11 et seq.), as amended by section 7, is further amended by adding at the end the following:

`SEC. 2813. BIOTERRORISM AND PUBLIC HEALTH RESPONSE EMERGENCY FUND.

`(a) In General- There is established a fund to provide short-term assistance to hospitals, federally qualified health centers, rural health clinics, public health laboratories, and other healthcare providers and other members of the public health workforce, as determined appropriate by the Secretary, in the event of bioterrorism or other public health emergency.

`(b) Authorization of Appropriations- There are authorized to be appropriated such sums as may be necessary to carry out this section for fiscal year 2007 and each subsequent fiscal year.'.

SEC. 108. AUTHORITY TO WAIVE STATE SHARE REQUIREMENTS AND TO ALLOW PRESUMPTIVE ELIGIBILITY FOR ANY CATEGORY OF ELIGIBLE INDIVIDUALS UNDER MEDICAID AND SCHIP DURING STATE EMERGENCIES.

Section 1135(b) of the Social Security Act (42 U.S.C. 1320b-5(b)) is amended--

(1) in paragraph (6), by striking `and' at the end;

(2) in paragraph (7)(C)(ii), by striking the period at the end and inserting a semicolon; and

(3) by inserting after paragraph (7)(C)(ii), the following new paragraphs:

`(8) the Federal matching rate being below 100 percent under title XIX or XXI for healthcare items and services furnished by a healthcare provider and administrative costs related to the furnishing of such items and services; and

`(9) providing for a period of presumptive eligibility under title XIX or XXI for any category of individuals eligible for medical assistance or child health assistance under such title (including under waiver authority).'.

TITLE II--PUBLIC HEALTH PREPAREDNESS WORKFORCE DEVELOPMENT

SEC. 201. PUBLIC HEALTH WORKFORCE SCHOLARSHIP AND LOAN REPAYMENT PROGRAM.

Part E of title VII of the Public Health Service Act (42 U.S.C. 294n et seq.) is amended by adding at the end the following:

`Subpart 3--Public Health Workforce Scholarship and Loan Repayment Program

`SEC. 780. PUBLIC HEALTH WORKFORCE SCHOLARSHIP PROGRAM.

`(a) Establishment- The Secretary shall establish the Public Health Workforce Scholarship Program (referred to in this section as the `Program') to assure an adequate supply of public health professionals to eliminate critical public health preparedness workforce shortages in Federal, State, local, and tribal public health agencies.

`(b) Eligibility- To be eligible to participate in the Program, an individual shall--

`(1) be accepted for enrollment, or be enrolled, as a full-time student--

`(A) in an accredited (as determined by the Secretary) educational institution in a State or territory; and

`(B) in a course of study or program, offered by such institution and approved by the Secretary, leading to a health professions degree (graduate, undergraduate, or associate) or certificate, which may include laboratory sciences, epidemiology, environmental health, health communications, health education and behavioral sciences, information sciences, or public administration;

`(2) be a United States citizen;

`(3) submit an application to the Secretary to participate in the Program; and

`(4) sign and submit to the Secretary, at the time of the submittal of such application, a written contract (described in subsection (d)) to serve, upon the completion of the course of study or program involved, for the applicable period of obligated service in the full-time employment of a Federal, State, local, or tribal public health agency.

`(c) Dissemination of Information-

`(1) APPLICATION AND CONTRACT FORMS- The Secretary shall disseminate application forms and contract forms to individuals desiring to participate in the Program. The Secretary shall include with such forms--

`(A) a fair summary of the rights and liabilities of an individual whose application is approved (and whose contract is accepted) by the Secretary, including in the summary a clear explanation of the damages to which the United States is entitled to recover in the case of the individual's breach of the contract; and

`(B) information relating to the service obligation and such other information as may be necessary for the individual to understand the individual's prospective participation in the Program.

`(2) INFORMATION FOR SCHOOLS- The Secretary shall distribute to health professions schools and other appropriate accredited academic institutions and relevant Federal, State, local, and tribal public health agencies, materials providing information on the Program and shall encourage such schools, institutions, and agencies to disseminate such materials to potentially eligible students.

`(3) UNDERSTANDABILITY AND TIMING- The application form, contract form, and all other information furnished by the Secretary under this section shall--

`(A) be written in a manner calculated to be understood by the average individual applying to participate in the Program; and

`(B) be made available by the Secretary on a date sufficiently early to ensure that such individuals have adequate time to carefully review and evaluate such forms and information.

`(d) Contract- The written contract (referred to in this section) between the Secretary and an individual shall contain--

`(1) an agreement on the part of the Secretary that the Secretary will provide the individual with a scholarship for a period of years (not to exceed 4 academic years) during which the individual shall pursue an approved course of study or program to prepare the individual to serve in the public health workforce;

`(2) an agreement on the part of the individual that the individual will--

`(A) maintain full-time enrollment in the approved course of study or program described in subsection (b)(1) until the individual completes that course of study or program;

`(B) while enrolled in the course of study or program, maintain an acceptable level of academic standing (as determined under regulations of the Secretary by the educational institution offering such course of study or program); and

`(C) immediately upon graduation, serve in the full-time employment of a Federal, State, local, or tribal public health agency in a position related to the course of study or program for which the contract was awarded for a period of time (referred to in this section as the `period of obligated service') equal to the greater of--

`(i) 1 year for each academic year for which the individual was provided a scholarship under the Program; or

`(ii) 2 years;

`(3) an agreement by both parties as to the nature and extent of the scholarship assistance, which may include--

`(A) payment of the tuition expenses of the individual;

`(B) payment of all other reasonable educational expenses of the individual including fees, books, equipment and laboratory expenses; and

`(C) payment of a stipend of not more than $1,200 per month for each month of the academic year involved (indexed to account for increases in the Consumer Price Index); and

`(4) a provision that any financial obligation of the United States arising out of a contract entered into under this section and any obligation of the individual which is conditioned thereon, is contingent upon funds being appropriated for scholarships under this section;

`(5) a statement of the damages to which the United States is entitled for the individual's breach of the contract; and

`(6) such other statements of the rights and liabilities of the Secretary and of the individual, not inconsistent with the provisions of this section.

`(e) Postponing Obligated Service- With respect to an individual receiving a degree or certificate from a school of medicine, public health, nursing, osteopathic medicine, dentistry, veterinary medicine, optometry, podiatry, pharmacy, psychology, or social work under a scholarship under the Program, the date of the initiation of the period of obligated service may be postponed, upon the submission by the individual of a petition for such postponement and approval by the Secretary, to the date on which the individual completes an approved internship, residency, or other relevant public health preparedness advanced training program.

`(f) Administrative Provisions-

`(1) CONTRACTS WITH INSTITUTIONS- The Secretary may contract with an educational institution in which a participant in the Program is enrolled, for the payment to the educational institution of the amounts of tuition and other reasonable educational expenses described in subsection (d)(3).

`(2) EMPLOYMENT CEILINGS- Notwithstanding any other provision of law, individuals who have entered into written contracts with the Secretary under this section, while undergoing academic training, shall not be counted against any employment ceiling affecting the Department or any other Federal agency.

`(g) Breach of Contract- An individual who fails to comply with the contract entered into under subsection (d) shall be subject to the same financial penalties as provided for under section 338E for breaches of scholarship contracts under sections 338A.

`SEC. 781. PUBLIC HEALTH WORKFORCE LOAN REPAYMENT PROGRAM.

`(a) Establishment- The Secretary shall establish the Public Health Workforce Loan Repayment Program (referred to in this section as the `Program') to assure an adequate supply of public health professionals to eliminate critical public health preparedness workforce shortages in Federal, State, local, and tribal public health agencies.

`(b) Eligibility- To be eligible to participate in the Program, an individual shall--

`(1)(A) be accepted for enrollment, or be enrolled, as a full-time or part-time student in an accredited academic educational institution in a State or territory in the final year of a course of study or program offered by that institution leading to a health professions degree or certificate, which may include a degree (graduate, undergraduate, or associate) or certificate relating to laboratory sciences, epidemiology, environmental health, health communications, health education and behavioral sciences, information sciences, or public administration; or

`(B) have graduated, within 10 years, from an accredited educational institution in a State or territory and received a health professions degree (graduate, undergraduate, or associate) or certificate, which may include a degree (graduate, undergraduate, or associate) or certificate relating to laboratory sciences, epidemiology, environmental health, health communications, health education and behavioral sciences, information sciences, or public administration;

`(2)(A) in the case of an individual described in paragraph (1)(A), have accepted employment with a Federal, State, local, or tribal public health agency, as recognized by the Secretary, to commence upon graduation; or

`(B) in the case of an individual described in paragraph (1)(B), be employed by, or have accepted employment with, a Federal, State, local, or tribal public health agency, as recognized by the Secretary;

`(3) be a United States citizen;

`(4) submit an application to the Secretary to participate in the Program; and

`(5) sign and submit to the Secretary, at the time of the submittal of such application, a written contract (described in subsection (d)) to serve for the applicable period of obligated service in the full-time employment of a Federal, State, local, or tribal public health agency.

`(c) Dissemination of Information-

`(B) information relating to the service obligation and such other information as may be necessary for the individual to understand the individual's prospective participation in the Program.

`(3) UNDERSTANDABILITY AND TIMING- The application form, contract form, and all other information furnished by the Secretary under this section shall--

`(A) be written in a manner calculated to be understood by the average individual applying to participate in the Program; and

`(B) be made available by the Secretary on a date sufficiently early to ensure that such individuals have adequate time to carefully review and evaluate such forms and information.

`(d) Contract- The written contract (referred to in this section) between the Secretary and an individual shall contain--

`(1) an agreement on the part of the Secretary that the Secretary will repay on behalf of the individual loans incurred by the individual in the pursuit of the relevant public health preparedness workforce educational degree or certificate in accordance with the terms of the contract;

`(2) an agreement on the part of the individual that the individual will serve, immediately upon graduation in the case of an individual described in subsection (b)(1)(A) service, or in the case of an individual described in subsection (b)(1)(B) continue to serve, in the full-time employment of a Federal, State, local, or tribal public health agency in a position related to the course of study or program for which the contract was awarded for a period of time (referred to in this section as the `period of obligated service') equal to the greater of--

`(A) 3 years; or

`(B) such longer period of time as determined appropriate by the Secretary and the individual;

`(3) an agreement, as appropriate, on the part of the individual to relocate for the entire period of obligated service to a political jurisdiction designated by the Secretary to be a priority service area in exchange for an additional loan repayment incentive amount that does not exceed 20 percent of the individual's eligible loan repayment award per academic year such that the total of the loan repayment and the incentive amount shall not exceed 1/3 of the eligible loan balance per year;

`(4) in the case of an individual described in subsection (b)(1)(A) who is in the final year of study and who has accepted employment with a Federal, State, local, or tribal public health agency upon graduation, an agreement on the part of the individual to complete the education or training, maintain an acceptable level of academic standing (as determined by the education institution offering the course of study or training), and agree to the period of obligated service;

`(5) a provision that any financial obligation of the United States arising out of a contract entered into under this section and any obligation of the individual that is conditioned thereon, is contingent on funds being appropriated for loan repayments under this section;

`(6) a statement of the damages to which the United States is entitled, under this section for the individual's breach of the contract; and

`(7) such other statements of the rights and liabilities of the Secretary and of the individual, not inconsistent with this section.

`(e) Payments-

`(1) IN GENERAL- A loan repayment provided for an individual under a written contract under the Program shall consist of payment, in accordance with paragraph (2), on behalf of the individual of the principal, interest, and related expenses on government and commercial loans received by the individual regarding the undergraduate or graduate education of the individual (or both), which loans were made for--

`(A) tuition expenses; or

`(B) all other reasonable educational expenses, including fees, books, and laboratory expenses, incurred by the individual.

`(2) PAYMENTS FOR YEARS SERVED-

`(A) IN GENERAL- For each year of obligated service that an individual contracts to serve under subsection (d) the Secretary may pay up to $35,000 on behalf of the individual for loans described in paragraph (1). With respect to participants under the Program whose total eligible loans are less than $105,000, the Secretary shall pay an amount that does not exceed 1/3 of the eligible loan balance for each year of obligated service of the individual.

`(B) REPAYMENT SCHEDULE- Any arrangement made by the Secretary for the making of loan repayments in accordance with this subsection shall provide that any repayments for a year of obligated service shall be made no later than the end of the fiscal year in which the individual completes such year of service.

`(3) TAX LIABILITY- For the purpose of providing reimbursements for tax liability resulting from payments under paragraph (2) on behalf of an individual--

`(A) the Secretary shall, in addition to such payments, make payments to the individual in an amount not to exceed 39 percent of the total amount of loan repayments made for the taxable year involved; and

`(B) may make such additional payments as the Secretary determines to be appropriate with respect to such purpose.

`(4) PAYMENT SCHEDULE- The Secretary may enter into an agreement with the holder of any loan for which payments are made under the Program to establish a schedule for the making of such payments.

`(f) Postponing Obligated Service- With respect to an individual receiving a degree or certificate from a school of medicine, public health, nursing, osteopathic medicine, dentistry, veterinary medicine, optometry, podiatry, pharmacy, psychology, or social work, the date of the initiation of the period of obligated service may be postponed, upon the submission by the individual of a petition for such postponement and approval by the Secretary, to the date on which the individual completes an approved internship, residency, or other relevant public health preparedness advanced training program.

`(g) Administrative Provisions-

`(1) HIRING PRIORITY- Notwithstanding any other provision of law, Federal, State, local, and tribal public health agencies may give hiring priority to any individual who has qualified for and is willing to execute a contract to participate in the Program.

`(2) EMPLOYMENT CEILINGS- Notwithstanding any other provision of law, individuals who have entered into written contracts with the Secretary under this section, who are serving as full-time employees of a State, local, or tribal public health agency, or who are in the last year of public health workforce academic preparation, shall not be counted against any employment ceiling affecting the Department or any other Federal agency.

`(h) Breach of Contract- An individual who fails to comply with the contract entered into under subsection (d) shall be subject to the same financial penalties as provided for under section 338E for breaches of loan repayment contracts under section 338B.

`SEC. 782. GRANTS FOR STATE AND LOCAL PROGRAMS.

`(a) In General- For the purpose of operating State, local, and tribal public health workforce loan repayment programs, the Secretary shall award a grant to any public health agency that receives public health preparedness cooperative agreements, or other successor cooperative agreements, from the Department of Health and Human Services.

`(b) Requirements- A State or local loan repayment program operated with a grant under subsection (a) shall incorporate all provisions of the Public Health Workforce Loan Repayment Program under section 781, including the ability to designate priority service areas within the relevant political jurisdiction.

`(c) Administration- The head of the State or local office that receives a grant under subsection (a) shall be responsible for contracting and operating the loan repayment program under the grant.

`(d) Rule of Construction- Nothing in this section shall be construed to obligate or limit any State, local, or tribal government entity from implementing independent or supplemental public health workforce development programs within their borders.

`SEC. 783. CATALOGUE OF FEDERAL PUBLIC HEALTH WORKFORCE EMPLOYMENT OPPORTUNITIES.

`(a) In General- The Director of the Office of Personnel Management, in cooperation with the Secretary, shall ensure that within the Office of Personnel Management's website, there is an on-line catalogue of public health workforce employment opportunities in the Federal Government.

`(b) Requirements- To the extent practical, the catalogue described in subsection (a) shall include--

`(1) existing and projected job openings in the Federal public health workforce; and

`(2) a general discussion of the occupations that comprise the Federal public health workforce.

`(c) Information- The Secretary shall include a copy of the catalogue, or a prominent reference to the catalogue, in--

`(1) the information for schools provided under section 780(c)(2) and 781(c)(2); and

`(2) the application forms provided under sections 780(c)(1) and 781(c)(1).

`SEC. 784. AUTHORIZATION OF APPROPRIATIONS.

`(a) Scholarship Program- For the purpose of carrying out section 780, there is authorized to be appropriated $35,000,000 for fiscal year 2006, and such sums as may be necessary for each of fiscal years 2007 through 2011.

`(b) Loan Repayment Programs-

`(1) IN GENERAL- For the purpose of carrying out sections 781 and 782, there is authorized to be appropriated $195,000,000 for fiscal year 2006, and such sums as may be necessary for each of fiscal years 2007 through 2011.

`(2) ALLOCATION- Not less than 80 percent of the amount appropriated under paragraph (1) in each fiscal year shall be made available to carry out section 782.

`SEC. 785. SEVERABILITY.

`If any provision of this subpart, or the application of such provision to any person or circumstance, is held to be unconstitutional, the remainder of this subpart and the application of the provisions of this subpart to any person or circumstance shall not be affected thereby.'.

END