42 U.S.C. § 247d–3a
Improving State and local public health security
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).
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.
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.
Nothing in this subsection may be construed as establishing new regulatory authority or as modifying any existing regulatory authority.
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.
Not later than 180 days after
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
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.
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).
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).
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.
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).
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.
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)).
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.
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.
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).
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.
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).
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.
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.
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.
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.
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.
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.
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).
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.
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.
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).
Not later than 2 years after
2022—Subsec. (b)(2)(A)(vii). Pub. L. 117–328, § 2111(a)(1)(A), inserted “during and” before “following a public health emergency”.
Subsec. (b)(2)(A)(viii). Pub. L. 117–328, § 2111(a)(1)(B), amended cl. (viii) generally. Prior to amendment, cl. (viii) read as follows: “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 educational agencies (as defined in section 7801 of title 20) and State child care lead agencies (designated under section 9858b of this title);”.
Subsec. (b)(2)(A)(xii), (xiii). Pub. L. 117–328, § 2111(a)(1)(C)–(E), added cl. (xii) and redesignated former cl. (xii) as (xiii).
Subsec. (b)(2)(D) to (I). Pub. L. 117–328, § 2111(a)(2), (3), added subpar. (D) and redesignated former subpars. (D) to (H) as (E) to (I), respectively.
2019—Subsec. (a). Pub. L. 116–22, § 202(a)(1), inserted “, acting through the Director of the Centers for Disease Control and Prevention,” after “the Secretary”.
Subsec. (b)(2)(A)(iv). Pub. L. 116–22, § 207(b), amended cl. (iv) generally. Prior to amendment, cl. (iv) read as follows: “a description of the mechanism the entity will implement to utilize the Emergency Management Assistance Compact or other mutual aid agreements for medical and public health mutual aid;”.
Subsec. (b)(2)(A)(vi). Pub. L. 116–22, § 202(a)(2)(A), inserted “, including public health agencies with specific expertise that may be relevant to public health security, such as environmental health agencies,” after “stakeholders”.
Subsec. (b)(2)(A)(vii) to (x). Pub. L. 116–22, § 202(a)(2)(B), (C), added cl. (vii) and redesignated former cls. (vii) to (ix) as (viii) to (x), respectively.
Subsec. (b)(2)(A)(xi), (xii). Pub. L. 116–22, § 202(a)(2)(D), (E), added cls. (xi) and (xii).
Subsec. (b)(2)(C). Pub. L. 116–22, § 705(b)(1), substituted “individuals,” for “individuals,,”.
Subsec. (b)(2)(F). Pub. L. 116–22, § 705(b)(2), substituted “makes satisfactory annual improvement and describes” for “make satisfactory annual improvement and describe”.
Subsec. (e). Pub. L. 116–22, § 203(e)(1), substituted “, 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.” for “, and local emergency plans.”
Subsec. (g)(5). Pub. L. 116–22, § 202(b)(1)(A)(i), substituted “Beginning with fiscal year 2019” for “Beginning with fiscal year 2009” in introductory provisions.
Subsec. (g)(5)(A). Pub. L. 116–22, § 202(b)(1)(A)(ii), substituted “for either of the 2 immediately preceding fiscal years” for “for the immediately preceding fiscal year” and “2018” for “2008”.
Subsec. (g)(6)(A). Pub. L. 116–22, § 202(b)(1)(B), amended subpar. (A) generally. Prior to amendment, subpar. (A) consisted of cls. (i) to (iv) describing amounts payable to an entity for the fiscal year immediately following one to four fiscal years in which the entity experienced a failure described in subsec. (g)(5)(A) or (B).
Subsec. (h)(1)(A). Pub. L. 116–22, § 202(d), substituted “$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)).” for “$641,900,000 for fiscal year 2014 for awards pursuant to paragraph (3) (subject to the authority of the Secretary to make awards pursuant to paragraphs (4) and (5)), and $641,900,000 for each of fiscal years 2015 through 2018.”
Subsec. (k). Pub. L. 116–22, § 201(a), added subsec. (k).
2015—Subsec. (b)(2)(A)(vii). Pub. L. 114–95 substituted “including State educational agencies (as defined in section 7801 of title 20)” for “including State educational agencies (as defined in section 7801(41) of title 20)”.
2013—Subsec. (b)(1)(B). Pub. L. 113–5, § 202(c)(1), substituted “subsection (h)(4)” for “subsection (i)(4)”.
Subsec. (b)(1)(C). Pub. L. 113–5, § 202(a)(1), substituted “consortium of States” for “consortium of entities described in subparagraph (A)”.
Subsec. (b)(2)(A)(i), (ii). Pub. L. 113–5, § 202(a)(2)(A)(i), added cls. (i) and (ii) and struck out former cls. (i) and (ii) which read as follows:
“(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;
“(ii) a pandemic influenza plan consistent with the requirements of paragraphs (2) and (5) of subsection (g);”.
Subsec. (b)(2)(A)(vi) to (ix). Pub. L. 113–5, § 202(a)(2)(A)(ii), (iii), added cls. (vi) to (ix).
Subsec. (b)(2)(C). Pub. L. 113–5, § 202(a)(2)(B), inserted “, including addressing the needs of at-risk individuals,” after “capabilities of such entity”.
Subsec. (b)(2)(D). Pub. L. 113–5, § 204(b), substituted “section 247d–4(c)(3)” for “section 247d–4(d)(3)”.
Subsec. (f)(2) to (4). Pub. L. 113–5, § 202(a)(3), inserted “and” at end of par. (2), substituted period for “; and” at end of par. (3), and struck out par. (4) which read as follows: “disseminate such recommendations and guidance, including through expanding existing lessons learned information systems to create a single Internet-based point of access for sharing and distributing medical and public health best practices and lessons learned from drills, exercises, disasters, and other emergencies.”
Subsec. (g)(1)(A). Pub. L. 113–5, § 202(a)(4)(A), added subpar. (A) and struck out former subpar. (A) which read as follows: “include outcome goals representing operational achievement of the National Preparedness Goals developed under section 300hh–1(b) of this title; and”.
Subsec. (g)(2)(A). Pub. L. 113–5, § 202(a)(4)(B), inserted at end “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).”
Subsec. (h). Pub. L. 113–5, § 202(a)(5), (6), redesignated subsec. (i) as (h) and struck out former subsec. (h) which related to grants for real-time disease detection improvement.
Subsec. (h)(1)(A). Pub. L. 113–5, § 202(a)(7)(A)(i), substituted “$641,900,000 for fiscal year 2014” for “$824,000,000 for fiscal year 2007, of which $35,000,000 shall be used to carry out subsection (h),” and “$641,900,000 for each of fiscal years 2015 through 2018” for “such sums as may be necessary for each of fiscal years 2008 through 2011”.
Subsec. (h)(1)(B) to (D). Pub. L. 113–5, § 202(a)(7)(A)(ii)–(iv), redesignated subpars. (C) and (D) as (B) and (C), respectively, substituted “subparagraph (B)” for “subparagraph (C)” in subpar. (C), and struck out former subpar. (B). Prior to amendment, text of subpar. (B) read as follows: “There are authorized to be appropriated, $10,000,000 for fiscal year 2007 to carry out subsection (f)(4) of this section and section 300hh–16 of this title.”
Subsec. (h)(3)(C), (D). Pub. L. 113–5, § 202(a)(7)(B), substituted “paragraph (1)(A)” for “paragraph (1)(A)(i)(I)” wherever appearing.
Subsec. (h)(4)(B). Pub. L. 113–5, § 202(a)(7)(C), substituted “subsection (b)” for “subsection (c)”.
Subsec. (h)(7). Pub. L. 113–5, § 202(a)(7)(D), added par. (7).
Subsec. (i). Pub. L. 113–5, § 202(a)(6), redesignated subsec. (j) as (i). Former subsec. (i) redesignated (h).
Subsec. (i)(1)(E). Pub. L. 113–5, § 202(a)(8)(A), substituted “subsection (j)” for “subsection (k)”.
Subsec. (i)(3). Pub. L. 113–5, § 202(a)(8)(B), struck out par. (3) which related to maximum amount of an award under this section that may be carried over to the succeeding fiscal year.
Subsecs. (j), (k). Pub. L. 113–5, § 202(a)(6), redesignated subsec. (k) as (j). Former subsec. (j) redesignated (i).
2006—Pub. L. 109–417, § 201(1), substituted “Improving State and local public health security” for “Grants to improve State, local, and hospital preparedness for and response to bioterrorism and other public health emergencies” in section catchline.
Subsecs. (a) to (h). Pub. L. 109–417, § 201(2), added subsecs. (a) to (h) and struck out former subsecs. (a) to (h) which related to grants to improve State, local, and hospital preparedness for and response to bioterrorism and other public health emergencies.
Subsec. (i). Pub. L. 109–417, § 201(3), redesignated subsec. (j) as (i).
Pub. L. 109–417, § 201(2), struck out subsec. (i) which defined “eligible entity”.
Subsec. (i)(1) to (3)(A). Pub. L. 109–417, § 201(4)(A), added pars. (1) to (3)(A) and struck out former pars. (1) to (3)(A) which related to appropriations for fiscal years 2003 through 2006, use of amounts to supplement and not supplant other funds, and conditions for receipt of award in fiscal year 2003.
Subsec. (i)(4)(A). Pub. L. 109–417, § 201(4)(B), substituted “fiscal year 2007” for “fiscal year 2003” and struck out “(A)(i)(I)” after “paragraph (1)”.
Subsec. (i)(4)(D). Pub. L. 109–417, § 201(4)(C), substituted “fiscal year 2006” for “fiscal year 2002”.
Subsec. (i)(5)(A). Pub. L. 109–417, § 201(4)(D), in introductory provisions, substituted “fiscal year 2007” for “fiscal year 2003” and struck out “(A)(i)(I)” after “paragraph (1)”.
Subsec. (i)(6). Pub. L. 109–417, § 201(4)(E), added par. (6) and struck out heading and text of former par. (6). Text read as follows: “For fiscal year 2003, the Secretary shall in making awards under this section ensure that appropriate portions of such awards are made available to political subdivisions, local departments of public health, hospitals (including children’s hospitals), clinics, health centers, or primary care facilities, or consortia of such entities.”
Subsec. (j). Pub. L. 109–417, § 201(5), added subsec. (j).
Pub. L. 109–417, § 201(3), redesignated subsec. (j) as (i).
Subsec. (k). Pub. L. 109–417, § 201(5), added subsec. (k).
Pub. L. 117–328, div. FF, title II, § 2111(b),
Pub. L. 116–22, title II, § 202(b)(2),
Amendment by Pub. L. 114–95 effective
Pub. L. 110–53, title XXII, § 2201(d),