[110th Congress Public Law 392]
[From the U.S. Government Printing Office]
[DOCID: f:publ392.110]
[[Page 122 STAT. 4195]]
Public Law 110-392
110th Congress
An Act
To amend the Public Health Service Act with respect to making progress
toward the goal of eliminating tuberculosis, and for other
purposes. <<NOTE: Oct. 13, 2008 - [H.R. 1532]>>
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress
assembled, <<NOTE: Comprehensive Tuberculosis Elimination Act of
2008.>>
SECTION 1. SHORT TITLE; <<NOTE: 42 USC 201 note.>> TABLE OF
CONTENTS.
(a) Short Title.--This Act may be cited as the ``Comprehensive
Tuberculosis Elimination Act of 2008''.
(b) Table of Contents.--The table of contents for this Act is as
follows:
Sec. 1. Short title; table of contents.
TITLE I--DEPARTMENT OF HEALTH AND HUMAN SERVICES IN COORDINATION WITH
THE CENTERS FOR DISEASE CONTROL AND PREVENTION AND OTHER APPROPRIATE
AGENCIES
Subtitle A--National Strategy for Combating and Eliminating Tuberculosis
Sec. 101. National strategy.
Subtitle B--Interagency Collaboration
Sec. 111. Advisory Council for Elimination of Tuberculosis and the
Federal Tuberculosis Task Force .
Subtitle C--Evaluation of Public Health Authorities
Sec. 121. Evaluation of public health authorities.
Subtitle D--Authorization of Appropriations
Sec. 131. Authorizations of appropriations.
TITLE II--NATIONAL INSTITUTES OF HEALTH
Sec. 201. Research and development concerning tuberculosis.
[[Page 122 STAT. 4196]]
TITLE I--DEPARTMENT OF HEALTH AND HUMAN SERVICES IN COORDINATION WITH
THE CENTERS FOR DISEASE CONTROL AND PREVENTION AND OTHER APPROPRIATE
AGENCIES
Subtitle A--National Strategy for Combating and Eliminating Tuberculosis
SEC. 101. NATIONAL STRATEGY.
Section 317E of the Public Health Service Act (42 U.S.C. 247b-6) is
amended--
(1) by striking the heading for the section and inserting
the following: ``national strategy for combating and eliminating
tuberculosis'';
(2) by amending subsection (b) to read as follows:
``(b) Research and Development; Demonstration Projects; Education
and Training.--With respect to the prevention, treatment, control, and
elimination of tuberculosis, the Secretary may, directly or through
grants to public or nonprofit private entities, carry out the following:
``(1) Research, with priority given to research and
development concerning latent tuberculosis infection, strains of
tuberculosis resistant to drugs, and research concerning cases
of tuberculosis that affect certain populations at risk for
tuberculosis.
``(2) Research and development and related activities to
develop new tools for the elimination of tuberculosis, including
drugs, diagnostics, vaccines, and public health interventions,
such as directly observed therapy and non-pharmaceutical
intervention, and methods to enhance detection and response to
outbreaks of tuberculosis, including multidrug resistant
tuberculosis. The Secretary is encouraged to give priority to
programmatically relevant research so that new tools can be
utilized in public health practice.
``(3) Demonstration projects for--
``(A) the development of regional capabilities to
prevent, control, and eliminate tuberculosis and prevent
multidrug resistant and extensively drug resistant
strains of tuberculosis;
``(B) the intensification of efforts to reduce
health disparities in the incidence of tuberculosis;
``(C) the intensification of efforts to control
tuberculosis along the United States-Mexico border and
among United States-Mexico binational populations,
including through expansion of the scope and number of
programs that--
``(i) detect and treat binational cases of
tuberculosis; and
``(ii) treat high-risk cases of tuberculosis
referred from Mexican health departments;
``(D) the intensification of efforts to prevent,
detect, and treat tuberculosis among foreign-born
persons who are in the United States;
[[Page 122 STAT. 4197]]
``(E) the intensification of efforts to prevent,
detect, and treat tuberculosis among populations and
settings documented as having a high risk for
tuberculosis; and
``(F) tuberculosis detection, control, and
prevention.
``(4) Public information and education activities.
``(5) Education, training, clinical skills improvement
activities, and workplace exposure prevention for health
professionals, including allied health personnel and emergency
response employees.
``(6) Support of Centers to carry out activities under
paragraphs (1) through (4).
``(7) Collaboration with international organizations and
foreign countries in carrying out such activities.
``(8) Develop, enhance, and expand information technologies
that support tuberculosis control including surveillance and
database management systems with cross-jurisdictional
capabilities, which shall conform to the standards and
implementation specifications for such information technologies
as recommended by the Secretary.''; and
(3) in subsection (d), by adding at the end the following:
``(3) Determination of amount of nonfederal contributions.--
``(A) Priority.--In awarding grants under subsection
(a) or (b), the Secretary shall give highest priority to
an applicant that provides assurances that the applicant
will contribute non-Federal funds to carry out
activities under this section, which may be provided
directly or through donations from public or private
entities and may be in cash or in kind, including
equipment or services.
``(B) Federal amounts not to be included as
contributions.--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 non-Federal
contributions as described in subparagraph (A).''.
Subtitle B--Interagency Collaboration
SEC. 111. ADVISORY COUNCIL FOR ELIMINATION OF TUBERCULOSIS AND THE
FEDERAL TUBERCULOSIS TASK FORCE.
(a) In General.--Section 317E(f) of the Public Health Service Act
(42 U.S.C. 247b-6(f)) is amended--
(1) by redesignating paragraph (5) as paragraph (6); and
(2) by striking paragraphs (2) through (4), and inserting
the following:
``(2) Duties.--The Council shall provide advice and
recommendations regarding the elimination of tuberculosis to the
Secretary. In addition, the Council shall, with respect to
eliminating such disease, provide to the Secretary and other
appropriate Federal officials advice on--
``(A) coordinating the activities of the Department
of Health and Human Services and other Federal agencies
that relate to the disease, including activities under
subsection (b);
``(B) responding rapidly and effectively to emerging
issues in tuberculosis; and
[[Page 122 STAT. 4198]]
``(C) efficiently utilizing the Federal resources
involved.
``(3) Comprehensive plan.--
``(A) In general.--In <<NOTE: Recommen-
dations.>> carrying out paragraph (2), the Council shall
make or update recommendations on the development,
revision, and implementation of a comprehensive plan to
eliminate tuberculosis in the United States.
``(B) Consultation.--In carrying out subparagraph
(A), the Council may consult with appropriate public and
private entities, which may, subject to the direction or
discretion of the Secretary, include--
``(i) individuals who are scientists,
physicians, laboratorians, and other health
professionals, who are not officers or employees
of the Federal Government and who represent the
disciplines relevant to tuberculosis elimination;
``(ii) members of public-private partnerships
or private entities established to address the
elimination of tuberculosis;
``(iii) members of national and international
nongovernmental organizations whose purpose is to
eliminate tuberculosis;
``(iv) members from the general public who are
knowledgeable with respect to tuberculosis
elimination including individuals who have or have
had tuberculosis; and
``(v) scientists, physicians, laboratorians,
and other health professionals who reside in a
foreign country with a substantial incidence or
prevalence of tuberculosis, and who represent the
specialties and disciplines relevant to the
research under consideration.
``(C) Certain components of plan.--In carrying out
subparagraph (A), the Council shall, subject to the
direction or discretion of the Secretary--
``(i) consider recommendations for the
involvement of the United States in continuing
global and cross-border tuberculosis control
activities in countries where a high incidence of
tuberculosis directly affects the United States;
and
``(ii) review the extent to which progress has
been made toward eliminating tuberculosis.
``(4) Biennial report.--
``(A) In general.--The Council shall submit a
biennial report to the Secretary, as determined
necessary by the Secretary, on the activities carried
under this section. Each such report shall include the
opinion of the Council on the extent to which its
recommendations regarding the elimination of
tuberculosis have been implemented, including with
respect to--
``(i) activities under subsection (b); and
``(ii) the national plan referred to in
paragraph (3).
``(B) Public.--The Secretary shall make a report
submitted under subparagraph (A) public.
``(5) Composition.--The Council shall be composed of--
``(A) ex officio representatives from the Centers
for Disease Control and Prevention, the National
Institutes of Health, the United States Agency for
International
[[Page 122 STAT. 4199]]
Development, the Agency for Healthcare Research and
Quality, the Health Resources and Services
Administration, the United States-Mexico Border Health
Commission, and other Federal departments and agencies
that carry out significant activities related to
tuberculosis;
``(B) State and local tuberculosis control and
public health officials;
``(C) individuals who are scientists, physicians,
laboratorians, and other health professionals who
represent disciplines relevant to tuberculosis
elimination; and
``(D) members of national and international
nongovernmental organizations established to address the
elimination of tuberculosis.''.
(b) Rule <<NOTE: 42 USC 247b-6 note.>> of Construction Regarding
Current Membership.--With respect to the advisory council under section
317E(f) of the Public Health Service Act, the amendments made by
subsection (a) may not be construed as terminating the membership on
such council of any individual serving as such a member as of the day
before the date of the enactment of this Act.
(c) Federal Tuberculosis Task Force.--Section 317E of the Public
Health Service Act (42 U.S.C. 247b-6) is amended--
(1) by redesignating subsection (g) as subsection (h); and
(2) by inserting after subsection (f) the following
subsection:
``(g) Federal Tuberculosis Task Force.--
``(1) Duties.--The Federal Tuberculosis Task Force (in this
subsection referred to as the `Task Force') shall provide to the
Secretary and other appropriate Federal officials advice on
research into new tools under subsection (b)(2), including
advice regarding the efficient utilization of the Federal
resources involved.
``(2) Comprehensive plan for new tools development.--In
carrying out <<NOTE: Recommen- dations.>> paragraph (1), the
Task Force shall make recommendations on the development of a
comprehensive plan for the creation of new tools for the
elimination of tuberculosis, including drugs, diagnostics, and
vaccines.
``(3) Consultation.--In developing the comprehensive plan
under paragraph (1), the Task Force shall consult with external
parties including representatives from groups such as--
``(A) scientists, physicians, laboratorians, and
other health professionals who represent the specialties
and disciplines relevant to the research under
consideration;
``(B) members from public-private partnerships,
private entities, or foundations (or both) engaged in
activities relevant to research under consideration;
``(C) members of national and international
nongovernmental organizations established to address
tuberculosis elimination;
``(D) members from the general public who are
knowledgeable with respect to tuberculosis including
individuals who have or have had tuberculosis; and
``(E) scientists, physicians, laboratorians, and
other health professionals who reside in a foreign
country with a substantial incidence or prevalence of
tuberculosis, and who represent the specialties and
disciplines relevant to the research under
consideration.''.
[[Page 122 STAT. 4200]]
Subtitle C--Evaluation of Public Health Authorities
SEC. 121. <<NOTE: 42 USC 264 note.>> EVALUATION OF PUBLIC HEALTH
AUTHORITIES.
(a) In General.--Not <<NOTE: Deadline. Reports.>> later than 180
days after the date of enactment of the Comprehensive Tuberculosis
Elimination Act of 2008, the Secretary of Health and Human Services
shall prepare and submit to the appropriate committees of Congress a
report that evaluates and provides recommendations on changes needed to
Federal and State public health authorities to address current disease
containment challenges such as isolation and quarantine.
(b) Contents of Evaluation.--The report described in subsection (a)
shall include--
(1) an evaluation of the effectiveness of current policies
to detain patients with active tuberculosis;
(2) an evaluation of whether Federal laws should be
strengthened to expressly address the movement of individuals
with active tuberculosis; and
(3) specific legislative recommendations for changes to
Federal laws, if any.
(c) Update of Quarantine Regulations.--Not <<NOTE: Deadline.>> later
than 240 days after the date of enactment of this Act, the Secretary of
Health and Human Services shall promulgate regulations to update the
current interstate and foreign quarantine regulations found in parts 70
and 71 of title 42, Code of Federal Regulations.
Subtitle D--Authorization of Appropriations
SEC. 131. AUTHORIZATIONS OF APPROPRIATIONS.
Section 317E of the Public Health Service Act, as amended by section
111(c) of this Act, is amended by striking subsection (h) and inserting
the following:
``(h) Authorization of Appropriations.--
``(1) General program.--
``(A) In general.--For the purpose of carrying out
this section, there are authorized to be appropriated
$200,000,000 for fiscal year 2009, $210,000,000 for
fiscal year 2010, $220,500,000 for fiscal year 2011,
$231,525,000 for fiscal year 2012, and $243,101,250 for
fiscal year 2013.
``(B) Reservation for emergency grants.--Of the
amounts appropriated under subparagraph (A) for a fiscal
year, the Secretary may reserve not more than 25 percent
for emergency grants under subsection (a) for any
geographic area, State, political subdivision of a
State, or other public entity in which there is,
relative to other areas, a substantial number of cases
of tuberculosis, multidrug resistant tuberculosis, or
extensively drug resistant tuberculosis or a substantial
rate of increase in such cases.
``(C) Priority.--In allocating amounts appropriated
under subparagraph (A), the Secretary shall give
priority to allocating such amounts for grants under
subsection (a).
[[Page 122 STAT. 4201]]
``(D) Allocation of funds.--
``(i) Requirement of formula.--Of the amounts
appropriated under subparagraph (A), not reserved
under subparagraph (B), and allocated by the
Secretary for grants under subsection (a), the
Secretary shall distribute a portion of such
amounts to grantees under subsection (a) on the
basis of a formula.
``(ii) Relevant factors.--The formula
developed by the Secretary under clause (i) shall
take into account the level of tuberculosis
morbidity and case complexity in the respective
geographic area and may consider other factors
relevant to tuberculosis in such area.
``(iii) No change to formula required.--This
subparagraph does not require the Secretary to
modify the formula that was used by the Secretary
to distribute funds to grantees under subsection
(a) for fiscal year 2009.
``(2) Limitation.--The authorization of appropriations
established in paragraph (1) for a fiscal year is effective only
if the amount appropriated under such paragraph for such year
equals or exceeds the amount appropriated to carry out this
section for fiscal year 2009.''.
TITLE II--NATIONAL INSTITUTES OF HEALTH
SEC. 201. RESEARCH AND DEVELOPMENT CONCERNING TUBERCULOSIS.
Subpart 2 of part C of title IV of the Public Health Service Act (42
U.S.C. 285b et seq.) is amended by inserting after section 424B the
following section:
``SEC. 424C. <<NOTE: 42 USC 285b-7c.>> TUBERCULOSIS.
``(a) In General.--The Director of the National Institutes of Health
may expand, intensify, and coordinate research and development and
related activities of the Institutes with respect to tuberculosis
including activities toward the goal of eliminating such disease.
``(b) Certain Activities.--Activities under subsection (a) may
include--
``(1) enhancing basic and clinical research on tuberculosis,
including drug resistant tuberculosis;
``(2) expanding research on the relationship between such
disease and the human immunodeficiency virus; and
``(3) developing new tools for the elimination of
tuberculosis, including public health interventions and methods
to enhance
[[Page 122 STAT. 4202]]
detection and response to outbreaks of tuberculosis, including
multidrug resistant tuberculosis.''.
Approved October 13, 2008.
LEGISLATIVE HISTORY--H.R. 1532 (S. 1551):
---------------------------------------------------------------------------
HOUSE REPORTS: No. 110-873 (Comm. on Energy and Commerce).
SENATE REPORTS: No. 110-329 accompanying S. 1551 (Comm. on Health,
Education, Labor, and Pensions).
CONGRESSIONAL RECORD, Vol. 154 (2008):
Sept. 23, 24, considered and passed House.
Sept. 27, considered and passed Senate.
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