Broad health preparedness bill advances in Senate

Jul 19, 2006 (CIDRAP News) – A US Senate committee today approved a bill packed with a wide variety of provisions designed to improve the nation's ability to handle public health emergencies, including pandemic influenza.

The bipartisan "Pandemic and All-Hazards Preparedness Act" was unanimously approved by the Senate Health, Education, Labor and Pensions Committee, according to Laura Caudell, a spokeswoman for Sen. Richard Burr, R-N.C., the bill's author.

"We passed it unanimously this morning out of committee, and now it'll be put on the legislative calendar in the Senate," Caudell told CIDRAP News.

Among other things, the bill names the secretary of health and human services as the government's leader for health emergencies, requires states to meet preparedness standards and to share some of the cost of preparedness, seeks to coordinate and strengthen the nation's system of medical volunteers, and calls for tracking of influenza vaccine supplies so that doses reach high-risk groups.

The measure reauthorizes the Public Health Security and Bioterrorism Preparedness and Response Act of 2002, which was passed following the terrorist attacks of 2001. That law is set to expire at the end of September, according to a Jul 18 news release from Burr's office.

Burr, chairman of the Senate Subcommittee on Bioterrorism and Public Health Preparedness, said discussions with New Orleans health officials last week about Hurricane Katrina underscored for him the need for the legislation.

"Everyone I met agreed we must ensure our hospitals and health care facilities are better prepared to respond to a disaster," he said in the news release. "This legislation is a first step toward making sure our federal, state, and local governments and public and private health care systems have more tools to better manage an emergency be it a hurricane, a terrorist attack, or a pandemic."

The bill, introduced yesterday, is cosponsored by Sens. Mike Enzi, R-Wyo.; Tom Harkin, D-Iowa; and Ted Kennedy, D-Mass. Caudell said the sponsors consulted with the Bush administration in developing the legislation and that it has the administration's support.

Enzi, chair of the Senate committee that approved the bill today, said in a news release that the measure "would integrate local, state, and federal public health infrastructures and create a clear chain of command."

Burr's office cited five major objectives of the bill:

  • To "put someone in charge" by designating the HHS secretary as the lead official for responding to public health emergencies. Caudell said current law doesn't specifically assign that job to anyone.
  • To "speed up coordinated responses to medical emergencies" by improving training, logistics, and planning for healthcare providers and by promoting the use of "mobile medical assets and alternative federal facilities" for accommodating surges of patients.
  • To establish standards of preparedness for states. "The legislation requires individual states to meet performance standards developed by the Secretary of HHS to ensure all states have a basic level of preparedness for disasters," the release states.
  • To fund public health and medical preparedness. The bill authorizes $824 million for state and local preparedness and $474 million for hospital preparedness for fiscal year 2007, plus "such sums as may be necessary" for 2008 through 2011.
  • To create a system to promote, organize, train, and support healthcare volunteers for emergency response work.

Regarding funding, the legislation requires states to match federal preparedness grants at the 5% level starting in 2009. The states' share would increase to 10% and then 20% in the two following years.

To improve state accountability, the bill calls on HHS within 6 months to develop "measurable evidence-based benchmarks and objective standards that measure levels of preparedness." In addition, HHS is directed to provide the states with criteria for an effective plan for responding to pandemic influenza.

States that fail to meet standards or submit a pandemic response plan would lose 10% of their annual grant the first year. With continuing failures, the penalty would rise to 15%, 20%, and 25% in the second, third, and fourth years.

Concerning flu vaccine supplies, the legislation directs HHS "to track and facilitate the distribution" of vaccines so that supplies can go to high-priority groups. It does not suggest how this should be done. The information gathered by HHS for this purpose must remain confidential.

The legislation also calls for some changes in lines of responsibility for emergency response. In particular, it transfers the National Disaster Medical System from the Department of Homeland Security (DHS) back to HHS, where it was before the DHS was established in 2002.

In addition, the bill moves the management of the Strategic National Stockpile of drugs and medical supplies from the Centers for Disease Control and Prevention to the office of the HHS assistant secretary for public health emergency preparedness, according to Caudell. The name of the latter position would change to "assistant secretary for preparedness and response" under the bill.

Concerning medical volunteers, the legislation "codifies" the existing system of local Medical Reserve Corps teams and puts them under a director appointed by the HHS secretary. The bill sets standards for the composition of the corps and the training and certification of its members.

Also under the bill, HHS would tie existing state volunteer verification systems into a nationwide network of systems that could quickly verify volunteers' credentials in an emergency.

Sen. Enzi's news release cited two other provisions of the bill as important:

  • A clause promoting "public health situational awareness with a nationwide, near real-time network, built on existing surveillance systems, to detect and contain public health threats"
  • A provision for grants to people who agree to serve in a state or local public health department in an underserved area.

See also:

Jul 19 news release from Sen. Richard Burr

Jul 19 news release Sen. Mike Enzi
http://help.senate.gov/old_site/Maj_press/2006_07_19_a.pdf

Jul 18 news release from Sen. Burr

November 2002 CIDRAP News article on establishment of the DHS
http://www.cidrap.umn.edu/cidrap/content/bt/bioprep/news/homelnd.html

CDC information on the Strategic National Stockpile
http://www.bt.cdc.gov/stockpile/

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