The Data Agenda

Saturday, January 19, 2013

Tuesday House Suspension Vote - International Biosurveillance

Tuesday the House is scheduled to vote on H.R. 307, the Pandemic and All-Hazards Preparedness Reauthorization Act of 2013.

Included in this bill is Section 204 on "Enhancing Situation Awareness and Biosurveillance" which requires the National Biodefense Science Board to "provide expert advice and guidance, including recommendations, regarding the measurable steps the Secretary should take" to "achieve a national biosurveillance system for human health, with international connectivity, where appropriate, that is predicated on State, regional, and community level capabilities and creates a networked system to allow for two-way information flow between and among Federal, State, and local government public health authorities and clinical health care providers."  (Full text of the section is below.)

If the purpose of this is to "achieve early warning and identification of such health threats," then an emergency is not required for implementing biosurveillance, and is, in fact, required when there is no public health emergency.

This bill came up in the 112th Congress: H.R. 2405, H.R. 6672, S. 1855.

In H.R. 2405, language on surveillance was struck out in the committee report.  The bill passed the House by voice vote December 6, 2011.  The only mention of biosurveillance was of crafting a plan at the end of Section 4, and little detail was given.

S. 1855 included the extensive language we see in H.R. 307 today.  The Senate passed the bill by unanimous consent on March 7, 2012.

H.R. 6672 included the same Section. 204 we see in H.R. 307.  It passed the House under suspension of the rules on December 19, 2012 by a vote of 383-16.

Suspension of the rules is where the House suspends its rules of regular order to vote up or down a bill with no option for amendment.  A two thirds majority is required for passage.  It is usually reserved for non-controversial bills and passage is usually expected.  Given H.R. 6672 passed easily last month, the same is surely expected for H.R. 307 on Tuesday's suspension calendar.

Conclusion: The House is scheduled to vote on legislation Tuesday that calls for international biosurveillance at all levels of government in the United States.  You might want to let the @GOPLeader and @GOPWhip know you want #NoInternationalBiosurveillance.


SEC. 204. ENHANCING SITUATIONAL AWARENESS AND BIOSURVEILLANCE.

    Section 319D of the Public Health Service Act (42 U.S.C. 247d-4) is amended--
      (1) in subsection (b)--
      (A) in paragraph (1)(B), by inserting `poison control centers,' after `hospitals,';
      (B) in paragraph (2), by inserting before the period at the end the following: `, allowing for coordination to maximize all-hazards medical and public health preparedness and response and to minimize duplication of effort'; and
      (C) in paragraph (3), by inserting before the period at the end the following: `and update such standards as necessary';
      (2) by striking subsection (c); and
      (3) in subsection (d)--
      (A) in the subsection heading, by striking `Public Health Situational Awareness' and inserting `Modernizing Public Health Situational Awareness and Biosurveillance';
      (B) in paragraph (1)--
      (i) by striking `Pandemic and All-Hazards Preparedness Act' and inserting `Pandemic and All-Hazards Preparedness Reauthorization Act of 2013'; and
      (ii) by inserting `, novel emerging threats,' after `disease outbreaks';
      (C) by striking paragraph (2) and inserting the following:
      `(2) STRATEGY AND IMPLEMENTATION PLAN- Not later than 180 days after the date of enactment of the Pandemic and All-Hazards Preparedness Reauthorization Act of 2013, the Secretary shall submit to the appropriate committees of Congress a coordinated strategy and an accompanying implementation plan that identifies and demonstrates the measurable steps the Secretary will carry out to--
      `(A) develop, implement, and evaluate the network described in paragraph (1), utilizing the elements described in paragraph (3);
      `(B) modernize and enhance biosurveillance activities; and
      `(C) improve information sharing, coordination, and communication among disparate biosurveillance systems supported by the Department of Health and Human Services.';
      (D) in paragraph (3)(D), by inserting `community health centers, health centers' after `poison control,';
      (E) in paragraph (5), by striking subparagraph (A) and inserting the following:
      `(A) utilize applicable interoperability standards as determined by the Secretary, and in consultation with the Office of the National Coordinator for Health Information Technology, through a joint public and private sector process;'; and
      (F) by adding at the end the following:
      `(6) CONSULTATION WITH THE NATIONAL BIODEFENSE SCIENCE BOARD- In carrying out this section and consistent with section 319M, the National Biodefense Science Board shall provide expert advice and guidance, including recommendations, regarding the measurable steps the Secretary should take to modernize and enhance biosurveillance activities pursuant to the efforts of the Department of Health and Human Services to ensure comprehensive, real-time, all-hazards biosurveillance capabilities. In complying with the preceding sentence, the National Biodefense Science Board shall--
      `(A) identify the steps necessary to achieve a national biosurveillance system for human health, with international connectivity, where appropriate, that is predicated on State, regional, and community level capabilities and creates a networked system to allow for two-way information flow between and among Federal, State, and local government public health authorities and clinical health care providers;
      `(B) identify any duplicative surveillance programs under the authority of the Secretary, or changes that are necessary to existing programs, in order to enhance and modernize such activities, minimize duplication, strengthen and streamline such activities under the authority of the Secretary, and achieve real-time and appropriate data that relate to disease activity, both human and zoonotic; and
      `(C) coordinate with applicable existing advisory committees of the Director of the Centers for Disease Control and Prevention, including such advisory committees consisting of representatives from State, local, and tribal public health authorities and appropriate public and private sector health care entities and academic institutions, in order to provide guidance on public health surveillance activities.';
      (4) in subsection (e)(5), by striking `4 years after the date of enactment of the Pandemic and All-Hazards Preparedness Act' and inserting `3 years after the date of enactment of the Pandemic and All-Hazards Preparedness Reauthorization Act of 2013';
      (5) in subsection (g), by striking `such sums as may be necessary in each of fiscal years 2007 through 2011' and inserting `$138,300,000 for each of fiscal years 2013 through 2017'; and
      (6) by adding at the end the following:
    `(h) Definition- For purposes of this section the term `biosurveillance' means the process of gathering near real-time biological data that relates to human and zoonotic disease activity and threats to human or animal health, in order to achieve early warning and identification of such health threats, early detection and prompt ongoing tracking of health events, and overall situational awareness of disease activity.'.

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