Public Health Infrastructure and Pandemic Preparedness Provisions in the Build Back Better Act

PUBLIC HEALTH INFRASTRUCTURE $36,050,000,000 SEC. 31001. FUNDING TO SUPPORT CORE PUBLIC HEALTH INFRASTRUCTURE FOR STATE, TERRITORIAL, LOCAL, AND TRIBAL HEALTH DEPARTMENTS AT THE CENTERS FOR DISEASE CONTROL AND PREVENTION $7,000,000,000 Funding to support core public health infrastructure activities to strengthen the public health system and expand and improve activities of the Centers for Disease Control and Prevention. Activities include: workforce capacity and competency; laboratory systems; all hazards public health and preparedness; testing capacity, including test platforms, mobile testing units, and personnel; health information, health information systems, and health information analysis; disease surveillance; contact tracing; communications; financing; other relevant components of organizational capacity; and other related activities.

Funding Allocation:

• Funding to support core public health infrastructure activities throughout the U.S. is to be awarded through grants as follows:
  • No less than 50% of total funding shall be provided through formula grants to each State or territorial health department, and to local health departments that serve counties with a population of at least 2,000,000 or cities with a population of at least 400,000 people. Formula must consider population size and the Social Vulnerability Index.
  • No less than 25% of total funding through competitive grants to State, territorial, local, or Tribal health departments
  • Of funding provided to State health departments through formula and competitive awards, at least 25% must be reallocated to local health departments.
• Of the total funding provided, not more than 25% may be used to expand and improve core public health infrastructure and activities of the CDC.

SEC. 31002. FUNDING FOR HOSPITAL INFRASTRUCTURE $10,000,000,000 Funding to be awarded through grants with priority given to applicants whose projects will include public health emergency preparedness, natural disaster emergency preparedness, or cybersecurity against cyber threats, for purposes of increasing capacity and updating hospitals and other medical facilities in order to better serve communities in need. SEC. 31003. FUNDING FOR COMMUNITY HEALTH CENTER CAPITAL GRANTS $10,000,000,000 Funding to be awarded through grants and cooperative agreements to support community health centers for capital improvement projects. SEC. 31004. FUNDING FOR COMMUNITY-BASED CARE INFRASTRUCTURE $500,000,000 Funding to be awarded to qualified teaching health centers, behavioral health care centers, and pediatric mental health care providers to improve, renovate, or modernize infrastructure, including to respond to public health emergencies. SEC. 31005. FUNDING FOR SCHOOLS OF MEDICINE IN UNDERSERVED AREAS $1,000,000,000 Funding to be awarded to support the establishment, improvement, or expansion of an allopathic or osteopathic school of medicine, with priority given to minority-serving institutions, and taking into consideration equitable distribution of awards among the geographical regions of the United States (including rural populations) in order to reach disadvantaged, rural, underserved, underrepresented, and low-income individuals.  Among other things, supported activities include: recruiting, enrolling, and retaining students; curricula development, implementation, expansion, and modernization; facilities construction, modernization, or expansion; accreditation; and the hiring of faculty and staff. SEC. 31006. FUNDING FOR NURSING EDUCATION ENHANCEMENT AND MODERNIZATION GRANTS IN UNDERSERVED AREAS $1,000,000,000 Funding to be awarded to support schools of nursing to enhance and modernize nursing education programs and increase the number of faculty and students at such schools, taking into consideration equitable distribution of awards among the geographical regions of the United States, the capacity of a school of nursing to provide care in underserved areas, and with priority to reach disadvantaged, rural, underserved, underrepresented, and low-income individuals. Among other things, supported activities include: recruiting, enrolling, and retaining students; creating, modernizing, enhancing, or expanding curricula and programs; hiring and retention of faculty; modernizing school infrastructure; and establishing partnerships with healthcare providers as well as interdisciplinary programs to further educational opportunities. SEC. 31007. FUNDING FOR TEACHING HEALTH CENTER GRADUATE MEDICAL EDUCATION $6,000,000,000 Funding for direct payments and awards to support the establishment of new as well as the maintenance and expansion of existing graduate medical residency training programs. SEC. 31008. FUNDING FOR CHILDREN’S HOSPITALS THAT OPERATE GRADUATE MEDICAL EDUCATION PROGRAMS $250,000,000 Funding to support children’s hospitals that operate graduate medical education programs. SEC. 31009. FUNDING FOR THE NURSE CORPS $300,000,000 Funding to support the Nurses Corps. PANDEMIC PREPAREDNESS $15,750,000,000 SEC. 31021. FUNDING FOR LABORATORY ACTIVITIES AT THE CENTERS FOR DISEASE CONTROL AND PREVENTION $5,000,000,000 Acting through the Director of the Centers for Disease Control and Prevention, funding shall be used to renovate, expand, and modernize State and local public health laboratory infrastructure as well as CDC laboratories. Activities supported include: increasing and enhancing testing and response capacity; upgrading and expanding the Laboratory Response Network for rapid outbreak detection; improving and expanding genomic sequencing capabilities to detect emerging diseases and variant strains; expanding biosafety and biosecurity capacity, and any other laboratory enhancements as deemed necessary by the Director.

Funding may also be used to enhance the ability of the Centers for Disease Control and Prevention to monitor and exercise oversight over biosafety and biosecurity of State and local public health laboratories.

SEC. 31022. FUNDING FOR STRENGTHENING VACCINE CONFIDENCE $1,250,000,000 Acting through the Director of the Centers for Disease Control and Prevention, directly or by making grants to public or private entities, to strengthen vaccine confidence; strengthen routinely recommended vaccine programs; and improve rates of vaccination. SEC. 31023. FUNDING FOR SURVEILLANCE ACTIVITIES AT THE CENTERS FOR DISEASE CONTROL AND PREVENTION $1,000,000,000 Acting through the Director of the Centers for Disease Control and Prevention, directly or by making grants to public or private entities, to enhance and strengthen early warning and detection systems, including public health and health care surveillance, wastewater testing, and global and domestic genomic surveillance; enhance and strengthen surveillance based in hospitals and other health care providers or facilities, and outpatient facility surveillance for severe acute respiratory infection, influenza-like illness, acute febrile illness, and other diseases; strengthen the antibiotic resistance initiative program to improve research, stewardship, genomic detection  capabilities, and surveillance of existing and emerging antimicrobial resistant pathogens. SEC. 31024. FUNDING FOR DATA MODERNIZATION AT THE CENTERS FOR DISEASE CONTROL AND PREVENTION $500,000,000 Acting through the Director of the Centers for Disease Control and Prevention, directly or by making grants to public or private entities, to support public health data surveillance, aggregation, and analytics infrastructure modernization initiatives; Enhance reporting and workforce core competencies in informatics and digital health; expand and maintain efforts to modernize the

United States disease warning system to forecast and track hotspots and emerging biological threats.

SEC. 31025. FUNDING FOR PUBLIC HEALTH AND PREPAREDNESS RESEARCH, DEVELOPMENT, AND COUNTERMEASURE CAPACITY $8,000,000,000 Acting through the Assistant Secretary for Preparedness and Response Activities:

• $3,000,000,000 to support surge capacity, including through construction, expansion, or modernization of facilities, to respond to a public health emergency, for procurement and domestic manufacture of drugs, active pharmaceutical ingredients, vaccines and other biological products, diagnostic technologies and products, personal protective equipment, medical devices, vials, syringes, needles, and other components or supplies for the Strategic National Stockpile
• $2,000,000,000 to support expanded global and domestic vaccine production capacity, including by developing or acquiring new technology and expanding manufacturing capacity through construction, expansion, or modernization of facilities
• $2,000,000,000 to support activities to mitigate supply chain risks and enhance supply chain elasticity and resilience for critical drugs, active pharmaceutical ingredients, and supplies (including essential medicines, medical countermeasures, and supplies in shortage or at risk of shortage), drug and vaccine raw materials, and other supplies through the construction, expansion, or modernization of facilities, adoption of advanced manufacturing processes, and other activities to support domestic manufacturing of such supplies
• $500,000,000 to support activities conducted by the Biomedical Advanced Research and Development Authority for advanced research, standards development, and domestic manufacturing capacity for drugs, including essential medicines, diagnostics, vaccines, therapeutics, and personal protective equipment
• $500,000,000 to support increased biosafety and biosecurity in research on infectious diseases, including by modernization or improvement of facilities.