MISSION ZERO Act

Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 6378) to reauthorize certain programs under the Public Health Service Act and the Federal Food, Drug, and Cosmetic Act with respect to public health security and all-hazards preparedness and response, and for other purposes, as amended.

Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days in which to revise and extend their remarks and insert extraneous materials in the Record on the bill.

Mr. Speaker, I yield myself such time as I may consume.

Mr. Speaker, I rise today to speak in support of the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018, known as PAHPA. I am proud to have introduced this important bill with Energy and Commerce Chairman Greg Walden, Ranking Member Frank Pallone, and my good friend Representative Eshoo, who is one of the original authors of the 2006 PAHPA bill and lead author of the last reauthorization in 2013.

This bipartisan public health and national security effort will ensure our Nation is better prepared to respond to natural disasters like hurricanes; emerging infectious diseases like Zika and Ebola; and chemical, biological, radiological, or nuclear attacks, whether from terrorist groups or from nation-states.

Seventeen years ago, Congress was the target of a biological attack when letters laced with anthrax arrived in Member offices just days or soon after the 9/11 terrorist attacks. In the aftermath of 9/11, the Blue Ribbon Study Panel on Biodefense was formed. It was led by bipartisan leaders: former Senator Joe Lieberman, former Governor Tom Ridge, and many others.

In October 2015, after extensive discussions around the country where they learned from experts, they created their ``National Blueprint for Biodefense,'' which provided us with a roadmap in drafting this important legislation.

I was the United States Attorney for the Southern District of Indiana during those 2001 anthrax attacks, and my own office dealt with an anthrax hoax when we received a letter with white powder inside. Of course, at the time, we didn't know it was a hoax. It was incredibly stressful for that staff member, who had to worry about their very own health. But that personal experience illustrated to me the importance of preparedness and sparked my interest in biodefense.

In the years since then, we know that the threat of a chemical, biological, radiological, or nuclear incident continues to grow. Every day, our adversaries are looking for more effective and faster ways to reduce the threat. It is not really a question of if we face the threat. It is a question of when.

Thanks to PAHPA and the 21st Century Cures Act, we are more prepared than ever for biological threats and attacks.

In July of just this last year, the FDA approved the first drug to treat smallpox. It is called TPOXX. But TPOXX isn't the only recent approval at the FDA. In July, the FDA also approved an autoinjector that provides a one-time dose of an antidote to block effects of a nerve agent. This new antidote and TPOXX will help protect Americans from biological attacks.

But PAHPA is much more than just a biodefense bill. It also ensures a coordinated healthcare response, whether to hurricanes or other natural disasters.

Florence has just hit the East Coast and residents in both North and South Carolina are still recovering and dealing with ongoing flooding. During the 2017 hurricane season, whether it was Hurricane Harvey, Irma, Jose, or Maria, far too many Americans were killed. It showed us that we need to do better to prioritize the needs of every person in our communities.

The PAHPA bill we are considering today does just that. It prioritizes our Nation's most vulnerable populations: our children, senior citizens, and those with disabilities. It reauthorizes the advisory committee focused on the specific needs of children and creates new advisory committees to ensure the needs of the elderly and those with disabilities are considered.

The bill provides liability protections for healthcare professionals who volunteer after medical disasters. In addition to these types of Good Samaritan provisions, the bill ensures more healthcare professionals like nurses, doctors, and others can be hired and trained when facing a public health crisis by strengthening our National Disaster Medical System, which provides grants to our regional healthcare network.

It also ensures we have a robust supply of vaccines and basic equipment like gloves, hazmat suits, masks, personal protective gear, and more in our strategic national stockpiles located all across the country, so that our healthcare professionals and first responders have what they need.

PAHPA ensures our preparedness and response capabilities will include a robust pipeline of medical countermeasures by reauthorizing and increasing funding for the BioShield Special Reserve Fund and BARDA, the Biomedical Advanced Research and Development Authority.

BARDA's work over the last decade has resulted in FDA approvals for more than 42 different medical countermeasures. The development of medical countermeasures is a lengthy and often risky endeavor, which is why sending a clear signal that BARDA remains a strong and committed partner with academic institutions and the private sector in these efforts is so very important.

Last week, we saw even another example of a success of research funded by BARDA when FDA approved a product called ReCell, the first spray-on skin product ever approved for use in the United States. This new treatment will help treat burn victims so they can heal faster and with less risk of infection from painful skin grafts. By using a piece of a patient's skin about the size of a credit card, a doctor can turn it into a single cell-based solution that can be sprayed over the patient's burns so that new skin can grow and replace the damaged skin.

These types of investments BARDA is making into innovative research are critical, but it is also important that we continue to address threats that have been around for years.

It has been 100 years since the 1918 pandemic influenza killed millions of people around the globe, including 675,000 Americans. Some experts predict that we are actually due for the potential of another global pandemic influenza.

To address that threat, the bill we are considering today authorizes $250 million for the Assistant Secretary for Preparedness and Response, the ASPR, to address threats like pandemic influenza. Specifically, the bill directs the ASPR to work to increase manufacturing capacity and stockpile medical countermeasures.

While the PAHPA bill we are considering today authorizes funding for research into known threats like pandemic influenza, it also maintains the flexibility that is the foundation of our medical countermeasure enterprise to deal with unknown threats for which we may have no defense today.

Even today, the Democratic Republic of the Congo continues to deal with an ongoing Ebola outbreak. In order to ensure we are better prepared when we face an outbreak like Ebola or Zika, the bill we are considering today does three important things.

First, it improves the existing emergency response fund so that the Secretary of Health and Human Services does not have to wait on approval from Congress to immediately fund response measures needed to contain an outbreak and save lives. This emergency response fund will create a bridge so that immediate funding is available, so we can then supplement with an emergency appropriations bill later.

Secondly, the bill requires GAO to conduct a review of the emergency response fund to help appropriators decide what funding levels and resources are needed.

The third thing the bill does to help address threats like Ebola and Zika is to authorize $250 million in funding for an emerging infectious disease program so that BARDA can invest in new research.

The PAHPA bill reauthorization we are considering is the process of months of committee work in both the House and the Senate, and I want to thank all the staff members and all of the organizations, everyone who has been involved, and all the Members who have participated, whether it is subcommittee or committee hearings on this bill, examining our response to threats. I thank everyone involved for their dedication and commitment to

making sure we have the procedures, resources, and support in place to protect our fellow citizens from public health and national security threats.

I can't emphasize enough how critically important it is to reauthorize PAHPA. We have a duty as Members of Congress to keep Americans safe and secure. This bill is an essential component of accomplishing that goal. I urge all Members to support this critical bipartisan piece of legislation.

Mr. Speaker, I include in the Record letters from many organizations that support the bill.

Adult Vaccine Access Coalition,

July 23, 2018.

Hon. Susan W. Brooks,

Member of Congress,

Washington, DC.

Hon. Anna Eshoo,

Member of Congress,

Washington, DC.

Dear Representatives Brooks and Eshoo: On behalf of the

Adult Vaccine Access Coalition (AVAC), we are pleased to

express our support for bipartisan legislation that recently

passed the House Energy and Commerce Committee, ``Pandemic

and All-Hazards Preparedness Reauthorization Act (PAHPA) of

2018''.

AVAC includes more than fifty organizational leaders in

health and public health who are committed to raising

awareness of and engaging in advocacy on the importance of

adult immunization. AVAC priorities and objectives are driven

by a consensus process with the goal of enabling stakeholders

to have a voice in the effort to improve access to and

utilization of adult immunizations.

The bipartisan reauthorization of the PAHPA provides

improvements to key preparedness and response programs,

enhances personnel and hiring authorities, as well as

prioritizes cybersecurity in health care and provides

necessary resources for the development of medical

countermeasures for pandemic influenza and emerging

infectious diseases. We are delighted the Managers' Amendment

included references to immunization programs and immunization

information systems under Section 319D. These additions will

help to strengthen and enhance coordination and integrate

immunization programs and immunization information systems

(IIS) capabilities into public health emergency preparedness,

planning, and response activities.

Immunization Information Systems (IIS), or registries,

confidential, population-based, computerized systems can

record immunization doses administered by participating

providers to persons residing within a given jurisdiction.

They provide state and local public health agencies aggregate

data on immunization coverage rates for disease surveillance

and program operations. IIS' can serve as a vital component

for emergency preparedness and response activities and are an

optimal tool for use during a pandemic or other emerging

infectious disease event by enabling communication with

providers, identifying variations in access and utilization

of immunization, and enabling implementation of targeted

strategies during emergency preparedness and response

activities.

Congratulations on putting together a strong, bipartisan

reauthorization package that reflects many of the important

priorities shared by stakeholders. We look forward to working

with you throughout the process to enact the 2018 Pandemic

and All-Hazards Preparedness Reauthorization Act.

Sincerely,

Lisa Foster,

AVAC Manager.

Abby Bownas,

AVAC Manager.

Mr. Speaker, I reserve the balance of my time.

House of Representatives,

Committee on Homeland Security,

Washington, DC, September 24, 2018.

Hon. Greg Walden,

Chairman, Committee on Energy & Commerce,

Washington, DC.

Dear Chairman Walden: I write concerning H.R. 6378, the

``Pandemic and All-Hazards Preparedness and Advancing

Innovation Act of 2018''. This legislation includes matters

that fall within the Rule X jurisdiction of the Committee on

Homeland Security.

In order to expedite floor consideration of H.R. 6378, the

Committee on Homeland Security will forgo action on this

bill. However, this is conditional on our mutual

understanding that forgoing consideration of the bill would

not prejudice the Committee with respect to the appointment

of conferees or to any future jurisdictional claim over the

subject matters contained in the bill or similar legislation

that fall within the Committee's Rule X jurisdiction. I

request you urge the Speaker to name members of the Committee

to any conference committee names to consider such

provisions.

Please place a copy of this letter and your response

acknowledging our jurisdictional interest in the

Congressional Record during House Floor consideration of the

bill. I look forward to working with the Committee on Energy

and Commerce as the bill moves through the legislative

process.

Sincerely,

Michael T. McCaul,

Chairman.

Mr. Speaker, I yield 5 minutes to the gentleman from Oregon (Mr. Walden), the chairman of the Energy and Commerce Committee.

Mr. Speaker, I yield 5 minutes to the gentleman from Texas (Mr. Burgess), the subcommittee chair for the Subcommittee on Health.

Mr. Speaker, I yield 1 minute to the gentleman from Florida (Mr. Bilirakis), who also serves on the Subcommittee on Health.

Mr. Speaker, I yield myself the balance of my time.

Mr. Speaker, I would like to particularly thank Dr. Burgess and the ranking member of the Subcommittee on Health, Gene Green, for their leadership in working with so many of us who have brought this legislation to the floor at this time.

It is really so very critical that all relevant Federal agencies, particularly the leadership of CDC and the ASPR, work together with our local and State partners that are truly on the ground; and I certainly urge my colleagues to

pass this important piece of legislation not only to ensure that public health is of paramount importance in this country, but, also, because this is an incredibly important piece of national security legislation.

Mr. Speaker, I yield back the balance of my time.

Mr. Speaker, I include the following letters in the Record.

Health Industry

Distributors Association,

July 17, 2018.

Hon. Greg Walden,

Chairman, House Energy and Commerce Committee, House of

Representatives, Washington, DC.

Hon. Susan Brooks,

House of Representatives, Washington, DC.

Hon. Frank Pallone,

Ranking Member, House Energy and Commerce Committee, House of

Representatives, Washington, DC.

Hon. Anna Eshoo,

House of Representatives,

Washington, DC.

Dear Chairman Walden, Ranking Member Pallone, Congresswoman

Brooks and Congresswoman Eshoo: On behalf of the Health

Industry Distributors Association (HIDA), we appreciate the

opportunity to express our support for H.R. 6378, the

Pandemic and All-Hazards Preparedness and Advancing

Innovation Act of 2018 (PAHPAI). HIDA commends you for your

leadership on this issue and appreciates the active

engagement of your staff with industry to incorporate lessons

learned from recent events such as Ebola and the 2017

hurricane season, in H.R. 6378, to continually improve our

nation's preparedness capabilities.

HIDA is the trade association representing medical products

distributors, all of which deliver medical products and

supplies, manage logistics, and offer customer services to

more than 294,000 points of care. HIDA members primarily

distribute items used in every day medical services and

procedures, ranging from gauze and gloves to diagnostic

laboratory tests. Their customers include over 210,000

physician offices, 6,500 hospitals, and 44,000 nursing home

and extended care facilities throughout the country, as well

as numerous federal agencies and their healthcare facilities.

As you know, the medical supply chain plays a critical role

in preparedness, as it supplies key infection prevention

products and protective equipment such as respirators, face

shields, hoods, impermeable gowns and gloves to first

responders and health care providers. Additionally, the

medical supply chain is the primary source for the diagnostic

and point-of-care rapid tests needed to identify infectious

disease, as well as the ancillary products such as gloves,

needles and syringes needed to deliver medical

countermeasures effectively.

HIDA and its members have collaborated with federal

agencies on identifying opportunities to improve coordination

and develop solutions that create more elasticity in the

supply chain for key products. One of the many lessons

learned during the 2017 hurricane season was a considerable

need to improve coordination during an emergency response,

ensuring appropriate infrastructure partners are included in

a prioritization process for access to affected areas after

an event. We appreciate the Committees' acknowledgement of

the importance of this issue in the legislation, as well as

the recognition of the healthcare supply chain in H.R. 6378.

Specifically, we support the following:

Section 101 provisions important to the healthcare supply

chain including

The value of public and private sector coordination during

an event to ensure critical supplies are delivered and

information is shared.

The requirement that ancillary products needed to deliver a

medical countermeasure are incorporated into the Public

Health Emergency Medical Countermeasure Enterprise planning

process.

Section 319C-3 provisions that create a regional healthcare

system plan and that it be communicated to supply chain

partners so needed product can be redirected during a

response.

HIDA thanks you for your continued commitment to

preparedness and look forward to working with you on H.R.

6378.

Sincerely,

Linda Rouse O'Neill,

Vice President, Government Affairs,

Health Industry Distributors Association.

Mr. Speaker, I include the following letters in the Record.

American Society

for Microbiology,

Washington, DC, July 23, 2018.

Hon. Paul Ryan,

Speaker of the House, House of Representatives, Washington,

Mr. Speaker, I include the following letters in the Record.

Cerus,

Concord, CA, July 17, 2018.

Hon. Greg Walden,

Chairman, House Energy and Commerce Committee, House of

Representatives, Washington, DC.

Hon. Frank Pallone,

Ranking Member, House Energy & Commerce Committee, House of

Representatives, Washington, DC,

Dear Chairman Walden and Ranking Member Pallone: As you

review and deliberate over H.R. 6378, the Pandemic and All-

Hazards Preparedness and Advancing Innovation Act of 2018, we

wanted to provide our support for the efforts in the

legislation to preserve and protect the nation's blood

supply--especially in a public health emergency.

As you know, the American public expects the nation's blood

supply is safe and available every day, but especially in

situations of natural or man-made disasters. Blood

transfusions can be lifesaving measures, but this depends on

our collective ability to ensure the safety and availability

of the blood supply. Though the danger of transfusion-

transmitted infections has decreased in recent years due to

improved blood testing for specific pathogens such as HIV and

hepatitis, these tests do not detect the presence of all

viruses, bacteria, and parasites known to contaminate blood

donations. In 2015 at the height of the Zika epidemic in

Puerto Rico, the FDA released guidance calling for the use of

blood treatment pathogen reduction technology as an option to

reduce the risk of transfusion-transmission of Zika. This

pathogen reduction technology helped ensure that very ill

patients would have adequate access to safe blood and that

they would not contract Zika virus infection from their

therapeutic blood transfusions.

Section 116 is critical to ensuring the blood collection

community, in concert with the Department of Health and Human

Services, begins to cohesively examine the challenges with

preserving capacity in the nation's blood supply for major

emergency care, addressing issues like recruiting sufficient

donors to ensure the adequacy of the current supply to meet

public health emergencies and implementation of innovative

and best safety practices.

The inclusion of blood banks in Section 203 is also

critical for ensuring the blood banking community has an

opportunity to engage along with hospitals, health care

facilities, public agencies and others to provide input into

our nation's new ``Healthcare Preparedness and it Response

Program.'' The inclusion of blood banks is critical in

providing feedback on the financial implications for the

program as the industry faces many challenges in ensuring a

transfusion-ready blood supply.

I sincerely appreciate the time and effort that both of

you, your fellow Committee members and the staff have placed

in drafting, reviewing, and deliberation over H.R. 6378. I

look forward to continuing to work with all of you in

supporting our nation's ability to respond in public health

emergencies.

Sincerely,

Dr. Laurence Corash, MD

Chief Scientific Officer, Cerus.

Mr. Speaker, I include the following letters in the Record.

July 18, 2018.

Hon. Susan Brooks,

Washington, DC.

Hon. Anna Eshoo,

Washington, DC.

Dear Representatives Brooks and Eshoo: I am writing on

behalf of Roche Diagnostics Corporation in support of H.R.

6378, Pandemic and All-Hazards Preparedness and Advancing

Innovation Act of 2018. Congratulations on advancing this

legislation out of the Energy and Commerce Committee.

We applaud your efforts in improving the nation's overall

preparedness and response capabilities. We especially

appreciate the Committee's recognition that diagnostics can

play a key role in responding to public health and medical

emergencies.

We look forward to continuing to work with you as this

legislation advances in Congress.

Sincerely,

Russell C. Ring,

Vice President, Government Affairs,

Roche Diagnostics Corporation.

Mr. Speaker, I yield myself such time as I may consume.

Mr. Speaker, I rise in support of H.R. 6378, the Pandemic All-Hazards Preparedness and Advancing Innovation Act of 2018. I want to thank Chairman Walden and Representatives Eshoo and Brooks, as well as all the staff, for their hard work on this bill. Together, we have ensured a robust product that reflects priorities for Members on both sides of the aisle and the agencies responsible for ensuring our emergency preparedness.

This is a vitally important public health bill that ensures that we can prepare for and respond to health security events like bioterrorism, emerging infectious diseases, and natural disasters. It will support the development of new treatments and the stockpiling of medications and supplies that will be deployed to communities nationwide in the case of an emergency.

As we all know, effectively preparing for and responding to these events requires extensive coordination between Federal, State, local, and Tribal governments, as well as private sector organizations across the country.

This bill reauthorizes or establishes critical programs that will help us better prepare and respond to any major health emergency.

Let me discuss some of the specifics of how this bill will help us do that.

It reauthorizes a loan repayment program that would help to strengthen and grow our public health workforce. This is critically important, as we are still trying to dig out of a public health funding hole that began during the Great Recession.

This bill also makes a technical update to the Hospital Preparedness Program to reflect the use of the term ``coalition'' instead of ``partnership'' by grantees and other stakeholders. This language change is not intended to make changes related to the current cooperative agreement structure, nor does it intend to alter the role and responsibilities of States, territories, and directly funded cities, which are awardees of funding under the Hospital Preparedness Program.

Therefore, it continues to require that the Centers for Disease Control and Prevention, the CDC, provide funding through cooperative agreements to States, territories, and cities to support healthcare coalitions in their communities through the Hospital Preparedness Program.

The bill also amends the Public Health Emergency Preparedness Program to require public health departments to partner with nursing homes and hospitals to promote and improve public health preparedness and response.

It also requires public health departments to work with utility companies and other critical infrastructure partners to help ensure that electricity and other critical infrastructure will remain functioning or return to function as soon as practicable after a public health emergency.

Both of these requirements are intended to help prevent another tragedy like the tragic deaths that occurred at a Florida nursing home last year in the aftermath of Hurricane Irma.

Mr. Speaker, this bill also updates the authorization for the public health emergency rapid response fund so we can prevent any delay in HHS' rapid response to public health emergencies in the future.

It also maintains the administration's flexibility to determine the best placement for the Strategic National Stockpile, or SNS. I have concerns with moving the SNS from the direction of the Centers for Disease Control and Prevention to the Assistant Secretary for Preparedness and Response. To date, I have yet to hear a strong argument in support of this move.

I also believe CDC has the relationships and expertise that make the most sense for managing and operationalizing the stockpile. The CDC also has a record of successful stewardship of the SNS. That is why I supported the increased transparency and reporting included in this bill.

Wherever the Strategic National Stockpile is placed, it is critical that we ensure that our current preparedness and response capabilities are not weakened by its placement.

I also want to highlight two provisions that were included that will ensure Congress receives the information it needs to respond to the Trump administration's family separation crisis. The Assistant Secretary for Preparedness and Response will be required to submit to the Energy and Commerce Committee a formal strategy on their family reunification efforts as well as keep the committee informed on the status of the children still awaiting reunification.

The Trump administration's cruel zero-tolerance policy resulted in a manmade crisis that has impacted the lives of thousands of parents and children. While we can't undo the damage done by this policy, these provisions ensure that Congress has the information it needs to help reunite each child with their family and make sure this never happens again.

Furthermore, while these provisions are important, they should not take the place of an actual oversight hearing on this cruel policy. This is something committee Democrats have repeatedly requested, and we will continue to do so.

Finally, Mr. Speaker, overall, I want to say this is a good bill. Our national preparedness and response capabilities will be better prepared to respond to public health threats thanks to the passage of the Pandemic and All-Hazards Preparedness and Advancing Innovation Act.

Mr. Speaker, I urge my colleagues to support H.R. 6378, and I reserve the balance of my time.

Mr. Speaker, I have no additional speakers, and I reserve the balance of my time.

Mr. Speaker, I yield myself the balance of my time.

Mr. Speaker, I want to again thank all my colleagues on both sides of the aisle for moving and working on this legislation.

Mr. Speaker, I urge my colleagues to support H.R. 6378, and I yield back the balance of my time.

Mr. Speaker, I rise in support of this bipartisan legislation, the Pandemic and All-Hazards Preparedness and Innovation Act and I'm very proud to have Representative Susan Brooks as my partner. This legislation is the product of negotiation and compromise between the House and the Senate and I'm pleased that my colleagues were able to reach agreement on a bill that ensures our nation is prepared to respond to a wide range of public health emergencies, whether man-made or occurring through a natural disaster or infectious disease.

In 2001 our nation endured the horrific attacks on September 11th and the anthrax attacks that followed shortly thereafter. Congress realized that our country was not prepared to coordinate responses to mass casualty events or chemical attacks, and in 2006, I wrote legislation with then-Representative Richard Burr to address these shortfalls. That important legislation, the original Pandemic and All-Hazards Preparedness Act, was signed into law the same year.

The Pandemic and All-Hazards Preparedness and Innovation Act we're considering today is critical to our national security. The legislation updates the original PAHPA by directing federal agencies to respond to new and emerging threats, and strengthens our nation's existing preparedness and response programs. The reauthorization meets the challenges that we face today and those we anticipate facing in the future.

Events over the past few years including Zika, the reemergence of Ebola, and the constant looming threat of a biological attack by another nation or hostile non-state enemies underscore the real threats our country continues to face. In 2017, our nation experienced the most destructive hurricane season in recent memory, followed quickly by the most deadly flu season in decades. This year, parts of our country have already faced devastating hurricanes and the season is not over yet. Our experience with each of these hazards reminds us that our country is not yet adequately prepared to deal with potentially devastating widespread public health crises. That's why this legislation is so critical.

The legislation provides the authorization and federal resources to invest in programs that allow the Biomedical Advanced Research and Development Authority to maintain its nimble and flexible framework while responding to the existing and emerging threats our country may face. It also directs BARDA to address antimicrobial resistance which is critical to our nation's biodefense If we have a chemical or biological attack that leaves individuals with burns or open wounds, the medical countermeasures BARDA has developed to treat that attack will be useless if those injured contract secondary antibiotic resistant infections.

BARDA was created by my original legislation and has been extremely successful in investing in drugs that are needed to be stockpiled, and where the federal government is the only customer. There is no other market for these products and that's why BARDA is so important. BARDA has worked with over 190 partners and brought 35 medical countermeasures through research and development to FDA approval No private company has a track record that compares to what BARDA has accomplished in just over 10 years.

This bill restores multiyear appropriations for the Project BioShield Special Reserve Fund. My original legislation provided advanced appropriations for Project BioShield for the purpose of accelerating the research, development, purchase, and availability of effective medical countermeasures against biological, chemical, radiological, and nuclear (CBRN) threats. Restoring multiyear appropriations offers our partners with the government the certainty they need to invest in these important medical countermeasures which are a matter of national security. I urge the appropriators to fully fund the multiyear appropriations this legislation authorizes.

I'm proud that our legislation incorporates many provisions that were important to Members in both the Republican Conference, the Democratic Caucus, and to our colleagues in the Senate, to meet the needs of vulnerable communities during natural and manmade disasters.

The legislation also reauthorizes the HHS National Advisory Committee on Children and Disasters and authorizes the Children's Preparedness Unit at the CDC. This is critically important to address the persistent gaps in our nation's preparedness and response for the most vulnerable in many crises, our nation's children

The bill also establishes an Advisory Council for People with Disabilities and an Advisory Council on Seniors to focus on the needs of these special populations during a public health emergency.

It includes a proposal to prioritize bringing nursing homes back onto the power grid at the same time as hospitals after a disaster.

It includes provisions related to regional health partnerships, pregnant and postpartum women and environmental health.

I'm proud of this legislation and I urge my colleagues to support the Pandemic and All-Hazards Preparedness and Innovation Act.

Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 880) to amend the Public Health Service Act to facilitate assignment of military trauma care providers to civilian trauma centers in order to maintain military trauma readiness and to support such centers, and for other purposes, as amended.

Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days to revise and extend their remarks and insert extraneous material into the Record on the bill.

Mr. Speaker, I yield myself such time as I may consume.

Mr. Speaker, 40 years ago I was an intern and resident at Parkland Hospital in Dallas. Any intern or resident will tell you the month of July is significant in the life of an intern or resident. You were last week's medical student, and you are this week's intern managing the emergency room; or you were last year's intern, and you are this week's house officer managing perhaps a busy practice, perhaps a busy emergency room. As such, every intern and resident remembers the end of that first week of their internship or residency. It is just something that you do. You got through the first week of what was a very trying time. So I remember well July 7 of my internship, July 7 of my residency.

Mr. Speaker, in 2016, July 7 also took on additional significance in Dallas, Texas. Five police officers were killed and 9 more were injured during a shooting in downtown Dallas. In the immediate aftermath of the attack, area hospitals sprang into action and activated their disaster plans. I am proud to say that the staff at Parkland Hospital, the staff at Baylor University Hospital, and other medical professionals provided excellent emergency care to the victims of the attack.

Mr. Speaker, it is critical that we have people who are able to respond when called. Now, additionally, I have long believed that the American military is the arsenal of democracy and that it is critical for upholding freedom in the world. Each member of the United States Armed Forces has an important role in a collective team effort. This is especially true in a combat zone, where trauma surgeons are some of the most crucial members of the Armed Forces. These medical professionals are trained to save the lives of soldiers who sustain traumatic injuries on the battlefield, and they are some of the best in the business.

However, as wars wind down and our soldiers come home, the experience that military trauma surgeons have gained overseas may be diminished or lost unless these surgeons continue to train and to prepare for their next possible deployment. To let this expertise and skill drift away would be a significant loss to trauma patients, both at home and abroad. Trauma, Mr. Speaker, is not limited to the battlefields and active conflicts. Unfortunately, no community is immune from the threat of traumatic injury, and community doctors must be prepared to give lifesaving care to trauma victims.

However, there is a way that we can ensure trained combat surgeons' skills are utilized to help American patients here in the homeland who need it. The MISSION ZERO Act seeks to connect American patients with battle-tested trauma care through the craft of military trauma care providers. The bill provides grants to allow military trauma care providers and teams to offer care in our Nation's leading trauma centers and systems.

Here is the bottom line: the MISSION ZERO Act is a win for both civilian patients and military trauma doctors.

Mr. Speaker, I am grateful that this bipartisan legislation has finally come

to the floor. Along with my fellow Texan, Mr. Gene Green, I introduced this bill in 2016 following that particularly traumatic incident that struck so close to home.

Texas is not unique in its need for this expertise. Over the last few months alone, our Nation has witnessed a need for trauma care hospitals across the country. One such incident was the Amtrak derailment near Dupont, Washington, on December 18, 2017. That incident resulted in 3 passenger fatalities and 70 injuries over a busy freeway.

As we have seen, having access to experienced trauma care can become the difference between life and death for a critically injured patient. There is no doubt that integrating military physicians into the trauma and disaster system is beneficial not only for American patients, but also for American soldiers.

I am encouraged by the bipartisan effort to support both our servicemen and our Nation's trauma system, and I thank the cosponsors from both sides of the aisle for their support of this important legislation.

Quite simply, the MISSION ZERO Act is common sense, and I urge Members to join me in supporting this lifesaving legislation.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, this is an important bill. I urge my colleagues to support it, and I yield back the balance of my time.

Mr. Speaker, I thank the gentlewoman for yielding.

Mr. Speaker, one century ago, our country was in the midst of the worst pandemic in history. It claimed the lives of almost 700,000 Americans and killed more than 50 million people worldwide.

Mr. Speaker, we listened to testimony; we discussed aspects of this legislation before us today; and it is critical that we remember the significance of the centennial anniversary of the 1918 influenza pandemic as we consider this legislation today.

The creation of the Assistant Secretary for Preparedness and Response under the original legislation of 2006 has helped us to make monumental strides in preparedness, coordination, and response. Close collaboration between the Centers for Disease Control and the Food and Drug Administration and our State, local, and territorial public health partners has been vital in making this progress.

Much like politics, much of public health is local and executed on the ground by our hospitals, our health departments, and our emergency responders, who are our front lines in addressing infectious diseases, disasters, and threats.

We must evaluate the domestic biological surveillance systems, such as BioWatch. This bill will help bring those programs up to date so they are operating with the most efficient capabilities and technologies. We must also look for innovative ways to continue to advance our medical countermeasures and ensure that Americans can access the medications that will provide critical protection in the future.

As we consider the problem of antimicrobial resistance in this country, we must discuss new methods to curb this growing problem.

It is important to note that this reauthorization bill is being heard on the floor of the House prior to the expiration of the fiscal year, at which time the current authorization expires. The House, once again, has done its work in this regard, and we do urge our counterparts in the Senate to do their work as well.

This reauthorization includes an important provision: The MISSION ZERO Act. The MISSION ZERO Act seeks to connect American patients with battle-tested trauma care through the craft of military trauma care providers. The bill provides grants to allow military trauma care providers and teams to offer care in our Nation's leading trauma centers and systems.

The need for top-notch trauma care extends across our Nation, far away from the battlefield. I first introduced this bipartisan bill with my fellow Texan, Representative Gene Green, following a police shooting in Dallas 2 years ago.

Over 2 years ago, five police officers were killed and nine more were injured in a shooting in downtown Dallas. In the immediate aftermath of the attack, area hospitals sprung into action and activated their disaster plans. The staff at Parkland Hospital, Baylor University Hospital, and other medical professionals provided excellent emergency care to victims of the attack.

Frontline facilities and responders in Dallas experienced this firsthand in 2014 when a patient presented with Ebola to a Dallas-Ft. Worth emergency department.

We must remember that infectious diseases are a mere plane ride away, and we must continue to ensure that we are prepared and ready to respond to emerging infectious diseases worldwide.

This Pandemic and All-Hazards Preparedness Reauthorization Act is critical to protecting the lives of Americans and providing the necessary tools and infrastructure when disaster strikes.

I want to thank Representative Susan Brooks and Anna Eshoo for their work on this legislation before us today. Mr. Speaker, I strongly support this legislation, and I urge my colleagues to do the same.