109-417 ), which authorizes appropriations through FY2011 to improve bioterrorism and other public health emergency preparedness and response activities, and establishes the Biomedical Advanced Research and Development Authority (BARDA) within the Department of Health and Human Services (HHS) for the advanced research and development of medical countermeasures. Many of these authorities, found principally in the Public Health Service Act and implemented by the Secretary of Health and Human Services (HHS), were first explicitly authorized in 2000 ( P.L. The 110 th Congress will likely be interested in the implementation of provisions in P.L. 109-417 , and in the continued evolution of relationships between HHS, DHS, the states, and others among whom coordination is essential in a time of heightened concern about national security. Members of the 110 th Congress may wish to consider legislation to address additional expiring public health authorities, such as the Select Agent program to control access to pathogens that could be used for bioterrorism, which expires at the end of FY2007. Congress may also wish to examine certain permanent emergency response and funding authorities of the Secretary of HHS. 109-417 with preexisting law is provided in Table 1 later in this report. 107-188 , the Public Health Security and Bioterrorism Preparedness and Response Act of 2002. A comparison of provisions in P.L. Both of the earlier bioterrorism laws, P.L. 106-505 and P.L. The Pandemic and All-Hazards Preparedness Act would require the Secretary of HHS to prepare a quadrennial National Health Security Strategy and implementation plan, to include preparedness goals for federal, state, and local governments in harmony with national preparedness and response efforts at DHS. The 108 th Congress launched the program in the Project BioShield Act of 2004 ( P.L. 107-296 , the Homeland Security Act, effective when the new department was created in 2003. The Bioterrorism Act also established, for the first time, a program of grants to states to prepare hospitals, clinics and other healthcare facilities for bioterrorism and other mass-casualty events, to be administered by HRSA. The Bioterrorism Act contained a number of other provisions for public health preparedness. Major Legislation Prior to the 2001 Terrorist Attacks

Prior to the terrorist attacks of 2001, Congress passed the Public Health Threats and Emergencies Act of 2000 (Title I of the Public Health Improvement Act, P.L. For more information regarding public health preparedness and response authorities and programs in general, and in the context of specific threats, see:
CRS Report RS22602, Public Health and Medical Preparedness and Response: Issues in the 110th Congress , by [author name scrubbed]; CRS Report RL33579, The Public Health and Medical Response to Disasters: Federal Authority and Funding , by [author name scrubbed]; CRS Report RL31719, An Overview of the U.S. Public Health System in the Context of Emergency Preparedness , by [author name scrubbed]; CRS Report RL33096, 2005 Gulf Coast Hurricanes: The Public Health and Medical Response , by [author name scrubbed]; CRS Report RL33145, Pandemic Influenza: Domestic Preparedness Efforts , by [author name scrubbed]; CRS Report RL33738, Gulf Coast Hurricanes: Addressing Survivors' Mental Health and Substance Abuse Treatment Needs , by [author name scrubbed], [author name scrubbed], and [author name scrubbed].
Authorities to direct federal preparedness for and response to public health emergencies are found principally in the Public Health Service Act (PHS Act), and are administered by the Secretary of Health and Human Services (HHS). Three recent laws provided the core of these authorities. P.L. 106-505, the Public Health Threats and Emergencies Act of 2000 (Title I of the Public Health Improvement Act), established a number of new programs and authorities, including grants to states to build public health preparedness. P.L. 107-188, the Public Health Security and Bioterrorism Preparedness and Response Act of 2002, was passed in the aftermath of the 2001 terror attacks. It reauthorized several existing programs and established new ones, including grants to states to build hospital and health system preparedness. P.L. 108-276, the Project BioShield Act of 2004, established authorities to encourage the development of specific countermeasures (such as drugs and vaccines for bioterrorism agents) that would not otherwise have a commercial market.
The laws above built upon existing broad authorities allowing or requiring the Secretary of HHS to prepare for or respond to outbreaks of infectious disease and other unanticipated health threats. Other laws—such as P.L. 107-296, creating a new Department of Homeland Security (DHS)—have added to the slate of public health preparedness and response authorities as well. Further, the Robert T. Stafford Disaster Relief and Emergency Assistance Act (the Stafford Act, administered by DHS), which authorizes federal assistance and other activities in response to presidentially declared emergencies and major disasters, is also, to some extent, a source of federal authority for the response to public health threats.
The 109th Congress passed P.L. 109-417, the Pandemic and All-Hazards Preparedness Act. The act reauthorized a number of expiring preparedness and response programs in the PHS Act, and established some new authorities, including the creation of a Biomedical Advanced Research and Development Authority (BARDA), a new office in HHS to support, coordinate, and provide oversight of advanced development of vaccines and biodefense countermeasures. The act's provisions reflected the concerns of Members of the 109th Congress and others regarding the flawed response to Hurricane Katrina in 2005, and the threat of a possible influenza pandemic. A comparison of provisions in P.L. 109-417 with preexisting law is provided in Table 1 later in this report.
The 110th Congress will likely be interested in the implementation of provisions in P.L. 109-417, and in the continued evolution of relationships between HHS, DHS, the states, and others among whom coordination is essential in a time of heightened concern about national security. Members of the 110th Congress may wish to consider legislation to address additional expiring public health authorities, such as the Select Agent program to control access to pathogens that could be used for bioterrorism, which expires at the end of FY2007. Congress may also wish to examine the adequacy of certain permanent emergency response and funding authorities of the Secretary of HHS.