Rep. Ritchie Torres Re-Introduces the Coordinated Agency Response Enhancement (CARE) Act

Today, Congressman Ritchie Torres (NY-15) re-introduced the Coordinated Agency Response Enhancement (CARE) Act in the U.S. House of Representatives as the country grapples with outbreaks of measles and bird flu. This legislation addresses systemic inefficiencies in public health emergency responses by mandating a comprehensive after-action review process at the Department of Health and Human Services (HHS) and ensures improved inter-agency coordination, faster response times, and enhanced communication to at-risk communities during crises. The bill would:

• Require the Secretary of HHS to develop and implement a coordinated, department-wide after-action program that encourages collaboration between HHS’s component agencies, including integrating the existing public health emergency after-action programs of these component agencies.
• The after-action program should include relevant external stakeholders involved in each public health emergency response — such as other federal agencies, jurisdictions and nongovernmental partners — when identifying challenges and associated solutions.
• Require a communication strategy that identifies at-risk populations and ensures outreach is targeted and accessible.

Rep. Torres first introduced this legislation in the previous Congress following a Government Accountability Office (GAO) report, which found that HHS lacked a unified strategy to resolve recurring emergency response failures. The GAO report, released last April, detailed persistent gaps in public communication, delays in testing and antivirals, and a lack of coordination across agencies—shortcomings that could severely hinder responses to bird flu, measles, and future public health threats.

With recent outbreaks of measles and bird flu underscoring the urgent need for a well-coordinated federal response, this legislation establishes a critical framework to enhance national preparedness and strengthen public health emergency management.

By implementing systematic improvements and learning from past public health failures, the CARE Act will ensure the nation is better prepared for future health crises and can respond swiftly and effectively.

The full bill text is attached here.

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In April 2024, the United States Government Accountability Office (GAO) released a long-awaited report: “Public Health Preparedness: Mpox Response Highlights Need for HHS to Address Recurring Challenges.” In GAO’s report, they concluded that the Department of Health and Human Services (HHS) lacks a cohesive, department-wide strategy for learning from past public health emergencies to improve future responses. The GAO’s findings revealed a significant gap in the coordination among HHS’s component agencies, resulting in missed opportunities for leveraging collective experiences and insights. This fragmentation impedes the effectiveness of public health emergency preparedness and response. In addition, the report found that HHS’s ability to apply lessons and learn following an emergency response was further limited due to not always having all relevant stakeholders involved when identifying challenges and associated solutions.

The report also identified shortcomings in risk communication efforts by HHS and the Centers for Disease Control and Prevention (CDC), particularly in reaching and clearly communicating risks to the most vulnerable populations. This includes the inadequacy of Mpox communication efforts in terms of inclusivity and the limitations faced by non-English speakers due to insufficient translation of critical public health information.

Beginning in July 2022, Rep. Torres was the leading Congressional voice urging the GAO and HHS to do such a report, and he is grateful to the GAO for tackling this crucial issue head-on. As a Co-Chair of the Congressional Equality Caucus and the sole LGBTQ+ member of Congress from New York City — which was the epicenter of the Mpox outbreak — Rep. Torres has fought tirelessly to ensure that his community’s vital health needs are not forgotten.

Additional context:

• The Advocate, April 2024: The federal government failed on mpox. Ritchie Torres’s new bill addresses that
• NY1 Interview, April 2024: Rep. Ritchie Torres Calls Out Subpar HHS Mpox Response and Introduces the CARE Act