[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[S. 2953 Introduced in Senate (IS)]







108th CONGRESS
  2d Session
                                S. 2953

   To amend the Public Health Service Act to establish a Coordinated 
         Environmental Health Network, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                            October 8, 2004

  Mrs. Clinton (for herself, Mr. Chafee, and Mr. Reid) introduced the 
 following bill; which was read twice and referred to the Committee on 
                 Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
   To amend the Public Health Service Act to establish a Coordinated 
         Environmental Health Network, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Coordinated Environmental Health 
Network Act of 2004''.

SEC. 2. FINDINGS AND PURPOSE.

    (a) Findings.--Congress finds that--
            (1) approximately 7 out of every 10 deaths in the United 
        States are attributable to chronic diseases;
            (2) with 100,000,000 people suffering from chronic diseases 
        each year, and $750,000,000,000 lost in health care costs as a 
        result, the national cost of chronic disease is extremely high 
        and must be appropriately addressed;
            (3) the rates of many chronic diseases, including asthma, 
        some birth defects, cancers, and autism, appear to be 
        increasing;
            (4) there is a growing amount of evidence that 
        environmental factors are strongly linked with specific chronic 
        disease;
            (5) a major gap in critical knowledge exists regarding the 
        prevalence and incidence of chronic diseases;
            (6) States, local communities, territories, and Indian 
        tribes need assistance with public health efforts that would 
        lead to prevention of chronic disease, including the 
        establishment and maintenance of necessary infrastructure for 
        disease and environmental hazard exposure surveillance; and
            (7) a Coordinated Environmental Health Network will help 
        target resources to areas of chronic disease prevention most in 
        need.
    (b) Purposes.--It is the purpose of this Act to--
            (1) develop, operate, and maintain a Coordinated 
        Environmental Health Network, State Environmental Health 
        Networks, and rapid response capabilities so that the Federal 
        Government, States, local governments, territories, and Indian 
        tribes can more effectively monitor, investigate, respond to, 
        research, and prevent increases in the incidence and prevalence 
        of certain chronic diseases and relevant environmental and 
        other risk factors;
            (2) provide information collected through the Coordinated 
        and State Environmental Health Networks to government agencies, 
        public health practitioners and researchers, policy makers, and 
        the public;
            (3) expand and coordinate among existing surveillance and 
        data collection systems and other infrastructure for chronic 
        diseases and relevant environmental, and other risk factors, 
        including those relevant to bioterrorism;
            (4) improve coordination between the areas of public 
        health, environmental protection, and chemical, radiological 
        and biological terrorism; and
            (5) provide necessary support to ensure the availability of 
        a sufficient number of well-trained environmental health and 
        public health personnel to participate and provide leadership 
        in the development and maintenance of the Coordinated and State 
        Environmental Health Networks.

SEC. 3. AMENDMENT TO THE PUBLIC HEALTH SERVICE ACT.

    The Public Health Service Act (42 U.S.C. 201 et seq.) is amended by 
adding at the end the following:

         ``TITLE XXIX--COORDINATED ENVIRONMENTAL HEALTH NETWORK

``SEC. 2900. DEFINITIONS.

    ``In this title:
            ``(1) Administrators.--The term `Administrators' means the 
        Director of the Centers for Disease Control and Prevention 
        Coordinating Center for Environmental Health, Injury 
        Prevention, and Occupational Health, and the Administrator of 
        the Environmental Protection Agency.
            ``(2) Committee.--The term `Committee' means the Advisory 
        Committee established under section 2901(d).
            ``(3) Director.--The term `Director' means the Director of 
        the Centers for Disease Control and Prevention.
            ``(4) Medical privacy regulations.--The term `medical 
        privacy regulations' means the regulations promulgated under 
        section 264(c) of the Health Insurance Portability and 
        Accountability Act of 1996.
            ``(5) Coordinated network.--The term `Coordinated Network' 
        means the Coordinated Environmental Health Network established 
        under section 2901(a).
            ``(6) Priority chronic condition.--The term `priority 
        chronic condition' means a condition to be tracked in the 
        Coordinated Network and the State Networks, including birth 
        defects, developmental disabilities (such as cerebral palsy, 
        autism, and mental retardation), asthma and chronic respiratory 
        diseases, neurological diseases (such as Parkinson's disease, 
        multiple sclerosis, Alzheimer's disease, and amyotrophic 
        lateral sclerosis), autoimmune diseases (such as lupus), 
        cancer, juvenile diabetes, and such other priority chronic 
conditions as the Secretary may specify.
            ``(7) State network.--The term `State Network' means a 
        State Environmental Health Network established under section 
        2901(b).
            ``(8) State.--The term `State' means a State, territory, or 
        Indian tribe that is eligible to receive a health tracking 
        grant under section 2901(b).

``SEC. 2901. ESTABLISHMENT OF COORDINATED AND STATE ENVIRONMENTAL 
              HEALTH NETWORKS.

    ``(a) Coordinated Environmental Health Network.--
            ``(1) Establishment.--Not later than 36 months after the 
        date of the enactment of this title, the Secretary, acting 
        through the Director and in consultation with the 
        Administrators, State and local health departments, and the 
        Committee, shall establish and operate a Coordinated 
        Environmental Health Network. In establishing and operating the 
        Coordinated Network, the Secretary shall--
                    ``(A) identify, build upon, expand, and coordinate 
                among existing data and surveillance systems, surveys, 
                registries, and other Federal public health and 
                environmental infrastructure wherever possible, 
                including--
                            ``(i) the National Electronic Disease 
                        Surveillance System;
                            ``(ii) State birth defects surveillance 
                        systems as supported under section 317C;
                            ``(iii) State cancer registries as 
                        supported under part M of title III;
                            ``(iv) State asthma surveillance systems as 
                        supported under section 317I;
                            ``(v) the National Health and Nutrition 
                        Examination Survey;
                            ``(vi) the Behavioral Risk Factor 
                        Surveillance System;
                            ``(vii) the Hazardous Substance Release/
                        Health Effects Database;
                            ``(viii) the Hazardous Substances Emergency 
                        Events Surveillance System;
                            ``(ix) the National Exposure Registry;
                            ``(x) the Health Alert Network; and
                            ``(xi) the State vital statistics systems 
                        as supported under section 306;
                    ``(B) provide for public access to an electronic 
                national database that accepts data from the State 
                Networks on the incidence and prevalence of priority 
                chronic conditions and relevant environmental and other 
                factors, in a manner which protects personal privacy 
                consistent with the medical privacy regulations;
                    ``(C) not later than 36 months after the date of 
                the enactment of this title, and annually thereafter, 
                prepare and publish, in accordance with paragraph (2), 
                a Coordinated Environmental Health Network Report to 
                provide the public with the findings of the Coordinated 
                Network;
                    ``(D) operate and maintain a National Environmental 
                Health Rapid Response Service within the Epidemic 
                Intelligence Service to carry out the activities 
                described in paragraph (3);
                    ``(E) provide for the establishment of State 
                Networks, and coordinate the State Networks as provided 
                for under subsection (b);
                    ``(F) provide technical assistance to support the 
                State Networks, including providing--
                            ``(i) training for environmental health 
                        investigators appointed or hired under 
                        subsection (b)(3)(D);
                            ``(ii) technical assistance as needed to 
                        States to build necessary capacity and 
                        infrastructure for the establishment of a State 
                        Network, including a computerized data 
                        collection, reporting, and processing system, 
                        and additional assistance identified by the 
                        States under subsection (b)(5)(C) as necessary 
                        for infrastructure development; and
                            ``(iii) such other technical assistance as 
                        the Secretary, in consultation with the 
                        Administrators, determines to be necessary;
                    ``(G) not later than 12 months after the date of 
                the enactment of this title, acting through the 
                Director and consulting with the Administrators, the 
                Surgeon General, the Director of the National 
                Institutes of Health, and States, develop minimum 
                standards and procedures in accordance with paragraph 
                (4) for data collection and reporting for the State 
                Networks, to be updated not less than annually 
                thereafter; and
                    ``(H) in developing the minimum standards and 
                procedures under subparagraph (G), include mechanisms 
                for allowing the States to set priorities, and allocate 
                resources accordingly, among the factors described in 
                subparagraphs (A), (B), and (C) of paragraph (4).
            ``(2) Coordinated environmental health network report.--
        Each Coordinated Environmental Health Network Report prepared 
        under paragraph (1)(C) shall include--
                    ``(A) a statement of the activities carried out 
                under this title;
                    ``(B) an analysis of the incidence, prevalence, and 
                trends of priority chronic conditions and potentially 
                relevant environmental and other factors by State and 
                census tract (or other political or administrative 
                subdivision determined appropriate by the Secretary in 
                consultation with the Administrator of the 
                Environmental Protection Agency) for the calendar year 
                preceding the year for which the report is prepared;
                    ``(C) the identification of gaps in the data of the 
                Coordinated Network, including diseases of concern and 
                environmental exposures not tracked; and
                    ``(D) recommendations regarding high risk 
                populations, public health concerns, response and 
prevention strategies, and additional tracking needs;
            ``(3) National environmental health rapid response 
        service.--The National Environmental Health Rapid Response 
        Service operated under paragraph (1)(D) shall--
                    ``(A) work with environmental health investigators 
                appointed or hired under subsection (b)(3)(D) to 
                develop and implement strategies, protocols, and 
                guidelines for the coordinated, rapid responses to 
                actual and perceived higher than expected incidence and 
                prevalence rates of priority chronic conditions and to 
                acute and potential environmental hazards and 
                exposures;
                    ``(B) conduct investigations into higher than 
                expected incidence and prevalence rates of priority 
                chronic conditions or environmental exposures after an 
                individual requests, through a process established by 
                the Secretary, the intervention of the Service;
                    ``(C) coordinate activities carried out under this 
                title with activities carried out under sections 319 
                through 319G; and
                    ``(D) coordinate activities carried out under this 
                title with the Administrators, the Surgeon General, and 
                the Director of the National Institutes of Health.
            ``(4) Data collection and reporting by state networks.--The 
        minimum standards and procedures referred to in paragraph 
        (1)(G) shall include--
                    ``(A) a list and definitions of the priority 
                chronic conditions to be tracked through the State 
                Networks;
                    ``(B) a list and definitions of relevant 
                environmental exposures of concern to be tracked, to 
                the extent practicable, through the State Networks, 
                including--
                            ``(i) hazardous air pollutants (as defined 
                        in section 302(g) of the Clean Air Act);
                            ``(ii) air pollutants for which national 
                        primary ambient air quality standards have been 
                        promulgated under section 109 of the Clean Air 
                        Act;
                            ``(iii) pollutants or contaminants (as 
                        defined in section 101 of the Comprehensive 
                        Environmental Response, Compensation, and 
                        Liability Act of 1980);
                            ``(iv) toxic chemicals (as described in 
                        section 313 of the Emergency Planning and 
                        Community Right-to-Know Act of 1986);
                            ``(v) substances reported under the Toxic 
                        Substances Control Act Inventory Update Rule as 
                        provided for in part 710 of title 40, Code of 
                        Federal Regulations, or successor regulations;
                            ``(vi) pesticides (as defined in section 
                        2(u) of the Federal Insecticide, Fungicide, and 
                        Rodenticide Act); and
                            ``(vii) such other potentially relevant 
                        environmental factors as the Secretary may 
                        specify;
                    ``(C) a list and definitions of potentially 
                relevant behavioral, socioeconomic, demographic, and 
                other risk factors, including race, ethnic status, 
                gender, age, occupation, and primary language, to be 
                tracked through the State Networks;
                    ``(D) procedures for the complete and timely 
                collection and reporting of data to the Coordinated 
                Network by census tract, or other political subdivision 
                determined appropriate by the Secretary, in 
                consultation with the Administrator of the 
                Environmental Protection Agency, regarding the factors 
                described in subparagraphs (A), (B), and (C);
                    ``(E) procedures for making data available to the 
                public and researchers, and for reporting to the 
                Coordinated Network, while protecting the 
                confidentiality of all personal data reported, in 
                accordance with medical privacy regulations;
                    ``(F) standards and procedures for the 
                establishment and maintenance of at least 7 regional 
                biomonitoring laboratories, including providing for an 
                equitable geographic distribution, by entering into 
                cooperative agreements with States, groups of States, 
                and academic institutions or consortia of academic 
                institutions, in order to expand the scope and amount 
                of biomonitoring data collected by the Centers for 
                Disease Control and Prevention;
                    ``(G) criteria for the environmental health 
                investigators as required under subsection (b)(3)(D); 
                and
                    ``(H) procedures for record and data maintenance 
                and verification.
    ``(b) State Environmental Health Networks.--
            ``(1) Grants.--Not later than 24 months after the date of 
        the enactment of this title, the Secretary, acting through the 
        Director, in consultation with the Administrators, and taking 
        into consideration the findings of the Committee, shall award 
        grants to States, local governments, territories, and Indian 
        tribes for the establishment, maintenance, and operation of 
        State Environmental Health Networks in accordance with the 
        minimum standards and procedures established by the Secretary 
        under subsection (a)(4).
            ``(2) Specialized assistance.--The Coordinated Network 
        shall provide specialized assistance to grantees in the 
        establishment, maintenance, and operation of State Networks.
            ``(3) Requirements.--A State, local government, territory, 
        or Indian tribe receiving a grant under this subsection shall 
        use the grant--
                    ``(A) to establish an environmental health network 
                that will provide--
                            ``(i) for the complete tracking of the 
                        incidence, prevalence, and trends of priority 
                        chronic conditions and potentially relevant 
                        environmental and other factors as set forth in 
                        subsection (a), as well as any additional 
                        priority chronic conditions and potentially 
                        related environmental exposures of concern to 
                        that State, local government, territory, or 
                        Indian tribe;
                            ``(ii) for identification of priority 
                        chronic conditions and potentially relevant 
                        environmental and other factors that 
                        disproportionately impact low income and 
                        minority communities;
                            ``(iii) for the protection of the 
                        confidentiality of all personal data reported, 
                        in accordance with the medical privacy 
                        regulations;
                            ``(iv) a means by which confidential data 
                        may, in accordance with Federal and State law, 
                        be disclosed to researchers for the purposes of 
                        public health research;
                            ``(v) the fullest possible public access to 
                        data collected by the State Network or through 
                        the Coordinated Network, while ensuring that 
                        individual privacy is protected in accordance 
                        with subsection (a)(1)(B); and
                            ``(vi) for the collection of exposure data 
                        through biomonitoring and other methods, 
                        including the entering into of cooperative 
                        agreements with the Coordinated Network in the 
                        establishment of the regional biomonitoring 
                        laboratories;
                    ``(B) to develop a publicly available plan for 
                establishing the State Network in order to meet minimum 
                standards and procedures as developed by the 
                Coordinated Network under subsection (a)(4), including 
                the State's priorities within the minimum standards, a 
                timeline by which all the standards will be met, and a 
                plan for coordinating and expanding existing data and 
                surveillance systems within the State including any 
                pilot projects established through the Centers for 
                Disease Control and Prevention prior to the date of the 
                enactment of this title;
                    ``(C) to appoint a lead environmental health 
                department or agency that will be responsible for the 
                development, operation, and maintenance of the State 
                Network, and ensure the appropriate coordination among 
                State and local agencies regarding the development, 
                operation, and maintenance of the State Network;
                    ``(D) to appoint or hire an environmental health 
                investigator who meets criteria established by the 
                Secretary under subsection (a)(4)(G) and who will 
                coordinate the development and maintenance of the rapid 
                response protocol established under subparagraph (E);
                    ``(E) to establish a rapid response protocol, 
                coordinated by the grantee's environmental health 
                investigator, in order to respond in a timely manner to 
                actual and perceived incidence and prevalence rates of 
                priority chronic diseases that are higher than 
                expected, acute and potential environmental hazards and 
                exposures, and other environmental health concerns, 
                including warning the public when emergent public 
                health concerns are detected through the State Network, 
                and concerns regarding vulnerable subpopulations and 
                disproportionately impacted subpopulations;
                    ``(F) to establish an advisory committee to ensure 
                local community input to the State Network; and
                    ``(G) to recruit and train public health officials 
                to continue to expand the State Network.
            ``(4) Limitation.--A State, local government, territory, or 
        Indian tribe that receives a grant under this section may not 
        use more than 10 percent of the funds made available through 
        the grant for administrative costs.
            ``(5) Application.--To seek a grant under this section, a 
        State, local government, territory, or Indian tribe shall 
        submit to the Secretary an application at such time, in such 
        form and manner, and accompanied by such information as the 
        Secretary may specify. The Secretary may not approve an 
        application for a grant under this subsection unless the 
        application--
                    ``(A) contains assurances that the State, local 
                government, territory, or tribe will--
                            ``(i) use the grant only in compliance with 
                        the requirements of this title; and
                            ``(ii) establish such fiscal control and 
                        fund accounting procedures as may be necessary 
                        to ensure the proper disbursement and 
                        accounting of Federal funds paid to the State, 
                        local government, territory, or tribe under the 
                        grant;
                    ``(B) contains the assurance that the State, local 
                government, territory, or tribe will establish a State 
                Network as required by this subsection; and
                    ``(C) contains assurances that if the State, local 
                government, territory, or tribe is unable to meet all 
                of the requirements described in this subsection within 
                the prescribed time period, the State, local 
                government, territory, or tribe will use grant funds to 
                increase the public health infrastructure of the State, 
                local government, territory, or tribe, acting in 
                cooperation with the Coordinated Network, in order to 
                implement and maintain a State Network within 24 months 
                of the receipt of such grant.
    ``(c) Pilot Projects.--
            ``(1) In general.--Beginning in fiscal year 2005, a State, 
        local government, territory, or Indian tribe may apply for a 
        grant under this subsection to implement a pilot project that 
        is approved by the Secretary, acting through the Director and 
        in consultation with the Administrators and the Committee.
            ``(2) Activities.--A State, local government, territory, or 
        Indian tribe shall use amounts received under a grant under 
        this subsection to carry out a pilot project designed to 
        develop State Network enhancements and to develop programs to 
        address specific local and regional concerns, including--
                    ``(A) the expansion of the State Network to include 
                additional chronic diseases or environmental exposures;
                    ``(B) the conduct of investigations of local 
                concerns of increased incidence or prevalence of 
                priority chronic conditions and environmental 
                exposures; and
                    ``(C) the carrying out of other activities as 
                determined to be a priority by the State or consortium 
                of regional States, local government, territory, or 
                tribe and the Secretary.
            ``(3) Results.--The Secretary may consider the results of 
        the pilot projects under this subsection for inclusion into the 
        Coordinated Network.
    ``(d) Advisory Committee.--
            ``(1) Establishment.--Not later than 3 months after the 
        date of the enactment of this title, the Secretary acting 
        jointly with the Administrators, shall establish an Advisory 
        Committee in accordance with the Federal Advisory Committee 
        Act.
            ``(2) Composition.--The Advisory Committee shall be 
        composed of 16 members to be appointed by the Secretary. Each 
        member of the Advisory Committee shall serve a 3-year term, 
        except that the Secretary may appoint the initial members of 
        the Advisory Committee for lesser terms in order to comply with 
        the following sentence. In appointing the members of the 
        Advisory Committee, the Secretary shall ensure that the terms 
        of 5 or 6 members expire each year. The Advisory Committee 
        shall include at least 9 members that have experience in the 
        areas of--
                    ``(A) public health;
                    ``(B) the environment, especially toxic chemicals 
                and human exposure;
                    ``(C) epidemiology; and
                    ``(D) biomonitoring and other relevant exposure 
                technologies.
            ``(3) Reporting.--The Advisory Committee shall not later 
        than 12 months after the date of the enactment of this title, 
        and at least once every 12 months thereafter, report to 
        Congress on the progress of the Coordinated Network.
            ``(4) Hearings.--The Advisory Committee shall hold such 
        hearings, sit and act at such times and places, take such 
        testimony, and receive such evidence as the Committee considers 
        appropriate to carry out the objectives of the Coordinated 
        Network.
            ``(5) Duties.--The Advisory Committee shall--
                    ``(A) review and provide input for the Coordinated 
                Environmental Health Network Report prior to 
                publication, and make recommendations as to the 
                progress of the Coordinated Network, including 
                identifying information gaps in the network;
                    ``(B) assist in developing the minimum standards 
                and procedures for the State Networks under subsection 
                (a)(4); and
                    ``(C) provide ongoing public input to the 
                Coordinated Network.
    ``(e) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section $100,000,000 for fiscal year 
2005 and such sums as may be necessary for each of fiscal years 2006 
through 2009.

``SEC. 2902. INCREASING PUBLIC HEALTH PERSONNEL CAPACITY.

    ``(a) Schools or Programs of Public Health Centers of Excellence.--
            ``(1) Grants.--Beginning in fiscal year 2005, the Secretary 
        may award grants to at least 5 accredited schools or programs 
        of public health for the establishment, maintenance, and 
        operation of Centers of Excellence for research and 
        demonstration with respect to chronic conditions and relevant 
        environmental factors.
            ``(2) Activities.--A Center of Excellence established or 
        operated under paragraph (1) shall undertake research and 
        development projects in at least 1 of the following areas:
                    ``(A) Investigating causal connections between 
                chronic conditions and environmental factors.
                    ``(B) Increasing the understanding of the causes of 
                higher than expected incidence and prevalence rates of 
                priority chronic conditions and developing more 
                effective intervention methods for when such elevated 
                rates occur.
                    ``(C) Identifying additional chronic conditions and 
                environmental factors that could be tracked by the 
                Coordinated Network.
                    ``(D) Improving translation of Coordinated Network 
                tracking results into effective prevention activities.
                    ``(E) Improving the training of public health 
                workforce in environmental epidemiology.
                    ``(F) Establishing links to the Coordinated Network 
                and the State Networks to identify associations that 
                warrant further study.
            ``(3) Requirements for centers of excellence.--To be 
        eligible to receive a grant under paragraph (1), a school or 
        program of public health shall provide assurances that the 
        school or program--
                    ``(A) meets the minimum requirements as established 
                by the Secretary in consultation with the Director;
                    ``(B) maintains privacy for public health 
                information if appropriate to the project; and
                    ``(C) makes public information regarding the 
                findings and results of the programs.
            ``(4) Authorization of appropriations.--There is authorized 
        to be appropriated to carry out this subsection $5,000,000 for 
        each of fiscal years 2005 through 2009.
    ``(b) John H. Chafee Public Health Scholar Program.--
            ``(1) In general.--The Secretary shall award scholarships, 
        to be known as John H. Chafee Public Health Scholarships, to 
        eligible students who are enrolled in an accredited school of 
        public health or medicine. The Secretary shall determine both 
        the criteria and eligibility requirements for such 
        scholarships, after consultation with the Committee.
            ``(2) Authorization of appropriations.--There is authorized 
        to be appropriated to carry out this subsection $2,500,000 for 
        each of fiscal years 2005 through 2009.
    ``(c) Applied Epidemiology Fellowship Programs.--
            ``(1) In general.--Beginning in fiscal year 2005, the 
        Secretary, acting through the Director, shall enter into a 
        cooperative agreement with the Council of State and Territorial 
        Epidemiologists to train and place, in State and local health 
        departments, applied epidemiology fellows to enhance State and 
        local epidemiology capacity in the areas of environmental 
        health, chronic disease, and birth defects and development 
        disabilities.
            ``(2) Authorization of appropriations.--There is authorized 
        to be appropriated to carry out this subsection $2,500,000 for 
        fiscal year 2005, and such sums as may be necessary in each of 
        fiscal years 2006 through 2009.

``SEC. 2903. GENERAL PROVISIONS.

    ``(a) Internal Monitoring and Coordination Regarding CDC.--The 
Secretary, acting through the Director, shall place primary 
responsibility for the coordination of the programs established under 
this title in the Office of the Director. The officers or employees of 
the Centers for Disease Control and Prevention who are assigned 
responsibility for monitoring and coordinating the activities carried 
out under this title by the Director shall include officers or 
employees within the Office of the Director.
    ``(b) Funding Through Appropriations Account for Public Health 
Improvement.--All authorizations of appropriations established in this 
title are authorizations exclusively for appropriations to the account 
that, among appropriations accounts for the Centers for Disease Control 
and Prevention, is designated `Public Health Improvement'.
    ``(c) Date Certain for Obligation of Appropriations.--With respect 
to the process of receiving applications for and making awards of 
grants, cooperative agreements, and contracts under this title, the 
Secretary, acting through the Director, shall to the extent practicable 
design the process to ensure that amounts appropriated under this title 
for such awards for a fiscal year are obligated not later than the 
beginning of the fourth quarter of the fiscal year, subject to 
compliance with section 1512 of title 31, United States Code (relating 
to deficiency or supplemental appropriations), and other applicable law 
regarding appropriations accounting.
    ``(d) Coordination With Agency for Toxic Substances and Disease 
Registry.--In carrying out this title, the Secretary, acting through 
the Director, shall coordinate activities and responses with the Agency 
for Toxic Substances and Disease Registry.
    ``(e) Coordination With Existing Pilot Projects Through CDC.--The 
Secretary shall integrate the enactment of this title with all 
environmental health tracking pilot projects funded prior to the date 
of enactment of this title.''.
                                 <all>