[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3426 Introduced in House (IH)]

111th CONGRESS
  1st Session
                                H. R. 3426

   To amend the Public Health Service Act to establish a Coordinated 
                  Environmental Public Health Network.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             July 30, 2009

 Ms. Pelosi (for herself, Ms. Slaughter, Mr. Markey of Massachusetts, 
Mrs. Capps, Ms. Schakowsky, Ms. Baldwin, Ms. DeLauro, Ms. McCollum, Mr. 
  Serrano, Mr. Grijalva, and Mr. Hare) introduced the following bill; 
       which was referred to the Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
   To amend the Public Health Service Act to establish a Coordinated 
                  Environmental Public Health Network.

    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 Public 
Health Network Act of 2009''.

SEC. 2. 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 XXXI--COORDINATED ENVIRONMENTAL PUBLIC HEALTH NETWORK

``SEC. 3100. DEFINITIONS.

    ``In this title:
            ``(1) Administrator.--The term `Administrator' means the 
        Administrator of the Environmental Protection Agency.
            ``(2) Coordinated network.--The term `Coordinated Network' 
        means the Coordinated Environmental Public Health Network 
        established under section 3101(a).
            ``(3) Director.--The term `Director' means the Director of 
        the Centers for Disease Control and Prevention.
            ``(4) Director of the center.--The term `Director of the 
        Center' means the Director of the National Center for 
        Environmental Health at the Centers for Disease Control and 
        Prevention.
            ``(5) 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.
            ``(6) Priority chronic conditions and health effects.--The 
        term `priority chronic conditions and health effects' means the 
        conditions, as specified by the Secretary, to be tracked in the 
        Coordinated Network and the State Networks.
            ``(7) State network.--The term `State Network' means a 
        State Environmental Public Health Network established under 
        section 3101(b).
            ``(8) State.--The term `State' means a State, local 
        government, territory, or Indian tribe that is eligible to 
        receive a health tracking grant under section 3101(b).

``SEC. 3101. ESTABLISHMENT OF COORDINATED AND STATE ENVIRONMENTAL 
              PUBLIC HEALTH NETWORKS.

    ``(a) Coordinated Environmental Public Health Network.--
            ``(1) Establishment.--Not later than 36 months after the 
        date of the enactment of this title, the Secretary, acting 
        through the Director, in consultation with the Administrator 
        and the Director of the Center, and with the involvement of 
        other Federal agencies, and State and local health departments, 
        shall establish and operate a Coordinated Environmental Public 
        Health Network. In establishing and operating the Coordinated 
        Network, the Secretary shall, as practicable--
                    ``(A) identify, build upon, expand, and coordinate 
                among existing data and surveillance systems, surveys, 
                registries, and other Federal public health and 
                environmental infrastructure as practicable, 
                including--
                            ``(i) the Public Health Information 
                        Network;
                            ``(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; and
                            ``(ix) 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 health effects and relevant 
                environmental and other factors, in a manner which 
                protects personal privacy consistent with the medical 
                privacy regulations;
                    ``(C) in order to allow the public to access and 
                understand information about environmental health at 
                the Federal, State, and, where practicable, local 
                level, prepare, publish, make publicly available on the 
                Web sites of the Centers for Disease Control and 
                Prevention and the Environmental Protection Agency, and 
                submit to Congress not later than 2 years after the 
                date of the enactment of this title, and biennially 
                thereafter, a Coordinated Network Health and 
                Environment Report, including--
                            ``(i) identification of gaps in the data of 
                        the Network, including diseases of concern and 
                        environmental exposures not tracked;
                            ``(ii) identification of activities carried 
                        out under this title and key milestones 
                        achieved during the preceding year; and
                            ``(iii) an analysis of the most currently 
                        available incidence, prevalence, and trends of 
                        priority chronic conditions and health effects, 
                        and potentially relevant environmental and 
                        other factors, by State and, as practicable by 
                        local areas, and recommendations regarding high 
                        risk populations, public health concerns, 
                        response and prevention strategies, and 
                        additional tracking needs;
                    ``(D) provide for the establishment of State 
                Networks, and coordinate the State Networks as provided 
                for under subsection (b);
                    ``(E) provide technical assistance to support the 
                State Networks;
                    ``(F) not later than 12 months after the date of 
                the enactment of this title, develop minimum standards 
                and procedures for data collection and reporting for 
                the State Networks, to be updated not less than 
                annually thereafter; and
                    ``(G) in developing the minimum standards and 
                procedures under subparagraph (F), include mechanisms 
                for allowing the States to set priorities, and allocate 
                resources accordingly.
            ``(2) Data collection and reporting by state networks.--The 
        minimum standards and procedures referred to in paragraph 
        (1)(F) shall include--
                    ``(A) a list and definitions of the priority 
                chronic conditions and health effects 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, and demographic 
                factors known to be associated with these priority 
                chronic conditions and health effects and other risk 
                factors, such as 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 local areas, such as a census tract or other 
                political subdivision determined appropriate by the 
                Secretary, in consultation with the Administrator, 
                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; and
                    ``(F) standards and procedures for the 
                establishment, operation, and maintenance of 
                laboratories conducting biomonitoring, in order to 
                expand the scope and amount of biomonitoring data 
                collected by the Centers for Disease Control and 
                Prevention as described in section 3104.
    ``(b) State Environmental Public Health Networks.--
            ``(1) Grants.--Not later than 12 months after the date of 
        the enactment of this title, the Secretary, acting through the 
        Director, in consultation with the Administrator and the 
        Director of the Center shall award grants to States for the 
        establishment, maintenance, and operation of State Networks in 
        accordance with the minimum standards and procedures 
        established by the Secretary under subsection (a)(1)(F).
            ``(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 receiving a grant under this 
        subsection shall use the grant--
                    ``(A) to establish an environmental public health 
                network that will provide--
                            ``(i) for the tracking of the incidence, 
                        prevalence, and trends of priority chronic 
                        conditions and health effects, as well as any 
                        additional priority chronic conditions and 
                        health effects and potentially related 
                        environmental exposures of concern to that 
                        State;
                            ``(ii) for identification of priority 
                        chronic conditions and health effects 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, which 
                        may include the entering into of cooperative 
                        agreements as described in section 3104;
                    ``(B) to develop a publicly available plan for 
                establishing the State Network in order to meet minimum 
                standards and procedures as developed by the Secretary 
                under subsection (a)(1)(F);
                    ``(C) to appoint a lead public 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, including environmental agencies, 
                regarding the development, operation, and maintenance 
                of the State Network; and
                    ``(D) to recruit and train public health officials 
                to continue to expand the State Network.
            ``(4) Limitation.--A State 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 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.
    ``(c) Pilot Projects.--
            ``(1) In general.--A State 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 Administrator, and the Director of the Center.
            ``(2) Activities.--A State 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.
            ``(3) Results.--The Secretary may consider the results of 
        the pilot projects under this subsection for inclusion into the 
        Coordinated Network.
    ``(d) Privacy.--In establishing and operating the Coordinated 
Network under subsection (a), and in making grants under subsections 
(b) and (c), the Secretary shall ensure the protection of privacy of 
individually identifiable health information, including ensuring 
protection consistent with the regulations promulgated under section 
264(c) of the Health Insurance Portability and Accountability Act of 
1996.
    ``(e) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section such sums as may be necessary 
for each of fiscal years 2010 through 2014.

``SEC. 3102. INCREASING PUBLIC HEALTH PERSONNEL CAPACITY.

    ``(a) In General.--Beginning in fiscal year 2010, 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 public health capacity in the areas 
of environmental health, chronic and other noninfectious diseases and 
conditions, and public health surveillance.
    ``(b) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section such sums as may be necessary 
for each of fiscal years 2010 through 2014.

``SEC. 3103. GENERAL PROVISIONS.

    ``(a) Integration of Environmental Health Tracking Programs.--The 
Secretary shall integrate the enactment of this title with all 
environmental health tracking programs funded prior to the date of the 
enactment of this title, including by integrating the programs, in 
existence on the date of the enactment of this title, to develop State 
Network enhancements and to develop programs to address specific local 
and regional concerns.
    ``(b) 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.

``SEC. 3104. EXPANSION OF BIOMONITORING CAPABILITIES AND DATA 
              COLLECTION.

    ``(a) Purpose.--It is the purpose of this section to expand the 
scope and amount of biomonitoring data collected and analyzed by the 
Centers for Disease Control and Prevention, State laboratories, and 
consortia of State laboratories, in order to obtain robust information, 
including information by geographically defined areas and 
subpopulations, about a range of environmental exposures.
    ``(b) In General.--In meeting the purpose of this section, the 
Secretary shall ensure that biomonitoring data are collected 
intramurally through appropriate sources, including the National Health 
and Nutrition Examination Survey, and extramurally shall enter into 
collaboration or partnerships with other entities to obtain additional 
information regarding vulnerable subpopulations or other 
subpopulations.
    ``(c) Cooperative Agreements.--
            ``(1) In general.--The Secretary, acting through the 
        Director, shall enter into cooperative agreements with States 
        or consortia of States to support the purposes of this title.
            ``(2) Applications.--Applications for such cooperative 
        agreements by consortia of States shall address the manner in 
        which such States will coordinate activities with other States 
        in the region, and shall designate a lead State for 
        administrative purposes.
            ``(3) Training and quality assurance.--The Secretary, 
        acting through the Director, shall through the cooperative 
        agreements with States or a consortia of States provide 
        laboratory training and quality assurance.
    ``(d) Privacy.--In carrying out this section, the Secretary shall 
ensure the protection of privacy of individually identifiable health 
information, including ensuring protection consistent with the 
regulations promulgated under section 264(c) of the Health Insurance 
Portability and Accountability Act of 1996.
    ``(e) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section such sums as may be necessary 
for each of fiscal years 2010 through 2014.''.
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