[Congressional Record Volume 167, Number 206 (Tuesday, November 30, 2021)]
[House]
[Pages H6684-H6687]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
IMMUNIZATION INFRASTRUCTURE MODERNIZATION ACT OF 2021
Mr. PALLONE. Mr. Speaker, I move to suspend the rules and pass the
bill (H.R. 550) to amend the Public Health Service Act with respect to
immunization system data modernization and expansion, and for other
purposes, as amended.
The Clerk read the title of the bill.
The text of the bill is as follows:
H.R. 550
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 ``Immunization Infrastructure
Modernization Act of 2021''.
SEC. 2. IMMUNIZATION INFORMATION SYSTEM DATA MODERNIZATION
AND EXPANSION.
Subtitle C of title XXVIII of the Public Health Service Act
(42 U.S.C. 300hh-31 et seq.) is amended by adding at the end
the following:
``SEC. 2824. IMMUNIZATION INFORMATION SYSTEM DATA
MODERNIZATION AND EXPANSION.
``(a) Expanding CDC and Public Health Department
Capabilities.--
``(1) In general.--The Secretary shall--
``(A) conduct activities (including with respect to
interoperability, population reporting, and bidirectional
reporting) to expand, enhance, and improve immunization
information systems that are administered by health
departments or other agencies of State, local, Tribal, and
territorial governments and used by health care providers;
and
``(B) award grants or cooperative agreements to the health
departments, or such other governmental entities as
administer immunization information systems, of State, local,
Tribal, and territorial governments, for the expansion,
enhancement, and improvement of immunization information
systems to assist public health departments in--
``(i) assessing current data infrastructure capabilities
and gaps among health care providers to improve and increase
consistency in patient matching, data collection, reporting,
bidirectional exchange, and analysis of immunization-related
information;
``(ii) providing for technical assistance and the efficient
enrollment and training of health care providers, including
at pharmacies and other settings where immunizations are
being provided, such as long-term care facilities, specialty
health care providers, community health centers, Federally
qualified health centers, rural health centers, organizations
serving adults 65 and older, and organizations serving
homeless and incarcerated populations;
``(iii) improving secure data collection, transmission,
bidirectional exchange, maintenance, and analysis of
immunization information;
``(iv) improving the secure bidirectional exchange of
immunization record data among Federal, State, local, Tribal,
and territorial governmental entities and non-governmental
entities, including by--
``(I) improving such exchange among public health officials
in multiple jurisdictions within a State, as appropriate; and
``(II) by simplifying and supporting electronic reporting
by any health care provider;
``(v) supporting the standardization of immunization
information systems to accelerate interoperability with
health information technology, including with health
information technology certified under section 3001(c)(5) or
with health information networks;
``(vi) supporting adoption of the immunization information
system functional standards of the Centers for Disease
Control and Prevention and the maintenance of security
standards to protect individually identifiable health
information;
``(vii) supporting and training immunization information
system, data science, and informatics personnel;
``(viii) supporting real-time immunization record data
exchange and reporting, to support rapid identification of
immunization coverage gaps;
``(ix) improving completeness of data by facilitating the
capability of immunization information systems to exchange
data, directly or indirectly, with immunization information
systems in other jurisdictions;
``(x) enhancing the capabilities of immunization
information systems to evaluate, forecast, and operationalize
clinical decision support tools in alignment with the
recommendations of the Advisory Committee on Immunization
Practices as approved by the Director of the Centers for
Disease Control and Prevention;
[[Page H6685]]
``(xi) supporting the development and implementation of
policies that facilitate complete population-level capture,
consolidation, and access to accurate immunization
information;
``(xii) supporting the procurement and implementation of
updated software, hardware, and cloud storage to adequately
manage information volume and capabilities;
``(xiii) supporting expansion of capabilities within
immunization information systems for outbreak response;
``(xiv) supporting activities within the applicable
jurisdiction related to the management, distribution, and
storage of vaccine doses and ancillary supplies;
``(xv) developing information related to the use and
importance of immunization record data and disseminating such
information to health care providers and other persons
authorized under State law to access such information,
including payors and health care facilities; or
``(xvi) supporting activities to improve the scheduling and
administration of vaccinations.
``(2) Data standards.--In carrying out paragraph (1), the
Secretary shall--
``(A) designate data and technology standards that must be
followed by governmental entities with respect to use of
immunization information systems as a condition of receiving
an award under this section, with priority given to standards
developed by--
``(i) consensus-based organizations with input from the
public; and
``(ii) voluntary consensus-based standards bodies; and
``(B) support a means of independent verification of the
standards used in carrying out paragraph (1).
``(3) Public-private partnerships.--In carrying out
paragraph (1), the Secretary may develop and utilize
contracts and cooperative agreements for technical
assistance, training, and related implementation support.
``(b) Requirements.--
``(1) Health information technology standards.--The
Secretary may not award a grant or cooperative agreement
under subsection (a)(1)(B) unless the applicant uses and
agrees to use standards adopted by the Secretary under
section 3004.
``(2) Waiver.--The Secretary may waive the requirement
under paragraph (1) with respect to an applicant if the
Secretary determines that the activities under subsection
(a)(1)(B) cannot otherwise be carried out within the
applicable jurisdiction.
``(3) Application.--A State, local, Tribal, or territorial
health department applying for a grant or cooperative
agreement under subsection (a)(1)(B) shall submit an
application to the Secretary at such time and in such manner
as the Secretary may require. Such application shall include
information describing--
``(A) the activities that will be supported by the grant or
cooperative agreement; and
``(B) how the modernization of the immunization information
systems involved will support or impact the public health
infrastructure of the health department, including a
description of remaining gaps, if any, and the actions needed
to address such gaps.
``(c) Strategy and Implementation Plan.--Not later than 90
days after the date of enactment of this section, the
Secretary shall submit to the Committee on Energy and
Commerce of the House of Representatives and the Committee on
Health, Education, Labor, and Pensions of the Senate a
coordinated strategy and an accompanying implementation plan
that identifies and demonstrates the measures the Secretary
will utilize to--
``(1) update and improve immunization information systems
supported by the Centers for Disease Control and Prevention;
and
``(2) carry out the activities described in this section to
support the expansion, enhancement, and improvement of State,
local, Tribal, and territorial immunization information
systems.
``(d) Consultation; Technical Assistance.--
``(1) Consultation.--In developing the strategy and
implementation plan under subsection (c), the Secretary shall
consult with--
``(A) health departments, or such other governmental
entities as administer immunization information systems, of
State, local, Tribal, and territorial governments;
``(B) professional medical associations, public health
associations, and associations representing pharmacists and
pharmacies;
``(C) community health centers, long-term care facilities,
and other appropriate entities that provide immunizations;
``(D) health information technology experts; and
``(E) other public or private entities, as appropriate.
``(2) Technical assistance.--In connection with
consultation under paragraph (1), the Secretary may--
``(A) provide technical assistance, certification, and
training related to the exchange of information by
immunization information systems used by health care and
public health entities at the local, State, Federal, Tribal,
and territorial levels; and
``(B) develop and utilize public-private partnerships for
implementation support applicable to this section.
``(e) Report to Congress.--Not later than 1 year after the
date of enactment of this section, the Secretary shall submit
a report to the Committee on Health, Education, Labor, and
Pensions of the Senate and the Committee on Energy and
Commerce of the House of Representatives that includes--
``(1) a description of any barriers to--
``(A) public health authorities implementing interoperable
immunization information systems;
``(B) the exchange of information pursuant to immunization
records; or
``(C) reporting by any health care professional authorized
under State law, using such immunization information systems,
as appropriate, and pursuant to State law; or
``(2) a description of barriers that hinder the effective
establishment of a network to support immunization reporting
and monitoring, including a list of recommendations to
address such barriers; and
``(3) an assessment of immunization coverage and access to
immunizations services and any disparities and gaps in such
coverage and access for medically underserved, rural, and
frontier areas.
``(f) Definition.--In this section, the term `immunization
information system' means a confidential, population-based,
computerized database that records immunization doses
administered by any health care provider to persons within
the geographic area covered by that database.
``(g) Authorization of Appropriations.--To carry out this
section, there is authorized to be appropriated $400,000,000,
to remain available until expended.''.
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from New
Jersey (Mr. Pallone) and the gentleman from Kentucky (Mr. Guthrie) each
will control 20 minutes.
The Chair recognizes the gentleman from New Jersey.
General Leave
Mr. PALLONE. Mr. Speaker, I ask unanimous consent that all Members
may have 5 legislative days in which to revise and extend their remarks
and include extraneous material on H.R. 550.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from New Jersey?
There was no objection.
Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I rise in strong support of H.R. 550, the Immunization
Infrastructure Modernization Act. This bill would authorize $400
million for grants to expand, enhance, and improve immunization
information systems administered by health departments and used by
healthcare providers.
Immunization information systems, also known as IIS, or immunization
registries, are confidential, population-based, computerized databases
that record immunization doses administered by providers to patients.
They are critical in our fight against COVID-19 and other public health
threats like measles and influenza.
Local public health officials use IIS to collect, analyze, store, and
view aggregated vaccination information, which is kept confidential and
separate from identifiable patient information. This information helps
them understand overall vaccination levels so they can better guide
public health decisions for their communities.
IIS also helps patients and healthcare providers by allowing them to
view a secure consolidated immunization history, helping them determine
appropriate and necessary vaccinations, and reminding patients about
vaccination schedules.
IIS have been critical in the COVID-19 pandemic. They have helped us
understand where vaccines are getting to patients, and where we need to
do more to reach people and provide access. They provided near real-
time information sharing, allowing State officials and leadership at
the Centers for Disease Control and Prevention to understand
vaccination rates and where people are choosing to receive their
vaccines.
Like all forms of infrastructure, IIS require maintenance and
upgrades. As I mentioned, IIS have been an important tool in the fight
against COVID-19, but the pandemic has also tested the ability of IIS
to keep up with the pace of our massive vaccination efforts.
According to the American Immunization Registry Association, one
State went from an average of 17,000 doses recorded in its IIS each day
to over 500,000 this past spring. This dramatic increase required the
State health department to nearly quadruple the number of digital
servers used to host the data. These are not one-time costs. Going
forward, these new servers and the new data collected during the
pandemic will need to be maintained and secured.
State and local leaders have also told us that inconsistent and
antiquated technology, incomplete provider participation, and faltering
interoperability are areas where we must improve to ensure that we have
useful and quality data.
It is important that the systems used by physicians are able to
communicate with the State and local public health departments, and
that these systems
[[Page H6686]]
can also communicate with other States and the CDC.
H.R. 550, the bill before us today, addresses these challenges by
providing grants for technological upgrades, provider outreach and
enrollment, policy development, and a skilled workforce to build and
maintain these systems.
The legislation also requires the Department of Health and Human
Services to create an implementation strategy and set clear data
standards that must be followed by all grantees. And this should help
ensure that States are coordinated going forward.
H.R. 550 will ensure all IIS are brought up to modern standards, help
control disease outbreaks, and put our public health infrastructure on
a solid foundation for years to come.
Mr. Speaker, I thank Representatives Kuster and Bucshon for their
bipartisan work on this bill. I urge all Members to support this
important bipartisan legislation, and I reserve the balance of my time.
Mr. GUTHRIE. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I rise in support of H.R. 550, the Immunization
Infrastructure Modernization Act, a bill introduced by my Energy and
Commerce Committee colleagues, Ms. Kuster and Mr. Bucshon.
Immunization information systems, or IIS, are important tools in
providing immunization care for patients by allowing providers to view
a patient's comprehensive immunization history to determine the
appropriate vaccinations throughout their life.
The Immunization Infrastructure Modernization Act authorizes the
Secretary of Health and Human Services to conduct activities to improve
immunization information systems. These activities include designating
data and technology standards, developing public-private partnerships,
and awarding grants or cooperative agreements to health departments to
enhance their systems.
Modernizing our immunization infrastructure will give us a better
understanding of our current vaccination efforts and will also help us
determine which communities may need additional vaccination outreach--
better targeting our efforts to improve health outcomes across the
country.
Mr. Speaker, I urge my colleagues to support this bill, and I reserve
the balance of my time.
Mr. PALLONE. Mr. Speaker, I have no additional speakers at this time,
and I reserve the balance of my time.
Mr. GUTHRIE. Mr. Speaker, I yield such time as he may consume to the
gentleman from Indiana (Mr. Bucshon).
Mr. BUCSHON. Mr. Speaker, I rise in support of H.R. 550, the
Immunization Infrastructure Modernization Act of 2021.
Immunization information systems serve as a vital link between public
health officials, community providers and individuals, not only in
cases of disease outbreak or emergencies, but also during routine
vaccination efforts.
The COVID-19 pandemic has made clear that our immunization
information systems are in need of modernization.
Decisions in response to outbreaks must be based on science, and we
must ensure our States and localities have access to meaningful data to
make targeted decisions that lessen the spread and quickly reopen our
economies.
H.R. 550 would repurpose previously appropriated funds to be spent
through an existing grant program to improve and enhance the ability of
immunization information systems to securely exchange real-time
immunization record data between all public health programs.
As a doctor, I would take my patients' medical privacy very
seriously. Therefore, I want to make clear that the immunization
information systems are secure, confidential, population-based
databases, and are completely deidentified.
Mr. Speaker, I would like to thank Representative Kuster for her
partnership, and I urge a ``yes'' vote.
Mr. GUTHRIE. Mr. Speaker, I yield back the balance of my time.
Mr. PALLONE. Mr. Speaker, I would ask that we support this bill, and
I yield back the balance of my time.
Ms. JACKSON LEE. Mr. Speaker, I rise in support of H.R. 550, the
``Immunization Infrastructure Modernization Act of 2021,'' which will
improve our public health infrastructure and expand information-sharing
between state and federal governments, as well as public and private
health care providers, to ensure vaccines are being administered
effectively and efficiently across all states and territories.
Mr. Speaker, public health agencies work every day to prevent disease
and viruses, promote health, and prepare for and respond to both
emergency situations and ongoing challenges--but they cannot do so
without the ability to access the best available data and share
information with other experts, and the COVID-19 pandemic highlighted
this fact.
As the Chair of the Congressional Coronavirus Task Force, I have used
every means possible to sound the alarm about the seriousness of the
COVID-19 virus.
On February 10, 2020, I held the first press conference on the issue
of COVID-19 at Houston Intercontinental Airport.
I then held a second press conference on February 24th to continue
efforts to raise public knowledge of the impending threat.
On February 26th, I wrote the Chair and Ranking Member of the
Committee on Homeland Security requesting to be briefed by Acting
Secretary of Homeland Security Chad Wolf regarding the preparedness of
the Department of Homeland Security to address a possible pandemic.
On March 19th, I announced an innovative partnership with United
Methodist Medical Center (UMMC) to open the first drive-through
Coronavirus Test Screening facility in the Greater Houston area, which
proved beneficial to everyone in the Greater Houston area, as with
UMMC's help we have opened multiple sites that are located within high-
risk communities in the Greater Houston area, to reduce the need for
travel to get access to COVID-19 testing.
Since the start of this pandemic, I have sought to proactively
address the critical issues and concerns tied to the COVID-19 virus.
As I stated at the beginning of this pandemic, We must not panic, but
prepare.''
I am pleased to see that this bill is not a panic-induced response,
but a well-thought-out proposal to further protect our citizens.
The COVID-19 pandemic revealed a number of challenges for public
health information systems, but worst among them is the limited
capacity of existing state Immunization Information Systems.
The importance of these systems cannot be understated: they allow
providers to keep vaccines and supplies in stock, prevent over--or
under--vaccination, remind patients when they are due for a recommended
vaccine, and identify areas with low vaccination rates to ensure
equitable distribution of vaccines.
However, states lack modern, comprehensive information systems that
can meet the challenges of COVID-19 and future public health threats
through the secure exchange of real-time immunization data.
Consequently, many state systems struggled to accommodate additional
demand, implement new functionalities, onboard immunization providers,
support interoperable exchange with health care partners and enable
timely reporting of immunization data to federal partners.
These issues are exactly what this legislation seeks to address.
Through H.R. 550, HHS will develop a strategy and a plan to improve
immunization information systems and designate data and technology
standards for use in these systems.
Additionally, HHS will award grants to health departments and other
government agencies to improve their systems contingent upon meeting
designated standards.
As the vaccine rollout continues and the time for boosters is upon
us, immunization data systems will be a critical tool in the success of
these efforts, and they are in need of modernization.
That is why I rise in ardent support of H.R. 550, and that is why the
bill has strong bipartisan backing.
Lastly, I want to thank Congresswoman Kuster and Congressman Bucshon
for introducing and shepherding this bill.
Mr. Speaker, I rise in support of H.R. 550, the ``Immunization
Infrastructure Modernization Act of 2021,'' which will improve our
public health infrastructure and expand information-sharing between
state and federal governments, as well as public and private health
care providers, to ensure vaccines are being administered effectively
and efficiently across all states and territories.
=========================== NOTE ===========================
November 30, 2021, on page H6686, in the third column, the
following appeared: Lastly, I want to thank Congresswoman Kuster
and Congressman Bucshon for introducing and shepherding this bill.
Ms. JACKSON LEE. Mr. Speaker, I rise in support of H.R. 550, the
``Immunization Infrastructure Modernization Act of 2021,'' which
The online version has been corrected to read: Lastly, I want to
thank Congresswoman Kuster and Congressman Bucshon for introducing
and shepherding this bill. Mr. Speaker, I rise in support of H.R.
550, the ``Immunization Infrastructure Modernization Act of
2021,'' which
========================= END NOTE =========================
Mr. Speaker, public health agencies work every day to prevent disease
and viruses, promote health, and prepare for and respond to both
emergency situations and ongoing challenges--but they cannot do so
without the ability to access the best available data and share
information with other experts, and the COVID-19 pandemic highlighted
this fact.
As the Chair of the Congressional Coronavirus Task Force, I have used
every mean possible to sound the alarm about the seriousness of the
COVID-19 virus.
On February 10th, 2020, I held the first press conference on the
issue of COVID-19 at Houston Intercontinental Airport.
[[Page H6687]]
I then held a second press conference on February 24th to continue
efforts to raise public knowledge of the impending threat.
On February 26th, I wrote the Chair and Ranking Member of the
Committee on Homeland Security requesting to be briefed by Acting
Secretary of Homeland Security Chad Wolf regarding the preparedness of
the Department of Homeland Security to address a possible pandemic.
On March 19th, I announced an innovative partnership with United
Methodist Medical Center (UMMC) to open the first drive-through
Coronavirus Test Screening facility in the Greater Houston area, which
proved beneficial to everyone in the Greater Houston area, as with
UMMC's help we have opened multiple that are located within high-risk
communities in the Greater Houston area, to reduce the need for travel
to get access to COVID-19 testing.
Since the start of this pandemic, I have sought to proactively
addressing the critical issues and concerns tied to the COVID-19 virus.
As I stated at the beginning of this pandemic, We must not panic, but
prepare.''
I am pleased to see that this bill is not a panic-induced response,
but a well-though-out proposal to further protect our citizens.
The COVID-19 pandemic revealed a number of challenges for public
health information systems, but worst among them is the limited
capacity of existing state Immunization Information Systems.
The importance of these systems cannot be understated: they allow
providers to keep vaccines and supplies in stock, prevent over--or
under--vaccination, remind patients when they are due for a recommended
vaccine, and identify areas with low vaccination rates to ensure
equitable distribution of vaccines.
However, states lack modern, comprehensive information systems that
can meet the challenges of COVID-19 and future public health threats
through the secure exchange of real-time immunization data.
Consequently, many state systems struggled to accommodate additional
demand, implement new functionalities, onboard immunization providers,
support interoperable exchange with health care partners and enable
timely reporting of immunization data to federal partners.
These issues are exactly what this legislation seeks to address.
Through H.R. 550, HHS will develop a strategy and a plan to improve
immunization information system and designate data and technology
standards for use in these systems.
Additionally, HHS will award grants to health departments and other
government agencies to improve their systems contingent upon meeting
designated standards.
As the vaccine rollout continues and the time for boosters is upon
us, immunization data systems will be a critical tool in the success of
these efforts, and they are in need of modernization.
That is why I rise in ardent support of H.R. 550, and that is why the
bill has strong bipartisan backing.
Lastly, I want to thank Congresswoman Kuster and Congressman Bucshon
for introducing and shepherding this bill.
The SPEAKER pro tempore. The question is on the motion offered by the
gentleman from New Jersey (Mr. Pallone) that the House suspend the
rules and pass the bill, H.R. 550, as amended.
The question was taken.
The SPEAKER pro tempore. In the opinion of the Chair, two-thirds
being in the affirmative, the ayes have it.
Mr. ROY. Mr. Speaker, on that I demand the yeas and nays.
The SPEAKER pro tempore. Pursuant to section 3(s) of House Resolution
8, the yeas and nays are ordered.
Pursuant to clause 8 of rule XX, further proceedings on this motion
are postponed.
____________________