[Congressional Record (Bound Edition), Volume 154 (2008), Part 14]
[Extensions of Remarks]
[Page 19092]
[From the U.S. Government Publishing Office, www.gpo.gov]




INTRODUCTION OF NATIONAL INTEGRATED PUBLIC HEALTH SURVEILLANCE SYSTEMS 
                     AND REPORTABLE CONDITIONS ACT

                                 ______
                                 

                             HON. LEE TERRY

                              of nebraska

                    in the house of representatives

                       Monday, September 15, 2008

  Mr. TERRY. Madam Speaker, I am pleased to join my colleagues, 
Congresswoman Baldwin (WI-02) and Congressman Towns (NY- 10) on the 
introduction of the National Integrated Public Health Surveillance 
Systems and Reportable Conditions Act which addresses a critical aspect 
of our public health system in the United States: our science 
infrastructure at all levels of government.
  That infrastructure, primarily applied epidemiology, laboratory 
science, and public health informatics, has greatly improved since the 
mid-1990s, but has not kept pace with the challenges we face today, 
such as increased foodborne disease outbreaks, emerging infections such 
as West Nile Virus, growing antimicrobial resistance, pandemic flu, and 
environmental health threats, particularly to clean air and water.
  Many parts of the local-State-Federal disease surveillance system 
remain fragmented and paper-based, and have not fully benefited from 
new technologies that could improve the thoroughness and timeliness of 
reporting. Only two State public health laboratories have bidirectional 
data flow and can both send and receive laboratory messages, the gold 
standard for disease reporting. The potential for new pathogen 
discovery, rapid electronic exchange of public health information, 
national bacterial and viral databases for DNA ``fingerprinting'' of 
infectious disease organisms has not been fully realized.
  Madam Speaker, we need a robust, universal, 21st century public 
health infrastructure that is strengthened at all levels of government 
to meet these challenges.
  The bill we are introducing today will achieve that goal. It will 
require a very modest expansion of resources, renewed focus and 
mission, and new areas of special emphasis for several existing 
programs within the Centers for Disease Control and Prevention, which 
have never before been authorized. These programs will give public 
health institutions the capacity to identify and monitor the occurrence 
of infectious diseases and other conditions of public health 
importance. It will also improve the detection of new and emerging 
infectious disease threats, including laboratory capacity to detect 
antimicrobial resistant infections, identify and respond to disease 
outbreaks, and hire and train necessary professional staff.
  The bill also focuses on improving electronic disease surveillance 
and reporting by requiring the Secretary, acting through the Director 
of the Centers for Disease Control to adopt, within 180 days of 
enactment, guidelines for public health entities to ensure that all 
State and local health departments and public health laboratories have 
access to receive, monitor, and report infectious diseases and other 
urgent conditions of public health importance. These guidelines will be 
coordinated with the office of the National Coordinator for Health 
Information Technology and the American Health Information Community .
  Grant mechanisms for achieving complete, and updated electronic 
disease reporting by State and local health departments, and public 
health laboratories are also delineated and modestly enhanced to ensure 
the Nation has a seamless, rapid information flow of disease detection 
and reporting.
  We are facing workforce shortages in many areas of our health and 
public health system. Three recent surveys conducted by the Council of 
State and Territorial Epidemiologists have established that the number 
and level of training of epidemiologists is perceived as seriously 
deficient in most States. The need to increase, well-trained, core 
public health science professionals is addressed in this bill. 
Fellowship training for key elements of the public health workforce, 
applied epidemiologists, laboratory scientists and public health 
informaticians, is authorized and modest funding targets provided.
  The bill also authorizes, for the first time, a process for 
determining a list of nationally notifiable diseases and conditions. 
The provisions are modeled on the existing process of collaboration 
between the States and the Centers for Disease Control and Prevention, 
but provide clarity and structure that enables Congress to monitor and 
support improvements as events and technology require.
  Madam Speaker, the ``National Integrated Public Health Surveillance 
Systems and Reportable Conditions Act'' will enhance the Nation's 
public health capacity by strengthening its core science infrastructure 
and ensuring a seamless, rapid flow of information. It will help us 
meet the serious public health challenges of today and tomorrow. I urge 
my colleagues to consider the benefits of this bill and join as a 
cosponsor and support its enactment.

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