[Senate Report 112-213]
[From the U.S. Government Publishing Office]


                                                       Calendar No. 514
112th Congress                                                   Report
                                 SENATE
 2d Session                                                     112-213

======================================================================



 
  STRENGTHENING PROTECTIONS FOR CHILDREN AND COMMUNITIES FROM DISEASE 
                              CLUSTERS ACT

                                _______
                                

               September 19, 2012.--Ordered to be printed

                                _______
                                

    Mrs. Boxer, from the Committee on Environment and Public Works, 
                        submitted the following

                              R E P O R T

                             together with

                             MINORITY VIEWS

                          [To accompany S. 76]

      [Including cost estimate of the Congressional Budget Office]

    The Committee on Environment and Public Works, to which was 
referred the bill (S. 76) to direct the Administrator of the 
Environmental Protection Agency to investigate and address 
cancer and disease clusters, including in infants and children, 
having considered the same, reports favorably thereon without 
amendment and recommends that the bill do pass.

                      PURPOSES OF THE LEGISLATION

    To direct the Administrator of the Environmental Protection 
Agency to investigate and address cancer and disease clusters, 
including in infants and children.

                    GENERAL STATEMENT AND BACKGROUND

    S. 76 seeks to increase the transparency, accountability 
and coordination of federal actions to investigate and address 
cancer and disease clusters. The bill authorizes the 
Administrator of the Environmental Protection Agency to 
investigate and address cancer and disease clusters, in 
conjunction with other federal public health agencies. The bill 
also increases the involvement of the public in participating 
in disease cluster investigations and actions to address the 
potential causes of such clusters.
    The need to modernize and update the federal government's 
approach to addressing disease clusters is clear. Over the last 
century, society has made tremendous advances in public health 
protections. Clean drinking and wastewater systems have reduced 
the number of people who die from typhoid and cholera. New 
medical systems, including early detection techniques, have 
helped to reduce deaths from heart disease and stroke. However, 
studies have shown the rates of some diseases have increased 
and the rates of other diseases, and associated deaths, still 
impact significant numbers of people, including children.
    For example, according to the Environmental Protection 
Agency (EPA), from 1975 to 2007, rates of childhood cancer have 
increased by almost 30 percent. Leukemia is the most common 
form of childhood cancer, accounting for 20 percent of the 
incidences. Between 1976 and 2005 there was a 24 percent 
increase in acute lymphoblastic leukemia in children.
    According to the National Cancer Institute, roughly 2,200 
children a year are diagnosed with cancer of the central 
nervous system, including of the brain and brain stem. The 
Department of Health and Human Services has found that birth 
defects are the leading cause of infant death in the first year 
of life, accounting for about 20 percent of infant deaths in 
2006.
    Diseases can have complex causes and researchers can have 
great difficulty fully describing the factors that cause 
children and other people to contract cancer and other 
illnesses. Experts focus on multiple potential causes, which 
often involve both environmental and genetic factors.
    Recently, the President's Cancer Panel issued its 2008-2009 
annual report, titled: ``Reducing Environmental Cancer Risk: 
What We Can Do Now.'' The report states that:

          ``In 2009 alone, approximately 1.5 million American 
        men, women, and children were diagnosed with cancer, 
        and 562,000 died from the disease. With the growing 
        body of evidence linking environmental exposures to 
        cancer, the public is becoming increasingly aware of 
        the unacceptable burden of cancer resulting from 
        environmental and occupational exposures that could 
        have been prevented through appropriate national 
        action.''

    The President's Cancer Panel went on to highlight the need 
to more fully address environmental links to cancer: ``The 
Panel was particularly concerned to find that the true burden 
of environmentally induced cancer has been grossly 
underestimated. . . . The Panel urges you [the President] most 
strongly to use the power of your office to remove the 
carcinogens and other toxins from our food, water, and air that 
needlessly increase health care costs, cripple our Nation's 
productivity, and devastate American lives.''
    The Committee also received testimony from people who have 
been impacted by childhood disease. The Committee notes the 
testimony of Mr. Trevor Schaefer, who is a twenty-one-year-old 
brain cancer survivor from McCall, ID. Mr. Schaefer was 
diagnosed with a malignant medullablastoma in November of 2002 
at the age of thirteen. He successfully fought the disease 
following treatment for his cancer and, thereafter, has helped 
to lead efforts to address the causes of childhood disease 
clusters. S. 76, which is also known as ``Trevor's Law,'' is 
designed to help children and other people like Mr. Schaefer 
who are affected by disease clusters.
    To accomplish goal, the bill seeks to strengthen federal 
agency coordination and accountability when investigating and 
helping to address potential disease clusters; increase 
resources to communities who may be impacted by potential 
disease clusters, including by providing for community-based 
committees that play an integral role in actions to investigate 
and help address such clusters; and enhance federal, state and 
academic capacity to investigate and help address such 
clusters, including through partnerships and grants and by 
developing new pollution and disease tracking tools to 
facilitate investigation and actions to address clusters.

                      SECTION-BY-SECTION ANALYSIS

Section 1. Short title

    Section 1 provides that the short title of the bill is the 
''Strengthening Protections for Children and Communities From 
Disease Clusters Act''.

Sec. 2. Findings

    Section 2 contains the findings made to highlight the need 
for the bill and the actions authorized by the bill.

Sec. 3. Purposes

    Section 3 defines the purposes for which the bill was 
created.

Sec. 4. Goals

    Section 4 defines the goals that the bill seeks to achieve.

Sec. 5. Definitions

    Section 5 contains the definitions of the bill.

Sec. 6. Guidelines for environmental investigations of disease clusters

    Section 6 describes the establishment and requirements for 
federal disease cluster investigation guidelines.
    Subsection (a) directs the Administrator of the EPA, in 
consultation with the Administrator of the Agency for Toxic 
Substances and Disease Registry, the Secretary of Health and 
Human Services, and the Director of the National Institute of 
Environmental Health Sciences to develop, publish, and 
periodically update guidelines that describe a systematic, 
integrated approach that uses the best available science to 
investigate suspected or potential disease clusters, 
environmental pollutants or toxic substances associated with 
one or more suspected or potential disease clusters, or the 
potential causes of such clusters.
    Subsection (b) describes the requirements for these 
guidelines, including the definition of key concepts and 
actions; identification and reporting protocols; standardized 
methods of reviewing and categorizing data, guidance for using, 
in a health-protective way, an appropriate epidemiological, 
statistical, or other approach for the circumstances of an 
investigation; procedures for peer review of key documents by 
individuals who have no direct or indirect conflict of 
interest; and a description of roles and responsibilities of 
federal agencies in conducting investigations.
    Subsection (c) describes the timing for the proposed and 
final guidelines.

Sec. 7. Enhanced support for environmental investigations of disease 
        clusters

    Subsection (a) describes the establishment of regional 
disease cluster information and response centers and teams. The 
subsection describes the federal agencies included in the 
process of creating these administrative structures and, to 
promote accountability and transparency, makes the 
Administrator of the EPA principally responsible for directing, 
coordinating and approving federal authorized under this 
section. This subsection also describes the coordination, 
grants and cooperative agreements, timing of creation, and the 
authorization of appropriations for these activities.
    Subsection (b) describes the response teams' membership and 
leadership structure and the activities authorized to be 
undertaken by the teams. The subsection provides for a petition 
process to request that a response team conduct an 
investigation or take other action to address the potential 
causes of disease clusters, and requires the issuance of 
criteria for the consideration of such petitions. The 
subsection describes the response teams' use of data and the 
requirements for transparency and accountability in conducting 
their activities. The subsection also provides for the creation 
of a database to assist the response teams and other efforts in 
investigating and addressing disease clusters.
    Subsection (c) describes the creation of community disease 
cluster advisory committees that are created to provide 
oversight, guidance, and advice relating to the investigation 
of suspected and potential disease clusters, and for other 
purposes. The subsection describes the membership of the 
committees and prohibits direct and indirect conflicts of 
interest by such members. The subsection authorized technical 
assistance, including grants, to groups of individuals that may 
be affected by a suspected or potential disease cluster and 
allows such grants to be used to facilitate active involvement 
in all aspects of Committee activities and to assist Committee 
members in obtaining technical assistance in interpreting 
information related to the investigation of suspected or 
potential disease clusters, and for other purposes.
    Subsection (d) describes the types of environmental 
research and analysis authorities that federal agencies shall 
utilize when undertaking authorized activities.

Sec. 8. Federal reports to Congress

    Subsection (a) describes the timing of reports to Congress 
on activities authorized to be undertaken by this bill.
    Subsection (b) describes the types of activities and 
information that should be included in the reports.
    Subsection (c) describes the submission and availability of 
such reports.

Sec. 9. Authorization of appropriations

    This section authorizes appropriations as are necessary to 
carry out this Act.

Sec. 10. Effect on other laws

    This section states that nothing in this Act modifies, 
limits, or otherwise affects the application of, or obligation 
to comply with, any law, including any environmental or public 
health law.

                          LEGISLATIVE HISTORY

    S. 76 was introduced by Senator Boxer on January 25, 2011. 
The bill was received, read twice, and referred to the 
Committee on Environment and Public Works. On June 9, 2011, the 
Committee on Environment and Public Works met to consider the 
bill. The bill was ordered reported favorably without amendment 
by voice vote.

                                HEARINGS

    In the 112th Congress, on March 29, 2011, the full 
Committee on Environment and Public Works held a hearing 
entitled, ``Oversight Hearing on Disease Clusters and 
Environmental Health.''

                             ROLLCALL VOTES

    The Committee on Environment and Public Works met to 
consider S. 76 on June 9, 2011. The bill was ordered reported 
favorably by a vote of 11 yeas to 7 nays.

                      REGULATORY IMPACT STATEMENT

    In compliance with section 11(b) of rule XXVI of the 
Standing Rules of the Senate, the Committee makes evaluation of 
the regulatory impact of the reported bill. The Committee finds 
that this legislation does not have substantial regulatory 
impacts.

                          MANDATES ASSESSMENT

    In compliance with the Unfunded Mandates Reform Act of 1995 
(Pub. L. 104-4), the Committee finds that this legislation does 
not impose intergovernmental mandates or private sector 
mandates as those terms are defined in the Unfunded Mandates 
Reform Act (UMRA). The Congressional Budget Office concurs, 
finding S. 76 contains no intergovernmental or private-sector 
mandates as defined in the UMRA and would not affect the 
budgets of state, local, or tribal governments.

                                                     June 22, 2011.
Hon. Barbara Boxer,
Chairman, Committee on Environment and Public Works,
U.S. Senate, Washington, DC.
    Dear Madam Chairman: The Congressional Budget Office has 
prepared the enclosed cost estimate for S. 76, the 
Strengthening Protections for Children and Communities from 
Disease Clusters Act.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Susanne 
Mehlman.
            Sincerely,
                                              Douglas W. Elmendorf.
    Enclosure.

S. 76--Strengthening Protections for Children and Communities from 
        Disease Clusters Act

    Summary: S. 76 would require the Environmental Protection 
Agency (EPA) to develop guidelines for establishing a 
systematic and integrated approach to investigating suspected 
disease clusters. (Disease clusters are defined as the 
occurrence of a greater-than-expected number of cases of a 
particular disease within a group of individuals, geographical 
area, or time period.) This legislation also would require EPA 
to establish and operate two regional response centers and 
response teams to investigate potential disease clusters or 
environmental pollutants or toxic substances associated with 
those disease clusters. In addition, S. 76 would authorize EPA 
to provide grants and enter into cooperative agreements with 
institutions of higher education to support research and 
operational activities performed by the response teams. Under 
the bill, EPA also could make technical assistance grants to 
any group of individuals affected by a suspected disease 
cluster.
    Based on information from EPA, CBO estimates that 
implementing S. 76 would cost about $76 million over the 2012-
2016 period, subject to appropriation of the necessary amounts. 
That funding would provide for additional personnel, 
contractors, grants and cooperative agreements, and other 
administrative activities.
    Pay-as-you-go procedures do not apply to this legislation 
because enacting the bill would not affect direct spending or 
revenues.
    S. 76 contains no intergovernmental or private-sector 
mandates as defined in the Unfunded Mandates Reform Act (UMRA) 
and would impose no costs on state, local, or tribal 
governments.
    Estimated cost to the Federal Government: The estimated 
budgetary impact of S. 76 is shown in the following table. The 
costs of this legislation fall within budget function 300 
(natural resources and environment).

----------------------------------------------------------------------------------------------------------------
                                                                 By fiscal year, in millions of dollars--
                                                         -------------------------------------------------------
                                                            2012     2013     2014     2015     2016   2012-2016
----------------------------------------------------------------------------------------------------------------
                                  CHANGES IN SPENDING SUBJECT TO APPROPRIATION

Grants and Cooperative Agreements with Institutions of
 Higher Learning:
    Estimated Authorization Level.......................        5        5        5        5        5        25
    Estimated Outlays...................................        2        4        5        5        5        21
Grants to Affected Groups:
    Estimated Authorization Level.......................        0        4        4        4        4        16
    Estimated Outlays...................................        0        4        4        4        4        16
Support for Response Centers and Teams:
    Estimated Authorization Level.......................        4        4        4        4        4        20
    Estimated Outlays...................................        3        4        4        4        4        19
Other EPA Administrative Support:
    Estimated Authorization Level.......................        4        4        4        4        4        20
    Estimated Outlays...................................        4        4        4        4        4        20
    Total Changes:
        Estimated Authorization Level...................       13       17       17       17       17        81
        Estimated Outlays...............................        9       16       17       17       17       76
----------------------------------------------------------------------------------------------------------------
Note: EPA = Environmental Protection Agency.

    Basis of estimate: For this estimate, CBO assumes that S. 
76 will be enacted by the end of fiscal year 2011 and that the 
necessary amounts will be appropriated each year.
    Based on information from EPA, CBO estimates that in 2012 
EPA would spend about $9 million to establish the guidelines 
for investigating disease clusters and to establish and provide 
some initial support for the response centers and teams 
responsible for investigating those disease clusters. Included 
in that cost is funding for about 25 additional personnel, 
contractors, a small number of grants and cooperative 
agreements for institutions of higher learning, and other 
administrative support. In subsequent years when the response 
centers and teams are fully operational, CBO expects that EPA 
would spend additional resources to provide grants and enter 
into cooperative agreements with institutions of higher 
education to support those response centers and teams and to 
provide grants to affected groups. As a result, EPA's costs 
would increase to $16 million in 2013 and $17 million annually 
in subsequent years.
    Intergovernmental and private-sector impact: S. 76 contains 
no intergovernmental mandates or private-sector mandates as 
defined in UMRA and would impose no costs on state, local, or 
tribal governments. State, local, and tribal governments could 
receive grants and technical assistance authorized by the bill.
    Estimate prepared by: Federal Spending: Susanne Mehlman; 
Impact on State, Local, and Tribal Governments: Ryan Miller; 
Impact on the Private Sector: Amy Petz.
    Estimate approved by: Theresa Gullo, Deputy Assistant 
Director for Budget Analysis.

               MINORITY VIEWS OF SENATORS INHOFE, VITTER

    Protecting communities including pregnant women, infants, 
and children is of the utmost importance. Physicians and local 
public health departments are on the front lines of caring for 
these communities and vulnerable subpopulations while defending 
them from illness and diseases every day. A ``cluster'' is 
defined by the Center for Disease Control (CDC) as ``an unusual 
aggregation, real or perceived, of health events that are 
grouped together in time and space and that is reported to a 
public health department.''
    Currently, at the federal level, CDC through the Agency for 
Toxic Substances and Disease Registry (ATSDR) investigates and 
addresses cancer and disease clusters. ATSDR is an agency with 
a long history in public health and possesses the expertise and 
knowledge necessary to identify and deal with disease clusters. 
It has an existing infrastructure that facilitates cooperation 
between states and local public health departments, as well as 
local physicians communication ATSDR has labeled ``essential in 
recognizing and responding to disease cluster concerns.'' ATSDR 
has also outlined procedures for investigating disease clusters 
at the federal, state, and local levels.
    S. 76, the ``Strengthening Protections for Children and 
Communities from Disease Clusters Act,'' needlessly shifts 
authorities away from local and federal public health experts 
at the CDC, ATSDR, and public health departments, to the 
Environmental Protection Agency (EPA), a regulatory agency with 
far less expertise and experience in identifying and responding 
to disease clusters.
    This legislation ignores the critical roles of CDC and 
ATSDR, but also of local doctors as well as public health 
departments in dealing with disease clusters in favor of a top 
down bureaucratic approach. Local physicians have the primary 
role in confirming diagnosis and completing applicable exposure 
histories as well as recognizing abnormal event patterns. This 
information is then reported to the appropriate local public 
health departments who have a critical role of their own in the 
investigation of disease clusters. They collect case 
information, conduct local surveillance and surveys, conduct 
environmental and occupational exposure assessments, ensure 
appropriate communication and education of the public as well 
as health professionals, and initiate effective and timely 
actions to allay potential factors associated with disease 
clusters.
    The stated purposes of this bill are to provide the EPA 
Administrator with broad new authorities ``to help conduct 
investigations'' and ``to undertake actions'' to help 
investigate and address ``potential environmental pollution and 
toxic substances that may contribute to the creation of disease 
clusters.'' Inclusion of ``potential'' is highly problematic. 
Potential refers to the possibility of a relationship, not 
likelihood. This would direct EPA onto ``fishing expeditions'' 
in search of ``potential'' chemical ``causes'' of disease 
clusters. It is at odds with EPA's expertise in risk 
assessment, under which EPA incorporates chemical specific 
hazard and exposure information developed under validated 
laboratory screens, tests and assessment of potential 
exposures, to determine the potential risk of harm from a 
specific exposure to a chemical substance. These risk 
assessments do not identify causes of disease and thus EPA's 
chemical specific risk assessment expertise is not readily 
transferrable to investigations of disease clusters. That 
expertise is held by physicians and public health agencies. 
Under S. 76, there is no requirement to show causality at all, 
let alone a rigorous weight of evidence assessment. EPA is 
given, by a literal reading, almost limitless authority. This 
new authority is nothing more than an attempt to circumvent 
appropriate jurisdictional and congressional limitations on the 
EPA, The foremost enumerated goal of this legislation is to 
protect individuals ``who have been, are, or could be harmed 
by, and become part of, a disease cluster.'' Reading that goal 
literally, who does not meet the criteria of someone who 
``could be harmed by, and become part of, a disease cluster?''
    Throughout this legislation, the rightful responsibilities 
of Congress are intentionally subrogated to the EPA, allowing 
the Agency great discretion in defining key terms, and even its 
own authorities. S. 76 assigns unelected EPA bureaucrats the 
lead role in implementing broad and vague authorities in any 
manner they desire.
    In S. 76, there is no definition of the term ``disease.'' 
The term ``disease cluster'' is loosely defined in part as 
``the occurrence of a greater-than-expected number of cases of 
a particular disease within a group of individuals, a 
geographical area, or period of time.'' There is no reference 
to how or where the ``greater-than-expected'' determination 
should be scientifically determined. Moreover, to determine 
expected numbers would require an immense database on the 
distributions of an array of various health endpoints, taking 
into account population statistics and comparative prevalence 
of disease within each subpopulation. This database simply does 
not exist. The definition goes on to also include ``the 
occurrence of a particular disease in such number of cases, or 
meeting such other criteria, as the Administrator . . . may 
determine,'' leaving EPA in consultation with ATSDR and the 
Director of the National Institute of Environmental Health 
Sciences (NIEHS)--limitless discretion to label virtually any 
situation as a ``disease cluster.''
    The terms ``environmental pollutants or toxic substances'' 
and ``potential causes of a disease cluster'' are defined 
similarly to include as wide a range as possible, including 
contaminants and pollutants regulated by the Clean Water and 
Safe Drinking Water Acts. While these are established 
environmental pollutants, this definition also includes any 
chemical substance regulated under the Toxic Substances Control 
Act regardless of any scientific findings that such substances 
are either toxic or pose significant exposures to humans.
    Under Section 6 of S. 76, the EPA Administrator is also in 
the lead role of developing guidelines for disease cluster 
investigations. These guidelines include defining ``key 
concepts and actions,'' developing ``disease cluster 
identification and reporting protocols,'' and ``guidance for 
using . . . appropriate epidemiological, statistical, or other 
approach for the circumstances of an investigation'' in a 
``health-protective way.'' This is extremely troubling, as the 
term ``health-protective'' is not defined and is open for 
interpretation, appearing to steer investigations on the use of 
overly conservative risk models and assumptions that are often 
controversial rather than the best available science. These 
guidelines further go on to include allowing the EPA 
Administrator the lead in assigning the ``roles and 
responsibilities'' of federal officials and creating 
``procedures for peer review'' that have no prohibition on 
individuals who possess a blatant appearance of partiality.
    EPA's largely unfettered grant of power continues into 
Section 7, entitled ``Enhanced Support for Environmental 
Investigations of Disease Clusters.'' This section directs the 
Agency to lead in the establishment and operation of Regional 
Disease Cluster Information and Response Centers (``Response 
Centers'') and Regional Disease Cluster Information and 
Response Teams (``Response Teams''). Under the subsection 
(a)(1)(B), the EPA Administrator is directed to ``be 
principally responsible for directing, coordinating, and 
approving Federal efforts and assistance authorized under this 
section.''
    The Response Teams, whose scope of activities are 
established through an EPA-led consultation process, are to be 
staffed using a loose set of criteria including requirements of 
individuals with ``community outreach'' experience. Similarly 
to S. 76's peer review criteria, Response Team membership has 
no prohibition against a lack of appearance of impartiality. 
One of the Response Teams' primary responsibilities is 
responding to petitions from ``any person . . . that requests 
that a Response team conduct an investigation or take other 
action to address the potential causes of disease clusters in 
accordance with this Act.'' These responses are regarding the 
broadly-labeled need ``to investigate suspected or potential 
disease clusters, environmental pollutants or toxic substances 
associated with these disease clusters, and potential causes of 
disease clusters.''
    Petitions made to Response Teams are to be considered using 
criteria to be established through an EPA-led process, again 
using ``health-protective factors'' rather than the best 
available science. Considerations are also required to include 
evidence of environmental releases of substances without any 
reference to human health impacts and the blanket provision 
including ``such other factors as the Administrator determines 
are necessary.'' This fails to recognize that there are many 
biological steps that must occur before exposure to a chemical 
or substance can cause an adverse outcome and it is imperative 
not to make blanket presuppositions that any exposure to any 
chemical or substance necessarily causes harm. Furthermore, 
this approach seems to grossly discount factors recognized by 
the National Cancer Institute and other reputable health based 
scientific organizations that potential causes for cancer and 
disease clusters such as heredity and behavior and lifestyle 
including diet, use of tobacco, drugs, alcohol, and even 
exposure to sunlight.
    Another troubling piece of this legislation is Section 7's 
requirement of a public database. While there is an important 
need for government transparency, there is also a need to 
recognize the serious potential for harm to be caused by 
disseminating inaccurate and incomplete information. The 
required database would be publically accessible through the 
internet and provide information relating to ongoing incomplete 
reports, substances and illnesses ``associated with suspected 
or potential disease clusters'' regardless if this information 
is irrefutably shown later to have been groundless--and often 
with disease cluster allegations, that is the conclusion. Such 
a database, then, could serve as an unsubstantiated inventory 
of chemicals for people to fear unnecessarily and even as a 
list of chemicals for businesses to avoid absent any scientific 
basis. These are just some of the potential pitfalls of this 
database that could have devastating impacts on local 
economies, businesses, and home values, often with absolutely 
no demonstrable health benefits.
    In further attempt to usurp and/or duplicate the 
authorities of other Federal Agencies and increase the 
bureaucratic expansion of EPA, this bill requires the EPA 
Administrator alone to establish Community Disease Cluster 
Advisory Committees. The purpose of these committees is to 
``provide oversight, guidance, and advice'' relating to the 
investigations of suspected and potential disease clusters and 
associated causes or pollutants. These committees too are 
required to have be comprised of a loosely defined membership 
which includes any individuals ``as determined by the 
Administrator'' of EPA along with some consultation. Of most 
concern is the broad required membership category which 
includes ``individuals who are or may be impacted by a 
suspected or potential disease cluster, and the designee of 
such an individual who may participate with or in the place of 
such and individual.'' This loose definition could include 
almost anyone and to make matters even more troubling, it 
includes any individuals ``designee'' which could encompass 
activists from outside of the communities or investigated 
areas.
    Finally, this bill provides no express opportunity for 
judicial review of any determinations made, and there is no 
requirement for EPA or any other Federal Agency to do any sort 
of economic analysis considering potential job losses and 
associated health impacts resulting from the implementation of 
any potential actions stemming from S. 76. Within S. 76, there 
are some areas requiring EPA and other federal agencies to 
provide for public notice of draft criteria and guidelines and 
some minimal opportunity for public comment; however, the 
timeframe for responses is too short to solicit meaningful 
review, and there is no requirement for the agencies to respond 
to any substantive comments.
    It is vitally important that we continue our efforts to 
identify, treat, and diagnose disease clusters using the best 
available science. S. 76 is nothing more than a misguided 
attempt to take authority away from science based public health 
and disease experts and give it to a regulatory agency far less 
qualified for the job.

                        CHANGES IN EXISTING LAW

    Section 12 of rule XXVI of the Standing Rules of the Senate 
requires the committee to publish changes in existing law made 
by the bill as reported. Passage of this bill will make no 
changes to existing law.

                                  
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