I 

108TH CONGRESS 

2D SESSION H. R. 5335

To amend the Public Health Service Act to establish a Coordinated 

Environmental Health Network, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

OCTOBER 8, 2004

Ms. PELOSI (for herself, Mrs. JONES of Ohio, Ms. SLAUGHTER, Mr. BROWN

of Ohio, Mr. GEORGE MILLER of California, Mr. MARKEY, Ms. 

SCHAKOWSKY, Ms. SOLIS, Ms. MCCARTHY of Missouri, Mr. CLYBURN, 

Ms. DELAURO, Mr. KENNEDY of Rhode Island, Ms. ROYBAL-ALLARD, 

Mr. SERRANO, Mrs. MALONEY, Mr. VAN HOLLEN, Mr. CROWLEY, Mr. 

KUCINICH, Ms. MCCOLLUM, Mr. KILDEE, Ms. BALDWIN, Mr. OWENS, 

Mrs. CHRISTENSEN, Mr. MORAN of Virginia, Mr. GRIJALVA, Mr. ISRAEL, 

Mr. JACKSON of Illinois, Mr. GONZALEZ, and Mr. TIERNEY) 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 Health Network, and for other 

purposes.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Coordinated Environ5 mental Health Network Act of 2004’’. 
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1 SEC. 2. FINDINGS AND PURPOSE. 

2 (a) FINDINGS.—Congress finds that—

3 (1) approximately 7 out of every 10 deaths in 

4 the United States are attributable to chronic dis5 eases; 

6 (2) with 100,000,000 people suffering from 

7 chronic diseases each year, and $750,000,000,000 

8 lost in health care costs as a result, the national cost 

9 of chronic disease is extremely high and must be ap10 propriately addressed; 

11 (3) the rates of many chronic diseases, includ12 ing asthma, some birth defects, cancers, and autism, 

13 appear to be increasing; 

14 (4) there is a growing amount of evidence that 

15 environmental factors are strongly linked with spe16 cific chronic disease; 

17 (5) a major gap in critical knowledge exists re18 garding the prevalence and incidence of chronic dis19 eases; 

20 (6) States, local communities, territories, and 

21 Indian tribes need assistance with public health ef22 forts that would lead to prevention of chronic dis23 ease, including the establishment and maintenance 

24 of necessary infrastructure for disease and environ25 mental hazard exposure surveillance; and 
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1 (7) a Coordinated Environmental Health Net2 work will help target resources to areas of chronic 

3 disease prevention most in need. 

4 (b) PURPOSES.—It is the purpose of this Act to—

5 (1) develop, operate, and maintain a Coordi6 nated Environmental Health Network, State Envi7 ronmental Health Networks, and rapid response ca8 pabilities so that the Federal Government, States, 

9 local governments, territories, and Indian tribes can 

10 more effectively monitor, investigate, respond to, re11 search, and prevent increases in the incidence and 

12 prevalence of certain chronic diseases and relevant 

13 environmental and other risk factors; 

14 (2) provide information collected through the 

15 Coordinated and State Environmental Health Net16 works to government agencies, public health practi17 tioners and researchers, policy makers, and the pub18 lic; 

19 (3) expand and coordinate among existing sur20 veillance and data collection systems and other infra21 structure for chronic diseases and relevant environ22 mental, and other risk factors, including those rel23 evant to bioterrorism; 
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1 (4) improve coordination between the areas of 

2 public health, environmental protection, and chem3 ical, radiological and biological terrorism; and 

4 (5) provide necessary support to ensure the 

5 availability of a sufficient number of well-trained en6 vironmental health and public health personnel to 

7 participate and provide leadership in the develop8 ment and maintenance of the Coordinated and State 

9 Environmental Health Networks. 

10 SEC. 3. AMENDMENT TO THE PUBLIC HEALTH SERVICE 

11 ACT. 

12 The Public Health Service Act (42 U.S.C. 201 et 

13 seq.) is amended by adding at the end the following: 

14 ‘‘TITLE XXIX—COORDINATED EN15 VIRONMENTAL HEALTH NET16 WORK 

17 ‘‘SEC. 2900. DEFINITIONS. 

18 ‘‘In this title: 

19 ‘‘(1) ADMINISTRATORS.—The term ‘Administra20 tors’ means the Director of the Centers for Disease 

21 Control and Prevention Coordinating Center for En22 vironmental Health, Injury Prevention, and Occupa23 tional Health, and the Administrator of the Environ24 mental Protection Agency. 
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1 ‘‘(2) COMMITTEE.—The term ‘Committee’ 

2 means the Advisory Committee established under 

3 section 2901(d). 

4 ‘‘(3) DIRECTOR.—The term ‘Director’ means 

5 the Director of the Centers for Disease Control and 

6 Prevention. 

7 ‘‘(4) MEDICAL PRIVACY REGULATIONS.—The 

8 term ‘medical privacy regulations’ means the regula9 tions promulgated under section 264(c) of the 

10 Health Insurance Portability and Accountability Act 

11 of 1996. 

12 ‘‘(5) COORDINATED NETWORK.—The term ‘Co13 ordinated Network’ means the Coordinated Environ14 mental Health Network established under section 

15 2901(a). 

16 ‘‘(6) PRIORITY CHRONIC CONDITION.—The 

17 term ‘priority chronic condition’ means a condition 

18 to be tracked in the Coordinated Network and the 

19 State Networks, including birth defects, develop20 mental disabilities (such as cerebral palsy, autism, 

21 and mental retardation), asthma and chronic res22 piratory diseases, neurological diseases (such as Par23 kinson’s disease, multiple sclerosis, Alzheimer’s dis24 ease, and amyotrophic lateral sclerosis), autoimmune 

25 diseases (such as lupus), cancer, juvenile diabetes, 
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1 and such other priority chronic conditions as the 

2 Secretary may specify. 

3 ‘‘(7) STATE NETWORK.—The term ‘State Net4 work’ means a State Environmental Health Network 

5 established under section 2901(b). 

6 ‘‘(8) STATE.—The term ‘State’ means a State, 

7 territory, or Indian tribe that is eligible to receive a 

8 health tracking grant under section 2901(b). 

9 ‘‘SEC. 2901. ESTABLISHMENT OF COORDINATED AND STATE 

10 ENVIRONMENTAL HEALTH NETWORKS. 

11 ‘‘(a) COORDINATED ENVIRONMENTAL HEALTH NET12 WORK.—

13 ‘‘(1) ESTABLISHMENT.—Not later than 36 

14 months after the date of the enactment of this title, 

15 the Secretary, acting through the Director and in 

16 consultation with the Administrators, State and local 

17 health departments, and the Committee, shall estab18 lish and operate a Coordinated Environmental 

19 Health Network. In establishing and operating the 

20 Coordinated Network, the Secretary shall—

21 ‘‘(A) identify, build upon, expand, and co22 ordinate among existing data and surveillance 

23 systems, surveys, registries, and other Federal 

24 public health and environmental infrastructure 

25 wherever possible, including—
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1 ‘‘(i) the National Electronic Disease 

2 Surveillance System; 

3 ‘‘(ii) State birth defects surveillance 

4 systems as supported under section 317C; 

5 ‘‘(iii) State cancer registries as sup6 ported under part M of title III; 

7 ‘‘(iv) State asthma surveillance sys8 tems as supported under section 317I; 

9 ‘‘(v) the National Health and Nutri10 tion Examination Survey; 

11 ‘‘(vi) the Behavioral Risk Factor Sur12 veillance System; 

13 ‘‘(vii) the Hazardous Substance Re14 lease/Health Effects Database; 

15 ‘‘(viii) the Hazardous Substances 

16 Emergency Events Surveillance System; 

17 ‘‘(ix) the National Exposure Registry; 

18 ‘‘(x) the Health Alert Network; and 

19 ‘‘(xi) the State vital statistics systems 

20 as supported under section 306; 

21 ‘‘(B) provide for public access to an elec22 tronic national database that accepts data from 

23 the State Networks on the incidence and preva24 lence of priority chronic conditions and relevant 

25 environmental and other factors, in a manner 
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1 which protects personal privacy consistent with 

2 the medical privacy regulations; 

3 ‘‘(C) not later than 36 months after the 

4 date of the enactment of this title, and annually 

5 thereafter, prepare and publish, in accordance 

6 with paragraph (2), a Coordinated Environ7 mental Health Network Report to provide the 

8 public with the findings of the Coordinated Net9 work; 

10 ‘‘(D) operate and maintain a National En11 vironmental Health Rapid Response Service 

12 within the Epidemic Intelligence Service to 

13 carry out the activities described in paragraph 

14 (3); 

15 ‘‘(E) provide for the establishment of State 

16 Networks, and coordinate the State Networks 

17 as provided for under subsection (b); 

18 ‘‘(F) provide technical assistance to sup19 port the State Networks, including providing—

20 ‘‘(i) training for environmental health 

21 investigators appointed or hired under sub22 section (b)(3)(D); 

23 ‘‘(ii) technical assistance as needed to 

24 States to build necessary capacity and in25 frastructure for the establishment of a 
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1 State Network, including a computerized 

2 data collection, reporting, and processing 

3 system, and additional assistance identified 

4 by the States under subsection (b)(5)(C) 

5 as necessary for infrastructure develop6 ment; and 

7 ‘‘(iii) such other technical assistance 

8 as the Secretary, in consultation with the 

9 Administrators, determines to be nec10 essary; 

11 ‘‘(G) not later than 12 months after the 

12 date of the enactment of this title, acting 

13 through the Director and consulting with the 

14 Administrators, the Surgeon General, the Di15 rector of the National Institutes of Health, and 

16 States, develop minimum standards and proce17 dures in accordance with paragraph (4) for 

18 data collection and reporting for the State Net19 works, to be updated not less than annually 

20 thereafter; and 

21 ‘‘(H) in developing the minimum standards 

22 and procedures under subparagraph (G), in23 clude mechanisms for allowing the States to set 

24 priorities, and allocate resources accordingly, 
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1 among the factors described in subparagraphs 

2 (A), (B), and (C) of paragraph (4). 

3 ‘‘(2) COORDINATED ENVIRONMENTAL HEALTH

4 NETWORK REPORT.—Each Coordinated Environ5 mental Health Network Report prepared under 

6 paragraph (1)(C) shall include—

7 ‘‘(A) a statement of the activities carried 

8 out under this title; 

9 ‘‘(B) an analysis of the incidence, preva10 lence, and trends of priority chronic conditions 

11 and potentially relevant environmental and 

12 other factors by State and census tract (or 

13 other political or administrative subdivision de14 termined appropriate by the Secretary in con15 sultation with the Administrator of the Envi16 ronmental Protection Agency) for the calendar 

17 year preceding the year for which the report is 

18 prepared; 

19 ‘‘(C) the identification of gaps in the data 

20 of the Coordinated Network, including diseases 

21 of concern and environmental exposures not 

22 tracked; and 

23 ‘‘(D) recommendations regarding high risk 

24 populations, public health concerns, response 
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1 and prevention strategies, and additional track2 ing needs; 

3 ‘‘(3) NATIONAL ENVIRONMENTAL HEALTH

4 RAPID RESPONSE SERVICE.—The National Environ5 mental Health Rapid Response Service operated 

6 under paragraph (1)(D) shall—

7 ‘‘(A) work with environmental health inves8 tigators appointed or hired under subsection 

9 (b)(3)(D) to develop and implement strategies, 

10 protocols, and guidelines for the coordinated, 

11 rapid responses to actual and perceived higher 

12 than expected incidence and prevalence rates of 

13 priority chronic conditions and to acute and po14 tential environmental hazards and exposures; 

15 ‘‘(B) conduct investigations into higher 

16 than expected incidence and prevalence rates of 

17 priority chronic conditions or environmental ex18 posures after an individual requests, through a 

19 process established by the Secretary, the inter20 vention of the Service; 

21 ‘‘(C) coordinate activities carried out under 

22 this title with activities carried out under sec23 tions 319 through 319G; and 

24 ‘‘(D) coordinate activities carried out 

25 under this title with the Administrators, the 
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1 Surgeon General, and the Director of the Na2 tional Institutes of Health. 

3 ‘‘(4) DATA COLLECTION AND REPORTING BY

4 STATE NETWORKS.—The minimum standards and 

5 procedures referred to in paragraph (1)(G) shall in6 clude—

7 ‘‘(A) a list and definitions of the priority 

8 chronic conditions to be tracked through the 

9 State Networks; 

10 ‘‘(B) a list and definitions of relevant envi11 ronmental exposures of concern to be tracked, 

12 to the extent practicable, through the State 

13 Networks, including—

14 ‘‘(i) hazardous air pollutants (as de15 fined in section 302(g) of the Clean Air 

16 Act); 

17 ‘‘(ii) air pollutants for which national 

18 primary ambient air quality standards 

19 have been promulgated under section 109 

20 of the Clean Air Act; 

21 ‘‘(iii) pollutants or contaminants (as 

22 defined in section 101 of the Comprehen23 sive Environmental Response, Compensa24 tion, and Liability Act of 1980); 
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1 ‘‘(iv) toxic chemicals (as described in 

2 section 313 of the Emergency Planning 

3 and Community Right-to-Know Act of 

4 1986); 

5 ‘‘(v) substances reported under the 

6 Toxic Substances Control Act Inventory 

7 Update Rule as provided for in part 710 of 

8 title 40, Code of Federal Regulations, or 

9 successor regulations; 

10 ‘‘(vi) pesticides (as defined in section 

11 2(u) of the Federal Insecticide, Fungicide, 

12 and Rodenticide Act); and 

13 ‘‘(vii) such other potentially relevant 

14 environmental factors as the Secretary 

15 may specify; 

16 ‘‘(C) a list and definitions of potentially 

17 relevant behavioral, socioeconomic, demo18 graphic, and other risk factors, including race, 

19 ethnic status, gender, age, occupation, and pri20 mary language, to be tracked through the State 

21 Networks; 

22 ‘‘(D) procedures for the complete and 

23 timely collection and reporting of data to the 

24 Coordinated Network by census tract, or other 

25 political subdivision determined appropriate by 
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1 the Secretary, in consultation with the Adminis2 trator of the Environmental Protection Agency, 

3 regarding the factors described in subpara4 graphs (A), (B), and (C); 

5 ‘‘(E) procedures for making data available 

6 to the public and researchers, and for reporting 

7 to the Coordinated Network, while protecting 

8 the confidentiality of all personal data reported, 

9 in accordance with medical privacy regulations; 

10 ‘‘(F) standards and procedures for the es11 tablishment and maintenance of at least 7 re12 gional biomonitoring laboratories, including pro13 viding for an equitable geographic distribution, 

14 by entering into cooperative agreements with 

15 States, groups of States, and academic institu16 tions or consortia of academic institutions, in 

17 order to expand the scope and amount of bio18 monitoring data collected by the Centers for 

19 Disease Control and Prevention; 

20 ‘‘(G) criteria for the environmental health 

21 investigators as required under subsection 

22 (b)(3)(D); and 

23 ‘‘(H) procedures for record and data main24 tenance and verification. 
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1 ‘‘(b) STATE ENVIRONMENTAL HEALTH NET2 WORKS.—

3 ‘‘(1) GRANTS.—Not later than 24 months after 

4 the date of the enactment of this title, the Secretary, 

5 acting through the Director, in consultation with the 

6 Administrators, and taking into consideration the 

7 findings of the Committee, shall award grants to 

8 States, local governments, territories, and Indian 

9 tribes for the establishment, maintenance, and oper10 ation of State Environmental Health Networks in 

11 accordance with the minimum standards and proce12 dures established by the Secretary under subsection 

13 (a)(4). 

14 ‘‘(2) SPECIALIZED ASSISTANCE.—The Coordi15 nated Network shall provide specialized assistance to 

16 grantees in the establishment, maintenance, and op17 eration of State Networks. 

18 ‘‘(3) REQUIREMENTS.—A State, local govern19 ment, territory, or Indian tribe receiving a grant 

20 under this subsection shall use the grant—

21 ‘‘(A) to establish an environmental health 

22 network that will provide—

23 ‘‘(i) for the complete tracking of the 

24 incidence, prevalence, and trends of pri25 ority chronic conditions and potentially rel-
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1 evant environmental and other factors as 

2 set forth in subsection (a), as well as any 

3 additional priority chronic conditions and 

4 potentially related environmental exposures 

5 of concern to that State, local government, 

6 territory, or Indian tribe; 

7 ‘‘(ii) for identification of priority 

8 chronic conditions and potentially relevant 

9 environmental and other factors that dis10 proportionately impact low income and mi11 nority communities; 

12 ‘‘(iii) for the protection of the con13 fidentiality of all personal data reported, in 

14 accordance with the medical privacy regu15 lations; 

16 ‘‘(iv) a means by which confidential 

17 data may, in accordance with Federal and 

18 State law, be disclosed to researchers for 

19 the purposes of public health research; 

20 ‘‘(v) the fullest possible public access 

21 to data collected by the State Network or 

22 through the Coordinated Network, while 

23 ensuring that individual privacy is pro24 tected in accordance with subsection 

25 (a)(1)(B); and 
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1 ‘‘(vi) for the collection of exposure 

2 data through biomonitoring and other 

3 methods, including the entering into of co4 operative agreements with the Coordinated 

5 Network in the establishment of the re6 gional biomonitoring laboratories; 

7 ‘‘(B) to develop a publicly available plan 

8 for establishing the State Network in order to 

9 meet minimum standards and procedures as de10 veloped by the Coordinated Network under sub11 section (a)(4), including the State’s priorities 

12 within the minimum standards, a timeline by 

13 which all the standards will be met, and a plan 

14 for coordinating and expanding existing data 

15 and surveillance systems within the State in16 cluding any pilot projects established through 

17 the Centers for Disease Control and Prevention 

18 prior to the date of the enactment of this title; 

19 ‘‘(C) to appoint a lead environmental 

20 health department or agency that will be re21 sponsible for the development, operation, and 

22 maintenance of the State Network, and ensure 

23 the appropriate coordination among State and 

24 local agencies regarding the development, oper25 ation, and maintenance of the State Network; 
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1 ‘‘(D) to appoint or hire an environmental 

2 health investigator who meets criteria estab3 lished by the Secretary under subsection 

4 (a)(4)(G) and who will coordinate the develop5 ment and maintenance of the rapid response 

6 protocol established under subparagraph (E); 

7 ‘‘(E) to establish a rapid response protocol, 

8 coordinated by the grantee’s environmental 

9 health investigator, in order to respond in a 

10 timely manner to actual and perceived incidence 

11 and prevalence rates of priority chronic diseases 

12 that are higher than expected, acute and poten13 tial environmental hazards and exposures, and 

14 other environmental health concerns, including 

15 warning the public when emergent public health 

16 concerns are detected through the State Net17 work, and concerns regarding vulnerable sub18 populations and disproportionately impacted 

19 subpopulations; 

20 ‘‘(F) to establish an advisory committee to 

21 ensure local community input to the State Net22 work; and 

23 ‘‘(G) to recruit and train public health offi24 cials to continue to expand the State Network. 
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1 ‘‘(4) LIMITATION.—A State, local government, 

2 territory, or Indian tribe that receives a grant under 

3 this section may not use more than 10 percent of 

4 the funds made available through the grant for ad5 ministrative costs. 

6 ‘‘(5) APPLICATION.—To seek a grant under this 

7 section, a State, local government, territory, or In8 dian tribe shall submit to the Secretary an applica9 tion at such time, in such form and manner, and ac10 companied by such information as the Secretary may 

11 specify. The Secretary may not approve an applica12 tion for a grant under this subsection unless the ap13 plication—

14 ‘‘(A) contains assurances that the State, 

15 local government, territory, or tribe will—

16 ‘‘(i) use the grant only in compliance 

17 with the requirements of this title; and 

18 ‘‘(ii) establish such fiscal control and 

19 fund accounting procedures as may be nec20 essary to ensure the proper disbursement 

21 and accounting of Federal funds paid to 

22 the State, local government, territory, or 

23 tribe under the grant; 

24 ‘‘(B) contains the assurance that the 

25 State, local government, territory, or tribe will 
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1 establish a State Network as required by this 

2 subsection; and 

3 ‘‘(C) contains assurances that if the State, 

4 local government, territory, or tribe is unable to 

5 meet all of the requirements described in this 

6 subsection within the prescribed time period, 

7 the State, local government, territory, or tribe 

8 will use grant funds to increase the public 

9 health infrastructure of the State, local govern10 ment, territory, or tribe, acting in cooperation 

11 with the Coordinated Network, in order to im12 plement and maintain a State Network within 

13 24 months of the receipt of such grant. 

14 ‘‘(c) PILOT PROJECTS.—

15 ‘‘(1) IN GENERAL.—Beginning in fiscal year 

16 2005, a State, local government, territory, or Indian 

17 tribe may apply for a grant under this subsection to 

18 implement a pilot project that is approved by the 

19 Secretary, acting through the Director and in con20 sultation with the Administrators and the Com21 mittee. 

22 ‘‘(2) ACTIVITIES.—A State, local government, 

23 territory, or Indian tribe shall use amounts received 

24 under a grant under this subsection to carry out a 

25 pilot project designed to develop State Network en-
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1 hancements and to develop programs to address spe2 cific local and regional concerns, including—

3 ‘‘(A) the expansion of the State Network 

4 to include additional chronic diseases or envi5 ronmental exposures; 

6 ‘‘(B) the conduct of investigations of local 

7 concerns of increased incidence or prevalence of 

8 priority chronic conditions and environmental 

9 exposures; and 

10 ‘‘(C) the carrying out of other activities as 

11 determined to be a priority by the State or con12 sortium of regional States, local government, 

13 territory, or tribe and the Secretary. 

14 ‘‘(3) RESULTS.—The Secretary may consider 

15 the results of the pilot projects under this subsection 

16 for inclusion into the Coordinated Network. 

17 ‘‘(d) ADVISORY COMMITTEE.—

18 ‘‘(1) ESTABLISHMENT.—Not later than 3 

19 months after the date of the enactment of this title, 

20 the Secretary acting jointly with the Administrators, 

21 shall establish an Advisory Committee in accordance 

22 with the Federal Advisory Committee Act. 

23 ‘‘(2) COMPOSITION.—The Advisory Committee 

24 shall be composed of 16 members to be appointed by 

25 the Secretary. Each member of the Advisory Com-
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1 mittee shall serve a 3-year term, except that the Sec2 retary may appoint the initial members of the Advi3 sory Committee for lesser terms in order to comply 

4 with the following sentence. In appointing the mem5 bers of the Advisory Committee, the Secretary shall 

6 ensure that the terms of 5 or 6 members expire each 

7 year. The Advisory Committee shall include at least 

8 9 members that have experience in the areas of—

9 ‘‘(A) public health; 

10 ‘‘(B) the environment, especially toxic 

11 chemicals and human exposure; 

12 ‘‘(C) epidemiology; and 

13 ‘‘(D) biomonitoring and other relevant ex14 posure technologies. 

15 ‘‘(3) REPORTING.—The Advisory Committee 

16 shall not later than 12 months after the date of the 

17 enactment of this title, and at least once every 12 

18 months thereafter, report to Congress on the 

19 progress of the Coordinated Network. 

20 ‘‘(4) HEARINGS.—The Advisory Committee 

21 shall hold such hearings, sit and act at such times 

22 and places, take such testimony, and receive such 

23 evidence as the Committee considers appropriate to 

24 carry out the objectives of the Coordinated Network. 
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1 ‘‘(5) DUTIES.—The Advisory Committee 

2 shall—

3 ‘‘(A) review and provide input for the Co4 ordinated Environmental Health Network Re5 port prior to publication, and make rec6 ommendations as to the progress of the Coordi7 nated Network, including identifying informa8 tion gaps in the network; 

9 ‘‘(B) assist in developing the minimum 

10 standards and procedures for the State Net11 works under subsection (a)(4); and 

12 ‘‘(C) provide ongoing public input to the 

13 Coordinated Network. 

14 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 

15 are authorized to be appropriated to carry out this section 

16 $100,000,000 for fiscal year 2005 and such sums as may 

17 be necessary for each of fiscal years 2006 through 2009. 

18 ‘‘SEC. 2902. INCREASING PUBLIC HEALTH PERSONNEL CA19 PACITY. 

20 ‘‘(a) SCHOOLS OR PROGRAMS OF PUBLIC HEALTH

21 CENTERS OF EXCELLENCE.—

22 ‘‘(1) GRANTS.—Beginning in fiscal year 2005, 

23 the Secretary may award grants to at least 5 accred24 ited schools or programs of public health for the es25 tablishment, maintenance, and operation of Centers 
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1 of Excellence for research and demonstration with 

2 respect to chronic conditions and relevant environ3 mental factors. 

4 ‘‘(2) ACTIVITIES.—A Center of Excellence es5 tablished or operated under paragraph (1) shall un6 dertake research and development projects in at 

7 least 1 of the following areas: 

8 ‘‘(A) Investigating causal connections be9 tween chronic conditions and environmental fac10 tors. 

11 ‘‘(B) Increasing the understanding of the 

12 causes of higher than expected incidence and 

13 prevalence rates of priority chronic conditions 

14 and developing more effective intervention 

15 methods for when such elevated rates occur. 

16 ‘‘(C) Identifying additional chronic condi17 tions and environmental factors that could be 

18 tracked by the Coordinated Network. 

19 ‘‘(D) Improving translation of Coordinated 

20 Network tracking results into effective preven21 tion activities. 

22 ‘‘(E) Improving the training of public 

23 health workforce in environmental epidemiology. 
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1 ‘‘(F) Establishing links to the Coordinated 

2 Network and the State Networks to identify as3 sociations that warrant further study. 

4 ‘‘(3) REQUIREMENTS FOR CENTERS OF EXCEL5 LENCE.—To be eligible to receive a grant under 

6 paragraph (1), a school or program of public health 

7 shall provide assurances that the school or pro8 gram—

9 ‘‘(A) meets the minimum requirements as 

10 established by the Secretary in consultation 

11 with the Director; 

12 ‘‘(B) maintains privacy for public health 

13 information if appropriate to the project; and 

14 ‘‘(C) makes public information regarding 

15 the findings and results of the programs. 

16 ‘‘(4) AUTHORIZATION OF APPROPRIATIONS.—

17 There is authorized to be appropriated to carry out 

18 this subsection $5,000,000 for each of fiscal years 

19 2005 through 2009. 

20 ‘‘(b) JOHN H. CHAFEE PUBLIC HEALTH SCHOLAR

21 PROGRAM.—

22 ‘‘(1) IN GENERAL.—The Secretary shall award 

23 scholarships, to be known as John H. Chafee Public 

24 Health Scholarships, to eligible students who are en25 rolled in an accredited school of public health or 
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1 medicine. The Secretary shall determine both the 

2 criteria and eligibility requirements for such scholar3 ships, after consultation with the Committee. 

4 ‘‘(2) AUTHORIZATION OF APPROPRIATIONS.—

5 There is authorized to be appropriated to carry out 

6 this subsection $2,500,000 for each of fiscal years 

7 2005 through 2009. 

8 ‘‘(c) APPLIED EPIDEMIOLOGY FELLOWSHIP PRO9 GRAMS.—

10 ‘‘(1) IN GENERAL.—Beginning in fiscal year 

11 2005, the Secretary, acting through the Director, 

12 shall enter into a cooperative agreement with the 

13 Council of State and Territorial Epidemiologists to 

14 train and place, in State and local health depart15 ments, applied epidemiology fellows to enhance State 

16 and local epidemiology capacity in the areas of envi17 ronmental health, chronic disease, and birth defects 

18 and development disabilities. 

19 ‘‘(2) AUTHORIZATION OF APPROPRIATIONS.—

20 There is authorized to be appropriated to carry out 

21 this subsection $2,500,000 for fiscal year 2005, and 

22 such sums as may be necessary in each of fiscal 

23 years 2006 through 2009. 
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1 ‘‘SEC. 2903. GENERAL PROVISIONS. 

2 ‘‘(a) INTERNAL MONITORING AND COORDINATION

3 REGARDING CDC.—The Secretary, acting through the Di4 rector, shall place primary responsibility for the coordina5 tion of the programs established under this title in the 

6 Office of the Director. The officers or employees of the 

7 Centers for Disease Control and Prevention who are as8 signed responsibility for monitoring and coordinating the 

9 activities carried out under this title by the Director shall 

10 include officers or employees within the Office of the Di11 rector. 

12 ‘‘(b) FUNDING THROUGH APPROPRIATIONS AC13 COUNT FOR PUBLIC HEALTH IMPROVEMENT.—All au14 thorizations of appropriations established in this title are 

15 authorizations exclusively for appropriations to the ac16 count that, among appropriations accounts for the Centers 

17 for Disease Control and Prevention, is designated ‘Public 

18 Health Improvement’. 

19 ‘‘(c) DATE CERTAIN FOR OBLIGATION OF APPRO20 PRIATIONS.—With respect to the process of receiving ap21 plications for and making awards of grants, cooperative 

22 agreements, and contracts under this title, the Secretary, 

23 acting through the Director, shall to the extent practicable 

24 design the process to ensure that amounts appropriated 

25 under this title for such awards for a fiscal year are obli26 gated not later than the beginning of the fourth quarter 
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1 of the fiscal year, subject to compliance with section 1512 

2 of title 31, United States Code (relating to deficiency or 

3 supplemental appropriations), and other applicable law re4 garding appropriations accounting. 

5 ‘‘(d) COORDINATION WITH AGENCY FOR TOXIC SUB6 STANCES AND DISEASE REGISTRY.—In carrying out this 

7 title, the Secretary, acting through the Director, shall co8 ordinate activities and responses with the Agency for 

9 Toxic Substances and Disease Registry. 

10 ‘‘(e) COORDINATION WITH EXISTING PILOT

11 PROJECTS THROUGH CDC.—The Secretary shall inte12 grate the enactment of this title with all environmental 

13 health tracking pilot projects funded prior to the date of 

14 enactment of this title.’’.

Æ