I 

111TH CONGRESS 

1ST SESSION H. R. 3426 

To amend the Public Health Service Act to establish a Coordinated 

Environmental Public Health Network. 

IN THE HOUSE OF REPRESENTATIVES 

JULY 30, 2009 

Ms. PELOSI (for herself, Ms. SLAUGHTER, Mr. MARKEY of Massachusetts, 

Mrs. CAPPS, Ms. SCHAKOWSKY, Ms. BALDWIN, Ms. DELAURO, Ms. 

MCCOLLUM, Mr. SERRANO, Mr. GRIJALVA, and Mr. HARE) introduced 

the following bill; which was referred to the Committee on Energy and 

Commerce 

A BILL 

To amend the Public Health Service Act to establish a 

Coordinated Environmental Public Health Network. 

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 Public Health Network Act of 2009’’. 

6 SEC. 2. AMENDMENT TO THE PUBLIC HEALTH SERVICE 

7 ACT. 

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

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


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1 ‘‘TITLE XXXI—COORDINATED EN2 VIRONMENTAL PUBLIC 

3 HEALTH NETWORK 

4 ‘‘SEC. 3100. DEFINITIONS. 

5 ‘‘In this title: 

6 ‘‘(1) ADMINISTRATOR.—The term ‘Adminis7 trator’ means the Administrator of the Environ8 mental Protection Agency. 

9 ‘‘(2) COORDINATED NETWORK.—The term ‘Co10 ordinated Network’ means the Coordinated Environ11 mental Public Health Network established under 

12 section 3101(a). 

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

14 the Director of the Centers for Disease Control and 

15 Prevention. 

16 ‘‘(4) DIRECTOR OF THE CENTER.—The term 

17 ‘Director of the Center’ means the Director of the 

18 National Center for Environmental Health at the 

19 Centers for Disease Control and Prevention. 

20 ‘‘(5) MEDICAL PRIVACY REGULATIONS.—The 

21 term ‘medical privacy regulations’ means the regula22 tions promulgated under section 264(c) of the 

23 Health Insurance Portability and Accountability Act 

24 of 1996. 


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1 ‘‘(6) PRIORITY CHRONIC CONDITIONS AND

2 HEALTH EFFECTS.—The term ‘priority chronic con3 ditions and health effects’ means the conditions, as 

4 specified by the Secretary, to be tracked in the Co5 ordinated Network and the State Networks. 

6 ‘‘(7) STATE NETWORK.—The term ‘State Net7 work’ means a State Environmental Public Health 

8 Network established under section 3101(b). 

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

10 local government, territory, or Indian tribe that is 

11 eligible to receive a health tracking grant under sec12 tion 3101(b). 

13 ‘‘SEC. 3101. ESTABLISHMENT OF COORDINATED AND STATE 

14 ENVIRONMENTAL PUBLIC HEALTH NET15 WORKS. 

16 ‘‘(a) COORDINATED ENVIRONMENTAL PUBLIC

17 HEALTH NETWORK.— 

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

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

20 the Secretary, acting through the Director, in con21 sultation with the Administrator and the Director of 

22 the Center, and with the involvement of other Fed23 eral agencies, and State and local health depart24 ments, shall establish and operate a Coordinated 

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1 lishing and operating the Coordinated Network, the 

2 Secretary shall, as practicable— 

3 ‘‘(A) identify, build upon, expand, and co4 ordinate among existing data and surveillance 

5 systems, surveys, registries, and other Federal 

6 public health and environmental infrastructure 

7 as practicable, including— 

8 ‘‘(i) the Public Health Information 

9 Network; 

10 ‘‘(ii) State birth defects surveillance 

11 systems as supported under section 317C; 

12 ‘‘(iii) State cancer registries as sup13 ported under part M of title III; 

14 ‘‘(iv) State asthma surveillance sys15 tems as supported under section 317I; 

16 ‘‘(v) the National Health and Nutri17 tion Examination Survey; 

18 ‘‘(vi) the Behavioral Risk Factor Sur19 veillance System; 

20 ‘‘(vii) the Hazardous Substance Re21 lease/Health Effects Database; 

22 ‘‘(viii) the Hazardous Substances 

23 Emergency Events Surveillance System; 

24 and 


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1 ‘‘(ix) the State vital statistics systems 

2 as supported under section 306; 

3 ‘‘(B) provide for public access to an elec4 tronic national database that accepts data from 

5 the State Networks on the incidence and preva6 lence of priority chronic conditions and health 

7 effects and relevant environmental and other 

8 factors, in a manner which protects personal 

9 privacy consistent with the medical privacy reg10 ulations; 

11 ‘‘(C) in order to allow the public to access 

12 and understand information about environ13 mental health at the Federal, State, and, where 

14 practicable, local level, prepare, publish, make 

15 publicly available on the Web sites of the Cen16 ters for Disease Control and Prevention and the 

17 Environmental Protection Agency, and submit 

18 to Congress not later than 2 years after the 

19 date of the enactment of this title, and bienni20 ally thereafter, a Coordinated Network Health 

21 and Environment Report, including— 

22 ‘‘(i) identification of gaps in the data 

23 of the Network, including diseases of con24 cern and environmental exposures not 

25 tracked; 


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1 ‘‘(ii) identification of activities carried 

2 out under this title and key milestones 

3 achieved during the preceding year; and 

4 ‘‘(iii) an analysis of the most cur5 rently available incidence, prevalence, and 

6 trends of priority chronic conditions and 

7 health effects, and potentially relevant en8 vironmental and other factors, by State 

9 and, as practicable by local areas, and rec10 ommendations regarding high risk popu11 lations, public health concerns, response 

12 and prevention strategies, and additional 

13 tracking needs; 

14 ‘‘(D) provide for the establishment of State 

15 Networks, and coordinate the State Networks 

16 as provided for under subsection (b); 

17 ‘‘(E) provide technical assistance to sup18 port the State Networks; 

19 ‘‘(F) not later than 12 months after the 

20 date of the enactment of this title, develop min21 imum standards and procedures for data collec22 tion and reporting for the State Networks, to 

23 be updated not less than annually thereafter; 

24 and 


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1 ‘‘(G) in developing the minimum standards 

2 and procedures under subparagraph (F), in3 clude mechanisms for allowing the States to set 

4 priorities, and allocate resources accordingly. 

5 ‘‘(2) DATA COLLECTION AND REPORTING BY

6 STATE NETWORKS.—The minimum standards and 

7 procedures referred to in paragraph (1)(F) shall in8 clude— 

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

10 chronic conditions and health effects to be 

11 tracked through the State Networks; 

12 ‘‘(B) a list and definitions of relevant envi13 ronmental exposures of concern to be tracked, 

14 to the extent practicable, through the State 

15 Networks, including— 

16 ‘‘(i) hazardous air pollutants (as de17 fined in section 302(g) of the Clean Air 

18 Act); 

19 ‘‘(ii) air pollutants for which national 

20 primary ambient air quality standards 

21 have been promulgated under section 109 

22 of the Clean Air Act; 

23 ‘‘(iii) pollutants or contaminants (as 

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1 sive Environmental Response, Compensa2 tion, and Liability Act of 1980); 

3 ‘‘(iv) toxic chemicals (as described in 

4 section 313 of the Emergency Planning 

5 and Community Right-to-Know Act of 

6 1986); 

7 ‘‘(v) substances reported under the 

8 Toxic Substances Control Act Inventory 

9 Update Rule as provided for in part 710 of 

10 title 40, Code of Federal Regulations, or 

11 successor regulations; 

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

13 2(u) of the Federal Insecticide, Fungicide, 

14 and Rodenticide Act); and 

15 ‘‘(vii) such other potentially relevant 

16 environmental factors as the Secretary 

17 may specify; 

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

19 relevant behavioral, socioeconomic, and demo20 graphic factors known to be associated with 

21 these priority chronic conditions and health ef22 fects and other risk factors, such as race, ethnic 

23 status, gender, age, occupation, and primary 

24 language, to be tracked through the State Net25 works; 


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1 ‘‘(D) procedures for the complete and 

2 timely collection and reporting of data to the 

3 Coordinated Network by local areas, such as a 

4 census tract or other political subdivision deter5 mined appropriate by the Secretary, in con6 sultation with the Administrator, regarding the 

7 factors described in subparagraphs (A), (B), 

8 and (C); 

9 ‘‘(E) procedures for making data available 

10 to the public and researchers, and for reporting 

11 to the Coordinated Network, while protecting 

12 the confidentiality of all personal data reported, 

13 in accordance with medical privacy regulations; 

14 and 

15 ‘‘(F) standards and procedures for the es16 tablishment, operation, and maintenance of lab17 oratories conducting biomonitoring, in order to 

18 expand the scope and amount of biomonitoring 

19 data collected by the Centers for Disease Con20 trol and Prevention as described in section 

21 3104. 

22 ‘‘(b) STATE ENVIRONMENTAL PUBLIC HEALTH NET23 WORKS.— 

24 ‘‘(1) GRANTS.—Not later than 12 months after 

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


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1 acting through the Director, in consultation with the 

2 Administrator and the Director of the Center shall 

3 award grants to States for the establishment, main4 tenance, and operation of State Networks in accord5 ance with the minimum standards and procedures 

6 established by the Secretary under subsection 

7 (a)(1)(F). 

8 ‘‘(2) SPECIALIZED ASSISTANCE.—The Coordi9 nated Network shall provide specialized assistance to 

10 grantees in the establishment, maintenance, and op11 eration of State Networks. 

12 ‘‘(3) REQUIREMENTS.—A State receiving a 

13 grant under this subsection shall use the grant— 

14 ‘‘(A) to establish an environmental public 

15 health network that will provide— 

16 ‘‘(i) for the tracking of the incidence, 

17 prevalence, and trends of priority chronic 

18 conditions and health effects, as well as 

19 any additional priority chronic conditions 

20 and health effects and potentially related 

21 environmental exposures of concern to that 

22 State; 

23 ‘‘(ii) for identification of priority 

24 chronic conditions and health effects and 

25 potentially relevant environmental and 


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1 other factors that disproportionately im2 pact low income and minority communities; 

3 ‘‘(iii) for the protection of the con4 fidentiality of all personal data reported, in 

5 accordance with the medical privacy regu6 lations; 

7 ‘‘(iv) a means by which confidential 

8 data may, in accordance with Federal and 

9 State law, be disclosed to researchers for 

10 the purposes of public health research; 

11 ‘‘(v) the fullest possible public access 

12 to data collected by the State Network or 

13 through the Coordinated Network, while 

14 ensuring that individual privacy is pro15 tected in accordance with subsection 

16 (a)(1)(B); and 

17 ‘‘(vi) for the collection of exposure 

18 data through biomonitoring and other 

19 methods, which may include the entering 

20 into of cooperative agreements as described 

21 in section 3104; 

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

23 for establishing the State Network in order to 

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1 veloped by the Secretary under subsection 

2 (a)(1)(F); 

3 ‘‘(C) to appoint a lead public health de4 partment or agency that will be responsible for 

5 the development, operation, and maintenance of 

6 the State Network, and ensure the appropriate 

7 coordination among State and local agencies, 

8 including environmental agencies, regarding the 

9 development, operation, and maintenance of the 

10 State Network; and 

11 ‘‘(D) to recruit and train public health of12 ficials to continue to expand the State Network. 

13 ‘‘(4) LIMITATION.—A State that receives a 

14 grant under this section may not use more than 10 

15 percent of the funds made available through the 

16 grant for administrative costs. 

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

18 section, a State shall submit to the Secretary an ap19 plication at such time, in such form and manner, 

20 and accompanied by such information as the Sec21 retary may specify. 

22 ‘‘(c) PILOT PROJECTS.— 

23 ‘‘(1) IN GENERAL.—A State may apply for a 

24 grant under this subsection to implement a pilot 

25 project that is approved by the Secretary, acting 


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1 through the Director and in consultation with the 

2 Administrator, and the Director of the Center. 

3 ‘‘(2) ACTIVITIES.—A State shall use amounts 

4 received under a grant under this subsection to 

5 carry out a pilot project designed to develop State 

6 Network enhancements and to develop programs to 

7 address specific local and regional concerns. 

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

9 the results of the pilot projects under this subsection 

10 for inclusion into the Coordinated Network. 

11 ‘‘(d) PRIVACY.—In establishing and operating the 

12 Coordinated Network under subsection (a), and in making 

13 grants under subsections (b) and (c), the Secretary shall 

14 ensure the protection of privacy of individually identifiable 

15 health information, including ensuring protection con16 sistent with the regulations promulgated under section 

17 264(c) of the Health Insurance Portability and Account18 ability Act of 1996. 

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

20 are authorized to be appropriated to carry out this section 

21 such sums as may be necessary for each of fiscal years 

22 2010 through 2014. 


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1 ‘‘SEC. 3102. INCREASING PUBLIC HEALTH PERSONNEL CA2 PACITY. 

3 ‘‘(a) IN GENERAL.—Beginning in fiscal year 2010, 

4 the Secretary, acting through the Director, shall enter into 

5 a cooperative agreement with the Council of State and 

6 Territorial Epidemiologists to train and place, in State 

7 and local health departments, applied epidemiology fellows 

8 to enhance State and local public health capacity in the 

9 areas of environmental health, chronic and other noninfec10 tious diseases and conditions, and public health surveil11 lance. 

12 ‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—There 

13 are authorized to be appropriated to carry out this section 

14 such sums as may be necessary for each of fiscal years 

15 2010 through 2014. 

16 ‘‘SEC. 3103. GENERAL PROVISIONS. 

17 ‘‘(a) INTEGRATION OF ENVIRONMENTAL HEALTH

18 TRACKING PROGRAMS.—The Secretary shall integrate the 

19 enactment of this title with all environmental health track20 ing programs funded prior to the date of the enactment 

21 of this title, including by integrating the programs, in ex22 istence on the date of the enactment of this title, to de23 velop State Network enhancements and to develop pro24 grams to address specific local and regional concerns. 

25 ‘‘(b) COORDINATION WITH AGENCY FOR TOXIC SUB26 STANCES AND DISEASE REGISTRY.—In carrying out this 


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1 title, the Secretary, acting through the Director, shall co2 ordinate activities and responses with the Agency for 

3 Toxic Substances and Disease Registry. 

4 ‘‘SEC. 3104. EXPANSION OF BIOMONITORING CAPABILITIES 

5 AND DATA COLLECTION. 

6 ‘‘(a) PURPOSE.—It is the purpose of this section to 

7 expand the scope and amount of biomonitoring data col8 lected and analyzed by the Centers for Disease Control 

9 and Prevention, State laboratories, and consortia of State 

10 laboratories, in order to obtain robust information, includ11 ing information by geographically defined areas and sub12 populations, about a range of environmental exposures. 

13 ‘‘(b) IN GENERAL.—In meeting the purpose of this 

14 section, the Secretary shall ensure that biomonitoring data 

15 are collected intramurally through appropriate sources, in16 cluding the National Health and Nutrition Examination 

17 Survey, and extramurally shall enter into collaboration or 

18 partnerships with other entities to obtain additional infor19 mation regarding vulnerable subpopulations or other sub20 populations. 

21 ‘‘(c) COOPERATIVE AGREEMENTS.— 

22 ‘‘(1) IN GENERAL.—The Secretary, acting 

23 through the Director, shall enter into cooperative 

24 agreements with States or consortia of States to 

25 support the purposes of this title. 


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1 ‘‘(2) APPLICATIONS.—Applications for such co2 operative agreements by consortia of States shall ad3 dress the manner in which such States will coordi4 nate activities with other States in the region, and 

5 shall designate a lead State for administrative pur6 poses. 

7 ‘‘(3) TRAINING AND QUALITY ASSURANCE.— 

8 The Secretary, acting through the Director, shall 

9 through the cooperative agreements with States or a 

10 consortia of States provide laboratory training and 

11 quality assurance. 

12 ‘‘(d) PRIVACY.—In carrying out this section, the Sec13 retary shall ensure the protection of privacy of individually 

14 identifiable health information, including ensuring protec15 tion consistent with the regulations promulgated under 

16 section 264(c) of the Health Insurance Portability and Ac17 countability Act of 1996. 

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

19 are authorized to be appropriated to carry out this section 

20 such sums as may be necessary for each of fiscal years 

21 2010 through 2014.’’. 

Æ 


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