I
107TH CONGRESS
2D SESSION
H. R. 4061
To amend the Public Health Service Act to establish a Nationwide Health
Tracking Network, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
MARCH 20, 2002
Ms. PELOSI (for herself, Mrs. JONES of Ohio, Mr. KING, Ms. SLAUGHTER,
Ms. DELAURO, Mr. FROST, Mr. WAXMAN, Mr. BROWN of Ohio, Mr.
TOWNS, Mr. MURTHA, Mr. GEORGE MILLER of California, Mr. FILNER,
Mr. KUCINICH, Mr. LYNCH, Ms. WOOLSEY, Mr. BLAGOJEVICH, Mr.
TIERNEY, Mr. HINCHEY, Mr. SERRANO, Ms. SCHAKOWSKY, Mr. JACKSON
of Illinois, Mr. STARK, Mr. RUSH, Ms. LEE, Mr. ISRAEL, Mr. ACKERMAN,
Mr. CLYBURN, Mr. KENNEDY of Rhode Island, Ms. MCKINNEY, Ms.
ROYBAL-ALLARD, Ms. BROWN of Florida, Ms. MCCOLLUM, Ms. SOLIS,
Ms. KAPTUR, Mr. ROTHMAN, Mr. CAPUANO, and Ms. BALDWIN) intro-
duced 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 Na-
tionwide Health Tracking Network, and for other pur-
poses.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Nationwide Health
Tracking Act of 2002’’.
SEC. 2. FINDINGS AND PURPOSE.
(a) FINDINGS.—Congress finds that—
(1) approximately 7 out of every 10 deaths in
the United States are attributable to chronic dis-
eases;
(2) with 100,000,000 people suffering from
chronic diseases each year, and $325,000,000,000
lost in annual health care and productivity costs as
a result, the national cost of chronic diseases is ex-
tremely high and needs to be appropriately ad-
dressed;
(3) the rates of many chronic diseases, includ-
ing asthma, some birth defects, and cancers, are on
the rise;
(4) there is growing scientific evidence that en-
vironmental factors are as strongly linked, or even
more strongly linked, to the incidence of certain
chronic diseases as is genetic predisposition;
(5) a gap in critical knowledge exists in under-
standing the prevalence and incidence of chronic dis-
eases and the environmental factors that may relate
to them, including statewide and community level in-
cidence data on chronic diseases that is critically
needed to identify trends and patterns and to im-
prove disease prevention efforts;
(6) States, territories, Indian tribes, and local
communities need assistance with chronic disease
and environmental exposure surveillance and preven-
tion efforts, including the establishment, operation,
and maintenance of the necessary infrastructure for
such activities; and
(7) a nationwide health tracking network, in-
cluding the integration of data systems and collabo-
rative programs and partnerships among environ-
mental and public health professionals and other
parts of the public health system, will help target re-
sources more efficiently to those areas most in need.
(b) PURPOSES.—It is the purpose of this Act to—
(1) develop, operate, and maintain Nationwide
and State Health Tracking Networks and rapid re-
sponse capabilities so that the Federal Government,
States, communities, territories, and Indian tribes
can more effectively monitor, investigate, respond to,
research, understand, and prevent increases in the
incidence and prevalence of certain chronic diseases;
(2) develop, operate, and maintain Nationwide
and State Health Tracking Networks that will pro-
vide information to Federal, State, territorial, tribal,
and local agencies, public health practitioners and
researchers, policymakers, and the public about cer-
tain chronic diseases and relevant environmental, be-
havioral, socioeconomic, demographic, and other risk
factors;
(3) develop, operate, and maintain Nationwide
and State Health Tracking Networks by building
upon, expanding, coordinating among, and, where
necessary, adding to existing surveillance and data
collection systems, registries, surveys, laboratories,
and other infrastructure; and
(4) provide the support necessary to ensure the
availability of a sufficient number of well-trained en-
vironmental health and public health personnel to
participate and provide leadership in the develop-
ment, operation, and maintenance of the Nationwide
and State Health Tracking Networks.
SEC. 3. AMENDMENT TO THE PUBLIC HEALTH SERVICE
ACT.
The Public Health Service Act (42 U.S.C. 201 et
seq.) is amended by adding at the end the following:
‘‘TITLE XXVIII—NATIONWIDE
HEALTH TRACKING NETWORK
‘‘SEC. 2800. DEFINITIONS.
‘‘In this title:
‘‘(1) COMMISSION.—The term ‘Commission’
means the Commission on Nationwide Health Track-
ing established under section 2802.
‘‘(2) NATIONWIDE NETWORK.—The term ‘Na-
tionwide Network’ means the Nationwide Health
Tracking Network established under section 2804.
‘‘(3) 
PRIORITY
CHRONIC
CONDITION.—The
term ‘priority chronic condition’ means a condition
that appears on the list developed under section
2804(b)(2)(A).
‘‘(4) STATE NETWORK.—The term ‘State Net-
work’ means a State Health Tracking Network es-
tablished under section 2803.
‘‘PART A—STATE BASED AND NATIONWIDE
HEALTH TRACKING NETWORKS
‘‘SEC. 2801. STATE PILOT PROGRAMS.
‘‘(a) IN GENERAL.—Beginning in fiscal year 2003,
the Secretary, acting through the Director of the Centers
for Disease Control and Prevention, in consultation with
the Administrator of the Environmental Protection Agen-
cy and the Administrator of the Agency for Toxic Sub-
stances, and taking into consideration the findings, con-
clusions and recommendations of the Commission, shall
enter into cooperative agreements, and continue existing
health tracking cooperative agreements funded under the
heading ‘Centers for Disease Control and Prevention’ (dis-
ease control, research, and training) under title II of the
Departments of Labor, Health and Human Services, and
Education, and Related Agencies Appropriations Act,
2002 (Public Law 107–116), with States and political
subdivisions of States, territories, and Indian tribes for
the purpose of funding pilot programs to develop improved
surveillance and data collection methods, procedures, prac-
tices, and systems, including integration of systems, for
collecting, analyzing, and sharing data and identifying,
understanding, preventing, and responding to regional
concerns regarding chronic health conditions and relevant
environmental, behavioral, and other factors.
‘‘(b) PURPOSE.—The purpose of the pilot programs
funded under subsection (a) is to provide for the establish-
ment and operation of the Nationwide and State Health
Tracking Networks as described in sections 2803 and
2804. Upon the establishment of such Networks, such
pilot programs shall be used to develop network enhance-
ments and to develop programs to address specific local
and regional concerns.
‘‘(c) APPLICATION.—The Secretary may enter into,
or continue existing, cooperative agreements under sub-
section (a) only if an application for such an agreement
is submitted to the Secretary, and the application is in
such form, is made in such manner, and contains such
agreements, assurances, and information as the Secretary
determines to be necessary to carry out this section.
‘‘(d) COORDINATION.—In approving applications
under this section, the Secretary shall ensure that there
is adequate coordination among the pilot programs to ef-
fectively advance the establishment and operation of the
Nationwide Network under section 2804.
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—For the
purpose of entering into, and continuing existing, coopera-
tive agreements under subsection (a), there is authorized
to be appropriated such sums as may be necessary for
each of fiscal years 2003 through 2007.
‘‘SEC. 2802. COMMISSION ON NATIONWIDE HEALTH TRACK-
ING.
‘‘(a) ESTABLISHMENT.—Not later than 3 months
after the date of enactment of this title, the Secretary,
jointly with the Administrator of the Environmental Pro-
tection Agency, shall establish a commission to be known
as the Commission on Nationwide Health Tracking.
‘‘(b) MEMBERSHIP.—
‘‘(1) IN GENERAL.—The Commission shall be
composed of—
‘‘(A) 15 voting members appointed in ac-
cordance with paragraphs (2) and (3); and
‘‘(B) nonvoting, ex officio members ap-
pointed in accordance with paragraph (3)(C).
‘‘(2) BACKGROUND AND EXPERTISE.—The vot-
ing members of the Commission shall be appointed
from among individuals who—
‘‘(A) are not officers or employees of the
Federal Government; and
‘‘(B) have expertise regarding—
‘‘(i) epidemiology;
‘‘(ii) environmental health;
‘‘(iii) public health;
‘‘(iv) pediatric health;
‘‘(v) vulnerable subpopulations and
disproportionately impacted groups;
‘‘(vi) biomonitoring;
‘‘(vii) environmental factors;
‘‘(viii) chronic conditions; and
‘‘(ix) privacy.
‘‘(3) REPRESENTATIVES.—
‘‘(A) APPOINTMENTS
BY
SECRETARY.—
Nine of the voting members of the Commission
shall be appointed by the Secretary, and shall
include at least 1 individual representing—
‘‘(i) an advocacy group that rep-
resents people who have been diagnosed
with a priority chronic disease referred to
in section 2804(b)(2)(A);
‘‘(ii) a public health advocacy group;
‘‘(iii) a State or local public health de-
partment;
‘‘(iv) a health care provider;
‘‘(v) the hospital industry;
‘‘(vi) a community health group;
‘‘(vii) a pediatric health group;
‘‘(viii) an accredited school of public
health or department of public health or
similar department within an accredited
school of medicine with expertise in envi-
ronmental health; and
‘‘(ix) the research community.
‘‘(B) ADMINISTRATOR.—Six of the voting
members of the Commission shall be appointed
by the Administrator of the Environmental Pro-
tection Agency, and shall include at least 1 in-
dividual representing—
‘‘(i) an environmental advocacy group;
‘‘(ii) a State or local environmental
protection agency;
‘‘(iii) private industry;
‘‘(iv) an environmental health advo-
cacy group;
‘‘(v) an environmental justice advo-
cacy group; and
‘‘(vi) the research community.
‘‘(C) EX
OFFICIO
MEMBERS.—The Sec-
retary shall appoint officers or employees of the
Department of Health and Human Services and
the Administrator shall appoint officers or em-
ployees of the Environmental Protection Agency
as nonvoting, ex officio members of the Com-
mission.
‘‘(c) TERMS OF APPOINTMENT.—Each member of
the Commission shall serve for a term of 4 years, except
that the terms of service of the members initially ap-
pointed under subsection (b)(1)(A) shall be (as specified
by the Secretary or the Administrator, as the case may
be) for such fewer number of years as will provide for the
expiration of the terms of such members on a staggered
basis.
‘‘(d) VACANCIES.—Any vacancy in the Commission
shall not affect the powers of the Commission and shall
be filled in the same manner as the original appointment.
‘‘(e) CO-CHAIRS.—The Secretary and the Adminis-
trator shall each select a Co-Chair of the Commission from
among the voting members of the Commission. A member
selected as a Co-Chair shall serve as a Co-Chair for a term
of 2 years.
‘‘(f) DUTIES.—
‘‘(1) IN GENERAL.—The Commission shall meet
regularly to provide advice and recommendations re-
garding the implementation of this title to the Sec-
retary and Administrator of the Environmental Pro-
tection Agency, including providing advice and rec-
ommendations regarding—
‘‘(A) the awarding and use of State grants
described in section 2803, including—
‘‘(i) methods for encouraging partici-
pation by all States in the establishment of
State Networks; and
‘‘(ii) recommendations for providing
technical assistance to those States deter-
mined to need such assistance to build the
capacity of the State to the level necessary
for the establishment of a State Network;
‘‘(B) the establishment and operation of
the Nationwide Network described in section
2804, including—
‘‘(i) existing infrastructure, surveys,
registries, protocols, surveillance systems,
together with additional recommendations for such
legislation and administrative actions as the Com-
mission considers to be appropriate.
‘‘(4) SELECTIONS.—The Commission shall re-
view applications and make selections for the Cen-
ters of Excellence described in section 2811 and the
John H. Chafee Scholarships described in section
2812.
‘‘(g) POWERS.—
‘‘(1) HEARINGS.—The Commission may hold
such hearings, sit and act at such times and places,
take such testimony, and receive such evidence as
the Commission considers advisable to carry out the
objectives of this section.
‘‘(2) INFORMATION
FROM
FEDERAL
AGEN-
CIES.—The Commission may secure directly from
any Federal department or agency such information
as the Commission considers necessary to carry out
the provisions of this section. Upon request of the
Commission, the head of such department or agency
shall furnish such information to the Commission.
‘‘(3) POSTAL SERVICES.—The Commission may
use the United States mails in the same manner and
under the same conditions as other departments and
agencies of the Federal Government.
‘‘(h) PERSONNEL.—
‘‘(1) TRAVEL EXPENSES.—The members of the
Commission shall not receive compensation for the
performance of services for the Commission, but
shall be allowed travel expenses, including per diem
in lieu of subsistence, at rates authorized for em-
ployees of agencies under subchapter I of chapter 57
of title 5, United States Code, while away from their
homes or regular places of business in the perform-
ance of services for the Commission. Notwith-
standing section 1342 of title 31, United States
Code, the Secretary may accept the voluntary and
uncompensated services of members of the Commis-
sion.
‘‘(2) DETAIL OF GOVERNMENT EMPLOYEES.—
Any Federal Government employee may be detailed
to the Commission without reimbursement, and such
detail shall be without interruption or loss of civil
service status or privilege.
‘‘(3) STAFF, INFORMATION, AND OTHER ASSIST-
ANCE.—The Secretary and the Administrator of the
Environmental Protection Agency shall provide to
the Commission such staff, information, and other
assistance as may be necessary to carry out the du-
ties of the Commission.
‘‘(i) PERMANENT COMMITTEE.—Section 14 of the
Federal Advisory Committee Act (5 U.S.C. App.) shall not
apply to the Commission.
‘‘(j) AUTHORIZATION OF APPROPRIATIONS.—There
is authorized to be appropriated to the Commission such
sums as may be necessary to carry out the objectives of
this section.
‘‘SEC. 2803. STATE HEALTH TRACKING NETWORK GRANTS.
‘‘(a) IN GENERAL.—The Secretary, acting through
the Director of the Centers for Disease Control and Pre-
vention, in consultation with the Administrator of the En-
vironmental Protection Agency and the Administrator of
the Agency for Toxic Substances and Disease Registry,
and taking into consideration the findings, conclusions,
and recommendations of the Commission, shall award
grants to eligible States, political subdivisions of States,
territories, and Indian tribes for the establishment, main-
tenance, and operation of State Networks in accordance
with the minimum standards and procedures established
by the Secretary under section 2804(b).
‘‘(b) USE OF FUNDS.—A State, political subdivision
of a State, territory, or Indian tribe that receives a grant
under this section shall use the amounts provided through
the grant to—
‘‘(1) conduct surveillance activities, building
and expanding on existing procedures and systems
where appropriate and available, to collect data, re-
port data, and make data available to researchers
and the public, in accordance with the minimum
standards and procedures established by the Sec-
retary under section 2804(b);
‘‘(2) collect data through biomonitoring and
other advanced methods;
‘‘(3) analyze collected data in accordance with
the minimum standards and procedures established
under section 2804(b) to identify populations at high
risk, examine and respond to health concerns, recog-
nize and address relevant environmental, behavioral,
socioeconomic, demographic, and other factors, effec-
tively communicate risk, assess the efficacy of med-
ical and public health intervention efforts, and estab-
lish and implement prevention strategies;
‘‘(4) establish the capacity to respond in a time-
ly manner to actual and perceived incidence rates of
priority chronic diseases that are higher than ex-
pected, acute and potential environmental hazards
and exposures, and other community environmental
health concerns, including concerns regarding vul-
nerable subpopulations and disproportionately im-
pacted subpopulations;
‘‘(5) establish an early warning system to de-
tect, investigate, and where necessary, respond to,
emergent public health concerns detected through
the State Network;
‘‘(6) recruit public health employees, including
the Environmental Health Investigators described in
subsection (e)(2)(B);
‘‘(7) train public health employees in epidemi-
ology, environmental health, risk communication,
and other relevant fields;
‘‘(8) pay for such staffing, administrative, and
other operating costs as may be required to carry
out this section;
‘‘(9) enhance the public health infrastructure,
including laboratories, outreach and communication
programs, and other related initiatives; and
‘‘(10) carry out such other activities as the Sec-
retary may determine necessary.
‘‘(c) EXISTING
SURVEILLANCE
SYSTEMS, REG-
ISTRIES, AND SURVEYS.—To the maximum extent prac-
ticable, States, political subdivisions of States, territories,
and Indian tribes shall use, expand, and integrate existing
surveillance and data collection systems, registries, and
surveys in the development and operation of a State Net-
work.
‘‘(d) LIMITATION.—A State, political subdivision of
a State, territory, or Indian tribe that receives a grant
under this section—
‘‘(1) may use not more than 10 percent of the
funds made available through the grant for adminis-
trative costs; and
‘‘(2) may not use less than 10 percent of the
funds made available through the grant for data
analysis activities.
‘‘(e) ELIGIBILITY.—
‘‘(1) APPLICATION.—
‘‘(A) IN GENERAL.—To be eligible to re-
ceive a grant under subsection (a) a State, po-
litical subdivision of a State, territory, or In-
dian tribe shall submit to the Secretary for ap-
proval an application that is in such form, sub-
mitted in such manner, and accompanied by
such information, as the Secretary may specify.
‘‘(B) REQUIREMENT FOR APPROVAL.—An
application submitted under subparagraph (A)
may not be approved by the Secretary unless
the application—
‘‘(i) contains assurances that the
State, political subdivision of a State, terri-
tory, or Indian tribe—
‘‘(I) will use grant funds only for
the purposes specified in the approved
application and in accordance with the
requirements of this section; and
‘‘(II) will establish such fiscal
control and fund accounting proce-
dures as may be necessary to assure
proper disbursement and accounting
of Federal funds paid to the State,
political subdivision of a State, terri-
tory, or Indian tribe under the grant;
and
‘‘(ii) contains the assurances described
in paragraph (2).
‘‘(2) ASSURANCES.—A State, political subdivi-
sion of a State, territory, or Indian tribe shall pro-
vide assurances satisfactory to the Secretary that
the State, political subdivision of a State, territory,
or Indian tribe will—
‘‘(A) establish a Health Tracking Network
in accordance with subsection (a) that will
provide—
‘‘(i) a means to ensure the complete
reporting of priority chronic conditions, as
set forth in section 2804(b)(2)(A), and rel-
evant environmental, behavioral, socio-
economic, demographic, and other factors
as set forth in subparagraphs (B) and (C)
of section 2804(b)(2), to the State Net-
work by health care providers, hospitals, or
other facilities that provide screening, diag-
nostic, or therapeutic services to patients;
‘‘(ii) a means to access necessary
records that would identify the incidence
and prevalence of priority chronic condi-
tions and relevant environmental, behav-
ioral, socioeconomic, demographic, and
other factors;
‘‘(iii) a means to collect information
regarding relevant environmental factors
through biomonitoring and other methods,
except that a State, political subdivision of
a State, territory, or Indian tribe may sat-
isfy the requirement of this clause through
the use of either its own laboratory or
through an agreement with other labora-
tories;
‘‘(iv) a means for the reporting of pri-
ority chronic conditions and relevant envi-
ronmental, behavioral, socioeconomic, de-
mographic, and other factors to the Na-
tionwide Network in such a format, with
such data elements, and in accordance with
such standards of quality, timeliness, and
completeness, as may be established by the
Secretary;
‘‘(v) a means for the protection of the
confidentiality of all personal data re-
ported, in accordance with the regulations
promulgated under section 264(c) of the
Health Insurance Portability and Account-
ability Act of 1996 (42 U.S.C. 1320d–2
note);
‘‘(vi) a means by which confidential
data may, in accordance with Federal and
State law, be disclosed to researchers for
the purposes of public health research;
‘‘(vii) a means for the protection of
individuals complying with the law, includ-
ing assurances that no such individual
shall be held liable in any civil action with
respect to data disclosed to the State Net-
work, or with respect to access to personal
information provided to the State Network;
and
‘‘(viii) a means for providing the full-
est possible access to data collected by the
State Network while ensuring that indi-
vidual privacy is protected in accordance
with clause (v) and that risk is effectively
communicated;
‘‘(B) appoint—
‘‘(i) in the case of a State, a State de-
partment or agency;
‘‘(ii) in the case of a political subdivi-
sion of a State, a local governmental de-
partment or agency;
‘‘(iii) in the case of a territory, a ter-
ritorial department or agency; or
‘‘(iv) in the case of an Indian tribe, a
tribal office;
as the environmental health lead department or
agency that will be responsible for reporting to
the Governor of the State (or other appropriate
State, territorial, or tribal official as the case
may be) regarding the State Network, be re-
sponsible for the development, operation, and
maintenance of the State Network, and ensure
the appropriate coordination among State and
local agencies regarding the development, oper-
ation, and maintenance of the State Network;
‘‘(C) appoint or hire an Environmental
Health Investigator who meets the criteria es-
tablished by the Secretary under section
2804(b)(2)(H) and who will provide leadership
with respect to the establishment, operation,
and maintenance of the State Network;
‘‘(D) comply with such minimum stand-
ards and procedures as the Secretary may pre-
scribe;
‘‘(E) maintain such records and data and
afford such access thereto as the Secretary may
find necessary to assure the correctness of, and
to verify, reports submitted to the Nationwide
Network under this section;
‘‘(F) establish an advisory committee to
ensure local community input to the State Net-
work;
‘‘(G) use the funds provided under this
section to build on, expand, and coordinate
among the existing public health and environ-
mental infrastructure, including surveys, reg-
istries, protocols, surveillance and data collec-
tion systems, and health alert and other early
warning networks; and
‘‘(H) provide an appropriate means for re-
ferring individuals with priority chronic condi-
tions to appropriate health services and for de-
termining their eligibility for health coverage
under the medicaid program carried out under
title XIX of the Social Security Act (42 U.S.C.
1396 et seq.) or the State Children’s Health In-
surance Program under title XXI of the Social
Security Act (42 U.S.C. 1397aa et seq.).
‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There
is authorized to be appropriated to carry out this section,
$100,000,000 for each of fiscal years 2005 through 2009.
‘‘SEC. 2804. ESTABLISHMENT AND OPERATION OF THE NA-
TIONWIDE HEALTH TRACKING NETWORK.
‘‘(a) IN GENERAL.—Not later than 36 months after
the date of enactment of this title, the Secretary, acting
through the Director of the Centers for Disease Control
and Prevention, in consultation with the Administrator of
the Environmental Protection Agency, the Administrator
of the Agency for Toxic Substances and Disease Registry,
States, political subdivisions of States, Indian tribes, and
territories and taking into consideration the findings, con-
clusions, and recommendations of the Commission, shall
establish and operate a Nationwide Health Tracking Net-
work. In establishing and operating the Nationwide Net-
work, the Secretary shall—
‘‘(1) identify, build upon, expand, and coordi-
nate among existing data and surveillance systems,
surveys, registries, and other Federal public health
and environmental infrastructure wherever possible,
including—
‘‘(A) the National Electronic Disease Sur-
veillance System;
‘‘(B) State birth defects surveillance sys-
tems as supported under section 317C;
‘‘(C) State cancer registries as supported
under part M of title III;
‘‘(D) State asthma surveillance systems as
supported under section 317I;
‘‘(E) the National Health and Nutrition
Examination Survey;
‘‘(F) the Behavioral Risk Factor Surveil-
lance System;
‘‘(G) the Substance Release/Health Effects
Database;
‘‘(H) the Hazardous Substances Emer-
gency Events Surveillance System;
‘‘(I) the National Exposure Registry;
‘‘(J) the Health Alert Network; and
‘‘(K) such other data and surveillance sys-
tems, registries, and surveys as considered ap-
propriate by the Secretary and the Adminis-
trator of the Environmental Protection Agency;
‘‘(2) develop, operate, and maintain a national
database that accepts data from the State Networks
on the occurrence, including incidence and preva-
lence, of priority chronic conditions and relevant en-
vironmental, behavioral, socioeconomic, demographic,
and other factors;
‘‘(3) coordinate the State Networks as provided
for under section 2803 and provide technical assist-
ance to support these Networks;
‘‘(4) establish minimum standards and proce-
dures for data collection, reporting, and availability
to ensure that data collected by the Nationwide and
State Networks are—
‘‘(A) accurate and of a high quality;
‘‘(B) accessible to the public in a form that
provides for the protection of individual privacy
and provides for effective risk communication
(including in an electronic format);
‘‘(C) accessible and sufficient to be used
and analyzed on a national scale by interested
parties; and
‘‘(D) maintained in a manner that sup-
ports the purposes of this title and protects in-
dividual privacy; and
‘‘(5) develop guidance for appropriate data
analysis, response, risk communication, and preven-
tion activities at the Federal and State level.
‘‘(b) ESTABLISHMENT OF MINIMUM STANDARDS AND
PROCEDURES.—
‘‘(1) IN GENERAL.—Not later than 36 months
after the date of enactment of this title, the Sec-
retary, acting through the Director of the Centers
for Disease Control and Prevention, and in consulta-
tion with the Administrator of the Environmental
Protection Agency, the Administrator of the Agency
for Toxic Substances and Disease Registry, the Sur-
geon General, the Director of the National Institutes
of Health, States, Indian tribes, territories, and
other interested parties, shall establish minimum
standards and procedures for the establishment and
operation of the State Networks. In developing such
minimum standards and procedures, the Secretary
shall take into consideration the findings, conclu-
sions, and recommendations of the Commission.
‘‘(2) CONTENTS.—The minimum standards and
procedures established under paragraph (1) shall
include—
‘‘(A) a list and definitions of the priority
chronic conditions to be tracked through the
State Networks, including—
‘‘(i) birth defects;
‘‘(ii) developmental disabilities (such
as cerebral palsy, autism, and mental re-
tardation);
‘‘(iii) asthma and chronic respiratory
diseases (such as chronic bronchitis and
emphysema);
‘‘(iv) cancer, including pediatric can-
cers;
‘‘(v) neurological diseases (such as
Parkinson’s, Multiple Sclerosis, and Alz-
heimer’s); and
‘‘(vi) other such priority chronic con-
ditions as the Secretary may specify;
‘‘(B) a list and definitions of relevant envi-
ronmental factors to be tracked through the
State Networks;
‘‘(C) a list and definitions of relevant be-
havioral, socioeconomic, demographic, and other
risk factors, including race, ethnic status, gen-
der, age, occupation, and primary language, to
be tracked through the State Networks;
‘‘(D) procedures for the complete, timely,
and high-quality collection and reporting of an-
nual data by census tract, or other political or
administrative subdivision determined appro-
priate by the Secretary, regarding the incidence
and prevalence of the priority chronic diseases
listed under subparagraph (A), the relevant en-
vironmental factors listed under subparagraph
(B), and the relevant behavioral, socioeconomic,
demographic, and other factors listed under
subparagraph (C) that will ensure the utility,
accuracy, and sufficiency of the data for all in-
terested parties and the protection of individual
privacy;
‘‘(E) procedures for making data available
to the public at a community level, in an easily
accessible and readily available format, ensuring
the protection of individual privacy and effective
communication of risk, and as quickly as pos-
sible after it is collected so that public health