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 Co-
ordinated Environmental Health Network, and for other 
purposes.
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 ‘‘Coordinated Environ-
mental Health Network Act of 2004’’.
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 $750,000,000,000 
lost in health care costs as a result, the national cost 
of chronic disease is extremely high and must be ap-
propriately addressed; 
(3) the rates of many chronic diseases, includ-
ing asthma, some birth defects, cancers, and autism, 
appear to be increasing; 
(4) there is a growing amount of evidence that 
environmental factors are strongly linked with spe-
cific chronic disease; 
(5) a major gap in critical knowledge exists re-
garding the prevalence and incidence of chronic dis-
eases; 
(6) States, local communities, territories, and 
Indian tribes need assistance with public health ef-
forts that would lead to prevention of chronic dis-
ease, including the establishment and maintenance 
of necessary infrastructure for disease and environ-
mental hazard exposure surveillance; and
(7) a Coordinated Environmental Health Net-
work will help target resources to areas of chronic 
disease prevention most in need. 
(b) PURPOSES.—It is the purpose of this Act to—
(1) develop, operate, and maintain a Coordi-
nated Environmental Health Network, State Envi-
ronmental Health Networks, and rapid response ca-
pabilities so that the Federal Government, States, 
local governments, territories, and Indian tribes can 
more effectively monitor, investigate, respond to, re-
search, and prevent increases in the incidence and 
prevalence of certain chronic diseases and relevant 
environmental and other risk factors; 
(2) provide information collected through the 
Coordinated and State Environmental Health Net-
works to government agencies, public health practi-
tioners and researchers, policy makers, and the pub-
lic; 
(3) expand and coordinate among existing sur-
veillance and data collection systems and other infra-
structure for chronic diseases and relevant environ-
mental, and other risk factors, including those rel-
evant to bioterrorism;
(4) improve coordination between the areas of 
public health, environmental protection, and chem-
ical, radiological and biological terrorism; and 
(5) provide necessary support 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 and maintenance of the Coordinated and State 
Environmental Health 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 XXIX—COORDINATED EN-
VIRONMENTAL HEALTH NET-
WORK 
‘‘SEC. 2900. DEFINITIONS. 
‘‘In this title: 
‘‘(1) ADMINISTRATORS.—The term ‘Administra-
tors’ means the Director of the Centers for Disease 
Control and Prevention Coordinating Center for En-
vironmental Health, Injury Prevention, and Occupa-
tional Health, and the Administrator of the Environ-
mental Protection Agency.
‘‘(2) 
COMMITTEE.—The 
term 
‘Committee’ 
means the Advisory Committee established under 
section 2901(d). 
‘‘(3) DIRECTOR.—The term ‘Director’ means 
the Director of the Centers for Disease Control and 
Prevention. 
‘‘(4) MEDICAL
PRIVACY
REGULATIONS.—The 
term ‘medical privacy regulations’ means the regula-
tions promulgated under section 264(c) of the 
Health Insurance Portability and Accountability Act 
of 1996. 
‘‘(5) COORDINATED NETWORK.—The term ‘Co-
ordinated Network’ means the Coordinated Environ-
mental Health Network established under section 
2901(a). 
‘‘(6) 
PRIORITY
CHRONIC
CONDITION.—The 
term ‘priority chronic condition’ means a condition 
to be tracked in the Coordinated Network and the 
State Networks, including birth defects, develop-
mental disabilities (such as cerebral palsy, autism, 
and mental retardation), asthma and chronic res-
piratory diseases, neurological diseases (such as Par-
kinson’s disease, multiple sclerosis, Alzheimer’s dis-
ease, and amyotrophic lateral sclerosis), autoimmune 
diseases (such as lupus), cancer, juvenile diabetes,
and such other priority chronic conditions as the 
Secretary may specify. 
‘‘(7) STATE NETWORK.—The term ‘State Net-
work’ means a State Environmental Health Network 
established under section 2901(b). 
‘‘(8) STATE.—The term ‘State’ means a State, 
territory, or Indian tribe that is eligible to receive a 
health tracking grant under section 2901(b). 
‘‘SEC. 2901. ESTABLISHMENT OF COORDINATED AND STATE 
ENVIRONMENTAL HEALTH NETWORKS. 
‘‘(a) COORDINATED ENVIRONMENTAL HEALTH NET-
WORK.—
‘‘(1) ESTABLISHMENT.—Not later than 36 
months after the date of the enactment of this title, 
the Secretary, acting through the Director and in 
consultation with the Administrators, State and local 
health departments, and the Committee, shall estab-
lish and operate a Coordinated Environmental 
Health Network. In establishing and operating the 
Coordinated Network, the Secretary shall—
‘‘(A) identify, build upon, expand, and co-
ordinate among existing data and surveillance 
systems, surveys, registries, and other Federal 
public health and environmental infrastructure 
wherever possible, including—
‘‘(i) the National Electronic Disease 
Surveillance System; 
‘‘(ii) State birth defects surveillance 
systems as supported under section 317C; 
‘‘(iii) State cancer registries as sup-
ported under part M of title III; 
‘‘(iv) State asthma surveillance sys-
tems as supported under section 317I; 
‘‘(v) the National Health and Nutri-
tion Examination Survey; 
‘‘(vi) the Behavioral Risk Factor Sur-
veillance System; 
‘‘(vii) the Hazardous Substance Re-
lease/Health Effects Database; 
‘‘(viii) 
the 
Hazardous 
Substances 
Emergency Events Surveillance System; 
‘‘(ix) the National Exposure Registry; 
‘‘(x) the Health Alert Network; and 
‘‘(xi) the State vital statistics systems 
as supported under section 306; 
‘‘(B) provide for public access to an elec-
tronic national database that accepts data from 
the State Networks on the incidence and preva-
lence of priority chronic conditions and relevant 
environmental and other factors, in a manner
which protects personal privacy consistent with 
the medical privacy regulations; 
‘‘(C) not later than 36 months after the 
date of the enactment of this title, and annually 
thereafter, prepare and publish, in accordance 
with paragraph (2), a Coordinated Environ-
mental Health Network Report to provide the 
public with the findings of the Coordinated Net-
work; 
‘‘(D) operate and maintain a National En-
vironmental Health Rapid Response Service 
within the Epidemic Intelligence Service to 
carry out the activities described in paragraph 
(3); 
‘‘(E) provide for the establishment of State 
Networks, and coordinate the State Networks 
as provided for under subsection (b); 
‘‘(F) provide technical assistance to sup-
port the State Networks, including providing—
‘‘(i) training for environmental health 
investigators appointed or hired under sub-
section (b)(3)(D); 
‘‘(ii) technical assistance as needed to 
States to build necessary capacity and in-
frastructure for the establishment of a