H. R. 2576—63 
factors, including an unreasonable risk to a potentially 
exposed or susceptible subpopulation, under the condi-
tions of use’’. 
(p) SECTION 24.—Section 24(b)(2)(B) of the Toxic Substances 
Control Act (15 U.S.C. 2623(b)(2)(B)) is amended— 
(1) by inserting ‘‘and’’ at the end of clause (i); 
(2) by striking clause (ii); and 
(3) by redesignating clause (iii) as clause (ii). 
(q) SECTION 26.—Section 26 of the Toxic Substances Control 
Act (15 U.S.C. 2625) is amended— 
(1) in subsection (e), by striking ‘‘Health, Education, and 
Welfare’’ each place it appears and inserting ‘‘Health and 
Human Services’’; and 
(2) in subsection (g)(1), by striking ‘‘data’’ and inserting 
‘‘information’’. 
(r) SECTION 27.—Section 27(a) of the Toxic Substances Control 
Act (15 U.S.C. 2626(a)) is amended— 
(1) by striking ‘‘Health, Education, and Welfare’’ and 
inserting ‘‘Health and Human Services’’; 
(2) by striking ‘‘test data’’ both places it appears and 
inserting ‘‘information’’; 
(3) by striking ‘‘rules promulgated’’ and inserting ‘‘rules, 
orders, or consent agreements’’; and 
(4) by striking ‘‘standards’’ and inserting ‘‘protocols and 
methodologies’’. 
(s) SECTION 30.—Section 30(2) of the Toxic Substances Control 
Act (15 U.S.C. 2629(2)) is amended by striking ‘‘rule’’ and inserting 
‘‘rule, order, or consent agreement’’. 
SEC. 20. NO RETROACTIVITY. 
Nothing in sections 1 through 19, or the amendments made 
by sections 1 through 19, shall be interpreted to apply retroactively 
to any State, Federal, or maritime legal action filed before the 
date of enactment of this Act. 
SEC. 21. TREVOR’S LAW. 
(a) PURPOSES.—The purposes of this section are— 
(1) to provide the appropriate Federal agencies with the 
authority to help conduct investigations into potential cancer 
clusters; 
(2) to ensure that Federal agencies have the authority 
to undertake actions to help address cancer clusters and factors 
that may contribute to the creation of potential cancer clusters; 
and 
(3) to enable Federal agencies to coordinate with other 
Federal, State, and local agencies, institutes of higher edu-
cation, and the public in investigating and addressing cancer 
clusters. 
(b) DESIGNATION
AND INVESTIGATION
OF POTENTIAL CANCER 
CLUSTERS.—Part P of title III of the Public Health Service Act 
(42 U.S.C. 280g et seq.) is amended by adding at the end the 
following: 
‘‘SEC. 399V–6. DESIGNATION AND INVESTIGATION OF POTENTIAL 
CANCER CLUSTERS. 
‘‘(a) DEFINITIONS.—In this section: 
‘‘(1) CANCER CLUSTER.—The term ‘cancer cluster’ means 
the incidence of a particular cancer within a population group,
H. R. 2576—64 
a geographical area, and a period of time that is greater than 
expected for such group, area, and period. 
‘‘(2) PARTICULAR
CANCER.—The term ‘particular cancer’ 
means one specific type of cancer or a type of cancers scientif-
ically proven to have the same cause. 
‘‘(3) POPULATION
GROUP.—The term ‘population group’ 
means a group, for purposes of calculating cancer rates, defined 
by factors such as race, ethnicity, age, or gender. 
‘‘(b) CRITERIA FOR DESIGNATION OF POTENTIAL CANCER CLUS-
TERS.— 
‘‘(1) DEVELOPMENT
OF
CRITERIA.—The Secretary shall 
develop criteria for the designation of potential cancer clusters. 
‘‘(2) REQUIREMENTS.—The criteria developed under para-
graph (1) shall consider, as appropriate— 
‘‘(A) a standard for cancer cluster identification and 
reporting protocols used to determine when cancer 
incidence is greater than would be typically observed; 
‘‘(B) scientific screening standards that ensure that 
a cluster of a particular cancer involves the same type 
of cancer, or types of cancers; 
‘‘(C) the population in which the cluster of a particular 
cancer occurs by factors such as race, ethnicity, age, and 
gender, for purposes of calculating cancer rates; 
‘‘(D) the boundaries of a geographic area in which 
a cluster of a particular cancer occurs so as not to create 
or obscure a potential cluster by selection of a specific 
area; and 
‘‘(E) the time period over which the number of cases 
of a particular cancer, or the calculation of an expected 
number of cases, occurs. 
‘‘(c) GUIDELINES
FOR INVESTIGATION
OF POTENTIAL CANCER 
CLUSTERS.—The Secretary, in consultation with the Council of State 
and Territorial Epidemiologists and representatives of State and 
local health departments, shall develop, publish, and periodically 
update guidelines for investigating potential cancer clusters. The 
guidelines shall— 
‘‘(1) recommend that investigations of cancer clusters— 
‘‘(A) use the criteria developed under subsection (b); 
‘‘(B) use the best available science; and 
‘‘(C) rely on a weight of the scientific evidence; 
‘‘(2) provide standardized methods of reviewing and catego-
rizing data, including from health surveillance systems and 
reports of potential cancer clusters; and 
‘‘(3) provide guidance for using appropriate epidemiological 
and other approaches for investigations. 
‘‘(d) INVESTIGATION OF CANCER CLUSTERS.— 
‘‘(1) SECRETARY DISCRETION.—The Secretary— 
‘‘(A) in consultation with representatives of the rel-
evant State and local health departments, shall consider 
whether it is appropriate to conduct an investigation of 
a potential cancer cluster; and 
‘‘(B) in conducting investigations shall have the discre-
tion to prioritize certain potential cancer clusters, based 
on the availability of resources. 
‘‘(2) COORDINATION.—In investigating potential cancer clus-
ters, the Secretary shall coordinate with agencies within the
H. R. 2576—65 
Department of Health and Human Services and other Federal 
agencies, such as the Environmental Protection Agency. 
‘‘(3) BIOMONITORING.—In investigating potential cancer 
clusters, the Secretary shall rely on all appropriate biomoni-
toring information collected under other Federal programs, such 
as the National Health and Nutrition Examination Survey. 
The Secretary may provide technical assistance for relevant 
biomonitoring studies of other Federal agencies. 
‘‘(e) DUTIES.—The Secretary shall— 
‘‘(1) ensure that appropriate staff of agencies within the 
Department of Health and Human Services are prepared to 
provide timely assistance, to the extent practicable, upon 
receiving a request to investigate a potential cancer cluster 
from a State or local health authority; 
‘‘(2) maintain staff expertise in epidemiology, toxicology, 
data analysis, environmental health and cancer surveillance, 
exposure assessment, pediatric health, pollution control, 
community outreach, health education, laboratory sampling and 
analysis, spatial mapping, and informatics; 
‘‘(3) consult with community members as investigations 
into potential cancer clusters are conducted, as the Secretary 
determines appropriate; 
‘‘(4) collect, store, and disseminate reports on investigations 
of potential cancer clusters, the possible causes of such clusters, 
and the actions taken to address such clusters; and 
‘‘(5) provide technical assistance for investigating cancer 
clusters to State and local health departments through existing 
programs, such as the Epi-Aids program of the Centers for 
Disease Control and Prevention and the Assessments of Chem-
ical Exposures Program of the Agency for Toxic Substances 
and Disease Registry.’’. 
TITLE II—RURAL HEALTHCARE 
CONNECTIVITY 
SEC. 201. SHORT TITLE. 
This title may be cited as the ‘‘Rural Healthcare Connectivity 
Act of 2016’’. 
SEC. 202. TELECOMMUNICATIONS SERVICES FOR SKILLED NURSING 
FACILITIES. 
(a) IN GENERAL.—Section 254(h)(7)(B) of the Communications 
Act of 1934 (47 U.S.C. 254(h)(7)(B)) is amended— 
(1) in clause (vi), by striking ‘‘and’’ at the end; 
(2) by redesignating clause (vii) as clause (viii); 
(3) by inserting after clause (vi) the following: 
‘‘(vii) skilled nursing facilities (as defined in section 
1819(a) of the Social Security Act (42 U.S.C. 1395i– 
3(a))); and’’; and 
(4) in clause (viii), as redesignated, by striking ‘‘clauses 
(i) through (vi)’’ and inserting ‘‘clauses (i) through (vii)’’. 
(b) SAVINGS CLAUSE.—Nothing in subsection (a) shall be con-
strued to affect the aggregate annual cap on Federal universal 
service support for health care providers under section 54.675 of 
title 47, Code of Federal Regulations, or any successor regulation.
H. R. 2576—66 
(c) EFFECTIVE DATE.—The amendments made by subsection 
(a) shall apply beginning on the date that is 180 days after the 
date of the enactment of this Act. 
Speaker of the House of Representatives. 
Vice President of the United States and
President of the Senate.