I 
117TH CONGRESS 
2D SESSION 
H. R. 8481 
To amend the Public Health Service Act with respect to public health data 
accessibility, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 21, 2022 
Ms. UNDERWOOD (for herself, Mr. BERA, Ms. CASTOR of Florida, and Ms. 
DELAURO) introduced the following bill; which was referred to the Com-
mittee on Energy and Commerce 
A BILL 
To amend the Public Health Service Act with respect to 
public health data accessibility, 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 ‘‘Improving Data Acces-
sibility Through Advancements in Public Health Act’’ or 
the ‘‘Improving DATA in Public Health Act’’. 
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SEC. 2. SUPPORTING PUBLIC HEALTH DATA AVAILABILITY 
AND ACCESS. 
(a) DESIGNATION OF PUBLIC HEALTH DATA STAND-
ARDS.—Section 2823(a)(2) of the Public Health Service 
Act (42 U.S.C. 300hh–33(a)(2)) is amended— 
(1) by striking ‘‘In carrying out’’ and inserting 
the following: 
‘‘(A) IN GENERAL.—In carrying out’’; 
(2) by striking ‘‘shall, as appropriate and’’ and 
inserting ‘‘shall, not later than 2 years after the date 
of enactment of the Improving DATA in Public 
Health Act,’’; and 
(3) by adding at the end the following: 
‘‘(B) SELECTION
OF
DATA
AND
TECH-
NOLOGY
STANDARDS.—The 
standards 
des-
ignated as described in subparagraph (A) may 
include standards to improve— 
‘‘(i) the exchange of electronic health 
information for— 
‘‘(I) electronic case reporting; 
‘‘(II) syndromic surveillance; 
‘‘(III) reporting of vital statistics; 
and 
‘‘(IV) reporting test orders and 
results electronically, including from 
laboratories; 
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‘‘(ii) automated electronic reporting to 
relevant public health data systems of the 
Centers for Disease Control and Preven-
tion; and 
‘‘(iii) such other uses as the Secretary 
determines appropriate. 
‘‘(C) NO DUPLICATIVE EFFORTS.— 
‘‘(i) IN
GENERAL.—In carrying out 
the requirements of this paragraph, the 
Secretary, in consultation with the Office 
of the National Coordinator for Health In-
formation Technology, may use input gath-
ered (including input and recommendations 
gathered from the Health Information 
Technology Advisory Committee), and ma-
terials developed, prior to the date of en-
actment of the Improving DATA in Public 
Health Act. 
‘‘(ii) DESIGNATION OF STANDARDS.— 
Consistent with sections 13111 and 13112 
of the HITECH Act, the data and tech-
nology standards designated pursuant to 
this paragraph shall align with the stand-
ards and implementation specifications 
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adopted by the Secretary pursuant to sec-
tion 3004, as applicable. 
‘‘(D) PRIVACY
AND
SECURITY.—Nothing 
in this paragraph shall be construed as modi-
fying applicable Federal or State information 
privacy or security law. 
‘‘(E) CONSIDERATIONS.—Standards des-
ignated under this paragraph shall include 
standards and implementation specifications 
necessary to ensure the appropriate capture, ex-
change, access, and use of information regard-
ing race, ethnicity, sex (including sexual ori-
entation and gender identity), disability status, 
veteran status, housing status, age, functional 
status, and other elements.’’. 
(b) STUDY ON LABORATORY INFORMATION STAND-
ARDS.— 
(1) IN GENERAL.—Not later than 1 year after 
the date of enactment of this Act, the Office of the 
National Coordinator for Health Information Tech-
nology shall conduct a study to review the use of 
standards for electronic ordering and reporting of 
laboratory test results. 
(2) AREAS OF CONCENTRATION.—In conducting 
the study under paragraph (1), the Office of the Na-
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tional Coordinator for Health Information Tech-
nology shall— 
(A) determine the extent to which clinical 
laboratories are using standards for electronic 
ordering and reporting of laboratory test re-
sults; 
(B) assess trends in laboratory compliance 
with standards for ordering and reporting lab-
oratory test results and the effect of such 
trends on the interoperability of laboratory data 
with public health data systems; 
(C) identify challenges related to collection 
and reporting of demographic and other data 
elements with respect to laboratory test results; 
(D) identify any challenges associated with 
using or complying with standards and report-
ing laboratory test results with data elements 
identified in standards for electronic ordering 
and reporting of such results; and 
(E) review other relevant areas determined 
appropriate by the Office of the National Coor-
dinator for Health Information Technology. 
(3) REPORT.—Not later than 2 years after the 
date of enactment of this Act, the Office of the Na-
tional Coordinator for Health Information Tech-
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nology shall submit to the Committee on Health, 
Education, Labor, and Pensions of the Senate and 
the Committee on Energy and Commerce of the 
House of Representatives a report concerning the 
findings of the study conducted under paragraph 
(1). 
(c) SUPPORTING INFORMATION SHARING THROUGH 
DATA USE AGREEMENTS.— 
(1) INTERAGENCY
DATA
USE
AGREEMENTS 
WITHIN THE DEPARTMENT OF HEALTH AND HUMAN 
SERVICES FOR PUBLIC HEALTH EMERGENCIES.— 
(A) 
IN
GENERAL.—The 
Secretary 
of 
Health and Human Services (referred to in this 
subsection as the ‘‘Secretary’’) shall, as appro-
priate, facilitate the development of, or updates 
to, memoranda of understanding, data use 
agreements, or other applicable interagency 
agreements regarding appropriate access, ex-
change, and use of public health data among 
the Centers for Disease Control and Prevention, 
the Office of the Assistant Secretary for Pre-
paredness and Response, other relevant agen-
cies or offices within the Department of Health 
and Human Services, and other relevant Fed-
eral agencies, in order to prepare for, identify, 
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monitor, and respond to declared or potential 
public health emergencies. 
(B) REQUIREMENTS.—In carrying out ac-
tivities pursuant to subparagraph (A), the Sec-
retary shall— 
(i) ensure that the agreements and 
memoranda of understanding described in 
such subparagraph— 
(I) address the methods of grant-
ing access to data held by one agency 
or office with another to support the 
respective missions of such agencies 
or offices; 
(II) consider minimum necessary 
principles of data sharing for appro-
priate use; 
(III) include appropriate privacy 
and cybersecurity protections; and 
(IV) are subject to regular up-
dates, as appropriate; 
(ii) collaborate with the Centers for 
Disease Control and Prevention, the Office 
of the Assistant Secretary for Prepared-
ness and Response, the Office of the Chief 
Information Officer, and, as appropriate, 
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the Office of the National Coordinator for 
Health Information Technology, and other 
entities within the Department of Health 
and Human Services; and 
(iii) consider the terms and conditions 
of any existing data use agreements with 
other public or private entities and any 
need for updates to such existing agree-
ments, consistent with paragraph (2). 
(2) DATA USE AGREEMENTS WITH EXTERNAL 
ENTITIES.—The Secretary, acting through the Di-
rector of the Centers for Disease Control and Pre-
vention and the Assistant Secretary for Prepared-
ness and Response, may update memoranda of un-
derstanding, data use agreements, or other applica-
ble agreements and contracts to improve appropriate 
access, exchange, and use of public health data 
among the Centers for Disease Control and Preven-
tion, the Office of the Assistant Secretary for Pre-
paredness and Response, and external entities, in-
cluding State, Tribal, local, and territorial health de-
partments, laboratories, hospitals and other health 
care providers, electronic health records vendors, and 
other entities, as applicable and appropriate, in 
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order to prepare for, identify, monitor, and respond 
to declared or potential public health emergencies. 
(3) REPORT.—Not later than 90 days after the 
date of enactment of this Act, the Secretary shall re-
port to the Committee on Health, Education, Labor, 
and Pensions of the Senate and the Committee on 
Energy and Commerce of the House of Representa-
tives on the status of the memoranda of under-
standing and other agreements under this sub-
section. 
(d) IMPROVING INFORMATION SHARING AND AVAIL-
ABILITY OF PUBLIC HEALTH DATA.—Part A of title III 
of the Public Health Service Act (42 U.S.C. 241 et seq.) 
is amended by adding at the end the following: 
‘‘SEC. 310B. IMPROVING INFORMATION SHARING AND 
AVAILABILITY OF PUBLIC HEALTH DATA. 
‘‘(a) IN GENERAL.—The Secretary acting through 
the Director of the Centers for Disease Control and Pre-
vention (in this section referred to as the ‘Secretary’) may 
require the reporting of public health and health care data 
and information to the Centers for Disease Control and 
Prevention by— 
‘‘(1) health care providers and facilities, includ-
ing pharmacies; 
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‘‘(2) public health, clinical, and other labora-
tories and diagnostic testing entities; 
‘‘(3) State, local, and Tribal health depart-
ments; and 
‘‘(4) other entities, as determined appropriate 
by the Secretary. 
‘‘(b) 
CONTENT, 
FORM, 
MANNER, 
AND
FRE-
QUENCY.— 
‘‘(1) COLLABORATION.—The Secretary shall 
collaborate with representatives of State, local, and 
Tribal health departments and other entities on de-
termining the content, form, manner, and frequency 
of the reporting of public health and health care 
data and information required pursuant to sub-
section (a). 
‘‘(2) SIMULTANEOUS
REPORTING.—In deter-
mining the content, form, manner, and frequency of 
the reporting of public health and health care data 
and information pursuant to subsection (a), where a 
disease, condition, or related event is reportable 
under applicable State or local law, the Secretary 
shall require the data and information to be reported 
first or simultaneously to the appropriate State or 
local jurisdiction. 
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‘‘(3) ALIGNMENT
WITH
STANDARDS
AND
IM-
PLEMENTATION
SPECIFICATIONS.—The 
content, 
form, manner, and frequency requirements required 
pursuant to this section shall align with the stand-
ards and implementation specifications adopted by 
the Secretary under section 3004, where applicable. 
‘‘(4) REASONABLE EFFORTS TO LIMIT REPORT-
ING.—The Secretary shall make reasonable efforts 
to limit the public health and health care data and 
information required to be reported under this sec-
tion to the minimum necessary to accomplish the in-
tended public health purpose. 
‘‘(5) IMPLEMENTATION
AND
REGULATIONS.— 
The Secretary— 
‘‘(A) may promulgate by regulation the 
content, form, manner, and frequency in which 
public health and health care data and informa-
tion is required to be reported under this sec-
tion; and 
‘‘(B) in the event of a public health emer-
gency declared under section 319, or where the 
Secretary determines there is a significant po-
tential for such an emergency to exist, may 
issue such requirements— 
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‘‘(i) by guidance in accordance with 
this section; and 
‘‘(ii) without regard to the procedures 
otherwise required by section 553 of title 
5, United States Code. 
‘‘(c) ENSURING THAT DATA IS ACCESSIBLE IN A 
TIMELY
MANNER
TO
STATE, LOCAL, AND
TRIBAL 
HEALTH AUTHORITIES.— 
‘‘(1) COLLABORATION.—The Secretary shall 
collaborate with representatives of State, local, and 
Tribal health departments, and entities representing 
such departments, to ensure that data and informa-
tion that is collected by the Centers for Disease Con-
trol and Prevention pursuant to this section are ac-
cessible, as appropriate, in a timely manner, to 
State, local, and Tribal health authorities. 
‘‘(2) RULES
OF
CONSTRUCTION.—Nothing in 
this section shall be construed— 
‘‘(A) to prevent any Federal agency, State, 
local, or Tribal health department, or other en-
tity from collecting data or information under 
other applicable law; or 
‘‘(B) to limit the authority of the Centers 
for Disease Control and Prevention to share 
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public health surveillance data with State, local, 
or Tribal health authorities. 
‘‘(3) REASONABLE EFFORTS TO REDUCE RE-
PORTING
BURDENS
AND
POTENTIAL
DUPLICA-
TION.—The Secretary shall make reasonable efforts 
to collaborate with representatives of Federal agen-
cies and State, local, and Tribal health departments 
to reduce reporting burdens and potential duplica-
tion of reporting requirements. Such efforts may in-
clude ensuring simultaneous sharing of data and in-
formation described in subsection (b) with State, 
local, and Tribal public health agencies. 
‘‘(d) 
CONFIDENTIALITY
AND
PROTECTION
OF 
DATA.—Any identifiable, sensitive information (as defined 
in section 301(d)) reported to the Centers for Disease 
Control and Prevention pursuant to this section shall not 
be further disclosed or provided to any other individual 
or party, including any party involved in civil, criminal, 
or administrative litigation, except— 
‘‘(1) as necessary for public health purposes, in-
cluding with relevant Federal, State, local, or tribal 
public health authorities; 
‘‘(2) as required under section 552a(d)(1) of 
title 5, United States Code; 
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‘‘(3) as required by applicable Federal laws, ex-
cluding instances of disclosure in any Federal, State, 
or local civil, criminal, administrative, legislative, or 
other proceeding; or 
‘‘(4) with the consent of each individual to 
whom the information pertains. 
‘‘(e) EXEMPTION
OF CERTAIN PUBLIC HEALTH 
DATA FROM DISCLOSURE.—The Secretary may exempt 
from disclosure under section 552(b)(3) of title 5, United 
States Code, public health and health care data and infor-
mation collected by the Centers for Disease Control and 
Prevention pursuant to this section or any other authority 
under which the Centers collects public health or health 
care data and information if— 
‘‘(1) an individual is identified through such 
data or information; or 
‘‘(2) there is at least a very small risk, as deter-
mined by current scientific practices or statistical 
methods, that some combination of the data or in-
formation, the request for disclosure under such sec-
tion 552(b)(3), and other available data sources or 
the application of technology could be used to de-
duce the identity of the individuals to which such 
data or information pertains. 
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‘‘SEC. 310C. PUBLIC HEALTH INFORMATION SHARING AND 
AVAILABILITY ADVISORY COMMITTEE. 
‘‘(a) 
ESTABLISHMENT.—The 
Secretary, 
acting 
through the Director of the Centers for Disease Control 
and Prevention, shall establish an advisory committee, to 
be known as the Public Health Information Sharing and 
Availability Advisory Committee, to advise, and make rec-
ommendations to, the Director with respect to the imple-
mentation of public health and health care data and infor-
mation reporting and sharing under section 310B. 
‘‘(b) MEMBERSHIP.—The membership of the advisory 
committee established pursuant to this section shall in-
clude— 
‘‘(1) individuals with subject matter expertise 
or experience in the following areas of public health 
and health care data and information, including— 
‘‘(A) State, territorial, local, and Tribal 
health department data systems or practices; 
and 
‘‘(B) health care data; 
‘‘(2) ex officio members, including from relevant 
Federal agencies such as the Office of the National 
Coordinator for Health Information Technology, the 
Centers for Medicare & Medicaid Services, the Cen-
ters for Disease Control and Prevention, and the Of-
fice of the Assistant Secretary for Health; 
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‘‘(3) representatives of national organizations, 
including the Council of State and Territorial Epi-
demiologists, the Association of Public Health Lab-
oratories, the Association of State and Territorial 
Health Officials, the National Association of County 
and City Health Officials, and the Big Cities Health 
Coalition; and 
‘‘(4) such additional members as the Secretary 
deems appropriate. 
‘‘(c) FACA APPLICABILITY.—The advisory com-
mittee established pursuant to this section is deemed to 
be an advisory committee subject to the Federal Advisory 
Committee Act.’’. 
(e) IMPROVING PUBLIC HEALTH DATA COLLEC-
TION.— 
(1) IN GENERAL.—The Secretary of Health and 
Human Services (referred to in this subsection as 
the ‘‘Secretary’’) shall award grants, contracts, or 
cooperative agreements to eligible entities for pur-
poses of identifying, developing, or disseminating 
best practices in the collection of electronic health 
information and the use of designated data stand-
ards and implementation specifications— 
(A) to improve the quality and complete-
ness of data, including demographic data, col-
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lected, accessed, or used for public health pur-
poses; and 
(B) to address health disparities and re-
lated health outcomes. 
(2) ELIGIBLE ENTITIES.—To be eligible to re-
ceive an award under this subsection an entity 
shall— 
(A) be a health care provider, academic 
medical center, community-based organization, 
State, local governmental entity, Indian Tribe 
or Tribal organization (as such terms are de-
fined in section 4 of the Indian Self Determina-
tion and Education Assistance Act (25 U.S.C. 
5304)), Urban Indian organization (as defined 
in section 4 of the Indian Health Care Improve-
ment Act (25 U.S.C. 1603)), or other appro-
priate public or private nonprofit entity, or a 
consortia of any such entities; and 
(B) submit an application to the Secretary 
at such time, in such manner, and containing 
such information as the Secretary may require. 
(3) ACTIVITIES.—Entities receiving awards 
under this subsection shall use such award to de-
velop and test best practices for training health care 
providers to use standards and implementation spec-
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ifications that assist in the capture, access, ex-
change, and use of electronic health information, in-
cluding demographic information, disability status, 
veteran status, housing status, functional status, 
and other data elements. Such activities shall, at a 
minimum, include— 
(A) improving, understanding, and using 
data standards and implementation specifica-
tions; 
(B) developing or identifying methods to 
improve communication with patients in a cul-
turally and linguistically appropriate manner, 
including to better capture information related 
to demographics of such individuals; 
(C) developing methods for accurately cat-
egorizing and recording patient responses using 
available data standards; 
(D) educating providers regarding the util-
ity of such information for public health pur-
poses and the importance of accurate collection 
and recording of such data; and 
(E) other activities, as the Secretary deter-
mines appropriate. 
(4) REPORTING.— 
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(A) REPORTING BY AWARD RECIPIENTS.— 
Each recipient of an award under this sub-
section shall submit to the Secretary a report 
on the results of best practices identified, devel-
oped, or disseminated through such award. 
(B) REPORT
TO
CONGRESS.—Not later 
than 1 year after the completion of the program 
under this subsection, the Secretary shall sub-
mit a report to Congress on the success of the 
best practices developed under such program, 
opportunities for further dissemination of such 
best practices, and recommendations for im-
proving the capture, access, exchange, and use 
of information to improve public health and re-
duce health disparities. 
(5) NONDUPLICATION OF EFFORTS.—The Sec-
retary shall ensure that the activities and programs 
carried out under this subsection are free of unnec-
essary duplication of effort. 
(6) AUTHORIZATION
OF
APPROPRIATIONS.— 
There is authorized to be appropriated $10,000,000 
for each of fiscal years 2023 through 2025 to carry 
out this subsection. 
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(f) INFORMATION COLLECTION.—Section 319D(a) of 
the Public Health Service Act (42 U.S.C. 247d–4(a)) is 
amended by adding at the end the following: 
‘‘(5) INFORMATION
COLLECTION.—Subchapter 
I of chapter 35 of title 44, United States Code, shall 
not apply to information collection by the Centers 
for Disease Control and Prevention, including the 
Agency for Toxic Substances and Disease Registry, 
that are part of investigations, research, surveil-
lance, or evaluations undertaken for public health 
purposes.’’. 
Æ 
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