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. 
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 Public Health Network Act of 2009’’. 
SEC. 2. 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: 
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‘‘TITLE XXXI—COORDINATED EN-
VIRONMENTAL 
PUBLIC 
HEALTH NETWORK 
‘‘SEC. 3100. DEFINITIONS. 
‘‘In this title: 
‘‘(1) ADMINISTRATOR.—The term ‘Adminis-
trator’ means the Administrator of the Environ-
mental Protection Agency. 
‘‘(2) COORDINATED NETWORK.—The term ‘Co-
ordinated Network’ means the Coordinated Environ-
mental Public Health Network established under 
section 3101(a). 
‘‘(3) DIRECTOR.—The term ‘Director’ means 
the Director of the Centers for Disease Control and 
Prevention. 
‘‘(4) DIRECTOR OF THE CENTER.—The term 
‘Director of the Center’ means the Director of the 
National Center for Environmental Health at the 
Centers for Disease Control and Prevention. 
‘‘(5) 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. 
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‘‘(6) PRIORITY
CHRONIC
CONDITIONS
AND 
HEALTH EFFECTS.—The term ‘priority chronic con-
ditions and health effects’ means the conditions, as 
specified by the Secretary, to be tracked in the Co-
ordinated Network and the State Networks. 
‘‘(7) STATE NETWORK.—The term ‘State Net-
work’ means a State Environmental Public Health 
Network established under section 3101(b). 
‘‘(8) STATE.—The term ‘State’ means a State, 
local government, territory, or Indian tribe that is 
eligible to receive a health tracking grant under sec-
tion 3101(b). 
‘‘SEC. 3101. ESTABLISHMENT OF COORDINATED AND STATE 
ENVIRONMENTAL 
PUBLIC 
HEALTH 
NET-
WORKS. 
‘‘(a) 
COORDINATED
ENVIRONMENTAL
PUBLIC 
HEALTH NETWORK.— 
‘‘(1) ESTABLISHMENT.—Not later than 36 
months after the date of the enactment of this title, 
the Secretary, acting through the Director, in con-
sultation with the Administrator and the Director of 
the Center, and with the involvement of other Fed-
eral agencies, and State and local health depart-
ments, shall establish and operate a Coordinated 
Environmental Public Health Network. In estab-
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lishing and operating the Coordinated Network, the 
Secretary shall, as practicable— 
‘‘(A) identify, build upon, expand, and co-
ordinate among existing data and surveillance 
systems, surveys, registries, and other Federal 
public health and environmental infrastructure 
as practicable, including— 
‘‘(i) the Public Health Information 
Network; 
‘‘(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; 
and 
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‘‘(ix) 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 health 
effects and relevant environmental and other 
factors, in a manner which protects personal 
privacy consistent with the medical privacy reg-
ulations; 
‘‘(C) in order to allow the public to access 
and understand information about environ-
mental health at the Federal, State, and, where 
practicable, local level, prepare, publish, make 
publicly available on the Web sites of the Cen-
ters for Disease Control and Prevention and the 
Environmental Protection Agency, and submit 
to Congress not later than 2 years after the 
date of the enactment of this title, and bienni-
ally thereafter, a Coordinated Network Health 
and Environment Report, including— 
‘‘(i) identification of gaps in the data 
of the Network, including diseases of con-
cern and environmental exposures not 
tracked; 
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‘‘(ii) identification of activities carried 
out under this title and key milestones 
achieved during the preceding year; and 
‘‘(iii) an analysis of the most cur-
rently available incidence, prevalence, and 
trends of priority chronic conditions and 
health effects, and potentially relevant en-
vironmental and other factors, by State 
and, as practicable by local areas, and rec-
ommendations regarding high risk popu-
lations, public health concerns, response 
and prevention strategies, and additional 
tracking needs; 
‘‘(D) provide for the establishment of State 
Networks, and coordinate the State Networks 
as provided for under subsection (b); 
‘‘(E) provide technical assistance to sup-
port the State Networks; 
‘‘(F) not later than 12 months after the 
date of the enactment of this title, develop min-
imum standards and procedures for data collec-
tion and reporting for the State Networks, to 
be updated not less than annually thereafter; 
and 
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‘‘(G) in developing the minimum standards 
and procedures under subparagraph (F), in-
clude mechanisms for allowing the States to set 
priorities, and allocate resources accordingly. 
‘‘(2) DATA
COLLECTION
AND
REPORTING
BY 
STATE
NETWORKS.—The minimum standards and 
procedures referred to in paragraph (1)(F) shall in-
clude— 
‘‘(A) a list and definitions of the priority 
chronic conditions and health effects to be 
tracked through the State Networks; 
‘‘(B) a list and definitions of relevant envi-
ronmental exposures of concern to be tracked, 
to the extent practicable, through the State 
Networks, including— 
‘‘(i) hazardous air pollutants (as de-
fined in section 302(g) of the Clean Air 
Act); 
‘‘(ii) air pollutants for which national 
primary ambient air quality standards 
have been promulgated under section 109 
of the Clean Air Act; 
‘‘(iii) pollutants or contaminants (as 
defined in section 101 of the Comprehen-
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sive Environmental Response, Compensa-
tion, and Liability Act of 1980); 
‘‘(iv) toxic chemicals (as described in 
section 313 of the Emergency Planning 
and Community Right-to-Know Act of 
1986); 
‘‘(v) substances reported under the 
Toxic Substances Control Act Inventory 
Update Rule as provided for in part 710 of 
title 40, Code of Federal Regulations, or 
successor regulations; 
‘‘(vi) pesticides (as defined in section 
2(u) of the Federal Insecticide, Fungicide, 
and Rodenticide Act); and 
‘‘(vii) such other potentially relevant 
environmental factors as the Secretary 
may specify; 
‘‘(C) a list and definitions of potentially 
relevant behavioral, socioeconomic, and demo-
graphic factors known to be associated with 
these priority chronic conditions and health ef-
fects and other risk factors, such as race, ethnic 
status, gender, age, occupation, and primary 
language, to be tracked through the State Net-
works; 
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‘‘(D) procedures for the complete and 
timely collection and reporting of data to the 
Coordinated Network by local areas, such as a 
census tract or other political subdivision deter-
mined appropriate by the Secretary, in con-
sultation with the Administrator, regarding the 
factors described in subparagraphs (A), (B), 
and (C); 
‘‘(E) procedures for making data available 
to the public and researchers, and for reporting 
to the Coordinated Network, while protecting 
the confidentiality of all personal data reported, 
in accordance with medical privacy regulations; 
and 
‘‘(F) standards and procedures for the es-
tablishment, operation, and maintenance of lab-
oratories conducting biomonitoring, in order to 
expand the scope and amount of biomonitoring 
data collected by the Centers for Disease Con-
trol and Prevention as described in section 
3104. 
‘‘(b) STATE ENVIRONMENTAL PUBLIC HEALTH NET-
WORKS.— 
‘‘(1) GRANTS.—Not later than 12 months after 
the date of the enactment of this title, the Secretary, 
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acting through the Director, in consultation with the 
Administrator and the Director of the Center shall 
award grants to States for the establishment, main-
tenance, and operation of State Networks in accord-
ance with the minimum standards and procedures 
established by the Secretary under subsection 
(a)(1)(F). 
‘‘(2) SPECIALIZED
ASSISTANCE.—The Coordi-
nated Network shall provide specialized assistance to 
grantees in the establishment, maintenance, and op-
eration of State Networks. 
‘‘(3) REQUIREMENTS.—A State receiving a 
grant under this subsection shall use the grant— 
‘‘(A) to establish an environmental public 
health network that will provide— 
‘‘(i) for the tracking of the incidence, 
prevalence, and trends of priority chronic 
conditions and health effects, as well as 
any additional priority chronic conditions 
and health effects and potentially related 
environmental exposures of concern to that 
State; 
‘‘(ii) for identification of priority 
chronic conditions and health effects and 
potentially relevant environmental and 
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other factors that disproportionately im-
pact low income and minority communities; 
‘‘(iii) for the protection of the con-
fidentiality of all personal data reported, in 
accordance with the medical privacy regu-
lations; 
‘‘(iv) 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; 
‘‘(v) the fullest possible public access 
to data collected by the State Network or 
through the Coordinated Network, while 
ensuring that individual privacy is pro-
tected 
in 
accordance 
with 
subsection 
(a)(1)(B); and 
‘‘(vi) for the collection of exposure 
data through biomonitoring and other 
methods, which may include the entering 
into of cooperative agreements as described 
in section 3104; 
‘‘(B) to develop a publicly available plan 
for establishing the State Network in order to 
meet minimum standards and procedures as de-
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veloped by the Secretary under subsection 
(a)(1)(F); 
‘‘(C) to appoint a lead public health de-
partment or agency that will be responsible for 
the development, operation, and maintenance of 
the State Network, and ensure the appropriate 
coordination among State and local agencies, 
including environmental agencies, regarding the 
development, operation, and maintenance of the 
State Network; and 
‘‘(D) to recruit and train public health of-
ficials to continue to expand the State Network. 
‘‘(4) LIMITATION.—A State that receives a 
grant under this section may not use more than 10 
percent of the funds made available through the 
grant for administrative costs. 
‘‘(5) APPLICATION.—To seek a grant under this 
section, a State shall submit to the Secretary an ap-
plication at such time, in such form and manner, 
and accompanied by such information as the Sec-
retary may specify. 
‘‘(c) PILOT PROJECTS.— 
‘‘(1) IN GENERAL.—A State may apply for a 
grant under this subsection to implement a pilot 
project that is approved by the Secretary, acting 
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through the Director and in consultation with the 
Administrator, and the Director of the Center. 
‘‘(2) ACTIVITIES.—A State shall use amounts 
received under a grant under this subsection to 
carry out a pilot project designed to develop State 
Network enhancements and to develop programs to 
address specific local and regional concerns. 
‘‘(3) RESULTS.—The Secretary may consider 
the results of the pilot projects under this subsection 
for inclusion into the Coordinated Network. 
‘‘(d) PRIVACY.—In establishing and operating the 
Coordinated Network under subsection (a), and in making 
grants under subsections (b) and (c), the Secretary shall 
ensure the protection of privacy of individually identifiable 
health information, including ensuring protection con-
sistent with the regulations promulgated under section 
264(c) of the Health Insurance Portability and Account-
ability Act of 1996. 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
such sums as may be necessary for each of fiscal years 
2010 through 2014. 
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‘‘SEC. 3102. INCREASING PUBLIC HEALTH PERSONNEL CA-
PACITY. 
‘‘(a) IN GENERAL.—Beginning in fiscal year 2010, 
the Secretary, acting through the Director, shall enter into 
a cooperative agreement with the Council of State and 
Territorial Epidemiologists to train and place, in State 
and local health departments, applied epidemiology fellows 
to enhance State and local public health capacity in the 
areas of environmental health, chronic and other noninfec-
tious diseases and conditions, and public health surveil-
lance. 
‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
such sums as may be necessary for each of fiscal years 
2010 through 2014. 
‘‘SEC. 3103. GENERAL PROVISIONS. 
‘‘(a) INTEGRATION
OF ENVIRONMENTAL HEALTH 
TRACKING PROGRAMS.—The Secretary shall integrate the 
enactment of this title with all environmental health track-
ing programs funded prior to the date of the enactment 
of this title, including by integrating the programs, in ex-
istence on the date of the enactment of this title, to de-
velop State Network enhancements and to develop pro-
grams to address specific local and regional concerns. 
‘‘(b) COORDINATION WITH AGENCY FOR TOXIC SUB-
STANCES AND DISEASE REGISTRY.—In carrying out this 
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title, the Secretary, acting through the Director, shall co-
ordinate activities and responses with the Agency for 
Toxic Substances and Disease Registry. 
‘‘SEC. 3104. EXPANSION OF BIOMONITORING CAPABILITIES 
AND DATA COLLECTION. 
‘‘(a) PURPOSE.—It is the purpose of this section to 
expand the scope and amount of biomonitoring data col-
lected and analyzed by the Centers for Disease Control 
and Prevention, State laboratories, and consortia of State 
laboratories, in order to obtain robust information, includ-
ing information by geographically defined areas and sub-
populations, about a range of environmental exposures. 
‘‘(b) IN GENERAL.—In meeting the purpose of this 
section, the Secretary shall ensure that biomonitoring data 
are collected intramurally through appropriate sources, in-
cluding the National Health and Nutrition Examination 
Survey, and extramurally shall enter into collaboration or 
partnerships with other entities to obtain additional infor-
mation regarding vulnerable subpopulations or other sub-
populations. 
‘‘(c) COOPERATIVE AGREEMENTS.— 
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Director, shall enter into cooperative 
agreements with States or consortia of States to 
support the purposes of this title. 
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‘‘(2) APPLICATIONS.—Applications for such co-
operative agreements by consortia of States shall ad-
dress the manner in which such States will coordi-
nate activities with other States in the region, and 
shall designate a lead State for administrative pur-
poses. 
‘‘(3) TRAINING
AND
QUALITY
ASSURANCE.— 
The Secretary, acting through the Director, shall 
through the cooperative agreements with States or a 
consortia of States provide laboratory training and 
quality assurance. 
‘‘(d) PRIVACY.—In carrying out this section, the Sec-
retary shall ensure the protection of privacy of individually 
identifiable health information, including ensuring protec-
tion consistent with the regulations promulgated under 
section 264(c) of the Health Insurance Portability and Ac-
countability Act of 1996. 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
such sums as may be necessary for each of fiscal years 
2010 through 2014.’’. 
Æ 
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