I 
117TH CONGRESS 
1ST SESSION 
H. R. 831 
To amend the Public Health Service Act to encourage the rapid development 
of certain public health data standards, authorize epidemiological surveil-
lance grants, and authorize a data linkage demonstration project, and 
for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 4, 2021 
Mr. PETERS (for himself, Ms. ESHOO, Mr. FITZPATRICK, Mrs. MCBATH, and 
Ms. CRAIG) introduced the following bill; which was referred to the Com-
mittee on Energy and Commerce 
A BILL 
To amend the Public Health Service Act to encourage the 
rapid development of certain public health data stand-
ards, authorize epidemiological surveillance grants, and 
authorize a data linkage demonstration project, 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 ‘‘Health Standards To 
Advance Transparency, Integrity, Science, Technology In-
frastructure, and Confidential Statistics Act of 2021’’ or 
the ‘‘Health STATISTICS Act of 2021’’. 
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SEC. 2. IMPROVING PUBLIC HEALTH DATA. 
Title XXXI of the Public Health Service Act (42 
U.S.C. 300kk) is amended— 
(1) by inserting before section 3101 the fol-
lowing subtitle designation and heading: 
‘‘Subtitle A—In General’’; 
and 
(2) by adding at the end the following new sub-
title: 
‘‘Subtitle B—Public Health 
Common Data Standards 
‘‘SEC. 3111. TREATMENT OF PUBLIC HEALTH DATA. 
‘‘(a) STANDARDIZED REPORTING.— 
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Director of the Centers for Disease 
Control and Prevention, shall— 
‘‘(A) adopt and update as necessary uni-
form standards for State and local health de-
partments to report data to the Centers; and 
‘‘(B) in adopting and updating standards 
under this subsection, give deference to— 
‘‘(i) corresponding standards devel-
oped by standards development organiza-
tions and voluntary consensus-based stand-
ards bodies; and 
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‘‘(ii) the recommendations of the 
working group established under para-
graph (3). 
‘‘(2) REQUIREMENTS.—The standards under 
paragraph (1) shall— 
‘‘(A) be consistent with— 
‘‘(i) standards for the interoperability 
of health information technology under 
subtitle A; 
‘‘(ii) Office of Management and Budg-
et Circular A–119 (or any successor there-
to); 
‘‘(iii) Office of Management and 
Budget standards for race and ethnicity 
and other relevant measures; and 
‘‘(iv) the data and technology stand-
ards designated under section 2823(a)(2); 
and 
‘‘(B) provide for the use of interoperable 
systems, consistent with the application pro-
gramming interface standards and associated 
implementation specifications under section 
170.215 of title 45 (or any successor regula-
tions). 
‘‘(3) WORKING GROUP.— 
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‘‘(A) 
ESTABLISHMENT.—The 
Secretary 
shall establish a technical working group (in 
this paragraph referred to as the ‘working 
group’) to make recommendations on an ongo-
ing basis and as needed to establish more com-
prehensive common standards across appro-
priate health care, public health, environmental, 
and public assistance data systems. 
‘‘(B) 
DUTIES.—In 
making 
the 
rec-
ommendations required by subparagraph (A), 
the working group shall— 
‘‘(i) coordinate, and consult with the 
Interagency Council on Statistical Policy 
established under section 3504 of title 44, 
United States Code, and any other relevant 
interagency or intra-agency committee; 
‘‘(ii) include recommendations for— 
‘‘(I) efficiencies to reduce redun-
dancy and the public reporting burden 
in Federal health data reporting re-
quirements and data collections; and 
‘‘(II) methods to facilitate evi-
dence-building through standardized 
local and State reporting and cross- 
agency, linkable data sharing between 
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and among local, State, and Federal 
agencies to collect, acquire, and com-
pile complete statistics; and 
‘‘(iii) build on existing efforts of pub-
lic multistakeholder initiatives seeking to 
standardize key data elements necessary 
for documenting clinical and other activi-
ties related to the social determinants of 
health in order to improve interoperability, 
exchange, and use of social determinants 
of health data across the health and 
human services sectors. 
‘‘(C) ADDITIONAL
CONSULTATION.—The 
working group may consult with outside ex-
perts, including State, local, Tribal, and terri-
torial public health officials, public health re-
searchers, and health care providers rep-
resenting communities most affected by health 
disparities. 
‘‘(D) TIMING.—Not later than 6 months 
after the date of enactment of this subtitle, the 
working group shall provide initial recommenda-
tions under subsection (a) to the Secretary and 
the Director of the Centers for Disease Control 
and Prevention. 
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‘‘(IV) the Veterans Health Ad-
ministration; 
‘‘(V) the Military Health System; 
and 
‘‘(VI) the Indian Health Service. 
‘‘(ii) CHAIR.—The chair of the work-
ing group shall be the Director of the Na-
tional Center for Health Statistics (or the 
Director’s designee). 
‘‘(b) INCREASING EFFICIENCY AND ADVANCING EVI-
DENCE BUILDING.—Consistent with the standards in ef-
fect under subsection (a), the Chief Statistician of the 
United States in the Office of Management and Budget, 
in accordance with section 3504(e) of title 44, United 
States Code, shall issue and update on an ongoing basis 
as needed, directives guiding Federal health data informa-
tion collection to reduce public reporting burden, ensure 
information quality, improve use of determinants of health 
data, and enhance access to health data for evidence-build-
ing activities. 
‘‘(c) COVID–19 HIGH-PRIORITY STANDARDS.—Not 
later than 30 days after the date of enactment of this sub-
title, the Secretary, acting through the Director of the 
Centers for Disease Control and Prevention, and in con-
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sultation with the Director of the National Institutes of 
Health, shall— 
‘‘(1) establish standards under subsection (a) 
with respect to COVID–19, including for genomic 
epidemiology, modeling outbreak preparedness and 
response, therapeutic interventions, treatment set-
tings, and associated outcomes; and 
‘‘(2) in carrying out paragraph (1), adopt or 
build upon existing standards. 
‘‘(d) SHARING DATA RELATED
TO COVID–19.— 
Subject to applicable law on the privacy and confiden-
tiality of individually identifiable information, the Sec-
retary shall— 
‘‘(1) share real-time data related to COVID–19 
data collected by the Department of Health and 
Human Services with— 
‘‘(A) the Centers for Disease Control and 
Prevention; and 
‘‘(B) Federal, State, and local public 
health agencies outside of the Department of 
Health and Human Services; and 
‘‘(2) make such data (including metadata as de-
fined in section 3502 of title 44, United States 
Code) publicly available using standardized, ma-
chine-readable formats— 
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‘‘(A) on the website of the Department of 
Health and Human Services; and 
‘‘(B) in the Federal data catalogue main-
tained under section 3511(c) of title 44, United 
States Code. 
‘‘SEC. 3112. EPIDEMIOLOGICAL SURVEILLANCE GRANTS. 
‘‘(a) GRANT AUTHORITY.—The Secretary, in con-
sultation with the Director of the National Center for 
Health Statistics, may award grants or cooperative agree-
ments to public health reporting entities— 
‘‘(1) to establish protocols and acquire tech-
nologies to implement the standards under section 
3111 for reporting, directly or indirectly, to the Fed-
eral Government, including by— 
‘‘(A) supporting expansion and moderniza-
tion of electronic case reporting, laboratory re-
porting, and mortality reporting with an em-
phasis on modernizing and linking, where ap-
propriate, modularized medical examiner and 
coroner case management systems, electronic 
death registration systems, electronic health 
records, and supporting laboratory systems to 
improve data timeliness and quality; 
‘‘(B) making data sharing with the Na-
tional Center for Health Statistics bidirectional, 
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such that the data received by the National 
Center for Health Statistics is provided quickly 
back to State and local offices and to Federal 
partners and in a form that is quickly under-
standable and actionable; 
‘‘(C) supporting survey activities to more 
broadly measure health disparities at the na-
tional, State, and local levels; 
‘‘(D) improving interoperability standards 
and implementation specifications for industry 
use to fulfill specific clinical health information 
technology interoperability needs; 
‘‘(E) developing and implementing protec-
tions required by subsection (b); and 
‘‘(F) conducting real-world testing of data 
important for forecasting to ensure viability, 
scalability, and adaptability of data collection 
and reporting activities; and 
‘‘(2) to carry out such reporting using such pro-
tocols and technologies. 
‘‘(b) ADOPTION OF STANDARDS AND DATA PROTEC-
TIONS.—The Secretary may not award a grant or coopera-
tive agreement under subsection (a) unless the applicant 
develops an implementation plan to develop and implement 
policies, practices, procedures, and controls related to— 
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‘‘(1) improving data quality and reporting time-
liness; 
‘‘(2) data security, in accordance with the most 
recent versions of the Cybersecurity Framework and 
Privacy Framework (or successor frameworks) of the 
National Institute of Standards and Technology; and 
‘‘(3) confidentiality and privacy of any informa-
tion that pertains to an individual and from which, 
either alone or in combination with other reasonably 
available information, the individual’s identity can be 
determined, including policies, practices, procedures, 
and controls for— 
‘‘(A) minimizing collection, processing, 
maintenance, retention, and disclosure of such 
information to what is necessary, proportionate, 
and limited for a good faith public health pur-
pose that is clearly described and limited in an 
agreement between the Federal Government 
and the recipient; 
‘‘(B) prohibiting disclosure of such infor-
mation to persons, including government enti-
ties, absent legal safeguards included in Federal 
or State laws or regulations, for protecting the 
security and privacy of such information; and 
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‘‘(C) making the data available to the Na-
tional Center for Health Statistics for statistical 
purposes under subchapter III of chapter 35 of 
title 44, United States Code. 
‘‘(c) COVID–19 REPORTING.—The Secretary may 
not award a grant or cooperative agreement under sub-
section (a) unless the applicant agrees— 
‘‘(1) to use the grant for activities under sub-
section (a) with respect to COVID–19, including 
with respect to— 
‘‘(A) testing results data; 
‘‘(B) testing results turnaround time; 
‘‘(C) hospitalization and intensive care unit 
data; 
‘‘(D) new infections among health care 
workers; 
‘‘(E) new cases among quarantined con-
tacts; and 
‘‘(F) long-term care facilities, prisons, and 
other congregate settings; and 
‘‘(2) in carrying out such activities, to 
disaggregate data by age, sex, race, ethnicity, sexual 
orientation, gender identity, and Zip Code, as appro-
priate and to the extent possible. 
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‘‘(d) APPLICATION.—A public health reporting entity 
applying for a grant or cooperative agreement under this 
section shall submit an application to the Secretary at 
such time and in such manner as the Secretary may re-
quire. 
‘‘(e) DEFINITION.—In this section, the term ‘public 
health reporting entity’ means any entity that reports data 
to the Centers for Disease Control and Prevention or an-
other public health authority, including a State or local 
public health department, a public health laboratory, and 
a health care provider. 
‘‘SEC. 3113. EVIDENCE-BUILDING DEMONSTRATION PRO-
GRAM. 
‘‘(a) IN GENERAL.—The Secretary acting through 
the Director of the National Center for Health Statistics 
(in this section referred to as the ‘Secretary’) shall expand 
the data linkage program of the Department of Health 
and Human Services consisting of Federal statistical and 
programmatic datasets from specified Federal entities, as 
authorized by subchapter III of chapter 35 of title 44, 
United States Code, for the purpose of facilitating statis-
tical public health research on trends and patterns across 
specifically defined, statistically relevant populations, with 
a particular focus on linking social determinants of health 
data, including with respect to— 
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‘‘(1) food insecurity; 
‘‘(2) housing instability; 
‘‘(3) transportation access; 
‘‘(4) safety; 
‘‘(5) social connection and isolation; 
‘‘(6) financial resource strain; 
‘‘(7) stress; 
‘‘(8) race and ethnicity; and 
‘‘(9) sexual orientation and gender identity. 
‘‘(b) ACTIVITIES.—The activities of the demonstra-
tion program under this section shall include: 
‘‘(1) Assessing the availability of identified and 
deidentified data sets held by Federal, State, local, 
and non-Federal entities that may be useful for re-
search described in subsection (a). 
‘‘(2) Using existing authorities and linkages of 
data in accordance with subchapter III of chapter 35 
of title 44, United States Code, when relevant to re-
quest the submission of datasets to the National 
Center for Health Statistics for linking. 
‘‘(c) LIMITATION.—The Secretary shall limit access 
to data under the demonstration program under this sec-
tion— 
‘‘(1) to Federal statistical agencies and quali-
fied public and private researchers, as determined by 
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the Director of the National Center for Health Sta-
tistics; 
‘‘(2) for a period to be specified by the Sec-
retary; and 
‘‘(3) exclusively for the purpose described in 
subsection (a). 
‘‘(d) PROCESS FOR MAKING DATA AVAILABLE.— 
‘‘(1) IN GENERAL.—Consistent with paragraph 
(2), the Secretary shall establish a rigorous process 
for making data available and usable pursuant to 
the demonstration program under this section. 
‘‘(2) REQUIREMENTS.—Before any data is 
made available pursuant to the demonstration pro-
gram under this section by an entity described in 
subsection (b)(1) to another entity described in sub-
section (b)(1)— 
‘‘(A) the receiving entity shall submit to 
the Director of the National Center for Health 
Statistics an application for data for the pur-
pose described in subsection (a); and 
‘‘(B) the Director shall approve or deny 
such request in writing, including in the case of 
a denial an explanation of the reasons for the 
denial. 
‘‘(e) RULEMAKING.— 
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‘‘(1) NO
DELAY
ON
IMPLEMENTATION.—The 
Secretary— 
‘‘(A) shall begin implementation of the 
demonstration program under this section upon 
the date of enactment of this subtitle; and 
‘‘(B) shall not delay such implementation 
for purposes of promulgating the regulations re-
quired by paragraph (2). 
‘‘(2) PROMULGATION.—The Secretary shall— 
‘‘(A) issue regulations for carrying out this 
section; and 
‘‘(B) specify in such regulations the al-
lowed and disallowed purposes for sharing and 
linking data through the program, including 
areas of potential research. 
‘‘(f) WEBSITE.—The Secretary shall maintain a pub-
licly accessible website— 
‘‘(1) providing information about a demonstra-
tion program under this section; 
‘‘(2) facilitating stakeholder participation in 
such demonstration program; 
‘‘(3) facilitating oversight of such demonstra-
tion program; 
‘‘(4) providing lists of datasets from Federal 
and non-Federal entities; 
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‘‘(5) 
providing 
lists 
of 
identified 
and 
deidentified datasets; 
‘‘(6) identifying linked datasets; 
‘‘(7) delineating a process to protect privacy 
and confidentiality; 
‘‘(8) identifying sources of the datasets; and 
‘‘(9) delineating categories of personal data. 
‘‘(g) PROGRAM REQUIREMENTS.—The demonstration 
program under this section shall be designed to— 
‘‘(1) support data matching services for agen-
cies and researchers using the National Death 
Index; and 
‘‘(2) facilitate collaboration with States and pri-
vate entities to examine, update, and modernize the 
fee structure of the National Death Index to support 
a broad range of data queries while assuring the 
continued support of the State systems collecting 
and providing this information to the National 
Death Index. 
‘‘(h) CONTRACTED ENTITIES.— 
‘‘(1) IN GENERAL.—Subject to the availability 
of appropriations, the Secretary may enter into con-
tracts with eligible entities, as appropriate, for infra-
structure and support services in carrying out the 
demonstration program under this section. 
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‘‘(2) ELIGIBILITY.—To be eligible for a con-
tract under paragraph (1), an entity shall— 
‘‘(A) demonstrate core capabilities for data 
sharing, data linkage, and compliance with sub-
chapter III of chapter 35 of title 44, United 
States Code; and 
‘‘(B) adhere to security standards in ac-
cordance with the Federal Risk and Authoriza-
tion Management Program (or any successor 
program). 
‘‘(i) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed to authorize the availability or use 
of data for— 
‘‘(1) law enforcement; or 
‘‘(2) any determination of the eligibility of an 
individual for any direct or indirect payment, ben-
efit, or service. 
‘‘(j) REPORT TO CONGRESS.—Not later than 1 year 
after the date of enactment of this Act, and annually 
thereafter, the Secretary shall submit a report to the Con-
gress on the implementation of this section, including— 
‘‘(1) identification of best States practices for— 
‘‘(A) sharing data with, and reporting data 
to, the National Death Index; and 
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‘‘(B) ensuring the quality of such data; 
and 
‘‘(2) recommendations to improve— 
‘‘(A) such sharing and reporting; and 
‘‘(B) access to the National Death Index 
by researchers. 
‘‘SEC. 3114. BUILDING STATISTICAL PUBLIC HEALTH RE-
SEARCH CAPACITY. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Director of the Centers for Disease Control and Pre-
vention, shall provide financial assistance to research enti-
ties and public health departments to establish, expand, 
or enhance capacity for conducting statistical public health 
research— 
‘‘(1) in connection with the programs and ac-
tivities under this subtitle; and 
‘‘(2) in accordance with subchapter III of chap-
ter 35 of title 44, United States Code. 
‘‘(b) CAPACITY FOR SHARING AND LINKING.—The 
capacity referred to in subsection (a) may include sharing 
and linking information and accessing and utilizing linked 
health data files in accordance with established data use 
agreements with data holders (including electronic case re-
porting, electronic health records, and electronic test or-
ders and results) with public health agencies and related 
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systems, including the National Death Index, immuniza-
tion information systems, syndromic surveillance systems, 
laboratory information management systems, electronic 
case reporting systems, medical examiner case manage-
ment systems, and Patient Unified Look-up Systems for 
Emergencies. 
‘‘SEC. 3115. RULE OF CONSTRUCTION. 
‘‘Nothing in this subtitle shall be construed to super-
sede the authority of the Director of the Office of Manage-
ment and Budget under title 44, United States Code, to 
determine and issue relevant standards for information 
management. 
‘‘SEC. 3116. AUTHORIZATION OF APPROPRIATIONS. 
‘‘There are authorized to be appropriated— 
‘‘(1) to carry out this subtitle (other than sec-
tion 3113), $450,000,000, to remain available until 
expended; and 
‘‘(2) to carry out section 3113, $100,000,000 
for the period of fiscal years 2020 through 2025.’’. 
Æ 
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