S3545-118

2. Supporting public health data availability and access Section 2823(a)(2) of the Public Health Service Act (42 U.S.C. 300hh–33(a)(2)) is amended by adding at the end the following: The standards designated as described in subparagraph (A) may include standards to improve— the exchange of electronic health information for— electronic case reporting; syndromic surveillance; reporting of vital statistics; and reporting test orders and results electronically, including from laboratories; automated electronic reporting to relevant public health data systems of the Centers for Disease Control and Prevention; and such other uses as the Secretary determines appropriate. Standards designated under this paragraph shall include standards and implementation specifications necessary to ensure the appropriate capture, exchange, access, and use of information regarding race, ethnicity, sex (including sexual orientation and gender identity), disability status, veteran status, housing status, age, functional status, and other elements. Section 310B of the Public Health Service Act (42 U.S.C. 242u) is amended to read as follows: The Secretary acting through the Director of the Centers for Disease Control and Prevention (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— health care providers and facilities, including pharmacies; public health, clinical, and other laboratories and diagnostic testing entities; State, local, and Tribal health departments; and other entities, as determined appropriate by the Secretary. The Secretary shall collaborate with representatives of State, local, and Tribal health departments and other entities on determining the content, form, manner, and frequency of the reporting of public health and health care data and information required pursuant to subsection (a). In determining 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. The content, form, manner, and frequency requirements required pursuant to this section shall align with the standards and implementation specifications adopted by the Secretary under section 3004, where applicable. The Secretary shall make reasonable efforts to limit the public health and health care data and information required to be reported under this section to the minimum necessary to accomplish the intended public health purpose. The Secretary— may promulgate by regulation the content, form, manner, and frequency in which public health and health care data and information is required to be reported under this section; and in the event of a public health emergency declared under section 319, or where the Secretary determines there is a significant potential for such an emergency to exist, may issue such requirements— by guidance in accordance with this section; and without regard to the procedures otherwise required by section 553 of title 5, United States Code. The Secretary shall collaborate with representatives of State, local, and Tribal health departments, and entities representing such departments, to ensure that data and information that is collected by the Centers for Disease Control and Prevention pursuant to this section are accessible, as appropriate, in a timely manner, to State, local, and Tribal health authorities. Nothing in this section shall be construed— to prevent any Federal agency, State, local, or Tribal health department, or other entity from collecting data or information under other applicable law; or to limit the authority of the Centers for Disease Control and Prevention to share public health surveillance data with State, local, or Tribal health authorities. The Secretary shall make reasonable efforts to collaborate with representatives of Federal agencies and State, local, and Tribal health departments to reduce reporting burdens and potential duplication of reporting requirements. Such efforts may include ensuring simultaneous sharing of data and information described in subsection (b) with State, local, and Tribal public health authorities. Any identifiable, sensitive information 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— as necessary for public health purposes, including with relevant Federal, State, local, or tribal public health authorities; as required under section 552a(d)(1) of title 5, United States Code; as required by applicable Federal laws, excluding instances of disclosure in any Federal, State, or local civil, criminal, administrative, legislative, or other proceeding; or with the consent of each individual to whom the information pertains. The Secretary may exempt from disclosure under section 552(b)(3) of title 5, United States Code, public health and health care data and information 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— an individual is identified through such data or information; or there is at least a very small risk, as determined by current scientific practices or statistical methods, that some combination of the data or information, the request for disclosure under such section 552(b)(3), and other available data sources or the application of technology could be used to deduce the identity of the individuals to which such data or information pertains. 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: 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 recommendations to, the Director with respect to the implementation of public health and health care data and information reporting and sharing under section 310B. The membership of the advisory committee established pursuant to this section shall include— individuals with subject matter expertise or experience in the following areas of public health and health care data and information, including— State, territorial, local, and Tribal health department data systems or practices; and health care data; 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 Centers for Disease Control and Prevention, and the Office of the Assistant Secretary for Health; representatives of national organizations, including the Council of State and Territorial Epidemiologists, the Association of Public Health Laboratories, the Association of State and Territorial Health Officials, the National Association of County and City Health Officials, and the Big Cities Health Coalition; and such additional members as the Secretary determines appropriate. The advisory committee established pursuant to this section is deemed to be an advisory committee subject to the Federal Advisory Committee Act. 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 purposes of identifying, developing, or disseminating best practices in the collection of electronic health information and the use of designated data standards and implementation specifications— to improve the quality and completeness of data, including demographic data, collected, accessed, or used for public health purposes; and to address health disparities and related health outcomes. To be eligible to receive an award under this subsection an entity shall— be a health care provider, academic medical center, community-based organization, State, local governmental entity, Indian Tribe or Tribal organization (as such terms are defined in section 4 of the Indian Self Determination and Education Assistance Act (25 U.S.C. 5304)), Urban Indian organization (as defined in section 4 of the Indian Health Care Improvement Act (25 U.S.C. 1603)), or other appropriate public or private nonprofit entity, or a consortia of any such entities; and submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require. Entities receiving awards under this subsection shall use such award to develop and test best practices for training health care providers to use standards and implementation specifications that assist in the capture, access, exchange, and use of electronic health information, including demographic information, disability status, veteran status, housing status, functional status, and other data elements. Such activities shall, at a minimum, include— improving, understanding, and using data standards and implementation specifications; developing or identifying methods to improve communication with patients in a culturally and linguistically appropriate manner, including to better capture information related to demographics of such individuals; developing methods for accurately categorizing and recording patient responses using available data standards; educating providers regarding the utility of such information for public health purposes and the importance of accurate collection and recording of such data; and other activities, as the Secretary determines appropriate. Each recipient of an award under this subsection shall submit to the Secretary a report on the results of best practices identified, developed, or disseminated through such award. Not later than 1 year after the completion of the program under this subsection, the Secretary shall submit 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 improving the capture, access, exchange, and use of information to improve public health and reduce health disparities. The Secretary shall ensure that the activities and programs carried out under this subsection are free of unnecessary duplication of effort. There is authorized to be appropriated $10,000,000 for each of fiscal years 2024 through 2026 to carry out this subsection. 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: 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, surveillance, or evaluations undertaken for public health purposes under any available authority. (D)Selection of data and technology standardsThe standards designated 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;(ii)automated electronic reporting to relevant public health data systems of the Centers for Disease Control and Prevention; and(iii)such other uses as the Secretary determines appropriate.(E)ConsiderationsStandards designated under this paragraph shall include standards and implementation specifications necessary to ensure the appropriate capture, exchange, access, and use of information regarding race, ethnicity, sex (including sexual orientation and gender identity), disability status, veteran status, housing status, age, functional status, and other elements.. 310B.Improving information sharing and availability of public health data(a)In generalThe Secretary acting through the Director of the Centers for Disease Control and Prevention (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, including pharmacies;(2)public health, clinical, and other laboratories and diagnostic testing entities;(3)State, local, and Tribal health departments; and(4)other entities, as determined appropriate by the Secretary.(b)Content, form, manner, and frequency(1)CollaborationThe Secretary shall collaborate with representatives of State, local, and Tribal health departments and other entities on determining the content, form, manner, and frequency of the reporting of public health and health care data and information required pursuant to subsection (a).(2)Simultaneous reportingIn determining 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.(3)Alignment with standards and implementation specificationsThe content, form, manner, and frequency requirements required pursuant to this section shall align with the standards and implementation specifications adopted by the Secretary under section 3004, where applicable.(4)Reasonable efforts to limit reportingThe Secretary shall make reasonable efforts to limit the public health and health care data and information required to be reported under this section to the minimum necessary to accomplish the intended public health purpose.(5)Implementation and regulationsThe Secretary—(A)may promulgate by regulation the content, form, manner, and frequency in which public health and health care data and information is required to be reported under this section; and(B)in the event of a public health emergency declared under section 319, or where the Secretary determines there is a significant potential for such an emergency to exist, may issue such requirements—(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)CollaborationThe Secretary shall collaborate with representatives of State, local, and Tribal health departments, and entities representing such departments, to ensure that data and information that is collected by the Centers for Disease Control and Prevention pursuant to this section are accessible, as appropriate, in a timely manner, to State, local, and Tribal health authorities.(2)Rules of constructionNothing in this section shall be construed—(A)to prevent any Federal agency, State, local, or Tribal health department, or other entity 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 public health surveillance data with State, local, or Tribal health authorities.(3)Reasonable efforts to reduce reporting burdens and potential duplicationThe Secretary shall make reasonable efforts to collaborate with representatives of Federal agencies and State, local, and Tribal health departments to reduce reporting burdens and potential duplication of reporting requirements. Such efforts may include ensuring simultaneous sharing of data and information described in subsection (b) with State, local, and Tribal public health authorities.(d)Confidentiality and protection of dataAny identifiable, sensitive information 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, including with relevant Federal, State, local, or tribal public health authorities;(2)as required under section 552a(d)(1) of title 5, United States Code;(3)as required by applicable Federal laws, excluding 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 disclosureThe Secretary may exempt from disclosure under section 552(b)(3) of title 5, United States Code, public health and health care data and information 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 determined by current scientific practices or statistical methods, that some combination of the data or information, the request for disclosure under such section 552(b)(3), and other available data sources or the application of technology could be used to deduce the identity of the individuals to which such data or information pertains.. 310C.Public Health Information Sharing and Availability Advisory Committee(a)EstablishmentThe 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 recommendations to, the Director with respect to the implementation of public health and health care data and information reporting and sharing under section 310B.(b)MembershipThe membership of the advisory committee established pursuant to this section shall include—(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 Centers for Disease Control and Prevention, and the Office of the Assistant Secretary for Health;(3)representatives of national organizations, including the Council of State and Territorial Epidemiologists, the Association of Public Health Laboratories, 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 determines appropriate.(c)FACA applicabilityThe advisory committee established pursuant to this section is deemed to be an advisory committee subject to the Federal Advisory Committee Act.. (5)Information collectionSubchapter 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, surveillance, or evaluations undertaken for public health purposes under any available authority..