,,ii ,cal5d> ,no4 #chf #aae? ,,congress 
#b;d ,session  ,s4 #chb  ,,9 ,,! ,,s5ate
 ,,( ,,! ,,unit$ ,,/ates  ,febru>y #ae1 
#bjag,mr4 ,m55dez 7= himself1 ,ms4      
,murk[ski1 ,mr4 ,rubio1 ,ms4 ,klobu*>1  
,mr4 ,m>key1 ,mr4 ,blum5?al1 ,mr4       
,da9es1 ,mr4 ,book]1 ,mr4 ,frank51 ,mr4 
,s*um]1 ,mr4 ,mc,cain1 ,mrs4 ,gillibr&1 
,mr4 ,te/]1 ,mr4 ,nelson1 ,mr4 ,s&]s1   
,ms4 ,baldw91 ,ms4 ,coll9s1 ,mr4 ,br[n1 
,ms4 ,/ab5[1 ,mr4 ,coons1 ,mr4          
,donnelly1 ,mrs4 ,mc,caskill1 ,mr4      
,murphy1 ,ms4 ,hassan1 ,mr4 ,m]kley1    
,mr4 ,:iteh\se1 ,mr4 ,van ,holl51 ,ms4  
,cortez ,ma/o1 ,ms4 ,cantwell1 ,mr4     
,c>d91 ,mr4 ,pet]s1 ,mrs4 ,fis*]1 ,mr4  
,ka9e1 ,mr4 ,re$1 ,mr4 ,durb91 ,ms4     
,w>r51 ,mr4 ,c>p]1 ,mr4 ,s*atz1 ,mr4    
,he9ri*1 ,ms4 ,duckwor?1 ,mrs4 ,fe9/e91 
,mrs4 ,%ahe51 ,mr4 ,blunt1 ,mr4 ,k+1    
,ms4 ,hirono1 ,ms4 ,smi?1 ,mr4 ,casey1  
,mr4 ,"y1 & ,mr4 ,leahy7 introduc$ !    
foll[+ bill2 :i* 0 read twice & ref]r$  
to ! ,committee on ,heal?1 ,education1  
,labor1 & ,p5sions  ,april #be1         

#bjah,report$ by ,mr4 ,alex&]1 ) an     
amendment,strike out all aft] ! enact+  
clause & ins]t ! "p pr9t$ 9 italic  ,a  
,,bill  ,to require ! ,secret>y ( ,heal?
 & ,human ,s]vices to develop a volunt>y
 regi/ry to collect data on canc]       
incid5ce among firefight]s4  #a4 ,%ort  
title ,?is ,act may be cit$ z !         
,firefight] ,canc] ,regi/ry ,act (      
#bjag4  #b4 ,pati5t regi/ry = firefight]
 canc] incid5ce  7a7 ,9 g5]al ,!        
,secret>y ( ,heal? & ,human ,s]vices1   
act+ ?r\gh ! ,director ( ! ,c5t]s =     
,disease ,control & ,prev5tion1 %all    
develop & ma9ta91 directly or ?r\gh a   
grant or coop]ative agreem5t1 a volunt>y
 regi/ry ( firefight]s 7ref]r$ to 9 ?is 
section z ! ,firefight] ,regi/ry7 to    
collect relevant hi/ory & occupational  
in=mation ( su* firefight]s t c be l9k$ 
to available canc] regi/ry data collect$
 by exi/+ ,/ate canc] regi/ries4  7b7   
,use ( ,firefight] ,regi/ry ,!          
,firefight] ,regi/ry %all be us$ = !    
foll[+ purposes3 7#a7 ,to e/abli% &     

improve collection infra/ructure &      
activities relat$ to ! nationwide       
monitor+ ( ! incid5ce ( canc] among     
firefight]s4  7#b7 ,to collect1         
consolidate1 /ore1 & make publicly      
available epidemiological in=mation     
relat$ to canc] incid5ce & tr5ds among  
firefight]s4  7c7 ,relevant data  7#a7  
,9 g5]al ,9 c>ry+ out ! volunt>y data   
collection = purposes ( inclusion "u !  
,firefight] ,regi/ry1 ! ,secret>y %\ld  
seek to include ! foll[+ in=mation3     
7,a7 ,id5tifiable in=mation f a         
repres5tative sample size1 z det]m9$ by 
! ,secret>y "u subsection 7d77#b77;,a71 
( volunte]1 paid-on-call1 & c>e]        
firefight]s1 indep5d5t ( canc] /atus or 
diagnosis4  7,b7 ,) respect to          
individual risk factors & "w hi/ory (   
firefight]s1 available in=mation on--   
7i7 basic demographic in=mation1 includ+
 ! age ( ! firefight] involv$2  7ii7 a  
li/+ ( /atus ( ! firefight] z ei!r      
volunte]1 paid-on-call1 or c>e]         
firefight]2  7iii7 ! numb] ( ye>s on !  

job & a detail+ ( additional employm5t  
exp]i5ce t 0 ei!r p]=m$ concurr5tly     
alongside firefight+ s]vice1 be=e1 or   
anytime !reaft]2  7iv7 7,i7 a measure ( 
! numb] ( fire incid5ts att5d$ z well z 
! type ( fire incid5ts 7su* z resid5tial
 h\se fire or comm]cial fire72 or       
7,,ii7 9 ! case ( a firefight] :o is    
unable to provide in=mation on su* numb]
 & type1 an e/imate ( su* numb] & type  
bas$ on ! me?od develop$ "u subsection  
7d77#b72  7v7 a li/ ( additional risk   
factors1 includ+ smok+ or drug use1 z   
det]m9$ relevant by ! ,secret>y2 &  7vi7
 ,o!r physical exam9ation & m$ical      
hi/ory in=mation relevant to a canc]    
incid5ce /udy or g5]al heal? (          
firefight]s n available 9 exi/+ canc]   
regi/ries4  7,c7 ,any additional        
in=mation t is deem$ necess>y by !      
,secret>y4  7#b7 ,diagnoses & treatm5t  
,9 c>ry+ out ! data collection =        
purposes ( inclusion "u ! ,firefight]   
,regi/ry1 ) respect to diagnoses &      
treatm5t ( firefight]s diagnos$ ) canc]1

 ! ,secret>y %all enable ! ,firefight]  
,regi/ry to l9k to ,/ate-bas$ canc]     
regi/ries1 = a purpose describ$ by      
clause 7vi7 or 7vii7 ( section          
#cii;,b7c77#b77;,d7 ( ! ,public ,heal?  
,s]vice ,act 7#db ,u4,s4,c4             
#bhj;e7c77#b77;,d771 to obta9 in=mation 
on--  7,a7 adm9i/rative in=mation1      
includ+ date ( diagnoses & s\rce (      
in=mation2 &  7,b7 pa?ological data     
*>act]iz+ ! canc]1 includ+ canc] site1  
/ate ( disease 7pursuant to ,/ag+       
,guide71 incid5ce1 & type ( treatm5t4   
7d7 ,me?ods  7#a7 ,9 g5]al ,= ! purposes
 describ$ 9 subsection 7b71 ! ,secret>y 
is au?oriz$ to incorporate que/ions into
 public heal? surveys1 que/ionnaires1 & 
o!r databases4  7#b7 ,requir$ /rategy ,!
 ,secret>y %all develop a /rategy1 work+
 9 consultation ) ! /akehold]s id5tifi$ 
9 subsection 7e71 to maximize           
p>ticipation 9 ! ,firefight] ,regi/ry   
e/abli%$ "u ?is ,act4 ,at m9imum1 !     
/rategy %all include ! foll[+3  7,a7    
,id5tifi$ m9imum p>ticipation t>gets =  

volunte]1 paid-on-call1 & c>e]          
firefight]s4  7,b7 ,a /rategy = increas+
 aw>5ess ( ! ,firefight] ,regi/ry &     
maximiz+ p>ticipation among volunte]1   
paid-on-call1 & c>e] firefight]s to meet
 m9imum p>ticipation t>gets4  7,c7      
,additional /eps t may be requir$ to    
ensure ! equitable repres5tation ( gr\ps
 id5tifi$ 9 p>agraph 7#e74  7,d7        
,in=mation on h[ ! ,secret>y w /ore data
 describ$ 9 subsection 7c77#a7 & provide
 l9ks to relevant heal? in=mation       
describ$ 9 subsection 7c77#b74  7,e7    
,work+ 9 consultation ) ! exp]ts        
describ$ 9 subsection 7e71 a reliable & 
/&>diz$ me?od = e/imat+ ! numb] ( fire  
incid5ts att5d$ by a firefight] z well z
 ! type ( fire incid5t s att5d$ 9 ! case
 su* firefight] is unable to provide su*
 in=mation4  7#c7 ,report to ,congress  
,! ,secret>y %all submit ! /rategy      
describ$ 9 p>agraph 7#b7 to ! ,committee
 on ,en]gy & ,comm]ce ( ! ,h\se (       
,repres5tatives & ! ,committee on       
,heal?1 ,education1 ,labor1 & ,p5sions (

 ! ,s5ate n lat] ?an #cj days aft] !    
date ( ! completion ( ! /rategy4  7#d7  
,guidance = inclusion & ma9t5ance ( data
 on firefight]s ,! ,secret>y %all       
develop1 9 consultation ) ! /akehold]s  
id5tifi$ 9 subsection 7e71 & dissem9ate 
guidance to ,/ate heal? ag5cies1 ,/ate  
dep>tm5ts ( homel& security1 & volunte]1
 paid-on-call1 comb9ation1 & c>e]       
firefight+ ag5cies t outl9es ! foll[+3  
7,a7 ,h[ new in=mation ab\t firefight]s 
w be submitt$ to ! ,firefight] ,regi/ry 
= inclusion4  7,b7 ,h[ in=mation ab\t   
firefight]s w be ma9ta9$ & updat$ 9 !   
,firefight] ,regi/ry ov] "t4  7,c7 ,a   
me?od = e/imat+ ! numb] ( fire incid5ts 
att5d$ by a firefight] z well z ! type (
 fire incid5t s att5d$ 9 ! case su*     
firefight] is unable to provide su*     
in=mation4  7,d7 ,fur!r in=mation1 z    
deem$ necess>y by ! ,secret>y4  7#e7    
,ensur+ repres5tation ( und]repres5t$   
gr\ps 9 regi/ry ,9 c>ry+ out ?is        
section1 ! ,secret>y %all take su*      
measures z ! ,secret>y deems appropriate

 to enc\rage ! inclusion ( data on      
m9ority1 female1 & volunte] firefight]s 
9 ! ,firefight] ,regi/ry e/abli%$ "u ?is
 section4  7e7 ,consultation ,!         
,secret>y %all1 on a regul> basis1 seek 
fe$back reg>d+ ! utility ( ! ,firefight]
 ,regi/ry e/abli%$ "u ?is section & ways
 ! ,firefight] ,regi/ry c be improv$ f  
non-,f$]al exp]ts 9 ! foll[+ areas3     
7#a7 ,public heal? exp]ts ) exp]i5ce 9  
develop+ & ma9ta9+ canc] regi/ries4     
7#b7 ,epidemiologi/s ) exp]i5ce 9 /udy+ 
canc] incid5ce4  7#c7 ,cl9icians )      
exp]i5ce 9 diagnos+ & treat+ canc]      
incid5ce4  7#d7 ,active & retir$        
volunte]1 paid-on-call1 & c>e]          
firefight]s z well z relevant national  
fire & em]g5cy response organizations4  
7f7 ,rese>* availability ,! ,secret>y   
%all develop & make public a process =  
de-id5tify+ data f ! ,firefight]        
,regi/ry & mak+ su* data available )\t a
 fee = rese>* or o!r purposes4 ,su*     
process %all provide t su* data %all be 
made available = su* rese>* purposes    

only if !re is an agreem5t to make      
f9d+s1 j\rnal articles1 or o!r pr9t or  
web-bas$ publications d]iv$ f su* rese>*
 public or available to ! relevant      
/akehold]s id5tifi$ 9 subsection 7e74   
7g7 ,privacy ,9 c>ry+ out ?is ,act1 !   
,secret>y %all apply to ! ,firefight]   
,regi/ry develop$ "u subsection 7a7 data
 security provisions & privacy /&>ds t  
comply ) ! be/ practices ( ! ,c5t]s =   
,disease ,control & ,prev5tion & provide
 = data privacy & security /&>ds simil> 
to ^? 9 ! ,,hipaa privacy regulation1 z 
def9$ 9 section #aahj7;b77#c7 ( !       
,social ,security ,act 7#db ,u4,s4,c4   
#acbj;d-#i7;b77#c774  7h7 ,au?orization 
( funds ,to c>ry out ?is section1 !re   
are au?oriz$ to be appropriat$          
#b1ejj1jjj = ea* ( ! fiscal ye>s #bjah  
?r\gh #bjbb4  #a4 ,%ort title ,?is ,act 
may be cit$ z ! ,firefight] ,canc]      
,regi/ry ,act ( #bjah4  #b4 ,volunt>y   
regi/ry = firefight] canc] incid5ce  7a7
 ,9 g5]al ,! ,secret>y ( ,heal? & ,human
 ,s]vices 7ref]r$ to 9 ?is section z !  

,secret>y71 act+ ?r\gh ! ,director ( !  
,c5t]s = ,disease ,control & ,prev5tion 
& 9 coord9ation ) o!r ag5cies z !       
,secret>y det]m9es appropriate1 %all    
develop & ma9ta91 directly or ?r\gh a   
grant or coop]ative agreem5t1 a volunt>y
 regi/ry ( firefight]s 7ref]r$ to 9 ?is 
section z ! ,firefight] ,regi/ry7 to    
collect relevant heal? & occupational   
in=mation ( su* firefight]s = purposes (
 det]m9+ canc] incid5ce4  7b7 ,use (    
,firefight] ,regi/ry ,! ,firefight]     
,regi/ry may be us$ = ! foll[+ purposes3
 7#a7 ,to improve data collection & data
 coord9ation activities relat$ to !     
nationwide monitor+ ( ! incid5ce ( canc]
 among firefight]s4  7#b7 ,to collect1  
consolidate1 & ma9ta91 consi/5t )       
subsection 7g71 epidemiological         
in=mation & analyses relat$ to canc]    
incid5ce & tr5ds among firefight]s  7c7 
,relevant data  7#a7 ,data collection ,9
 c>ry+ out ! volunt>y data collection = 
purposes ( inclusion "u ! ,firefight]   
,regi/ry1 ! ,secret>y may collect !     

foll[+3  7,a7 ,in=mation1 z det]m9$ by !
 ,secret>y "u subsection 7d77#a71 (     
volunte]1 paid-on-call1 & c>e]          
firefight]s1 indep5d5t ( canc] /atus or 
diagnosis4  7,b7 ,individual risk       
factors & occupational hi/ory (         
firefight]s4  7,c7 ,in=mation1 if       
available1 relat$ to--  7i7 basic       
demographic in=mation1 includ+-- 7,i7 ! 
age ( ! firefight] involv$ dur+ !       
relevant dates ( occupation z a         
firefight]2 &  7,,ii7 ! age ( canc]     
diagnosis2  7ii7 ! /atus ( ! firefight] 
z ei!r volunte]1 paid-on-call1 or c>e]  
firefight]2  7iii7 ! total numb] ( ye>s 
( occupation z a firefight] & a detail+ 
( additional employm5t exp]i5ce1 :e!r   
concurr5t1 be=e1 or anytime !reaft]2    
7iv7 7,i7 ! approximate numb] ( fire    
incid5ts att5d$1 includ+ in=mation      
relat$ to ! type ( fire incid5ts & !    
role ( ! firefight] 9 respond+ to !     
incid5t2 or  7,,ii7 9 ! case ( a        
firefight] = :om in=mation on su* numb] 
& type is unavailable1 an e/imate ( su* 

numb] & type bas$ on ! me?od develop$ "u
 subsection 7d77#a77;,d72 &  7v7 o!r    
m$ical in=mation & heal? hi/ory1 includ+
 additional risk factors1 z appropriate1
 & o!r in=mation relevant to a canc]    
incid5ce /udy ( firefight]s4  7#b7      
,in=mation on diagnoses & treatm5t ,9   
c>ry+ out p>agraph 7#a71 ) respect to   
diagnoses & treatm5t ( firefight]s )    
canc]1 ! ,secret>y %all1 z appropriate1 
enable ! ,firefight] ,regi/ry to        
electronically connect to ,/ate-bas$    
canc] regi/ries1 = a purpose describ$ by
 clause 7vi7 or 7vii7 ( section         
#cii;,b7c77#b77;,d7 ( ! ,public ,heal?  
,s]vice ,act 7#db ,u4,s4,c4             
#bhj;e7c77#b77;,d771 to obta9--  7,a7   
date ( diagnoses & s\rce ( in=mation2 & 
7,b7 pa?ological data *>act]iz+ ! canc]1
 includ+ canc] site1 /ate ( disease     
7pursuant to ,/ag+ ,guide71 incid5ce1 & 
type ( treatm5t4  7d7 ,firefight]       
regi/ry coord9ation /rategy  7#a7       
,requir$ /rategy ,! ,secret>y %all1 9   
consultation ) ! relevant /akehold]s1   

su* z m$ical pr(essionals & public heal?
 exp]ts ) exp]i5ce develop+ & ma9ta9+   
canc] regi/ries1 /udy+ canc] incid5ce1  
or diagnos+ & treat+ canc]1 includ+     
epidemiologi/s & pa?ologi/s1 develop a  
/rategy to coord9ate data collection    
activities1 includ+ )9 exi/+ ,/ate      
regi/ries1 = inclusion 9 ! ,firefight]  
,regi/ry e/abli%$ "u ?is ,act4 ,!       
/rategy may include ! foll[+3  7,a7     
,increas+ aw>5ess ( ! ,firefight]       
,regi/ry & enc\rag+ p>ticipation among  
volunte]1 paid-on-call1 & c>e]          
firefight]s4  7,b7 ,consid]ation (      
unique data collection ne$s t may arise 
to g5]ate a /ati/ically reliable        
repres5tation ( m9ority1 female1 &      
volunte] firefight]s1 includ+ me?ods1 z 
ne$$1 to enc\rage p>ticipation f su*    
populations4  7,c7 ,in=mation on h[ !   
,secret>y w /ore data describ$ 9        
subsection 7c77#a7 & provide electronic 
access to relevant heal? in=mation      
describ$ 9 subsection 7c77#b74  7,d7    
,work+ 9 consultation ) ! exp]ts        

describ$ 9 subsection 7e71 a reliable & 
/&>diz$ me?od = e/imat+ ! numb] ( fire  
incid5ts att5d$ by a firefight] z well z
 ! type ( fire incid5t s att5d$ 9 ! case
 su* firefight] is unable to provide su*
 in=mation4  7#b7 ,report to ,congress  
,! ,secret>y %all submit ! /rategy      
describ$ 9 p>agraph 7#a7 to ! ,committee
 on ,en]gy & ,comm]ce ( ! ,h\se (       
,repres5tatives & ! ,committee on       
,heal?1 ,education1 ,labor1 & ,p5sions (
 ! ,s5ate n lat] ?an #cj days aft] !    
date ( ! completion ( ! /rategy4  7#c7  
,guidance = inclusion & ma9t5ance ( data
 on firefight]s ,! ,secret>y %all       
develop1 9 consultation ) ! /akehold]s  
id5tifi$ 9 subsection 7e71 ,/ate heal?  
ag5cies1 ,/ate dep>tm5ts ( homel&       
security1 & volunte]1 paid-on-call1     
comb9ation1 & c>e] firefight+ ag5cies1 a
 /rategy = inclusion ( firefight]s 9 !  
regi/ry t are repres5tative ( ! g5]al   
population ( firefight]s1 t outl9es !   
foll[+3  7,a7 ,h[ new in=mation ab\t    
firefight]s w be submitt$ to !          

,firefight] ,regi/ry = inclusion4  7,b7 
,h[ in=mation ab\t firefight]s w be     
ma9ta9$ & updat$ 9 ! ,firefight]        
,regi/ry ov] "t4  7,c7 ,a me?od =       
e/imat+ ! numb] ( fire incid5ts att5d$  
by a firefight] z well z ! type ( fire  
incid5t s att5d$ 9 ! case su* firefight]
 is unable to provide su* in=mation4    
7,d7 ,fur!r in=mation1 z deem$ necess>y 
by ! ,secret>y4  7e7 ,consultation &    
report ,! ,secret>y %all consult )      
non-,f$]al exp]ts on ! ,firefight]      
,regi/ry e/abli%$ "u ?is section1 & %all
 submit to ! ,committee on ,heal?1      
,education1 ,labor1 & ,p5sions ( !      
,s5ate & ! ,committee on ,en]gy &       
,comm]ce ( ! ,h\se ( ,repres5tatives a  
report t includes1 z appropriate1       
in=mation on goals a*iev$ & improvem5ts 
ne$$ to /r5g!n ! ,firefight] ,regi/ry4  
,su* non-,f$]al exp]ts %all include !   
foll[+3  7#a7 ,public heal? exp]ts )    
exp]i5ce 9 develop+ & ma9ta9+ canc]     
regi/ries4  7#b7 ,epidemiologi/s )      
exp]i5ce 9 /udy+ canc] incid5ce4  7#c7  

,cl9icians ) exp]i5ce 9 diagnos+ &      
treat+ canc] incid5ce4  7#d7 ,active &  
retir$ volunte]1 paid-on-call1 & c>e]   
firefight]s z well z relevant national  
fire & em]g5cy response organizations4  
7f7 ,rese>* availability ,subject to    
subsection 7g71 ! ,secret>y %all ensure 
t in=mation & analysis 9 ! ,firefight]  
,regi/ry are available1 z appropriate1  
to ! public1 includ+ rese>*]s &         
firefight]s4  7g7 ,privacy ,9 c>ry+ out 
?is ,act1 ! ,secret>y %all ensure t     
in=mation 9 & analysis ( ! ,firefight]  
,regi/ry are made available 9 a mann] t1
 at a m9imum1 protects p]sonal privacy  
to ! ext5t requir$ by applicable ,f$]al 
& ,/ate privacy law4  7h7 ,au?orization 
( funds ,to c>ry out ?is section1 !re   
are au?oriz$ to be appropriat$          
#b1ejj1jjj = ea* ( ! fiscal ye>s #bjah  
?r\gh #bjbb4  ,april #be1 #bjah,report$ 
) an am5dm5t