,,ii  #aagth ,,congress  #b;d ,session  
,s4 #ciac  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,march #bd1    
#bjbb,mr4 ,kaine 7for himself1 ,ms4     
,baldwin1 ,ms4 ,smith1 and ,mr4 ,murphy7
 introduced the following bill2 which   
was read twice and referred to the      
,committee on ,health1 ,education1      
,labor1 and ,pensions  ,a ,,bill  ,to   
amend the ,public ,health ,service ,act 
with respect to public health data      
accessibility1 and for other purposes4  
#a4 ,short title ,this ,act may be cited
 as the ,improving ,data ,accessibility 
,through ,advancements in ,public       
,health ,act or the ,improving ,,data in
 ,public ,health ,act4  #b4 ,supporting 
public health data availability and     
access  7a7 ,designation of public      
health data standards ,section          
#bhbc7;a77#b7 of the ,public ,health    
,service ,act 7#db ,u4,s4,c4            
#cjj;hh-#cc7;a77#b77 is amended-- 7#a7  
by striking ,in carrying out and        
inserting the following3  7,a7 ,in      

general ,in carrying out  2  7#b7 by    
striking shall1 as appropriate and and  
inserting shall1 not later than #b years
 after the date of enactment of the     
,improving ,,data in ,public ,health    
,act12 and  7#c7 by adding at the end   
the following3  7,b7 ,selection of data 
and technology standards ,the standards 
designated as described in subparagraph 
7,a7 may include standards to improve-- 
7i7 the exchange of electronic health   
information for-- 7,i7 electronic case  
reporting2  7,,ii7 syndromic            
surveillance2  7,,iii7 reporting of     
vital statistics2 and  7,,iv7 reporting 
test orders and results electronically1 
including from laboratories2  7ii7      
automated electronic reporting to       
relevant public health data systems of  
the ,centers for ,disease ,control and  
,prevention2 and  7iii7 such other use  
cases as the ,secretary determines      
appropriate4  7,c7 ,no duplicative      
efforts  7i7 ,in general ,in carrying   
out the requirements of this paragraph1 

the ,secretary1 in consultation with the
 ,office of the ,national ,coordinator  
for ,health ,information ,technology1   
may use input gathered 7including input 
and recommendations gathered from the   
,health ,information ,technology        
,advisory ,committee71 and materials    
developed1 prior to the date of         
enactment of the ,improving ,,data in   
,public ,health ,act4  7ii7 ,designation
 of standards ,consistent with sections 
#acaaa and #acaab of the ,,hitech ,act1 
the data and technology standards       
designated pursuant to this paragraph   
shall align with the standards and      
implementation specifications previously
 adopted by the ,secretary pursuant to  
section #cjjd1 as applicable4  7,d7     
,privacy and security ,nothing in this  
paragraph shall be construed as         
modifying applicable ,federal or ,state 
information privacy or security law4    
7,e7 ,considerations ,standards         
designated under this paragraph shall   
include standards and implementation    

specifications necessary to ensure the  
appropriate capture1 exchange1 access1  
and use1 of information regarding race1 
ethnicity1 sex 7including sexual        
orientation and gender identity71       
disability status1 veteran status1      
housing status1 age1 functional status1 
and other elements4  4  7b7 ,study on   
laboratory information standards  7#a7  
,in general ,not later than #a year     
after the date of enactment of this     
,act1 the ,office of the ,national      
,coordinator for ,health ,information   
,technology shall conduct a study to    
review the use of standards for         
electronic ordering and reporting of    
laboratory test results4  7#b7 ,areas of
 concentration ,in conducting the study 
under paragraph 7#a71 the ,office of the
 ,national ,coordinator for ,health     
,information ,technology shall-- 7,a7   
determine the extent to which clinical  
laboratories are using standards for    
electronic ordering and reporting of    
laboratory test results2  7,b7 assess   

trends in laboratory compliance with    
standards for ordering and reporting    
laboratory test results and the effect  
of such trends on the interoperability  
of laboratory data with public health   
data systems2  7,c7 identify challenges 
related to collection and reporting of  
demographic and other data elements with
 respect to laboratory test results2    
7,d7 identify any challenges associated 
with using or complying with standards  
and reporting laboratory test results   
with data elements identified in        
standards for electronic ordering and   
reporting of such results2 and  7,e7    
review other relevant areas determined  
appropriate by the ,office of the       
,national ,coordinator for ,health      
,information ,technology4  7#c7 ,report 
,not later than #b years after the date 
of enactment of this ,act1 the ,office  
of the ,national ,coordinator for       
,health ,information ,technology shall  
submit to the ,committee on ,health1    
,education1 ,labor1 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 7#a74  7c7 ,supporting        
information sharing through data use    
agreements  7#a7 ,interagency data use  
agreements within the ,department of    
,health and ,human ,services for public 
health emergencies  7,a7 ,in general    
,the ,secretary of ,health and ,human   
,services 7referred to in this          
subsection as the ,secretary7 shall1 as 
appropriate1 facilitate the development 
of1 or updates to1 memoranda of         
understanding1 data use agreements1 or  
other applicable interagency agreements 
regarding appropriate access1 exchange1 
and use of public health data between   
the ,centers for ,disease ,control and  
,prevention1 the ,office of the         
,assistant ,secretary for ,preparedness 
and ,response1 other relevant agencies  
or offices within the ,department of    
,health and ,human ,services1 and other 

relevant ,federal agencies1 in order to 
prepare for1 identify1 monitor1 and     
respond to declared or potential public 
health emergencies4  7,b7 ,requirements 
,in carrying out activities pursuant to 
subparagraph 7,a71 the ,secretary       
shall-- 7i7 ensure that the agreements  
and memoranda of understanding described
 in such subparagraph-- 7,i7 address the
 methods of granting access to data held
 by one agency or office with another to
 support the respective missions of such
 agencies or offices2  7,,ii7 consider  
minimum necessary principles of data    
sharing for appropriate use2  7,,iii7   
include appropriate privacy and         
cybersecurity protections2 and  7,,iv7  
are subject to regular updates1 as      
appropriate2  7ii7 collaborate with the 
,centers for ,disease ,control and      
,prevention1 the ,office of the         
,assistant ,secretary for ,preparedness 
and ,response1 the ,office of the ,chief
 ,information ,officer1 and1 as         
appropriate1 the ,office of the         

,national ,coordinator for ,health      
,information ,technology1 and other     
entities within the ,department of      
,health and ,human ,services2 and  7iii7
 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      
agreements1 consistent with paragraph   
7#b74  7#b7 ,data use agreements with   
external entities ,the ,secretary1      
acting through the ,director of the     
,centers for ,disease ,control and      
,prevention and the ,assistant          
,secretary for ,preparedness and        
,response1 may update memoranda of      
understanding1 data use agreements1 or  
other applicable agreements and         
contracts to improve appropriate access1
 exchange1 and use of public health data
 between the ,centers for ,disease      
,control and ,prevention and the ,office
 of the ,assistant ,secretary for       
,preparedness and ,response and external
 entities1 including ,state1 ,tribal1   

and territorial health departments1     
laboratories1 hospitals and other health
 care providers1 electronic health      
records vendors1 and other entities1 as 
applicable and appropriate1 in order to 
prepare for1 identify1 monitor1 and     
respond to declared or potential public 
health emergencies4  7#c7 ,report ,not  
later than #ij days after the date of   
enactment of this ,act1 the ,secretary  
shall report to the ,committee on       
,health1 ,education1 ,labor1 and        
,pensions of the ,senate and the        
,committee on ,energy and ,commerce of  
the ,house of ,representatives on the   
status of the agreements under this     
subsection4  7d7 ,improving information 
sharing and availability of public      
health data ,part ,a of title ,,iii of  
the ,public ,health ,service ,act 7#db  
,u4,s4,c4 #bda et seq47 is amended by   
adding at the end the following3        
#caj;,b4 ,improving information sharing 
and availability of public health data  
7a7 ,in general ,the ,secretary1 acting 

through the ,director of the ,centers   
for ,disease ,control and ,prevention1  
may require the reporting of public     
health and health care data and         
information to the ,centers for ,disease
 ,control and ,prevention by-- 7#a7     
health care providers and facilities1   
including pharmacies2  7#b7 public      
health1 clinical1 and other laboratories
 and diagnostic testing entities2  7#c7 
,state1 local1 and ,tribal health       
departments2  7#d7 health information   
exchanges and health information        
networks2 and  7#e7 other entities1 as  
determined by the ,secretary4  7b7      
,content1 form1 and manner ,the         
,secretary shall prescribe the content1 
form1 manner1 and frequency of the      
reporting of public health and health   
care data and information required by   
subsection 7a71 including necessary     
demographic data or other data elements 
that the ,secretary determines is       
necessary for public health surveillance
 under this section4 ,the ,secretary may

 collaborate with representatives of    
,state1 local1 and ,tribal health       
departments and other entities1 in      
developing the content1 form1 manner1   
and frequency requirement under this    
subsection4 ,such requirements shall    
align with the standards and            
implementation specifications adopted by
 the ,secretary under section #cjjd1 as 
applicable4  7c7 ,decreased burden ,the 
,secretary shall make reasonable efforts
 to limit public health and health care 
data and information reported under this
 section to the minimum necessary       
information needed to accomplish the    
intended public health purpose4  7d7    
,access by relevant public health       
authorities ,the ,secretary shall       
collaborate with representatives of     
,state1 local1 and ,tribal health       
departments1 and entities representing  
such departments to ensure data         
collected under this section is         
accessible1 as appropriate1 to ,state1  
local1 or ,tribal health authorities4   

,nothing in this section shall be       
construed to limit the authority to     
share public health surveillance data   
with ,state1 local1 or ,tribal health   
authorities4  7e7 ,exemption of certain 
public health data from disclosure ,the 
,secretary1 acting through the ,director
 of the ,centers for ,disease ,control  
and ,prevention1 may exempt from        
disclosure under section #eeb7;b77#c7 of
 title #e1 ,united ,states ,code1 public
 health data that are collected by the  
,centers for ,disease ,control and      
,prevention1 if-- 7#a7 an individual is 
identified through such data2 or  7#b7  
there is at least a very small risk1 as 
determined by current scientific        
practices or statistical methods1 that  
some combination of the information1 the
 request1 and other available data      
sources or the application of technology
 could be used to deduce the identity of
 an individual4  4  7e7 ,improving      
public health data collection  7#a7 ,in 
general ,the ,secretary of ,health and  

,human ,services 7referred to in this   
subsection as the ,secretary7 shall     
award grants1 contracts1 or cooperative 
agreements to eligible entities for     
purposes of identifying1 developing1 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 data1 including     
demographic data1 collected1 accessed1  
or used for public health purposes and  
to address health disparities and       
related health outcomes4  7#b7 ,eligible
 entities ,to be eligible to receive an 
award under this subsection an entity   
shall-- 7,a7 be a health care provider1 
academic medical center1 community-based
 organization1 ,state1 local            
governmental entity1 ,indian ,tribe or  
,tribal organization 7as such terms are 
defined in section #d of the ,indian    
,self ,determination and ,education     
,assistance ,act 7#be ,u4,s4,c4 #ecjd771

 urban ,indian organization 7as defined 
in section #d of the ,indian ,health    
,care ,improvement ,act 7#be ,u4,s4,c4  
#afjc771 or other appropriate public or 
private nonprofit entity1 or a consortia
 of any such entities2 and  7,b7 submit 
an application to the ,secretary at such
 time1 in such manner1 and containing   
such information as the ,secretary may  
require4  7#c7 ,activities ,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 capture1 access1 exchange1
 and use of electronic health           
information1 including demographic      
information1 disability status1 veteran 
status1 housing status1 functional      
status1 and other data elements4 ,such  
activities shall include1 at a minimum--
 7,a7 improving1 understanding1 and     
using data standards and implementation 
specifications2  7,b7 developing or     

identifying methods to improve          
communication with patients in a        
culturally and linguistically           
appropriate manner1 including to better 
capture information related to          
demographics of such individuals2  7,c7 
developing methods for accurately       
categorizing and recording patient      
responses using available data          
standards2  7,d7 educating providers    
regarding the utility of such           
information for public health purposes  
and the importance of accurate          
collection and recording of such data2  
and  7,e7 other activities1 as the      
,secretary determines appropriate4  7#d7
 ,reporting  7,a7 ,reporting by award   
recipients ,each recipient of an award  
under this subsection shall submit to   
the ,secretary a report on the results  
of best practices identified1 developed1
 or disseminated through such award4    
7,b7 ,report to congress ,not later than
 #a year after the completion of the    
program under this subsection1 the      

,secretary shall submit a report to     
,congress on the success of best        
practices developed under such program1 
opportunities for further dissemination 
of such best practices1 and             
recommendations for improving the       
capture1 access1 exchange1 and use of   
information to improve public health and
 reduce health disparities4  7#e7       
,non-duplication of efforts ,the        
,secretary shall ensure that the        
activities and programs carried out     
under this subsection are free of       
unnecessary duplication of effort4  7#f7
 ,authorization of appropriations ,there
 are authorized to be appropriated      
#aj1jjj1jjj for each of fiscal years    
#bjbc through #bjbe to carry out this   
subsection4  7f7 ,information collection
 ,section #cai;,d7a7 of the ,public     
,health ,service ,act 7#db ,u4,s4,c4    
#bdg;d-#d7;a77 is amended by adding the 
following new paragraph3  7#e7          
,information collection ,subchapter ,i  
of chapter #ce of title #dd1 ,united    

,states ,code1 shall not apply to       
information collection by the ,centers  
for ,disease ,control and ,prevention1  
including the ,agency for ,toxic        
,substances and ,disease ,registry1 that
 are part of investigations1 research1  
surveillance1 or evaluations undertaken 
for public health purposes4  4