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115th Congress } { Report
HOUSE OF REPRESENTATIVES
1st Session } { 115-301
======================================================================
FIREFIGHTER CANCER REGISTRY ACT OF 2017
_______
September 8, 2017.--Committed to the Committee of the Whole House on
the State of the Union and ordered to be printed
_______
Mr. Walden, from the Committee on Energy and Commerce, submitted the
following
R E P O R T
[To accompany H.R. 931]
[Including cost estimate of the Congressional Budget Office]
The Committee on Energy and Commerce, to whom was referred
the bill (H.R. 931) to require the Secretary of Health and
Human Services to develop a voluntary registry to collect data
on cancer incidence among firefighters, having considered the
same, report favorably thereon with an amendment and recommend
that the bill as amended do pass.
CONTENTS
Purpose and Summary.............................................. 3
Background and Need for Legislation.............................. 4
Committee Action................................................. 4
Committee Votes.................................................. 4
Oversight Findings and Recommendations........................... 4
New Budget Authority, Entitlement Authority, and Tax Expenditures 5
Congressional Budget Office Estimate............................. 5
Federal Mandates Statement....................................... 6
Statement of General Performance Goals and Objectives............ 6
Duplication of Federal Programs.................................. 6
Committee Cost Estimate.......................................... 6
Earmark, Limited Tax Benefits, and Limited Tariff Benefits....... 6
Disclosure of Directed Rule Makings.............................. 6
Advisory Committee Statement..................................... 6
Applicability to Legislative Branch.............................. 6
Section-by-Section Analysis of the Legislation................... 6
Changes in Existing Law Made by the Bill, as Reported............ 7
The amendment is as follows:
Strike all after the enacting clause and insert the
following:
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Firefighter Cancer Registry Act of
2017''.
SEC. 2. POPULATION-BASED REGISTRY FOR FIREFIGHTER CANCER INCIDENCE.
(a) In General.--The Secretary of Health and Human Services, acting
through the Director of the Centers for Disease Control and Prevention,
shall develop and maintain, directly or through a grant or cooperative
agreement, a voluntary registry of firefighters (referred to in this
section as the ``Firefighter Registry'') to collect relevant history
and occupational information of such firefighters that can be linked to
available cancer registry data collected by existing State cancer
registries.
(b) Use of Firefighter Registry.--The Firefighter Registry shall be
used for the following purposes:
(1) To establish and improve collection infrastructure and
activities related to the nationwide monitoring of the
incidence of cancer among firefighters.
(2) To collect, consolidate, store, and make publicly
available epidemiological information related to cancer
incidence and trends among firefighters.
(c) Relevant Data.--
(1) In general.--In carrying out the voluntary data
collection for purposes of inclusion under the Firefighter
Registry, the Secretary should seek to include the following
information:
(A) Identifiable information from a representative
sample size, as determined by the Secretary under
subsection (d)(2)(A), of volunteer, paid-on-call, and
career firefighters, independent of cancer status or
diagnosis.
(B) With respect to individual risk factors and work
history of firefighters, available information on--
(i) basic demographic information, including
the age of the firefighter involved;
(ii) a listing of status of the firefighter
as either volunteer, paid-on-call, or career
firefighter;
(iii) the number of years on the job and a
detailing of additional employment experience
that was either performed concurrently
alongside firefighting service, before, or
anytime thereafter;
(iv)(I) a measure of the number of fire
incidents attended as well as the type of fire
incidents (such as residential house fire or
commercial fire); or
(II) in the case of a firefighter for whom
information on such number and type is not
available, an estimate of such number and type
based on the method developed under subsection
(d)(2);
(v) a list of additional risk factors,
including smoking or drug use, as determined
relevant by the Secretary; and
(vi) other physical examination and medical
history information relevant to a cancer
incidence study or general health of
firefighters not available in existing cancer
registries.
(C) Any additional information that is deemed
necessary by the Secretary.
(2) Diagnoses and treatment.--In carrying out the data
collection for purposes of inclusion under the Firefighter
Registry, with respect to diagnoses and treatment of
firefighters diagnosed with cancer, the Secretary shall enable
the Firefighter Registry to link to State-based cancer
registries, for a purpose described by clause (vi) or (vii) of
section 399B(c)(2)(D) of the Public Health Service Act (42
U.S.C. 280e(c)(2)(D)), to obtain information on--
(A) administrative information, including date of
diagnoses and source of information; and
(B) pathological data characterizing the cancer,
including cancer site, state of disease (pursuant to
Staging Guide), incidence, and type of treatment.
(d) Methods.--
(1) In general.--For the purposes described in subsection
(b), the Secretary is authorized to incorporate questions into
public health surveys, questionnaires, and other databases.
(2) Required strategy.--The Secretary shall develop a
strategy, working in consultation with the stakeholders
identified in subsection (e), to maximize participation in the
Firefighter Registry established under this Act. At minimum,
the strategy shall include the following:
(A) Identified minimum participation targets for
volunteer, paid-on-call, and career firefighters.
(B) A strategy for increasing awareness of the
Firefighter Registry and maximizing participation among
volunteer, paid-on-call, and career firefighters to
meet minimum participation targets.
(C) Additional steps that may be required to ensure
the equitable representation of groups identified in
paragraph (5).
(D) Information on how the Secretary will store data
described in subsection (c)(1) and provide links to
relevant health information described in subsection
(c)(2).
(E) Working in consultation with the experts
described in subsection (e), a reliable and
standardized method for estimating the number of fire
incidents attended by a firefighter as well as the type
of fire incident so attended in the case such
firefighter is unable to provide such information.
(3) Report to congress.--The Secretary shall submit the
strategy described in paragraph (2) to the Committee on Energy
and Commerce of the House of Representatives and the Committee
on Health, Education, Labor, and Pensions of the Senate not
later than 30 days after the date of the completion of the
strategy.
(4) Guidance for inclusion and maintenance of data on
firefighters.--The Secretary shall develop, in consultation
with the stakeholders identified in subsection (e), State
health agencies, State departments of homeland security, and
volunteer, paid-on-call, combination, and career firefighting
agencies, a strategy for inclusion of firefighters in the
registry that are representative of the general population of
firefighters, that outlines the following:
(A) How new information about firefighters will be
submitted to the Firefighter Registry for inclusion.
(B) How information about firefighters will be
maintained and updated in the Firefighter Registry over
time.
(C) A method for estimating the number of fire
incidents attended by a firefighter as well as the type
of fire incident so attended in the case such
firefighter is unable to provide such information.
(D) Further information, as deemed necessary by the
Secretary.
(5) Ensuring representation of underrepresented groups in
registry.--In carrying out this section, the Secretary shall
take such measures as the Secretary deems appropriate to
encourage the inclusion of data on minority, female, and
volunteer firefighters in the Firefighter Registry established
under this section.
(e) Consultation.--The Secretary shall, on a regular basis, seek
feedback regarding the utility of the Firefighter Registry established
under this section and ways the Firefighter Registry can be improved
from non-Federal experts in the following areas:
(1) Public health experts with experience in developing and
maintaining cancer registries.
(2) Epidemiologists with experience in studying cancer
incidence.
(3) Clinicians with experience in diagnosing and treating
cancer incidence.
(4) Active and retired volunteer, paid-on-call, and career
firefighters as well as relevant national fire and emergency
response organizations.
(f) Research Availability.--The Secretary shall develop and make
public a process for de-identifying data from the Firefighter Registry
and making such data available without a fee for research or other
purposes. Such process shall provide that such data shall be made
available for such research purposes only if there is an agreement to
make findings, journal articles, or other print or web-based
publications derived from such research public or available to the
relevant stakeholders identified in subsection (e).
(g) Privacy.--In carrying out this Act, the Secretary shall apply to
the Firefighter Registry developed under subsection (a) data security
provisions and privacy standards that comply with the best practices of
the Centers for Disease Control and Prevention and provide for data
privacy and security standards similar to those in the HIPAA privacy
regulation, as defined in section 1180(b)(3) of the Social Security Act
(42 U.S.C. 1320d-9(b)(3)).
(h) Authorization of Funds.--To carry out this section, there are
authorized to be appropriated $2,500,000 for each of the fiscal years
2018 through 2022.
PURPOSE AND SUMMARY
H.R. 931 was introduced on February 2, 2017, by Rep. Chris
Collins (R-NY). The bill requires the Centers for Disease
Control and Prevention (CDC) to develop and maintain a registry
to collect data regarding the incidence of cancer in
firefighters.
BACKGROUND AND NEED FOR LEGISLATION
Firefighting is one of the most hazardous yet least studied
occupations in terms of exposure effects and the relationship
to occupational disease. Firefighters routinely work in
environments where they come into contact with carcinogenic
materials and toxic chemicals. According to research by the
CDC's National Institute for Occupational Safety and Health,
firefighters are at increased risk for developing cancer.
Currently, the extent to which firefighters are at increased
risk for cancer, and how that risk can be reduced in the future
are not fully understood. Having better data to understand the
overall epidemiological cancer trends among firefighters will
lead to better protective measures and decontamination
procedures, ultimately reducing some of the hazards these first
responders face on the job.
COMMITTEE ACTION
On May 17, 2017, the Subcommittee on Health held a hearing
on H.R. 931. The hearing was entitled ``Examining Initiatives
to Advance Public Health.'' The Subcommittee received testimony
from:
Kevin O'Connor, Assistant to the General
President, International Association of Fire Fighters;
Cheryl D. Watson-Lowry, DDS; General
Dentist, American Dental Association;
Martin S. Levine, DO, MPH, FACOFP, dist;
Interim Clinical Dean, Professor of Family and
Community Medicine, Touro College of Osteopathic
Medicine; and
Jordan Greenbaum, MD; Medical Director,
Institute for Healthcare and Human Trafficking at
Children's Healthcare of Atlanta; Medical Director,
Global Initiative for Child Health and Well Being at
the International Centre for Missing and Exploited
Children.
On June 29, 2017, the Subcommittee on Health met in open
markup session and forwarded H.R. 931, as amended, to the full
Committee by a voice vote. On July 27, 2017, the full Committee
on Energy and Commerce met in open markup session and ordered
H.R. 931, as amended, favorably reported to the House by a
voice vote.
COMMITTEE VOTES
Clause 3(b) of rule XIII requires the Committee to list the
record votes on the motion to report legislation and amendments
thereto. There were no record votes taken in connection with
ordering H.R. 931 reported.
OVERSIGHT FINDINGS AND RECOMMENDATIONS
Pursuant to clause 2(b)(1) of rule X and clause 3(c)(1) of
rule XIII, the Committee held a hearing and made findings that
are reflected in this report.
NEW BUDGET AUTHORITY, ENTITLEMENT AUTHORITY, AND TAX EXPENDITURES
Pursuant to clause 3(c)(2) of rule XIII, the Committee
finds that H.R. 931 would result in no new or increased budget
authority, entitlement authority, or tax expenditures or
revenues.
CONGRESSIONAL BUDGET OFFICE ESTIMATE
Pursuant to clause 3(c)(3) of rule XIII, the following is
the cost estimate provided by the Congressional Budget Office
pursuant to section 402 of the Congressional Budget Act of
1974.
U.S. Congress,
Congressional Budget Office,
Washington, DC, August 31, 2017.
Hon. Greg Walden,
Chairman, Committee on Energy and Commerce,
House of Representatives, Washington, DC.
Dear Mr. Chairman: The Congressional Budget Office has
prepared the enclosed cost estimate for H.R. 931, the
Firefighter Cancer Registry Act of 2017.
If you wish further details on this estimate, we will be
pleased to provide them. The CBO staff contact is Rebecca Yip.
Sincerely,
Keith Hall.
Enclosure.
H.R. 931--Firefighter Cancer Registry Act of 2017
H.R. 931 would require the Secretary of Health and Human
Services, through the Centers for Disease Control and
Prevention, to develop and maintain a voluntary registry to
monitor cancer incidence among firefighters. The registry would
incorporate relevant information--including demographic
characteristics, number and type of fire incidents attended,
and health information relevant to cancer incidence--that would
be linked to state cancer registries. H.R. 931 would authorize
the appropriation of a total of $12.5 million for fiscal years
2018 through 2022 to carry out those activities.
Based on historical spending for similar activities, CBO
estimates that implementing H.R. 931 would cost $10 million
over the 2018-2022 period; the remainder would be spent in
years after 2022. Enacting H.R. 931 would not affect direct
spending or revenues; therefore, pay-as-you-go procedures do
not apply.
CBO estimates that enacting the legislation would not
increase net direct spending or on-budget deficits in any of
the four consecutive 10-year periods beginning in 2028.
H.R. 931 contains no intergovernmental or private-sector
mandates as defined in the Unfunded Mandates Reform Act and
would impose no costs on state, local, or tribal governments.
The CBO staff contact for this estimate is Rebecca Yip. The
estimate was approved by Holly Harvey, Deputy Assistant
Director for Budget Analysis.
FEDERAL MANDATES STATEMENT
The Committee adopts as its own the estimate of Federal
mandates prepared by the Director of the Congressional Budget
Office pursuant to section 423 of the Unfunded Mandates Reform
Act.
STATEMENT OF GENERAL PERFORMANCE GOALS AND OBJECTIVES
Pursuant to clause 3(c)(4) of rule XIII, the general
performance goal or objective of this legislation is to develop
a centralized voluntary registry to collect data on the
incidence of cancer among firefighters in order to improve
occupational-associated cancer prevention and treatment.
DUPLICATION OF FEDERAL PROGRAMS
Pursuant to clause 3(c)(5) of rule XIII, no provision of
H.R. 931 is known to be duplicative of another Federal program,
including any program that was included in a report to Congress
pursuant to section 21 of Public Law 111-139 or the most recent
Catalog of Federal Domestic Assistance.
COMMITTEE COST ESTIMATE
Pursuant to clause 3(d)(1) of rule XIII, the Committee
adopts as its own the cost estimate prepared by the Director of
the Congressional Budget Office pursuant to section 402 of the
Congressional Budget Act of 1974.
EARMARK, LIMITED TAX BENEFITS, AND LIMITED TARIFF BENEFITS
Pursuant to clause 9(e), 9(f), and 9(g) of rule XXI, the
Committee finds that H.R. 931 contains no earmarks, limited tax
benefits, or limited tariff benefits.
DISCLOSURE OF DIRECTED RULE MAKINGS
Pursuant to section 3(i) of H. Res. 5, the Committee finds
that H.R. 931 contains no directed rule makings.
ADVISORY COMMITTEE STATEMENT
No advisory committees within the meaning of section 5(b)
of the Federal Advisory Committee Act were created by this
legislation.
APPLICABILITY TO LEGISLATIVE BRANCH
The Committee finds that the legislation does not relate to
the terms and conditions of employment or access to public
services or accommodations within the meaning of section
102(b)(3) of the Congressional Accountability Act.
SECTION-BY-SECTION ANALYSIS OF THE LEGISLATION
Section 1. Short title
Section 1 provides that the Act may be cited as the
``Firefighter Cancer Registry Act of 2017.''
Section 2. Population-based registry for firefighter cancer incidence
Section 2 authorizes the appropriation of $2.5 million for
each of fiscal years 2018 to 2022 to establish a voluntary
registry of firefighters, to be developed and maintained by the
CDC, which will collect relevant history and occupational
information that can be linked to available cancer data
collected by existing State cancer registries.
CHANGES IN EXISTING LAW MADE BY THE BILL, AS REPORTED
This legislation does not amend any existing Federal
statute.
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