H.R.3067 - High Risk Occupational Disease Notification and Prevention Act101st Congress (1989-1990)
|Sponsor:||Rep. Gaydos, Joseph M. [D-PA-20] (Introduced 08/01/1989)|
|Committees:||House - Education and Labor|
|Latest Action:||House - 08/24/1989 Referred to the Subcommittee on Health and Safety. (All Actions)|
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Text: H.R.3067 — 101st Congress (1989-1990)All Information (Except Text)
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Introduced in House
HR 3067 IH 101st CONGRESS 1st Session H. R. 3067 To establish a system for identifying, notifying, and preventing illness and death among workers who are at increased or high risk of occupational disease, and for other purposes. IN THE HOUSE OF REPRESENTATIVES August 1, 1989 Mr. GAYDOS (for himself, Mr. KENNEDY, Mr. AUCOIN, Mr. HALL of Ohio, Mr. PENNY, Mr. STARK, Mr. BRYANT, Mr. CONTE, Mr. OWENS of Utah, Mr. NOWAK, Mr. HAYES of Illinois, Mr. MORRISON of Connecticut, Mr. MATSUI, Mr. PERKINS, Mr. FORD of Michigan, Mr. FAUNTROY, Mr. DICKS, Mr. WEISS, Mr. CLAY, Mr. KOLTER, Mr. FRANK, Mrs. COLLINS, Mr. HAMILTON, Mr. RICHARDSON, Mr. DYMALLY, Mr. CROCKETT, Mr. PALLONE, Mr. FASCELL, Mr. BROWN of California, Mr. DE LA GARZA, Mrs. BOXER, Mr. BILBRAY, Mr. OBEY, Mr. RUSSO, Ms. PELOSI, Mr. WILLIAMS, Mr. LEVINE of California, Mrs. UNSOELD, Mr. KANJORSKI, Mr. LEVIN of Michigan, Mr. GEJDENSON, Mr. DWYER of New Jersey, Mr. LEWIS of Georgia, Mr. MCCLOSKEY, Mr. WHEAT, Mr. GUARINI, Mr. JONTZ, Mr. MCCURDY, Mr. ATKINS, Mr. OBERSTAR, Mr. VENTO, Mr. FAZIO, Mr. COURTER, Mr. SABO, Mr. MCDERMOTT, Mr. KILDEE, Mr. COYNE, Mr. SIKORSKI, Mr. EVANS, Mr. FORD of Tennessee, Mr. POSHARD, Mr. ENGEL, Mr. FLORIO, Mr. FLAKE, Mr. OWENS of New York, Mr. KASTENMEIER, Mr. MARKEY, Mr. SKAGGS, Mr. MURTHA, Mr. SAVAGE, Mr. WALGREN, Mr. STOKES, Mr. AKAKA, Mr. MURPHY, Mr. WILSON, Mr. COOPER, Mr. MOAKLEY, Mr. KLECZKA, Mr. GILMAN, Mr. MANTON, Mr. HAWKINS, Mr. MILLER of California, Mr. ACKERMAN, Mr. BROOKS, Mr. DELLUMS, Mr. DIXON, Mr. ESPY, Mr. FOGLIETTA, Mr. KOSTMAYER, Mr. MRAZEK, Mr. EDWARDS of California, Mr. MAVROULES, Mr. TORRES, Mr. PEASE, Mr. BERMAN, Mrs. LOWEY of New York, Mr. PAYNE of New Jersey, Mr. FUSTER, Mr. MOODY, Mr. VISCLOSKY, Mr. MARTINEZ, Mr. LANTOS, Mr. MFUME, Mr. MINETA, Mr. ROYBAL, Mr. TOWNS, Mrs. SCHROEDER, Mr. LIPINSKI, Mr. BOSCO, Mr. TRAFICANT, Mr. WAXMAN, Mr. BATES, Ms. KAPTUR, and Ms. OAKAR) introduced the following bill; which was referred to the Committee on Education and Labor A BILL To establish a system for identifying, notifying, and preventing illness and death among workers who are at increased or high risk of occupational disease, and for other purposes. Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, SECTION 1. SHORT TITLE. This Act may be cited as the `High Risk Occupational Disease Notification and Prevention Act'. SEC. 2. FINDINGS AND PURPOSE. (a) FINDINGS- The Congress finds that-- (1) potentially hazardous substances, agents, and processes are in wide industrial and commercial use in the United States; (2) during the past two decades, considerable scientific progress has been made in-- (A) the identification of hazardous substances, agents, and processes; (B) the identification of medical problems associated with exposure to such substances, agents, and processes; and (C) the diagnosis and treatment of diseases related to such exposure; (3) progress also has been made in controlling the exposure of individuals to such substances, agents, and processes; (4) despite the progress described in paragraphs (2) and (3), there are significant gaps in efforts to promote the health and safety of individuals exposed to such substances, agents, and processes; (5) a significant number of workers suffer disability or death or both from occupational diseases caused by hazardous occupational exposures; (6) diseases caused by exposures to occupational health hazards constitute a substantial burden on interstate commerce and have an adverse effect on the public welfare; (7) workers have a basic and fundamental right to know they have been and are being exposed to an occupational health hazard and are at risk of contracting an occupational disease; (8) there is a period of time between exposure and the onset of disease when it often is possible to intervene medically in the biological process of disease either to prevent or, by early detection, successfully treat many disease conditions; (9) social and family services that reinforce health promoting behavior can reduce the risk of contracting an occupational disease; (10) identifiable occupational populations are at risk of developing diseases because of exposure to occupational health hazards; (11) by means of established epidemiological, clinical, and toxicological studies, it is possible to define and identify very specific worker populations at risk of contracting occupational diseases; (12) there is no established national program for identifying, notifying, counseling, and medically monitoring worker populations at risk of occupational disease; (13) there is a lack of adequately trained health and human service professionals, as well as appropriately staffed and equipped health facilities to recognize and diagnose occupational diseases; (14) there is a need for increased research to identify and monitor worker populations at risk of occupational disease; and (15) through prevention and early detection of occupational disease the staggering costs of medical treatment and care in the United States can be substantially reduced. (b) PURPOSES- The purposes of this Act are-- (1) to establish a Federal program to notify individual employees within populations at risk of occupationally induced disease that they are at risk because of exposure to an occupational health hazard, and to counsel them appropriately; (2) to authorize and direct the certification of health facilities which have a primary purpose of educating, training, and advising physicians and health and social service professionals in local communities throughout the United States to recognize, diagnose, and treat occupational disease; (3) to expand Federal research efforts to improve means of identifying and monitoring worker populations at risk of occupational disease; and (4) to establish a set of protections prohibiting discrimination against employees on the basis of identification and notification of occupational disease risk. SEC. 3. DEFINITIONS. For the purposes of this Act-- (1) The term `employee' means-- (A) any individual currently employed by an employer, or (B) any individual formerly employed by an employer as to whom any Federal agency maintains records pertaining to work history or the employer maintains personnel records, medical records, or exposure records. (2) The term `employer' means any person engaged in commerce or in an industry or business affecting commerce, or any agency of Federal, State, or local government. (3) The term `Secretary' means Secretary of Health and Human Services. (4) The term `Institute' means the National Institute for Occupational Safety and Health. (5) The term `Board' means the Risk Assessment Board established by section 4 of this Act. (6) The term `occupational health hazard' means a chemical, a physical, or a biological agent, generated by or integral to the work process and found in the workplace, or an industrial or commercial process found in the workplace, for which there is statistically significant evidence, based on clinical or epidemiologic study conducted in accordance with established scientific principles, that chronic health effects have occurred in employees exposed to such agents and processes. Such term includes chemicals that are carcinogens, toxic or highly toxic agents, reproductive toxins, irritants, corrosives, sensitizers, hepatoxins, nephrotoxins, neurotoxins, agents that act on the hematopoietic system, and agents that damage the lungs, skin, eyes, or mucous membranes. (7) The term `population at risk' means a class or category of employees-- (A) exposed to an occupational health hazard under working conditions (such as concentrations of exposure, or durations of exposure, or both) comparable to the clinical or epidemiologic data referred to in paragraph (6); and (B) identified and designated as a population at risk of disease by the Board pursuant to section 4(b). (8) The term `hazard communication standard' means the standard contained in sections 1910.1200, 1915.99, 1917.28, 1918.90, and 1926.59 of title 29 of the Code of Federal Regulations as in effect on October 1, 1987. (9) The term `medical monitoring' means periodic examinations or laboratory tests to diagnose or aid in the diagnosis of a disease that has been the subject of a notification, or the appropriate type of health counseling, or both, as determined by the Board for the disease associated with the risk. (10) The term `ethical manner' means conduct that recognizes the confidentiality of information evolving from the patient-physician relationship. SEC. 4. RISK ASSESSMENT BOARD. (a) ESTABLISHMENT- (1) There is hereby established within the Department of Health and Human Services the Risk Assessment Board. The Board shall consist of 9 members, which shall include the Director of the Institute (who shall serve as chairman) and 8 members appointed by the Secretary from a list of nominees provided by the National Academy of Sciences that includes at least 3 nominees for each category of individuals required by paragraph (2). In making the appointments under this paragraph, the Secretary may request additional lists of nominees. (2) Of the 8 members appointed by the Secretary-- (A) 4 shall be Government employees, including a board certified occupational physician, an epidemiologist, a toxicologist, and an occupational biostatistician; and (B) 4 shall be individuals who are not Government employees, including a board certified occupational physician, an epidemiologist, an occupational health nurse, and an industrial hygienist. (3) The members of the Board appointed by the Secretary shall be appointed for terms of 5 years except that-- (A) of members first appointed, one of the members appointed under paragraph (2)(A) and one of the members appointed under paragraph (2)(B) shall be appointed, as designated at the time of their appointment, for each of the following terms: 2 years, 3 years, 4 years, and 5 years; (B) in the event a vacancy on the Board occurs prior to the expiration of a term, the Secretary shall ask the National Academy of Sciences to provide a list of nominees from which the Secretary shall appoint a member for the remainder of that term; and (C) upon the expiration of their terms, members may be reappointed if their names shall appear on the lists provided by the National Academy of Sciences. (4) The Institute shall provide full-time staff necessary to carry out the functions of the Board. (b) FUNCTIONS- (1) The Board shall-- (A) review pertinent medical and other scientific studies and reports concerning the incidence of disease associated with exposure to occupational health hazards; (B) identify and designate from this review, and from field assessments where appropriate, those populations at risk of disease associated with exposure to occupational health hazards that should be notified pursuant to this Act, including the size, nature, and composition of the population to be notified; (C) develop an appropriate form and method of notification that will be used by the Secretary, or agents of the Secretary described under section 5(h), to notify the designated populations at risk; and (D) determine the appropriate type, if any, of medical monitoring, or beneficial health counseling, or both, for the disease associated with the risk which shall be described in the notice pursuant to section 5(c). (2) In carrying out its responsibilities under this section, the Board shall, subject to the requirements of section 552a of title 5, United States Code, and other applicable provisions of Federal law, have access to information and data contained in the records of-- (A) any Federal agency, or State or political subdivision of a State, solely for the purpose of obtaining names, addresses, and work histories of employees subject to notification under this section; (B) any employer insofar as Federal access is provided for under the Occupational Safety and Health Act of 1970 or the Federal Mine Safety and Health Act of 1977 or regulations promulgated pursuant thereto; and (C) any employer insofar as such information is maintained by such employer under a State or Federal law concerning occupational safety and health matters. (3) In identifying the populations at risk of disease, the Board shall consider the following factors based upon the best available scientific evidence: (A) the extent of clinical and epidemiologic evidence that specific substances, agents, or processes may be a causal factor in the etiology of chronic illnesses or long-latency diseases among employees exposed to such substances, agents, or processes in specific working conditions (such as concentrations of exposure, or durations of exposure, or both); (B) the extent of supporting evidence from clinical, epidemiologic, or toxicologic studies that specific substances, agents, or processes may be a causal factor in the etiology of chronic illnesses or long-latency diseases among persons exposed to such substances, agents, or processes; (C) the employees involved in particular industrial classifications and job categories who are or have been exposed to such substances, agents, or processes under working conditions (such as concentrations of exposure, or durations of exposure, or both) that may be a causal factor in the etiology of the illnesses or diseases; (D) the extent of the increased risk of illness or disease created by the occupational health hazard alone or in combination with other factors, including (but not limited to) smoking and diet; (E) other medical, health, and epidemiological factors, including consistency of association, specificity of association, strength of association, dose-response relationships, biological plausibility, temporal relationships, statistical significance, and the health consequence of notifying or failing to notify a population at risk; and (F) the extent to which risk has been reduced as a result of the promulgation of an applicable occupational substance-specific health standard. (4) If the Board, after considering the factors described in paragraph (3), identifies a long-latency disease among persons exposed to substances, agents, or processes, the Board may, in designating a population at risk that should be notified under paragraph (1)(B), limit such notification to persons whose exposure occurred within a time period that corresponds to, but encompasses, the period of latency of such disease. (5) In carrying out activities under this section, the Board is authorized to engage the services of experts in occupational health hazards and diseases related to those occupational health hazards. (c) PRIORITIES- (1) In designating populations at risk of disease for notification, the Board shall undertake, as its first priority, to designate employee populations exposed to occupational health hazards whose members are most likely to benefit from medical monitoring, or health counseling, or both. In making this designation, the Board shall consider exposures for which there exists a permanent standard promulgated under section 6(b)(5) of the Occupational Safety and Health Act of 1970 (29 U.S.C. 665(b)(5)), the extent of medical monitoring and surveillance already available to employee populations covered by the permanent standards, and the need to notify former employees as well as current employees. (2) For purposes of paragraph (1), the Board shall consider individuals who have been exposed to dioxin and health care and emergency care workers who have been exposed to acquired immune deficiency syndrome or the virus known as HTLV-III or LAV as members of employee populations most likely to benefit from medical monitoring, or health counseling, or both. (d) PROCEDURES- (1) For each population designated for notification, the Board shall issue a notice of proposed findings and recommendations. (2) The notice shall-- (A) be published in the Federal Register; (B) set forth which classes or categories of employees are being considered for inclusion in a population at risk and the reasons for such inclusion; (C) provide for the public to submit written views on the proposed findings and recommendations within 60 days of the notice; and (D) provide for a hearing within 30 days after the conclusion of such 60-day period, at which the public may express views on the Board's proposed findings and recommendations. (3) After its deliberations and the taking of public views, the Board shall issue its final findings and determinations within 60 days following the hearing. If the Board determines that a class or category of employees is a population at risk based on the record developed pursuant to paragraph (2) of this subsection, the Board shall, within 10 days of making such a finding and determination, transmit that finding and determination to the Secretary. Such finding and determination shall require that the individuals within such a population at risk be notified under section 5 of this Act. (4) Any aggrieved person may bring a civil action for mandamus in the appropriate United States district court if the final agency action is not completed within 160 days. SEC. 5. EMPLOYEE NOTIFICATION AND COUNSELING. (a) ACTIONS BY THE SECRETARY- Upon presentation of final findings and determinations by the Board that a given class or category of employee is a population at risk of disease to be notified pursuant to this Act, the Secretary shall adopt those findings and determinations, without further notice and without public comment, unless the Secretary concludes that-- (1) procedural requirements set forth in section 4(d) are not met, or (2) to do so will endanger the health and safety of a class or category of employees. (b) NOTIFICATION OF POPULATION AT RISK- (1) Upon adopting the findings and determinations of the Board that a given class or category of employee is a population at risk of disease, the Secretary shall make every reasonable effort to notify each individual within such population, and their respective employers, of that risk. The Secretary, through the Institute, shall be responsible for conducting the necessary notification, except as provided in subsection (h). (2) In addition, the Secretary may make simultaneous use of public service announcements and other means of notification appropriate to reach the population at risk. (3) In the case of employees for whom any exposure to the occupational health hazard occurred in the course of current employment, notification shall be transmitted by the Secretary to individual employees and to employers and be posted prominently by the employer in places at the worksite that are easily accessible to and frequented by the employees in the population at risk. (4) The Secretary shall establish procedures for notifying persons who have been subjects of epidemiological studies demonstrating findings of increased risk of occupational disease conducted by an agency within the Department of Health and Human Services and shall require such notification procedures be included in all future epidemiological studies by such agency. (c) EXEMPTION- (1) Within 30 days after the Board issues a final determination that a given class or category of employee is a population at risk of disease to be notified pursuant to this Act, an employer who employs or has employed employees within that population may apply to the Institute to have those employees exempted from the notification because they are not at risk of disease based on significant mitigating factors. (2) If the Institute concludes that any such application raises an issue of material fact which is subject to reasonable dispute, it shall publish a notice so stating in the Federal Register within 30 days after receiving the employer's detailed application and shall schedule a hearing on the disputed issues. All applications for exemption with respect to any one population at risk shall be consolidated into a single hearing and such hearing shall be concluded within 60 days following publication of such notice in the Federal Register. (3) While an application for exemption is pending before the Institute, the Secretary shall not proceed with the notification requirements of the Board's determination with respect to the affected employees of the employer or employers seeking such exemption. (4) Within 30 days after the conclusion of the hearing, or, where no hearing was conducted, within 30 days of the receipt of the application, the Institute shall grant an exemption from notification to any employer who has demonstrated by a preponderance of the evidence that his employees should not be included within the population at risk of disease and shall deny such exemption to all other employers. In determining whether an exemption shall be granted, the Institute shall take into account such mitigating factors as work practices, health and safety programs, engineering controls, or other factors that are fundamentally different from those used by the Board that substantially eliminate the risk of developing the occupational disease under examination. (5) No employer who has not applied for an exemption may benefit from a decision favorable to any other employer. (6) Determinations of the Institute pursuant to this subsection shall not be subject to judicial review. (d) CONTENTS OF NOTIFICATION- (1) The notification under subsection (b) shall include-- (A) an identification of the occupational health hazard, including the name, composition, and properties of known chemical agents; (B) the disease or diseases associated with exposure to the occupational health hazard, and the fact that such association pertains to classes or categories of employees; (C) any known latency periods from time of exposure to time of clinical manifestation of the disease; (D) counseling appropriate to the nature of the risk including, but not limited to-- (i) the advisability of initiating a personal medical monitoring program; (ii) the most appropriate type of medical monitoring or beneficial health counseling for the disease associated with the risk; (iii) the name and address of the nearest health center certified under this Act; (iv) the protections for notified employees, as established under section 7 of this Act; (v) employer responsibilities with respect to medical monitoring for notified employees, as established under section 7 of this Act; and (vi) the telephone number of the `hot line' established under subsection (e) of this section. (2) If the notification transmitted under subsection (b) concerns an occupational health hazard for which the hazard communication standard requires the preparation and use of any material safety data sheet, such notification shall include the material safety data sheet or a concise summary of the information contained in such data sheet, or both. Such summary shall be written in a manner so as to be easily understood by the average employee. (e) TELEPHONE INFORMATION- The Institute shall establish a telephone `hot line' for the employees notified under this section and for their personal physicians for the purpose of providing additional medical, health, and scientific information concerning the nature of the risk and its associated disease. (f) DISSEMINATION OF INFORMATION- The Institute shall prepare and distribute other medical and health promotion materials and information on any risk subject to notification under this section and its associated disease as the Institute deems appropriate. (g) ACCESS TO INFORMATION- In carrying out the notification responsibilities under this section, the Secretary shall, subject to the requirements of section 552a of title 5, United States Code, and other applicable provisions of Federal law, have access to information and data contained in the records of-- (1) any Federal agency, or State or political subdivision of a State, solely for the purpose of obtaining names, addresses, and work histories of employees subject to notification under this section; (2) any employer insofar as Federal access is provided for under the Occupational Safety and Health Act of 1970 or the Federal Mine Safety and Health Act of 1977 or regulations promulgated pursuant thereto; and (3) any employer insofar as such information is maintained by such employer under a State or Federal law concerning occupational safety and health matters. (h) COOPERATION WITH PRIVATE EMPLOYERS AND STATE AND LOCAL GOVERNMENTS- (1) In carrying out the notification responsibilities under this section, the Secretary shall cooperate with private employers and State and local governments and, upon request, may certify a private employer or a State or local government to transmit notification under this section, pursuant to subsection (d) of this section and in accordance with regulations issued by the Secretary. (2) No private employer or State or local government certified under this paragraph may receive payment for the cost of such notification from the United States, or have a right of access to Federal records for the purposes of carrying out the notification. (i) LIABILITY- The United States or any agency or employee thereof, including any employer or government acting pursuant to subsection (h) of this section, shall not be subjected to suit or judicial or nonjudicial proceedings of any kind that seek monetary damages with respect to or arising out of any act or omission pursuant to this Act. This subsection shall not apply to-- (1) an employee of the United States for any act or omission that is a knowing and willful violation of a provision of this Act to the extent that Federal law otherwise authorizes suit against that individual for monetary damages; and (2) an employer or State or local government acting pursuant to subsection (g) of this section for any act or omission that is a knowing or reckless violation of a provision of this Act. (j) JUDICIAL REVIEW- (1) Any person adversely affected or aggrieved by a determination by the Board under this Act that a given class or category of employees is or is not a population at risk of disease to be notified under the Act is entitled to judicial review of that determination in the appropriate United States Court of Appeals upon a petition filed in such court by such person. Any petition filed pursuant to this section shall be filed within 30 days after the adoption of such determination by the Secretary. (2) A copy of any petition filed under paragraph (1) shall be promptly transmitted to the Secretary by the clerk of the court. The Secretary shall file in the court, as provided in section 2112 of title 28, United States Code, the record of the proceedings of the Board on which the determination is based. (3) The determination of the Board shall be subject to review in accordance with section 706 of title 5, United States Code. (4) The commencement of proceedings under this subsection shall not operate as a stay of the action of the Secretary to notify employees unless the court specifically orders a stay based upon a determination by the court that the complaining party is highly likely to succeed on the merits. SEC. 6. HEALTH CENTERS; RESEARCH, TRAINING, AND EDUCATION. (a) Health Centers- (1) ESTABLISHMENT OF CENTERS- (A) Within 90 days after the effective date of this Act, the Secretary shall establish and certify 10 health centers. The Secretary, in selecting the 10 health centers, shall choose from among the education resource centers of the Institute and similar facilities of the National Institute for Environmental Health Sciences, the National Cancer Institute, and other private and governmental organizations that apply for such designation by the Secretary. The Secretary shall consider regional distribution in selecting the 10 health centers. At a later date, but not more than 5 years after the effective date of this Act, the Secretary shall establish and certify additional health centers from among the health care facilities described in this paragraph so as to obtain no less than one center per State throughout the United States. (B) Such centers and personnel assigned to them shall be selected on the basis of-- (i) their demonstrated ability and experience in the recognition, diagnosis, and treatment of occupationally related diseases in an ethical manner, and (ii) their capability to offer training and assistance to physicians and health and social service professionals engaged in the management of populations and individuals at risk of occupational disease, and to fulfill other functions assigned to them under this section. (C) Such centers shall be certified under criteria developed by the Secretary. (2) FUNCTIONS OF CENTERS- The centers shall-- (A) provide education, training, and technical assistance to personal physicians and health and social service professionals who serve employees notified under section 5 of this Act; and (B) be capable, in the event that adequate facilities are not otherwise reasonably available, of providing diagnosis, medical monitoring and family services, and treatment for employees notified under section 5 of this Act. (3) COST OF TRAINING AND EQUIPMENT- The Secretary shall, from funds appropriated under this Act, reimburse the health centers certified under this section for the cost of developing a training program and procuring specialized equipment required under the certification criteria developed pursuant to paragraph (1) of this subsection. (b) IMPROVED METHODS OF MONITORING AND IDENTIFICATION- The Secretary shall, from amounts available under section 10(b) of this Act, make grants to certified health centers, schools of public health and other institutions, and organizations that meet criteria established by the Secretary to conduct research, training, and education aimed at improving the means of assisting employees exposed to occupational health hazards and the means of identifying worker populations exposed to such hazards. Such research, training, and education shall include (but not be limited to) the following areas: (1) studying the etiology and development of occupationally related diseases and the disabilities resulting from such diseases; (2) developing means of medical monitoring of employees exposed to occupational health hazards; (3) examining the types of medical treatment of workers exposed to occupational health hazards and means of medical intervention to prevent the deterioration of the health and functional capabilities of employees disabled by occupational disease; (4) studying and developing medical treatment and allied social services for employees exposed to occupational health hazards; (5) developing education programs designed to train physicians, health, and social services professionals to assist employees and their families in undertaking measures which ameliorate the effects of those diseases; and (6) sponsoring epidemiological, clinical, and laboratory research to identify and define additional employee populations at risk of disease from exposure to an occupational health hazard. (c) Education- (1) GRANTS TO INSTITUTIONS WITH EXISTING PROGRAMS- (A) The Secretary may make grants to, and enter into contracts with, schools of medicine and schools of nursing in which occupational medicine or occupational health programs exist on the date of enactment of this section to assist such programs in meeting the costs of providing projects-- (i) to provide continuing education for faculty in departments of internal medicine and family medicine or in schools of nursing in order to enable such faculty to provide instruction in the diagnosis and treatment of occupational diseases; (ii) to develop, publish, and disseminate curricula and training materials concerning occupational medicine or health for use in undergraduate medical or nursing training; or (iii) to establish, for residents in graduate medical education programs in internal medicine, family medicine, and other specialties with a primary care focus, or in graduate nursing programs in schools of nursing, training programs in occupational medicine or health consisting of clinical training, for periods of between 1 and 4 months, in settings such as medical facilities, union offices, and industrial worksites. (B) In making grants and entering into contracts under this paragraph, the Secretary shall give preference to applicants which demonstrate-- (i) the ability to recruit a significant number of participants to participate in the project to be carried out under the grant or contract (in the case of a project described in subparagraph (A) (i) or (iii) of this paragraph); and (ii) expertise and experience in the provision of continuing education in occupational medicine or health (in the case of a project described in subparagraph (A)(i)) or the provision of residency training in occupational medicine or health (in the case of a project described in subparagraph (A)(iii)). (2) GRANTS TO SUPPORT NEW PROGRAMS- (A) The Secretary may make grants to, and enter into contracts with, schools of medicine and schools of nursing in which, on the date of enactment of this section, there do not exist training programs in occupational medicine or health. The purpose of grants and contracts under this paragraph is to provide support for projects to provide training in occupational medicine or health for faculty who are certified in internal medicine or family medicine by the appropriate national medical specialty board or faculty who have similar qualifications in professional nursing. (B) Each project for which a grant or contract is made under this paragraph shall-- (i) be based in a graduate medical education program in internal medicine or family medicine or in graduate programs in a school of nursing; (ii) have an arrangement with an accredited training program in occupational medicine or health for the provision of training in occupational medicine or health to the faculty selected by the recipient of the grant or contract under this subsection; and (iii) have a plan for the use of the faculty receiving training with a grant or contract under this section to provide education and training in occupational medicine or health to other individuals. (3) MINIMUM NUMBER OF GRANTS- The Secretary shall, during the period October 1, 1990, through September 30, 1993, make grants and contracts to not less than 10 schools of medicine or schools of nursing under paragraphs (1) and (2) of this subsection. (4) SOURCES OF FUNDS- Unexpended amounts described in section 10(a) of this Act shall be available to carry out this subsection. (5) DEFINITIONS- For the purpose of this subsection-- (A) the term `graduate medical education program' has the same meaning as in section 788(e)(4)(A) of the Public Health Service Act; and (B) the term `school of nursing' has the same meaning as in section 853(2) of such Act. SEC. 7. EMPLOYEE MEDICAL MONITORING, DISCRIMINATION, AND CONFIDENTIALITY. (a) EMPLOYEE MEDICAL MONITORING- (1) Upon the request of any employee notified under section 5(b) of this Act, the testing, evaluation, and medical monitoring recommended by the Board with respect to the occupational health hazard for which that employee received notice shall be provided or made available by the current employer-- (A) at no additional cost to the employee (above any existing employee health care contribution) if any part of such exposure occurred in the course of the employee's employment by that employer; or (B) at a charge to the employee not exceeding the additional cost to the employer (above any existing employer health care contribution), or at no charge, if no part of such exposure occurred in the course of the employee's employment by that employer. (2) The means of providing medical monitoring shall be left to the judgment of the employer and his medical representative insofar as the means is consistent with sound and approved medical practices. (3)(A) An employer with 50 or fewer employees may not be required to pay more than $250 for medical monitoring requested in connection with a notification under this Act for any employee in any year. (B) The dollar amount specified in subparagraph (A) shall be adjusted annually based on the percentage change in the consumer price index for medical care services, as maintained by the Bureau of Labor Statistics. The Secretary shall publish such adjusted dollar amounts in the Federal Register. (4) The Secretary shall develop a means for providing medical monitoring for any seasonal agricultural worker who has not been employed by a single employer for more than 6 months of continuous employment and may consider facilities such as (or similar to) migrant health centers. (5) An employer shall not be required to duplicate any medical monitoring already required under a permanent health standard promulgated under section 6(b)(5) of the Occupational Safety and Health Act of 1970 (29 U.S.C. 665(b)(4)), or under section 101(d) of the Federal Mine Safety Act of 1969 (30 U.S.C. 811(d)). (b) Discrimination Prohibited- (1) No employer or other person shall discharge or in any manner discriminate against any employee or any applicant for employment on the basis that the employee or applicant is or has been a member of a population that has been determined by the Board to be at risk of disease. This subsection shall not prohibit an employer from refusing to employ an applicant who is or has been a member of a population at risk with respect to an occupational health hazard in a position requiring exposure to the same occupational health hazard. (2) An employer with 50 or fewer employees may transfer an employee who is or has been a member of a population at risk to another job without violating this subsection so long as the new job has earnings, seniority, and other employment rights and benefits as comparable as practicable to the job from which the employee has been removed. In providing such alternative job assignment, the employer shall not violate the terms of any applicable collective bargaining agreement. (c) BENEFIT REDUCTION PROHIBITED- (1) If, based on a determination by the Board under this Act, an initial medical determination is made by the employee's physician that an employee who is a member of a population at risk shows evidence of the development of the diseases described in the notification, or other objective symptoms and conditions increasing the likelihood of the manifestation of such disease, that employee shall have the option of being transferred to a less hazardous or nonexposed job. If within 10 working days after the employee has exercised such transfer option and transmitted to the employer that determination, the employer's medical representative has not requested independent reconsideration of the employee's transfer determination, the employee shall be removed to a less hazardous or nonexposed job and shall maintain the earnings, seniority, and other employment rights and benefits as though the employee had not been removed from the former job. (2) If the employer's medical representative requests independent reconsideration of the initial determination, the employee's medical representative shall, within 14 working days of the transmittal of the transfer determination, submit the matter to another mutually acceptable, qualified independent physician for a final medical determination. Such final determination shall be made within 21 working days of the transmittal of the transfer determination, unless a longer period is agreed to by the parties. If the two medical representatives have been unable to agree upon the third physician, the Secretary or the Secretary's local designee for such purpose shall immediately, at the request of the employee or the employee's physician, appoint a qualified independent physician who shall make the final medical determination within such 21-working-day period (or within such longer period as is agreed to by the parties). The employer shall bear all costs related to the procedure required by this paragraph. (3) The medical removal protection described in this subsection shall be provided for as long as a less hazardous or nonexposed job is available. The availability of such a job shall depend on the employee's skills, qualifications, and aptitudes, and the job's requirements. Where such a job is not available, medical removal protection shall be provided for a period not to exceed 12 months. The employer may condition the provision of medical removal protection upon the employee's participation in follow-up medical monitoring for the occupational health effects in question, based on the procedure required by this subsection. The employer's obligation to provide medical removal protection benefits shall be reduced to the extent that the employee receives worker's compensation, disability compensation, or other compensation for earnings lost during the period of removal, or receives income from employment with another employer made possible by virtue of the employee's removal. (4) No actions may be brought for any claim based on a good faith determination made by a physician in carrying out such responsibilities under this subsection. (5) Provisions for medical removal protection under this subsection shall not apply if-- (A) a medical removal protection procedure already exists under a standard promulgated under the Occupational Safety and Health Act of 1970 or the Federal Mine Safety and Health Act of 1977 for the occupational health hazard for which the employee has been or is being notified; or (B) in providing such alternative job assignment, the employer is required to violate the terms of any applicable collective bargaining agreement, or is required to displace, lay off, or terminate any other employee. (5) Provisions for medical removal protection under this subsection shall not apply to any seasonal agricultural worker employed by an employer for less than 6 months of continuous employment. (6) An employer is not required to provide medical removal protection for employees if the employer-- (A) has 50 or fewer full-time employees at the time medical removal protection is requested, and (B) has made or is in the process of making a reasonable good faith effort to eliminate the occupational health hazard that is the basis for the medical removal decision. (d) CONFIDENTIALITY- Any records of the identity, diagnosis, prognosis, or treatment of an individual employee which are maintained in connection with the performance of any function authorized by this Act shall be confidential and may be disclosed only-- (1) if necessary to perform any function authorized by this Act, including the performance of medical monitoring; or (2) with the written consent of such individual employee or the employee's personal representative, as designated in writing. (e) REVIEW OF COMPLAINTS- (1) Any employee who is aggrieved by a violation of this section, may, within 6 months after such violation occurs, apply to the Secretary of Labor for a review of such alleged violation. Upon receipt of such application, the Secretary of Labor shall cause an investigation to be made as he deems appropriate. If upon such investigation the Secretary of Labor determines that the provisions of this section have been violated, he shall bring an action in any appropriate United States district court. In any such action, the United States district courts shall have jurisdiction for cause shown to restrain violations of this section and to order all appropriate relief under this section. (2) Within 90 days of the receipt of the application filed under this subsection, the Secretary of Labor shall notify the complainant of his determination under paragraph (1) of this subsection. If the Secretary of Labor finds that there was no such violation, he shall issue an order denying the application. (f) REINSTATEMENT AND OTHER RELIEF- Any employee who is discriminated against in violation of this section shall be restored to his or her employment and shall be compensated for-- (1) any lost wages (including fringe benefits and seniority); (2) costs associated with medical monitoring that are incurred while the violation continues; and (3) costs associated with bringing the allegation of violation. (g) CIVIL PENALTIES- Any person or institution that violates this section shall be liable for a civil penalty of not less than $1,000 or more than $10,000 for each violation as may be determined by the Secretary of Labor. SEC. 8. ENFORCEMENT AUTHORITY. (a) INJUNCTIVE RELIEF- Whenever the Secretary determines that any person or institution has engaged, is engaged, or is about to engage in an act or practice constituting a violation of this Act or any rule or regulation promulgated under this Act, the Secretary may bring an action in the proper United States district court to enjoin such acts or practices, and upon a proper showing an injunction or permanent or temporary restraining order shall be granted without bond. The provisions of section 5(i) shall not limit the authority of the Secretary under this subsection. (b) EFFECT ON OTHER LAWS AND PROHIBITION ON THE USE OF BOARD DETERMINATIONS- (1) In connection with any claim for compensation, loss, or damage brought under State or Federal law, the following may not serve as a legal basis for or be introduced as evidence in connection with such claim: (A) a finding or determination of the Board, or an action by the Secretary based on such finding or determination, that an employee is or is not a member of, or that an employee population is or is not, a population at risk of disease as determined under this Act; (B) evidence that an employee or employee population is or is not about to receive (or has or has not received) notification under this Act; and (C) evidence that medical monitoring or evaluation is or is not to be initiated (or has or has not been initiated) under this Act. (2) With respect to any claim for compensation, loss, or damage under State or Federal law, nothing in this Act shall preclude the admission into evidence of-- (A) the results of any medical monitoring or evaluation; (B) any medical and other scientific studies and reports concerning the incidence of disease associated with exposure to occupational health hazards; or (C) any data related to exposure to occupational health hazards for individual employees. (3) Notification pursuant to this Act shall not be relevant in determining whether such a claim is timely under any applicable statute of limitations. (4) No person shall bring any tort or workers' compensation claim based on mental or emotional harm, fear of disease, or stress resulting, directly or indirectly, from any report, finding, notice, medical evaluation decision, or monitoring decision made under this Act, from any other action taken under this Act, or from any failure to take an action required by this Act. Such prohibition applies whether the person seeking to bring such a claim-- (A) has been directly subject to such a report, finding, notice, medical evaluation decision, monitoring decision, other action, or failure of required action; or (B) has learned about such a report, finding, notice, medical evaluation decision, monitoring decision, other action, or failure of required action that directly affected another person. SEC. 9. REPORTS TO CONGRESS. (a) HAZARD COMMUNICATION STANDARD REPORT- The Secretary of Labor shall report to the Congress annually, not later than January 15 of each year, regarding implementation and enforcement of the hazard communication standard. The report shall include detailed information on-- (1) monitoring and enforcement of noncompliance, significant areas of noncompliance, penalties assessed, and steps taken to correct noncompliance; (2) evaluation of the effectiveness of the standard, the material safety data sheets, and training and education programs for employees; and (3) efforts to assist employers in complying with the standard. (b) OCCUPATIONAL DISEASE NOTIFICATION REPORT- The Secretary shall report to the Congress annually, not later than January 15 of each year, regarding the implementation and enforcement of notification under this Act. The report shall include detailed information on-- (1) numbers, types, and results of notifications carried out pursuant to this Act; and (2) research efforts carried out pursuant to this Act. SEC. 10. AUTHORIZATIONS. (a) IN GENERAL- There are authorized to be appropriated $25,000,000 for each of the fiscal years 1989 and 1990, and $30,000,000 for each of the fiscal years 1991, 1992, and 1993 to carry out the provisions of this Act. (b) GRANTS FOR IMPROVED METHODS OF MONITORING AND IDENTIFICATION- Of the total amount appropriated under subsection (a) for each fiscal year, no less than $4,000,000 shall be available to carry out the activities under section 6(b) of this Act. (c) MEDICAL MONITORING FOR SEASONAL AGRICULTURAL WORKERS- Of the total amount appropriated under subsection (a) for each fiscal year, no less than $1,000,000 shall be available to the Secretary to carry out activities under section 7(a)(4). SEC. 11. EFFECT ON OTHER RIGHTS AND REMEDIES. The rights and remedies provided by this Act are in addition to, and not in lieu of, any rights and remedies available under any other law. SEC. 12. EFFECTIVE DATE. Except as may be otherwise provided therein, the provisions of this Act shall become effective January 1, 1990, or 6 months after the date of enactment of this Act, whichever occurs first, except that-- (1) the Board shall be appointed within 60 days after the date of enactment of this Act; and (2) the Secretary shall issue regulations necessary to administer this Act within 120 days after the date of enactment of this Act.