A BILL TO BE ENTITLED
AN ACT implementing the recommendations of the advisory panel on cancer research and appropriating funds for this purpose.
The General Assembly of North Carolina enacts:
SECTION 1.  G.S. 130A‑208 reads as rewritten:
"§ 130A‑208.  Central cancer registry; powers and duties.
A central cancer registry is established within the Department. The central cancer registry shall have the following powers and duties:
(1)	Compile, tabulate and preserve statistical, clinical, and other reports and records pursuant to this Part relating to the incidence, treatment, and cure of cancer.
(2)	Provide assistance and consultation for public health work.
(3)	Serve as the lead agency for cancer cluster inquiries and investigations in North Carolina, as provided in G.S. 130A‑208.1."
SECTION 2.  Part 1 of Article 7 of Chapter 130A of the General Statutes is amended by adding new sections to read:
"§ 130A‑208.1.  Lead agency for cancer cluster investigations.
(a)	As the lead agency for cancer cluster investigations in North Carolina, the central cancer registry shall oversee the coordination of State‑level efforts and activities related to cancer cluster inquiries and investigations, including efforts and activities by the Occupational and Environmental Epidemiology Branch and the Department of Environmental Quality, in a way that maximizes efficiency and effectiveness.
(b)	The Department shall maintain a Web page on its Internet Web site dedicated to cancer cluster investigations, which shall include the identity of, and contact information for, the cancer epidemiologist selected to serve as the single point of contact for State‑level cancer cluster activities pursuant to G.S. 130A‑208.2(a)(2).
"§ 130A‑208.2.  Cancer epidemiologist.
(a)	The central cancer registry shall employ and retain an epidemiologist with knowledge, training, and experience in cancer epidemiology, including cancer cluster investigations, whose primary responsibility shall be to coordinate and communicate State‑level cancer cluster activities. To fulfill this primary responsibility, the cancer epidemiologist shall have the following duties and powers:
(1)	Lead State‑level cancer cluster inquiries and investigations in collaboration with the Occupational and Environmental Epidemiology Branch and the Department of Environmental Quality, as appropriate.
(2)	Serve as the single designated point of contact for State‑level cancer cluster activities.
(3)	Conduct routine cancer surveillance activities.
(4)	Proactively monitor cancer rates statewide, including analyzing patterns of cancer incidence over geographic areas and time.
(5)	Lead in the development, ongoing review, and updating of the statewide cancer cluster protocol established pursuant to G.S. 130A‑208.3, with assistance from the Advisory Committee.
(6)	Developing and disseminating reports.
"§ 130A‑208.3.  Enhanced statewide cancer cluster protocol.
The central cancer registry, in collaboration with the Cancer Cluster Subcommittee created by G.S. 130A‑33.52, shall establish and periodically update an enhanced statewide cancer cluster protocol for addressing suspected cancer clusters within the State. The protocol shall be based on the most current Centers for Disease Control and Prevention (CDC) guidelines for public health agencies to assess and respond to potential cancer clusters. At a minimum, the protocol shall incorporate all of the following:
(1)	Best practices for all phases of cancer cluster assessment, including (i) surveillance for identifying new cancer cases and monitoring trends, (ii) inquiries, and (iii) detection and investigation.
(2)	State and local infrastructure needs.
(3)	Innovative statistical methods, software tools, and analytic approaches for analyzing cancer rates and detecting cancer clusters.
(4)	A comprehensive plan for internal communication within the Department as well as external communication with local health departments, the community, the media, and other stakeholders."
SECTION 3.  Part 4 of Article 1B of Chapter 130A of the General Statutes is amended by adding a new section to read:
"§ 130A‑33.52.  Cancer Cluster Subcommittee.
There is created the Cancer Cluster Subcommittee of the Advisory Committee on Cancer Coordination and Control to collaborate with the Central Cancer Registry on State‑level cancer cluster activities. The Cancer Cluster Subcommittee shall meet at least quarterly with the cancer epidemiologist described in G.S. 130A‑208.2 to provide advice and assistance on (i) the enhanced statewide cancer cluster protocol and (ii) any State‑level cancer cluster activities being conducted across the State. The subcommittee shall be comprised of eleven individuals with expertise in cancer cluster investigations, who shall be appointed as follows:
(1)	Two cancer epidemiologists, one each appointed by the President Pro Tempore of the Senate and the Speaker of the House of Representatives.
(2)	Two environmental health scientists, one each appointed by the President Pro Tempore of the Senate and the Speaker of the House of Representatives 
(3)	One local health director from a rural area of the State, appointed by the Governor.
(4)	One local health director from an urban area of the State, appointed by the Governor.
(5)	One statistician appointed by the Governor.
(6)	Two public members appointed by the Governor.
(7)	The Director of the Central Cancer Registry or a designee of the Director.
(8)	The Director of the Occupational and Environmental Epidemiology Branch or a designee of the Director.
(9)	The Secretary of the Department of Environmental Quality or a designee of the Secretary."
SECTION 4.(a)  Not later than October 1, 2020, and within available appropriations, the Department of Health and Human Services, Division of Public Health, Central Cancer Registry, shall develop and implement a one‑year pilot project to establish a statewide environmental public health tracking Web portal that allows North Carolina residents and others to view aggregated environmental and health data by time, geography, cancer type, age, group, year, and other factors determined by the Central Cancer Registry. The purpose of this pilot project is to better inform the assessment and communication of cancer and environmental patterns in North Carolina through a Web portal that is distinct from the Central Cancer Registry's Internet Web site. The staff of the Central Cancer Registry and the Occupational and Environmental Epidemiology Branch shall work collaboratively with the cancer epidemiologist described in G.S. 130A‑208.2 to develop and implement the statewide environmental public health tracking Web portal authorized by this section.
SECTION 4.(b)  The Department of Health and Human Services, Division of Public Health, Central Cancer Registry, shall provide a report on the results of the pilot project authorized under subsection (a) of this section to the Joint Legislative Oversight Committee on Health and Human Services on or before December 1, 2021. The report shall include a detailed estimate of the projected annual cost to the Department to maintain the Web portal on a permanent basis.
SECTION 4.(c)  This section is effective when it becomes law.
SECTION 5.(a)  There is appropriated from the General Fund to the Department of Health and Human Services, Division of Public Health, the following amounts for the 2020‑2021 fiscal year:
(1)	The sum of ninety‑seven thousand nine hundred eleven dollars ($97,911) in recurring funds to create one full‑time equivalent Cancer Epidemiologist position within the Central Cancer Registry dedicated to cancer cluster investigations.
(2)	The sum of eighty‑four thousand eight hundred ninety dollars ($84,890) in recurring funds to create one full‑time equivalent Public Health Educator II position within the Occupational and Environmental Epidemiology Branch dedicated to assisting the Department of Health and Human Services and local health departments with communications during cancer cluster investigations and as the results of these investigations are made available to local health departments, the media, and the general public.
(3)	The sum of one hundred seven thousand three hundred twenty dollars ($107,320) in recurring funds to create one full‑time equivalent Geographic Information Systems (GIS) Analyst position within the Central Cancer Registry dedicated to GIS activities in support of cancer cluster investigations and geographic analysis of cancer patterns.
(4)	The sum of one hundred twenty‑eight thousand three hundred fourteen dollars ($128,314) in recurring funds to create one full‑time equivalent Business and Technology Application Specialist (Website Developer) position within the Central Cancer Registry dedicated to enhancing and supporting the State Center for Health Statistics Web site to include data visualization tools for identifying cancer rates by geographic regions.
(5)	The sum of one hundred thirty‑one thousand nine hundred seventy‑six dollars ($131,976) in recurring funds to create two full‑time equivalent Certified Tumor Registrar positions within the Central Cancer Registry dedicated to coordinating outreach, communication, and onboarding with physician practices to improve cancer case identification across the State. These positions shall be responsible for (i) designing and implementing an onboarding and training program to support increased compliance with State‑mandated cancer case reporting requirements imposed on physician practices, (ii) providing training and when necessary re‑training on cancer case reporting when necessary to physician practice staff, including case entry into a web‑based application developed by the CDC and maintained by the Central Cancer Registry information technology staff, and (iii) monitoring compliance with State‑mandated cancer case reporting requirements.
(6)	The sum of sixteen thousand sixty‑five dollars ($16,065) in recurring funds to purchase geographic information system software for the Central Cancer Registry, to purchase tracking software for the Occupational and Environmental Epidemiology Branch, and to fund storage and maintenance costs associated with both.
SECTION 5.(b)  The funds appropriated in this section to create full‑time equivalent positions shall not be used to supplant any other source of funding for these positions.
SECTION 5.(c)  This section becomes effective July 1, 2020.
SECTION 6.  Except as otherwise provided, this act becomes effective October 1, 2020.