[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3841 Referred in Senate (RFS)]
<DOC>
117th CONGRESS
1st Session
H. R. 3841
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
June 24, 2021
Received; read twice and referred to the Committee on Indian Affairs
_______________________________________________________________________
AN ACT
To amend the Public Health Service Act with respect to the collection
and availability of health data with respect to Indian Tribes, 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 ``Tribal Health Data Improvement Act
of 2021''.
SEC. 2. COLLECTION AND AVAILABILITY OF HEALTH DATA WITH RESPECT TO
INDIAN TRIBES.
(a) Data Collection.--Section 3101(a)(1) of the Public Health
Service Act (42 U.S.C. 300kk(a)(1)) is amended--
(1) by striking ``, by not later than 2 years after the
date of enactment of this title,''; and
(2) in subparagraph (B), by inserting ``Tribal,'' after
``State,''.
(b) Data Reporting and Dissemination.--Section 3101(c) of the
Public Health Service Act (42 U.S.C. 300kk(c)) is amended--
(1) by amending subparagraph (F) of paragraph (1) to read
as follows:
``(F) the Indian Health Service, Indian Tribes,
Tribal organizations, and epidemiology centers
authorized under the Indian Health Care Improvement
Act;''; and
(2) in paragraph (3), by inserting ``Indian Tribes, Tribal
organizations, and epidemiology centers,'' after ``Federal
agencies,''.
(c) Protection and Sharing of Data.--Section 3101(e) of the Public
Health Service Act (42 U.S.C. 300kk(e)) is amended by adding at the end
the following new paragraphs:
``(3) Data sharing strategy.--With respect to data access
for Tribal epidemiology centers and Tribes, the Secretary shall
create a data sharing strategy that takes into consideration
recommendations by the Secretary's Tribal Advisory Committee
for--
``(A) ensuring that Tribal epidemiology centers and
Indian Tribes have access to the data sources necessary
to accomplish their public health responsibilities; and
``(B) protecting the privacy and security of such
data.
``(4) Tribal public health authority.--
``(A) Availability.--Beginning not later than 180
days after the date of the enactment of the Tribal
Health Data Improvement Act of 2021, the Secretary
shall make available to the entities listed in
subparagraph (B) all data that is collected pursuant to
this title with respect to health care and public
health surveillance programs and activities, including
such programs and activities that are federally
supported or conducted, so long as--
``(i) such entities request the data
pursuant to statute; and
``(ii) the data is requested for use--
``(I) consistent with Federal law
and obligations; and
``(II) to satisfy a particular
purpose or carry out a specific
function consistent with the purpose
for which the data was collected.
``(B) Entities.--The entities listed in this
subparagraph are--
``(i) the Indian Health Service;
``(ii) Indian Tribes and Tribal
organizations; and
``(iii) epidemiology centers.''.
(d) Technical Updates.--Section 3101 of the Public Health Service
Act (42 U.S.C. 300kk) is amended--
(1) by striking subsections (g) and (h); and
(2) by redesignating subsection (i) as subsection (h).
(e) Definitions.--After executing the amendments made by subsection
(d), section 3101 of the Public Health Service Act (42 U.S.C. 300kk) is
amended by inserting after subsection (f) the following new subsection:
``(g) Definitions.--In this section:
``(1) The term `epidemiology center' means an epidemiology
center established under section 214 of the Indian Health Care
Improvement Act, including such Tribal epidemiology centers
serving Indian Tribes regionally and any Tribal epidemiology
center serving Urban Indian organizations nationally.
``(2) The term `Indian Tribe' has the meaning given to the
term `Indian tribe' in section 4 of the Indian Self-
Determination and Education Assistance Act.
``(3) The term `Tribal organization' has the meaning given
to the term `tribal organization' in section 4 of the of the
Indian Self-Determination and Education Assistance Act.
``(4) The term `Urban Indian organization' has the meaning
given to that term in section 4 of the Indian Health Care
Improvement Act.''.
(f) Technical Correction.--Section 3101(b) of the Public Health
Service Act (42 U.S.C. 300kk(b)) is amended by striking ``Data
Analysis.--'' and all that follows through ``For each federally'' and
inserting ``Data Analysis.--For each federally''.
SEC. 3. IMPROVING HEALTH STATISTICS REPORTING WITH RESPECT TO INDIAN
TRIBES.
(a) Technical Aid to States and Localities.--Section 306(d) of the
Public Health Service Act (42 U.S.C. 242k(d)) is amended by inserting
``, Indian Tribes, Tribal organizations, and epidemiology centers''
after ``jurisdictions''.
(b) Cooperative Health Statistics System.--Section 306(e)(3) of the
Public Health Service Act (42 U.S.C. 242k(e)(3)) is amended by
inserting ``, Indian Tribes, Tribal organizations, and epidemiology
centers'' after ``health agencies''.
(c) Federal-State-Tribal Cooperation.--Section 306(f) of the Public
Health Service Act (42 U.S.C. 242k(f)) is amended--
(1) by inserting ``the Indian Health Service,'' before
``the Departments of Commerce'';
(2) by inserting a comma after ``the Departments of
Commerce and Labor'';
(3) by inserting ``, Indian Tribes, Tribal organizations,
and epidemiology centers'' after ``State and local health
departments and agencies''; and
(4) by striking ``he shall'' and inserting ``the Secretary
shall''.
(d) Registration Area Records.--Section 306(h)(1) of the Public
Health Service Act (42 U.S.C. 242k(h)(1)) is amended--
(1) by striking ``in his discretion'' and inserting ``in
the discretion of the Secretary''; and
(2) by striking ``Hispanics, Asian Americans, and Pacific
Islanders'' and inserting ``American Indians and Alaska
Natives, Hispanics, Asian Americans, and Native Hawaiian and
other Pacific Islanders''.
(e) National Committee on Vital and Health Statistics.--Section
306(k) of the Public Health Service Act (42 U.S.C. 242k(k)) is
amended--
(1) in paragraph (3), by striking ``, not later than 60
days after the date of the enactment of the Health Insurance
Portability and Accountability Act of 1996,'' each place it
appears; and
(2) in paragraph (7), by striking ``Not later than 1 year
after the date of the enactment of the Health Insurance
Portability and Accountability Act of 1996, and annually
thereafter, the Committee shall'' and inserting ``The Committee
shall, on a biennial basis,''.
(f) Grants for Assembly and Analysis of Data on Ethnic and Racial
Populations.--Section 306(m)(4) of the Public Health Service Act (42
U.S.C. 242k(m)(4)) is amended--
(1) in subparagraph (A)--
(A) by striking ``Subject to subparagraph (B),
the'' and inserting ``The''; and
(B) by striking ``and major Hispanic subpopulation
groups and American Indians'' and inserting ``, major
Hispanic subgroups, and American Indians and Alaska
Natives''; and
(2) by amending subparagraph (B) to read as follows:
``(B) In carrying out subparagraph (A), with respect to American
Indians and Alaska Natives, the Secretary shall--
``(i) consult with Indian Tribes, Tribal organizations, the
Tribal Technical Advisory Group of the Centers for Medicare &
Medicaid Services maintained under section 5006(e) of the
American Recovery and Reinvestment Act of 2009, and the Tribal
Advisory Committee established by the Centers for Disease
Control and Prevention, in coordination with epidemiology
centers, to develop guidelines for State and local health
agencies to improve the quality and accuracy of data with
respect to the birth and death records of American Indians and
Alaska Natives;
``(ii) confer with Urban Indian organizations to develop
guidelines for State and local health agencies to improve the
quality and accuracy of data with respect to the birth and
death records of American Indians and Alaska Natives;
``(iii) enter into cooperative agreements with Indian
Tribes, Tribal organizations, Urban Indian organizations, and
epidemiology centers to address misclassification and
undersampling of American Indians and Alaska Natives with
respect to--
``(I) birth and death records; and
``(II) health care and public health surveillance
systems, including, but not limited to, data with
respect to chronic and infectious diseases,
unintentional injuries, environmental health, child and
adolescent health, maternal health and mortality,
foodborne and waterborne illness, reproductive health,
and any other notifiable disease or condition;
``(iv) encourage States to enter into data sharing
agreements with Indian Tribes, Tribal organizations, and
epidemiology centers to improve the quality and accuracy of
public health data; and
``(v) not later than 180 days after the date of enactment
of the Tribal Health Data Improvement Act of 2021, and
biennially thereafter, issue a report on the following:
``(I) Which States have data sharing agreements
with Indian Tribes, Tribal organizations, Urban Indian
organizations, and Tribal epidemiology centers to
improve the quality and accuracy of health data.
``(II) What the Centers for Disease Control and
Prevention is doing to encourage States to enter into
data sharing agreements with Indian Tribes, Tribal
organizations, Urban Indian organizations, and Tribal
epidemiology centers to improve the quality and
accuracy of health data.
``(III) Best practices and guidance for States,
Indian Tribes, Tribal organizations, Urban Indian
organizations, and Tribal epidemiology centers that
wish to enter into data sharing agreements.
``(IV) Best practices and guidance for local,
State, Tribal, and Federal uniform standards for the
collection of data on race and ethnicity.''.
(g) Definitions.--Section 306 of the Public Health Service Act (42
U.S.C. 242k) is amended--
(1) by redesignating subsection (n) as subsection (o); and
(2) by inserting after subsection (m) the following:
``(n) In this section:
``(1) The term `epidemiology center' means an epidemiology
center established under section 214 of the Indian Health Care
Improvement Act, including such Tribal epidemiology centers
serving Indian Tribes regionally and any Tribal epidemiology
center serving Urban Indian organizations nationally.
``(2) The term `Indian Tribe' has the meaning given to the
term `Indian tribe' in section 4 of the Indian Self-
Determination and Education Assistance Act.
``(3) The term `Tribal organization' has the meaning given
to the term `tribal organization' in section 4 of the Indian
Self-Determination and Education Assistance Act.
``(4) The term `Urban Indian organization' has the meaning
given to that term in section 4 of the Indian Health Care
Improvement Act.''.
(h) Authorization of Appropriations.--Section 306(o) of the Public
Health Service Act, as redesignated by subsection (g), is amended to
read as follows:
``(o)(1) To carry out this section, there is authorized to be
appropriated $185,000,000 for each of the fiscal years 2022 through
2026.
``(2) Of the amount authorized to be appropriated to carry out this
section for a fiscal year, the Secretary shall not use more than 10
percent for the combined costs of--
``(A) administration of this section; and
``(B) carrying out subsection (m)(2).''.
Passed the House of Representatives June 23, 2021.
Attest:
CHERYL L. JOHNSON,
Clerk.