I 

116TH CONGRESS 

2D SESSION H. R. 7948 

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. 

IN THE HOUSE OF REPRESENTATIVES 

AUGUST 7, 2020 

Mr. GIANFORTE (for himself, Mr. LUJA ́N, Mrs. RODGERS of Washington, Mr. 

MULLIN, Mr. O’HALLERAN, and Mr. RUIZ) introduced the following bill; 

which was referred to the Committee on Energy and Commerce 

A BILL 

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. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Tribal Health Data 

5 Improvement Act of 2020’’. 


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1 SEC. 2. COLLECTION AND AVAILABILITY OF HEALTH DATA 

2 WITH RESPECT TO INDIAN TRIBES. 

3 (a) DATA COLLECTION.—Section 3101(a)(1) of the 

4 Public Health Service Act (42 U.S.C. 300kk(a)(1)) is 

5 amended— 

6 (1) by striking ‘‘, by not later than 2 years 

7 after the date of enactment of this title,’’; and 

8 (2) in subparagraph (B), by inserting ‘‘Tribal,’’ 

9 after ‘‘State,’’. 

10 (b) DATA REPORTING AND DISSEMINATION.—Sec11 tion 3101(c) of the Public Health Service Act (42 U.S.C. 

12 300kk(c)) is amended— 

13 (1) by amending subparagraph (F) of para14 graph (1) to read as follows: 

15 ‘‘(F) the Indian Health Service, Indian 

16 Tribes, and epidemiology centers;’’; and 

17 (2) in paragraph (3), by inserting ‘‘Indian 

18 Tribes, epidemiology centers,’’ after ‘‘Federal agen19 cies,’’. 

20 (c) PROTECTION AND SHARING OF DATA.—Section 

21 3101(e) of the Public Health Service Act (42 U.S.C. 

22 300kk(e)) is amended by adding at the end the following 

23 new paragraph: 

24 ‘‘(3) TRIBAL PUBLIC HEALTH AUTHORITY.— 

25 Beginning not later than 30 days after the date of 

26 the enactment of the Tribal Health Data ImproveVerDate Sep 11 2014 01:42 Aug 28, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H7948.IH H7948

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1 ment Act of 2020, the Secretary shall make avail2 able all data collected pursuant to this title with re3 spect to health care and public health surveillance 

4 programs and activities, including such programs 

5 and activities that are federally supported or con6 ducted, to— 

7 ‘‘(A) the Indian Health Service; 

8 ‘‘(B) Indian Tribes; and 

9 ‘‘(C) epidemiology centers.’’. 

10 (d) TECHNICAL UPDATES.—Section 3101 of the 

11 Public Health Service Act (42 U.S.C. 300kk) is amend12 ed— 

13 (1) by striking subsections (g) and (h); and 

14 (2) by redesignating subsection (i) as subsection 

15 (h). 

16 (e) DEFINITIONS.—After executing the amendments 

17 made by subsection (d), section 3101 of the Public Health 

18 Service Act (42 U.S.C. 300kk) is amended by inserting 

19 after subsection (f) the following new subsection: 

20 ‘‘(g) DEFINITIONS.—In this section: 

21 ‘‘(1) The term ‘Indian Tribe’ has the meaning 

22 given to the term ‘Indian tribe’ in section 4 of the 

23 Indian Self-Determination and Education Assistance 

24 Act. 


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1 ‘‘(2) The term ‘epidemiology center’ means an 

2 epidemiology center established under section 214 of 

3 the Indian Health Care Improvement Act.’’. 

4 (f) TECHNICAL CORRECTION.—Section 3101(b) of 

5 the Public Health Service Act (42 U.S.C. 300kk(b)) is 

6 amended by striking ‘‘DATA ANALYSIS.—’’ and all that 

7 follows through ‘‘For each federally’’ and inserting ‘‘DATA

8 ANALYSIS.—For each federally’’. 

9 SEC. 3. IMPROVING HEALTH STATISTICS REPORTING WITH 

10 RESPECT TO INDIAN TRIBES. 

11 (a) TECHNICAL AID TO STATES AND LOCALITIES.— 

12 Section 306(d) of the Public Health Service Act (42 

13 U.S.C. 242k(d)) is amended by inserting ‘‘, Indian Tribes, 

14 and epidemiology centers’’ after ‘‘jurisdictions’’. 

15 (b) COOPERATIVE HEALTH STATISTICS SYSTEM.— 

16 Section 306(e)(3) of the Public Health Service Act (42 

17 U.S.C. 242k(e)(3)) is amended by inserting ‘‘, Indian 

18 Tribes, and epidemiology centers’’ after ‘‘health agencies’’. 

19 (c) FEDERAL-STATE COOPERATION.—Section 306(f) 

20 of the Public Health Service Act (42 U.S.C. 242k(f)) is 

21 amended— 

22 (1) by inserting ‘‘the Indian Health Service,’’ 

23 before ‘‘the Departments of Commerce’’; 

24 (2) by inserting a comma after ‘‘the Depart25 ments of Commerce and Labor’’; 


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1 (3) by inserting ‘‘, Indian Tribes, and epidemi2 ology centers’’ after ‘‘State and local health depart3 ments and agencies’’; and 

4 (4) by striking ‘‘he shall’’ and inserting ‘‘the 

5 Secretary shall’’. 

6 (d) REGISTRATION AREA RECORDS.—Section 

7 306(h)(1) of the Public Health Service Act (42 U.S.C. 

8 242k(h)(1)) is amended— 

9 (1) by striking ‘‘in his discretion’’ and inserting 

10 ‘‘in the discretion of the Secretary’’; and 

11 (2) by inserting ‘‘American Indians and Alaska 

12 Natives,’’ before ‘‘Hispanics’’. 

13 (e) NATIONAL COMMITTEE ON VITAL AND HEALTH

14 STATISTICS.—Section 306(k) of the Public Health Service 

15 Act (42 U.S.C. 242k(k)) is amended— 

16 (1) in paragraph (3), by striking ‘‘, not later 

17 than 60 days after the date of the enactment of the 

18 Health Insurance Portability and Accountability Act 

19 of 1996,’’ each place it appears; and 

20 (2) in paragraph (7), by striking ‘‘Not later 

21 than 1 year after the date of the enactment of the 

22 Health Insurance Portability and Accountability Act 

23 of 1996, and annually thereafter, the Committee 

24 shall’’ and inserting ‘‘The Committee shall, on an 

25 annual basis,’’. 


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1 (f) GRANTS FOR ASSEMBLY AND ANALYSIS OF DATA

2 ON ETHNIC AND RACIAL POPULATIONS.—Section 

3 306(m)(4) of the Public Health Service Act (42 U.S.C. 

4 242k(m)(4)) is amended— 

5 (1) in subparagraph (A)— 

6 (A) by striking ‘‘Subject to subparagraph 

7 (B), the’’ and inserting ‘‘The’’; and 

8 (B) by striking ‘‘and major Hispanic sub9 population groups and American Indians’’ and 

10 inserting ‘‘, major Hispanic subgroups, and 

11 American Indians and Alaska Natives’’; and 

12 (2) by amending subparagraph (B) to read as 

13 follows: 

14 ‘‘(B) In carrying out subparagraph (A), with respect 

15 to American Indians and Alaska Natives, the Secretary 

16 shall— 

17 ‘‘(i) consult with Indian Tribes, Tribal organi18 zations, the Tribal Technical Advisory Group of the 

19 Centers for Medicare & Medicaid Services main20 tained under section 5006(e) of the American Recov21 ery and Reinvestment Act of 2009, and the Tribal 

22 Advisory Committee established by the Centers for 

23 Disease Control and Prevention to develop guidelines 

24 for State and local health agencies to improve the 

25 quality and accuracy of data with respect to the 


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1 birth and death records of American Indians and 

2 Alaska Natives; 

3 ‘‘(ii) enter into cooperative agreements with In4 dian Tribes, Tribal organizations, Urban Indian or5 ganizations, and epidemiology centers to address 

6 misclassification and undersampling of American In7 dians and Alaska Natives with respect to— 

8 ‘‘(I) birth and death records; and 

9 ‘‘(II) health care and public health surveil10 lance systems; and 

11 ‘‘(iii) encourage States to enter into data shar12 ing agreements with Indian Tribes and epidemiology 

13 centers to improve the quality and accuracy of 

14 health data.’’. 

15 (g) DEFINITIONS.—Section 306 of the Public Health 

16 Service Act (42 U.S.C. 242k) is amended— 

17 (1) by redesignating subsection (n) as sub18 section (o); and 

19 (2) by inserting after subsection (m) the fol20 lowing: 

21 ‘‘(n) In this section: 

22 ‘‘(1) The term ‘Indian Tribe’ has the meaning 

23 given to the term ‘Indian tribe’ in section 4 of the 

24 Indian Self-Determination and Education Assistance 

25 Act. 


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1 ‘‘(2) The term ‘epidemiology center’ means an 

2 epidemiology center established under section 214 of 

3 the Indian Health Care Improvement Act. 

4 ‘‘(3) The term ‘Urban Indian organization’ has 

5 the meaning given to that term in section 4 of the 

6 Indian Health Care Improvement Act.’’. 

7 (h) AUTHORIZATION OF APPROPRIATIONS.—Section 

8 306(o) of the Public Health Service Act, as redesignated 

9 by subsection (g), is amended to read as follows: 

10 ‘‘(o)(1) To carry out this section, there is authorized 

11 to be appropriated $174,397,000 for each of the fiscal 

12 years 2021 through 2025. 

13 ‘‘(2) Of the amount authorized to be appropriated to 

14 carry out this section for a fiscal year, the Secretary shall 

15 not use more than 10 percent for the combined costs of— 

16 ‘‘(A) administration of this section; and 

17 ‘‘(B) carrying out subsection (m)(2).’’. 

Æ 


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