IB 

Union Calendar No. 446 

116TH CONGRESS 

2D SESSION H. R. 7948 

[Report No. 116–546] 

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 

SEPTEMBER 29, 2020 

Additional sponsor: Mr. ARMSTRONG

SEPTEMBER 29, 2020 

Reported with an amendment; committed to the Committee of the Whole 

House on the State of the Union and ordered to be printed 

[Strike out all after the enacting clause and insert the part printed in italic] 

[For text of introduced bill, see copy of bill as introduced on August 7, 2020] 


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•HR 7948 RH

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. 


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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 Im5 provement Act of 2020’’. 

6 SEC. 2. COLLECTION AND AVAILABILITY OF HEALTH DATA 

7 WITH RESPECT TO INDIAN TRIBES. 

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

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

10 amended— 

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

12 the date of enactment of this title,’’; and 

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

14 after ‘‘State,’’. 

15 (b) DATA REPORTING AND DISSEMINATION.—Section 

16 3101(c) of the Public Health Service Act (42 U.S.C. 

17 300kk(c)) is amended— 

18 (1) by amending subparagraph (F) of paragraph 

19 (1) to read as follows: 

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

21 Tribes, Tribal organizations, and epidemiology 

22 centers authorized under the Indian Health Care 

23 Improvement Act;’’; and 


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

2 Tribes, Tribal organizations, and epidemiology cen3 ters,’’ after ‘‘Federal agencies,’’. 

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

5 3101(e) of the Public Health Service Act (42 U.S.C. 

6 300kk(e)) is amended by adding at the end the following 

7 new paragraphs: 

8 ‘‘(3) DATA SHARING STRATEGY.—With respect to 

9 data access for Tribal epidemiology centers and 

10 Tribes, the Secretary shall create a data sharing 

11 strategy that takes into consideration recommenda12 tions by the Secretary’s Tribal Advisory Committee 

13 for— 

14 ‘‘(A) ensuring that Tribal epidemiology cen15 ters and Indian Tribes have access to the data 

16 sources necessary to accomplish their public 

17 health responsibilities; and 

18 ‘‘(B) protecting the privacy and security of 

19 such data. 

20 ‘‘(4) TRIBAL PUBLIC HEALTH AUTHORITY.— 

21 ‘‘(A) AVAILABILITY.—Beginning not later 

22 than 180 days after the date of the enactment of 

23 the Tribal Health Data Improvement Act of 

24 2020, the Secretary shall make available to the 

25 entities listed in subparagraph (B) all data that 


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1 is collected pursuant to this title with respect to 

2 health care and public health surveillance pro3 grams and activities, including such programs 

4 and activities that are federally supported or 

5 conducted, so long as— 

6 ‘‘(i) such entities request the data pur7 suant to statute; and 

8 ‘‘(ii) the data is requested for use— 

9 ‘‘(I) consistent with Federal law 

10 and obligations; and 

11 ‘‘(II) to satisfy a particular pur12 pose or carry out a specific function 

13 consistent with the purpose for which 

14 the data was collected. 

15 ‘‘(B) ENTITIES.—The entities listed in this 

16 subparagraph are— 

17 ‘‘(i) the Indian Health Service; 

18 ‘‘(ii) Indian Tribes and Tribal organi19 zations; and 

20 ‘‘(iii) epidemiology centers.’’. 

21 (d) TECHNICAL UPDATES.—Section 3101 of the Public 

22 Health Service Act (42 U.S.C. 300kk) is amended— 

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

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

25 (h). 


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1 (e) DEFINITIONS.—After executing the amendments 

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

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

4 subsection (f) the following new subsection: 

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

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

7 epidemiology center established under section 214 of 

8 the Indian Health Care Improvement Act, including 

9 such Tribal epidemiology centers serving Indian 

10 Tribes regionally and any Tribal epidemiology center 

11 serving Urban Indian organizations nationally. 

12 ‘‘(2) The term ‘Indian Tribe’ has the meaning 

13 given to the term ‘Indian tribe’ in section 4 of the In14 dian Self-Determination and Education Assistance 

15 Act. 

16 ‘‘(3) The term ‘Tribal organization’ has the 

17 meaning given to the term ‘tribal organization’ in 

18 section 4 of the of the Indian Self-Determination and 

19 Education Assistance Act. 

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

21 the meaning given to that term in section 4 of the In22 dian Health Care Improvement Act.’’. 

23 (f) TECHNICAL CORRECTION.—Section 3101(b) of the 

24 Public Health Service Act (42 U.S.C. 300kk(b)) is amended 

25 by striking ‘‘DATA ANALYSIS.—’’ and all that follows 


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1 through ‘‘For each federally’’ and inserting ‘‘DATA ANAL2 YSIS.—For each federally’’. 

3 SEC. 3. IMPROVING HEALTH STATISTICS REPORTING WITH 

4 RESPECT TO INDIAN TRIBES. 

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

6 Section 306(d) of the Public Health Service Act (42 U.S.C. 

7 242k(d)) is amended by inserting ‘‘, Indian Tribes, Tribal 

8 organizations, and epidemiology centers’’ after ‘‘jurisdic9 tions’’. 

10 (b) COOPERATIVE HEALTH STATISTICS SYSTEM.— 

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

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

13 Tribes, Tribal organizations, and epidemiology centers’’ 

14 after ‘‘health agencies’’. 

15 (c) FEDERAL-STATE-TRIBAL COOPERATION.—Section 

16 306(f) of the Public Health Service Act (42 U.S.C. 242k(f)) 

17 is amended— 

18 (1) by inserting ‘‘the Indian Health Service,’’ be19 fore ‘‘the Departments of Commerce’’; 

20 (2) by inserting a comma after ‘‘the Depart21 ments of Commerce and Labor’’; 

22 (3) by inserting ‘‘, Indian Tribes, Tribal organi23 zations, and epidemiology centers’’ after ‘‘State and 

24 local health departments and agencies’’; and 


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1 (4) by striking ‘‘he shall’’ and inserting ‘‘the Sec2 retary shall’’. 

3 (d) REGISTRATION AREA RECORDS.—Section 

4 306(h)(1) of the Public Health Service Act (42 U.S.C. 

5 242k(h)(1)) is amended— 

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

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

8 (2) by striking ‘‘Hispanics, Asian Americans, 

9 and Pacific Islanders’’ and inserting ‘‘American In10 dians and Alaska Natives, Hispanics, Asian Ameri11 cans, and Native Hawaiian and other Pacific Island12 ers’’. 

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 than 

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

22 Insurance Portability and Accountability Act of 1996, 

23 and annually thereafter, the Committee shall’’ and in24 serting ‘‘The Committee shall, on an biennial 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 organiza18 tions, the Tribal Technical Advisory Group of the 

19 Centers for Medicare & Medicaid Services maintained 

20 under section 5006(e) of the American Recovery and 

21 Reinvestment Act of 2009, and the Tribal Advisory 

22 Committee established by the Centers for Disease Con23 trol and Prevention, in coordination with epidemi24 ology centers, to develop guidelines for State and local 

25 health agencies to improve the quality and accuracy 


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1 of data with respect to the birth and death records of 

2 American Indians and Alaska Natives; 

3 ‘‘(ii) confer with Urban Indian organizations to 

4 develop guidelines for State and local health agencies 

5 to improve the quality and accuracy of data with re6 spect to the birth and death records of American Indi7 ans and Alaska Natives; 

8 ‘‘(iii) enter into cooperative agreements with In9 dian Tribes, Tribal organizations, Urban Indian or10 ganizations, and epidemiology centers to address 

11 misclassification and undersampling of American In12 dians and Alaska Natives with respect to— 

13 ‘‘(I) birth and death records; and 

14 ‘‘(II) health care and public health surveil15 lance systems, including, but not limited to, data 

16 with respect to chronic and infectious diseases, 

17 unintentional injuries, environmental health, 

18 child and adolescent health, maternal health and 

19 mortality, foodborne and waterborne illness, re20 productive health, and any other notifiable dis21 ease or condition; 

22 ‘‘(iv) encourage States to enter into data sharing 

23 agreements with Indian Tribes, Tribal organizations, 

24 and epidemiology centers to improve the quality and 

25 accuracy of public health data; and 


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1 ‘‘(v) not later than 180 days after the date of en2 actment of the Tribal Health Data Improvement Act 

3 of 2020, and biennially thereafter, issue a report on 

4 the following: 

5 ‘‘(I) Which States have data sharing agree6 ments with Indian Tribes, Tribal organizations, 

7 Urban Indian organizations, and Tribal epide8 miology centers to improve the quality and accu9 racy of health data. 

10 ‘‘(II) What the Centers for Disease Control 

11 and Prevention is doing to encourage States to 

12 enter into data sharing agreements with Indian 

13 Tribes, Tribal organizations, Urban Indian or14 ganizations, and Tribal epidemiology centers to 

15 improve the quality and accuracy of health data. 

16 ‘‘(III) Best practices and guidance for 

17 States, Indian Tribes, Tribal organizations, 

18 Urban Indian organizations, and Tribal epide19 miology centers that wish to enter into data 

20 sharing agreements. 

21 ‘‘(IV) Best practices and guidance for local, 

22 State, Tribal, and Federal uniform standards for 

23 the collection of data on race and ethnicity.’’. 

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

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


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1 (1) by redesignating subsection (n) as subsection 

2 (o); and 

3 (2) by inserting after subsection (m) the fol4 lowing: 

5 ‘‘(n) In this section: 

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

7 epidemiology center established under section 214 of 

8 the Indian Health Care Improvement Act, including 

9 such Tribal epidemiology centers serving Indian 

10 Tribes regionally and any Tribal epidemiology center 

11 serving Urban Indian organizations nationally. 

12 ‘‘(2) The term ‘Indian Tribe’ has the meaning 

13 given to the term ‘Indian tribe’ in section 4 of the In14 dian Self-Determination and Education Assistance 

15 Act. 

16 ‘‘(3) The term ‘Tribal organization’ has the 

17 meaning given to the term ‘tribal organization’ in 

18 section 4 of the Indian Self-Determination and Edu19 cation Assistance Act. 

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

21 the meaning given to that term in section 4 of the In22 dian Health Care Improvement Act.’’. 

23 (h) AUTHORIZATION OF APPROPRIATIONS.—Section 

24 306(o) of the Public Health Service Act, as redesignated by 

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


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

2 to be appropriated $185,000,000 for each of the fiscal years 

3 2021 through 2025. 

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

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

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

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

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


kjohnson on DSK79L0C42PROD with BILLS
Union Calendar No. 446 

116TH CONGRESS 

2D SESSION H. R. 7948 

[Report No. 116–546] 

A BILL 

To amend the Public Health Service Act with repurposes. data with respect to Indian Tribes, and for other spect to the collection and availability of health 

SEPTEMBER 29, 2020 

Reported with an amendment; committed to the Comand ordered to be printed mittee of the Whole House on the State of the Union 


kjohnson on DSK79L0C42PROD with BILLS