503 
social work, psychiatry, other mental and behavioral 
health, allied health, community health, social work, or 
other fields determined appropriate by the Secretary, 
other than in a position that involves research. 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section 
such sums as may be necessary for each of fiscal years 
2021 through 2025. 
‘‘SEC. 3416. RESEARCH ON THE EFFECT OF WORKFORCE DI-
VERSITY ON QUALITY. 
‘‘(a) IN GENERAL.—The Director of the Agency for 
Healthcare Research and Quality, in collaboration with 
the Deputy Assistant Secretary for Minority Health and 
the Director of the National Institute on Minority Health 
and Health Disparities, shall award grants to eligible enti-
ties to expand research on the link between health work-
force diversity and quality health care. 
‘‘(b) ELIGIBILITY.—To be eligible to receive a grant 
under subsection (a), an entity shall— 
‘‘(1) be a clinical, public health, or health serv-
ices research entity or other entity determined ap-
propriate by the Director; and 
‘‘(2) submit to the Secretary an application at 
such time, in such manner, and containing such in-
formation as the Secretary may require. 
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‘‘(c) USE OF FUNDS.—Amounts received under a 
grant awarded under subsection (a) shall be used to sup-
port research that investigates the effect of health work-
force diversity on— 
‘‘(1) language access; 
‘‘(2) cultural competence; 
‘‘(3) patient satisfaction; 
‘‘(4) timeliness of care; 
‘‘(5) safety of care; 
‘‘(6) effectiveness of care; 
‘‘(7) efficiency of care; 
‘‘(8) patient outcomes; 
‘‘(9) community engagement; 
‘‘(10) resource allocation; 
‘‘(11) organizational structure; 
‘‘(12) compliance of care; or 
‘‘(13) other topics determined appropriate by 
the Director. 
‘‘(d) PRIORITY.—In awarding grants under sub-
section (a), the Director shall give individualized consider-
ation to all relevant aspects of the applicant’s background. 
Consideration of prior research experience involving the 
health of underserved communities shall be such a factor. 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section 
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such sums as may be necessary for each of fiscal years 
2021 through 2025. 
‘‘SEC. 3417. HEALTH DISPARITIES EDUCATION PROGRAM. 
‘‘(a) 
ESTABLISHMENT.—The 
Secretary, 
acting 
through the Office of Minority Health, in collaboration 
with the National Institute on Minority Health and Health 
Disparities, the Office for Civil Rights, the Centers for 
Disease Control and Prevention, the Centers for Medicare 
& Medicaid Services, the Health Resources and Services 
Administration, and other appropriate public and private 
entities, shall establish and coordinate a health and health 
care disparities education program to support, develop, 
and implement educational initiatives and outreach strate-
gies that inform health care professionals and the public 
about the existence of and methods to reduce racial and 
ethnic disparities in health and health care. 
‘‘(b) ACTIVITIES.—The Secretary, through the edu-
cation program established under subsection (a), shall, 
through the use of public awareness and outreach cam-
paigns targeting the general public and the medical com-
munity at large— 
‘‘(1) disseminate scientific evidence for the ex-
istence and extent of racial and ethnic disparities in 
health care, including disparities that are not other-
wise attributable to known factors such as access to 
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care, patient preferences, or appropriateness of 
intervention, as described in the 2002 Institute of 
Medicine Report entitled ‘Unequal Treatment: Con-
fronting Racial and Ethnic Disparities in Health 
Care’, as well as the impact of disparities related to 
age, disability status, socioeconomic status, sex, gen-
der identity, and sexual orientation on racial and 
ethnic minorities; 
‘‘(2) disseminate new research findings to 
health care providers and patients to assist them in 
understanding, reducing, and eliminating health and 
health care disparities; 
‘‘(3) disseminate information about the impact 
of linguistic and cultural barriers on health care 
quality and the obligation of health providers who 
receive Federal financial assistance to ensure that 
individuals with limited English proficiency have ac-
cess to language access services; 
‘‘(4) disseminate information about the impor-
tance and legality of racial, ethnic, disability status, 
socioeconomic status, sex, gender identity, and sex-
ual orientation, and primary language data collec-
tion, analysis, and reporting; 
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‘‘(5) design and implement specific educational 
initiatives to health care providers relating to health 
and health care disparities; 
‘‘(6) assess the impact of the programs estab-
lished under this section in raising awareness of 
health and health care disparities and providing in-
formation on available resources; and 
‘‘(7) design and implement specific educational 
initiatives to educate the health care workforce relat-
ing to unconscious bias. 
‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section 
such sums as may be necessary for each of fiscal years 
2021 through 2025.’’. 
SEC. 1203. HISPANIC-SERVING INSTITUTIONS, HISTORI-
CALLY BLACK COLLEGES AND UNIVERSITIES, 
ASIAN AMERICAN AND NATIVE AMERICAN PA-
CIFIC 
ISLANDER-SERVING 
INSTITUTIONS, 
TRIBAL COLLEGES, REGIONAL COMMUNITY- 
BASED ORGANIZATIONS, AND NATIONAL MI-
NORITY MEDICAL ASSOCIATIONS. 
Part B of title VII of the Public Health Service Act 
(42 U.S.C. 293 et seq.) is amended by adding at the end 
the following: 
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‘‘SEC. 742. HISPANIC-SERVING INSTITUTIONS, HISTORI-
CALLY BLACK COLLEGES AND UNIVERSITIES, 
ASIAN AMERICAN AND NATIVE AMERICAN PA-
CIFIC 
ISLANDER-SERVING 
INSTITUTIONS, 
AND TRIBAL COLLEGES. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Administrator of the Health Resources and Services 
Administration and in consultation with the Secretary of 
Education, shall award grants to Hispanic-serving institu-
tions, Historically Black Colleges and Universities, Asian 
American and Native American Pacific Islander-serving 
institutions, Tribal Colleges or Universities, regional com-
munity-based organizations, and national minority med-
ical associations, for counseling, mentoring and providing 
information on financial assistance to prepare underrep-
resented minority individuals to enroll in and graduate 
from health professional schools and to increase services 
for underrepresented minority students including— 
‘‘(1) mentoring with underrepresented health 
professionals; and 
‘‘(2) providing financial assistance information 
for continued education and applications to health 
professional schools. 
‘‘(b) DEFINITIONS.—In this section: 
‘‘(1) ASIAN AMERICAN AND NATIVE AMERICAN 
PACIFIC
ISLANDER-SERVING
INSTITUTION.—The 
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term ‘Asian American and Native American Pacific 
Islander-serving institution’ has the meaning given 
such term in section 320(b) of the Higher Education 
Act of 1965. 
‘‘(2) 
HISPANIC-SERVING
INSTITUTION.—The 
term ‘Hispanic-serving institution’ means an entity 
that— 
‘‘(A) is a school or program for which 
there is a definition under 799B; 
‘‘(B) has an enrollment of full-time equiva-
lent students that is made up of at least 9 per-
cent Hispanic students; 
‘‘(C) has been effective in carrying out pro-
grams to recruit Hispanic individuals to enroll 
in and graduate from the school; 
‘‘(D) has been effective in recruiting and 
retaining Hispanic faculty members; 
‘‘(E) has a significant number of graduates 
who are providing health services to medically 
underserved populations or to individuals in 
health professional shortage areas; and 
‘‘(F) is a Hispanic Center of Excellence in 
Health Professions Education designated under 
section 736(d)(2) of the Public Health Service 
Act (42 U.S.C. 293(d)(2)). 
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‘‘(3) HISTORICALLY
BLACK
COLLEGES
AND 
UNIVERSITY.—The term ‘historically black college 
and university’ has the meaning given the term ‘part 
B institution’ as defined in section 322 of the High-
er Education Act of 1965. 
‘‘(4) TRIBAL COLLEGE OR UNIVERSITY.—The 
term ‘Tribal College or University’ has the meaning 
given such term in section 316(b) of the Higher 
Education Act of 1965. 
‘‘(c) CERTAIN LOAN REPAYMENT PROGRAMS.—In 
carrying out the National Health Service Corps Loan Re-
payment Program established under subpart III of part 
D of title III and the loan repayment program under sec-
tion 317F, the Secretary shall ensure, notwithstanding 
such subpart or section, that loan repayments of not less 
than $50,000 per year per person are awarded for repay-
ment of loans incurred for enrollment or participation of 
underrepresented minority individuals in health profes-
sional schools and other health programs described in this 
section. 
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section 
such sums as may be necessary for each of fiscal years 
2021 through 2026.’’. 
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SEC. 1204. LOAN REPAYMENT PROGRAM OF CENTERS FOR 
DISEASE CONTROL AND PREVENTION. 
Section 317F(c)(1) of the Public Health Service Act 
(42 U.S.C. 247b–7(c)(1)) is amended— 
(1) by striking ‘‘and’’ after ‘‘1994,’’; and 
(2) by inserting before the period at the end the 
following: ‘‘, $750,000 for fiscal year 2020, and such 
sums as may be necessary for each of the fiscal 
years 2021 through 2025’’. 
SEC. 1205. STUDY AND REPORT ON STRATEGIES FOR IN-
CREASING DIVERSITY. 
(a) STUDY.—The Comptroller General of the United 
States shall conduct a study on strategies for increasing 
the diversity of the health professional workforce. Such 
study shall include an analysis of strategies for increasing 
the number of health professionals from rural, lower in-
come, and underrepresented minority communities, includ-
ing which strategies are most effective for achieving such 
goal. 
(b) REPORT.—Not later than 2 years after the date 
of enactment of this Act, the Comptroller General shall 
submit to Congress a report on the study conducted under 
subsection (a), together with recommendations for such 
legislation and administrative action as the Comptroller 
General determines appropriate. 
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SEC. 1206. AMENDMENTS TO THE PANDEMIC EBT ACT. 
Section 1101 of the Families First Coronavirus Re-
sponse Act (Public Law 116–127) is amended— 
(1) in subsection (a)— 
(A) by striking ‘‘fiscal year 2020’’ and in-
serting ‘‘fiscal years 2020 and 2021’’; 
(B) by striking ‘‘during which the school 
would otherwise be in session’’; and 
(C) by inserting ‘‘until the school reopens’’ 
after ‘‘assistance’’; 
(2) in subsection (b)— 
(A) by inserting ‘‘and State agency plans 
for child care covered children in accordance 
with subsection (i)’’ after ‘‘with eligible chil-
dren’’; 
(B) by inserting ‘‘, a plan to enroll chil-
dren who become eligible children during a pub-
lic health emergency designation’’ before ‘‘, and 
issuances’’; 
(C) by striking ‘‘in an amount not less 
than the value of meals at the free rate over the 
course of 5 school days’’ and inserting ‘‘in ac-
cordance with subsection (h)(1)’’; and 
(D) by inserting ‘‘and for each child care 
covered child in the household’’ before the pe-
riod at the end; 
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(3) in subsection (c), by inserting ‘‘or child care 
center’’ after ‘‘school’’; 
(4) by amending subsection (e) to read as fol-
lows: 
‘‘(e) RELEASE OF INFORMATION.—Notwithstanding 
any other provision of law, the Secretary of Agriculture 
may authorize— 
‘‘(1) State educational agencies and school food 
authorities administering a school lunch program 
under the Richard B. Russell National School Lunch 
Act (42 U.S.C. 1751 et seq.) to release to appro-
priate officials administering the supplemental nutri-
tion assistance program such information as may be 
necessary to carry out this section with respect to el-
igible children; and 
‘‘(2) State agencies administering a child and 
adult care food program under section 17 of the 
Richard B. Russell National School Lunch Act (42 
U.S.C. 1766) to release to appropriate officials ad-
ministering the supplemental nutrition assistance 
program such information as may be necessary to 
carry out this section with respect to child care cov-
ered children.’’; 
(5) by amending subsection (g) to read as fol-
lows: 
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‘‘(g) AVAILABILITY OF COMMODITIES.— 
‘‘(1) IN GENERAL.—Subject to paragraph (2), 
during fiscal year 2020, the Secretary of Agriculture 
may purchase commodities for emergency distribu-
tion in any area of the United States during a public 
health emergency designation. 
‘‘(2) PURCHASES.—Funds made available to 
carry out this subsection on or after the date of the 
enactment of the Child Nutrition and Related Pro-
grams Recovery Act may only be used to purchase 
commodities for emergency distribution— 
‘‘(A) under commodity distribution pro-
grams and child nutrition programs that were 
established and administered by the Food and 
Nutrition Service on or before the day before 
the date of the enactment of the Families First 
Coronavirus Response Act (Public Law 116– 
127); 
‘‘(B) to Tribal organizations (as defined in 
section 3 of the Food and Nutrition Act of 
2008 (7 U.S.C. 2012)), that are not admin-
istering the food distribution program estab-
lished under section 4(b) of the Food and Nu-
trition Act of 2008 (7 U.S.C. 2013(b)); or 
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‘‘(C) to emergency feeding organizations 
that are eligible recipient agencies (as such 
terms are defined in section 201A of the Emer-
gency Food Assistance Act of 1983 (7 U.S.C. 
7501)).’’; 
(6) by redesignating subsections (h) and (i) as 
subsections (l) and (m); 
(7) by inserting after subsection (g) the fol-
lowing: 
‘‘(h) AMOUNT OF BENEFITS.— 
‘‘(1) IN GENERAL.—A household shall receive 
benefits under this section in an amount equal to 1 
breakfast and 1 lunch at the free rate for each eligi-
ble child or child care covered child in such house-
hold for each day. 
‘‘(2) TREATMENT OF NEWLY ELIGIBLE CHIL-
DREN.—In the case of a child who becomes an eligi-
ble child during a public health emergency designa-
tion, the Secretary and State agency shall— 
‘‘(A) if such child becomes an eligible child 
during school year 2019–2020, treat such child 
as if such child was an eligible child as of the 
date the school in which the child is enrolled 
closed; and 
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‘‘(B) if such child becomes an eligible child 
after school year 2019–2020, treat such child 
as an eligible child as of the first day of the 
month in which such child becomes so eligible. 
‘‘(i) CHILD CARE COVERED CHILD ASSISTANCE.— 
‘‘(1) IN GENERAL.—During fiscal years 2020 
and 2021, in any case in which a child care center 
is closed for at least 5 consecutive days during a 
public health emergency designation, each household 
containing at least 1 member who is a child care 
covered child attending the child care center shall be 
eligible until the schools in the State in which such 
child care center is located reopen, as determined by 
the Secretary, to receive assistance pursuant to— 
‘‘(A) a State agency plan approved under 
subsection (b) that includes— 
‘‘(i) an application by the State agen-
cy seeking to participate in the program 
under this subsection; and 
‘‘(ii) a State agency plan for tem-
porary emergency standards of eligibility 
and levels of benefits under the Food and 
Nutrition Act of 2008 (7 U.S.C. 2011 et 
seq.) for households with child care covered 
children; or 
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‘‘(B) an addendum application described in 
paragraph (2). 
‘‘(2) ADDENDUM APPLICATION.—In the case of 
a State agency that submits a plan to the Secretary 
of Agriculture under subsection (b) that does not in-
clude an application or plan described in clauses (i) 
and (ii) of paragraph (1)(A), such State agency may 
apply to participate in the program under this sub-
section by submitting to the Secretary of Agriculture 
an addendum application for approval that includes 
a State agency plan described in such clause (ii). 
‘‘(3) REQUIREMENTS FOR PARTICIPATION.—A 
State agency may not participate in the program 
under this subsection if— 
‘‘(A) the State agency plan submitted by 
such State agency under subsection (b) with re-
spect to eligible children is not approved by the 
Secretary under such subsection; or 
‘‘(B) the State agency plan submitted by 
such State agency under subsection (b) or this 
subsection with respect to child care covered 
children is not approved by the Secretary under 
either such subsection. 
‘‘(4) AUTOMATIC ENROLLMENT.— 
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‘‘(A) IN
GENERAL.—Subject to subpara-
graph (B), the Secretary shall deem a child who 
is less than 6 years of age to be a child care 
covered child eligible to receive assistance under 
this subsection if— 
‘‘(i) the household with such child at-
tests that such child is a child care covered 
child; 
‘‘(ii) such child resides in a household 
that includes an eligible child; 
‘‘(iii) such child receives cash assist-
ance benefits under the temporary assist-
ance for needy families program under 
part A of title IV of the Social Security 
Act (42 U.S.C. 601 et seq.); 
‘‘(iv) such child receives assistance 
under the Child Care and Development 
Block Grant Act of 1990 (42 U.S.C. 9857 
et seq.); 
‘‘(v) such child is— 
‘‘(I) enrolled as a participant in a 
Head Start program authorized under 
the Head Start Act (42 U.S.C. 9831 
et seq.); 
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‘‘(II) a foster child whose care 
and placement is the responsibility of 
an agency that administers a State 
plan under part B or E of title IV of 
the Social Security Act (42 U.S.C. 
621 et seq.); 
‘‘(III) a foster child who a court 
has placed with a caretaker house-
hold; or 
‘‘(IV) a homeless child or youth 
(as defined in section 725(2) of the 
McKinney-Vento Homeless Assistance 
Act (42 U.S.C. 11434a(2))); 
‘‘(vi) such child participates in the 
special supplemental nutrition program for 
women, infants, and children under section 
17 of the Child Nutrition Act of 1966 (42 
U.S.C. 1786); 
‘‘(vii) through the use of information 
obtained by the State agency for the pur-
pose of participating in the supplemental 
nutrition assistance program under the 
Food and Nutrition Act of 2008 (7 U.S.C. 
2011 et seq.), the State agency elects to 
treat as a child care covered child each 
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child less than 6 years of age who is a 
member of a household that receives sup-
plemental nutrition assistance program 
benefits under such Act; or 
‘‘(viii) the State in which such child 
resides determines that such child is a 
child care covered child, using State data 
approved by the Secretary. 
‘‘(B) ACCEPTANCE
OF
ANY
FORM
OF 
AUTOMATIC ENROLLMENT.— 
‘‘(i) ONE
CATEGORY.—For purposes 
of deeming a child to be a child care cov-
ered child under subparagraph (A), a State 
agency may not be required to show that 
a child meets more than one requirement 
specified in clauses (i) through (viii) of 
such subparagraph. 
‘‘(ii) DEEMING REQUIREMENT.—If a 
State agency submits to the Secretary in-
formation that a child meets any one of 
the requirements specified in clauses (i) 
through (viii) of subparagraph (A), the 
Secretary shall deem such child a child 
care covered child under such subpara-
graph. 
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‘‘(j) EXCLUSIONS.—The provisions of section 16 of 
the Food and Nutrition Act of 2008 (7 U.S.C. 2025) re-
lating to quality control shall not apply with respect to 
assistance provided under this section. 
‘‘(k) FEASIBILITY ANALYSIS.— 
‘‘(1) IN
GENERAL.—Not later than 30 days 
after the date of the enactment of the Child Nutri-
tion and Related Programs Recovery Act, the Sec-
retary shall submit to the Education and Labor 
Committee and the Agriculture Committee of the 
House of Representatives and the Committee on Ag-
riculture, Nutrition, and Forestry of the Senate a 
report on— 
‘‘(A) the feasibility of implementing the 
program for eligible children under this section 
using an EBT system in Puerto Rico, the Com-
monwealth of the Northern Mariana Islands, 
and American Samoa similar to the manner in 
which the supplemental nutrition assistance 
program under the Food and Nutrition Act of 
2008 is operated in the States, including an 
analysis of— 
‘‘(i) the current nutrition assistance 
program issuance infrastructure; 
‘‘(ii) the availability of— 
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‘‘(I) an EBT system, including 
the ability for authorized retailers to 
accept EBT cards; and 
‘‘(II) EBT cards; 
‘‘(iii) the ability to limit purchases 
using nutrition assistance program benefits 
to food for home consumption; and 
‘‘(iv) the availability of reliable data 
necessary for the implementation of such 
program under this section for eligible chil-
dren and child care covered children, in-
cluding the names of such children and the 
mailing addresses of their households; and 
‘‘(B) the feasibility of implementing the 
program for child care covered children under 
subsection (i) in Puerto Rico, the Common-
wealth of the Northern Mariana Islands, and 
American Samoa, including with respect to such 
program each analysis specified in clauses (i) 
through (iv) of subparagraph (A). 
‘‘(2) CONTINGENT AVAILABILITY OF PARTICIPA-
TION.—Beginning 30 days after the date of the en-
actment of the Child Nutrition and Related Pro-
grams Recovery Act, Puerto Rico, the Common-
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wealth of the Northern Mariana Islands, and Amer-
ican Samoa may each— 
‘‘(A) submit a plan under subsection (b), 
unless the Secretary makes a finding, based on 
the analysis provided under paragraph (1)(A), 
that the implementation of the program for eli-
gible children under this section is not feasible 
in such territories; and 
‘‘(B) submit a plan under subsection (i), 
unless the Secretary makes a finding, based on 
the analysis provided under paragraph (1)(B), 
that the implementation of the program for 
child care covered children under subsection (i) 
is not feasible in such territories. 
‘‘(3) TREATMENT
OF
PLANS
SUBMITTED
BY 
TERRITORIES.—Notwithstanding any other provision 
of law, with respect to a plan submitted pursuant to 
this subsection by Puerto Rico, the Commonwealth 
of the Northern Mariana Islands, or American 
Samoa under subsection (b) or subsection (i), the 
Secretary shall treat such plan in the same manner 
as a plan submitted by a State agency under such 
subsection, including with respect to the terms of 
funding provided under subsection (m).’’; 
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(8) in subsection (l), as redesigned by para-
graph (7)— 
(A) by redesignating paragraph (1) as 
paragraph (3); 
(B) by redesignating paragraphs (2) and 
(3) as paragraphs (5) and (6), respectively; 
(C) by inserting before paragraph (3) (as 
so redesignated) the following: 
‘‘(1) The term ‘child care center’ means an or-
ganization described in subparagraph (A) or (B) of 
section 17(a)(2) of the Richard B. Russell National 
School Lunch Act (42 U.S.C. 1766(a)(2)) and a 
family or group day care home. 
‘‘(2) The term ‘child care covered child’ means 
a child served under section 17 of the Richard B. 
Russell National School Lunch Act (42 U.S.C. 
1766) who, if not for the closure of the child care 
center attended by the child during a public health 
emergency designation and due to concerns about a 
COVID–19 outbreak, would receive meals under 
such section at the child care center.’’; and 
(D) by inserting after paragraph (3) (as so 
redesignated) the following: 
‘‘(4) The term ‘free rate’ means— 
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‘‘(A) with respect to a breakfast, the rate 
of a free breakfast under the school breakfast 
program under section 4 of the Child Nutrition 
Act of 1966 (42 U.S.C. 1773); and 
‘‘(B) with respect to a lunch, the rate of 
a free lunch under the school lunch program 
under the Richard B. Russell National School 
Lunch Act (42 U.S.C. 1771 et seq.).’’; and 
(9) in subsection (m), as redesignated by para-
graph (7), by inserting ‘‘(including all administrative 
expenses)’’ after ‘‘this section’’. 
TITLE XIII—PUBLIC HEALTH 
ASSISTANCE TO TRIBES 
SEC. 1301. APPROPRIATIONS FOR THE INDIAN HEALTH 
SERVICE. 
HEROES Act Division A, Title V—Department of 
Health & Human Services—Indian Health Service—The 
$2.1 billion in COVID–19 response funding for the Indian 
Health Service. 
SEC. 1302. IMPROVING STATE, LOCAL, AND TRIBAL PUBLIC 
HEALTH SECURITY. 
Section 319C–1 of the Public Health Service Act (42 
U.S.C. 247d–3a) is amended— 
(1) in the section heading, by striking ‘‘AND 
LOCAL’’ and inserting ‘‘, LOCAL, AND TRIBAL’’; 
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(2) in subsection (b)— 
(A) in paragraph (1)— 
(i) in subparagraph (B), by striking 
‘‘or’’ at the end; 
(ii) in subparagraph (C), by striking 
‘‘and’’ at the end and inserting ‘‘or’’; and 
(iii) by adding at the end the fol-
lowing: 
‘‘(D) be an Indian Tribe, Tribal organiza-
tion, or a consortium of Indian Tribes or Tribal 
organizations; and’’; and 
(B) in paragraph (2)— 
(i) in the matter preceding subpara-
graph (A), by inserting ‘‘, as applicable’’ 
after ‘‘including’’; 
(ii) in subparagraph (A)(viii)— 
(I) by inserting ‘‘and Tribal’’ 
after ‘‘with State’’; 
(II) by striking ‘‘(as defined in 
section 8101 of the Elementary and 
Secondary Education Act of 1965)’’ 
and inserting ‘‘and Tribal educational 
agencies (as defined in sections 8101 
and 6132, respectively, of the Elemen-
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tary and Secondary Education Act of 
1965)’’; and 
(III) by inserting ‘‘and Tribal’’ 
after ‘‘and State’’; 
(iii) in subparagraph (G), by striking 
‘‘and tribal’’ and inserting ‘‘Tribal, and 
urban Indian organization’’; and 
(iv) in subparagraph (H), by inserting 
‘‘, Indian Tribes, and urban Indian organi-
zations’’ after ‘‘public health’’; 
(3) in subsection (e), by inserting ‘‘Indian 
Tribes, Tribal organizations, urban Indian organiza-
tions,’’ after ‘‘local emergency plans,’’; 
(4) in subsection (g)(1), by striking ‘‘tribal offi-
cials’’ and inserting ‘‘Tribal officials’’; 
(5) in subsection (h)— 
(A) in paragraph (1)(A)— 
(i) by striking ‘‘through 2023’’ and 
inserting ‘‘and 2020’’; and 
(ii) by inserting before the period ‘‘; 
and $690,000,000 for each of fiscal years 
2021 through 2023 for awards pursuant to 
paragraph (3) (subject to the authority of 
the Secretary to make awards pursuant to 
paragraphs (4) and (5)) and paragraph 
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(8), of which not less than $5,000,000 
shall be reserved each fiscal year for 
awards under paragraph (8)’’; 
(B) in subsection (h)(2)(B), by striking 
‘‘tribal public’’ and inserting ‘‘Tribal public’’; 
(C) in the heading of paragraph (3), by in-
serting ‘‘FOR STATES’’ after ‘‘AMOUNT’’; and 
(D) by adding at the end the following: 
‘‘(8) TRIBAL ELIGIBLE ENTITIES.— 
‘‘(A) 
DETERMINATION
OF
FUNDING 
AMOUNT.— 
‘‘(i) IN
GENERAL.—The Secretary 
shall award at least 10 cooperative agree-
ments under this section, in amounts not 
less than the minimum amount determined 
under clause (ii), to eligible entities de-
scribed in subsection (b)(1)(D) that sub-
mits to the Secretary an application that 
meets the criteria of the Secretary for the 
receipt of such an award and that meets 
other reasonable implementation conditions 
established by the Secretary, in consulta-
tion with Indian Tribes, for such awards. 
If the Secretary receives more than 10 ap-
plications under this section from eligible 
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entities described in subsection (b)(1)(D) 
that meet the criteria and conditions de-
scribed in the previous sentence, the Sec-
retary, in consultation with Indian Tribes, 
may make additional awards under this 
section to such entities. 
‘‘(ii) MINIMUM
AMOUNT.—In deter-
mining the minimum amount of an award 
pursuant to clause (i), the Secretary, in 
consultation with Indian Tribes, shall first 
determine an amount the Secretary con-
siders appropriate for the eligible entity. 
‘‘(B) AVAILABLE
UNTIL
EXPENDED.— 
Amounts provided to a Tribal eligible entity 
under a cooperative agreement under this sec-
tion for a fiscal year and remaining unobligated 
at the end of such year shall remain available 
to such entity during the entirety of the per-
formance period, for the purposes for which 
said funds were provided. 
‘‘(C) NO MATCHING REQUIREMENT.—Sub-
paragraphs (B), (C), and (D) of paragraph (1) 
shall not apply with respect to cooperative 
agreements awarded under this section to eligi-
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ble entities described in subsection (b)(1)(D).’’; 
and 
(6) by adding at the end the following: 
‘‘(l) SPECIAL RULES RELATED TO TRIBAL ELIGIBLE 
ENTITIES.— 
‘‘(1) MODIFICATIONS.—After consultation with 
Indian Tribes, the Secretary may make necessary 
and appropriate modifications to the program under 
this section to facilitate the use of the cooperative 
agreement program by eligible entities described in 
subsection (b)(1)(D). 
‘‘(2) WAIVERS.— 
‘‘(A) IN GENERAL.—Except as provided in 
subparagraph (B), the Secretary may waive or 
specify alternative requirements for any provi-
sion of this section (including regulations) that 
the Secretary administers in connection with 
this section if the Secretary finds that the waiv-
er or alternative requirement is necessary for 
the effective delivery and administration of this 
program with respect to eligible entities de-
scribed in subsection (b)(1)(D). 
‘‘(B) EXCEPTION.—The Secretary may not 
waive or specify alternative requirements under 
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subparagraph (A) relating to labor standards or 
the environment. 
‘‘(3) CONSULTATION.—The Secretary shall con-
sult with Indian Tribes and Tribal organizations on 
the design of this program with respect to such 
Tribes and organizations to ensure the effectiveness 
of the program in enhancing the security of Indian 
Tribes with respect to public health emergencies. 
‘‘(4) REPORTING.— 
‘‘(A) IN GENERAL.—Not later than 2 years 
after the date of enactment of this subsection, 
and as an addendum to the biennial evaluations 
required under subsection (k), the Secretary, in 
coordination with the Director of the Indian 
Health Service, shall— 
‘‘(i) conduct a review of the implemen-
tation of this section with respect to eligi-
ble 
entities 
described 
in 
subsection 
(b)(1)(D), including any factors that may 
have limited its success; and 
‘‘(ii) submit a report describing the 
results of the review described in clause (i) 
to— 
‘‘(I) the Committee on Indian Af-
fairs, the Committee on Health, Edu-
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cation, Labor, and Pensions, and the 
Committee on Appropriations of the 
Senate; and 
‘‘(II) the Subcommittee for In-
digenous Peoples of the United States 
of the Committee on Natural Re-
sources, the Committee on Energy 
and Commerce, and the Committee on 
Appropriations of the House of Rep-
resentatives. 
‘‘(B) 
ANALYSIS
OF
TRIBAL
PUBLIC 
HEALTH
EMERGENCY
INFRASTRUCTURE
LIMI-
TATION.—The Secretary shall include in the 
initial report submitted under subparagraph (A) 
a description of any public health emergency in-
frastructure limitation encountered by eligible 
entities described in subsection (b)(1)(D).’’. 
SEC. 1303. PROVISION OF ITEMS TO INDIAN PROGRAMS 
AND FACILITIES. 
(a) STRATEGIC
NATIONAL
STOCKPILE.—Section 
319F–2(a)(3)(G) of the Public Health Service Act (42 
U.S.C. 247d–6b(a)(3)(G)) is amended by inserting ‘‘, and, 
in the case that the Secretary deploys the stockpile under 
this subparagraph, ensure, in coordination with the appli-
cable States and programs and facilities, that appropriate 
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drugs, vaccines and other biological products, medical de-
vices, and other supplies are deployed by the Secretary di-
rectly to health programs or facilities operated by the In-
dian Health Service, an Indian Tribe, a Tribal organiza-
tion (as those terms are defined in section 4 of the Indian 
Self-Determination and Education Assistance Act (25 
U.S.C. 5304)), or an inter-Tribal consortium (as defined 
in section 501 of the Indian Self-Determination and Edu-
cation Assistance Act (25 U.S.C. 5381)) or through an 
urban Indian organization (as defined in section 4 of the 
Indian Health Care Improvement Act), while avoiding du-
plicative distributions to such programs or facilities’’ be-
fore the semicolon. 
(b) DISTRIBUTION OF QUALIFIED PANDEMIC OR EPI-
DEMIC PRODUCTS TO IHS FACILITIES.—Title III of the 
Public Health Service Act (42 U.S.C. 241 et seq.) is 
amended by inserting after section 319F–4 the following: 
‘‘SEC. 319F–5. DISTRIBUTION OF QUALIFIED PANDEMIC OR 
EPIDEMIC PRODUCTS TO INDIAN PROGRAMS 
AND FACILITIES. 
‘‘In the case that the Secretary distributes qualified 
pandemic or epidemic products (as defined in section 
319F–3(i)(7)) to States or other entities, the Secretary 
shall ensure, in coordination with the applicable States 
and programs and facilities, that, as appropriate, such 
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products are distributed directly to health programs or fa-
cilities operated by the Indian Health Service, an Indian 
Tribe, a Tribal organization (as those terms are defined 
in section 4 of the Indian Self-Determination and Edu-
cation Assistance Act (25 U.S.C. 5304)), or an inter-Trib-
al consortium (as defined in section 501 of the Indian 
Self-Determination and Education Assistance Act (25 
U.S.C. 5381)) or through an urban Indian organization 
(as defined in section 4 of the Indian Health Care Im-
provement Act), while avoiding duplicative distributions to 
such programs or facilities.’’. 
SEC. 1304. HEALTH CARE ACCESS FOR URBAN NATIVE VET-
ERANS. 
Section 405 of the Indian Health Care Improvement 
Act (25 U.S.C. 1645) is amended— 
(1) in subsection (a)(1), by inserting ‘‘urban In-
dian organizations,’’ before ‘‘and tribal organiza-
tions’’; and 
(2) in subsection (c)— 
(A) by inserting ‘‘urban Indian organiza-
tion,’’ before ‘‘or tribal organization’’; and 
(B) by inserting ‘‘an urban Indian organi-
zation,’’ before ‘‘or a tribal organization’’. 
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SEC. 1305. PROPER AND REIMBURSED CARE FOR NATIVE 
VETERANS. 
Section 405(c) of the Indian Health Care Improve-
ment Act (25 U.S.C. 1645(c)) is amended by inserting be-
fore the period at the end the following: ‘‘, regardless of 
whether such services are provided directly by the Service, 
an Indian tribe, or tribal organization, through contract 
health services, or through a contract for travel described 
in section 213(b)’’. 
Æ 
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