HR 3841 RFS
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 sub-
population 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 organi-
zations, the Tribal Technical Advisory Group of the 
Centers for Medicare & Medicaid Services main-
tained under section 5006(e) of the American Recov-
ery 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; 
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‘‘(ii) confer with Urban Indian organizations to 
develop guidelines for State and local health agencies 
to improve the quality and accuracy of data with re-
spect to the birth and death records of American In-
dians and Alaska Natives; 
‘‘(iii) enter into cooperative agreements with In-
dian Tribes, Tribal organizations, Urban Indian or-
ganizations, and epidemiology centers to address 
misclassification and undersampling of American In-
dians and Alaska Natives with respect to— 
‘‘(I) birth and death records; and 
‘‘(II) health care and public health surveil-
lance systems, including, but not limited to, 
data with respect to chronic and infectious dis-
eases, 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 shar-
ing agreements with Indian Tribes, Tribal organiza-
tions, and epidemiology centers to improve the qual-
ity and accuracy of public health data; and 
‘‘(v) not later than 180 days after the date of 
enactment of the Tribal Health Data Improvement 
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Act of 2021, and biennially thereafter, issue a report 
on the following: 
‘‘(I) Which States have data sharing agree-
ments with Indian Tribes, Tribal organizations, 
Urban Indian organizations, and Tribal epide-
miology centers to improve the quality and ac-
curacy 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 or-
ganizations, 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 epide-
miology centers that wish to enter into data 
sharing agreements. 
‘‘(IV) Best practices and guidance for 
local, State, Tribal, and Federal uniform stand-
ards for the collection of data on race and eth-
nicity.’’. 
(g) DEFINITIONS.—Section 306 of the Public Health 
Service Act (42 U.S.C. 242k) is amended— 
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(1) by redesignating subsection (n) as sub-
section (o); and 
(2) by inserting after subsection (m) the fol-
lowing: 
‘‘(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 Edu-
cation 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: 
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‘‘(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. 
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