IIB 
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 Representa-
tives of the United States of America in Congress assembled, 
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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.—Sec-
tion 3101(c) of the Public Health Service Act (42 U.S.C. 
300kk(c)) is amended— 
(1) by amending subparagraph (F) of para-
graph (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 cen-
ters,’’ after ‘‘Federal agencies,’’. 
(c) PROTECTION AND SHARING OF DATA.—Section 
3101(e) of the Public Health Service Act (42 U.S.C. 
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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 recommenda-
tions 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 pub-
lic 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 pro-
grams and activities, including such programs 
and activities that are federally supported or 
conducted, so long as— 
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‘‘(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 pur-
pose 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 organi-
zations; and 
‘‘(iii) epidemiology centers.’’. 
(d) TECHNICAL UPDATES.—Section 3101 of the 
Public Health Service Act (42 U.S.C. 300kk) is amend-
ed— 
(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: 
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‘‘(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’’. 
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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 ‘‘ju-
risdictions’’. 
(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.—Sec-
tion 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 Depart-
ments of Commerce and Labor’’; 
(3) by inserting ‘‘, Indian Tribes, Tribal organi-
zations, and epidemiology centers’’ after ‘‘State and 
local health departments and agencies’’; and 
(4) by striking ‘‘he shall’’ and inserting ‘‘the 
Secretary shall’’. 
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(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 In-
dians and Alaska Natives, Hispanics, Asian Ameri-
cans, and Native Hawaiian and other Pacific Island-
ers’’. 
(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 bi-
ennial basis,’’. 
(f) GRANTS FOR ASSEMBLY AND ANALYSIS OF DATA 
ON
ETHNIC
AND
RACIAL
POPULATIONS.—Section 
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