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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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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Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Tribal Health Data Im-
provement Act of 2020’’. 
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.—Section 
3101(c) of the Public Health Service Act (42 U.S.C. 
300kk(c)) is amended— 
(1) by amending subparagraph (F) of paragraph 
(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 
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(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. 
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 cen-
ters and Indian Tribes have access to the data 
sources necessary to accomplish their public 
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 
2020, the Secretary shall make available to the 
entities listed in subparagraph (B) all data that 
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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— 
‘‘(i) such entities request the data pur-
suant 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 amended— 
(1) by striking subsections (g) and (h); and 
(2) by redesignating subsection (i) as subsection 
(h). 
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(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: 
‘‘(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 In-
dian 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 In-
dian 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 
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through ‘‘For each federally’’ and inserting ‘‘DATA ANAL-
YSIS.—For each federally’’. 
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 ‘‘jurisdic-
tions’’. 
(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.—Section 
306(f) of the Public Health Service Act (42 U.S.C. 242k(f)) 
is amended— 
(1) by inserting ‘‘the Indian Health Service,’’ be-
fore ‘‘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 
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(f) GRANTS FOR ASSEMBLY AND ANALYSIS OF DATA 
ON
ETHNIC
AND
RACIAL
POPULATIONS.—Section 
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 organiza-
tions, the Tribal Technical Advisory Group of the 
Centers for Medicare & Medicaid Services maintained 
under section 5006(e) of the American Recovery and 
Reinvestment Act of 2009, and the Tribal Advisory 
Committee established by the Centers for Disease Con-
trol and Prevention, in coordination with epidemi-
ology centers, to develop guidelines for State and local 
health agencies to improve the quality and accuracy 
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of data with respect to the birth and death records of 
American Indians and Alaska Natives; 
‘‘(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 Indi-
ans 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 diseases, 
unintentional injuries, environmental health, 
child and adolescent health, maternal health and 
mortality, foodborne and waterborne illness, re-
productive health, and any other notifiable dis-
ease or condition; 
‘‘(iv) encourage States to enter into data sharing 
agreements with Indian Tribes, Tribal organizations, 
and epidemiology centers to improve the quality and 
accuracy of public health data; and 
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‘‘(v) not later than 180 days after the date of en-
actment of the Tribal Health Data Improvement Act 
of 2020, 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 accu-
racy 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 standards for 
the collection of data on race and ethnicity.’’. 
(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 subsection 
(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 In-
dian 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 In-
dian 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 
2021 through 2025. 
‘‘(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).’’. 
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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 re-
spect to the collection and availability of health 
data with respect to Indian Tribes, and for other 
purposes. 
SEPTEMBER 29, 2020 
Reported with an amendment; committed to the Com-
mittee of the Whole House on the State of the Union 
and ordered to be printed 
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