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.
Short title
This Act may be cited as the Tribal Health Data Improvement Act of 2021
.
Collection and availability of health data with respect to Indian Tribes
Data collection
Section 3101(a)(1) of the Public Health Service Act (42 U.S.C. 300kk(a)(1)) is amended—
by striking , by not later than 2 years after the date of enactment of this title,
; and
in subparagraph (B), by inserting Tribal,
after State,
.
Data reporting and dissemination
Section 3101(c) of the Public Health Service Act (42 U.S.C. 300kk(c)) is amended—
by amending subparagraph (F) of paragraph (1) to read as follows:
the Indian Health Service, Indian Tribes, Tribal organizations, and epidemiology centers authorized under the Indian Health Care Improvement Act;
; and
in paragraph (3), by inserting Indian Tribes, Tribal organizations, and epidemiology centers,
after Federal agencies,
.
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:
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 recommendations by the Secretary’s Tribal Advisory Committee for—
ensuring that Tribal epidemiology centers and Indian Tribes have access to the data sources necessary to accomplish their public health responsibilities; and
protecting the privacy and security of such data.
Tribal public health authority
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 programs and activities, including such programs and activities that are federally supported or conducted, so long as—
such entities request the data pursuant to statute; and
the data is requested for use—
consistent with Federal law and obligations; and
to satisfy a particular purpose or carry out a specific function consistent with the purpose for which the data was collected.
Entities
The entities listed in this subparagraph are—
the Indian Health Service;
Indian Tribes and Tribal organizations; and
epidemiology centers.
.
Technical updates
Section 3101 of the Public Health Service Act (42 U.S.C. 300kk) is amended—
by striking subsections (g) and (h); and
by redesignating subsection (i) as subsection (h).
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:
Definitions
In this section:
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.
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.
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.
The term Urban Indian organization has the meaning given to that term in section 4 of the Indian Health Care Improvement Act.
.
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
.
Improving health statistics reporting with respect to Indian Tribes
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 jurisdictions
.
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
.
Federal-State-Tribal cooperation
Section 306(f) of the Public Health Service Act (42 U.S.C. 242k(f)) is amended—
by inserting the Indian Health Service,
before the Departments of Commerce
;
by inserting a comma after the Departments of Commerce and Labor
;
by inserting , Indian Tribes, Tribal organizations, and epidemiology centers
after State and local health departments and agencies
; and
by striking he shall
and inserting the Secretary shall
.
Registration area records
Section 306(h)(1) of the Public Health Service Act (42 U.S.C. 242k(h)(1)) is amended—
by striking in his discretion
and inserting in the discretion of the Secretary
; and
by striking Hispanics, Asian Americans, and Pacific Islanders
and inserting American Indians and Alaska Natives, Hispanics, Asian Americans, and Native Hawaiian and other Pacific Islanders
.
National Committee on Vital and Health Statistics
Section 306(k) of the Public Health Service Act (42 U.S.C. 242k(k)) is amended—
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
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 biennial basis,
.
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—
in subparagraph (A)—
by striking Subject to subparagraph (B), the
and inserting The
; and
by striking and major Hispanic subpopulation groups and American Indians
and inserting , major Hispanic subgroups, and American Indians and Alaska Natives
; and
by amending subparagraph (B) to read as follows:
In carrying out subparagraph (A), with respect to American Indians and Alaska Natives, the Secretary shall—
consult with Indian Tribes, Tribal organizations, 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 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;
confer with Urban Indian organizations 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;
enter into cooperative agreements with Indian Tribes, Tribal organizations, Urban Indian organizations, and epidemiology centers to address misclassification and undersampling of American Indians and Alaska Natives with respect to—
birth and death records; and
health care and public health surveillance 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, reproductive health, and any other notifiable disease or condition;
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
not later than 180 days after the date of enactment of the Tribal Health Data Improvement Act of 2021, and biennially thereafter, issue a report on the following:
Which States have data sharing agreements with Indian Tribes, Tribal organizations, Urban Indian organizations, and Tribal epidemiology centers to improve the quality and accuracy of health data.
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 organizations, and Tribal epidemiology centers to improve the quality and accuracy of health data.
Best practices and guidance for States, Indian Tribes, Tribal organizations, Urban Indian organizations, and Tribal epidemiology centers that wish to enter into data sharing agreements.
Best practices and guidance for local, State, Tribal, and Federal uniform standards for the collection of data on race and ethnicity.
.
Definitions
Section 306 of the Public Health Service Act (42 U.S.C. 242k) is amended—
by redesignating subsection (n) as subsection (o); and
by inserting after subsection (m) the following:
In this section:
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.
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.
The term Tribal organization has the meaning given to the term tribal organization in section 4 of the Indian Self-Determination and Education Assistance Act.
The term Urban Indian organization has the meaning given to that term in section 4 of the Indian Health Care Improvement Act.
.
Authorization of appropriations
Section 306(o) of the Public Health Service Act, as redesignated by subsection (g), is amended to read as follows:
To carry out this section, there is authorized to be appropriated $185,000,000 for each of the fiscal years 2022 through 2026.
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—
administration of this section; and
carrying out subsection (m)(2).
.
Passed the House of Representatives June 23, 2021.
Cheryl L. Johnson,
Clerk