,,ib ,union ,calendar ,no4 #ddf #aafth ,,congress #b;d ,session ,h4 ,r4 #gidh ,report ,no4 #aaf-edf ,,in ,,the ,,house ,,of ,,representatives ,august #g1 #bjbj,mr4 ,gianforte 7for himself1 ,mr4 ,lujn1 ,mrs4 ,rodgers of ,washington1 ,mr4 ,mullin1 ,mr4 ,o',halleran1 and ,mr4 ,ruiz7 introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce ,september #bi1 #bjbj;,additional sponsor3 ,mr4 ,armstrong ,september #bi1 #bjbj,reported with an amendment2 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 bill1 see copy of bill as introduced on ,august #g1 #bjbj ,a ,,bill ,to amend the ,public ,health ,service ,act with respect to the collection and availability of health data with respect to ,indian ,tribes1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,tribal ,health ,data ,improvement ,act of #bjbj4 #b4 ,collection and availability of health data with respect to ,indian ,tribes 7a7 ,data collection ,section #caja7;a77#a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjjkk7a77#a77 is amended-- 7#a7 by striking 1 by not later than #b years after the date of enactment of this title12 and 7#b7 in subparagraph 7,b71 by inserting ,tribal1 after ,state14 7b7 ,data reporting and dissemination ,section #caja7;c7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjjkk7c77 is amended-- 7#a7 by amending subparagraph 7,f7 of paragraph 7#a7 to read as follows3 7,f7 the ,indian ,health ,service1 ,indian ,tribes1 ,tribal organizations1 and epidemiology centers authorized under the ,indian ,health ,care ,improvement ,act2 2 and 7#b7 in paragraph 7#c71 by inserting ,indian ,tribes1 ,tribal organizations1 and epidemiology centers1 after ,federal agencies14 7c7 ,protection and sharing of data ,section #caja7;e7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjjkk7e77 is amended by adding at the end the following new paragraphs3 7#c7 ,data sharing strategy ,with respect to data access for ,tribal epidemiology centers and ,tribes1 the ,secretary shall create a data sharing strategy that takes into consideration recommendations by the ,secretary's ,tribal ,advisory ,committee for-- 7,a7 ensuring that ,tribal epidemiology centers and ,indian ,tribes have access to the data sources necessary to accomplish their public health responsibilities2 and 7,b7 protecting the privacy and security of such data4 7#d7 ,tribal public health authority 7,a7 ,availability ,beginning not later than #ahj days after the date of the enactment of the ,tribal ,health ,data ,improvement ,act of #bjbj1 the ,secretary shall make available to the entities listed in subparagraph 7,b7 all data that is collected pursuant to this title with respect to health care and public health surveillance programs and activities1 including such programs and activities that are federally supported or conducted1 so long as-- 7i7 such entities request the data pursuant to statute2 and 7ii7 the data is requested for use-- 7,i7 consistent with ,federal law and obligations2 and 7,,ii7 to satisfy a particular purpose or carry out a specific function consistent with the purpose for which the data was collected4 7,b7 ,entities ,the entities listed in this subparagraph are-- 7i7 the ,indian ,health ,service2 7ii7 ,indian ,tribes and ,tribal organizations2 and 7iii7 epidemiology centers4 4 7d7 ,technical updates ,section #caja of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjjkk7 is amended-- 7#a7 by striking subsections 7g7 and 7h72 and 7#b7 by redesignating subsection 7i7 as subsection 7h74 7e7 ,definitions ,after executing the amendments made by subsection 7d71 section #caja of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjjkk7 is amended by inserting after subsection 7f7 the following new subsection3 7g7 ,definitions ,in this section3 7#a7 ,the term epidemiology center means an epidemiology center established under section #bad of the ,indian ,health ,care ,improvement ,act1 including such ,tribal epidemiology centers serving ,indian ,tribes regionally and any ,tribal epidemiology center serving ,urban ,indian organizations nationally4 7#b7 ,the term ,indian ,tribe has the meaning given to the term ,indian tribe in section #d of the ,indian ,self-,determination and ,education ,assistance ,act4 7#c7 ,the term ,tribal organization has the meaning given to the term tribal organization in section #d of the of the ,indian ,self-,determination and ,education ,assistance ,act4 7#d7 ,the term ,urban ,indian organization has the meaning given to that term in section #d of the ,indian ,health ,care ,improvement ,act4 4 7f7 ,technical correction ,section #caja7;b7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjjkk7b77 is amended by striking ,data analysis4-- and all that follows through ,for each federally and inserting ,data analysis4--,for each federally4 #c4 ,improving health statistics reporting with respect to ,indian ,tribes 7a7 ,technical aid to ,states and localities ,section #cjf7;d7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdbk7d77 is amended by inserting 1 ,indian ,tribes1 ,tribal organizations1 and epidemiology centers after jurisdictions4 7b7 ,cooperative health statistics system ,section #cjf7;e77#c7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdbk7e77#c77 is amended by inserting 1 ,indian ,tribes1 ,tribal organizations1 and epidemiology centers after health agencies4 7c7 ,federal-,state-,tribal cooperation ,section #cjf7;f7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdbk7f77 is amended-- 7#a7 by inserting the ,indian ,health ,service1 before the ,departments of ,commerce2 7#b7 by inserting a comma after the ,departments of ,commerce and ,labor2 7#c7 by inserting 1 ,indian ,tribes1 ,tribal organizations1 and epidemiology centers after ,state and local health departments and agencies2 and 7#d7 by striking he shall and inserting the ,secretary shall4 7d7 ,registration area records ,section #cjf7;h77#a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdbk7h77#a77 is amended-- 7#a7 by striking in his discretion and inserting in the discretion of the ,secretary2 and 7#b7 by striking ,hispanics1 ,asian ,americans1 and ,pacific ,islanders and inserting ,american ,indians and ,alaska ,natives1 ,hispanics1 ,asian ,americans1 and ,native ,hawaiian and other ,pacific ,islanders4 7e7 ,national ,committee on ,vital and ,health ,statistics ,section #cjf7k7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdbk7k77 is amended-- 7#a7 in paragraph 7#c71 by striking 1 not later than #fj days after the date of the enactment of the ,health ,insurance ,portability and ,accountability ,act of #aiif1 each place it appears2 and 7#b7 in paragraph 7#g71 by striking ,not later than #a year after the date of the enactment of the ,health ,insurance ,portability and ,accountability ,act of #aiif1 and annually thereafter1 the ,committee shall and inserting ,the ,committee shall1 on an biennial basis14 7f7 ,grants for assembly and analysis of data on ethnic and racial populations ,section #cjf7m77#d7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdbk7m77#d77 is amended-- 7#a7 in subparagraph 7,a7-- 7,a7 by striking ,subject to subparagraph 7,b71 the and inserting ,the2 and 7,b7 by striking and major ,hispanic subpopulation groups and ,american ,indians and inserting 1 major ,hispanic subgroups1 and ,american ,indians and ,alaska ,natives2 and 7#b7 by amending subparagraph 7,b7 to read as follows3 7,b7 ,in carrying out subparagraph 7,a71 with respect to ,american ,indians and ,alaska ,natives1 the ,secretary shall-- 7i7 consult with ,indian ,tribes1 ,tribal organizations1 the ,tribal ,technical ,advisory ,group of the ,centers for ,medicare ,medicaid ,services maintained under section #ejjf7;e7 of the ,american ,recovery and ,reinvestment ,act of #bjji1 and the ,tribal ,advisory ,committee established by the ,centers for ,disease ,control and ,prevention1 in coordination with epidemiology centers1 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 ,natives2 7ii7 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 ,natives2 7iii7 enter into cooperative agreements with ,indian ,tribes1 ,tribal organizations1 ,urban ,indian organizations1 and epidemiology centers to address misclassification and undersampling of ,american ,indians and ,alaska ,natives with respect to-- 7,i7 birth and death records2 and 7,,ii7 health care and public health surveillance systems1 including1 but not limited to1 data with respect to chronic and infectious diseases1 unintentional injuries1 environmental health1 child and adolescent health1 maternal health and mortality1 foodborne and waterborne illness1 reproductive health1 and any other notifiable disease or condition2 7iv7 encourage ,states to enter into data sharing agreements with ,indian ,tribes1 ,tribal organizations1 and epidemiology centers to improve the quality and accuracy of public health data2 and 7v7 not later than #ahj days after the date of enactment of the ,tribal ,health ,data ,improvement ,act of #bjbj1 and biennially thereafter1 issue a report on the following3 7,i7 ,which ,states have data sharing agreements with ,indian ,tribes1 ,tribal organizations1 ,urban ,indian organizations1 and ,tribal epidemiology centers to improve the quality and accuracy of health data4 7,,ii7 ,what the ,centers for ,disease ,control and ,prevention is doing to encourage ,states to enter into data sharing agreements with ,indian ,tribes1 ,tribal organizations1 ,urban ,indian organizations1 and ,tribal epidemiology centers to improve the quality and accuracy of health data4 7,,iii7 ,best practices and guidance for ,states1 ,indian ,tribes1 ,tribal organizations1 ,urban ,indian organizations1 and ,tribal epidemiology centers that wish to enter into data sharing agreements4 7,,iv7 ,best practices and guidance for local1 ,state1 ,tribal1 and ,federal uniform standards for the collection of data on race and ethnicity4 4 7g7 ,definitions ,section #cjf of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdbk7 is amended-- 7#a7 by redesignating subsection 7n7 as subsection 7o72 and 7#b7 by inserting after subsection 7m7 the following3 7n7 ,in this section3 7#a7 ,the term epidemiology center means an epidemiology center established under section #bad of the ,indian ,health ,care ,improvement ,act1 including such ,tribal epidemiology centers serving ,indian ,tribes regionally and any ,tribal epidemiology center serving ,urban ,indian organizations nationally4 7#b7 ,the term ,indian ,tribe has the meaning given to the term ,indian tribe in section #d of the ,indian ,self-,determination and ,education ,assistance ,act4 7#c7 ,the term ,tribal organization has the meaning given to the term tribal organization in section #d of the ,indian ,self-,determination and ,education ,assistance ,act4 7#d7 ,the term ,urban ,indian organization has the meaning given to that term in section #d of the ,indian ,health ,care ,improvement ,act4 4 7h7 ,authorization of appropriations ,section #cjf7o7 of the ,public ,health ,service ,act1 as redesignated by subsection 7g71 is amended to read as follows3 7o7 7#a7 ,to carry out this section1 there is authorized to be appropriated #ahe1jjj1jjj for each of the fiscal years #bjba through #bjbe4 7#b7 ,of the amount authorized to be appropriated to carry out this section for a fiscal year1 the ,secretary shall not use more than #aj percent for the combined costs of-- 7,a7 administration of this section2 and 7,b7 carrying out subsection 7m77#b74 4 ,september #bi1 #bjbj,reported with an amendment2 committed to the ,committee of the ,whole ,house on the ,state of the ,union and ordered to be printed