,,ib ,union ,cal5d> ,no4 #ddf #aaf?     
,,congress  #b;d ,session  ,h4 ,r4 #gidh
 ,report ,no4 #aaf-edf ,,9 ,,! ,,h\se   
,,( ,,repres5tatives  ,augu/ #g1        
#bjbj,mr4 ,gian=te 7= himself1 ,mr4     
,lujn1 ,mrs4 ,rodg]s ( ,wa%+ton1 ,mr4   
,mull91 ,mr4 ,o',hall]an1 & ,mr4 ,ruiz7 
introduc$ ! foll[+ bill2 :i* 0 ref]r$ to
 ! ,committee on ,en]gy & ,comm]ce      
,septemb] #bi1 #bjbj;,additional        
sponsor3 ,mr4 ,arm/rong  ,septemb] #bi1 
#bjbj,report$ ) an am5dm5t2 committ$ to 
! ,committee ( ! ,:ole ,h\se on ! ,/ate 
( ! ,union & ord]$ to be printed,strike 
out all aft] ! enact+ clause & ins]t !  
"p pr9t$ 9 italic,for text ( introduc$  
bill1 see copy ( bill z introduc$ on    
,augu/ #g1 #bjbj  ,a ,,bill  ,to am5d ! 
,public ,heal? ,s]vice ,act ) respect to
 ! collection & availability ( heal?    
data ) respect to ,indian ,tribes1 & =  
o!r purposes4  #a4 ,%ort title ,?is ,act
 may be cit$ z ! ,tribal ,heal? ,data   
,improvem5t ,act ( #bjbj4  #b4          
,collection & availability ( heal? data 

) respect to ,indian ,tribes  7a7 ,data 
collection ,section #caja7;a77#a7 ( !   
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #cjjkk7a77#a77 is am5d$-- 7#a7
 by /rik+ 1 by n lat] ?an #b ye>s aft] !
 date ( enactm5t ( ?is title12 &  7#b7 9
 subp>agraph 7,b71 by ins]t+ ,tribal1   
aft] ,/ate14  7b7 ,data report+ &       
dissem9ation ,section #caja7;c7 ( !     
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #cjjkk7c77 is am5d$-- 7#a7 by 
am5d+ subp>agraph 7,f7 ( p>agraph 7#a7  
to read z foll[s3  7,f7 ! ,indian ,heal?
 ,s]vice1 ,indian ,tribes1 ,tribal      
organizations1 & epidemiology c5t]s     
au?oriz$ "u ! ,indian ,heal? ,c>e       
,improvem5t ,act2  2 &  7#b7 9 p>agraph 
7#c71 by ins]t+ ,indian ,tribes1 ,tribal
 organizations1 & epidemiology c5t]s1   
aft] ,f$]al ag5cies14  7c7 ,protection &
 %>+ ( data ,section #caja7;e7 ( !      
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #cjjkk7e77 is am5d$ by add+ at
 ! end ! foll[+ new p>agraphs3  7#c7    
,data %>+ /rategy ,) respect to data    

access = ,tribal epidemiology c5t]s &   
,tribes1 ! ,secret>y %all create a data 
%>+ /rategy t takes into consid]ation   
recomm5dations by ! ,secret>y's ,tribal 
,advisory ,committee =-- 7,a7 ensur+ t  
,tribal epidemiology c5t]s & ,indian    
,tribes h access to ! data s\rces       
necess>y to accompli% _! public heal?   
responsibilities2 &  7,b7 protect+ !    
privacy & security ( su* data4  7#d7    
,tribal public heal? au?ority  7,a7     
,availability ,beg9n+ n lat] ?an #ahj   
days aft] ! date ( ! enactm5t ( !       
,tribal ,heal? ,data ,improvem5t ,act ( 
#bjbj1 ! ,secret>y %all make available  
to ! entities li/$ 9 subp>agraph 7,b7   
all data t is collect$ pursuant to ?is  
title ) respect to heal? c>e & public   
heal? surveillance programs &           
activities1 includ+ su* programs &      
activities t are f$]ally support$ or    
conduct$1 s long z-- 7i7 su* entities   
reque/ ! data pursuant to /atute2 &     
7ii7 ! data is reque/$ = use-- 7,i7     
consi/5t ) ,f$]al law & obligations2 &  

7,,ii7 to satisfy a p>ticul> purpose or 
c>ry out a specific function consi/5t ) 
! purpose = :i* ! data 0 collect$4  7,b7
 ,entities ,! entities li/$ 9 ?is       
subp>agraph are-- 7i7 ! ,indian ,heal?  
,s]vice2  7ii7 ,indian ,tribes & ,tribal
 organizations2 &  7iii7 epidemiology   
c5t]s4  4  7d7 ,te*nical updates        
,section #caja ( ! ,public ,heal?       
,s]vice ,act 7#db ,u4,s4,c4 #cjjkk7 is  
am5d$-- 7#a7 by /rik+ subsections 7g7 & 
7h72 &  7#b7 by r$esignat+ subsection   
7i7 z subsection 7h74  7e7 ,def9itions  
,aft] execut+ ! am5dm5ts made by        
subsection 7d71 section #caja ( !       
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #cjjkk7 is am5d$ by ins]t+    
aft] subsection 7f7 ! foll[+ new        
subsection3  7g7 ,def9itions ,9 ?is     
section3 7#a7 ,! t]m epidemiology c5t]  
means an epidemiology c5t] e/abli%$ "u  
section #bad ( ! ,indian ,heal? ,c>e    
,improvem5t ,act1 includ+ su* ,tribal   
epidemiology c5t]s s]v+ ,indian ,tribes 
regionally & any ,tribal epidemiology   

c5t] s]v+ ,urban ,indian organizations  
nationally4  7#b7 ,! t]m ,indian ,tribe 
has ! mean+ giv5 to ! t]m ,indian tribe 
9 section #d ( ! ,indian                
,self-,det]m9ation & ,education         
,assi/ance ,act4  7#c7 ,! t]m ,tribal   
organization has ! mean+ giv5 to ! t]m  
tribal organization 9 section #d ( ! ( !
 ,indian ,self-,det]m9ation & ,education
 ,assi/ance ,act4  7#d7 ,! t]m ,urban   
,indian organization has ! mean+ giv5 to
 t t]m 9 section #d ( ! ,indian ,heal?  
,c>e ,improvem5t ,act4  4  7f7 ,te*nical
 correction ,section #caja7;b7 ( !      
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #cjjkk7b77 is am5d$ by /rik+  
,data analysis4-- & all t foll[s ?r\gh  
,= ea* f$]ally & ins]t+ ,data           
analysis4--,= ea* f$]ally4  #c4 ,improv+
 heal? /ati/ics report+ ) respect to    
,indian ,tribes  7a7 ,te*nical aid to   
,/ates & localities ,section #cjf7;d7 ( 
! ,public ,heal? ,s]vice ,act 7#db      
,u4,s4,c4 #bdbk7d77 is am5d$ by ins]t+ 1
 ,indian ,tribes1 ,tribal organizations1

 & epidemiology c5t]s aft]              
jurisdictions4  7b7 ,coop]ative heal?   
/ati/ics sy/em ,section #cjf7;e77#c7 ( !
 ,public ,heal? ,s]vice ,act 7#db       
,u4,s4,c4 #bdbk7e77#c77 is am5d$ by     
ins]t+ 1 ,indian ,tribes1 ,tribal       
organizations1 & epidemiology c5t]s aft]
 heal? ag5cies4  7c7                    
,f$]al-,/ate-,tribal coop]ation ,section
 #cjf7;f7 ( ! ,public ,heal? ,s]vice    
,act 7#db ,u4,s4,c4 #bdbk7f77 is am5d$--
 7#a7 by ins]t+ ! ,indian ,heal?        
,s]vice1 be=e ! ,dep>tm5ts ( ,comm]ce2  
7#b7 by ins]t+ a comma aft] ! ,dep>tm5ts
 ( ,comm]ce & ,labor2  7#c7 by ins]t+ 1 
,indian ,tribes1 ,tribal organizations1 
& epidemiology c5t]s aft] ,/ate & local 
heal? dep>tm5ts & ag5cies2 &  7#d7 by   
/rik+ he %all & ins]t+ ! ,secret>y %all4
  7d7 ,regi/ration area records ,section
 #cjf7;h77#a7 ( ! ,public ,heal? ,s]vice
 ,act 7#db ,u4,s4,c4 #bdbk7h77#a77 is   
am5d$-- 7#a7 by /rik+ 9 8 discretion &  
ins]t+ 9 ! discretion ( ! ,secret>y2 &  
7#b7 by /rik+ ,hispanics1 ,asian        

,am]icans1 & ,pacific ,isl&]s & ins]t+  
,am]ican ,indians & ,alaska ,natives1   
,hispanics1 ,asian ,am]icans1 & ,native 
,hawaiian & o!r ,pacific ,isl&]s4  7e7  
,national ,committee on ,vital & ,heal? 
,/ati/ics ,section #cjf7k7 ( ! ,public  
,heal? ,s]vice ,act 7#db ,u4,s4,c4      
#bdbk7k77 is am5d$-- 7#a7 9 p>agraph    
7#c71 by /rik+ 1 n lat] ?an #fj days    
aft] ! date ( ! enactm5t ( ! ,heal?     
,insurance ,portability & ,acc\ntability
 ,act ( #aiif1 ea* place x appe>s2 &    
7#b7 9 p>agraph 7#g71 by /rik+ ,n lat]  
?an #a ye> aft] ! date ( ! enactm5t ( ! 
,heal? ,insurance ,portability &        
,acc\ntability ,act ( #aiif1 & annually 
!reaft]1 ! ,committee %all & ins]t+ ,!  
,committee %all1 on an bi5nial basis14  
7f7 ,grants = assembly & analysis ( data
 on e?nic & racial populations ,section 
#cjf7m77#d7 ( ! ,public ,heal? ,s]vice  
,act 7#db ,u4,s4,c4 #bdbk7m77#d77 is    
am5d$-- 7#a7 9 subp>agraph 7,a7-- 7,a7  
by /rik+ ,subject to subp>agraph 7,b71 !
 & ins]t+ ,!2 &  7,b7 by /rik+ & major  

,hispanic subpopulation gr\ps & ,am]ican
 ,indians & ins]t+ 1 major ,hispanic    
subgr\ps1 & ,am]ican ,indians & ,alaska 
,natives2 &  7#b7 by am5d+ subp>agraph  
7,b7 to read z foll[s3  7,b7 ,9 c>ry+   
out subp>agraph 7,a71 ) respect to      
,am]ican ,indians & ,alaska ,natives1 ! 
,secret>y %all-- 7i7 consult ) ,indian  
,tribes1 ,tribal organizations1 !       
,tribal ,te*nical ,advisory ,gr\p ( !   
,c5t]s = ,m$ic>e  ,m$icaid ,s]vices     
ma9ta9$ "u section #ejjf7;e7 ( !        
,am]ican ,recov]y & ,re9ve/m5t ,act (   
#bjji1 & ! ,tribal ,advisory ,committee 
e/abli%$ by ! ,c5t]s = ,disease ,control
 & ,prev5tion1 9 coord9ation )          
epidemiology c5t]s1 to develop guidel9es
 = ,/ate & local heal? ag5cies to       
improve ! quality & accuracy ( data )   
respect to ! bir? & dea? records (      
,am]ican ,indians & ,alaska ,natives2   
7ii7 conf] ) ,urban ,indian             
organizations to develop guidel9es =    
,/ate & local heal? ag5cies to improve !
 quality & accuracy ( data ) respect to 

! bir? & dea? records ( ,am]ican        
,indians & ,alaska ,natives2  7iii7 ent]
 into coop]ative agreem5ts ) ,indian    
,tribes1 ,tribal organizations1 ,urban  
,indian organizations1 & epidemiology   
c5t]s to address misclassification &    
und]sampl+ ( ,am]ican ,indians & ,alaska
 ,natives ) respect to-- 7,i7 bir? &    
dea? records2 &  7,,ii7 heal? c>e &     
public heal? surveillance sy/ems1       
includ+1 b n limit$ to1 data ) respect  
to *ronic & infecti\s diseases1         
un9t5tional injuries1 environm5tal      
heal?1 *ild & adolesc5t heal?1 mat]nal  
heal? & mortality1 foodborne & wat]borne
 illness1 reproductive heal?1 & any o!r 
notifiable disease or condition2  7iv7  
enc\rage ,/ates to ent] into data %>+   
agreem5ts ) ,indian ,tribes1 ,tribal    
organizations1 & epidemiology c5t]s to  
improve ! quality & accuracy ( public   
heal? data2 &  7v7 n lat] ?an #ahj days 
aft] ! date ( enactm5t ( ! ,tribal      
,heal? ,data ,improvem5t ,act ( #bjbj1 &
 bi5nially !reaft]1 issue a report on ! 

foll[+3 7,i7 ,:i* ,/ates h data %>+     
agreem5ts ) ,indian ,tribes1 ,tribal    
organizations1 ,urban ,indian           
organizations1 & ,tribal epidemiology   
c5t]s to improve ! quality & accuracy ( 
heal? data4  7,,ii7 ,:at ! ,c5t]s =     
,disease ,control & ,prev5tion is do+ to
 enc\rage ,/ates to ent] into data %>+  
agreem5ts ) ,indian ,tribes1 ,tribal    
organizations1 ,urban ,indian           
organizations1 & ,tribal epidemiology   
c5t]s to improve ! quality & accuracy ( 
heal? data4  7,,iii7 ,be/ practices &   
guidance = ,/ates1 ,indian ,tribes1     
,tribal organizations1 ,urban ,indian   
organizations1 & ,tribal epidemiology   
c5t]s t wi% to ent] into data %>+       
agreem5ts4  7,,iv7 ,be/ practices &     
guidance = local1 ,/ate1 ,tribal1 &     
,f$]al uni=m /&>ds = ! collection ( data
 on race & e?nicity4  4  7g7 ,def9itions
 ,section #cjf ( ! ,public ,heal?       
,s]vice ,act 7#db ,u4,s4,c4 #bdbk7 is   
am5d$-- 7#a7 by r$esignat+ subsection   
7n7 z subsection 7o72 &  7#b7 by ins]t+ 

aft] subsection 7m7 ! foll[+3  7n7 ,9   
?is section3 7#a7 ,! t]m epidemiology   
c5t] means an epidemiology c5t] e/abli%$
 "u section #bad ( ! ,indian ,heal? ,c>e
 ,improvem5t ,act1 includ+ su* ,tribal  
epidemiology c5t]s s]v+ ,indian ,tribes 
regionally & any ,tribal epidemiology   
c5t] s]v+ ,urban ,indian organizations  
nationally4  7#b7 ,! t]m ,indian ,tribe 
has ! mean+ giv5 to ! t]m ,indian tribe 
9 section #d ( ! ,indian                
,self-,det]m9ation & ,education         
,assi/ance ,act4  7#c7 ,! t]m ,tribal   
organization has ! mean+ giv5 to ! t]m  
tribal organization 9 section #d ( !    
,indian ,self-,det]m9ation & ,education 
,assi/ance ,act4  7#d7 ,! t]m ,urban    
,indian organization has ! mean+ giv5 to
 t t]m 9 section #d ( ! ,indian ,heal?  
,c>e ,improvem5t ,act4  4  7h7          
,au?orization ( appropriations ,section 
#cjf7o7 ( ! ,public ,heal? ,s]vice ,act1
 z r$esignat$ by subsection 7g71 is     
am5d$ to read z foll[s3  7o7 7#a7 ,to   
c>ry out ?is section1 !re is au?oriz$ to

 be appropriat$ #ahe1jjj1jjj = ea* ( !  
fiscal ye>s #bjba ?r\gh #bjbe4  7#b7 ,( 
! am\nt au?oriz$ to be appropriat$ to   
c>ry out ?is section = a fiscal ye>1 !  
,secret>y %all n use m ?an #aj p]c5t = !
 comb9$ co/s (-- 7,a7 adm9i/ration ( ?is
 section2 &  7,b7 c>ry+ out subsection  
7m77#b74  4  ,septemb] #bi1             
#bjbj,report$ ) an am5dm5t2 committ$ to 
! ,committee ( ! ,:ole ,h\se on ! ,/ate 
( ! ,union & ord]$ to be pr9t$