,,ii #aafth ,,congress #b;d ,session ,s4 #defb ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,september #aj1 #bjbj,ms4 ,smith 7for herself1 ,ms4 ,murkowski1 ,mr4 ,tester1 ,mr4 ,daines1 ,ms4 ,warren1 and ,mr4 ,cramer7 introduced the following bill2 which was read twice and referred to the ,committee on ,indian ,affairs ,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 ,tribal organizations1 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 centers2 2 and 7#b7 in paragraph 7#c71 by inserting ,indian ,tribes1 ,tribal organizations1 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-- 7#a7 in paragraph 7#b7-- 7,a7 by striking 44 and inserting 42 7,b7 by striking ,the ,secretary shall and inserting the following3 7,a7 ,in general ,the ,secretary shall 2 and 7,c7 by adding at the end the following3 7,b7 ,epidemiology centers and ,indian ,tribes ,with respect to data access for epidemiology centers and ,indian ,tribes1 the ,secretary shall establish a data sharing strategy1 in consultation with the ,secretary's ,tribal ,advisory ,committee1 for purposes of providing access to data to the epidemiology centers and ,indian ,tribes that protect data privacy and security and data governance while ensuring that epidemiology centers and ,indian ,tribes have access to data sources necessary to accomplish their public health responsibilities and plans for use4 2 and 7#b7 by adding at the end the following new paragraph3 7#c7 ,tribal public health authority ,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 all requested data 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 to-- 7,a7 the ,indian ,health ,service2 7,b7 ,indian ,tribes and ,tribal organizations2 and 7,c7 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 any epidemiology center serving ,indian ,tribes regionally or serving urban ,indian organizations nationally that is receiving funding from the ,indian ,health ,service4 7#b7 ,the terms ,indian ,tribe and ,tribal organization have the meanings given to the terms ,indian tribe and tribal organization1 respectively1 in section #d of the ,indian ,self-,determination and ,education ,assistance ,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 1 the ,indian ,health ,service1 after ,commerce and ,labor2 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 ,asians1 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 a 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 in consultation 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 and in coordination with epidemiology centers1 develop guidance 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 guidance 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 analyze and address misclassification and undersampling of ,american ,indians and ,alaska ,natives in data systems at the ,federal1 ,state1 and local levels1 with respect to-- 7,i7 birth and death records2 and 7,,ii7 ,federal1 ,state1 and local health care and public health surveillance systems1 including 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 adopt1 based on local1 statewide1 ,tribal1 and national best practices1 uniform standards for the collection of health data on race and ethnicity2 7v7 encourage ,states to enter into data sharing agreements with ,indian ,tribes and epidemiology centers to improve the quality and accuracy of public health data regarding ,american ,indians and ,alaska natives1 including by addressing misclassification and undersampling of ,american ,indians and ,alaska ,natives in ,state and local public health data systems1 including with respect to vital statistics1 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 7vi7 encourage ,states to adopt1 based on local1 statewide1 ,tribal1 and national best practices1 uniform standards for the collection of health data on race and ethnicity2 and 7vii7 #ahj days after the date of enactment of the ,tribal ,health ,data ,improvement ,act of #bjbj and biennially thereafter1 issue a report on-- 7,i7 which ,states have data sharing agreements with ,indian ,tribes1 ,tribal ,organizations1 urban ,indian organizations1 or epidemiology centers to improve the quality and accuracy of health data1 listed by data system name2 and 7,,ii7 actions taken by the ,director of the ,centers for ,disease ,control and ,prevention to encourage ,states to enter into data sharing agreements with ,indian ,tribes1 ,tribal ,organizations1 urban ,indian organizations1 and epidemiology centers to improve the quality and accuracy of health data4 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 any epidemiology center serving ,indian ,tribes regionally or serving urban ,indian organizations nationally that is receiving funding from the ,indian ,health ,service4 7#b7 ,the terms ,indian ,tribe and ,tribal organization have the meanings given to the terms ,indian tribe and tribal organization1 respectively1 in section #d of the ,indian ,self-,determination and ,education ,assistance ,act4 7#c7 ,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 ,to carry out this section1 there is authorized to be appropriated #ahe1jjj1jjj for each of the fiscal years #bjba through #bjbe4 4