,,ii  #aaf? ,,congress  #b;d ,session   
,s4 #defb  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,septemb] #aj1         
#bjbj,ms4 ,smi? 7= h]self1 ,ms4         
,murk[ski1 ,mr4 ,te/]1 ,mr4 ,da9es1 ,ms4
 ,w>r51 & ,mr4 ,cram]7 introduc$ !      
foll[+ bill2 :i* 0 read twice & ref]r$  
to ! ,committee on ,indian ,affairs  ,a 
,,bill  ,to am5d ! ,public ,heal?       
,s]vice ,act ) respect to ! collection &
 availability ( heal? data ) respect to 
,indian ,tribes & ,tribal organizations1
 & = 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$-- 7#a7 by 
am5d+ subp>agraph 7,f7 ( p>agraph 7#a7  
to read z foll[s3  7,f7 ! ,indian ,heal?
 ,s]vice1 ,indian ,tribes1 ,tribal      
organizations1 & epidemiology c5t]s2  2 
&  7#b7 9 p>agraph 7#c71 by ins]t+      
,indian ,tribes1 ,tribal organizations1 
epidemiology c5t]s1 aft] ,f$]al         
ag5cies14  7c7 ,protection & %>+ ( data 
,section #caja7;e7 ( ! ,public ,heal?   
,s]vice ,act 7#db ,u4,s4,c4 #cjjkk7e77  
is am5d$-- 7#a7 9 p>agraph 7#b7-- 7,a7  
by /rik+ 44 & ins]t+ 42  7,b7 by /rik+  
,! ,secret>y %all & ins]t+ ! foll[+3    
7,a7 ,9 g5]al ,! ,secret>y %all  2 &    
7,c7 by add+ at ! end ! foll[+3  7,b7   
,epidemiology c5t]s & ,indian ,tribes ,)
 respect to data access = epidemiology  
c5t]s & ,indian ,tribes1 ! ,secret>y    
%all e/abli% a data %>+ /rategy1 9      
consultation ) ! ,secret>y's ,tribal    
,advisory ,committee1 = purposes (      
provid+ access to data to ! epidemiology
 c5t]s & ,indian ,tribes t protect data 

privacy & security & data gov]nance :ile
 ensur+ t epidemiology c5t]s & ,indian  
,tribes h access to data s\rces necess>y
 to accompli% _! public heal?           
responsibilities & plans = use4  2 &    
7#b7 by add+ at ! end ! foll[+ new      
p>agraph3  7#c7 ,tribal public heal?    
au?ority ,beg9n+ n lat] ?an #ahj days   
aft] ! date ( ! enactm5t ( ! ,tribal    
,heal? ,data ,improvem5t ,act ( #bjbj1 !
 ,secret>y %all make available all      
reque/$ data 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$1 to-- 7,a7 ! ,indian ,heal?    
,s]vice2  7,b7 ,indian ,tribes & ,tribal
 organizations2 &  7,c7 epidemiology    
c5t]s4  4  7d7 ,te*nical updates        
,section #caja ( ! ,public ,heal?       
,s]vice ,act 7#db ,u4,s4,c4 #cjjkk7 is  
am5d$-- 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+ any           
epidemiology c5t] s]v+ ,indian ,tribes  
regionally or s]v+ urban ,indian        
organizations nationally t is receiv+   
fund+ f ! ,indian ,heal? ,s]vice4  7#b7 
,! t]ms ,indian ,tribe & ,tribal        
organization h ! mean+s giv5 to ! t]ms  
,indian tribe & tribal organization1    
respectively1 9 section #d ( ! ,indian  
,self-,det]m9ation & ,education         
,assi/ance ,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+ 1 ! ,indian ,heal?      
,s]vice1 aft] ,comm]ce & ,labor2  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$-- 7#a7 by /rik+ 9 8 discretion &  
ins]t+ 9 ! discretion ( ! ,secret>y2 &  
7#b7 by /rik+ ,hispanics1 ,asian        
,am]icans1 & ,pacific ,isl&]s & ins]t+  
,am]ican ,indians & ,alaska ,natives1   
,hispanics1 ,asians1 & ,native ,hawaiian
 & o!r ,pacific ,isl&]s4  7e7 ,national 
,committee on ,vital & ,heal? ,/ati/ics 
,section #cjf7k7 ( ! ,public ,heal?     
,s]vice ,act 7#db ,u4,s4,c4 #bdbk7k77 is
 am5d$-- 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 a 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$-- 7#a7 
9 subp>agraph 7,a7-- 7,a7 by /rik+      
,subject to subp>agraph 7,b71 ! & ins]t+
 ,!2 &  7,b7 by /rik+ & major ,hispanic 
subpopulation gr\ps & ,am]ican ,indians 
& ins]t+ 1 major ,hispanic subgr\ps1 &  
,am]ican ,indians & ,alaska ,natives2 & 
7#b7 by am5d+ subp>agraph 7,b7 to read z
 foll[s3  7,b7 ,9 c>ry+ out subp>agraph 
7,a71 ) respect to ,am]ican ,indians &  
,alaska ,natives1 ! ,secret>y %all-- 7i7
 9 consultation ) ,indian ,tribes1      
,tribal organizations1 ! ,tribal        
,te*nical ,advisory ,gr\p ( ! ,c5t]s =  
,m$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  
develop guidance = ,/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 guidance =     
,/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 analyze & address              
misclassification & und]sampl+ (        
,am]ican ,indians & ,alaska ,natives 9  
data sy/ems at ! ,f$]al1 ,/ate1 & local 
levels1 ) respect to-- 7,i7 bir? & dea? 
records2 &  7,,ii7 ,f$]al1 ,/ate1 &     
local heal? c>e & public heal?          
surveillance sy/ems1 includ+ ) 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  

adopt1 bas$ on local1 /atewide1 ,tribal1
 & national be/ practices1 uni=m /&>ds =
 ! collection ( heal? data on race &    
e?nicity2  7v7 enc\rage ,/ates to ent]  
into data %>+ agreem5ts ) ,indian       
,tribes & epidemiology c5t]s to improve 
! quality & accuracy ( public heal? data
 reg>d+ ,am]ican ,indians & ,alaska     
natives1 includ+ by address+            
misclassification & und]sampl+ (        
,am]ican ,indians & ,alaska ,natives 9  
,/ate & local public heal? data sy/ems1 
includ+ ) respect to vital /ati/ics1    
*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  7vi7  
enc\rage ,/ates to adopt1 bas$ on local1
 /atewide1 ,tribal1 & national be/      
practices1 uni=m /&>ds = ! collection ( 
heal? data on race & e?nicity2 &  7vii7 
#ahj days aft] ! date ( enactm5t ( !    
,tribal ,heal? ,data ,improvem5t ,act ( 

#bjbj & bi5nially !reaft]1 issue a      
report on-- 7,i7 :i* ,/ates h data %>+  
agreem5ts ) ,indian ,tribes1 ,tribal    
,organizations1 urban ,indian           
organizations1 or epidemiology c5t]s to 
improve ! quality & accuracy ( heal?    
data1 li/$ by data sy/em "n2 &  7,,ii7  
actions tak5 by ! ,director ( ! ,c5t]s =
 ,disease ,control & ,prev5tion to      
enc\rage ,/ates to ent] into data %>+   
agreem5ts ) ,indian ,tribes1 ,tribal    
,organizations1 urban ,indian           
organizations1 & epidemiology c5t]s to  
improve ! quality & accuracy ( heal?    
data4  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+ any epidemiology c5t]    
s]v+ ,indian ,tribes regionally or s]v+ 

urban ,indian organizations nationally t
 is receiv+ fund+ f ! ,indian ,heal?    
,s]vice4  7#b7 ,! t]ms ,indian ,tribe & 
,tribal organization h ! mean+s giv5 to 
! t]ms ,indian tribe & tribal           
organization1 respectively1 9 section #d
 ( ! ,indian ,self-,det]m9ation &       
,education ,assi/ance ,act4  7#c7 ,! 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 ,to c>ry   
out ?is section1 !re is au?oriz$ to be  
appropriat$ #ahe1jjj1jjj = ea* ( !      
fiscal ye>s #bjba ?r\gh #bjbe4  4