[Congressional Record Volume 167, Number 108 (Tuesday, June 22, 2021)]
[House]
[Pages H2950-H2952]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
TRIBAL HEALTH DATA IMPROVEMENT ACT OF 2021
Mr. PALLONE. Mr. Speaker, I move to suspend the rules and pass the
bill (H.R. 3841) 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.
The Clerk read the title of the bill.
The text of the bill is as follows:
H.R. 3841
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Tribal Health Data
Improvement Act of 2021''.
SEC. 2. COLLECTION AND AVAILABILITY OF HEALTH DATA WITH
RESPECT TO INDIAN TRIBES.
(a) Data Collection.--Section 3101(a)(1) of the Public
Health Service Act (42 U.S.C. 300kk(a)(1)) is amended--
(1) by striking ``, by not later than 2 years after the
date of enactment of this title,''; and
(2) in subparagraph (B), by inserting ``Tribal,'' after
``State,''.
(b) Data Reporting and Dissemination.--Section 3101(c) of
the Public Health Service Act (42 U.S.C. 300kk(c)) is
amended--
(1) by amending subparagraph (F) of paragraph (1) to read
as follows:
``(F) the Indian Health Service, Indian Tribes, Tribal
organizations, and epidemiology centers authorized under the
Indian Health Care Improvement Act;''; and
(2) in paragraph (3), by inserting ``Indian Tribes, Tribal
organizations, and epidemiology centers,'' after ``Federal
agencies,''.
(c) 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:
``(3) 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--
``(A) ensuring that Tribal epidemiology centers and Indian
Tribes have access to the data sources necessary to
accomplish their public health responsibilities; and
``(B) protecting the privacy and security of such data.
``(4) Tribal public health authority.--
``(A) 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--
``(i) such entities request the data pursuant to statute;
and
``(ii) the data is requested for use--
``(I) consistent with Federal law and obligations; and
``(II) to satisfy a particular purpose or carry out a
specific function consistent with the purpose for which the
data was collected.
``(B) Entities.--The entities listed in this subparagraph
are--
``(i) the Indian Health Service;
``(ii) Indian Tribes and Tribal organizations; and
``(iii) epidemiology centers.''.
(d) Technical Updates.--Section 3101 of the Public Health
Service Act (42 U.S.C. 300kk) is amended--
(1) by striking subsections (g) and (h); and
(2) by redesignating subsection (i) as subsection (h).
(e) 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:
``(g) Definitions.--In this section:
``(1) 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.
``(2) 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.
``(3) 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.
``(4) The term `Urban Indian organization' has the meaning
given to that term in section 4 of the Indian Health Care
Improvement Act.''.
(f) 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''.
SEC. 3. IMPROVING HEALTH STATISTICS REPORTING WITH RESPECT TO
INDIAN TRIBES.
(a) 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''.
(b) 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''.
(c) Federal-State-Tribal Cooperation.--Section 306(f) of
the Public Health Service Act (42 U.S.C. 242k(f)) is
amended--
(1) by inserting ``the Indian Health Service,'' before
``the Departments of Commerce'';
(2) by inserting a comma after ``the Departments of
Commerce and Labor'';
(3) by inserting ``, Indian Tribes, Tribal organizations,
and epidemiology centers'' after ``State and local health
departments and agencies''; and
(4) by striking ``he shall'' and inserting ``the Secretary
shall''.
(d) Registration Area Records.--Section 306(h)(1) of the
Public Health Service Act (42 U.S.C. 242k(h)(1)) is amended--
(1) by striking ``in his discretion'' and inserting ``in
the discretion of the Secretary''; and
(2) 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''.
(e) National Committee on Vital and Health Statistics.--
Section 306(k) of the Public Health Service Act (42 U.S.C.
242k(k)) is amended--
(1) 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
(2) 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,''.
(f) 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--
(1) in subparagraph (A)--
(A) by striking ``Subject to subparagraph (B), the'' and
inserting ``The''; and
(B) by striking ``and major Hispanic subpopulation groups
and American Indians'' and inserting ``, major Hispanic
subgroups, and American Indians and Alaska Natives''; and
(2) by amending subparagraph (B) to read as follows:
``(B) In carrying out subparagraph (A), with respect to
American Indians and Alaska Natives, the Secretary shall--
``(i) 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
[[Page H2951]]
agencies to improve the quality and accuracy of data with
respect to the birth and death records of American Indians
and Alaska Natives;
``(ii) 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;
``(iii) 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--
``(I) birth and death records; and
``(II) 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;
``(iv) 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
``(v) 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:
``(I) 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.
``(II) 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.
``(III) 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.
``(IV) Best practices and guidance for local, State,
Tribal, and Federal uniform standards for the collection of
data on race and ethnicity.''.
(g) Definitions.--Section 306 of the Public Health Service
Act (42 U.S.C. 242k) is amended--
(1) by redesignating subsection (n) as subsection (o); and
(2) by inserting after subsection (m) the following:
``(n) In this section:
``(1) 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.
``(2) 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.
``(3) 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.
``(4) The term `Urban Indian organization' has the meaning
given to that term in section 4 of the Indian Health Care
Improvement Act.''.
(h) Authorization of Appropriations.--Section 306(o) of the
Public Health Service Act, as redesignated by subsection (g),
is amended to read as follows:
``(o)(1) To carry out this section, there is authorized to
be appropriated $185,000,000 for each of the fiscal years
2022 through 2026.
``(2) 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--
``(A) administration of this section; and
``(B) carrying out subsection (m)(2).''.
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from New
Jersey (Mr. Pallone) and the gentleman from Florida (Mr. Bilirakis)
each will control 20 minutes.
The Chair recognizes the gentleman from New Jersey.
General Leave
Mr. PALLONE. Mr. Speaker, I ask unanimous consent that all Members
have 5 legislative days in which to revise and extend their remarks and
to include any extraneous material on H.R. 3841.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from New Jersey?
There was no objection.
Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, American Indian and Alaska Native communities experience
disproportionately worse health outcomes than other groups in the
United States. The root causes of these poor health outcomes are
complex, but, unfortunately, not surprising. For centuries, American
Indian and Alaska Native communities have been displaced and damaged by
violence, poverty, disease, and adverse social conditions. As a result,
Tribal members live shorter lives than any other demographic group.
Unfortunately, the COVID-19 pandemic has also devastated Tribal
communities. According to data from the Centers for Disease Control and
Prevention, American Indians and Alaska Natives are at greater risk of
COVID-19 infection and more than three times more likely to be
hospitalized.
Moreover, there are significant gaps in data collection and the full
picture of the disease burden is really unknown. So it is important for
us to improve Tribal health data collection efforts so that we can
improve health outcomes. Tribal Epidemiology Centers manage regional
public health information systems and disease prevention and control
services. These centers also collaborate with other public health
authorities to study, collect, and analyze epidemiological data.
Clear communication and coordination by Federal, State, and local
public health departments is necessary to the success and security of
these efforts. So the bill before us, H.R. 3841, the Tribal Health Data
Improvement Act, equips Tribal communities with enhanced resources to
collect public health data and adapt public health programs to improve
health outcomes.
The bill clarifies the Federal Government's role in the collection
and distribution of public health and disease surveillance data. It
does this by creating a strategy to share information with the Indian
Health Service, Indian Tribes and organizations, and Tribal
Epidemiology Centers.
The legislation requires the Secretary of Health and Human Services
to release all applicable public health data to Tribal entities within
180 days of enactment.
It also requires the CDC to encourage and enhance collaborative
efforts between States and Tribal organizations to synergize data
collection.
Finally, the bill reauthorizes the National Center for Health
Statistics with an additional $185 million in funding to implement the
programs established by the legislation.
I thank Representatives Mullin and O'Halleran for their bipartisan
efforts to bringing this bill forward. They are always champions for
the Tribes.
Mr. Speaker, I urge my colleagues to support the bill, and I reserve
the balance of my time.
Mr. BILIRAKIS. Mr. Speaker, I yield myself such time as I may
consume.
Mr. Speaker, I rise today in support of H.R. 3841, the Tribal Health
Data Improvement Act of 2021, introduced by my Energy and Commerce
colleagues, Representatives Mullin and O'Halleran.
This important public health bill addresses the chronic challenges
faced by Tribal Nations and Tribal Epidemiology Centers in gaining
access to critical healthcare and public health surveillance data.
Obtaining this data is necessary for engaging in preventative public
health work and combating the current health crises in American Indian
and Alaska Native communities.
Structural barriers to accessing data have been especially
problematic during the COVID-19 pandemic, which has disproportionately
impacted these communities. In order to ensure that Tribal Nations and
Tribal Epidemiology Centers have access to the data necessary to
accomplish public health priorities, the bill requires that the
Secretary of HHS create a data-sharing strategy that takes into
consideration the recommendations of the Secretary's Tribal Advisory
Committee.
In addition, in reauthorizing the CDC's National Center for Health
Statistics, the bill requires the Secretary to make public health
surveillance data available to the Indian Health Service, Indian
Tribes, the Tribal organizations, and Tribal Epidemiology Centers so
long as the data requested for use is consistent with Federal law and
obligations.
The Secretary must also consult with Indian Tribes, Tribal
organizations, urban Indian organizations, and the Tribal Technical
Advisory Group of the Centers for Medicare and Medicaid Services to
develop guidelines for State and local health agencies to improve the
quality and accuracy of birth and death records of American Indians and
Alaska Natives.
It makes a lot of sense. By improving the sharing of data between the
Federal Government and the Tribes, this
[[Page H2952]]
important bill would help address the health disparities in American
Indian and Alaska Native communities.
I urge a ``yes'' vote on this particular bill. Let's pass this bill
swiftly and get it to the Senate.
Mr. Speaker, I yield back the balance of my time.
Mr. PALLONE. Mr. Speaker, I also urge support for the bill, and I
yield back the balance of my time.
The SPEAKER pro tempore. The question is on the motion offered by the
gentleman from New Jersey (Mr. Pallone) that the House suspend the
rules and pass the bill, H.R. 3841.
The question was taken.
The SPEAKER pro tempore. In the opinion of the Chair, two-thirds
being in the affirmative, the ayes have it.
Mr. ROSENDALE. Mr. Speaker, on that I demand the yeas and nays.
The SPEAKER pro tempore. Pursuant to section 3(s) of House Resolution
8, the yeas and nays are ordered.
Pursuant to clause 8 of rule XX, further proceedings on this motion
are postponed.
Parliamentary Inquiry
Mr. DEUTCH. Mr. Speaker, I make a point of order.
The SPEAKER pro tempore. The gentleman will state his point of order.
Mr. DEUTCH. Mr. Speaker, on all of these good bills that are being
debated with strong bipartisan support on the Democratic side and the
Republican side when they go to a voice vote, Mr. Speaker, does there
need to be even one ``no'' vote, which there have not been for this
whole series, for a Member to ask for a recorded vote?
The SPEAKER pro tempore. The gentleman has not stated a proper point
of order, but the Chair would inform Members that the gentleman from
Montana requested the yeas and nays, and pursuant to section 3(s) of
House Resolution 8, the yeas and nays have been ordered.
____________________