Title III of the Public Health Service Act is amended by inserting after section 319F–4 of such Act (42 U.S.C. 247d–6e) the following new section:

(a) In general.—The Comptroller General of the United States shall conduct a study to investigate the feasibility of establishing user fees to offset certain Federal costs attributable to the procurement of single-source materials for the Strategic National Stockpile under section 319F–2 of the Public Health Service Act (42 U.S.C. 247d–6b) and distributions of such materials from the Stockpile. In conducting this study, the Comptroller General shall consider, to the extent information is available—

(1) whether entities receiving such distributions generate profits from those distributions;

(2) any Federal costs attributable to such distributions;

(3) whether such user fees would provide the Secretary with funding to potentially offset procurement costs of such materials for the Strategic National Stockpile; and

(4) any other issues the Comptroller General identifies as relevant.

(b) Report.—Not later than February 1, 2023, the Comptroller General of the United States shall submit to the Congress a report on the findings and conclusions of the study under subsection (a).

(a) In general.—The Secretary of Health and Human Services or the Assistant Secretary for Preparedness and Response, in consultation with the Administrator of the Federal Emergency Management Agency, shall—

(1) not later than 30 days after the date of enactment of this Act, issue a report to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate regarding all State, local, Tribal, and territorial requests for supplies from the Strategic National Stockpile related to COVID–19; and

(2) not less than every 30 days thereafter through the end of the emergency period (as such term is defined in section 1135(g)(1)(B) of the Social Security Act (42 U.S.C. 1320b–5(g)(1)(B))), submit to such committees an updated version of such report.

(b) Reporting period.—

(1) INITIAL REPORT.—The initial report under subsection (a) shall address all requests described in such subsection made during the period—

(A) beginning on January 31, 2020; and

(B) ending on the date that is 30 days before the date of submission of the report.

(2) UPDATES.—Each update to the report under subsection (a) shall address all requests described in such subsection made during the period—

(A) beginning at the end of the previous reporting period under this section; and

(B) ending on the date that is 30 days before the date of submission of the updated report.

(c) Contents of report.—The report under subsection (a) (and updates thereto) shall include—

(1) the details of each request described in such subsection, including—

(A) the specific medical countermeasures, devices, personal protective equipment, and other materials requested; and

(B) the amount of such materials requested; and

(2) the outcomes of each request described in subsection (a), including—

(A) whether the request was wholly fulfilled, partially fulfilled, or denied;

(B) if the request was wholly or partially fulfilled, the fulfillment amount; and

(C) if the request was partially fulfilled or denied, a rationale for such outcome.

(a) In general.—Not later than January 1, 2021, the Secretary of Health and Human Services shall develop and implement improved, transparent processes for the use and distribution of drugs, vaccines and other biological products, medical devices, and other supplies (including personal protective equipment, ancillary medical supplies, and other applicable supplies required for the administration of drugs, vaccines and other biological products, medical devices, and diagnostic tests) in the Strategic National Stockpile under section 319F–2 of the Public Health Service Act (42 U.S.C. 247d–6b) (in this section referred to as the “Stockpile”).

(b) Processes.—The processes developed under subsection (a) shall include—

(1) the form and manner in which States, localities, Tribes, and territories are required to submit requests for supplies from the Stockpile;

(2) the criteria used by the Secretary of Health and Human Services in responding to such requests, including the reasons for fulfilling or denying such requests;

(3) what circumstances result in prioritization of distribution of supplies from the Stockpile to States, localities, Tribes, or territories;

(4) clear plans for future, urgent communication between the Secretary and States, localities, Tribes, and territories regarding the outcome of such requests; and

(5) any differences in the processes developed under subsection (a) for geographically related emergencies, such as weather events, and national emergencies, such as pandemics.

(c) Classification.—The processes developed under subsection (a) shall be unclassified to the greatest extent possible consistent with national security. The Secretary of Health and Human Services may classify portions of such processes as necessary to protect national security.

(d) Report to Congress.—Not later than January 1, 2021, the Secretary of Health and Human Services shall—

(1) submit a report to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate regarding the improved, transparent processes developed under this section;

(2) include in such report recommendations for opportunities for communication (by telebriefing, phone calls, or in-person meetings) between the Secretary and States, localities, Tribes, and territories regarding such improved, transparent processes; and

(3) submit such report in unclassified form to the greatest extent possible, except that the Secretary may include a classified appendix if necessary to protect national security.

Section 319F–2(f)(1) of the Public Health Service Act (42 U.S.C. 247d–6b(f)(1)) is amended by striking “$610,000,000 for each of fiscal years 2019 through 2023” and inserting “$705,000,000 for each of fiscal years 2021 through 2023”.

Subtitle C of title XXVIII of the Public Health Service Act (42 U.S.C. 300hh–31 et seq.) is amended by adding at the end the following:

(a) Improving infectious disease data collection.—Section 319D of the Public Health Service Act (42 U.S.C. 247d–4) is amended—

(1) in subsection (c)—

(A) in paragraph (3)(A)(iv), by inserting “(such as commercial, academic, and other hospital laboratories)” after “clinical laboratories”;

(B) in paragraph (5)—

(i) in subparagraph (A)—

(I) in the matter preceding clause (i), by striking “and operating” and inserting “, operating, and updating”;

(II) in clause (iv), by striking “and” at the end;

(III) in clause (v), by striking the period and inserting “; and”; and

(IV) by adding at the end the following:

“(vi) integrate and update applicable existing Centers for Disease Control and Prevention data systems and networks in collaboration with State, local, tribal, and territorial public health officials, including public health surveillance and disease detection systems.”; and

(ii) in subparagraph (B)—

(I) in clause (i), by inserting “and 60 days after the date of enactment of the Commitment to Defeat the Virus and Keep America Healthy Act” after “Innovation Act of 2019”;

(II) in clause (ii), by inserting “epidemiologists, clinical microbiologists, pathologists and laboratory experts, experts in health information technology, privacy, and data security” after “forecasting);”; and

(III) in clause (iii)—

(aa) in subclause (V), by striking “and” at the end;

(bb) in subclause (VI), by striking the period; and

(cc) by adding at the end the following:

“(VII) strategies to integrate laboratory and epidemiology systems and capabilities to conduct rapid and accurate laboratory tests;

“(VIII) strategies to improve the collection and reporting of appropriate, aggregated, deidentified demographic data to inform responses to public health emergencies, including identification of at-risk populations and to address health disparities; and

“(IX) strategies to improve the electronic exchange of health information between State and local health departments and health care providers and facilities to improve public health surveillance.”; and

(C) in paragraph (6)—

(i) in subparagraph (A)—

(I) in clause (iii)—

(aa) in subclause (III), by striking “and” at the end;

(bb) in subclause (IV), by inserting “, including the ability to conduct and report on rapid and accurate laboratory testing during a public health emergency” before the semicolon; and

(cc) by adding at the end the following:

“(V) improve coordination and collaboration, as appropriate, with other Federal departments; and

“(VI) implement applicable lessons learned from recent public health emergencies to address gaps in situational awareness and biosurveillance capabilities, including an evaluation of ways to improve the collection and reporting of aggregated, deidentified demographic data to inform public health preparedness and response”;

(II) in clause (iv), by striking “and” at the end;

(III) in clause (v), by striking the period and inserting “including a description of how such steps will further the goal of improving awareness of and timely responses to emerging infectious disease threats; and”; and

(IV) by adding at the end the following:

“(vi) identifies and demonstrates measurable steps the Secretary will take to further develop and integrate infectious disease detection, including expanding capabilities to conduct rapid and accurate diagnostic laboratory testing during a public health emergency, and improve coordination and collaboration with State, local, Tribal, and territorial public health officials, clinical laboratories (including commercial, hospital and academic laboratories), and other entities with expertise in public health surveillance.”; and

(ii) by redesignating subparagraph (B) as subparagraph (C); and

(iii) by inserting after subparagraph (A), the following:

“(B) REPORTS.—

“(i) IN GENERAL.—Not later than 1 month after date of enactment of the Commitment to Defeat the Virus and Keep America Healthy Act, and as provided for in clause (ii), the Secretary shall submit to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives, a report on the status of the Department of Health and Human Services’ biosurveillance modernization and assessment progress with respect to emerging infectious disease threats.

“(ii) ADDITIONAL REPORTS.—During the 2-year period beginning on the date of enactment of the Commitment to Defeat the Virus and Keep America Healthy Act, the Secretary shall provide additional reports under clause (i) every 90 days after the submission of the initial report under such clause. The Secretary shall provide such reports annually thereafter. The Secretary may provide such additional reports less frequently, but not less frequently than every 180 days, during an ongoing public health emergency or another significant infectious disease outbreak.”;

(2) in subsection (d)—

(A) in paragraph (2)(C), by inserting “, including any public-private partnerships entered into to improve such capacity” before the semicolon; and

(B) in paragraph (3)—

(i) in subparagraph (B), by striking “and” at the end;

(ii) in subparagraph (C), by striking the period and inserting “; and”; and

(iii) by adding at the end the following:

“(D) may establish, enhance, or maintain a system or network for the collection of data to provide for early detection of infectious disease outbreaks, near real-time access to relevant electronic data and integration of electronic data and information from public health and other appropriate sources, such as laboratories, hospitals, and epidemiology systems, to enhance the capability to conduct rapid and accurate diagnostic laboratory tests to provide for disease detection.”;

(3) in subsection (f)(1)(A), by inserting “pathologists, clinical microbiologists, laboratory professionals, epidemiologists,” after “forecasting),”; and

(4) in subsection (h), by adding at the end the following: “Such evaluation shall include identification of any gaps in biosurveillance and situational awareness capabilities identified related to recent public health emergencies, any immediate steps taken to address such gaps, and any long-term plans to address such gaps, including steps related to activities authorized under this section.”.

(b) National health security strategy.—Section 2802(b)(2) of the Public Health Service Act (42 U.S.C. 300hh–1(b)(2)) is amended—

(1) in subparagraph (A), by inserting “such as by integrating laboratory and epidemiology systems and capability to conduct rapid and accurate laboratory tests,” after “detection, identification,”; and

(2) in subparagraph (B), by inserting “laboratory testing,” after “services and supplies,”.

(c) Epidemiology-Laboratory capacity grants.—Section 2821(a) of the Public Health Service Act (42 U.S.C. 300hh–31(a)) is amended—

(1) in paragraph (3), by striking “and”;

(2) in paragraph (4), by striking the period and inserting “; and”; and

(3) by adding at the end the following:

“(5) supporting activities of State and local public health departments related to biosurveillance and disease detection, which may include activities related to section 319D, as appropriate.”.

Section 2821 of the Public Health Service Act (42 U.S.C. 300hh–31) is amended—

(1) by redesignating subsection (b) as subsection (c);

(2) by inserting after subsection (a) the following new subsection:

“(b) Grants for public health laboratories To acquire high-Throughput diagnostic equipment.—

“(1) GRANTS.—The Secretary shall award grants to eligible entities to assist such entities in purchasing high-throughput diagnostic equipment and related supplies and in hiring and training staff to use such equipment.

“(2) ELIGIBILITY.—To be eligible for a grant under paragraph (1), an entity shall—

“(A) be—

“(i) a State, local, or Tribal public health laboratory;

“(ii) a laboratory within a public health laboratory network coordinated or managed by the Centers for Disease Control and Prevention;

“(iii) a laboratory not described in clause (i) or (ii) that the Secretary determines (at the Secretary’s discretion) provides population-based testing for the prevention and control of infectious, communicable, genetic, or chronic diseases; or

“(iv) a consortium of 2 or more entities described in any of clauses (i) through (iii); and

“(B) submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may reasonably require.

“(3) USE OF FUNDS.—Amounts received through a grant under this subsection shall be used—

“(A) to purchase high-throughput diagnostic equipment and such materials as are necessary to administer, store, and process applicable tests, including diagnostic and serological tests; and

“(B) to hire and train staff to use such equipment.

“(4) AMOUNT OF GRANT.—The amount of a grant under paragraph (1) may not exceed $2,000,000, except in the case of eligible entity described in paragraph (2)(A)(iv).

“(5) HIGH-THROUGHPUT DIAGNOSTIC EQUIPMENT DEFINED.—In this subsection, the term ‘high-throughput diagnostic equipment’ means legally marketed equipment and supplies capable of performing multichannel analysis for use in clinical laboratory diagnostic testing.”; and

(3) in subsection (c), as so redesignated—

(A) by redesignating paragraphs (1), (2), and (3) as subparagraphs (A), (B), and (C), respectively, and moving the margin of each such redesignated subparagraph 2 ems to the right;

(B) by striking “There are authorized to be appropriated to carry out this section” and inserting the following:

“(1) IN GENERAL.—There are authorized to be appropriated to carry out subsection (a)”; and

(C) by adding at the end the following new paragraph:

“(2) AUTHORIZATION OF APPROPRIATIONS.—

“(A) IN GENERAL.—For the purpose of carrying out subsection (b), there is authorized to be appropriated $250,000,000 for fiscal year 2021, to remain available until expended.

“(B) ADMINISTRATIVE EXPENSES.—Of the amount made available to carry out subsection (b) for any fiscal year, the Secretary may not use more than 5 percent of such amount for the expenses of administering subsection (b).”.

Section 2821 of the Public Health Service Act (42 U.S.C. 300hh–31) is amended—

(1) by redesignating subsection (c), as redesignated by section 4021, as subsection (d);

(2) by inserting after subsection (b), as added by section 4021, the following new subsection:

“(c) Grants for same-Day point-of-Care clinical laboratory diagnostic testing in communities.—

“(1) GRANTS.—The Secretary shall award grants to eligible entities to assist such entities in acquiring legally marketed equipment and supplies capable of performing same-day clinical laboratory diagnostic testing in a point-of-care setting.

“(2) ELIGIBILITY.—To be eligible for a grant under paragraph (1), an entity shall—

“(A) be—

“(i) a hospital;

“(ii) a primary care facility;

“(iii) a clinic;

“(iv) a physician; or

“(v) another type of health care provider as the Secretary may define; and

“(B) submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may reasonably require.

“(3) USE OF FUNDS.—Amounts received through a grant under this subsection shall be used to purchase legally marketed rapid diagnostic equipment and such materials as are necessary to administer, store, and process same-day clinical laboratory diagnostic testing in a point-of-care setting, including diagnostic and serological tests.

“(4) AMOUNT OF GRANT.—The amount of a grant under paragraph (1) may not exceed $20,000.

“(5) PRIORITY IN MAKING AWARDS.—In awarding grants under paragraph (1), the Secretary shall give priority to eligible entities providing services to—

“(A) medically underserved populations (as defined in section 330(b)(3)) in rural areas; and

“(B) all other areas.”; and

(3) by adding at the end of subsection (d), as redesignated, the following new paragraph:

“(3) AUTHORIZATION OF APPROPRIATIONS.—

“(A) IN GENERAL.—For the purpose of carrying out subsection (c), there is authorized to be appropriated $500,000,000 for fiscal year 2021, to remain available until expended.

“(B) ADMINISTRATIVE EXPENSES.—Of the amount made available to carry out subsection (c) for any fiscal year, the Secretary may not use more than 5 percent of such amount for the expenses of administering this section.”.

Part D of title III of the Public Health Service Act (42 U.S.C. 254b et seq.), as amended by section 2031, is further amended by adding at the end the following new subpart:

(a) In general.—The Public Health Service Act is amended by striking section 313 of such Act (42 U.S.C. 245) and inserting the following:

(b) Grants To address vaccine-Preventable diseases.—Section 317 of the Public Health Service Act (42 U.S.C. 247b) is amended—

(1) in subsection (k)(1)—

(A) in subparagraph (C), by striking “; and” and inserting a semicolon;

(B) in subparagraph (D), by striking the period and inserting a semicolon; and

(C) by adding at the end the following:

“(E) planning, implementation, and evaluation of activities to address vaccine-preventable diseases, including activities to—

“(i) identify communities at high risk of outbreaks related to vaccine-preventable diseases, including through improved data collection and analysis;

“(ii) pilot innovative approaches to improve vaccination rates in communities and among populations with low rates of vaccination;

“(iii) reduce barriers to accessing vaccines and evidence-based information about the health effects of vaccines;

“(iv) partner with community organizations and health care providers to develop and deliver evidence-based interventions, including culturally and linguistically appropriate interventions, to increase vaccination rates;

“(v) improve delivery of evidence-based, vaccine-related information to parents and others; and

“(vi) improve the ability of State, local, Tribal, and territorial public health departments to engage communities at high risk for outbreaks related to vaccine-preventable diseases, in coordination, as appropriate, with local educational agencies, as defined in section 8101 of the Elementary and Secondary Education Act of 1965; and

“(F) research related to strategies for improving awareness of scientific and evidence-based, vaccine-related information, including for communities with low rates of vaccination, in order to understand barriers to vaccination, improve vaccination rates, and assess the public health outcomes of such strategies.”; and

(2) by adding at the end the following:

“(n) Vaccination data.—The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall expand and enhance, and, as appropriate, establish and improve, programs and conduct activities to collect, monitor, and analyze vaccination coverage data to assess levels of protection from vaccine-preventable diseases, including by assessing factors contributing to underutilization of vaccines and variations of such factors, and identifying communities at high risk of outbreaks associated with vaccine-preventable diseases.”.

(c) Supplemental grant funds.—Section 330(d)(1) of the Public Health Service Act (42 U.S.C. 254b) is amended—

(1) in subparagraph (F), by striking “and” at the end;

(2) in subparagraph (G), by striking the period and inserting “; and”; and

(3) by adding at the end the following:

“(H) improving access to recommended immunizations.”.

(d) Update of 2015 NVAC report.—The National Vaccine Advisory Committee established under section 2105 of the Public Health Service Act (42 U.S.C. 300aa–5) shall, as appropriate, update the report entitled, “Assessing the State of Vaccine Confidence in the United States: Recommendations from the National Vaccine Advisory Committee”, approved by the National Vaccine Advisory Committee on June 10, 2015, with respect to factors affecting childhood vaccination.

(a) In general.—The Secretary of Health and Human Services (in this subtitle referred to as the “Secretary”) shall establish within the Office of the Assistant Secretary for Health a National COVID–19 Resource Center for Older Adults (in this section referred to as the “Center”) to identify, curate, and disseminate, promising and proven practices and tools for the care of older adults in their homes, community-based care settings, hospitals, and nursing and acute care facilities.

(b) Involvement by Federal departments and all levels of government.—The Center shall—

(1) be advised by a team of senior officials from—

(A) agencies across the Department of Health and Human Services, including the Administration for Community Living (including the Administration on Aging), the Centers for Disease Control and Prevention, the Centers for Medicare & Medicaid Services, the Health Resources and Services Administration, the Indian Health Service, and the Office of Minority Health in the Office of the Secretary; and

(B) other Federal departments, including the Department of Housing and Urban Development and the Department of Veterans Affairs; and

(2) collaborate with State and local governments, Indian tribes and Tribal organizations, and nonprofit organizations.

(c) Activities.—The Center shall perform the following activities:

(1) Develop a set of best practices for older adult health and well-being during and beyond the period of the COVID–19 pandemic, including such best practices with respect to the following focus areas:

(A) Providing specialized services to overcome the risks associated with social isolation, such as additional resources for home-delivered meals and other nutrition programs to provide not only food but also face-to-face interactions.

(B) Streamlining and improving access to screening, testing, and health care services and resources, and prioritizing venues older adults can reach.

(C) Expanding the use of telemedicine, including the provision of technology to execute televisits that safely and comprehensively address older adults’ health care needs.

(D) Supporting family caregivers, including those with additional responsibilities for homebound individuals.

(E) Reducing disparities among underserved populations.

(F) Developing cross-sector collaborative efforts.

(2) Create and disseminate tools, technical assistance, training, and funding to State, local, Tribal, and territorial governments to adopt best practices developed under subparagraphs (E) and (F) of paragraph (1).

(3) Establish mechanisms for providing training and technical assistance to State, local, Tribal, and territorial governments to ensure that complementary cross-sector activities are replicated at the State, local, Tribal, and territorial levels.

(4) Facilitate the development of learning networks of practitioners at the hospital, nursing facility, and community levels to disseminate the best practices developed under paragraph (1) and ensure implementation of such best practices to reduce morbidity and mortality of older adults affected by COVID–19.

(5) Identify and disseminate approaches that strengthen public health and health care system capacity to serve older Americans with regard to health issues during and beyond the COVID–19 pandemic.

(a) In general.—The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall establish a Healthy Aging Program for the purpose of promoting the health and well-being of older adults by—

(1) improving the coordination of public health interventions that promote the health and well-being of older adults;

(2) disseminating and implementing evidence-based best practices and programs with respect to promoting the health and well-being of older adults; and

(3) coordinating multisectoral efforts to promote the health and well-being of older adults across governmental and nongovernmental health and related agencies.

(b) Activities.—For the purpose described in subsection (a), the Secretary shall design the Healthy Aging Program to carry out the following activities:

(1) Regularly assess the health-related needs of older adults and promote policies addressing those needs through evidence-based public health interventions to promote overall health and well-being among older adults and reduce health care costs.

(2) Identify disparities in health among vulnerable populations of older adults.

(3) Identify gaps in existing public health programs and policies that focus on older adults.

(4) Promote public health partnerships with aging and other sector stakeholders to ensure nonduplication of efforts and increase efficiency by working collaboratively across sectors.

(5) Work with multisectoral agencies to improve emergency preparedness plans and activities for vulnerable older adult populations.

(6) Coordinate efforts to promote the health of older adults with the Administration for Community Living, other Federal departments and agencies, and nonprofit organizations.

(7) Identify resources and evidence-based programs available to local and State health departments, including resources and programs that could be coordinated across sectors, to address the health and well-being of older adults.

(c) Grants to health departments.—The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall award grants or cooperative agreements to eligible health departments to carry out any of the following activities:

(1) Improving availability of data on the older adult population, including through data-sharing with elder affairs agencies.

(2) Linking the health care sector with the community services sector (including aging services and supports) to coordinate and promote community-based prevention services.

(3) Ensuring that State and local emergency preparedness plans and activities address the special needs of older adults, particularly the most vulnerable populations.

(4) Training State and local public health personnel to implement or adapt evidence-based and innovative health promotion and disease prevention programs and policies.

(5) Improving community conditions and addressing social determinants to promote health and well-being and foster independence among older adults, such as efforts to advance age-friendly communities and dementia-friendly communities.

(d) Technical assistance.—The Secretary shall (directly or through grants, cooperative agreements, or contracts) provide technical assistance to eligible health departments in carrying out activities described in subsection (c).

(e) Evaluations.—The Secretary shall (directly or through grants, cooperative agreements, or contracts) provide for the evaluation of activities carried out under subsections (a), (b), and (c) in order to determine the extent to which such activities have been effective in carrying out the purpose described in subsection (a), including the effects of such activities on addressing health disparities.

(f) Definition.—In this section, the term “eligible health department” means a health department of a State, the District of Columbia, the Commonwealth of Puerto Rico, the United States Virgin Islands, Guam, American Samoa, the Commonwealth of the Northern Mariana Islands, a Tribe (as defined in section 4 of the Indian Self-Determination and Education Assistance Act (25 U.S.C. 5304)), or a large city (as defined by the Director of the Centers for Disease Control and Prevention for purposes of this section).

There is authorized to be appropriated—

(1) $10,000,000 for the period of fiscal years 2021 through 2025 to carry out section 4061, to remain available until September 30, 2025; and

(2) $20,000,000 for each of fiscal years 2021 through 2025 to carry out section 4062, including for grants under section 4062(c), to remain available until September 30, 2025.

Title III of the Public Health Service Act is amended by inserting after section 330M (42 U.S.C. 254c–19) the following:

Subtitle C of title XXVIII of the Public Health Service Act (42 U.S.C. 300hh–31 et seq.) is amended by adding at the end the following:

(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 Commitment to Defeat the Virus and Keep America Healthy Act, 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”.

(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 an 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 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 Commitment to Defeat the Virus and Keep America Healthy Act, 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 2021 through 2025.

“(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).”.

(a) Strategic national stockpile.—Section 319F–2(a)(3)(G) of the Public Health Service Act (42 U.S.C. 247d–6b(a)(3)(G)) is amended by inserting “, and, in the case that the Secretary deploys the stockpile under this subparagraph, ensure that appropriate drugs, vaccines and other biological products, medical devices, and other supplies are deployed by the Secretary directly to health programs or facilities operated by the Indian Health Service, an Indian tribe, a tribal organization (as those terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act (25 U.S.C. 5304)), or an inter-tribal consortium (as defined in section 501 of the Indian Self-Determination and Education Assistance Act (25 U.S.C. 5381)) or through an urban Indian organization (as defined in section 4 of the Indian Health Care Improvement Act), while avoiding duplicative distributions to such programs or facilities” before the semicolon.

(b) Distribution of qualified pandemic or epidemic products to IHS facilities.—Title III of the Public Health Service Act (42 U.S.C. 241 et seq.), as amended by section 3015, is further amended by inserting after section 319F–5 the following:

Section 520E(b) of the Public Health Service Act (42 U.S.C. 290bb–36(b)) is amended by inserting after paragraph (3) the following:

“(4) CONSULTATION.—A State applying for a grant or cooperative agreement under this section shall, in the development and implementation of a statewide early intervention strategy, consult or confer with entities described in paragraph (1)(C) in such State.”.

Part D of title V of the Public Health Service Act (42 U.S.C. 290dd et seq.) is amended by adding at the end the following:

Not later than 6 months after the date of the enactment of this Act, the Director of the National Institutes of Health shall enter into an arrangement with the National Academies of Sciences, Engineering, and Medicine (or, if the National Academies of Sciences, Engineering, and Medicine decline to enter into such an arrangement, the Patient-Centered Outcomes Research Institute, the Agency for Healthcare Research and Quality, or another appropriate entity)—

(1) to conduct a study with respect to mental health disparities in racial and ethnic minority groups (as defined in section 1707(g) of the Public Health Service Act (42 U.S.C. 300u–6(g))); and

(2) to submit to the Congress a report on the results of such study, including—

(A) a compilation of information on the dynamics of mental disorders in such racial and ethnic minority groups; and

(B) a compilation of information on the impact of exposure to community violence, adverse childhood experiences, structural racism, and other psychological traumas on mental disorders in such racial and minority groups.

(a) In general.—The Secretary of Health and Human Services shall award grants to qualified national organizations for the purposes of—

(1) developing, and disseminating to health professional educational programs best practices or core competencies addressing mental health disparities among racial and ethnic minority groups for use in the training of students in the professions of social work, psychology, psychiatry, marriage and family therapy, mental health counseling, and substance misuse counseling; and

(2) certifying community health workers and peer wellness specialists with respect to such best practices and core competencies and integrating and expanding the use of such workers and specialists into health care to address mental health disparities among racial and ethnic minority groups.

(b) Best practices; core competencies.—Organizations receiving funds under subsection (a) may use the funds to engage in the following activities related to the development and dissemination of best practices or core competencies described in subsection (a)(1):

(1) Formation of committees or working groups comprised of experts from accredited health professions schools to identify best practices and core competencies relating to mental health disparities among racial and ethnic minority groups.

(2) Planning of workshops in national fora to allow for public input into the educational needs associated with mental health disparities among racial and ethnic minority groups.

(3) Dissemination and promotion of the use of best practices or core competencies in undergraduate and graduate health professions training programs nationwide.

(4) Establishing external stakeholder advisory boards to provide meaningful input into policy and program development and best practices to reduce mental health disparities among racial and ethnic minority groups.

(c) Definitions.—In this section:

(1) QUALIFIED NATIONAL ORGANIZATION.—The term “qualified national organization” means a national organization that focuses on the education of students in one or more of the professions of social work, psychology, psychiatry, marriage and family therapy, mental health counseling, and substance misuse counseling.

(2) RACIAL AND ETHNIC MINORITY GROUP.—The term “racial and ethnic minority group” has the meaning given to such term in section 1707(g) of the Public Health Service Act (42 U.S.C. 300u–6(g)).

Part D of title V of the Public Health Service Act (42 U.S.C. 290dd et seq.), as amended by section 5031, is further amended by adding at the end the following new section:

(a) In general.—In addition to amounts otherwise authorized to be appropriated to the National Institutes of Health, there is authorized to be appropriated to such Institutes $100,000,000 for each of fiscal years 2021 through 2025 to build relations with communities and conduct or support clinical research, including clinical research on racial or ethnic disparities in physical and mental health.

(b) Definition.—In this section, the term “clinical research” has the meaning given to such term in section 409 of the Public Health Service Act (42 U.S.C. 284d).

In addition to amounts otherwise authorized to be appropriated to the National Institute on Minority Health and Health Disparities, there is authorized to be appropriated to such Institute $650,000,000 for each of fiscal years 2021 through 2025.

Section 597(c) of the Public Health Service Act (42 U.S.C. 297ll(c)) is amended by striking “$12,669,000 for each of fiscal years 2018 through 2022” and inserting “$25,000,000 for each of fiscal years 2021 through 2025”.

(a) In general.—Not later than 1 year after the date of enactment of this Act, the Secretary of Health and Human Services shall conduct or support research on—

(1) smartphone and social media use by adolescents; and

(2) the effects of such use on—

(A) emotional, behavioral, and physical health and development; and

(B) disparities in minority and underserved populations.

(b) Report.—Not later than 5 years after the date of the enactment of this Act, the Secretary shall submit to the Congress, and make publicly available, a report on the findings of research described in this section.

Title V of the Public Health Service Act (42 U.S.C. 290aa et seq.) is amended—

(1) by redesignating the second section 550 of such Act (42 U.S.C. 290ee–10) (relating to Sobriety Treatment And Recovery Teams) as section 553; and

(2) by moving such section 553, as so redesignated, so as to appear after section 552 of such Act (42 U.S.C. 290ee–7).

Part D of title III of the Public Health Service Act (42 U.S.C. 254b et seq.), as amended by section 4071, is further amended—

(1) in the section designation of section 330M of such Act (42 U.S.C. 254c–19) by inserting a period after “330M”; and

(2) by inserting after section 330N of such Act, as inserted by section 4071, the following:

Title VII of the Public Health Service Act is amended by striking section 763 (42 U.S.C. 294p) and inserting the following:

Not later than 2 years after date of enactment of this Act, the Secretary of Health and Human Services shall, through a contract with an independent research organization, conduct a study and make recommendations for accredited schools of allopathic medicine, osteopathic medicine, and nursing, and other health professional training programs, on best practices related to training to reduce and prevent discrimination, including training related to implicit and explicit biases, in the provision of health care services related to prenatal care, labor care, birthing, and postpartum care.

Section 317K(a)(2) of the Public Health Service Act (42 U.S.C. 247b–12(a)(2)) is amended by adding at the end the following:

“(E) (i) The Secretary, acting through the Director of the Centers for Disease Control and Prevention and in coordination with other offices and agencies, as appropriate, shall establish or continue a competitive grant program for the establishment or support of perinatal quality collaboratives to improve perinatal care and perinatal health outcomes for pregnant and postpartum women and their infants. A State, Indian Tribe, or Tribal organization may use funds received through such grant to—

“(I) support the use of evidence-based or evidence-informed practices to improve outcomes for maternal and infant health;

“(II) work with clinical teams; experts; State, local, and, as appropriate, Tribal public health officials; and stakeholders, including patients and families, to identify, develop, or disseminate best practices to improve perinatal care and outcomes; and

“(III) employ strategies that provide opportunities for health care professionals and clinical teams to collaborate across health care settings and disciplines, including primary care and mental health, as appropriate, to improve maternal and infant health outcomes, which may include the use of data to provide timely feedback across hospital and clinical teams to inform responses, and to provide support and training to hospital and clinical teams for quality improvement, as appropriate.

“(ii) To be eligible for a grant under clause (i), an entity shall submit to the Secretary an application in such form and manner and containing such information as the Secretary may require.”.

(a) Grants.—Title III of the Public Health Service Act is amended by inserting after section 330O of such Act, as added by section 5041, the following:

(b) Report on grant outcomes and dissemination of best practices.—

(1) REPORT.—Not later than February 1, 2026, the Secretary of Health and Human Services shall submit to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives a report that describes—

(A) the outcomes of the activities supported by the grants awarded under the amendment made by this section on maternal and child health;

(B) best practices and models of care used by recipients of grants under such amendment; and

(C) obstacles identified by recipients of grants under such amendment, and strategies used by such recipients to deliver care, improve maternal and child health, and reduce health disparities.

(2) DISSEMINATION OF BEST PRACTICES.—Not later than August 1, 2026, the Secretary of Health and Human Services shall disseminate information on best practices and models of care used by recipients of grants under the amendment made by this section (including best practices and models of care relating to the reduction of health disparities, including such disparities associated with racial and ethnic minority populations, in rates of maternal mortality and severe maternal morbidity) to relevant stakeholders, which may include health providers, medical schools, nursing schools, relevant State, Tribal, and local agencies, and the general public.

(a) Maternal mortality and morbidity activities.—Section 301(e) of the Public Health Service Act (42 U.S.C. 241(e)) is amended by inserting “, preventable maternal mortality and severe maternal morbidity,” after “delivery”.

(b) Office of women’s health.—Section 310A(b)(1) of the Public Health Service Act (42 U.S.C. 242s(b)(1)) is amended by striking “and sociocultural contexts,” and inserting “sociocultural (including among American Indians, Native Hawaiians, and Alaska Natives), and geographical contexts”.

(c) Safe motherhood.—Section 317K of the Public Health Service Act (42 U.S.C. 247b–12) is amended—

(1) in subsection (a)(2)(A), by inserting “, including improving collection of data on race, ethnicity, and other demographic information” before the period; and

(2) in subsection (b)(2)—

(A) in subparagraph (L), by striking “and” at the end;

(B) by redesignating subparagraph (M) as subparagraph (N); and

(C) by inserting after subparagraph (L) the following:

“(M) an examination of the relationship between maternal health and obstetric services in rural areas and outcomes in delivery and postpartum care; and”.

(d) Office of research on women’s health.—Section 486 of the Public Health Service Act (42 U.S.C. 287d) is amended—

(1) in subsection (b), by amending paragraph (3) to read as follows:

“(3) carry out paragraphs (1) and (2) with respect to—

“(A) the aging process in women, with priority given to menopause; and

“(B) pregnancy, with priority given to deaths related to preventable maternal mortality and severe maternal morbidity;”; and

(2) in subsection (d)(4)(A)(iv), by inserting “, including preventable maternal morbidity and severe maternal morbidity” before the semicolon.

The Public Health Service Act is amended by inserting after section 330A–1 (42 U.S.C. 254c–1a) the following:

Section 330I of the Public Health Service Act (42 U.S.C. 254c–14) is amended—

(1) in subsection (f)(3), by adding at the end the following:

“(M) Providers of maternal care, including prenatal, labor care, birthing, and postpartum care services and entities operating obstetric care units.”; and

(2) in subsection (h)(1)(B), by inserting “labor care, birthing care, postpartum care,” before “or prenatal”.

Subpart 1 of part E of title VII of the Public Health Service Act (42 U.S.C. 294n et seq.) is amended by adding at the end the following:

Section 1920 of the Public Health Service Act (42 U.S.C. 300x–9) is amended—

(1) in subsection (a), by striking “$532,571,000 for each of fiscal years 2018 through 2022” and inserting “$532,571,000 for each of fiscal years 2018 through 2020, and $758,000,000 for each of fiscal years 2021 through 2022”; and

(2) by adding at the end the following:

“(d) Crisis care.—

“(1) IN GENERAL.—Except as provided in paragraph (3), a State shall expend at least 5 percent of the amount the State receives pursuant to section 1911 for each fiscal year to support evidenced-based programs that address the crisis care needs of individuals with serious mental disorders, and children with serious mental and emotional disturbances.

“(2) CORE ELEMENTS.—At the discretion of the single State agency responsible for the administration of the program of the State under a grant under section 1911, funds expended pursuant to paragraph (1) may be used to fund some or all of the core crisis care service components, delivered according to evidence-based principles, including the following:

“(A) Crisis call centers.

“(B) 24/7 mobile crisis services.

“(C) Crisis stabilization programs offering acute care or subacute care in a hospital or appropriately licensed facility, as determined by the Substance Abuse and Mental Health Services Administration, with referrals to inpatient or outpatient care.

“(3) STATE FLEXIBILITY.—In lieu of expending 5 percent of the amount the State receives pursuant to section 1911 for a fiscal year to support evidence-based programs as required by paragraph (1), a State may elect to expend not less than 10 percent of such amount to support such programs by the end of two consecutive fiscal years.”.

Subpart 3 of part B of title V of the Public Health Service Act (42 U.S.C. 290bb–31 et seq.) is amended by inserting after section 520A (42 U.S.C. 290bb–32) the following: