H-3535.1

SUBSTITUTE HOUSE BILL 2685

ByHouse Appropriations (originally sponsored by Representatives Lekanoff, Parshley, Ramel, and Pollet)

AN ACT Relating to improving the state governmental public health system and the health system and health status of American Indians and Alaska Natives through the sharing and protection of tribal data; reenacting and amending RCW 43.71B.010; adding a new section to chapter 43.71B RCW; adding a new section to chapter 43.20 RCW; adding a new section to chapter 42.56 RCW; and creating a new section.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION.  Sec. 1. A new section is added to chapter 43.71B RCW to read as follows:

(1) State agencies listed in RCW 43.71B.020(1)(b)(i) shall use and share tribal data in a manner consistent with the following tribal data sovereignty principles:

(a) Tribes must have the same or enhanced access to state data as other public health jurisdictions and nongovernmental entities to effectively carry out their governmental duties including preventing and controlling infectious and noninfectious conditions, providing health care services, and improving the health status of their community members;

(b) Tribes must possess the sovereign authority to manage the collection, ownership, application, and interpretation of their own data even when it is collected by federal, state, or local governments or other third parties;

(c) Tribes must retain an ownership interest in their data even when the tribe's data is located in state, federal, or other data sets. This interest remains when the tribe's data is aggregated with other data;

(d) Unless otherwise required by law, tribes have the right to informed consent on how their data, including protected health information about tribal members, is used or shared with third parties; and

(e) State agencies must meaningfully consult and engage with tribes in accordance with chapter 43.376 RCW on how and when to share, analyze, report, or interpret tribal data.

(2) State agencies listed in RCW 43.71B.020(1)(b)(i) shall:

(a) Include the tribal data sovereignty principles provided in this section in data sharing agreements;

(b) Refer to the governor's Indian health advisory council tribal data sharing agreement checklist in the development of tribal data sharing agreements; and

(c) Seek input and guidance from the governor's Indian health advisory council tribal data sovereignty committee for implementation of this section and on any other issues related to tribal data.

(3) Any tribal data, as defined in RCW  43.71B.010, pertaining to American Indians, Alaska Natives, or Indian tribes that is prepared, owned, used, or retained by the agencies listed in RCW 43.71B.020(1)(b)(i) or by local health jurisdictions as defined in RCW 43.70.575 is exempt from public disclosure under chapter 42.56 RCW.

Sec. 2. RCW 43.71B.010 and 2020 c 256 s 102 are each reenacted and amended to read as follows:

The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.

(1) "Advisory council" means the governor's Indian health advisory council established in RCW 43.71B.020.

(2) "Advisory plan" means the plan described in RCW 43.71B.030.

(3) "American Indian" or "Alaska Native" means any individual who is: (a) A member of a federally recognized tribe; or (b) eligible for the Indian health service.

(4) "Authority" means the health care authority.

(5) "Board" means the northwest Portland area Indian health board, an Oregon nonprofit corporation wholly controlled by the tribes in the states of Idaho, Oregon, and Washington.

(6) "Commission" means the American Indian health commission for Washington state, a Washington nonprofit corporation wholly controlled by the tribes and urban Indian organizations in the state.

(7) "Community health aide" means a tribal community health provider certified by a community health aide program of the Indian health service or one or more tribes or tribal organizations consistent with the provisions of 25 U.S.C. Sec. 1616l, who can perform a wide range of duties within the provider's scope of certified practice in health programs of a tribe, tribal organization, Indian health service facility, or urban Indian organization to improve access to culturally appropriate, quality care for American Indians and Alaska Natives and their families and communities, including but not limited to community health aides, community health practitioners, behavioral health aides, behavioral health practitioners, dental health aides, and dental health aide therapists.

(8) "Community health aide program" means a community health aide certification board for the state consistent with 25 U.S.C. Sec. 1616l and the training programs and certification requirements established thereunder.

(9) "Fee-for-service" means the state's medicaid program for which payments are made under the state plan, without a managed care entity, in accordance with the fee-for-service payment methodology.

(10) "Historical trauma" means situations where a community experienced traumatic events, the events generated high levels of collective distress, and the events were perpetuated by outsiders with a destructive or genocidal intent.

(11) "Indian health care provider" means a health care program operated by the Indian health service or by a tribe, tribal organization, or urban Indian organization as those terms are defined in 25 U.S.C. Sec. 1603.

(12) "Indian health service" means the federal agency within the United States department of health and human services.

(13) "New state savings" means the savings to the state general fund that are achieved as a result of the centers for medicare and medicaid services state health official letter 16-002 and related guidance, calculated as the difference between (a) medicaid payments received from the centers for medicare and medicaid services based on the one hundred percent federal medical assistance percentage; and (b) medicaid payments received from the centers for medicare and medicaid services based on the federal medical assistance percentage that would apply in the absence of state health official letter 16-002 and related guidance.

(14) "Reinvestment account" means the Indian health improvement reinvestment account created in RCW 43.71B.040.

(15) "Reinvestment committee" means the Indian health improvement reinvestment committee established in RCW 43.71B.020(4).

(16) "Tribal data" means data or information that is specific to an individual tribe and includes public or private data or information on or about a tribe or its people subject to tribal rights of ownership and control. Tribal data also includes, but is not limited to, tribal membership, tribal affiliation, events and conditions within the tribe's jurisdiction and lands, information about tribal members and any persons living within the tribe's jurisdiction, tribal census tract, tribal land, and identification of tribal facilities, entities, and enterprises and any individuals they serve.

(18) "Tribal organization" has the meaning set forth in 25 U.S.C. Sec. 5304.

(((17)))(19) "Tribally operated facility" means a health care facility operated by one or more tribes or tribal organizations to provide specialty services, including but not limited to evaluation and treatment services, secure detox services, inpatient psychiatric services, nursing home services, and residential substance use disorder services.

(((18)))(20) "Tribe" means any Indian tribe, band, nation, or other organized group or community, including any Alaska Native village or group or regional or village corporation as defined in or established pursuant to the Alaska Native claims settlement act (43 U.S.C. Sec. 1601 et seq.) which is recognized as eligible for the special programs and services provided by the United States to Indians because of their status as Indians.

(((19)))(21) "Urban Indian" means any individual who resides in an urban center and is: (a) A member of a tribe terminated since 1940 and those tribes recognized now or in the future by the state in which they reside, or who is a descendant, in the first or second degree, of any such member; (b) an Eskimo or Aleut or other Alaska Native; (c) considered by the secretary of the interior to be an Indian for any purpose; or (d) considered by the United States secretary of health and human services to be an Indian for purposes of eligibility for Indian health services, including as a California Indian, Eskimo, Aleut, or other Alaska Native.

(((20)))(22) "Urban Indian organization" means an urban Indian organization, as defined by 25 U.S.C. Sec. 1603.

NEW SECTION.  Sec. 3. A new section is added to chapter 43.20 RCW to read as follows:

(1) The state board shall, no later than July 31, 2027, and in accordance with RCW 43.20.050(2)(f), amend rules for the prevention and control of infectious and noninfectious diseases, including food borne and vector-borne illnesses as follows:

(a) Requiring health care providers, health care facilities, laboratories, and other required entities to report notifiable conditions to tribal health jurisdictions in Washington state where the patient resides, or in the event the patient's residence cannot be determined, the tribal health department in which the patient received treatment; and

(b) Requiring notification to tribal health jurisdictions wherever notification is required to local health jurisdictions.

(2) Nothing in this section may be read as an assertion of state jurisdiction or regulatory authority over a tribe.

NEW SECTION.  Sec. 4. A new section is added to chapter 42.56 RCW to read as follows:

Any tribal data, as defined in RCW 43.71B.010, pertaining to American Indians, Alaska Natives, or Indian tribes that is prepared, owned, used, or retained by the agencies listed in RCW 43.71B.020(1)(b)(i) or by local health jurisdictions as defined in RCW 43.70.575 is exempt from public disclosure.

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