This bill significantly amends the Public Health Service Act to enhance public health security for State, local, and Tribal entities. It explicitly includes Indian Tribes, Tribal organizations, and consortia as eligible entities for cooperative agreements aimed at improving public health preparedness and response capabilities. The legislation also mandates greater collaboration with Tribal educational agencies and the inclusion of Tribal stakeholders in public health planning. The bill authorizes an increase in appropriations for these cooperative agreements, raising the amount to $750,000,000 for each of fiscal years 2026 through 2028 . A crucial provision reserves not less than 5 percent of this funding annually for awards to Tribal eligible entities , ensuring dedicated resources for their public health infrastructure. Furthermore, it requires the Secretary to award at least 10 cooperative agreements to Tribal entities and waives the usual matching fund requirements for them, making these funds more accessible. To facilitate effective implementation, the bill establishes several special rules for Tribal entities. The Secretary is empowered to make necessary program modifications and shall waive or specify alternative requirements for provisions, excluding labor and environmental standards, to better suit Tribal needs, following consultation with Indian Tribes. Mandatory consultation with Tribes on program design is also required to ensure the program's effectiveness in enhancing Tribal public health security. Finally, the legislation mandates a comprehensive reporting mechanism. Within two years, the Secretary, in coordination with the Indian Health Service, must conduct a review of the program's implementation for Tribal entities. This review will include a report to Congress detailing award recipients, waivers granted, and recommendations for program improvements, alongside an analysis of any public health emergency infrastructure limitations faced by Tribal entities.