This bill significantly amends the Public Health Service Act to enhance public health security for Indian Tribes, Tribal organizations, and urban Indian organizations. It explicitly expands eligibility for public health security and preparedness cooperative agreements to include these Tribal entities, ensuring their direct participation in federal programs. The legislation also updates various provisions to integrate Tribal perspectives, such as including Tribal educational agencies and stakeholders in planning and coordination efforts. To support these efforts, the bill authorizes $750,000,000 annually for fiscal years 2027 through 2029 for public health security awards. Crucially, it reserves not less than 5 percent of these funds each fiscal year specifically for Tribal eligible entities, mandating at least ten cooperative agreements. These Tribal awards benefit from significant flexibilities, including funds remaining available until expended and the elimination of any matching requirements. The bill empowers the Secretary to make necessary modifications and waive or specify alternative requirements for program provisions to facilitate effective delivery to Tribal entities, with exceptions for labor and environmental standards. This flexibility is contingent upon consultation with Indian Tribes on program design and implementation. Furthermore, it mandates a comprehensive report to Congress within two years, evaluating the program's success for Tribal entities, detailing awards and waivers, and recommending improvements, including an analysis of Tribal public health emergency infrastructure limitations.