Tribal Health Systems and the Role of Tribal Epidemiology Centers. Vanesscia Cresci, MSW, MPA Michael Mudgett, MPH
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1 Tribal Health Systems and the Role of Tribal Epidemiology Centers Vanesscia Cresci, MSW, MPA Michael Mudgett, MPH
2 Background on Tribes in California 109 federally recognized Tribes Two methods of recognition Restoration of status (tribe was terminated) Newly recognized (Congress, BIA, Executive) Non-Federally recognized tribes Sovereignty Inherent right to self-governance Health, education, housing, etc. Lands Often small/isolated (Rancheria/Reservation) Cultural diversity
3 California Indian Houses
4 AIAN Demographics in California US Census counts for AIANs (2010) 723,225 (Alone or in combination) 362,801 (Alone) Indian Health Service estimates (2017) 88,888 (IHS User Population)
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6 *To Scale
7 Indian Health Programs PL Tribes contract directly with Indian Health Service to administer their own health programs Many California Tribes opt to pool their resources together Creates 1 Tribal Health Program that serves Tribes Health Program governed by multiple Tribes Some Health Programs can have multiple clinics that serve different regions Tribal/Urban Indian Health Programs
8 Indian Health Programs
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18 Tribal Epidemiology Centers, Contd. 7 core functions 1. Collect data 2. Evaluate 3. Assist 4. Recommendations for targeting of services 5. Recommendations to improve health care delivery 6. Technical Assistance 7. Disease surveillance Each TEC addresses these in their own unique way
19 California Tribal Epidemiology Center Est Housed within the California Rural Indian Health Board, Inc. (CRIHB) Director, Epidemiologist, Evaluators, Outreach Coordinator, Research Associate, and others Advisory Council Improve the overall health of AIANs in CA
20 California Tribal Epidemiology Center, Contd. Core Funding Indian Health Service DEDP Supplemental Funding Various State and National grants (CDC, RWJ, etc.)
21 5 years Core Funding 5 years 5 years 4 years 1 year Funding Supplement for Methamphetamine Suicide Prevention Initiative/Domestic Violence Prevention Initiative (MSPI/DVPI) Technical Assistance Supplemental program evaluation funding from Indian Health Service, Administration for Children and Families, and Substance Abuse and Mental Health Services Administration Funding Supplement for Enhanced Community Health Profiles Council for State and Territorial Epidemiologists (CSTE) Good Health and Wellness in Indian Country (GHWIC) funding
22 California Tribal Epidemiology Center, Contd. Collect and disseminate health data Produce regional and Indian Health Program specific health status reports Support Public Health emergency response Provide technical assistance to Tribes, Tribal organizations, and Indian Health Programs
23 Mission AIAN health priorities Changes in AIAN health priorities/condit ions Determine Track Improve Provide Health of Californian AIAN Health data Statistics Technical assistance
24 CTEC Data Access California BRFSS: California Area Epi Data Mart (EDM): Current California Health Interview Survey (CHIS): National Health Interview Survey (NHIS): 2016 California Department of Public Health (CDPH) Pending Heart disease and Opioid data OSHPD Hospitalization Emergency Department: Inpatient:
25 Data Sharing Agreements Signed between Indian Health Programs and CTEC Access to pertinent health information Monitor pertinent health information Monitor health status Evaluate needs
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27 Establishing AIAN Health Priorities
28 Overview of CTEC Data Projects AIAN Health Priorities Project Community Health Profiles Enhanced Community Health Profiles CTEC Portal Data Linkage Project Surveillance Database Project Tribal Behavioral Risk Factor Surveillance System (BRFSS) Tribal Youth Risk Behavior Surveillance System (YRBSS)
29 Overview of CTEC Data Projects, Contd. Dental Transformation Initiative (DTI) Data Project Building Public Health Infrastructure (BPHI) Project Advanced California Opportunities to Renew Native Health Systems (ACORNS) Evaluation Hepatitis-C Monitoring Program Mini-Health Priorities Data briefs, fact sheets, surveillance updates, data booklets, etc. Technical Assistance Trainings to enhance CTEC capacity & infrastructure GIS, SAS, SPSS, In-Design, Adobe, Microsoft Access, Grant Writing
30 Overview of CTEC Evaluation Good Health and Wellness in Indian Country (GHWIC) Tribal PREP Evaluation Native Connections Evaluation Project PaTHwAY Evaluation CRIHB Methamphetamine and Suicide Prevention Initiative (MSPI)/Domestic Violence Prevention Initiative (DVPI) Evaluation CTEC Core Objective Evaluation
31 Questions?
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