Tribal Public Health

Tribal Public Health Law Resources

There are 574 federally recognized American Indian and Alaska Native tribes and villages in the United States. These tribes are sovereign nations that maintain a government-to-government relationship with the United States and have the inherent powers of self-government. As sovereign nations, tribes are uniquely situated to use law as a public health tool to promote the health and well-being of their communities. Additionally, federal law creates a framework that governs the relationships among tribes, states, and the federal government that can affect tribal public health. The resources below are law and policy resources related to tribal public health.

• The Tribal Legal Preparedness Project
  Public health emergencies are issues that every community faces. Therefore, it is critical for all jurisdictions to understand how law can be used to enhance public health preparedness as well as improve coordination and collaboration across jurisdictions. As sovereign entities, tribal governments have the authority to create their own laws and take steps to prepare for and respond to public health emergencies. The Tribal Legal Preparedness Project has been established to assist tribal nations interested in expanding their legal preparedness capacity.
• Selected Tribal Laws Related to Occupational Safety and Health
  This document offers examples of selected tribal laws related to occupational safety and health that can be referenced by jurisdictions interested in developing or updating their own occupational safety and health laws. It provides examples of occupational safety and health codes, laws specific to certain industries or activities, child labor laws, and workers’ compensation laws.
• Tribal Emergency Preparedness Law
  This issue brief provides an introduction to tribal emergency preparedness law. It discusses tribal emergency preparedness authorities and provides examples of these authorities across various tribal laws; examines federal Indian law in the context of emergency preparedness; and addresses cross-jurisdictional coordination between tribes and other jurisdictions.
• Tribal Public Health Law Resource Table
  This table lists organizations with experience in tribal and public health law, classified as Epidemiology Centers, Academic, Non-profit and Public, and Legal Services. Contact information and relevant areas of practice or foci are also provided (to the extent available).
• Marijuana Legalization in Indian Country: Selected Resources
  A list of resources collected and published by CDC’s Public Health Law Program that describe and comment on the legalization of marijuana in Indian Country.
• Menu of Selected Tribal Laws Related to Mosquito and Vector Control
  An inventory of select tribal laws related to mosquito and vector control laws. This menu offers examples of selected tribal laws related to mosquito and vector control that can be used by jurisdictions interested in developing or updating their own vector control laws to respond to vector-borne disease threats.
• Tribal Public Health and the Law: Selected Resources [PDF – 347KB]
  A list of resources collected and published by CDC’s Public Health Law Program (PHLP) that describe and comment on tribal public health law topics, including infectious disease control, emergency preparedness, and public health data.
• Senators Introduce Bill on Tribal Healing to Wellness Court [PDF – 178KB]
  Provides information on Tribal Healing to Wellness Courts and a short overview of a recent US Senate bill authorizing funding to support tribes establishing Tribal Healing to Wellness Courts.
• Tribal Consultation: Selected Resources [PDF – 279KB]
  A list of resources that describe and offer commentary on state and federal tribal consultation. The list includes summaries of relevant laws, scholarly articles, and resources for consultation support.
• Emergency Declarations and Tribes: Mechanisms Under Tribal and Federal Law 
  Tribes have inherent authority as sovereign nations to undertake measures to prepare for and manage public health emergencies in the manner most appropriate for their communities. Coupled with existing federal statutes, there are multiple mechanisms for tribes, either directly or through a state or the US federal government, to declare an emergency or receive the benefits of a federal declaration. This article summarizes several types of emergency declarations, including tribal declarations, Stafford Act declarations, and federal public health emergency declarations, and their implications for tribes. Sunshine G, Hoss A. Emergency declarations and tribes: mechanisms under tribal and federal law. Michigan State International Law Review 2015;24:33–44.
• Menu of Selected Tribal Laws Related to Motor Vehicle Safety [PDF – 409 KB]
  An inventory of select tribal laws related to motor vehicle safety. This menu informs tribal public health practitioners, policy makers, and attorneys about tribes’ use of law as a tool to address motor vehicle-related injuries.
• Tribal Water Rights: Exploring Dam Construction in Indian Country [PDF – 105 KB]
  This article examines the legal and policy framework related to tribal water rights, with a focus on the impacts of dam construction in Indian Country. Three dam projects were highlighted—the Dalles Dam, Elwha River Dams, and Pick-Sloan Missouri River Basin Program. Church J, Ekechi CO, Hoss A, and Larson AJ. Tribal water rights: exploring dam construction in Indian Country. The Journal of Law, Medicine and Ethics  2015;60–3. DOI: 10.111/jlme.12218.
• Tribal Epidemiology Centers Designated as Public Health Authorities [PDF – 500KB]
  Provides an overview of tribal epidemiology centers and the recent amendment to the Indian Health Care Improvement Act (permanently reauthorized by the Affordable Care Act), which designated these centers as public health authorities. The issue brief further outlines the impact of this designation under HIPAA.
• The Affordable Care Act & American Indian and Alaska Native Communities: Selected Readings and Resources [PDF – 229KB]
  A list of readings and resources that describe the Affordable Care Act and the Indian Health Care Improvement Act’s impact on American Indian and Alaska Native (AI/AN) communities. The list includes summaries of the laws, scholarly articles, and resources on enrollment and exemptions.
• American Indian and Alaska Native Hunting and Fishing Rights [PDF – 166KB]
  An overview about key legal doctrines courts have developed to explain off-reservation AI/AN hunting and fishing rights. These doctrines are significant in a public health context because many tribal communities rely on traditional foods for subsistence.
• Infectious Disease Control Menu [PDF – 295KB]
  An inventory of select tribal laws related to infectious disease control. This menu informs tribal public health practitioners, policy makers, and attorneys about tribes’ use of law as a tool to address infectious disease control.

Tribal Public Health Law Webinars

• Infectious Disease Reporting and American Indian and Alaska Native Populations: Law and Practice
  As sovereign nations, tribes have the inherent authority to undertake measures to prepare and manage public health infectious disease threats in the manner most appropriate for their communities. However, cross-jurisdictional issues between tribes, states, and the federal government can affect infectious disease management and reporting in practice. This webinar offers a discussion on how law can affect infectious disease reporting, including a discussion of tribal, federal, and state law. You must enter your email address to view the recording. (Mar. 28, 2016)
• Working With Tribal Communities
  This webinar, hosted by the American Public Health Association, provides insights regarding the environmental health concerns of tribal communities and how the Agency for Toxic Substances and Disease Registry supports tribes in addressing these concerns. (Dec. 17, 2015)
• Improving Data Sharing for Tribal Health: What Public Health Departments Need to Understand About HIPAA Data Privacy Requirements – Network for Public Health Law (networkforphl.org)
  Tribes, tribal organizations, and Tribal Epidemiology Centers (TECs) (tribal organizations) need continuous and routine access to comprehensive and specific public health data to drive public health decision making, particularly during the current pandemic. Nothing in HIPAA prevents public health departments from sharing public health data with tribal organizations just as they can share data with any other public health authority. Sharing these data with tribal public health authorities is essential for addressing the health disparities American Indians and Alaska Natives experience.

Additional Resources

• CDC’s Office for Tribal Affairs and Strategic Alliances (OTASA), housed within CDC’s National Center for State, Tribal, Local, and Territorial Public Health Infrastructure and Workforce, is the primary link between CDC, the Agency for Toxic Substance and Disease Registry, and tribal governments. OTASA activities focus on fulfilling CDC’s supportive role in ensuring that AI/AN communities receive public health services that keep them safe and healthy.
• Indian Health Service, an agency within the Department of Health and Human Services, is responsible for providing federal health services to AI/ANs.
• Bureau of Indian Affairs is responsible for the administration and management of 55 million surface acres and 57 million acres of subsurface minerals estates held in trust by the United States for American Indians, Indian tribes, and Alaska Natives.

Disclaimer: Information available on this website that was not developed by the Centers for Disease Control and Prevention (CDC) does not necessarily represent any CDC policy, position, or endorsement of that information or of its sources. The information contained on this website is not legal advice; if you have questions about a specific law or its application you should consult your legal counsel.