CDC and Tribal Epidemiology Centers: Working Relationship Update

Victoria Warren-MearsEpicenter Directorvwarrenmears@npaihb.org

CDC and Tribal Epidemiology Centers: Working Relationship UpdateOverviewCDC historical relationshipGranting of Public Health Authority StatusVisit to NWTEC by Dr. Ursula BauerCalls with Dr. BauerLetter to Dr. FriedenFuture DirectionsNW TEC and CDCWe have had funding from CDC for a variety of projects, including the Tribal EpiCenter Consortium and Data into Action, Comprehensive Cancer Program, and Tribal Community Survey (Tribal BRFSS)Public Health Authorities of TECsIn the Affordable Care Act Indian Health Care Improvement Act reauthorization TECs were designated at Public Health AuthoritiesTribal Epidemiology Centers 2010 AFFORDABLE CARE ACTPermanently reauthorized the IHCIATECs given public health authority status

Tribal Epidemiology Centers 2010 AFFORDABLE CARE ACTHealth and Human Services (HHS) directed to give TECs access to HHS data systems and protected health informationCenters for Disease Control and Prevention must provide TECs technical assistance

Each IHS Area must have TEC access

Core TEC FunctionsCitations from the Patient Protection and Affordable Care Act (2010), which includes the permanent reauthorization of the Indian Health Care Improvement Act, that establishes (continues) the TECs (United States Code > Title 25 Chapter 18 Subchapter II 1621m). http://www.law.cornell.edu/uscode/text/25/1621m ).

a. Functions of TECs: In consultation with and on the request of Indian tribes, tribal organizations, and urban Indian organizations, each Service area epidemiology center established under this section shall, with respect to the applicable Service area collect data relating to, and monitor progress made toward meeting, each of the health status objectives of the Service, the Indian tribes, tribal organizations, and urban Indian organizations in the Service area; evaluate existing delivery systems, data systems, and other systems that impact the improvement of Indian health; assist Indian tribes, tribal organizations, and urban Indian organizations in identifying highest-priority health status objectives and the services needed to achieve those objectives, based on epidemiological data; make recommendations for the targeting of services needed by the populations served; make recommendations to improve health care delivery systems for Indians and urban Indians; provide requested technical assistance to Indian tribes, tribal organizations, and urban Indian organizations in the development of local health service priorities and incidence and prevalence rates of disease and other illness in the community; provide disease surveillance and assist Indian tribes, tribal organizations, and urban Indian communities to promote public health.

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TEC Core FunctionsIn consultation with and on the request of Indian tribes, tribal organizations, and urban Indian organizations, each Service area epidemiology center established under this section shall, with respect to the applicable Service area:Collect dataEvaluate data and programsIdentify health priorities with tribesMake recommendations for health service needs

Citations from the Patient Protection and Affordable Care Act (2010), which includes the permanent reauthorization of the Indian Health Care Improvement Act, that establishes (continues) the TECs (United States Code > Title 25 Chapter 18 Subchapter II 1621m). http://www.law.cornell.edu/uscode/text/25/1621m ).

a. Functions of TECs: In consultation with and on the request of Indian tribes, tribal organizations, and urban Indian organizations, each Service area epidemiology center established under this section shall, with respect to the applicable Service area collect data relating to, and monitor progress made toward meeting, each of the health status objectives of the Service, the Indian tribes, tribal organizations, and urban Indian organizations in the Service area; evaluate existing delivery systems, data systems, and other systems that impact the improvement of Indian health; assist Indian tribes, tribal organizations, and urban Indian organizations in identifying highest-priority health status objectives and the services needed to achieve those objectives, based on epidemiological data; make recommendations for the targeting of services needed by the populations served; make recommendations to improve health care delivery systems for Indians and urban Indians; provide requested technical assistance to Indian tribes, tribal organizations, and urban Indian organizations in the development of local health service priorities and incidence and prevalence rates of disease and other illness in the community; provide disease surveillance and assist Indian tribes, tribal organizations, and urban Indian communities to promote public health.

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TEC Core FunctionsMake recommendations for improving health care delivery systemsProvide epidemiologic technical assistance Provide disease surveillance to tribes

Citations from the Patient Protection and Affordable Care Act (2010), which includes the permanent reauthorization of the Indian Health Care Improvement Act, that establishes (continues) the TECs (United States Code > Title 25 Chapter 18 Subchapter II 1621m). http://www.law.cornell.edu/uscode/text/25/1621m ).

a. Functions of TECs: In consultation with and on the request of Indian tribes, tribal organizations, and urban Indian organizations, each Service area epidemiology center established under this section shall, with respect to the applicable Service area collect data relating to, and monitor progress made toward meeting, each of the health status objectives of the Service, the Indian tribes, tribal organizations, and urban Indian organizations in the Service area; evaluate existing delivery systems, data systems, and other systems that impact the improvement of Indian health; assist Indian tribes, tribal organizations, and urban Indian organizations in identifying highest-priority health status objectives and the services needed to achieve those objectives, based on epidemiological data; make recommendations for the targeting of services needed by the populations served; make recommendations to improve health care delivery systems for Indians and urban Indians; provide requested technical assistance to Indian tribes, tribal organizations, and urban Indian organizations in the development of local health service priorities and incidence and prevalence rates of disease and other illness in the community; provide disease surveillance and assist Indian tribes, tribal organizations, and urban Indian communities to promote public health.

10TEC ActivitiesCollect and disseminate data Provide analysis of health dataArea/Tribal specific health status reports Community Health ProfilesMaintain/provide access to surveillance databasesConduct epidemiologic studiesSupport public health emergency responseAssist Tribes in disease control and preventionProvide training Epidemiology, Data Collection, and Public Health

TECs play a critical role in building public health capacity among AI/AN regions and communities. Working with Tribal entities and urban AI/AN communities, TECs collect and disseminate data, including regional and tribal specific reports such as Community Health Profiles. TECS also perform various surveillance activities, epidemiological studies, public health Emergency response, disease control and prevention and training. Training includes building tribal capacity to use patient management systems such as the immunization registry and the diabetes registry. The NPAIHB NARCH Summer Institute is an example of epidemiologic and public health training that TECs provide.The Resource and Patient Management System (RPMS): A set of integrated computer applications designed to support the clinical and administrative functions of the IHS health care program.11Visit with Dr. Ursula Bauer

Recent Tribe and Tribal Organization Specific CDC RFPAll TEC Directors call with Dr. Bauer to address needs from CDCTC from Dr. Bauer to suggest a letter to Dr. Frieden to elevate concerns to the Agency levelRelease of CDC RFPLetter sent to Dr. Frieden signed by all TEC directorsResponse received June 8, 2014 from Dr. FriedenRecent Tribe and Tribal Organization Specific CDC RFPCDC RFP:Two componentsTribesTribal OrganizationsRequire letters of support from 50% of the area served plus 1Conversations with Dr. Frieden

Future DirectionsContinue to dialogue with CDCShare movement with Tribal leadership Questions and Comments