1. CDC and Tribal Epidemiology Centers: Working Relationship Update
Victoria Warren-Mears
Epicenter Director

2. Overview CDC historical relationship
Granting of Public Health Authority Status
Visit to NWTEC by Dr. Ursula Bauer
Calls with Dr. Bauer
Letter to Dr. Frieden
Future Directions

3. NW TEC and CDC
We 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)

4. Public Health Authorities of TECs
In the Affordable Care Act Indian Health Care Improvement Act reauthorization TECs were designated at Public Health Authorities

5. Tribal Epidemiology Centers
2010 AFFORDABLE CARE ACT
Permanently reauthorized the IHCIA
TECs given “public health authority” status

6. Tribal Epidemiology Centers
2010 AFFORDABLE CARE ACT
Health and Human Services (HHS) directed to give TECs access to HHS data systems and protected health information
Centers for Disease Control and Prevention must provide TECs technical assistance
Each IHS Area must have TEC access

7. Seven Core Functions of Tribal Epidemiology Centers
Evaluate Delivery Systems
Collect and Monitor Progress toward meeting health status objectives
Assist Tribes and Tribal Organizations with Epi Data
Make recommendations for service targets
Provide TA to Tribes and Tribal Organizations
Seven Core Functions of Tribal Epidemiology Centers
Make recommendations to improve health care delivery
Provide disease surveillance

8. Core TEC Functions
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). ).
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.”

9. TEC Core Functions
“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
Evaluate data and programs
Identify health priorities with tribes
Make 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). ).
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.”

10. TEC Core Functions
Make recommendations for improving health care delivery systems
Provide 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). ).
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.”

11. TEC Activities
Collect and disseminate data… Provide analysis of health data
Area/Tribal specific health status reports… Community Health Profiles
Maintain/provide access to surveillance databases
Conduct epidemiologic studies
Support public health emergency response
Assist Tribes in disease control and prevention
Provide 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.

12. Visit with Dr. Ursula Bauer

13. Recent Tribe and Tribal Organization Specific CDC RFP
All TEC Directors call with Dr. Bauer to address needs from CDC
TC from Dr. Bauer to suggest a letter to Dr. Frieden to elevate concerns to the Agency level
Release of CDC RFP
Letter sent to Dr. Frieden signed by all TEC directors
Response received June 8, 2014 from Dr. Frieden

14. Recent Tribe and Tribal Organization Specific CDC RFP
Two components
Tribes
Tribal Organizations
Require letters of support from 50% of the area served plus 1

15. Conversations with Dr. Frieden

16. Future Directions Continue to dialogue with CDC
Share movement with Tribal leadership

17. Questions and Comments