1. TRIBAL REGISTRATION ISSUES Patricia Adams Chief Arizona Office of Vital Records

2. The NAPHSIS/NCHS Collaboration Past Successes and Future Challenges Salt Lake City, UT June 3 rd – 7 th, 2007 GENERAL INFORMATION Arizona is home to 21 federally recognized tribes Population of over 250,000 Native Americans Over a quarter of the state land is comprised of reservations and tribal communities Tribal council has jurisdiction over reservations

3. The NAPHSIS/NCHS Collaboration Past Successes and Future Challenges Salt Lake City, UT June 3 rd – 7 th, 2007 GENERAL INFORMATION CONTINUED Some reservations cross state lines Some cross county lines One reservation crosses US/Mexico border Large geographic areas, sparsely populated

4. The NAPHSIS/NCHS Collaboration Past Successes and Future Challenges Salt Lake City, UT June 3 rd – 7 th, 2007 WE DON’T KNOW WHAT WE DON’T KNOW

5. The NAPHSIS/NCHS Collaboration Past Successes and Future Challenges Salt Lake City, UT June 3 rd – 7 th, 2007 BIRTH REGISTRATION ISSUES Home Births: Unattended Families not aware of need for registration If the are aware – means of communicating are limited We don’t know how to educate the community

6. The NAPHSIS/NCHS Collaboration Past Successes and Future Challenges Salt Lake City, UT June 3 rd – 7 th, 2007 BIRTH CONTINUED Delayed Births High percentage Lack of documentation Communication challenges

7. The NAPHSIS/NCHS Collaboration Past Successes and Future Challenges Salt Lake City, UT June 3 rd – 7 th, 2007 BIRTH CONTINUED Foundlings Communication with Tribal CPS Tribal Registration Offices Often receive certificates and hold them Tribal Courts Orders do not reference state law Inadequate proof of event

8. The NAPHSIS/NCHS Collaboration Past Successes and Future Challenges Salt Lake City, UT June 3 rd – 7 th, 2007 DEATH REGISTRATION ISSUES Tradition vs. State Law Tribal law enforcement vs. medical examiner Cause of death reporting is suspect

9. The NAPHSIS/NCHS Collaboration Past Successes and Future Challenges Salt Lake City, UT June 3 rd – 7 th, 2007 DEATH CONTINUED Noncompliance with time requirements Out-of-state funeral homes not regulated by Arizona Requests for corrections go unheeded

10. The NAPHSIS/NCHS Collaboration Past Successes and Future Challenges Salt Lake City, UT June 3 rd – 7 th, 2007 RESOLUTION APPROACHES Establish relationships Educate! Educate! Educate!