NEW! Benefits of Public Health Accreditation for Tribal Nations: Fact Sheet
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Tribal Public Health Accreditation Readiness Case Study: Chickasaw Nation
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Tribal Specific Companion Document to PHAB Standards and Measures
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NIHB Recognized by the Public Health Accreditation Board
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Strengthening Tribal Public Health Systems
(Formally Tribal ASI)

Background

Historically, Tribes ensured their communities’ health by integrating systems of health and well-being. As with most if not all indigenous people, prior to European contact, Native Americans had complex traditions, cultural practices, social organizations, economies, forms of government, education, and spirituality that interrelatedly worked together to ensure the health and survival of the people.

Contemporary Tribal public health systems, shaped by a history of colonialism, epidemics, government policy, and a lack of funding evolved along a different trajectory than their local and state counterparts and hence they are often overlooked or underrepresented in the US public health system. “Tribal nations have an inherent right to promote and protect the health and welfare of their citizens, using the methods most relevant for their communities.”1 As such, the National Indian Health Board supports Tribal nations as they rebuild and define their current systems.

Since 2008, the (NIHB) has partnered with Tribal nations and national partners in an effort to advance public health practice in Indian Country. With the support of the Centers for Disease Control and Prevention, NIHB has provided funding and technical assistance to Tribes pursuing performance improvement and public health accreditation projects and initiatives.

Strong Systems, Stronger Communities

Strong Systems, Stronger Communities (SSSC), (created in 2018), is a funding opportunity provided by the National Indian Health Board (NIHB) and supported by the CDC. This opportunity builds on a former project - NIHB’s Tribal Accreditation Support Initiative (ASI) and continues NIHB’s commitment to strengthening Tribal public health systems by offering support and technical assistance specifically to Tribes as they complete projects to improve their performance, meet national public health accreditation standards, and/or promote interconnection across the public health system to improve population health.

The intended outcomes of SSSC include;

  • Increased performance improvement practice
  • Increased innovation in response to system integration challenges, and
  • Progress toward national public health standards.

While performance improvement focuses on internal changes to improve services, system improvement focuses on incorporating health equity and interconnection of various systems that can impact the public health of a community. Interconnection is defined as "the linkage of programs, activities, and/or stakeholders to promote overall efficiency and effectiveness and achieve gains in population health."

New this Year! Request for Applications: 2020 Cross-jurisdictional Systems Improvement Partnership Technical Assistance Opportunity

Applications due Friday, December 6, 2019 at 11:59pm ET

ARE YOU READY TO WORK WITH OTHER HEALTH DEPARTMENTS IN YOUR REGION?

Public health and systems issues often span jurisdictional boundaries. To improve public health systems and infrastructure, the Centers for Disease Control and Prevention (CDC) has partnered with the Association of State and Territorial Health Officials (ASTHO), the National Association of City and County Health Officials (NACCHO), and the National Indian Health Board (NIHB) to support a collaborative technical assistance opportunity, the Cross-jurisdictional Systems Improvement Partnership (CJSIP) program, as part of its Strong Systems, Stronger Communities (SSSC) initiative. This opportunity aims to improve performance improvement practice and increase innovation in response to systems challenges, and to support progress toward meeting national public health standards among local, Tribal, and state health departments. This project is designed to strengthen cross-jurisdictional partnerships among local, Tribal, and state health entities to develop and implement a shared action plan toward public health systems improvement. This opportunity requires a shared commitment from at least one Tribal, one local, and one state health department to collaborate on a joint public health systems improvement project. Partners are to submit a letter of interest no later than December 6, 2019. The selected partnership will receive in-person and remote performance improvement capacity-building technical assistance provided by ASTHO, NACCHO, and NIHB from January to July 2020, including through at a 2-day in-person workshop. This opportunity does not include direct funding.

TO APPLY: For more information and to submit a letter of interest please click here. To download the RFA announcement as a PDF, click here. Completed applications are due via the online application form by Friday, December 6, 2019 at 11:59pm ET


Current SSSC Awardees 2019-2020

Awardees are divided into two cohorts for this grant cycle.

The Self-Assessment Cohort awardees are receiving training in performance improvement, creating a performance-improvement team, and engaging in a self-assessment of their current public health capacities. These awardees include:

  • Port Gamble S’Klallam Tribe
  • Rosebud Sioux Tribe

The Performance/System Improvement Cohort awardees are each pursuing their own performance/system improvement projects based on need identified in their community and health system. These awardees and projects include:

  • Forest County Potawatomi Community- Provide staff training on quality improvement and the public health services. Review and update performance management measures.
  • Oglala Sioux Tribe- Use strategic planning to increase integration and coordination between behavioral health and public health services.
  • Taos Pueblo- Develop a Community Health Improvement Plan (CHIP)
  • Wichita and Affiliated Tribes- Engage in strategic planning for public health activities, and establish a health board.
  • Winnebago Tribe of Nebraska- Develop a CHIP
  • Confederated Tribes of the Umatilla Indian Reservation- Update their Community Health Assessment (CHA) and host a mock PHAB accreditation site visit

Tribal Accreditation Support Initiative

From 2014-2018, NIHB supported Tribal efforts to increase their readiness for public health accreditation through the Tribal Accreditation Support Initiative (ASI). Over the course of four years, twenty Tribal awardees performed performance improvement tasks such as Community/Tribal Health Assessments and Improvement Plans, strategic planning, workforce development, and quality improvement projects. As a measure of readiness, NIHB adapted the evidence-based Community Readiness Model to an Accreditation Readiness Model, and used this to track progress and assist awardees in charting their course for systems improvement.

View Tribal ASI Awardees 2014-2108

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View Past Awardees Project Presentations

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1.Reference: Tribes maintain “inherent powers of limited sovereignty which has never been extinguished.” United States v. Wheeler, 435 U.S. 313, 322–3 (1978) (quoting F. Cohen, HANDBOOK OF FEDERAL INDIAN LAW 122 (1945)). Wheeler further explains that “Indian tribes still possess those aspects of sovereignty not withdrawn by treaty or statute, or by implication as a necessary result of their dependent status.” Wheeler, 435 U.S. at 323. See also, Lawrence O. Gostin, PUBLIC HEALTH LAW: POWER, DUTY, RESTRAINT 5, 8–9 (2nd ed. 2008), which describes governments as not only having the power to promote the health and welfare of its citizens but also the duty and obligation to do so.


Resources

A collection of guides, templates, self-assessments, worksheets and other resources.
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TOOLS
TALC is free webinar series designed for sharing and learning about public health accreditations in Tribal communities. Upcoming webinars and past recordings are available.
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TRIBAL ACCREDITATION LEARNING COMMUNITY (TALC) WEBINAR SERIES
Tribal examples of the six major documents required for public health accreditation: community health assessment, community health improvement plan, strategic plan, quality improvement plan, workforce development plan, emergency preparedness plan.
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TRIBAL EXAMPLES OF MAJOR PLANS
General information, costs and benefits, the steps to accreditation, positions papers, etc.
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OVERVIEW OF ACCREDITATION
News, case studies, videos and presentations featuring the Tribal experience with public health accreditation.
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STORIES FROM THE FIELD
Tribal Public Health Accreditation Advisory Board
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TRIBAL PUBLIC HEALTH ACCREDITATION ADVISORY BOARD


 

NIHB Contact:

Carolyn Angus-Hornbuckle, JD
Director of Public Health Policy and Programs

National Indian Health Board
910 Pennsylvania Ave, SE
Washington, DC 20003
Phone: 202-507-4089
[email protected]

 

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