{"id":50,"date":"2024-05-29T14:44:18","date_gmt":"2024-05-29T14:44:18","guid":{"rendered":"https:\/\/triballive.wpenginepowered.com\/?page_id=50"},"modified":"2025-11-19T15:44:03","modified_gmt":"2025-11-19T15:44:03","slug":"tribal-background","status":"publish","type":"page","link":"https:\/\/tribal.cste.org\/?page_id=50","title":{"rendered":"Tribal Background"},"content":{"rendered":"<p>[et_pb_section fb_built=&#8221;1&#8243; admin_label=&#8221;Header&#8221; _builder_version=&#8221;4.27.0&#8243; use_background_color_gradient=&#8221;on&#8221; background_color_gradient_stops=&#8221;rgba(255,255,255,0.4) 0%|#ffffff 90%&#8221; background_color_gradient_overlays_image=&#8221;on&#8221; background_color_gradient_start=&#8221;rgba(255,255,255,0.4)&#8221; background_color_gradient_end=&#8221;#ffffff&#8221; background_color_gradient_end_position=&#8221;90%&#8221; background_image=&#8221;https:\/\/triballive.wpenginepowered.com\/wp-content\/uploads\/2024\/07\/GettyImages-148780185-scaled.jpg&#8221; parallax=&#8221;on&#8221; custom_margin=&#8221;||||false&#8221; custom_padding=&#8221;40vw||0vw||false|false&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row _builder_version=&#8221;4.16&#8243; custom_margin=&#8221;-492px|auto||auto||&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.16&#8243; custom_padding=&#8221;|||&#8221; global_colors_info=&#8221;{}&#8221; custom_padding__hover=&#8221;|||&#8221;][et_pb_text _builder_version=&#8221;4.16&#8243; text_font=&#8221;||||||||&#8221; ul_font=&#8221;||||||||&#8221; ol_font=&#8221;||||||||&#8221; header_font=&#8221;Montserrat|500||on|||||&#8221; header_font_size=&#8221;18px&#8221; header_letter_spacing=&#8221;5px&#8221; header_line_height=&#8221;1.5em&#8221; header_2_font=&#8221;Merriweather|||on|||||&#8221; header_2_font_size=&#8221;70px&#8221; header_2_letter_spacing=&#8221;5px&#8221; header_2_line_height=&#8221;1.4em&#8221; header_3_font=&#8221;||||||||&#8221; header_4_font=&#8221;||||||||&#8221; header_5_font=&#8221;||||||||&#8221; header_6_font=&#8221;||||||||&#8221; text_orientation=&#8221;center&#8221; header_font_size_tablet=&#8221;&#8221; header_font_size_phone=&#8221;12px&#8221; header_font_size_last_edited=&#8221;on|desktop&#8221; header_2_font_size_tablet=&#8221;50px&#8221; header_2_font_size_phone=&#8221;30px&#8221; header_2_font_size_last_edited=&#8221;on|desktop&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h2><span style=\"color: #374db2;\">Tribal Background<\/span><\/h2>\n<h1><\/h1>\n<p>[\/et_pb_text][et_pb_text _builder_version=&#8221;4.16&#8243; text_font=&#8221;||||||||&#8221; ul_font=&#8221;||||||||&#8221; ol_font=&#8221;||||||||&#8221; header_font=&#8221;Montserrat|500||on|||||&#8221; header_font_size=&#8221;18px&#8221; header_letter_spacing=&#8221;5px&#8221; header_line_height=&#8221;1.5em&#8221; header_2_font=&#8221;Merriweather|||on|||||&#8221; header_2_font_size=&#8221;70px&#8221; header_2_letter_spacing=&#8221;5px&#8221; header_2_line_height=&#8221;1.4em&#8221; header_3_font=&#8221;||||||||&#8221; header_4_font=&#8221;||||||||&#8221; header_5_font=&#8221;||||||||&#8221; header_6_font=&#8221;||||||||&#8221; text_orientation=&#8221;center&#8221; header_font_size_tablet=&#8221;&#8221; header_font_size_phone=&#8221;12px&#8221; header_font_size_last_edited=&#8221;on|desktop&#8221; header_2_font_size_tablet=&#8221;50px&#8221; header_2_font_size_phone=&#8221;30px&#8221; header_2_font_size_last_edited=&#8221;on|desktop&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h1><span data-contrast=\"none\" xml:lang=\"EN-US\" lang=\"EN-US\" class=\"TextRun SCXW18981165 BCX0\" style=\"color: #374db2;\"><span class=\"NormalTextRun SCXW18981165 BCX0\" data-ccp-charstyle=\"Intense Emphasis\">\u201c<span data-contrast=\"none\" xml:lang=\"EN-US\" lang=\"EN-US\" class=\"TextRun SCXW263992132 BCX0\"><span class=\"NormalTextRun SCXW263992132 BCX0\" data-ccp-charstyle=\"Intense Emphasis\">As sovereign nations, Tribes have inherent authority to protect their Tribal citizens\u2019 health and wellness and provide public health services as they determine best.&#8221;<\/span><\/span><\/span><\/span><\/h1>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; admin_label=&#8221;Header&#8221; _builder_version=&#8221;4.16&#8243; custom_margin=&#8221;-15px|||||&#8221; custom_padding=&#8221;4px||0px|||&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row _builder_version=&#8221;4.16&#8243; background_size=&#8221;contain&#8221; custom_margin=&#8221;-217px|auto||auto||&#8221; animation_style=&#8221;zoom&#8221; animation_intensity_zoom=&#8221;10%&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.16&#8243; custom_padding=&#8221;80px|||&#8221; custom_padding_tablet=&#8221;0px|||&#8221; custom_padding_phone=&#8221;0px|||&#8221; custom_padding_last_edited=&#8221;on|tablet&#8221; global_colors_info=&#8221;{}&#8221; custom_padding__hover=&#8221;|||&#8221;][et_pb_video src=&#8221;https:\/\/videopress.com\/v\/XUZHJvNx&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_margin=&#8221;3px|||||&#8221; global_colors_info=&#8221;{}&#8221;][\/et_pb_video][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.27.0&#8243; text_font=&#8221;||||||||&#8221; text_line_height=&#8221;2em&#8221; header_font=&#8221;||||||||&#8221; header_2_font=&#8221;Merriweather|700|||||||&#8221; header_2_font_size=&#8221;36px&#8221; header_2_line_height=&#8221;1.6em&#8221; custom_margin=&#8221;-14px||59px|||&#8221; header_2_font_size_tablet=&#8221;&#8221; header_2_font_size_phone=&#8221;20px&#8221; header_2_font_size_last_edited=&#8221;on|phone&#8221; locked=&#8221;off&#8221; inline_fonts=&#8221;Poppins&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p style=\"text-align: center;\"><span style=\"font-family: Poppins; font-weight: normal; font-size: large; color: #374db2;\"><span style=\"font-size: large;\"><span class=\"NormalTextRun SCXW45921820 BCX0\">This Toolkit focuses on federally recognized Tribes, but similar values can be applied to state recognized tribes. State-recognized Tribes do not have same the relationship with the federal government and federal laws do not apply in the same way. However, there may be state laws that do apply. It is encouraged to learn about any applicable laws or policies <\/span><span class=\"NormalTextRun SCXW45921820 BCX0\">regarding<\/span><span class=\"NormalTextRun SCXW45921820 BCX0\"> any state-recognized Tribes in your <\/span><span class=\"NormalTextRun ContextualSpellingAndGrammarErrorV2Themed SCXW45921820 BCX0\">jurisdiction<\/span><\/span><\/span><span style=\"color: #374db2; font-size: 18px; font-family: Poppins;\">.\u00a0<\/span><\/p>\n<p>[\/et_pb_text][et_pb_divider color=&#8221;#374db2&#8243; divider_style=&#8221;dotted&#8221; divider_weight=&#8221;10px&#8221; _builder_version=&#8221;4.25.1&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][\/et_pb_divider][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; admin_label=&#8221;Coaching&#8221; _builder_version=&#8221;4.27.0&#8243; use_background_color_gradient=&#8221;on&#8221; background_color_gradient_stops=&#8221;#374db2 3%|#ffffff 100%&#8221; custom_padding=&#8221;||0px|||&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row _builder_version=&#8221;4.16&#8243; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.16&#8243; custom_padding=&#8221;|||&#8221; global_colors_info=&#8221;{}&#8221; custom_padding__hover=&#8221;|||&#8221;][et_pb_text _builder_version=&#8221;4.27.0&#8243; text_font=&#8221;Poppins||||||||&#8221; text_line_height=&#8221;2em&#8221; header_font=&#8221;||||||||&#8221; header_2_font=&#8221;Merriweather|700|||||||&#8221; header_2_font_size=&#8221;36px&#8221; header_2_line_height=&#8221;1.6em&#8221; header_3_font=&#8221;Merriweather|700|||||||&#8221; header_3_text_color=&#8221;#ffc47c&#8221; header_3_font_size=&#8221;18px&#8221; header_3_line_height=&#8221;1.8em&#8221; text_orientation=&#8221;center&#8221; header_2_font_size_tablet=&#8221;&#8221; header_2_font_size_phone=&#8221;20px&#8221; header_2_font_size_last_edited=&#8221;on|phone&#8221; header_3_font_size_tablet=&#8221;&#8221; header_3_font_size_phone=&#8221;14px&#8221; header_3_font_size_last_edited=&#8221;on|phone&#8221; locked=&#8221;off&#8221; inline_fonts=&#8221;Poppins&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h2><span data-contrast=\"none\" xml:lang=\"EN-US\" lang=\"EN-US\" class=\"TextRun SCXW200830675 BCX0\" style=\"color: #ffffff;\"><span class=\"NormalTextRun SCXW200830675 BCX0\" data-ccp-charstyle=\"Heading 2 Char\">Sovereign Dependent Nations<\/span><\/span><\/h2>\n<h3><span style=\"color: #ffffff; font-family: Poppins;\"><span data-contrast=\"auto\" xml:lang=\"EN-US\" lang=\"EN-US\" class=\"TextRun SCXW9422137 BCX0\"><span class=\"NormalTextRun SCXW9422137 BCX0\">Sovereignty is the authority to self-govern. Tribes have the inherent authority to govern their Nations \u2013 including the protection and promotion of the public\u2019s health.<\/span><\/span><span class=\"EOP SCXW9422137 BCX0\" data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559685&quot;:720,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/span><\/h3>\n<p>[\/et_pb_text][et_pb_toggle title=&#8221;What is an %22Indian%22&#8243; open_toggle_text_color=&#8221;#374db2&#8243; open_toggle_background_color=&#8221;#ffffff&#8221; closed_toggle_background_color=&#8221;#ffffff&#8221; icon_color=&#8221;#15c39a&#8221; open_icon_color=&#8221;#15c39a&#8221; _builder_version=&#8221;4.27.0&#8243; title_text_color=&#8221;#374db2&#8243; title_font=&#8221;Poppins|700||on|||||&#8221; title_text_align=&#8221;center&#8221; title_font_size=&#8221;18px&#8221; title_letter_spacing=&#8221;1px&#8221; title_line_height=&#8221;2em&#8221; closed_title_font=&#8221;Poppins||||||||&#8221; body_font=&#8221;Poppins||||||||&#8221; body_text_align=&#8221;left&#8221; body_font_size=&#8221;18px&#8221; custom_padding=&#8221;24px||24px||true&#8221; animation_style=&#8221;zoom&#8221; animation_intensity_zoom=&#8221;10%&#8221; border_radii=&#8221;on|10px|10px|10px|10px&#8221; border_width_all=&#8221;0px&#8221; box_shadow_style=&#8221;preset1&#8243; box_shadow_vertical=&#8221;10px&#8221; box_shadow_blur=&#8221;60px&#8221; box_shadow_color=&#8221;rgba(1,33,92,0.1)&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p><span data-contrast=\"auto\"><span style=\"color: #374db2;\">American Indian and Alaska Native (AI\/AN) refer to people who identify with one or more Tribes of the continental US or Alaska. Native Hawaiians are not AI\/AN.<\/span><\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559685&quot;:1440,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\" style=\"color: #374db2;\">\u00a0<\/span><\/p>\n<p><span style=\"color: #374db2;\">Native American generally refers to members of groups Native to the US or its territories or people who are Native to any part of the Americas (Canada, Mexico, South America) that are also US residents.\u00a0<\/span><\/p>\n<p><span style=\"color: #374db2;\">AI\/AN can refer to a race \u2013 such as in Census or public health data \u2013 but also to a political status because some people, but not all, who identify as AI\/AN are also members of federally recognized Tribes.\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\" style=\"color: #374db2;\">AI\/AN \u201crace\u201d is often used to identify Tribal members in public health data, but the two groups are not identical. Tribal members can be of any race or ethnicity and be AI\/ANs in terms of political status<\/span><\/p>\n<p>[\/et_pb_toggle][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=&#8221;4.16&#8243; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.16&#8243; custom_padding=&#8221;|||&#8221; global_colors_info=&#8221;{}&#8221; custom_padding__hover=&#8221;|||&#8221;][et_pb_text _builder_version=&#8221;4.27.0&#8243; text_font=&#8221;Poppins||||||||&#8221; text_font_size=&#8221;16px&#8221; text_line_height=&#8221;2em&#8221; header_font=&#8221;||||||||&#8221; header_2_font=&#8221;Merriweather|700|||||||&#8221; header_2_font_size=&#8221;36px&#8221; header_2_line_height=&#8221;1.6em&#8221; text_orientation=&#8221;center&#8221; custom_margin=&#8221;-25px|||||&#8221; header_2_font_size_tablet=&#8221;&#8221; header_2_font_size_phone=&#8221;20px&#8221; header_2_font_size_last_edited=&#8221;on|phone&#8221; locked=&#8221;off&#8221; inline_fonts=&#8221;Poppins&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p><a href=\"https:\/\/www.federalregister.gov\/documents\/2022\/01\/28\/2022-01789\/indian-entities-recognized-by-and-eligible-to-receive-services-from-the-united-states-bureau-of\" target=\"_blank\" rel=\"noopener\"><span><span style=\"color: #ffc47c;\">There are currently 574 federally recognized tribes in the US.<\/span><\/span><\/a><span style=\"color: #ffffff;\"> Federally recognized tribes have a government-to-government relationship with the US government that authorizes certain benefits.\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\"><span style=\"color: #ffc47c;\">There are also more than 300 state-recognized tribes that are not recognized by the federal government.<\/span> <span style=\"color: #ffffff;\">These state-recognized tribes do not have the same government-to-government relationship with the federal government that federally recognized tribes do. Their authorities are more limited than federally recognized Tribes and not addressed in this toolkit. If you work with a Tribe that is not federally recognized, but is state recognized, contact state officials to learn more about the Tribe\u2019s rights and responsibilities under state law.<\/span><\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559685&quot;:720,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\" style=\"color: #ffffff;\">\u00a0<\/span><\/p>\n<p>[\/et_pb_text][et_pb_text _builder_version=&#8221;4.27.0&#8243; text_font=&#8221;||||||||&#8221; ul_font=&#8221;||||||||&#8221; ol_font=&#8221;||||||||&#8221; header_font=&#8221;Montserrat|500||on|||||&#8221; header_font_size=&#8221;18px&#8221; header_letter_spacing=&#8221;5px&#8221; header_line_height=&#8221;1.5em&#8221; header_2_font=&#8221;Merriweather|||on|||||&#8221; header_2_font_size=&#8221;70px&#8221; header_2_letter_spacing=&#8221;5px&#8221; header_2_line_height=&#8221;1.4em&#8221; header_3_font=&#8221;||||||||&#8221; header_4_font=&#8221;||||||||&#8221; header_5_font=&#8221;||||||||&#8221; header_6_font=&#8221;||||||||&#8221; text_orientation=&#8221;center&#8221; header_font_size_tablet=&#8221;&#8221; header_font_size_phone=&#8221;12px&#8221; header_font_size_last_edited=&#8221;on|desktop&#8221; header_2_font_size_tablet=&#8221;50px&#8221; header_2_font_size_phone=&#8221;30px&#8221; header_2_font_size_last_edited=&#8221;on|desktop&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h1><span style=\"color: #ffffff;\"><span data-contrast=\"none\" xml:lang=\"EN-US\" lang=\"EN-US\" class=\"TextRun SCXW204629935 BCX0\"><span class=\"NormalTextRun SCXW204629935 BCX0\" data-ccp-charstyle=\"Intense Emphasis\">\u201cNative peoples and governments have inherent rights and a political relationship with the U.S. government that does not derive from race or ethnicity. Tribal citizens are citizens of three sovereigns: their tribal nations, the United States, and the state in which they <\/span><span class=\"NormalTextRun SCXW204629935 BCX0\" data-ccp-charstyle=\"Intense Emphasis\">reside<\/span><span class=\"NormalTextRun SCXW204629935 BCX0\" data-ccp-charstyle=\"Intense Emphasis\">.\u201d\u00a0<\/span><\/span><span class=\"EOP SCXW204629935 BCX0\" data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559685&quot;:720,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/span><\/h1>\n<p>[\/et_pb_text][et_pb_divider color=&#8221;#ffc47c&#8221; divider_style=&#8221;dotted&#8221; divider_weight=&#8221;10px&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][\/et_pb_divider][et_pb_text _builder_version=&#8221;4.27.0&#8243; text_font=&#8221;||||||||&#8221; text_line_height=&#8221;2em&#8221; header_font=&#8221;||||||||&#8221; header_2_font=&#8221;Merriweather|700|||||||&#8221; header_2_font_size=&#8221;36px&#8221; header_2_line_height=&#8221;1.6em&#8221; header_3_font=&#8221;Merriweather|700|||||||&#8221; header_3_text_color=&#8221;#ffc47c&#8221; header_3_font_size=&#8221;18px&#8221; header_3_line_height=&#8221;1.8em&#8221; text_orientation=&#8221;center&#8221; header_2_font_size_tablet=&#8221;&#8221; header_2_font_size_phone=&#8221;20px&#8221; header_2_font_size_last_edited=&#8221;on|phone&#8221; header_3_font_size_tablet=&#8221;&#8221; header_3_font_size_phone=&#8221;14px&#8221; header_3_font_size_last_edited=&#8221;on|phone&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h2><span data-contrast=\"none\" xml:lang=\"EN-US\" lang=\"EN-US\" class=\"TextRun SCXW38192000 BCX0\" style=\"color: #374db2;\"><span class=\"NormalTextRun SCXW38192000 BCX0\" data-ccp-charstyle=\"Heading 2 Char\">Trust Responsibility<\/span><\/span><\/h2>\n<p>[\/et_pb_text][et_pb_toggle title=&#8221;Trust Relationship&#8221; open_toggle_text_color=&#8221;#374db2&#8243; open_toggle_background_color=&#8221;#ffffff&#8221; closed_toggle_background_color=&#8221;#ffffff&#8221; icon_color=&#8221;#15c39a&#8221; open_icon_color=&#8221;#15c39a&#8221; _builder_version=&#8221;4.27.4&#8243; title_text_color=&#8221;#374db2&#8243; title_font=&#8221;Poppins|700||on|||||&#8221; title_text_align=&#8221;center&#8221; title_font_size=&#8221;18px&#8221; title_letter_spacing=&#8221;1px&#8221; title_line_height=&#8221;2em&#8221; closed_title_font=&#8221;Poppins||||||||&#8221; body_font=&#8221;Poppins||||||||&#8221; body_text_align=&#8221;left&#8221; body_font_size=&#8221;18px&#8221; custom_padding=&#8221;24px||24px||true&#8221; animation_style=&#8221;zoom&#8221; animation_intensity_zoom=&#8221;10%&#8221; border_radii=&#8221;on|10px|10px|10px|10px&#8221; border_width_all=&#8221;0px&#8221; box_shadow_style=&#8221;preset1&#8243; box_shadow_vertical=&#8221;10px&#8221; box_shadow_blur=&#8221;60px&#8221; box_shadow_color=&#8221;rgba(1,33,92,0.1)&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p><span data-contrast=\"none\" style=\"color: #374db2;\">Due to the government-to-government relationship between them, the federal government and Tribes have what is called a <\/span><a href=\"https:\/\/www.bia.gov\/faqs\/what-federal-indian-trust-responsibility\" target=\"_blank\" rel=\"noopener\"><span>\u201ctrust\u201d relationship<\/span><\/a><span style=\"color: #374db2;\"> or the \u201ctrust responsibility\u201d.\u00a0\u00a0<\/span><\/p>\n<p><span style=\"color: #374db2;\">This relationship is based on treaties that the US entered into with Tribes. The treaties guaranteed that the federal government would, among other things, \u201cprovide for the well-being of the tribes\u201d in exchange for Tribal lands.\u00a0<\/span><\/p>\n<p><a href=\"https:\/\/www.usetinc.org\/uset\/trust-modernization\/\" target=\"_blank\" rel=\"noopener\"><span>The relationship is also considered to be nation-to-nation, differing from state-to-federal government or state-to-state relationships.<\/span><\/a><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559685&quot;:720,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<p><span style=\"color: #374db2;\">Federal, State, or local public health agencies partnering with Tribal public health agencies should, therefore, treat these relationships as government-to-government interactions. Tribes are not non-profit organizations or other private entities; they are Nations.\u00a0<\/span><\/p>\n<p><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559685&quot;:720,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<p>[\/et_pb_toggle][et_pb_toggle title=&#8221;Why is it important to public health? &#8221; open_toggle_text_color=&#8221;#374db2&#8243; open_toggle_background_color=&#8221;#ffffff&#8221; closed_toggle_background_color=&#8221;#ffffff&#8221; icon_color=&#8221;#15c39a&#8221; open_icon_color=&#8221;#15c39a&#8221; _builder_version=&#8221;4.27.0&#8243; title_text_color=&#8221;#374db2&#8243; title_font=&#8221;Poppins|700||on|||||&#8221; title_text_align=&#8221;center&#8221; title_font_size=&#8221;18px&#8221; title_letter_spacing=&#8221;1px&#8221; title_line_height=&#8221;2em&#8221; closed_title_font=&#8221;Poppins||||||||&#8221; body_font=&#8221;Poppins||||||||&#8221; body_text_align=&#8221;left&#8221; body_font_size=&#8221;18px&#8221; custom_padding=&#8221;24px||24px||true&#8221; animation_style=&#8221;zoom&#8221; animation_intensity_zoom=&#8221;10%&#8221; border_radii=&#8221;on|10px|10px|10px|10px&#8221; border_width_all=&#8221;0px&#8221; box_shadow_style=&#8221;preset1&#8243; box_shadow_vertical=&#8221;10px&#8221; box_shadow_blur=&#8221;60px&#8221; box_shadow_color=&#8221;rgba(1,33,92,0.1)&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"10\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:2880,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\uf0b7&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"1\" data-aria-level=\"4\"><span style=\"color: #374db2;\">Tribal governments have the same rights, authorities, and responsibilities of other nations to protect and promote the health of their citizens or members.\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"10\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:2880,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\uf0b7&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"2\" data-aria-level=\"4\"><span style=\"color: #374db2;\">They can monitor public health threats and provide public health services.\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"10\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:2880,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\uf0b7&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"3\" data-aria-level=\"4\"><span style=\"color: #374db2;\">They should be treated as Nations in interactions with other governments. Both state and federal agencies should interact with Tribes on a government-to-government basis.\u00a0<\/span><\/li>\n<\/ul>\n<p><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/p>\n<p><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559685&quot;:720,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<p>[\/et_pb_toggle][et_pb_text _builder_version=&#8221;4.27.0&#8243; text_font=&#8221;||||||||&#8221; text_line_height=&#8221;2em&#8221; header_font=&#8221;||||||||&#8221; header_2_font=&#8221;Merriweather|700|||||||&#8221; header_2_font_size=&#8221;36px&#8221; header_2_line_height=&#8221;1.6em&#8221; header_3_font=&#8221;Merriweather|700|||||||&#8221; header_3_text_color=&#8221;#ffc47c&#8221; header_3_font_size=&#8221;18px&#8221; header_3_line_height=&#8221;1.8em&#8221; text_orientation=&#8221;center&#8221; custom_margin=&#8221;66px|||||&#8221; header_2_font_size_tablet=&#8221;&#8221; header_2_font_size_phone=&#8221;20px&#8221; header_2_font_size_last_edited=&#8221;on|phone&#8221; header_3_font_size_tablet=&#8221;&#8221; header_3_font_size_phone=&#8221;14px&#8221; header_3_font_size_last_edited=&#8221;on|phone&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h2><span style=\"color: #374db2;\"><span data-contrast=\"none\" xml:lang=\"EN-US\" lang=\"EN-US\" class=\"TextRun SCXW99401685 BCX0\"><span class=\"NormalTextRun SCXW99401685 BCX0\" data-ccp-charstyle=\"Heading 2 Char\">History of Indian Health Care<\/span><\/span><span class=\"EOP SCXW99401685 BCX0\" data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/span><\/h2>\n<p>[\/et_pb_text][et_pb_video src=&#8221;https:\/\/videopress.com\/v\/P4ix85Fh&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_margin=&#8221;-25px|||||&#8221; global_colors_info=&#8221;{}&#8221;][\/et_pb_video][et_pb_toggle title=&#8221;us government involvement&#8221; open_toggle_text_color=&#8221;#374db2&#8243; open_toggle_background_color=&#8221;#ffffff&#8221; closed_toggle_background_color=&#8221;#ffffff&#8221; icon_color=&#8221;#15c39a&#8221; open_icon_color=&#8221;#15c39a&#8221; _builder_version=&#8221;4.27.4&#8243; title_text_color=&#8221;#374db2&#8243; title_font=&#8221;Poppins|700||on|||||&#8221; title_text_align=&#8221;center&#8221; title_font_size=&#8221;18px&#8221; title_letter_spacing=&#8221;1px&#8221; title_line_height=&#8221;2em&#8221; closed_title_font=&#8221;Poppins||||||||&#8221; body_font=&#8221;Poppins||||||||&#8221; body_text_align=&#8221;left&#8221; body_font_size=&#8221;18px&#8221; custom_padding=&#8221;24px||24px||true&#8221; animation_style=&#8221;zoom&#8221; animation_intensity_zoom=&#8221;10%&#8221; border_radii=&#8221;on|10px|10px|10px|10px&#8221; border_width_all=&#8221;0px&#8221; box_shadow_style=&#8221;preset1&#8243; box_shadow_vertical=&#8221;10px&#8221; box_shadow_blur=&#8221;60px&#8221; box_shadow_color=&#8221;rgba(1,33,92,0.1)&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p><span style=\"color: #374db2;\">The US government has provided American Indians and, later, Alaska Natives, health care for over 200 years. Initially care was provided by military surgeons and Indian affairs were housed in the War Department until 1849. With the establishment of reservations, the US government provided services to American Indians, including food and healthcare.\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\" style=\"color: #374db2;\">Many treaties commit the US government to providing healthcare for American Indians and Alaska Natives. <\/span><a href=\"https:\/\/www.nihb.org\/education\/indian-health-101\/\" target=\"_blank\" rel=\"noopener\"><span>Through its trust responsibility to Tribal nations<\/span><\/a><span data-contrast=\"auto\">, <span style=\"color: #374db2;\">the federal government is required to provide, among other things, healthcare to AI\/ANs in a way that it is not obligated to other Americans. This unique obligation also impacts the legal relationship between Tribes and the federal government.<\/span><\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559685&quot;:720,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\" style=\"color: #374db2;\">\u00a0<\/span><\/p>\n<p><span style=\"color: #374db2;\">After different ways of providing care, the US created the Indian Health Service (IHS) in 1955 within the Public Health Service.\u00a0<\/span><\/p>\n<p><span style=\"color: #374db2; font-size: 18px;\"><\/span><\/p>\n<p><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/p>\n<p><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559685&quot;:720,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<p>[\/et_pb_toggle][et_pb_text _builder_version=&#8221;4.27.0&#8243; text_font=&#8221;||||||||&#8221; text_line_height=&#8221;2em&#8221; header_font=&#8221;||||||||&#8221; header_2_font=&#8221;Merriweather|700|||||||&#8221; header_2_font_size=&#8221;36px&#8221; header_2_line_height=&#8221;1.6em&#8221; header_3_font=&#8221;Merriweather|700|||||||&#8221; header_3_text_color=&#8221;#ffc47c&#8221; header_3_font_size=&#8221;18px&#8221; header_3_line_height=&#8221;1.8em&#8221; text_orientation=&#8221;center&#8221; custom_margin=&#8221;66px|||||&#8221; header_2_font_size_tablet=&#8221;&#8221; header_2_font_size_phone=&#8221;20px&#8221; header_2_font_size_last_edited=&#8221;on|phone&#8221; header_3_font_size_tablet=&#8221;&#8221; header_3_font_size_phone=&#8221;14px&#8221; header_3_font_size_last_edited=&#8221;on|phone&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h2><span data-contrast=\"none\" xml:lang=\"EN-US\" lang=\"EN-US\" class=\"TextRun SCXW148230285 BCX0\" style=\"color: #374db2;\"><span class=\"NormalTextRun SCXW148230285 BCX0\" data-ccp-charstyle=\"Heading 2 Char\">Indian Health Service<\/span><\/span><\/h2>\n<p>[\/et_pb_text][et_pb_toggle title=&#8221;The IHS&#8221; open_toggle_text_color=&#8221;#374db2&#8243; open_toggle_background_color=&#8221;#ffffff&#8221; closed_toggle_background_color=&#8221;#ffffff&#8221; icon_color=&#8221;#15c39a&#8221; open_icon_color=&#8221;#15c39a&#8221; _builder_version=&#8221;4.27.4&#8243; title_text_color=&#8221;#374db2&#8243; title_font=&#8221;Poppins|700||on|||||&#8221; title_text_align=&#8221;center&#8221; title_font_size=&#8221;18px&#8221; title_letter_spacing=&#8221;1px&#8221; title_line_height=&#8221;2em&#8221; closed_title_font=&#8221;Poppins||||||||&#8221; body_font=&#8221;Poppins||||||||&#8221; body_text_align=&#8221;left&#8221; body_font_size=&#8221;18px&#8221; custom_padding=&#8221;24px||24px||true&#8221; animation_style=&#8221;zoom&#8221; animation_intensity_zoom=&#8221;10%&#8221; hover_enabled=&#8221;0&#8243; border_radii=&#8221;on|10px|10px|10px|10px&#8221; border_width_all=&#8221;0px&#8221; box_shadow_style=&#8221;preset1&#8243; box_shadow_vertical=&#8221;10px&#8221; box_shadow_blur=&#8221;60px&#8221; box_shadow_color=&#8221;rgba(1,33,92,0.1)&#8221; global_colors_info=&#8221;{}&#8221; sticky_enabled=&#8221;0&#8243;]<\/p>\n<p><a href=\"https:\/\/www.ihs.gov\/aboutihs\/\" target=\"_blank\" rel=\"noopener\"><span>The Indian Health Service (IHS)<\/span><\/a><span style=\"color: #374db2;\"> provides direct health services to 2.6 million American Indians and Alaska Natives in 37 states. It is not health insurance, it is a system of direct care providers, similar to the Veterans Affairs system.\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\" style=\"color: #374db2;\">IHS can provide care through federally run facilities or Tribes can opt to operate their own facilities by contracting for those services. Most of these services are reservation-based and in rural areas. <\/span><a href=\"https:\/\/www.ihs.gov\/sites\/newsroom\/themes\/responsive2017\/display_objects\/documents\/factsheets\/IHSProfile.pdf\" target=\"_blank\" rel=\"noopener\"><span>Tribes operate over half of all IHS facilities<\/span><\/a><span style=\"color: #374db2;\">, including clinics, hospitals, and treatment centers.\u00a0\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\" style=\"color: #374db2;\">There is also a system of 45 Urban Indian Organizations (UIOs) serving urban AI\/AN throughout the country. <\/span><a href=\"https:\/\/www.ihs.gov\/newsroom\/factsheets\/uihp\/\" target=\"_blank\" rel=\"noopener\"><span>The majority of AI\/ANs live in urban areas and not on reservations<\/span><\/a><span style=\"color: #374db2;\">. A quarter (25%) of AI\/ANs living in urban areas live in a county served by an urban Indian Health program.\u00a0\u00a0<\/span><\/p>\n<p><span style=\"color: #374db2;\">Alaska Department of Public Health created <a href=\"https:\/\/www.astho.org\/topic\/resource\/data-sharing-lessons-from-alaska\/\" target=\"_blank\" rel=\"noopener\">a groundbreaking umbrella data sharing agreement<\/a> with the Alaska Native Tribal Health Consortium that covers all the universal terms of data disclosures to ANTHC. Each subsequent data disclosure thus only has to cover terms specific to the data set being requested. This significantly speeds up the process and strengthens the relationship between the state of Alaska and ANTHC. <\/span><\/p>\n<p><span style=\"color: #374db2; font-size: 18px;\"><\/span><\/p>\n<p><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/p>\n<p><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559685&quot;:720,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<p>[\/et_pb_toggle][et_pb_text _builder_version=&#8221;4.27.0&#8243; text_font=&#8221;||||||||&#8221; text_line_height=&#8221;2em&#8221; header_font=&#8221;||||||||&#8221; header_2_font=&#8221;Merriweather|700|||||||&#8221; header_2_font_size=&#8221;36px&#8221; header_2_line_height=&#8221;1.6em&#8221; header_3_font=&#8221;Merriweather|700|||||||&#8221; header_3_text_color=&#8221;#ffc47c&#8221; header_3_font_size=&#8221;18px&#8221; header_3_line_height=&#8221;1.8em&#8221; text_orientation=&#8221;center&#8221; custom_margin=&#8221;66px|||||&#8221; header_2_font_size_tablet=&#8221;&#8221; header_2_font_size_phone=&#8221;20px&#8221; header_2_font_size_last_edited=&#8221;on|phone&#8221; header_3_font_size_tablet=&#8221;&#8221; header_3_font_size_phone=&#8221;14px&#8221; header_3_font_size_last_edited=&#8221;on|phone&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h2><span data-contrast=\"none\" xml:lang=\"EN-US\" lang=\"EN-US\" class=\"TextRun SCXW27898448 BCX0\" style=\"color: #374db2;\"><span class=\"NormalTextRun SCXW27898448 BCX0\" data-ccp-charstyle=\"Heading 3 Char\">Tribal Epidemiology Centers<\/span><\/span><\/h2>\n<p>[\/et_pb_text][et_pb_toggle title=&#8221;TECs&#8221; open_toggle_text_color=&#8221;#374db2&#8243; open_toggle_background_color=&#8221;#ffffff&#8221; closed_toggle_background_color=&#8221;#ffffff&#8221; icon_color=&#8221;#15c39a&#8221; open_icon_color=&#8221;#15c39a&#8221; _builder_version=&#8221;4.27.0&#8243; title_text_color=&#8221;#374db2&#8243; title_font=&#8221;Poppins|700||on|||||&#8221; title_text_align=&#8221;center&#8221; title_font_size=&#8221;18px&#8221; title_letter_spacing=&#8221;1px&#8221; title_line_height=&#8221;2em&#8221; closed_title_font=&#8221;Poppins||||||||&#8221; body_font=&#8221;Poppins||||||||&#8221; body_text_align=&#8221;left&#8221; body_font_size=&#8221;18px&#8221; custom_padding=&#8221;24px||24px||true&#8221; animation_style=&#8221;zoom&#8221; animation_intensity_zoom=&#8221;10%&#8221; border_radii=&#8221;on|10px|10px|10px|10px&#8221; border_width_all=&#8221;0px&#8221; box_shadow_style=&#8221;preset1&#8243; box_shadow_vertical=&#8221;10px&#8221; box_shadow_blur=&#8221;60px&#8221; box_shadow_color=&#8221;rgba(1,33,92,0.1)&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p><span style=\"color: #374db2;\">Tribal Epidemiology Centers (TECs) are part of the federal government\u2019s efforts to provide health services to AI\/AN communities.\u00a0<\/span><\/p>\n<p><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559685&quot;:1440,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\" style=\"color: #374db2;\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\" style=\"color: #374db2;\">In 1992, <\/span><a href=\"https:\/\/www.congress.gov\/102\/statute\/STATUTE-106\/STATUTE-106-Pg4526.pdf\" target=\"_blank\" rel=\"noopener\"><span data-contrast=\"none\">Congress authorized the creation of TECs under the Indian Health Care Improvement Act<\/span><\/a><span style=\"color: #374db2;\"> to help provide public health services and support to Tribes. TECs fulfill seven core functions:\u00a0<\/span><\/p>\n<ol>\n<li><span style=\"color: #374db2;\">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;\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0<\/span><\/li>\n<li><span style=\"color: #374db2;\">Evaluate existing delivery systems, data systems, and other systems that impact the improvement of Indian health;\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0<\/span><\/li>\n<li><span style=\"color: #374db2;\">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;\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0<\/span><\/li>\n<li><span style=\"color: #374db2;\">Make recommendations for the targeting of services needed by the populations served;\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0\u00a0<\/span><\/li>\n<li><span style=\"color: #374db2;\">Make recommendations to improve health care delivery systems for Indians and urban Indians;\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0<\/span><\/li>\n<li><span style=\"color: #374db2;\">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;\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0<\/span><\/li>\n<li><span style=\"color: #374db2;\">Provide disease surveillance and assist Indian Tribes, Tribal organizations, and urban Indian communities to promote public health.\u00a0<\/span><\/li>\n<\/ol>\n<p><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559685&quot;:1440,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<p><a href=\"https:\/\/tribalepicenters.org\/wp-content\/uploads\/2021\/04\/TEC-Timeline-041521.pdf\" target=\"_blank\" rel=\"noopener\"><span>Twelve TECs came to be established throughout the country<\/span><\/a><span style=\"color: #374db2;\">, with eleven TECs serving the IHS Areas and one Urban Indian TEC.\u00a0<\/span><\/p>\n<p><span style=\"color: #374db2;\">In 2010, TECs were designated as public health authorities for the purposes of HIPAA, allowing them to receive protected health information for public health purposes. More information about public health authority can be found in the <a href=\"https:\/\/triballive.wpenginepowered.com\/?page_id=52\" target=\"_blank\" rel=\"noopener\">Public Health Authority section<\/a> of this toolkit.\u00a0<\/span><\/p>\n<p><span style=\"color: #374db2; font-size: 18px;\"><\/span><\/p>\n<p><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/p>\n<p><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559685&quot;:720,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<p>[\/et_pb_toggle][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row _builder_version=&#8221;4.25.1&#8243; _module_preset=&#8221;default&#8221; custom_margin=&#8221;67px|auto||auto||&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.25.1&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.25.1&#8243; text_font=&#8221;||||||||&#8221; text_font_size=&#8221;17px&#8221; text_line_height=&#8221;2em&#8221; header_font=&#8221;||||||||&#8221; header_2_font=&#8221;Merriweather|700|||||||&#8221; header_2_font_size=&#8221;36px&#8221; header_2_line_height=&#8221;1.6em&#8221; header_2_font_size_tablet=&#8221;&#8221; header_2_font_size_phone=&#8221;20px&#8221; header_2_font_size_last_edited=&#8221;on|phone&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h2 style=\"text-align: center;\"><span style=\"color: #374db2;\">Continue The Toolkit<\/span><span style=\"font-size: 17px; color: #666666; font-family: 'Open Sans', Arial, sans-serif; font-weight: 500;\">\u00a0<\/span><\/h2>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row column_structure=&#8221;1_6,1_6,1_6,1_6,1_6,1_6&#8243; _builder_version=&#8221;4.25.1&#8243; _module_preset=&#8221;default&#8221; custom_margin=&#8221;-54px|auto|8px|auto||&#8221; custom_padding=&#8221;||0px|||&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;1_6&#8243; _builder_version=&#8221;4.25.1&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.16&#8243; text_font=&#8221;||||||||&#8221; text_line_height=&#8221;2em&#8221; header_font=&#8221;||||||||&#8221; header_2_font=&#8221;Merriweather|700|||||||&#8221; header_2_font_size=&#8221;36px&#8221; header_2_line_height=&#8221;1.6em&#8221; header_3_font=&#8221;Merriweather|700|||||||&#8221; header_3_text_color=&#8221;#ffc47c&#8221; header_3_font_size=&#8221;18px&#8221; header_3_line_height=&#8221;1.8em&#8221; text_orientation=&#8221;center&#8221; header_2_font_size_tablet=&#8221;&#8221; header_2_font_size_phone=&#8221;20px&#8221; header_2_font_size_last_edited=&#8221;on|phone&#8221; header_3_font_size_tablet=&#8221;&#8221; header_3_font_size_phone=&#8221;14px&#8221; header_3_font_size_last_edited=&#8221;on|phone&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h2><span style=\"color: #374db2; font-size: small;\">Data Is Essential<\/span><\/h2>\n<h3><\/h3>\n<p>[\/et_pb_text][et_pb_image src=&#8221;https:\/\/triballive.wpenginepowered.com\/wp-content\/uploads\/2024\/05\/TribalCollaborationIcon.jpg&#8221; title_text=&#8221;TribalCollaborationIcon&#8221; url=&#8221;https:\/\/triballive.wpenginepowered.com\/?page_id=54&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_margin=&#8221;-63px|||||&#8221; global_colors_info=&#8221;{}&#8221;][\/et_pb_image][\/et_pb_column][et_pb_column type=&#8221;1_6&#8243; _builder_version=&#8221;4.25.1&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.16&#8243; text_font=&#8221;||||||||&#8221; text_line_height=&#8221;2em&#8221; header_font=&#8221;||||||||&#8221; header_2_font=&#8221;Merriweather|700|||||||&#8221; header_2_font_size=&#8221;36px&#8221; header_2_line_height=&#8221;1.6em&#8221; header_3_font=&#8221;Merriweather|700|||||||&#8221; header_3_text_color=&#8221;#ffc47c&#8221; header_3_font_size=&#8221;18px&#8221; header_3_line_height=&#8221;1.8em&#8221; text_orientation=&#8221;center&#8221; header_2_font_size_tablet=&#8221;&#8221; header_2_font_size_phone=&#8221;20px&#8221; header_2_font_size_last_edited=&#8221;on|phone&#8221; header_3_font_size_tablet=&#8221;&#8221; header_3_font_size_phone=&#8221;14px&#8221; header_3_font_size_last_edited=&#8221;on|phone&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h2><span style=\"color: #374db2; font-size: small;\">Tribal Background<\/span><\/h2>\n<h3><\/h3>\n<p>[\/et_pb_text][et_pb_image src=&#8221;https:\/\/triballive.wpenginepowered.com\/wp-content\/uploads\/2024\/05\/TribalBackgroundIcon.jpg&#8221; title_text=&#8221;TribalBackgroundIcon&#8221; url=&#8221;https:\/\/triballive.wpenginepowered.com\/?page_id=50&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_margin=&#8221;-63px|||||&#8221; global_colors_info=&#8221;{}&#8221;][\/et_pb_image][\/et_pb_column][et_pb_column type=&#8221;1_6&#8243; _builder_version=&#8221;4.25.1&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.27.0&#8243; text_font=&#8221;||||||||&#8221; text_line_height=&#8221;2em&#8221; header_font=&#8221;||||||||&#8221; header_2_font=&#8221;Merriweather|700|||||||&#8221; header_2_font_size=&#8221;36px&#8221; header_2_line_height=&#8221;1.6em&#8221; header_3_font=&#8221;Merriweather|700|||||||&#8221; header_3_text_color=&#8221;#ffc47c&#8221; header_3_font_size=&#8221;18px&#8221; header_3_line_height=&#8221;1.8em&#8221; text_orientation=&#8221;center&#8221; header_2_font_size_tablet=&#8221;&#8221; header_2_font_size_phone=&#8221;20px&#8221; header_2_font_size_last_edited=&#8221;on|phone&#8221; header_3_font_size_tablet=&#8221;&#8221; header_3_font_size_phone=&#8221;14px&#8221; header_3_font_size_last_edited=&#8221;on|phone&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h2><span style=\"color: #374db2; font-size: small;\">Cultural Humility<\/span><\/h2>\n<h3><\/h3>\n<p>[\/et_pb_text][et_pb_image src=&#8221;https:\/\/triballive.wpenginepowered.com\/wp-content\/uploads\/2024\/05\/TribalCollectionIcon.jpg&#8221; title_text=&#8221;TribalCollectionIcon&#8221; url=&#8221;https:\/\/triballive.wpenginepowered.com\/?page_id=51&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_margin=&#8221;-63px|||||&#8221; global_colors_info=&#8221;{}&#8221;][\/et_pb_image][\/et_pb_column][et_pb_column type=&#8221;1_6&#8243; _builder_version=&#8221;4.25.1&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.16&#8243; text_font=&#8221;||||||||&#8221; text_line_height=&#8221;2em&#8221; header_font=&#8221;||||||||&#8221; header_2_font=&#8221;Merriweather|700|||||||&#8221; header_2_font_size=&#8221;36px&#8221; header_2_line_height=&#8221;1.6em&#8221; header_3_font=&#8221;Merriweather|700|||||||&#8221; header_3_text_color=&#8221;#ffc47c&#8221; header_3_font_size=&#8221;18px&#8221; header_3_line_height=&#8221;1.8em&#8221; text_orientation=&#8221;center&#8221; custom_margin=&#8221;|-5px||-11px||&#8221; header_2_font_size_tablet=&#8221;&#8221; header_2_font_size_phone=&#8221;20px&#8221; header_2_font_size_last_edited=&#8221;on|phone&#8221; header_3_font_size_tablet=&#8221;&#8221; header_3_font_size_phone=&#8221;14px&#8221; header_3_font_size_last_edited=&#8221;on|phone&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h2><span style=\"color: #374db2; font-size: small;\">Sovereignty &amp; Health\u00a0<\/span><\/h2>\n<h3><\/h3>\n<p>[\/et_pb_text][et_pb_image src=&#8221;https:\/\/triballive.wpenginepowered.com\/wp-content\/uploads\/2024\/05\/TribalSharingIcon.jpg&#8221; title_text=&#8221;TribalSharingIcon&#8221; url=&#8221;https:\/\/triballive.wpenginepowered.com\/?page_id=52&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_margin=&#8221;-62px|||||&#8221; global_colors_info=&#8221;{}&#8221;][\/et_pb_image][\/et_pb_column][et_pb_column type=&#8221;1_6&#8243; _builder_version=&#8221;4.25.1&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.16&#8243; text_font=&#8221;||||||||&#8221; text_line_height=&#8221;2em&#8221; header_font=&#8221;||||||||&#8221; header_2_font=&#8221;Merriweather|700|||||||&#8221; header_2_font_size=&#8221;36px&#8221; header_2_line_height=&#8221;1.6em&#8221; header_3_font=&#8221;Merriweather|700|||||||&#8221; header_3_text_color=&#8221;#ffc47c&#8221; header_3_font_size=&#8221;18px&#8221; header_3_line_height=&#8221;1.8em&#8221; text_orientation=&#8221;center&#8221; custom_margin=&#8221;|-17px||-28px||&#8221; header_2_font_size_tablet=&#8221;&#8221; header_2_font_size_phone=&#8221;20px&#8221; header_2_font_size_last_edited=&#8221;on|phone&#8221; 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State-recognized Tribes do not have same the relationship with the federal government and [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"class_list":["post-50","page","type-page","status-publish","hentry"],"featured_image_src":null,"featured_image_src_square":null,"_links":{"self":[{"href":"https:\/\/tribal.cste.org\/index.php?rest_route=\/wp\/v2\/pages\/50","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/tribal.cste.org\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/tribal.cste.org\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/tribal.cste.org\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/tribal.cste.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=50"}],"version-history":[{"count":0,"href":"https:\/\/tribal.cste.org\/index.php?rest_route=\/wp\/v2\/pages\/50\/revisions"}],"wp:attachment":[{"href":"https:\/\/tribal.cste.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=50"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}