Using Public Health to strengthen Tribal

sovereigntyJoe Finkbonner RPh MHA,

Executive Director

Northwest Portland Area Indian Health Board

2

Objectives of discussion

• Elucidate the necessity for sovereign tribal governments to develop public health codes and regulations

• Review and discuss meaning of sovereign

• Review definition and elements of public health

Sovereignty

• Supreme power or authority• The authority of a state to govern itself.• Autonomous state• The quality or state of being sovereign. • The status, dominion, power, or authority of a sovereign;

royalty. • Supreme and independent power or authority in a state. • Rightful status, independence, or prerogative. • A sovereign state, community, or political unit.

Public health definition

• the health of the population as a whole, especially as monitored, regulated, and promoted by the state.

Tribes possess authority to act in matters of public health Tribes hold public health authority as defined by the US Department of

Health and Human Services In addition to their inherent authority, tribes are authorized under

Public Law 93-638, the Indian Self- Determination and Education Assistance Act, to directly administer

their own public health (and other) Programs. Though some tribes may have laws requiring collaboration with other

governments, there is no general legal requirement that tribes share public health services with other entities.

Tribes authority

http://iom.edu/Reports/1988/The-Future-of-Public-Health.aspxhttp://www.health.gov/phfunctions/public.htm

Core Functions of Public Health Assessment Policy development Assurance

Purpose of Public Health Prevent epidemics and spread of disease Protect against environmental hazards Prevent injuries Promote and encourage healthy behaviors Respond to disasters and assist communities in recovery Assure the quality and accessibility of services

Core Functions of Public Health Steering”Public Health in America”

The 10 Essential Public Health Services

1. Monitor health status to identify and solve community health problems

2. Diagnose and investigate health problems and health hazards in the community

3. Inform, educate, and empower people about health issues

4. Mobilize community partnerships to identify and solve health problems

5. Develop policies and plans that support individual and community health efforts

The 10 Essential Public Health Services

6. Enforce laws and regulations that protect health and ensure safety

7. Link people to needed personal health services and assure the provision of health care when otherwise unavailable

8. Assure a competent public and personal health care workforce

9. Evaluate effectiveness, accessibility, and quality of personal and population-based health services

10. Research for new insights and innovative solutions to health problems

Essential Public Health Services

Elements of public health

• Promote health• Protection from harm

– Disease– injury

Public health powers

• Can hold someone without cause.

• police powers• from the 10th Amendment to the • Constitution, which reserves to the states the rights and • powers "not delegated to the United States" which include • protection of the welfare, safety, health and even morals of the • public. Police powers include licensing, inspection, zoning, • safety regulations (which cover a lot of territory), quarantines, • and working conditions as well as law enforcement.

Police powers – cont’d

• Tribes also have police power authority to take actions that promote the health, safety, and welfare of their own tribal members. Tribal health authorities may enforce their own isolation and quarantine laws within tribal lands, if such laws exist.

Contact information

Joe Finkbonner RPh MHA, Executive Director

NW Portland Area Indian Health Board2121 SW Broadway, Suite 300

Portland, OR 97201Phone: 503.228.4185

Fax: 503.228.8182Jfinkbonner@npaihb.org