1. Co-Hosted by Northwest Portland Area Indian Health Board October 17, 2012 Bow, Washington Aleena M. Hernandez, MPH Aimee Centivany, MPH

2. Overview Tribal Public Health Institute Feasibility Project: Funded by Robert Wood Johnson Foundation 18 month project: July 2011- December 2012 National Network of Public Health Institutes is partner and provider of technical assistance Technical assistance provided is funded by the Centers for Disease Control and Prevention (CDC) and RWJF

3. Red Star Innovations Project facilitator Ensure goals of the project are fulfilled Ensure ongoing communication and information sharing with Tribal communities and organizations Complete a final report summarizing key outcomes, recommendations and considerations

4. Overview Background Call to Action: TPHI feasibility concept Project Framework Facilitated Discussion Open comment

5. What is public health?

6. Assuring the conditions for community (population) health Tribal Public Health Stakeholders Community Health Tribal Gov Tribal Health Dept/Clinic Federal agencies Private Industry Local/ State Health Depart Tribal Colleges Community Leaders ITC’s/Epi Centers

7. 10 Essential Public Health Services

8. The Essential Public Health Services 1.Monitor health status 2.Diagnose and investigate health problems 3.Inform, educate and empower people 4.Mobilize communities to address health problems 5.Develop policies and plans 6.Enforce laws and regulations 7.Link people to needed health services 8.Assure a competent workforce 9.Evaluate health services 10.Conduct research for new innovations

9. Tribal Public Health Infrastructure Community Health Tribal Gov Tribal Health Care Delivery System Federal agencies Private Industry Local/ State Health Depart Tribal Colleges Communi ty Leaders ITC’s/E pi Centers

10. Tribal Strengths in Public Health Tribal sovereignty; self-determination Concepts of health, wellness, and healing are often holistic Strong knowledge of our community, culture, and way of life Innovation in public health service delivery; partnerships and collaboration Community engagement Leadership – formal and informal

11. Challenges for Tribes American Indian/Alaska Native communities experience the most significant health disparities Leading causes of death are preventable Limited availability of tools, resources and technical support for Tribes and Tribal Organizations New national initiatives and limited investment to prepare Tribes to compete or participate Public health workforce challenges Assure respect Tribal Sovereignty and that the trust responsibility is upheld

12. Public Health Institute Non-profit, non-governmental organizations Stakeholder driven and mission focused It exists to meet the needs of those it serves Greater flexibility; more responsive Neutral convening and partnering Linking communities to support, services and information that already exists Reinforce, support, connect, network

13. Common PHI Functions Population-based health program delivery Non-biased health policy development and analysis Training and technical assistance Research and evaluation Health information services Health communication and social marketing

15. Tribal Public Health Institute Is there interest and support among Tribes and Tribal Organizations for a TPHI? What would be the role of the TPHI? How can we ensure that it does not duplicate existing services? What will the structure be and where will it be housed? Who will run it and how much will it cost? How can we ensure sustainability?

16. Guiding Principles Facilitate a Tribally led and driven process Ensure ongoing communication and engagement of Tribes, Tribal Organizations and key stakeholders Provide Advisory Board with opportunities for training and technical assistance for informed decision making Focus on Tribal self-determination and how a TPHI might support the national Tribal public health system Integrity and transparency

17. Tribal Advisory Board Tom Anderson, MPH (Cherokee) - OCITHB Tribal Epi Center Jay Butler, MD – ANTHC Community Health Services Joe Finkbonner, RPh, MHA (Lummi) NPAIHB Kristin Hill, BSN, MSHSA - GLITC Tribal Epi Center Jackie Kaslow, (Miwok, Maidu) CRIHB Family/Community Health Myra Parker, JD, MPH, PhD (Mandan/Hidatsa)- University of Washington Kristine Rhodes, MPH (Bad River Anishinaabe) - American Indian Cancer Foundation

18. Role of Advisory Board Inform all aspects of the project Assist with information dissemination o Attend and/or co-host a regional Tribal Roundtable o Share information with Tribes in their region and at national meetings Provide key recommendations on feasibility of a TPHI

19. Engaging Tribes 7 Tribal Roundtables Phoenix – October 2011 Bemidji – February 2012 NCAI - June Oklahoma - July Alaska - August NIHB - September Portland – October Roundtable Format Overview of the project Key questions and facilitated discussion Open comment

20. Feasibility Project Components 1.Needs and Assets Analysis Tribes, Tribal Organizations, Organizations serving Tribes Environmental scan – national public health initiatives 2.Organizational analysis Best organizational structure; Governance 3.Conduct a financial analysis to determine costs Start-up and sustain

21. Potential Role of Tribal Public Health Institute Provide leadership in gathering and sharing information to support self-determination Serve as a trusted source of information for Tribal leaders, decision makers and administrators Develop evidence and experience based resources that are cultural relevant Address technical assistance needs and training Serve as a central location for information, resource materials, practice models

22. QUESTIONS

23. FACILITATED DISCUSSION

24. Tribal Public Health Partners Tribal Governments and Tribal Health Departments work in partnership with a number of key stakeholders to safeguard and maintain the community’s health.

25. Roundtable Question When you think about everyone who is working together: What’s working well to address the health needs of your community?

26. Roundtable Question When you think about everyone who is working together: What can be improved to address the health needs of your community?

27. Roundtable Question What types of information, tools and technical assistance are needed, but not currently available?

28. Roundtable Question What role, if any, could a Tribal Public Health Institute have to address these needs?

29. OPEN COMMENT

30. Thank You! www.redstar1.org/tphifeasibilityproject/ (520) 407-6307