History - Tribal Epidemiology Centers

Authorized by Congress in 1996, four Tribal Epidemiology Centers (TECs) were established by the Indian Health Care Improvement Act (IHCIA) as a way to provide enhanced public health support to American Indian and Alaska Native (AIAN) peoples, Tribes, Tribal organizations, and urban Indian organizations (T/TO/UIOs). Today, 12 TECs serve AIAN people and T/TO/UIOs in each of the 12 Indian Health Service Areas and one serves urban AIAN people across the nation. The reauthorization of the Indian Health Care Improvement Act (IHCIA) in 2010 acknowledged TECs as public health authorities. This law directs the Secretary of the Department of Health and Human Services (DHHS) to grant each TEC access to data, data sets, monitoring systems, delivery systems, and other protected health information (PHI) within the possession of the Secretary (25 USC 1621m(e)(1)).

TECs designated as Public Health Authorities (PDF 685KB)

The TEC Mission is: “To improve the health status of American Indian and Alaska Native people by identification and understanding of health risks and inequities, strengthening public health capacity, and assisting in disease prevention and control.” The TECs have much in common. The TECs share the mission of improving AIAN health by identifying health risks, strengthening public health capacity, and developing solutions for disease prevention and control. The TECs work in partnership with T/TO/UIOs and other partners to improve the health and well-being of AIAN people. This is done by offering culturally-informed approaches that work toward eliminating health disparities and achieving health equity for AIAN populations. All TECs work to fulfill their mission of improving the health of AIAN people by performing seven core functions:
Collecting data;

Evaluating data and programs;
Identifying health priorities;
Making recommendations for health service needs;
Making recommendations for improving health care delivery systems;
Providing epidemiologic technical assistance; and
Providing disease surveillance.

However, each TEC is unique and vary widely in structure, staffing, and programs. The TECs also operationalize the seven core functions in different ways based on priorities and needs of the AIAN people and T/TO/UIOs they serve, as well as to the presence or absence of funding sources for additional projects and programs.

Along with support from Tribal and urban Indian leadership, there are two essential factors that make TECs work – funding and data.

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A cornerstone to improved public health capacity is ensuring the existence of valid and reliable data. Reliable health data is crucial because it influences health care policy, funding, and decision-making. TECs provide data analysis and dissemination, surveillance and applied epidemiological studies, culturally appropriate health information, and technical assistance and training resulting in AIAN peoples and T/TO/UIOs gaining greater knowledge, empowerment, and influence over their own health care and wellness. TECs often collaborate with federal agencies, state, local, and federal agencies. With a designation as public health authorities, TECs hold a critical role and are uniquely positioned to support AIAN people and T/TO/UIO response efforts in public health emergencies, as well as a variety of surveillance activities.

Additionally, TECs are data stewards of Tribal data and trust is a huge part of collecting and working with their data. Tribes, as sovereign nations, own and control the use and dissemination of their data.

TECs operate on funding provided through cooperative agreements with the IHS, other federal agencies, (such as the CDC, NIH and OMH), states, and other organizations that align with the overall mission and vision of each individual TEC and the population they serve.

IHCIA was permanently reauthorized in 2010. This reauthorization defined TECs as “public health authorities” for purposes of the HIPAA Privacy Rule for data sharing. The permanent reauthorization of IHCIA directs the Secretary of the Department of Health and Human Services (DHHS) to grant each TEC access to use of the data, data sets, monitoring systems, delivery systems, and other protected health information (PHI) in the possession of the Secretary. It also requires that the Centers for Disease Control and Prevention (CDC) provide technical assistance, and that CDC work closely with each TEC in strengthening AI/AN disease surveillance.