The Importance of Data & Public Health Authority
Data are the foundation for good public health decision-making. Gaining access to and improving AI/AN data quality is a priority. TECs work as advocates and educators to increase access to data and improve data quality to understand the health status of AI/AN people and make progress in reducing health inequities. TECs often collaborate with other jurisdictions, including state, local, and federal agencies. Data-sharing agreements make some of these data requests possible However, AI/AN people are often misrepresented in local, state, and federal data and health status reports. This is due to various challenges, like the absence of race and ethnicity data, small population sizes, or data collection instruments that may need to be culturally responsive to AI/AN people.

With the enactment of the Patient Protection and Affordable Care Act in 2010, Congress permanently reauthorized IHCIA.4, 5 The reauthorization of IHCIA included provisions designating TECs as public health authorities under the Health Insurance Portability and Accountability Act (HIPAA). As public health authorities, TECs have access to protected health information. The reauthorization also gave the TECs access to data held by the US Department of Health and Human Services. Even with the designation of a public health authority, TECs continue to have challenges accessing data.

The Tribal, federal, state, and local health data that TECs obtain, analyze, and disseminate provide a unique lens to view the health status of AI/AN people throughout the US. Improved transparency and reciprocity between all partners working towards a goal of increasing access to all available health-related data sets allows for more complete and accurate information at each level. This will ultimately lead to a greater understanding of the nation’s health.

 

“Congress declares that it is the policy of this Nation, in fulfillment of its special trust responsibilities and legal obligations to Indians…to ensure the highest possible health status for Indians and urban Indians and to provide all resources necessary to effect that policy.”

 

– 25 U.S.C. Ch. 18

 

TECS are Public Health Authorities

Brochure: TECs are Public Health Authorities (PDF 3 MB)
TECs designated as Public Health Authority (PDF 927 KB)

Per IHCIA ,“an epidemiology center … shall be treated as a public health authority … for purposes of HIPAA of 1996 (Public Law 104–191; 110 Stat. 1936) … The Secretary shall grant to each epidemiology center described in paragraph access to use of the data, datasets, monitoring systems, delivery systems, and other protected health information in the possession of the Secretary” of the US Department of Health and Human Services.
25 U.S.C.A § 1621m(e)(1).

HIPAA authorizes public health authorities’ access to protected health information “for the purpose of preventing or controlling disease, injury, or disability, including, but not limited to, the reporting of disease, injury, vital events such as birth or death, and the conduct of public health surveillance, public health investigations, and public health interventions.”6
45 C.F.R. § 164.512(b)(1)(i).

4The Patient Protection and Affordable Care Act, Pub. L. No. 111-148 (2010).
525 U.S.C. §§ 1601 & 1602.
645 C.F.R. § 164.512(b)(1)(i).