Public Health Authority & the Importance of Data

With the enactment of the Patient Protection and Affordable Care Act in 2010, Congress permanently reauthorized IHCIA.^4,5 The reauthorization of IHCIA designated 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.

TECs often collaborate with other jurisdictions, including state, local, and federal agencies. Data-sharing agreements make some of these data requests possible. However, many state and local jurisdictions will not engage in data-sharing agreements with TECs, creating delays in accessing data.

The Act was a significant step toward achieving health equity for AIAN people.

“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.”⁸

– 25 U.S.C.A. § 1602

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.⁸
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.”¹⁰
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.
⁶25 U.S.C.A § 1621m(e)(1).
⁷Best Practices in American Indian & Alaska Native Public Health: A Report From Tribal Epidemiology Centers 2013,125, available at http://itcaonline.com/wp-content/uploads/2014/03/TEC_Best_Practices_Book_2013.pdf
¹⁰45 C.F.R. § 164.512(b)(1)(i).