The Tribal Public Health Law Database: An Overview

1. The Tribal Public Health Law Database: An Overview Prepared for the Tribal Public Health Forum Rapid City, SD May 16, 2014 Dr. Malia Villegas, Director Sarah Cline Pytalski, MPP, Policy Research & Evaluation Manager NCAI Policy Research Center

2. Protecting Tribal Sovereignty Since 1944 National Congress of American Indians Founded in 1944 Serves the broad interests of tribal governments and communities A representative congress of American Indian and Alaska Native tribes United to protect and enhance treaty and sovereign rights while securing our traditional laws, cultures, and ways of life for our descendants Advance a common understanding of the rightful place of tribes in the family of American governments

3. Tribal Public Health Law Project Foster awareness in Tribal Public Health Law Produce an online database Create a series of other products and tools Funded by RWJF, partnership with NIHB

4. Policy Briefs

5. Tribal Public Health Law Database • Host legal information on publically-available tribal public health laws • Overview • Total codes: 383 tribal codes, representing 82 tribal nations • Highest number of codes: NCAI Midwest Region (111); Northwest (95 codes); Western (44 codes); and Pacific (36 codes) • Primary types of codes: Alcohol and drug; animals; and traffic and road safety; agriculture; environment; public health; research; and infrastructure. • Permissions

6. Tribal Public Health Law Database

7. Tribal Public Health Law Database

8. Insights from the Database • Some regions have more codes than others (e.g., Midwest), which raises questions about why this might be the case and how tribes can support each other in code development. • TPHL is distinct in some key ways from PHL (Squaxin Island Tribe – cigarette and sales tax code; Rez Dogs). • TPHL can be a tool for tribal governments to steward both culture and community development needs.

9. Sisseton Wahpeton Oyate Codes • Adult Protection Code • Alcohol and Drug Abuse Treatment Act • Child Passenger Restraint Code • Control of Dogs • Domestic Abuse Mandatory Arrest Ordinance • Domestic Violence Ordinance • Elder Provisions • Environmental Protection Code • Food Service Sanitation Code • Harassment and Stalking Code • Housing Code • Individual Sewage Disposal Systems Ordinance • Involuntary Treatment of Mentally Ill • Penal Code • Public Health Law • Retail Food Store Sanitation • Sanitary Sewer Systems • Traffic Code • Treatment of Prisoners • Tribal Contraceptives Code • Use of a Safety Seat Belt System in Passenger Vehicles

10. Infectious Disease Codes • Infrastructure • Leech Lake Band of Ojibwe; Hoopa; Sisseton-Wahpeton Oyate; Tohono O’odham • Cultural Practices • RezDogs – Ely Shoshone Tribe; Bay Mills;  Leech Lake Band of Ojibwe; Sisseton; Tohono O’odham • Food • Hoopa; Sisseton-Wahpeton Tribe • Environmental Health • Air Quality/burn ordinance/pesticide control & conservation code – Leech Lake Band of Ojibwe • Sexual Health • Sisseton-Wahpeton Oyate

11. Hoopa Valley Tribal Code Title 35.Riparian Protection and Surface Mining Practices Ordinance, Effective August 3, 1992 “WHEREAS: The Tribal Council has concluded that it is necessary to exercise comprehensive tribal regulatory authority over surface mining within the exterior boundaries of the Hoopa Valley Reservation, and over surface mining and other activities in the Trinity River and Klamath River riparian areas, in order to protect fundamental tribal ceremonial, fishery, and property interests, water quality, and the public health and safety…” Beyond culturally relevant fish, the river is used for drinking water, ceremonial bathing; roots, materials, and tribal medicinal plants are gathered from the riverbank; in basket weaving, the weaver may use their teeth to strip bark pulled from the river, offering an avenue of direct exposure to water-borne toxins…   Activities to be regulated hereunder shall include but not be limited to: • Any activities in the Trinity River of Klamath River riparian areas with potential to affect the riverbed or river flow, ground or surface water quality, or fishery, cultural, or ceremonial values. Regulatory powers. • Can issue (or decline) permits, now require a reclamation plan, can conduct reviews, [and] require environmental impact statements.

12. Hoopa Valley Food Code Title 56.402 Supplement, Effective November 24, 2003 Designed to safeguard public health and provide to consumers food that is safe, unadulterated, and honestly presented. The Code will be utilized for monitoring and responding to inquiries of any non-licensed public and private food-related activities conducted within the Reservation. “Food establishment” does not include: (iii) A kitchen in a private home if only food that is not potentially hazardous is prepared for sale or service at a function such as a religious or charitable organization’s bake sale if allowed by law and if the consumer is informed by a clearly visible placard at the location that the food is prepared in a kitchen that is not subject to regulation and inspection; (iv) An area where food that is prepared as specified in (iii) is sold or offered for human consumption. In food establishments, wild game animals that are live-caught or field-dressed may be served so long as they abide by a voluntary inspection program, its processing and transportation requirements.

13. Sisseton-Wahpeton OyateFood Sanitation Codes Chapter 49. Food Service Sanitation Code, Effective February 24, 1988 Prohibits the sale of unsound or mislabeled food or drink, mandates inspection—in accordance with the 1976 edition of the FDA “Food Service Sanitation Ordinance.” Chapter 50. Retail Food Store Sanitation Code A sanitation code regulating-the sale of food through retail food stores in accordance with the 1982 edition of the Association of Food and Drug Official's and the Food and Drug Administration's "Retail Food Store Sanitation Code."

14. Sisseton-Wahpeton OyateTreatment of Prisoners • Accommodations • Windows to allow for natural light and fresh air. Artificial light to allow prisoners to read or work without injury to eyesight • Personal Hygiene • Bathing allowed at least once a week • Clothing and Bedding • Outfit suitable for the climate; not degrading or humiliating • Medical Services • Education, Recreation & Cultural Activities • Language

15. Sisseton-Wahpeton OyateContraceptives Code Sisseton-Wahpeton Tribe – Chapter 4-A Contraceptives Code, Effective May 7, 1997 Authorizes minors (under 18) to give effective consent to access and receive non-surgical contraceptives, without parental consent, to avoid pregnancy and sexually-transmitted diseases. Parents may file an objection. Confidential records by the medical provider are accessible to the minor and the parent or legal guardian of the minor. Findings.Minor Indians maintain a higher risk of acquiring sexually transmitted diseases than non-Indians. An untreated sexually transmitted disease may sterilize the minor Indian.

16. Public Health & Safety Code: HIV/AIDS Confidentiality Resolution Effective July 2013 Section 3.5: “All health care providers shall cooperate to prevent the spread of the HIV/AIDS virus. Activities coordinated under this code shall emphasize [Tribal name] concepts of harmony, culture, traditional practices and the role of family, kinship, and community.” According to [Tribe] HIV/AIDS Coalition Chair and Public Health Emergency Preparedness Coordinator [Name], this resolution should help curtail the spread of communicable infectious diseases such as HIV/AIDS. It offers tribal members “the system needed to continuously address the threat such diseases pose to the [tribal] community,” [the coordinator] says. “The implementation of such a Code supports enforcement of public health responsibilities and the authority needed to identify the risk factors associated with the spread of infectious disease.” Another key component is that it renders HIV testing optional. The Centers for Disease Control (CDC) reports that American Indians and Alaska Natives ranked fifth in rates of HIV infection in 2011, “with lower rates than blacks/African Americans, Hispanics/Latinos, Native Hawaiians/Other Pacific Islanders, and people reporting multiple races, but higher rates than Asians and whites.” However, American Indians and Alaska Natives have poorer survival rates than all other ethnicities and races.

17. NEXT STEPS • Hearing from Indian Country • Permissions process • Conference presentations • Developing Policy Briefs & Other Tools • Updating the Database

18. Contact Information Sarah Pytalski TPHL Project Manager spytalski@ncai.org