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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
Protecting Tribal Sovereignty Since 1944
2
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
Tribal Public Health Law Project
3
 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
Policy Briefs
4
Tribal Public Health Law Database
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 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
Tribal Public Health Law Database
6
Tribal Public Health Law Database
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Insights from the Database
8
 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.
Sisseton Wahpeton Oyate Codes
9
 Adult Protection Code
 Individual Sewage Disposal Systems
Ordinance
 Alcohol and Drug Abuse Treatment
Act
 Involuntary Treatment of Mentally
Ill
 Child Passenger Restraint Code
 Penal Code
 Control of Dogs
 Domestic Abuse Mandatory Arrest  Public Health Law
Ordinance
 Retail Food Store Sanitation
 Domestic Violence Ordinance
 Sanitary Sewer Systems
 Elder Provisions
 Traffic Code
 Environmental Protection Code
 Treatment of Prisoners
 Food Service Sanitation Code
 Tribal Contraceptives Code
 Harassment and Stalking Code
 Use of a Safety Seat Belt System in
Passenger Vehicles
 Housing Code
Infectious Disease Codes
10

Infrastructure


Cultural Practices


Hoopa; Sisseton-Wahpeton Tribe
Environmental Health


Rez Dogs – Ely Shoshone Tribe; Bay Mills; Leech Lake Band of
Ojibwe; Sisseton; Tohono O’odham
Food


Leech Lake Band of Ojibwe; Hoopa; Sisseton-Wahpeton Oyate;
Tohono O’odham
Air Quality/burn ordinance/pesticide control & conservation code –
Leech Lake Band of Ojibwe
Sexual Health

Sisseton-Wahpeton Oyate
Hoopa Valley Tribal Code
11
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.
Hoopa Valley Food Code
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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.
Sisseton-Wahpeton Oyate Food Sanitation Codes
13
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."
Sisseton-Wahpeton Oyate
Treatment of Prisoners
14
 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
Sisseton-Wahpeton Oyate
Contraceptives Code
15
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.
Public Health & Safety Code:
HIV/AIDS Confidentiality Resolution
16
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.
NEXT STEPS
17
 Hearing from Indian Country

Permissions process

Conference presentations
 Developing Policy Briefs & Other Tools
 Updating the Database
Contact Information
18
Sarah Pytalski
TPHL Project Manager
[email protected]