CRIHB: Strengthening Public Health Systems In Indian Country - The California Rural Indian Health Board, Inc. (CRIHB) California Tribal Epidemiology Center
(CTEC) was established in 2005 and is based out of Roseville, CA. CRIHB is a non-profit
Tribal organization operating since 1969 under the Indian Self-Determination Act (PL 93-638).
As an Indian Health Service California (IHS) area-wide program, CRIHB CTEC supports the
epidemiologic needs of California Tribal and Urban Indian Health Programs, including those of
the 109 California Tribes and American Indians/Alaska Natives (AIAN) in urban areas.
CRIHB CTEC will target Tribal Health Programs among 58 Tribes within the California Rural
Indian Health Board’s (CRIHB) service area. CRIHB CTEC plans to strengthen Tribal data/
information subsidizing the maintenance cost of electronic health record software required for
data collection and optimization costs. Annual EHR maintenance and support costs amount to
20% of the original purchase price of licenses and software. Funding to help subsidize these
costs will help stabilize Tribal Health Programs using a commercial off the shelf EHR and work
towards optimizing data collection, software use, and developing interfaces with other health
care systems. In order to conduct surveillance in Tribes to determine trends and health needs,
Tribal Health Programs need to maintain and upgrade EHR software and systems interfaces.
Through this program, CRIHB CTEC will carry out program capacity building and quality
improvement strategies and outcomes within Tribes in order to improve Tribal data and
information systems via surveillance capacity expansion. CRIHB CTEC anticipates the
following short term and intermediate outcomes that will ultimately build capacity in Tribes to
independently identify and address current health issues and decrease the burden of the public
health issue(s) identified by the Tribe.
Short-term Outcomes:
•Improved collection, maintenance, interpretation, and dissemination of Tribal health data
•Translation of evidence-based and evidence-informed practices into culturally appropriate
public health programs, policies, and services
•Increase in the number of data sharing agreements between Tribal Health Programs and Tribes
and the CRIHB CTEC.
Intermediate Outcome:
•Implementation of culturally practice-based evidence programs and services
In order to measure how these outcomes are accomplished, CRIHB CTEC will 1) Detail the
number of Tribes whose capacity to collect or enhance Tribal health data is improved; and 2)
Detail the number of overall culturally appropriate public health programs, policies, or services
identified by Tribes. These outcomes will contribute to the strengthening of the Tribes’ public
health capacity and capabilities to improve and protect the lives of AIANs and create healthier
communities. This process allows for Tribes to continue to take control of their own health that
is appropriate for their respective Tribe, while also allowing autonomy and protection of Tribal
sovereignty.
Estimated number of people to be served as a result of the award of this grant: 55,674