Utah, tribes sign health pact

Utah officials on Thursday signed an agreement with the state's eight federally recognized Indian tribes detailing coordination and communication processes for health issues and health policy development.

The agreement updates and replaces a "tribal consultation" agreement that was enacted in 2002, said Melissa Zito, the Indian health liaison for the Utah Department of Health. It's a government-to-government agreement between the tribes, the state health department, state government and federal government regarding public health. They agree to an "open exchange of information" to simplify processes and promote understanding of health issues.

The priority is to improve health delivery at the street level, Zito said.

"It provides an environment for trust and respect so we can talk about barriers," she said. "We can problem-solve and develop action plans."

The agreement will lead to better coordination of services, so American Indians can access tribal and state health services, said Robin Troxell, health administrator for the Northwestern Band of Shoshone Nation and chair of the Utah Indian Health Advisory Board. It also leads to more culturally competent care, she said.

"It gives the tribes a communication path with the Department of Health on any policies," Troxell said. "The department can receive information from the tribes on how those policies affect Indian people in Utah."

The agreement was signed Thursday by representatives of the tribes — the Confederated Tribes of Goshute Indians, Navajo Nation, Northern Ute Tribe, Northwestern Band of Shoshone, Paiute Indian Tribe of Utah, San Juan Southern Paiute, Skull Valley Band of Goshute and White Mesa Band of the Ute Mountain Ute — Gov. Jon Huntsman Jr. and state health director Dr. David Sundwall.

It has been in the works for a year, but each of the tribal councils, plus state and federal government entities, had to sign off on it. Tribal consultation is the formalized process by which all involved parties agree to an open exchange of information to improve the way health services are delivered and coordinated so that people who need those services actually receive them.

That means isolated tribes will work with state and federal health officials to see that equipment needs are met and to secure links with local governments, which are already in place, to deal with a flu pandemic or bioterrorism, for instance, Zito said. Or that all those involved know whom to contact and what to do if there is a chemical spill on a rural road on tribal land. It's a way, as well, to boost the enrollment of American Indians in programs like Medicaid by understanding and working through barriers, such as those posed by their geographic isolation.

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