Overview

To work effectively with tribes, it’s important to understand the broader organizational context. Unlike many other governmental agencies, tribes work on public health issues:

• Directly with various agencies of the federal and state governments including tribal-specific agencies, such as the Indian Health Service (IHS).
• As part of tribal organizations, such as the Northwest Portland Area Indian Health Board, who then work with agencies at the federal, regional, state, and local level.

Tribes work directly with federal agencies as part of the government-to-government relationship. For example, they might work with the EPA on environmental issues, rather than through a local coalition, or they might work with tribal-specific agencies such as the IHS.

In addition to working directly with governmental agencies, tribes are also represented by tribal governmental bodies at the regional and federal levels such as the Northwest Portland Area Indian Health Board. These organizations exist to advocate for tribal interests. At the regional level, these tribal organizations also help coordinate relationships with the federal government, so that government agencies do not need to negotiate hundreds of individual agreements for every government-to-government action.

To work successfully with tribes, public health officials need to consider this complex organizational environment. This can help them to recognize where there might be overlap or conflict with other ongoing work or relationships.