family photoHealth and Human Services



Updated October 2011

Tribal communities have more flexibility in implementing human services programs as the result of legislation signed into law in 1996.  Tribes are now able to create programs that are better equipped to address the unique circumstances faced by Native families.

For example, several tribes now design and administer their own Temporary Assistance to Needy Families (TANF) programs.  The U.S. Department of Health and Human services has approved at least 40 tribal TANF plans that serve 180 tribes in 16 states.  States and tribes have also worked cooperatively on the issue of foster care by developing state-tribal agreements that allow states to pass federal foster care funding to tribes.  These agreements increase the ability of states and tribes to provide culturally appropriate services and allow tribes to exercise their sovereignty by implementing their own programs.

Providing culturally appropriate health care is also an issue where states and tribes can work together.  Quality health care for both Native and non-Native populations should address the increasing epidemics of cardiovascular disease, type 2 diabetes and childhood obesity, among other ailments.  Improved communication between states and tribes to address health care and health disparity issues, could result in the development of creative approaches to improve overall health in all communities.

Red Cross imageResources:

  • "State-Tribal Partnerships on Child Support," (Legislators/Legislative Staff) NCSL Legisbrief, January 2005, Vol. 13, No. 4, by Natalie O'Donnell. 

  • "Health Care in Indian Country: Obstacles and Opportunities," State Health Notes, November 15, 2004, Vol. 25, Issue 432, by Therese Droste, A freelance writer in Washington, D.C.

  • "Welfare Reform on Tribal Lands: Examples of State-Tribal Collaboration," State and Tribes: Building New Traditions, January 2004. (for copies contact Irene Kawanabe (303) 364-7700)  Bookstore link.

  • "The Indian Child Welfare Act and the State", NCSL Legisbrief, August/September 2004, Vol. 12, Number 32, by Andrea Wilkins.

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