WINDRIVER HEALTH CODES
TITLE 17–CODE OF HEALTH AND SANITATION
CHAPTER 1GENERAL PROVISIONS
Section 17-1-1Definitions
(1)“Board” means the Wind River Tribal Health Board designated by theWind River Joint Business Council as a tribal organization.
(2)“Communicable disease” means diseases spread by direct or indirectcontact and includes the causative agent or the disease itself.
(3)“Contamination” is the spreading or the potential spreading, through
contact, of impure, infected, or polluted matter.
(4)“Inspection” means the physical observation and analysis done by the Tribal Health Officer or his/her agent or designee.
(5)‘Imminent health hazard’ means the immediate threat to the population of an adverse health outcome posed by a practice, situation, or environmental condition.
(6)“Nuisance” means an act, or by failure to perform a legal duty, that
causes or permits a condition to exist which `injures or endangers the public health.
(7)“Public Health’ encompasses health concerns which are noticed or
corroborated by government authorities or health professionals. Public health concerns are matters which involve and require and organized community response.
(8)“Physician” means a physician legally authorized to practice medicine.
(9)“Healthcare provider” means a provider of medical or healthcare services and any other individual that furnishes, bills, or is paid for health care in the normal course of business.
(10)“Sanitary Conditions” means a health environment achieved through theelimination of contaminants, disease and communicable disease.
(11) ‘Tribal Health Officer’ means the physician or other healthcare provider so designated by the Joint Business Council (Tribes).
Section 17-1-2Jurisdiction
The provisions of this Titleapply to all areas within the jurisdiction of the Wind River Indian Reservation (WRIR) as defined in Title 1, Chapter 2 of the current Shoshone and Arapaho Law and Order Code and shall also include establishments operatedby the Eastern Shoshone or the Northern Arapaho tribal organizations located exterior to WRIR boundaries.
Section 17-1-3 Applicability to Tribal Law and Order Code.
Failure to comply with provisions of this Codewill be addressed by applicable Titles in the current version of the Shoshone and Arapaho Law and Order Codeexcept where specified otherwise in this Code.
Section 17-1-4 Federal Funds - acceptance - allocation
With approval of the Tribal Health Board, the Tribal Health Officer may accept funds for public health from an agency of the Federal Government, or from any other agency or person, and allocate funds within the Tribal Health Department.
Section17-1-5Legal Advisor
Tribal attorneys shall serve as legal advisors to the Tribal Health Board and shall represent the Board in those matters relating to the functions, powers and duties of the Board.
CHAPTER 2TRIBAL HEALTH OFFICER AND WIND RIVER TRIBAL HEALTH BOARD
Section 17-2-1Tribal Health Officer – appointment
On an annual basis, the Joint Business Council (JBC) will formally appoint a Tribal Health Officer.
The Tribal Health Officer may be an Indian Health Service (IHS)-employed physician or other healthcare provider or, alternatively,a non-IHS-employed physician or other healthcare provider with appropriate training and experience. If the Tribal Health Officer is non-IHS employed, the JBC shall fix or otherwise arrange for the portion of his salary and other necessary expenses that relate to his Tribal Health Officer duties.
The annual start date of the Tribal Health Officer appointment shall correspond either with the start date of the IHS Chief Medical Officer position or January 1st, as is appropriate.
The JBC has the power to dismiss the Tribal Health Officer at any time. If the Tribal Health Officer resigns prior to the end of his term, or the position becomes vacant for any other reason,the JBC shall appoint an Acting Tribal Health Officer within 45 days of the position’s vacancy.
Section 17-2-2Wind River Tribal Health Board - appointment
The Wind River Tribal Health Board (Board) shall include the following composition: one representative each from the Eastern Shoshone Business Council and Northern Arapaho Business Council; the Tribal Health Officer; the Eastern Shoshone Tribal Health Director or his/her designee; the Northern Arapaho Tribal Health Director or his/her designee; the Wind River Health Systems Director or his/her designee; and the Wind River Environmental Quality CommissionDirector or his/her designee. The term of Board membership will be 2 years.
The JBC shall appoint one Eastern Shoshone and one Northern Arapaho a representative to the Tribal Health Board. The Tribal Health Officer shall appointthe other Board members with assistance from the Tribal Health Department Directors; the Wind River Health Systems Director; and the Wind River Environmental Quality Commission Director. The Board’s membership requires final written approval of the Joint Business Council. Prior to each Board term, the Tribal Health Officer will submit a list of recommended members to the Joint Business Council for their approval.Within 45 days of receiving the list, the Joint Business Council will, in writing, either approve the list or provide the Health Officer’s names of suggested alternates. Ifthe Joint Business Council does not provide written approvalor names of suggested alternates within 45 days, then the persons recommended by the Health Officer will automatically becomemembers of the Health Board.
If, for any reason, a Board member vacates their position prior to the end of their term, the Tribal Health Officer will work with the member’s Program Director to appoint an interim representative within 45 days.
Section 17-2-3Wind River Tribal Health Board - Functions, Powers and Duties
The Board shall carry out the followingactionsbased on current public health guidelines:
a)Elect a Chairperson, Secretary, and other necessary officers. The Chairperson will call meetings to order, conduct meetings, organize the agenda and may call special meetings as necessary. The Chairperson will also serve as the formal communication link between the Board and the Tribal Council. The Secretary will take minutes from the meetings, summarize and distribute minutes to the Board, develop and distribute agendas prior to meetings
b)Adopt bylaws to govern meetings.
c)Hold regular meetings and special meetings as necessary.
d)Apprise the JBC of decisions and actions.
e)Authorizedestruction and removal of all sources of contamination
which cause disease.
f)Guard against the introduction and spread of communicable disease.
g)Authorizeinspections of public establishments for sanitary
conditions and safety.
h)Guard against the introduction of hazardous materials and wastes.
i)Authorizethe clean-up and disposal of all sources of contamination or contaminated conditions.
j)Guard against other conditions which are deemed to threaten community health and safety.
The Board may carry out the following actions based on current public health guidelines:
a)Adopt regulations ensuring proper, safe construction and operation of sanitary facilities (e.g., food establishments, water supply, sewage disposal and solid and liquid waste disposal).
b)Coordinatetreatment for persons who have communicable diseases.
c)Prohibit the use of places which are infected with communicable diseases or contaminated with hazardous materials or are otherwise unsafe or hazardous.
d)Authorizeand provide means for disinfecting or decontaminating places which are infected with communicable diseases
e)Provide recommendations for reducing, avoiding, and evaluating harmful health effects of exposure to hazardous materials.
f)Accept and spend funds received from a federal agency, the state, tribe(s), other agencies or persons.
g)Contractor enter mutual agreements with other Boards of Health, federal, state or local agencies or persons for all, or part of, local health services.
h)Authorize abatement of nuisances affecting public health and safety or bring action necessary to restrain the violation of federal or tribal health and safety codes or rules.
i)Adopt necessary regulations and fees for the control and disposal of sewage from private and public buildings.
j)Adopt rules for the removal of conditions which might cause disease or adversely affect public health.
k)Adopt rules for the control of communicable diseases and hazardous materials.
l)Adopt rules on sanitation and safety in public buildings which affect public health.
m)Adopt rules for construction, heating, ventilation, water supply, waste disposal, plumbing, safety, fire prevention, and other items in public or private facilities which might endanger human lives or health.
n)Adopt rules for reducing death and injury from transportation related accidents and other causes of personal injury.
o)Adopt rules for reducing and/or eliminating abuse of methamphetamines, alcohol, and other substances of abuse.
Section 17-2-4 Tribal Health Officer –Functions, Powers and Duties
(1) The Tribal Health Officer or his/her designee shallcarry out the following actions based on current public health guidelines:
a) Apprise the JBC and the Board of decisions and actions.
b) Make inspectionsfor health and safety conditions.
c)Issue written orders for the removal of environmental conditions, animals, or situations which might cause disease.
d)Establish, maintain,and enforce isolation and quarantine of persons and propertyas necessary for the protection of the public’s health.
e)Require disinfection or decontamination of places which are infected with communicable disease.
f)Forbid persons to assemble in any place if the assembly endangers public health or safety.
g)File a complaint with the tribal court if provisions of this Title are violated or with the Federal Court if federal regulations are violated.
h)Enforcefederal or tribal laws, codes and regulations and construction standards that pertain to public health and safety.
i)Authorize the abatement of nuisances or public health or safety hazards or bring action necessary to restrain the violation of federal or tribal health and safety codes or rules.
j)Notify the Wyoming Department of Health of all instances of reportable conditions using established mechanisms and criteria.
k)Assist the tribal health departments to review, modify,and implement public health policies, programs, and services on the Wind River Indian Reservation.
l)Work closely and constructively with the State Health Officer or designee and surrounding public health departments.
m)Assist the State Epidemiologist, the State Health Officer, and surrounding public health departments in disease outbreak investigation and in preventing the spread of communicable disease.
n)Work closely with federal government and tribal health departments to assist with issuing boil orders.
o)Provide leadership on Wind River Indian Reservation as it relates to bioterrorism and weapons of mass destruction and coordinate tribal bioterrorism efforts with the State Health Officer, State Epidemiologist, Indian Health Service, and the tribal public health departments.
(2) The Tribal Health Officer or his/her designeemaycarry out the following actions based on current public health guidelines:
a)Declare imminent health hazards and issue orders for their abatement.
b)Authorize the disinfection of facilities or the clean-up and disposal of hazardous materials.
c)Advise on the disinfection or decontamination of places which are contaminated with hazardous materials.
d)Order buildings or facilities where people congregate closed due to health or safety hazards.
e)Close schools, food establishments or vending operations, casinos, and other public places, and forbid gatherings of people as necessary to protect the public health.
f) Quarantine persons who have exposed to or are at risk of being exposed to
communicable diseases.
g) Require isolation of persons or things which are infected with
communicable diseases or contaminated with hazardous materials or are otherwise unsafe or hazardous.
h) During a public health emergency, subject a person to vaccination or
medical treatment without consent in the following circumstances:
- If the parent, legal guardian or other adult person authorized to consent to medical treatment of a minor child cannot be located and consulted and the vaccination of or medical treatment for the minor child is reasonably needed to protect the public health or protect the minor child from disease, death, disability or suffering;
- If the person authorized to consent on behalf of an incompetent person cannot be located and consulted and the vaccination of or medical treatment for the incompetent person is reasonably needed to protect the public health or protect the incompetent person from disease, death, disability or suffering.
- If a person withholds or refuses consent for himself, a minor or other incompetent when the vaccination or medical treatment is reasonably needed to protect the health of others from a disease carrying the risk of death or disability, then the person for whom the vaccination or medical treatment is refused may be quarantined by the Tribal Health Officer.
i) If there is a reasonable belief that a vaccine-preventable communicable disease threatens or may threaten public health, require any or all persons frequenting any public facility within the infected or threatened area to be vaccinated or to present evidence of successful vaccination according to current guidelines. Unless a person presents evidence of vaccination, it is unlawful for him/her to enter the named public facility/facilities.
j) By delegation of authority that is subject to Joint Business Council approval, request Tribal or other government personnel to assist them in carrying out the provisions of this Health Code.
Section 17-2-5Communicable Disease Reportingby Healthcare Providers or Practitioners of the Healing Arts
If a healthcare provider or other practitioner of the healing arts (e.g., traditional healer, physical therapist, etc.) examines or treats a person whom s/he knows or believes has a communicable disease, or a disease declared reportable by the Wyoming Department of Health, s/he shall immediately report the case to the Tribal Health Officeror his/her designee who will report the case to Wyoming Department of Health using the State of Wyoming standard disease reporting form. A list of Wyoming reportable diseases is maintained by the Tribal Health Officer and is shared with IHS provider staff, Tribal health directors and other tribal organizations. Copies of Wyoming Reportable Disease list are available by calling Wyoming Department of Health at 307.777.5596.
Section 17-2-6 Diseased Prisoners - Removal fromJail to Medical Facility
On written order of the Tribal Health Officer, a diseased prisoner who is held in a jail or detention facility and who is considered dangerous to the health of other prisoners may be removed to a medical facility or other place of safety. When the prisoner recovers from the disease, he shall be returned to jail. If the prisoner was committed to jail by order of the court, the order for removal and treatment shall be signed by the Tribal Health Officer and filed with the court.
Section 17-2-7Obstructing the Tribal Health Officer in the Performance of his/herDuties - Unlawful
It is unlawful to:
(1) Hinder the Tribal Health Officer or his/her authorized representatives in the performance of their duties.
(2) Remove or deface any placard or notice posted by the Tribal Health Officer or his/her representative.
(3) Violatequarantine or a lawful order of the Tribal Health Officer or his/herauthorized representatives.
Section 17-2-8 Penalties
(1) Any person refusing or neglecting to comply with a written order of the Tribal Health Officer or his designated representatives within a reasonable time specified in the order has committed a failure to comply with this Code. Such refusal or neglect will initiate actions in accordance with applicable sections the Shoshone and Arapaho Law and Order Code to cause the order to be enforced; to levy appropriate penalties therein; andto recover any incurred expenses from the person who refused or neglected to comply with the order. The action to recover the expenses shall be brought in the name of the Tribes.
(2) Each day of violation constitutes a separate offense.
Section 17-2-9 Pleadings
A person or entity to whom a written order is directed under this Title (Title XVII) and who opposes the order may plead for a Claim for Relief per the Shoshone and Arapaho Law and Order Code, Title II, Chapter 2, Rule 4, ‘General Rules for Pleadings.’
CHAPTER 3ANIMAL CONTROL
This Chapter complements and expands upon animal control provisions currently found in the Shoshone and Arapaho Law and Order Code Title 14, Chapter 14, Dog Regulation.
Section 17-3-1 Animal Control Officers – Appointment
The Joint Business Council shall appoint 2 Animal Control Officers (ACOs) - one for the Northern Arapaho Tribe and one for the Eastern Shoshone Tribe; assign their geographic areas of responsibility; and provide adequate animal control program training. The ACOs shall coordinatewith existing tribal animal control authorities to carry out their duties.
Section 17-3-2Animal Control Officers – Functions, Powers, and Duties
(1) The ACO has the authority to impound and quarantine animals deemed to be afflicted with a disease that poses a threat to public health andtoauthorize the humane destruction of animals having illness suggestive of rabies.
(2) The ACO may authorize the humane destruction of animals deemed to be vicious.
(3) The ACO shall have the authority to impound any animal deemed unvaccinated against rabies, unwanted, or unowned.
(4) The ACO shall have the authority to order an aggressive dog to be controlled by leash, chain, or penned at all times.
(5) The ACO shall investigate and report cruelty to animals to law enforcement authorities and the Tribal Health Officer.
(6) The ACO shall report all cases of animal bites to humans to the Tribal Health Officer or the State Public Health Veterinarian.
CHAPTER 4 PREVENTION OF RABIES
Section17-4-1Background
This Chapter complements and expands upon rabies vaccination provisions currently found in the Shoshone and Arapaho Law and Order Code Title 14, Chapter 14, Dog Regulation.
Section 17-4-2Management of animals that bite humans
(1) Whenever an animal bites any person, the incident shall be reported to the ACO, Tribal Health Officer, or his/her designee by any person having direct knowledge.
(2) Dogs, cats, and ferrets: Rabies virus may be excreted in the saliva of infected dogs, cats, and ferrets during illness and/or for only a few days prior to illness or death. An apparently healthy dog, cat, ferret that bites a person shall be confined and observed by the ACOfor a period of 10days in accordance with current public health guidelines. The quarantine location shall be determined by the ACO and may include the location where the animal is currently harbored, a local animal shelter, or the owner’s home. Rabies vaccination shall not be administeredto that animal during the observation period to avoidadverse vaccine side effects that could be confused with rabies.At the first sign of illness the ACO shall ensure that the biting animal(s)under observation are evaluated by a veterinarian and that an attending healthcare provider is notified of the situation. If the animal develops signs suggestive of rabies, the ACO shall coordinate with a local licensed veterinarian and tribal law enforcement officials to have the animal humanely euthanized and the head shipped for testing to the Wyoming Veterinary Diagnostic Laboratory in Laramie. Previous vaccination might not preclude the necessity for euthanasia and rabies testing.