WINDRIVER HEALTH CODES TITLE 17 – CODE OF HEALTH AND SANITATION CHAPTER 1 GENERAL PROVISIONS Section 17-1-1 Definitions (1) “Board” means the Wind River Tribal Health Board designated by the Wind River Joint Business Council as a tribal organization. (2) “Communicable disease” means diseases spread by direct or indirect contact 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 the elimination 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 17-1-2 Jurisdiction The provisions of this Title apply to all areas within the jurisdiction of the DRAFT August 4, 2009 Title XVII (Code of Health and Sanitation) S &A LOC 1 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 operated by 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 Code will be addressed by applicable Titles in the current version of the Shoshone and Arapaho Law and Order Code except 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. Section17-1-5 Legal 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 2 TRIBAL HEALTH OFFICER AND WIND RIVER TRIBAL HEALTH BOARD Section 17-2-1 Tribal 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 17-2-2 Wind River Tribal Health Board - appointment DRAFT August 4, 2009 Title XVII (Code of Health and Sanitation) S &A LOC 2 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 Commission Director 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 appoint the 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. If the Joint Business Council does not provide written approval or names of suggested alternates within 45 days, then the persons recommended by the Health Officer will automatically become members 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 17-2-3 Wind River Tribal Health Board - Functions, Powers and Duties The Board shall carry out the following actions based 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) Authorize destruction and removal of all sources of contamination which cause disease. DRAFT August 4, 2009 Title XVII (Code of Health and Sanitation) S &A LOC 3 f) Guard against the introduction and spread of communicable disease. g) Authorize inspections of public establishments for sanitary conditions and safety. h) Guard against the introduction of hazardous materials and wastes. i) Authorize the 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) Coordinate treatment 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) Authorize and 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) Contract or 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. DRAFT August 4, 2009 Title XVII (Code of Health and Sanitation) S &A LOC 4 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 shall carry out the following actions based on current public health guidelines: a) Apprise the JBC and the Board of decisions and actions. b) Make inspections for health and safety conditions. c) Issue written orders for the removal of environmental conditions, animals, or situations which might cause disease. Establish, maintain, and enforce isolation and quarantine of persons and property as necessary for the protection of the public’s health. d) 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) Enforce federal 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 DRAFT August 4, 2009 Title XVII (Code of Health and Sanitation) S &A LOC 5 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 designee may carry 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. DRAFT August 4, 2009 Title XVII (Code of Health and Sanitation) S &A LOC 6 h) During a public health emergency, subject a person to vaccination or medical treatment without consent in the following circumstances: i. 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; ii. 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. iii. 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 17-2-5 Communicable Disease Reporting by 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 Officer or 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. DRAFT August 4, 2009 Title XVII (Code of Health and Sanitation) S &A LOC 7 Section 17-2-6 Diseased Prisoners - Removal from Jail 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 17-2-7 Obstructing the Tribal Health Officer in the Performance of his/her Duties - 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) Violate quarantine 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; and to 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 3 ANIMAL CONTROL DRAFT August 4, 2009 Title XVII (Code of Health and Sanitation) S &A LOC 8 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 coordinate with existing tribal animal control authorities to carry out their duties. Section 17-3-2 Animal 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 and to authorize 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 Section17-4-1 Background 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 17-4-2 Management of animals that bite humans (1) Whenever an animal bites any person, the incident shall be reported to the DRAFT August 4, 2009 Title XVII (Code of Health and Sanitation) S &A LOC 9 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 ACO for a period of 10 days 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 administered to that animal during the observation period to avoid adverse 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. (3) Wildlife: Wild mammals and hybrids (i.e. wolf hybrids) that bite or otherwise expose persons, pets, or livestock to rabies should be considered for collection, euthanasia and rabies examination. Persons with knowledge of such animals shall immediately report them to the ACO. Persons bitten by any wild mammal should report the incident to the Tribal Health Officer or his representative who will coordinate medical care including possible postexposure rabies prophylaxis Section 17-4-3 Management Dogs, Cats, and Other Animals Exposed to Rabid Animals Unvaccinated dogs, cats, and ferrets exposed to a rabid animal should be euthanized immediately. If the owner is unwilling to have this done, the animal should be placed in strict isolation for 6 months. Isolation in this context refers to confinement in an enclosure that precludes direct contact with people and other animals. Rabies vaccine should be administered upon entry into isolation or 1 month prior to release to comply with preexposure vaccination recommendations. There are currently no USDA licensed biologics for postexposure prophylaxis of previously unvaccinated domestic animals, and there is evidence that the use of vaccine alone will not reliably prevent the disease in these animals. Animals overdue for a booster vaccination need to be evaluated on a caseby-case basis (e.g., severity of exposure, time elapsed since last vaccination, number of prior vaccinations, current health status, and local rabies epidemiology). Dogs, cats, and ferrets that are currently vaccinated should be revaccinated immediately, kept under the owner’s control, and observed for 45 days. Any illness in an isolated or confined animal should be reported immediately to the local health department. If signs suggestive of rabies develop, the animal should be euthanized and the head shipped for testing. Section 17-4-4 Livestock DRAFT August 4, 2009 Title XVII (Code of Health and Sanitation) S &A LOC 10 All species of livestock are susceptible to rabies; cattle and horses are the most frequently reported infected species. Livestock exposed to a rabid animal and currently vaccinated with a vaccine approved by USDA for that species should be revaccinated immediately and observed for 45 days. Unvaccinated livestock should be euthanized immediately. If the animal is not euthanized it should be kept under close observation for 6 months. Any illness in an animal under observation should be reported immediately to the local health department. If signs suggestive of rabies develop, the animal should be euthanized and the head shipped for testing. Section 17-4-5 Duty to Report If any animal owner or other person knows, or has reason to believe that an animal has rabies, symptoms of rabies, or has been exposed to rabies, they shall report this to the ACO or representative, who in turn will notify the Tribal Health Officer or his/her representative and a local veterinarian. Section 17-4-6 Movement of Rabid Animals It shall be unlawful for any animal owner, or other person, knowing that an animal has rabies, or has been exposed to rabies, to remove the animal from the owner’s residence or from the Wind River Indian Reservation, except under the order of the ACO, local law enforcement authority, or Tribal Health Officer or his/her designee. CHAPTER 5 CRUELTY TO ANIMALS Section 17-5-1 Background This Chapter complements and expands upon animal cruelty provisions currently found in the Shoshone and Arapaho Law and Order Code Title 7, Chapter 6, Cruelty to Animals. Section 17-5-2 Definitions A person commits animal cruelty when he: (1) Knowingly and with intent to cause harm overrides an animal or drives an animal when overloaded; or (2) Unnecessarily or cruelly beats, tortures, torments, injures, mutilates or attempts to kill an animal; or (3) Knowingly and with intent to cause harm carries an animal in a manner that poses undue risk of injury or death; or DRAFT August 4, 2009 Title XVII (Code of Health and Sanitation) S &A LOC 11 (4) While having custody of any animal, unnecessarily fails to provide it with the proper food, drink or protection from the weather, or cruelly abandons the animal, or in the case of immediate, obvious, serious illness or injury, fails to provide the animal with appropriate care; or (5) Is knowingly present at any place where an exhibition of fighting fowls or dogs is occuring for amusement or gain. A person commits aggravated cruelty to animals when he: (1) Owns, possesses, keeps or trains fowls or dogs with the intent to allow the dog or fowl to engage in an exhibition of fighting with another dog or fowl; or (2) For gain causes or allows any dog or fowl to fight with another dog or fowl. (3) Knowingly permits any act prohibited under items (1) and (2) immediately above on any premises under his charge or control (4) Promotes any act prohibited under items (1) and (2) immediately above. (5) Knowingly and with intent to cause death, injury or undue suffering, cruelly beats, tortures, toments, injures or mutilates and animal resulting in the death or required euthanasia of the animal. Section 17-5-3 Penalties A person commits a felony if he commits aggravated cruelty to animals as defined in Section 17-5-2 above. A felony under under this section is pubishable by not more than two (2) years imprisonment or a fine of not more than $5,000, or both. CHAPTER 6 ELDERLY AND INCAPACITATED ADULT PROTECTION Section 17-6-1 Background It is the tradition and custom of the Tribes to honor and protect their elderly as they are the possessors of the spiritual and collective wisdom and traditions of the Arapaho/Shoshone Tribes of the Wind River Reservation which are passed on from generation to generation. As such, the elderly warrant the special concern and protection of Tribes. This Elderly Protection Section is to be liberally construed for their protection. This Section complements and expands upon provisions currently found in the Shoshone and Arapaho Law and Order Code, Title 7, Chapter 7-3-11, Abuse of Spouse, or Handicapped, or Elderly Persons Section 17-6-2 Definitions DRAFT August 4, 2009 Title XVII (Code of Health and Sanitation) S &A LOC 12 (1) “Adult” means any person who is eighteen years of age or older. (2) “Exploitation” means the illegal or improper use of an elderly person or an incapacitated adult or his resources for another’s profit or advantage. (3) “Incapacity” means an impairment by reason of mental illness, mental deficiency, mental disorder, physical illness or disability, advanced age, chronic use of drugs, chronic intoxication or other cause to the extent that the person lacks sufficient understanding or capacity to make or communicate responsible decisions concerning his person or property. (4) “Neglect” means a pattern of conduct resulting in deprivation of necessities to maintain physical and mental health. (5) “Protective services worker” means a person who has been trained and employed to provide protective services to the elderly and incapacitated; and shall consist of, but not be limited to, Elderly Services Staff, Social Services Staff and any other person specifically employed to protect the best interest of the elderly and incapacitated adults. Section 17-6-3 Protective Services Workers: Functions, Powers and Duties (1) Protective Services Workers shall: a) Receive oral or written reports of abused, exploited or neglected incapacitated adults and elderly persons. b) Upon receipt of such information, determine if the incapacitated adult or elderly is in need of protective services. c) File petitions as necessary for the appointment of a guardian or conservator or the appointment of a temporary guardian or temporary conservator as provided for in the Arapaho/Shoshone Tribal Probate Code. When filing petitions for Guardianship or Conservator, the Protective Services Worker shall try to locate a responsible and willing person to accept the responsibility of guardian and/or conservator. Every attempt shall be made to notify immediate members of the family of any guardianship proceedings. d) Immediately file a report with the Tribal Prosecutor for investigation in all cases of possible abuse, neglect or exploitation of elderly or incapacitated persons. In cases of physical abuse, the prosecutor shall cause the case to be investigated within 12 hours of receiving the report. (2) A member of the Protective Services staff may not be appointed as guardian, conservator, or temporary guardian for their own clients. DRAFT August 4, 2009 Title XVII (Code of Health and Sanitation) S &A LOC 13 (3) The Protective Services Workers are immune from the civil liability for applying for or filing a petition for guardianship or conservatorship unless the application or filing is done in bad faith. (4) A guardian need not be a member of the Northern Arapaho/Eastern Shoshone Tribe or reside on the Wind River Reservation if the Court determines it would be in the best interest of the client to appoint a person as guardian who does not meet these qualifications. Section 17-6-4 Duty to Report Abuse, Neglect and Exploitation (1) A physician, surgeon, dentist, psychologist, social worker, peace officer or other person who has responsibility for the care of an adult or elderly who suffers from incapacity and whose examination or observation of the adult or elderly yields a reasonable basis to believe that abuse or neglect of the adult or elderly has occurred or the exploitation of the adult’s or elderly’s property has occurred shall immediately report such incidents to a protective services worker. (2) An attorney, accountant, trustee, guardian, conservator or other person who has responsibility for preparing the tax records of an adult or elderly who suffers from incapacity or a person who has responsibility for any other action concerning the use or preservation of the adult’s or elderly’s property and who, in the course of fulfilling that responsibility, discovers a reasonable basis to believe that exploitation of the adult’s or elderly’s property has occurred shall immediately report or cause reports to be made to a protective services worker. (3) Reports shall contain: a) The names and addresses of the adult or elderly and any persons having control or custody of the adult or elderly, if known. b) The adult’s or elderly’s age and the nature and extent of his incapacity. c) The nature and extent of the adult’s or elderly’s injuries or physical neglect or of the exploitation of the adult’s or elderly’s resources. d) Any other information that the person reporting believes might be helpful in establishing the cause of the adult’s or elder’s injuries or physical neglect or of the exploitation of the adult’s or elder’s property. (4) Any person other than one required to report in subsection A who has a reasonable basis to believe that abuse or neglect of an incapacitated adult or elderly has occurred may report the information to a peace officer or protective services worker. (5) A person required to receive reports pursuant to subsection 1, 2, or 4 may take photographs of the abused adult or elderly and the vicinity involved. Medical DRAFT August 4, 2009 Title XVII (Code of Health and Sanitation) S &A LOC 14 examinations including radiological examinations of the involved adult or elderly may be performed. Accounts, inventories, or audits of the exploited adult’s or elder’s property may be performed. The person, department, agency, or court that initiates such photographs, examinations, accounts, inventories, or audits shall pay the associated costs in accordance with the existing statutes and rules. If any person is found to be responsible for the abuse, neglect or exploitation of an incapacitated adult or elderly in a criminal or civil action, the tribal court may order the person to make restitution as the court deems appropriate. CHAPTER 7 TRANSPORTATION SAFETY Collaborative efforts will be made among Tribal Councils, BIA, IHS, Tribal Health Board, and community members at large to decrease injuries and death related to modes of transportation and recreation. CHAPTER 8 SUBSTANCE ABUSE Collaborative efforts will be made among Tribal Business Councils, BIA, IHS, Wind River Tribal Health Board, and community members at large to decrease the abuse of methamphetamines, alcohol, and other substances of abuse. DRAFT August 4, 2009 Title XVII (Code of Health and Sanitation) S &A LOC 15