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Abstract As the Indian Health Service restructures and more Indian tribes assume control for their health care services, more collaborative initiatives between Indian tribal health and other organizations may be anticipated. This paper addresses the topic of interorganizational collaboration and tribal health care. There are unique issues related to Indian tribal healthcare, and this paper provides a cautionary note to public health nurses who work with and for Indian tribes. Interorganizational collaboration and tribal health care will be of interest not only to the public health nurses working for a tribe, but also to the county and state public health nurses who may be entering into a collaborative effort with a tribal health care agency.