March 31, 2022

Warren, Gallego, Heinrich, Cole Introduce Bicameral Bill to Increase Tribal Public Health Security and Preparedness

Legislation Would Ensure Tribal Nations Have Equal Access to Centers for Disease Control and Prevention Resources to Prepare for Public Health Emergencies

Bill Text (PDF) | One Pager (PDF)

Washington, D.C. – United States Senator Elizabeth Warren (D-Mass.), Representative Ruben Gallego (D-Ariz.), Senator Martin Heinrich (D-N.M.), and Representative Tom Cole (R-Okla.) introduced the Centers for Disease Control and Prevention (CDC) Tribal Public Health Security and Preparedness Act, legislation that would ensure tribal nations have equal access to funding through the CDC to prepare for public health emergencies. Currently, tribal nations are not eligible to apply for the CDC’s Public Health Emergency Preparedness (PHEP) cooperative agreement program that provides grants to local public health departments to help them prepare for emergencies. This bill would change that.

The CDC PHEP program is a critical source of funding for eligible state, local, and territorial public health departments, helping them build and strengthen their ability to respond to public health threats and associated emergencies, such as the COVID-19 pandemic. Many heavily rely on these funds to meet needs related to staffing, supplies, planning, training, and exercises, but under the current program, no tribal public health departments are able to apply for these funds. 

“The federal government unjustly excluded tribal nations from public health prevention and mitigation resources that could have helped Indian Country prepare for the disproportionately devastating effects of the pandemic,” said Senator Warren. “Our bill would ensure tribal nations have equal access to the CDC PHEP program funding for future public health emergencies.”

“The COVID-19 pandemic has underlined the public health inequities that still exist in our nation - especially in Tribal communities. To tackle this disparity, we must ensure that sovereign Tribes can access the resources they need not only to respond to, but to prevent and prepare for public health emergencies. The Tribal Public Health Security and Preparedness Act will do just that. It’s a critical piece of building the public health infrastructure we need to both end this pandemic and prevent the next one. That’s why I am so proud to introduce this bill with Rep. Tom Cole and Sen. Warren,” said Congressman Gallego. 

“The American Rescue Plan provided immense relief to help Tribes endure the pandemic. The Infrastructure Law is creating jobs and economic opportunities on Tribal lands. And now, the Omnibus Appropriations Agreement is delivering direct investments to support Tribal projects in New Mexico,” said Senator Heinrich. “Now, we have an opportunity to solidify Tribal resilience. That’s why I want to open up CDC Public Health Emergency Preparedness grants for Tribes to ensure these communities have the resources – ahead of time – to prepare for future public health emergencies. The legislation Senator Warren and I are introducing will do just that.”

“As we have learned over the last few years throughout the coronavirus pandemic, preparedness is key to keeping communities healthy,” said Congressman Cole, Co-Chair of the Congressional Native American Caucus and Member of the Chickasaw Nation of Oklahoma. “Just as individual states and local governments can receive grants for pandemic preparedness from the Centers for Disease Control and Prevention, tribal governments deserve the same access. I am proud to join my colleagues in introducing this common sense legislation that would allow that access for tribal nations.”

The COVID-19 pandemic has had a disproportionate impact on Indian Country, in part worsened by inequities in access to public health prevention and mitigation resources. While the Indian Health Service serves as the primary federal agency charged with providing health care in Indian Country, all federal agencies – including the CDC – share the requirement to fulfill the federal government’s trust and treaty obligations to Native Nations. The CDC Tribal Public Health Security and Preparedness Act would: 

  • Allow tribal nations and tribal organizations to apply directly to the CDC PHEP program;
  • Require the CDC to fund at least ten tribes for emergency preparedness and include a 5% tribal set-aside of total CDC PHEP funds;
  • Exempt tribes from needing to match funds and waive many of the reporting requirements to minimize the administrative burden on tribal nations; and 
  • Require the CDC to consult with tribal nations and tribal organizations and allow the CDC to make certain modifications to the program to fit the needs of tribal applicants.

The CDC Tribal Public Health Security and Preparedness Act is cosponsored by Senators Tina Smith (D-Minn.), Amy Klobuchar (D-Minn.), Cory Booker (D-N.J.), Tammy Baldwin (D-Wisc.), and Bernie Sanders (I-Vt.).

The CDC Tribal Public Health Security and Preparedness Act is supported by the National Indian Health Board, the National Congress of American Indians, and the National Council of Urban Indian Health. 

“The NIHB applauds Senators Warren and Heinrich and Representatives Gallego and Cole for introducing the Centers for Disease Control and Prevention (CDC) Tribal Public Health Security and Preparedness Act.  For too long, Tribal nations have not had equitable access to resources as other state or local governments have had.  This inequity has contributed to severe health disparities and an unacceptable situation this legislation seeks to end.  This bill would help Tribal nations secure the resources to address and prevent public health emergencies and contribute to building public health infrastructure.  It is a significant step toward achieving health equity for Tribal communities.  We are pleased to support this legislation and urge Congress to move swiftly in passing it this year.” – National Indian Health Board

“NCUIH is pleased to endorse Rep. Gallego, Senator Warren, Rep. Cole, and Senator Heinrich’s CDC Tribal Public Health Security and Preparedness Act which provides Tribes access to Public Health Emergency Preparedness (PHEP) program funds and includes urban Indian organization input on the development of public health plans. The COVID-19 pandemic has had devastating impacts on Native communities, and this bill’s equitable access to critical preparedness funds will ensure Indian Country will be better prepared to respond to future public health emergencies.” – Francys Crevier (Algonquin), CEO, NCUIH

During her time in the Senate, Senator Warren has worked to protect and advance tribal sovereignty, to emphasize the federal government's trust and treaty responsibilities to tribal nations, and to affirm Washington's government-to-government relationship with tribal nations. She fought to ensure that sovereign Native nations have the resources needed to protect the health and well-being of their citizens during this pandemic. She has introduced a number of bills to advance the health and welfare of Native peoples, including the American Indian and Alaska Native Child Abuse Prevention and Treatment Act. Provisions of the bill were included in the Child Abuse Prevention and Treatment Act (CAPTA) Reauthorization Act of 2021. Senator Warren recently reintroduced the Tribal Medical Supplies Stockpile Access Act, legislation originally introduced in 2020 that would guarantee that the Indian Health Service, tribal health authorities, and urban Indian organizations have access to the Strategic National Stockpile, a federal repository of drugs and medical supplies that can be tapped if a public health emergency could exhaust local supplies. She also reintroduced the Comprehensive Addiction Resources Emergency (CARE) Act, which would provide nearly $1 billion a year directly to tribal governments and organizations to combat the substance use epidemic. Senator Warren also introduced the Native American Suicide Prevention Act, a version of which was enacted in December 2020 as part of the Consolidated Appropriations Act, 2021 (Public Law No. 116-260).