Bill Overview
Title: CDC Tribal Public Health Security and Preparedness Act
Description: This bill allows tribes and tribal organizations to apply directly to the Centers for Disease Control and Prevention (CDC) for Public Health Emergency Preparedness (PHEP) program funds. Currently, only states and certain local entities may apply for PHEP funds to respond to public health emergencies, such as COVID-19. The CDC must award at least 10 cooperative agreements to tribal applicants. Additionally, the CDC must consult with tribes and tribal organizations to ensure the PHEP program enables these entities to respond to public health emergencies. The CDC may make certain modifications to the program after the consultation.
Sponsors: Sen. Warren, Elizabeth [D-MA]
Target Audience
Population: People living in tribal communities and areas served by tribal organizations in the U.S.
Estimated Size: 5000000
- The bill focuses on tribal entities being able to access CDC funds directly, which means it directly impacts tribal communities across the United States.
- There are 574 federally recognized tribes in the U.S., which collectively consist of millions of American Indians and Alaska Natives.
- This legislation also involves tribal organizations, which are instrumental in public health across various tribal nations.
- The CDC's obligation to consult with tribes and tribal organizations implies that the impacted population includes all those living within or closely tied to tribal community governance and healthcare systems.
- The improvement of tribal public health response capability may indirectly affect non-tribal members living in or around tribal areas.
Reasoning
- Despite a sizable population of 6.8 million American Indians and Alaska Natives in the U.S., not all will be directly impacted by the policy. Only those closely tied to public health emergency preparedness efforts will likely experience substantial impacts.
- The policy has a budget of $50,000,000 in the first year and $547,000,000 over 10 years, focusing on direct support to tribal communities for public health emergency preparedness. This is a significant investment for the purpose it serves, but still must be allocated carefully among various tribal entities.
- Given the nature of the program, which centers around improving health response capabilities, the policy's success heavily depends on strategic collaborations with tribal organizations, which historically play key roles in community health.
- Post-policy wellbeing improvements are likely to be seen after year 1 as programs and resources take time to effectively establish, impacting not only tribal members but possibly non-tribal residents in these regions.
Simulated Interviews
Healthcare worker (Navajo Nation, Arizona)
Age: 34 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 20.0 years
Commonness: 15/20
Statement of Opinion:
- I feel this policy is crucial for us to have direct resources instead of going through the state.
- Healthcare on the reservation could really improve, especially in emergencies with direct funding.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 9 | 6 |
| Year 20 | 9 | 6 |
Tribal leader (Cherokee Nation, Oklahoma)
Age: 50 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 8/20
Statement of Opinion:
- Being able to apply directly will empower our nation to bolster health systems without state level bureaucracy.
- I see this as an opportunity to train more people in emergency response within the tribe.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 8 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 9 | 6 |
| Year 10 | 9 | 6 |
| Year 20 | 8 | 5 |
Community Organizer (Urban area with a large Native American population, Minneapolis)
Age: 27 | Gender: other
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 10/20
Statement of Opinion:
- I'm unsure how directly this will help urban Natives like those I work with.
- It's a step in the right direction, but we also need focus on urban health disparities.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 6 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 5 | 5 |
Epidemiologist (Sioux Falls, South Dakota)
Age: 41 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 10.0 years
Commonness: 7/20
Statement of Opinion:
- Direct funding and strategic partnerships can transform tribal health responses.
- The success will greatly depend on the cooperation and negotiation processes between tribes and the CDC.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 8 | 7 |
| Year 10 | 9 | 8 |
| Year 20 | 8 | 8 |
Teacher (Pine Ridge Reservation, South Dakota)
Age: 32 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 15.0 years
Commonness: 12/20
Statement of Opinion:
- I hope this supports education initiatives as well to spread public health awareness.
- Access to emergency preparedness resources should improve our community health outcomes.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 8 | 5 |
Student (Alaska Native Village, Fairbanks)
Age: 23 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 20.0 years
Commonness: 9/20
Statement of Opinion:
- I hope this encourages more young people to enter healthcare fields in our communities.
- Direct access to funds might speed up improving healthcare infrastructure.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 8 | 6 |
| Year 10 | 8 | 6 |
| Year 20 | 8 | 6 |
Healthcare Administration (Los Angeles, California)
Age: 45 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 5/20
Statement of Opinion:
- The policy could streamline access to emergency supplies, tailored for tribal needs.
- Realistically, it will take time before we see large improvements in infrastructure.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 8 | 6 |
| Year 20 | 7 | 6 |
Retired (Rural Montana, Crow Nation)
Age: 60 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 11/20
Statement of Opinion:
- The policy sounds promising, but execution and continuous support are critical.
- My hope is to see improved emergency services and healthcare access here.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 7 | 4 |
| Year 5 | 7 | 4 |
| Year 10 | 7 | 4 |
| Year 20 | 6 | 4 |
Public Health Analyst (Phoenix, Arizona)
Age: 39 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 15.0 years
Commonness: 9/20
Statement of Opinion:
- If designed well, this can be a model for how federal programs interact with tribal entities.
- Monitoring and evaluation will be key for adjustments and better outcomes over time.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 8 | 7 |
| Year 10 | 9 | 7 |
| Year 20 | 8 | 7 |
Non-Tribal Resident Near Reservation (Portland, Oregon)
Age: 30 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 20.0 years
Commonness: 6/20
Statement of Opinion:
- I'm interested to see if this policy encourages partnership and support for health across both tribal and adjacent non-tribal communities.
- While not directly affected, improvements nearby could trickle over.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 5 |
| Year 2 | 5 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 6 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 6 | 5 |
Cost Estimates
Year 1: $50000000 (Low: $40000000, High: $60000000)
Year 2: $50000000 (Low: $40000000, High: $60000000)
Year 3: $52000000 (Low: $42000000, High: $62000000)
Year 5: $54000000 (Low: $44000000, High: $64000000)
Year 10: $60000000 (Low: $48000000, High: $72000000)
Year 100: $60000000 (Low: $48000000, High: $72000000)
Key Considerations
- The necessity for culturally adapted public health strategies enhances the importance of tribal-specific allocations.
- The bill aligns with federal initiatives to empower tribal sovereignty and enhance self-reliance in public health matters.
- Potential long-term savings in healthcare costs depend on the effectiveness of tribal emergency preparedness enhancements.