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Tribal Access to Emergency Medical Countermeasures 

 

The ability to secure essential supplies is critical for tribal communities during public health emergencies. There are established processes for federally recognized tribal nations and urban Indian organizations (UIOs) to access the Strategic National Stockpile (SNS) and other federal emergency resources.

For Tribal Nations

Tribal nations may access stockpiled medical countermeasures through any of four processes, and they may activate multiple processes simultaneously. Coordination among relevant agencies and stakeholders is essential to avoid duplication of efforts, streamline support from the U.S. government, and ensure the availability of resources for native communities to respond to public health emergencies. The processes are as follows:

  • Indian Health Service (IHS): Tribal nations may request access to SNS or other federal response supplies through the Emergency Management Point of Contact (EMPOC) for their IHS area office. When IHS receives a request for SNS assets from a tribal nation, IHS will work internally to determine if the IHS National Supply Service Center (NSSC) can fulfill the request, or whether it should be elevated as a request to SNS via the HHS Secretary's Operations Center (SOC).

  • Centers for Disease Control and Prevention (CDC): Tribal nations may seek guidance on clinical or public health issues through direct consultation with CDC experts. Based on these consultations, requests for SNS assets and other resources can be made through the CDC Emergency Operations Center (EOC).

  • Federal Regional Administrators (ASPR and FEMA): Tribal nations may directly request assistance from federal regional administrators, particularly during large-scale emergencies. ASPR and FEMA regional offices play a key role in coordinating responses and providing support to tribal nations.

  • States: Tribal nations may leverage existing relationships with states to access SNS assets and federal resources. This involves working with state public health and emergency management authorities to initiate requests for support. 
    Flow diagram showing four pathways a Tribal Nation can use to request public health or medical assistance. The Tribal Nation is centered, with requests coordinated through: (1) HHS Indian Health Service, (2) clinical consultation via the HHS/CDC Emergency Operations Center, (3) HHS ASPR or DHS/FEMA Regional Administrators, or (4) State Public Health/Emergency Management. All requests route through the HHS Secretary’s Operations Center, where HHS directs and the Strategic National Stockpile (SNS) provides support back to the Tribal Nation

Tribal nations may seek technical assistance from various sources, including ASPR regional administrators, IHS representatives, the Department of Health and Human Services Secretary's Operations Center, the CDC EOC, the SNS Operations Center and state agencies.

For Urban Indian Organizations (UIOs)

UIOs, as nonprofit organizations providing health care services to urban Indian beneficiaries, have limited processes for requesting federal resources. Unlike tribal nations, UIOs do not have the authority to make direct requests for federal assistance from FEMA or ASPR regional administrators.

  • IHS: Like tribal nations, UIOs may request access to SNS medicines, supplies and equipment through the EMPOC for their IHS area office. The process involves initiating requests through IHS, which then flow through relevant channels to ASPR and the SNS.

  • States: UIOs typically rely on their relationships with states to access federal resources. Requests for SNS assets and other support are made through state public health and emergency management authorities.

  • CDC: UIOs may not directly request SNS assets through this process and must coordinate requests through state authorities or IHS. But, UIO clinicians may seek guidance from CDC experts on clinical or public health issues. The flow chart shows the Urban Indian Organization Pathways for Accessing Emergency Medical Countermeasures from the Strategic N