Public Health Grand Rounds
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A Menu of Suggested
Provisions for
Public Health Mutual Aid Agreements
Special Note
Relating to Tribes
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Tribes represent an array of culturally rich and diverse communities
spread across the country. There are over 560 federally recognized
Indian tribes located in over 30 states. Tribal governments are
sovereign entities with inherent authority to protect the health,
safety and welfare of their communities. Jurisdictional authorities
in Indian country, however, are complex because the delivery of
public health services is often distributed across tribal, county,
state, and federal public health service providers. Tribal communities
are generally not subject to state public health laws and the extent
to which tribal governments have codified public health authority
within tribal law is not clear.
Public health legal preparedness is an emerging issue in Indian
country that is gaining broader recognition by a wide array of tribal
leaders. In response to requests from these tribal leaders, CDC
established a Tribal Public Health Law Work Group. The Work Group
recently coordinated a Tribal Forum on Legal Foundations for Public
Health Practice in Indian Country. Mutual aid agreements were recognized
as an essential component of public health legal preparedness, and
development of such agreements will certainly be among the Forum-related
“next steps” to be taken by the Work Group.
There are some recent examples of collaborative efforts demonstrating
that agreements between tribes and other governmental entities can
effectively facilitate the sharing of information, resources, equipment,
or personnel for the purpose of protecting the public’s health.
As state and local governments continue their mutual aid efforts,
and as they work to cultivate similar working relationships with
tribes, the number of agreements between tribes and other levels
of government (and perhaps Mexican states, Canadian provinces and
First Nations as well) will undoubtedly increase.
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