Department of Health and Human Services

Centers for Disease Control and Prevention 

Agency for Toxic Substances and Disease Registry

Tribal Consultation Advisory Committee (TCAC) Meeting and 

4

th Biannual Tribal Consultation Session 

January 26-28, 2010

Executive Summary

Department of Health and Human Services

Centers for Disease Control and Prevention 

Agency for Toxic Substances and Disease Registry

Tribal Consultation Advisory Committee (TCAC) Meeting 

January 26-27, 2010

Executive Summary

The purpose of the Tribal Consultation Advisory Committee (TCAC) to the Director is to advise 

the Director of CDC and Administrator of ATSDR, on policy issues and broad strategies that 

may affect American Indian / Alaska Native (AI/AN) tribes and people. The TCAC assists CDC 

in fulfilling its mission to promote health and quality of life by preventing and controlling disease, 

injury, and disability through established and on-going relationships and consultation sessions. 

CDC honors the sovereignty of AI/AN governments, respects the inherent rights of selfgovernance, commits to work on a government-to-government basis, and uphold the federal 

trust responsibility. The TCAC provides a forum for meetings between CDC leadership and 

elected or appointed tribal leaders (or their designated employees with authority to act on their 

behalf); as well as representatives of national tribal organizations designated by tribal leaders to 

act on their behalf, in compliance with the exemptions with the Federal Advisory Committee Act 

(FACA). The meetings facilitate the exchange of views, information, or advice concerning the 

intergovernmental responsibilities in the implementation and / or administration of CDC 

programs, including those that arise explicitly or implicitly under statute, regulation or Executive 

Order. Such meetings include, but are not limited to, seeking consensus, exchanging views, 

information, advice, and/or recommendations, or facilitating any other interaction relating to 

intergovernmental responsibilities or administration. Meetings may be face-to-face or via 
CDC TCAC Meeting and Consultation Session Executive Summary January 26-28, 2010

2

conference call. TCAC meetings complement and do not supplant the Tribal Consultation 

process between CDC and Tribes. 

The TCAC Meeting itself was convened on January 26-27, 2010; a Tribal Leader Orientation 

was convened on January 27, 2010; and the Tribal Consultation Session was convened on 

January 28, 2010. A number of presentations were made during the TCAC Meeting, TCAC 

Orientation Session, and Tribal Consultation Session, which are very briefly summarized here. 

These presentations may be read in their entirety in the following detailed summary documents:

 January 26-27, 2010 TCAC Meeting Summary

 January 27, 2010 Tribal Leader Orientation Summary

 January 28, 2010 Tribal Consultation Session Summary

During the January 26-27, 2010 TCAC Meeting, members first approved the agenda and then 

addressed the administrative matter of approving the TCAC August 11, 2009 and August 13 

2009 minutes. The minutes were approved unanimously, with minor edits to be submitted to 

CAPT Snesrud and Dr. Bryan.

TCAC members presented their regional / national updates, which included highlights of new or 

critical public health issues occurring since the February 2009 TCAC meeting. The following 

members offered updates: Derek C. Valdo (Pueblo of Acoma, Southwest Area Regional Vice 

President, National Congress of American Indians); Roger Trudell (Chairman, Santee Sioux 

Tribe of Nebraska, Aberdeen Area); Joe Finkbonner (Executive Director, Northwest Portland 

Area Indian Health Board); Dee Sabattus, Interim Director, Tribal Health Program Support, 

Nashville, United South and Eastern Tribes); JT Petherick (Health Legislative Officer, Cherokee 

Nation, Oklahoma City Area); Roselyn Begay (Navajo Nation, Division of Health, Program 

Evaluation Manager): Lester Secatero (Chairman, Albuquerque Area Indian Health Board), 

Cynthia Manuel (Councilwoman, Tohono O’odham Nation, Indian Health Board Tucson), Reno 

Franklin (Chairman, California Rural Indian Health Board), Chester Antone (TCAC Chair, 

Councilman, Tohono O’odham Nation, Tucson), Alicia Reft (Alaska, Karluk Ira Tribal Council), 

and Kathy Hughes (TCAC Co-Chair, Vice Chairwoman, Oneida Business Committee). The 

following members articulated that they would be submitting written reports as well: Mr. Antone, 

Ms. Begay, Mr. Finkbonner, Mr. Franklin, Ms. Reft, Ms. Manuel Ms. Sebattus, Mr. Secataro, and 

Mr. Trudell.

Major health issues that resonated from the TCAC members’ updates and throughout the 

meeting that continue to plague Indian Country, often at higher rates than in the general 

population, include in alphabetical order: cardiovascular disease, cancer, child / adult obesity, 

diabetes, hepatitis C, sexually transmitted diseases, and suicide. It was noted that often when 

information is reported about tribes, it is “awfulized” with no solutions offered. However, in 

addition to articulating their health issues, TCAC members also described some of the methods 

by which they are attempting to address these issues in Indian Country, which include: Census 

participation, community gardens and tribally-owned farms, Community Health Representatives 

(CHRs), Head Start and school nutrition and physical activity programs, health care reform 

activities, healthy snack programs, medicine wheels, prevention / intervention / screening 

programs, Public Health Accreditation Board (PHAB) beta test site participation by several 

tribes, Tribal Epidemiology Center activities, wellness calendars with healthy recipes, and 

wellness facilities. With respect to the novel H1N1 pandemic, TCAC members reported that the 

success of vaccination efforts varied widely. Despite best efforts, there were areas where 
CDC TCAC Meeting and Consultation Session Executive Summary January 26-28, 2010

3

insufficient vaccine was available and areas where leftover vaccine may expire unused. It is 

anticipated that once the data are reviewed, higher vaccine uptake will be observed in areas 

where tribes were treated as true partners. 

 

Tribes reported a number of overarching issues that contribute to persistent health problems. 

Foremost is a lack of resources, which is compounded by state budget deficits. Some states 

have even demanded that tribes return funds. Contributing to the on-going financial issues is 

that the quality of tribes’ relationships with states varies widely. In addition to some states not 

parsing out funds to tribes as they should, they also fail to provide tribes with data sharing 

agreements and vital local data pertaining to tribes. These data are imperative for many funding 

opportunity announcements (FOAs) for which tribes could apply themselves. TCAC members 

pointed out that this also represents a failure to honor treaties and recognize government-togovernment relationships, and they emphasized the importance of, and right to, direct funding to 

tribes. 

Smoking continues to be a major contributor to health problems in Indian Country; however, this 

is a difficult issue to address given the economic implications. Tobacco sales represent an 

important source of funding. The issue of ceremonial tobacco versus commercial tobacco must 

also be taking into consideration. Tribes are attempting to address the smoking issue in various 

ways. For example, the Oneida Nation is working on a tribal law that will implement a smoking 

ban in part in some public facilities, but which will protect casinos by continuing to permit 

smoking in these facilities. Other issues that continue to affect health include difficulties in 

maintaining staff in some areas, lack of health care due to some areas being highly remote 

and / or experiencing inclement weather that does not permit those who live there to get out or 

health care personnel to get in, border issues for Tribes residing along the Mexico / US border, 

and illnesses from previous mining operations and the potential reopening of uranium mines on 

some reservations.

With respect to the CDC organizational improvement effort, TCAC members expressed concern 

that TCAC did not have sufficient input into organizational change. Members expressed 

surprise to learn that the proposed new structure was published in the December 28, 2009 

Federal Register as a completed effort rather than first being published for comments. In 

reviewing the proposed new organizational structure, it was noted that TCAC appeared to have 

lost ground and that the relationship they were trying to formulate with CDC was taking a step 

backward under the new administration and new organizational structured. The rationale 

behind the transition of Tribal Affairs from the Office of Minority Health and Health Disparities 

(OMHD) to the Office of State and Local Support (OSLS) was explained, but TCAC members 

remained troubled that the OSLS did not actually include the word “Tribal.” They felt that this 

was an important oversight that again undermined the notion of treaties and government-togovernment relationships. OSLS representatives assured TCAC members that addressing 

Indian Country issues would be a priority in this new office.

Luke Johnson (Public Health Emergency Preparedness Coordinator, Fort Mojave Indian Tribe) 

and Brenda Granillo (Director, Arizona Center for Public Health Preparedness) reported on the 

Arizona Tribal Public Health Preparedness Strategic Plan. They described the strategic 

planning process, purpose, plan components, timeline, mission / vision / goals, benefits, 

challenges, and next steps. The Arizona Tribal Public Health Preparedness Strategic Plan is a 

“living document” that will continually be updated to meet the challenges of bioterrorism or 

disease outbreak. 
CDC TCAC Meeting and Consultation Session Executive Summary January 26-28, 2010

4

 

Dr. Mick Ballesteros, Associate Director for Science, offered an overview of the mission, vision, 

organizational structure, divisions, priority areas, research agenda, and resources of CDC’s 

National Center for Injury Prevention and Control (NCIPC). Dr. Alex Crosby of NCIPC’s Division 

of Violence Prevention (DVP) described the public health approach taken by NCIPC and its 

divisions, and reviewed data and FVP programs specific to American Indian / Alaska Native 

(e.g., Selected activities in violence prevention among Native Americans; enhanced evaluation 

of the Garrett Lee Smith funded suicide prevention act; collaboration with Tribal Epidemiology 

Centers, health disparities meetings, et cetera). CDR Holly Billie then described evidencebased programs implemented in tribal communities, including: effective strategies to reduce 

motor vehicle injuries among American Indian Tribes; elder fall prevention collaboration with 

HIS; highway safety collaboration with IHS, BIA, NHTSA; and Native American injury prevention 

web pages.

Wayne Giles, MD, Acting Deputy Director presented an overview of the National Center for 

Chronic Disease Prevention & Health Promotion (NCCDPHP). He discussed the burden of 

chronic disease and described NCCDPHP’s organizational structure, divisions, public health 

strategy, priorities, and contribution to public health in the American Indian / Alaskan Native 

communities. Dr. Marcus Plescia, Director of the Division of Cancer Prevention and Control

(DCPC) offered an overview of the division and described a number of programs implemented 

by the division in terms of how they specifically addresses tribes (e.g., National Breast and 

Cervical Cancer Early Detection Program, Colorectal Cancer Control Program, Tribal 

Comprehensive Cancer Control Programs); and programs specifically focused on tribes (e.g., 

data linkages in NPCR to improve cancer burden data; research on AI/ANexperiences with 

cancer prevention and treatment, and colorectal cancer prevention projects with Tribal 

Epidemiology Centers). Opportunities include continuing work with NPCR and IHS to link 

cancer incidence data for AIs / ANs; providing support for tribe and tribal organization cancer 

prevention and control programs; and continuing research into AI/ANcancer disparities. 

Dr. Nell Brownstein, of NCCDPHP’s Division for Heart Disease and Stroke Prevention (DHDSP) 

described the mission, vision, organizational structure, and priorities of DHDSP. She reported 

on heart disease and stroke in AI/AN populations versus the general population, and described 

DHDSP programs specific to tribes (e.g., WISEWOMAN Tribal Programs and toolkit, Montana’s

Cardiovascular Health Program and collateral materials). A potential opportunity with this 

division is the research study titled “Reducing Time to Treatment for Myocardial Infarction (MI) 

for Rural American Indians and Alaska Natives.” Dr. Myra Tucker, Tribal Liaison for 

NCCDPHP’s Division of Reproductive Health (DRH) offered an overview of the division, and 

described previous tribal-specific work (e.g., 30 Tribal Behavioral Risk Surveys; and Research

titled “Risk Factors for Sudden Infant Death Syndrome Among Northern Plains Indians), as well 

as current work with tribes (e.g., capacity-building; surveillance; research; emergency response; 

and cross-cutting themes in working with tribal entities for all activities, and providing

appropriate data / enhancing the knowledge base). Future activities are to maximize use of 

existing data systems on behalf of AI/AN Maternal and Child Health (MCH), and to develop 

tribal data systems and tribal epidemiology programs.

Dr. Linda Crossett of NCCDPHP’s Division of Adolescent and School Health (DASH) explained 

the role of DASH in addressing six priority risk behaviors for youth (e.g., behaviors that result in 

intentional and unintentional injuries, alcohol and other drug use, sexual behavior, tobacco use, 

dietary behavior, and physical inactivity). She described DASH’s surveillance systems and a 
CDC TCAC Meeting and Consultation Session Executive Summary January 26-28, 2010

5

few of the many other tools that CDC has developed to help schools implement science-based, 

effective programs to combat these six priority areas. In addition, she described a number of

activities addressing risk behaviors specifically among American Indian / Alaska Native youth

(e.g., technical assistance and funding for the YRBS, funding of some Tribal Governments to 

implement school health programs, activities supported through State Education Agency 

cooperative agreements, training in evidence-based tools, and Expert Panel titled “Adolescent 

Suicide: Addressing Disparities through Research, Programs, Policy, and Partnerships” 

convened in September 2009, and an upcoming article titled, “Health Risk Behaviors Among 

American Indian and Alaska Native High School Students in the United States, 2001-2007.”

Additional opportunities with DASH include training and professional development, expansion of 

funding opportunities to support implementation of the YRBS and school health programs, and 

collaboration with other divisions and offices across CDC. 

Dr. William Kohn of NCCDPHP’s Division of Oral Health (DOR) described DOR’s mission, 

vision, and primary activities and programs, as well as specific AI/ANefforts (e.g., Healthy 

People 2010 / 2020 activities; assistance in 2009 in developing and Alaska YKHC Epi-Aid on 

caries in children; provision of $50,000 for water fluoridation improvement to improve 

fluoridation in Alaska; help with accreditation of the IHS Residency Program; provide speakers 

at conferences; and in 2004-2008 was represented on the IHS National Health Promotion /

Disease Prevention Committee). He also reviewed data on AI/ANdental caries, and described 

future opportunities (e.g., surveillance consultation and inclusion of tribal disease data on the 

National Oral Health Surveillance System (NOHSS), assistance with remote monitoring of 

fluoridated water systems, and quality assurance monitoring of tribal water systems through the 

CDC Water Fluoridation Reporting System (WFRS)).

Dr. Rosanne Farris of NCCDPHP’s Division of Nutrition, Physical Activity, & Obesity (DNPAO)

explained DNPAO’s mission, vision, goals, and priorities areas. She also described various 

DNPAO tribal efforts in breastfeeding and / or physical activity in Montana, Michigan, New 

Mexico, and Minnesota. Potential opportunities with DNAPO include increasing the number of 

program examples, tailoring interventions to specific culture and health priorities, and enhancing

capacity to work on other issues. Dr. Dianne May of NCCDPHP’s Office On Smoking and 

Health (OSH) described OSH’s vision, mission, and funding allocations (which includes the 

funding of 6 Tribal Support Centers). Current OSH AI/AN activities include an MOU with IHS to 

provide data analysis on the American Indian Adult Tobacco Survey (AI ATS), develop tribal 

funding recommendations, and conduct strategic planning. The American Indian / Alaska 

Native National Network cooperative agreement with the Inter-Tribal Council of Michigan

provides training and technical assistance for tribes and tribal organizations on implementing / 

analyzing the AI ATS and to convene a national advisory board. The Tribal Support Centers 

capacity-building programs lead tribal efforts to reduce abuse of commercial tobacco and 

secondhand smoke exposure; and support implementation programs to implement and evaluate 

tobacco control strategies. Dr. May described several specific Tribal Support Center activities.

Dr. Lynda Anderson, Acting Director of NCCDPHP’s Division of Adult and Community Health

(DACH) described DACH’s efforts in terms of center wide services, crosscutting approaches, 

and emerging issues. DACH’s REACH U.S. program funds 40 communities throughout the 

country to advance the prevention and elimination of health disparities among racial and ethnic 

minority groups and to understand and spread successful strategies for achieving significant 

changes at the community level. Forty REACH US Communities include 18 Centers of 

Excellence in the Elimination of Health Disparities (CEEDs) and 22 Action Communities. 
CDC TCAC Meeting and Consultation Session Executive Summary January 26-28, 2010

6

CEEDs have expertise in working with specific ethnic groups and widely disseminating effective 

strategies. Under the REACH US program, CDC awarded 6 entities targeting the elimination of 

health disparities in American Indian communities, all six of which are fully engaged in 

intervention activities. Dr. Anderson also described DACH’s Prevention Research Center (PRC) 

activities with AI/AN communities, as well as the American Recovery and Reinvestment Act 

(ARRA) Communities Putting Prevention to Work (CPPW) community grant program and 

evaluation.

Dr. Dawn Satterfield of NCCDPHP’s Division of Diabetes Translation (DDT) reported on DDT’s 

vision and mission, as well as its programs, priorities, and strategies in Indian Country. To 

address a prevalence of diabetes in the AI/AN population that is greater than two times that of 

Whites, Dr. Satterfield indicated that with its 2010 appropriation of $66 million, this division 

strives to identify trends in diabetes incidence, prevalence, and mortality; and translate science 

to action by communicating evidence-based prevention messages and implementing effective 

public health programs. She described DDT’s program dedicated to supporting diabetes

prevention efforts in Indian Country, the Native Diabetes Wellness Program. The goals of this 

program are to support sustainable ecological approaches to restore traditional foods and 

activities in communities; and to share messages about traditional ways of health that are 

remembered, retold, and talked about in homes, schools, and communities. Since 2001, the 

National Institutes of Health, NIDDK, in partnership with the Tribal Leaders Diabetes Committee, 

CDC Native Diabetes Wellness Program, the Indian Health Service Division of Diabetes 

Treatment and Prevention, and eight tribal colleges and universities (TCUs), have developed 

the K-12 science and culturally based Health is Life in Balance Diabetes Education in Tribal 

Schools (DETS) curriculum.

Mr. Robert Curlee, Deputy Director of CDC’s Financial Management Office (FMO) shared 

several tables representing CDC / ATSDR resources committed to programs that benefit 

American Indian / Alaska Native (AI/AN) populations and communities from 2009 compared to 

2008. Fiscal information was summarized in the data presented according to organizational and 

disease-specific programs, and by defined funding allocation categories. Recovery act funding 

was not included in this information, nor had 2010 information been prepared at this time, 

although Mr. Curlee noted that there are some efforts underway. Mr. Curlee also described 

grants to tribes broken down by state, by HHS area, and by IHS area. Highlights are that total 

CDC / ATSDR funding with VFC (73%) is $168,275,464. Total funding without the VFC is

$46,009,312 (27%). Excluding ATSDR, total funding with VFC is $167,637,959 and without is 

$45,371,807. In comparison to 2008, 2009 indirect AI/ANawards (with VFC) increased from $65 

million to $123 million. AI/AN Fiscal Year 2009 funding (with VFC) in the amount of $168 million 

represents 2% of the total CDC / ATSDR budget, while the $45 million in AI/AN funding 

represents 1% of the total CDC / ATSDR budget. Of particular interest was Mr. Curlee’s 

message that TCAC still had an opportunity to develop and submit a special project for inclusion 

in the 2012 CDC budget. To that end, he agreed to provide samples templates to give TCAC 

guidance on the types of projects that have been funded in the past.

Dr. Annabelle Allison of NCEH / ATSDR explained the goals of NCEH / ATSDR and described 

the activities of the Office of Tribal Affairs (OTA) during 2009 (e.g., collaborated with NCEH and 

ATSDR divisions on several tribal projects; conducted outreach at several meetings /

conferences / forums; coordinated with others regarding NCEH / ATSDR’s National 

Conversation; coordinated efforts with the Navajo Nation and others regarding uranium 

assessment and remediation; and is in the last year of 5-year cooperative agreement with two 
CDC TCAC Meeting and Consultation Session Executive Summary January 26-28, 2010

7

Tribal Colleges and Universities: Turtle Mountain Community College in North Dakota and Dine 

College in New Mexico). Dr. Allison described the goal and activities of the National 

Conversation, including the six workgroups and tribal representatives (e.g., Scientific 

Understanding: Susan Hanson, Shoshone Bannock Tribe; Policies & Practices: Kristin Hill, 

Great Lakes Inter-Tribal Epi Center; Chemical Emergencies: Syndi Smallwood, Pechanga 

Band of Luiseno Indians; Serving Communities: Steve Crawford, Passamaquaddy-Pleasant

Point Tribe; Education & Communication: Rosemary Ahtuangaruak, Inupiat Community of the 

Arctic Slope; and Monitoring: Nancy John, Cherokee Nation). In addition, she reported on the 

health and environmental impacts of uranium on the Navajo Nation including the history, 

Representative Waxman’s charge to give federal agencies (EPA, IHS, BIA, DOE, NRC) to 

develop a five-year plan to assess and remediate, and ATSDR past and future studies 

pertaining to uranium mining. 

With respect to TCAC Recommendations / Organizational Improvements Dr. Ralph Bryan, 

Senior Tribal Liaison for Science and Public Health explained two documents provided to TCAC 

members: 1) “A Summary Report for the 4th Biannual CDC Consultation Session January 28, 

2010: Resource Allocations, Strategic Partnerships, and Capacity-Building,” which he indicated 

was basically the CDC component of the HHS annual report just packaged separately for 

TCAC’s use; and 2) “CDC Tribal Consultation Advisory Committee (TCAC) Update on 

Recommendations / Response January 2010,” which lists 24 of the cumulative formal 

recommendations since the inception of TCAC in 2006 listed more or less chronologically. 

Recommendations will continue to be added to this list as formal recommendations are 

delineated during TCAC meetings and Tribal Consultation Sessions. No recommendations 

have been removed from the list to date as completed and done, because many of the activities, 

once implemented, are on-going. Some of the activities are partially implemented, in progress, 

or in transition. Of the 24 formal recommendations, a number have been implemented and are 

on-going. During this session, Dr. Bryan and CAPT Snesrud offered TCAC members an 

opportunity to respond this document, and to offer feedback with regard to whether this format 

was the most useful for them. Several TCAC members articulated that they like this format. 

CAPT Snesrud explained that what they mean by “having an open door policy” was that 

although they do convene two specific bi-annual Tribal Consultation Sessions during which 

testimony can be provided by any and all tribal leaders, tribal leaders are still permitted to 

participate with HHS and, if there is a particular tribe that chooses to engage in a consultation, 

this can be recommended to CDC as well. No formal recommendations were made during the 

January 2010 TCAC meeting.

Stacey Ecoffey, Principal Advisor for Tribal Affairs, Intergovernmental Affairs, Department of 

Health and Human Services (HHS) reported that many changes are underway at HHS 

department-wide that appear to be positive for Indian Country and which should elevate tribal 

issues the HHS agencies. Leadership members who have extensive histories with Indian 

Country now have much better access directly to the Office of the Secretary, and the Secretary

has articulate plans for a lot of interactions with Indian Country. With respect to the Budget 

Consultation, she encouraged tribal leaders to join the calls to help plan the agenda. She 

stressed that HHS has always complied with and taken very seriously “Executive Order 13175: 

Consultation and Coordination With Indian Tribal Governments.” The President’s memo has 

made it a lot easier for the inner agencies to talk to each other about how to engage in

consultation. All HHS agencies will be required to develop formal consultation plans. HHS is 

setting the dates for the consultations and is focusing primarily on the consultation policy 

process, the agency policies, and open tribal leader comments on consultations in general. 
CDC TCAC Meeting and Consultation Session Executive Summary January 26-28, 2010

8

HHS will convene one-day sessions throughout the country in each region, with the exception of 

Regions 9 and 10 which will have two sessions given the large number of tribes in those two 

regions. She hoped the Secretary would have a letter soon and that she would be able to share 

the dates by the next week. These meetings will be convened from the end of March through 

the beginning of May 2010. They also plan to visit Indian Country during that time frame as 

well. They also plan to form a Federal Tribal Work Group that will meet over the summer. They 

will ask for nominations from the tribes for that work group in May or June, and will convene the 

first meeting of that group in July to review all of the comments heard internally and externally 

because this is a partnership and develop a better plan and determine which agencies need to 

be targeted to develop consultation policies. Plans are also anticipated to created a Secretary’s 

Tribal Advisory Committee. There will soon be a budget roll out, for which there should be a 

webcast. Ms. Ecoffey will provide a link for the webcast as well as budget documents to TCAC. 

The consultation report should be published by the end of March. The HHS website is being 

improved. She stressed that when tribal leaders were developing their testimonies for the 

budget consultation, they would not have to offer a 101 and suggested instead using concrete 

tribal-specific examples, such as “If the budget is not improved in this area, X will increase” so 

that HHS can see where they need to target specific items in the budget for programs that will 

benefit Indian Country. While she could not always guarantee the secretary, Ms. Ecoffey 

encouraged tribal leaders to visit HHS. 

Dr. Walter Williams, Director of OMHD, formally announced the transition of tribal affairs 

activities, including work on CDC’s tribal consultation policy and working with TCAC and related 

affairs, from the Office of Minority and Health Disparities (OMHD) to the Office of State and 

Local Readiness (OSLS). He said in part for him this was a celebration of many 

accomplishments since they began their journey together in 2005. His recollection was that 

CDC was the first HHS agency to establish an agency tribal consultation policy. This work 

began in 2004 and the policy was actually adopted in 2005. Abundant work has been 

accomplished since that time, including the establishment of the TCAC. In 2008, OMHD was 

transitioned from its position in the Office of Strategy and Innovation (OSI) to the Office of the 

Chief of Public Health Practice (OCPHP). That transition occurred after a transition from an 

office that reported directly to the CDC Director, which had been in existence for 14 years. They 

had to deal with some of the concerns raised throughout this meeting with respect to position 

within the organization, when they found themselves having to report through another person to 

get information and action items to the CDC Director. During a very intensive process that took 

into consideration current functions, staffing, budget authority, et cetera, and asking critical 

questions with regard to the new CDC Director’s priorities, it was determined that the tribal 

activities aligned best with OSLS. Most activities that are important to the programs that 

support Indian Country have not been affected, and others that are mission critical are 

continuing in other organizational components at CDC. Regarding the transition of 

responsibilities as a proponent for the CDC tribal consultation policy and work with TCAC from 

OMHD to OSLS, a primary focus is enhancing support for public health activities in tribal, state, 

and local communities. Dr. Williams perceived this as an opportunity for enhanced synergy with 

regard to state and tribal collaboration and enhancing state and tribal relationships, and stated 

that he was personally looking forward to continuing to work with the CDC Tribal Liaisons. The 

intent of OMHD is to continue its critical support of the critical areas in which they are partnering 

with TCAC to support.

Dr. Karen White, Acting Director of OSLS highlighted the work that had been done over the last 

several years in OMHD, and explained what that mean to CDC. Having a separation between 
CDC TCAC Meeting and Consultation Session Executive Summary January 26-28, 2010

9

OMHD and tribes to move into OSLS has been a long time coming. She stressed that this was 

to be celebrated because finally tribes would be recognized as a separate entity, and that they 

should be working at the same level as state and local health departments and territories versus 

being within an umbrella of other work at CDC. She perceived this transition as a relay in the 

journey that Dr. Williams discussed. This is the next step and OSLS has been charged with the 

obligation and responsibility to ensure that this occurs. She made a promise to those present 

that this would move forward, and that she, Dr. Bryan, and CAPT Snesrud had already engaged 

in some discussions regarding what the next steps would immediately follow this TCAC 

meeting. She expressed her gratitude to Dr. Williams for the work he has done to bring this 

program this far, indicating that she would pick up the baton and move forward from there.

In closing the TCAC portion of the meeting, Ms. Hughes requested that in contemplation of a 

potential project to submit for inclusion in the 2012 CDC budget, which would be a priority for 

their first teleconference, the Budget Subcommittee be resurrected. Based on the discussion 

earlier in the morning, she pointed out that additional work also needs to be done to the TCAC 

charter, and there needs to be recognition of delegates and alternates to serve on this council. 

With this in mind, the following subcommittees were established:

Budget Charter

Joe Finkbonner Joe Finkbonner

Kathy Hughes Reno Franklin

JT Petherick

Roger Trudell

Derek Valdo

The entire TCAC will be notified about these two subcommittees so that anyone who is 

interested may participate.

Mr. Finkbonner reported that John Pipe, Councilman of the Fort Peck Tribe and member of the 

National Diabetes Indian Coalition (NDIC), passed on January 23, 2010 having succumbed to 

the complications of diabetes. This brought home the efforts that the TCAC was engaged in 

around the table, and called attention to the public health messages and prevention programs 

that they want to put in place. Mr. Pipe was one of many Native Americans who have passed 

as a result of complications of diabetes. His passing represents a great loss for Indian Country. 

He was a quiet man, but there was great wisdom in the words he did speak because he chose 

them selectively. To honor Mr. Pipe, as everyone bowed their heads to say the closing prayer,

they lifted up Mr. Pipe, his family, and the community who lost a great leader.

An Orientation Session for Tribal Leaders was convened on January 27, 2010. During this 

session, tribal leaders were presented with the following:

 Overview of CDC Organizational Improvement Process

Louis Salinas, OD / Chief of Staff

 Office of Communications: Overview of CDC 

 Donna Garland, Acting Director, Office of Communications 
CDC TCAC Meeting and Consultation Session Executive Summary January 26-28, 2010

10

 Overview & Importance of CDC Tribal Consultation Policy (Working Lunch)

 CDC Tribal Consultation Advisory Committee

 CAPT Mike Snesrud, OD / Senior Tribal Liaison for Policy and Evaluation

 Office of State and Local Support (OSLS) 

 Karen White, Acting Director of OSLS 

 Office of Public Health Preparedness and Response (OPHPR) 

 Christine Kosmos, Division of State and Local Readiness Director (DSLR)

 Office of Surveillance, Epidemiology, and Laboratory Services 

 Steve Thacker, Deputy Director 

 Explanation of Epi Aids & Examples from Indian Country

 Doug Hamilton, Epidemiologist, EIS Chief, OSELS 

Following the Orientation Session for Tribal Leaders on January 27, 2010, the Tribal Leaders 

Caucus was convened.

Department of Health and Human Services

Centers for Disease Control and Prevention 

Agency for Toxic Substances and Disease Registry

4

th Biannual Tribal Consultation Session 

January 28, 2010

Executive Summary

On January 28, 2010, the 4th Biannual CDC / ATSDR Tribal Consultation Session was 

convened at the Roybal Campus of CDC in the Global Communications Center. Dr. Thomas R. 

Frieden, Director of CDC and Administrator of ATSDR offered the welcoming remarks. During 

this time, he outlined and explained his five basic priorities, which are to: 1) Improve knowledge 

of what is occurring in communities through better surveillance, epidemiology, and laboratory 

services in order to better understand the problems and share that information (e.g., convey it in 

ways that are understandable and impactful); 2) support communities through the leadership 

responsible for health; 3) increase impacts in global health; 4) increase policy impact; and 5) 

through all of the activities of CDC focus on the bottom line of preventing illness, disability, and 

death. In thinking about 2010 and forward, there are at least six areas in which Dr. Frieden 

believes there are winnable battles that need to be fought from which a big difference can be 

made: Tobacco, Nutrition and Obesity, Hospital Infection Control, Motor Vehicle Injuries, Teen 

and Unintended Pregnancy, and HIV / AIDS. With respect to accountability, Dr. Frieden said 

that he saw these consultations as an on-going partnership to ensure that they are accountable 

to themselves and to each other, and that they think about the types of interventions in which 
CDC TCAC Meeting and Consultation Session Executive Summary January 26-28, 2010

11

they can partner and be accountable for whether or not they occur. In closing, he said he was 

honored to be in attendance at the 4th Biannual CDC / ATSDR Tribal Consultation Session, and 

that he was looking forward to listening to and learning from their insights, perspectives, and 

suggestions. 

Themes that emerged during tribal leaders’ testimony to Dr. Frieden and CDC / ATSDR 

executive leadership included the following:

 Honor treaties and the United State’s commitments to Indian Nations

 Honor tribal consultation policies

 Respect tribal traditions (e.g., prayers, ceremonies, healing, language, et cetera)

 Engage in direct government-to-government relationships with tribes

 Specifically include the word “Tribal” in the name of the Office of State and Local Support

 Strive for better interagency coordination

 Clarify where tribal recommendations now go in the agency

 Assist tribes in obtaining data sharing agreements and local data, which are vital to measure 

need and accomplishments and to apply for funding

 Redirect funds directly to tribes

 Develop funding opportunities specifically for tribes such that they do not have to compete 

with states and academia, and engage tribal reviewers in the grant review process who 

understand AI/AN people and their issues and traditions

 Decrease disparities in Indian Country by developing programs / materials / media 

campaigns specifically for AI/AN populations to address alcohol / drug problems, 

cardiovascular disease, cancer, child / adult obesity, diabetes, environmental health, 

hepatitis C, mental health, pandemic responses, sexually transmitted diseases (including 

the creation of National Native HIV Resource Center), and suicide

 Expand the thought process regarding priorities

 Recognize and respect that many problems faced by AI/AN communities are because of the 

history of how tribes have been treated

 Continue the consultation process such that tribal leaders are able to speak to the highest 

level of CDC

In response to the tribal leaders’ testimony, Dr. Frieden thanked each of those present for taking 

time from their families, communities, and schedules to attend the Tribal Consultation and to 

share with CDC in order to reach a situation of better partnership. He said he thought he 
CDC TCAC Meeting and Consultation Session Executive Summary January 26-28, 2010

12

learned something different from each person who spoke, and he appreciated that. He offered 

the following feedback, in no particular order, after which he departed:

 Regarding the name of the office, perhaps CDC made a mistake. If they make a mistake, 

they admit, fix it, and move on. Certainly, no offense was intended, and Dr. Frieden said 

that he had always felt that if offense was taken, it was usually not the problem of the person 

who took offense. This suggestion will be considered very seriously. One of the things that 

CDC has tried to do by creating this office focused on community health, whatever it ends 

up being named, is accountability. By that Dr. Frieden means not just that they need to do a 

better job of providing technical advice, data, more guidance and technical support, and 

more staff, but also accountability in the sense of tough love—that they are very frank with 

the groups with which CDC works in that they expect the funding to flow down to where the 

work actually needs to get done. As a City Health Officer for 7.5 years, he assured them 

that this was a standpoint that was very strongly in his perspective on programs. 

 The Tribal Epidemiology Centers was not something with which Dr. Frieden was familiar 

until reading the background materials for this Tribal Consultation. He said he would be 

very interested in expanding CDC’s cooperation with those centers. This is an area where 

CDC can definitely do more. He would like to learn more about the data access agreements 

in terms of what is not working and whether CDC can help in some way.

 Regarding direct funding, with the stimulus package, Communities Putting Prevention to 

Work (CPPW) there is a separate tribal track, so there will be direct funding. Unfortunately, 

this will not go to nearly as many tribes as CDC would like. However, CDC hopes that with 

that program, which focuses on nutrition and tobacco, is that they will fund some tribal 

communities, some large cities, some urban cities, and some rural cities enough so that they 

can really make an impact, demonstrate that impact, and serve as a model for other places. 

CDC was not able to fund tribes directly for H1N1. In fact, the agency was not able to fund 

in many ways because of the timeframe required. They had to try to make the government 

system move quickly, which is very difficult. However, tribes were quite prominent in CDC’s 

planning in terms of the need to ensure that each state worked effectively with their tribal 

populations, which are believed to be, for whatever reason, at higher risk of serious illness 

from H1N1. This is something that Dr. Frieden was regularly both asking about and being 

briefed about, so he was able to confirm that it was taken very seriously. When there were 

any miscommunications, perceptions, or issues these were immediately raised and 

addressed. Thought must be given to organizations that aggregate groups, because 565 

tribes is a large number. 

 As several tribal leaders mentioned, money is scarce and will be for some time. They are 

dealing with the aftermath of a very unfortunate period of time when a lot of people made a 

lot of money, but people who needed money did not make much money. Now the 

consequences must be paid for very irresponsible financial approaches. It is not fair, and it 

means that they must do whatever they can in this time to better address inequalities and to 

be clear about making the best possible uses of the scarce resources there are. There is a 

real value to programs that are demonstration projects from which others can learn. 

 In terms of the functions at CDC, Dr. Frieden would like to understand more, as they 

continue these Tribal Consultations in the future, what things are not being done from a 
CDC TCAC Meeting and Consultation Session Executive Summary January 26-28, 2010

13

content perspective that tribes believe should be done so that they can be addressed 

specifically. 

 With respect to inter-agency coordination, there is a wonderful, really positive set of 

interactions between various agencies. For whatever reason, there is a very strong 

commitment to working together. He met the previous day with Pamela Hyde, the new 

SAMHSA Administrator, and they talked about areas in which they can work together. He 

and Mary Wakefield, the Health Resources and Services Administration (HRSA), 

Administrator were to speak later in the afternoon. 

 He thanked the tribal leaders for the testimony they submitted, stressing that he does read 

what he is given, and that he would read and learn from their submissions.

 In regard to information and training for CDC’s own staff, Dr. Frieden is a big fan of elearning. With the shortage of dollars, they must do things that are more efficient. He did 

this in New York City, which allowed them to train more people for less money better. He 

would like to do this with the CDC and to make electronic resources available to whomever 

is interested. The first thing that he did as the new Director of CDC was to establish a Public 

Health Grand Rounds, which is typically on the third Thursday of each month. 

Unfortunately, it is at 9:00 AM, which has been complained about from CDC’s colleagues on 

the West Coast. However, it is archived and available. Each session is approximately an 

hour and 15 minutes on a cutting edge topic in public health. A host of electronic resources 

is important.

 One of the reasons for the organizational change was to emphasize data and policy change. 

In New York City, Dr. Frieden created a policy called Take Care New York, which identified 

the key things about which they could do something, and then set measurable goals for 

trying to deal with that. He stressed that he really appreciated the point that was made 

about priorities. In fact, within CDC there has been a lot of discussion about this. Instead of 

talking about priorities, because each program and community will have its own priorities, 

they talk about winnable battles: What are the things that we know we can do something 

about, and let’s challenge ourselves to accomplish that. He also appreciated the education 

about community values. One of the things he thought about in preparing for this meeting 

regarded how burden is prioritized and measured. One of the means in public health has 

traditionally been a measure known as Years of Life Loss (YLL), which is a simple measure 

which says that if someone dies at the age of 75, then YLL before age 80 would be 5. If 

someone dies at the age of 5, that would be 75 YLL. Everyone would probably say that in 

some ways, a younger person dying is more tragic than an older person dying, yet in 

communities which revere their elders, perhaps that is not an appropriate way to prioritize.

 Pertaining to responsibility and blame, which was a theme he heard, Dr. Frieden shared his 

philosophy. He typically shows a slide of a pyramid that has five levels. At the bottom of the 

pyramid is the social structure (e.g., education, poverty, housing, jobs, inequality). These 

are the things that have the biggest impact on health. One level above that are the classic 

public health programs (e.g., clean water, fluoridated water, et cetera). These are things 

that change the context so that people would have to really work to not do the healthy thing. 

One level above that are light touch clinical interventions (e.g., immunizations, colon cancer 

screening, et cetera), which only have to be done once a year or once every five, but which 

will have long-term protective effects, so they are easier to do. One level above that is long-
CDC TCAC Meeting and Consultation Session Executive Summary January 26-28, 2010

14

term clinical care (e.g., treatment for high blood pressure, high cholesterol, diabetes, et 

cetera). These are issues that require on-going, effective clinical care. One level above that 

are counseling and education—telling people what to do (e.g., eat healthy, be physically 

active, et cetera). These levels are in a pyramid form because they are roughly in a level of 

effectiveness of interventions. People can be told to eat less and exercise more incessantly 

and it will not make any difference, but the structures must be addressed to make it easier 

for people to do the healthy thing.

Throughout the remainder of the day, tribal leaders offered additional testimony related to the 

specific topic areas of 2009 H1N1 Influenza: Lessons from Indian Country; Chronic Disease 

and Environmental Health Topics; and Injuries, Suicide, and Youth / Family / Intimate Partner 

Violence. In addition, general testimony was offered during open testimony sessions which 

echoed the themes reflected during the TCAC meeting with respect to major health problems, 

factors contributing to those problems, and existing / potential solutions. During the session 

with Dr. Frieden and throughout the day, members of the executive leadership were present and 

responded to the testimony provided.

Tribal Consultation Advisory Committee (TCAC) Members 

Chester Antone, Tucson, TCAC Chair (Tohono O’odham Nation, Councilman)

Roselyn Begay, Navajo Nation (Division of Health, Program Evaluation Manager)

Joe Finkbonner, Portland (Northwest Portland Area Indian Health Board, Executive Director)

Reno Franklin, California (California Rural Indian Health Board, Chairman)

Kathy Hughes, Bemidji, TCAC Co-Chair (Oneida Business Committee)

Cynthia Manuel, NIHB (Tohono O’odham Nation, Councilwoman)

Michael Peercy, Tribal Self-Governance Advisory Committee, Choctaw Nation of Oklahoma, 

Epidemiologist

J.T. Petherick, Oklahoma (Cherokee Nation, Health Legislative Officer)

Alicia Reft, Alaska (Karluk Ira Tribal Council)

Dee Sabattus, Nashville (United South and Eastern Tribes, Inc., Interim THPS Director)

Lester Secatero, Albuquerque (Albuquerque Area Indian Health Board, Chairman)

Roger Trudell, Aberdeen (Santee Sioux Tribe of Nebraska, Chairman)

Derek Valdo, NCAI (from Pueblo of Acoma, National Congress of American Indians)

Other Elected Tribal Leaders

Cathy Abramson, Sault Tribe of Chippewa Indians, Board Member 

Candida Hunter, Hualapai, Councilwoman

Joyce Jones, Karluk IRA Tribal Council, Vice-President

Andy Joseph, Jr., Colville Tribes, Northwest Portland Area Indian Health Board Chair, HHS 

Chair Tribe Council, NIHB

Buford L. Rolin, Poarch Band of Creek Indians, Tribal Chairman

Attendant Roster
CDC TCAC Meeting and Consultation Session Executive Summary January 26-28, 2010

15

Other Tribal Organizations / Tribal Health Boards / Tribal Health Professionals 

Stacy Bohlen, NIHB, Executive Director

Michael Bristow (Osage Tribe of Oklahoma) 

Jessica Burger, NIHB, Deputy Director 

Bridget Canniff, Northwest Portland Area Indian Health Board, Tribal Epi Center Consortium, 

Project Director 

Kristal Chichlowska, Colville Confederated Tribes, California Tribal Epidemiology Center, 

Director 

Alan Crawford (former AI CDC employee) 

Feliciano Cruz, Pascua Yaqui Tribe, Public Health Emergency Preparedness Coordinator

Larry Curley, Indian Health Board of Nevada, Executive Director

Elaine Dado, Northwest Portland Area Indian Health Board 

Maria Garcia, Pascua Yaqui Tribe, Program Manager Alternative Medicine 

Tim Gilbert, Alaska Native Tribal Health Consortium, Senior Director, Community Health

Kristin Hill, Great Lakes Inter-Tribal Epidemiology Center, Director 

Lyle Ignace, Coeur D’Alene, Indian Health Service, Medical Officer

Luke Johnson, Fort Mojave Indian Tribe, Public Health Emergency Preparedness Coordinator 

Angela Kaslow, CRIHB, Director, Family and Community Health Services 

Deborah Klaus, Navajo Division of Health, Director / Senior Epidemiologist, Navajo Epi Center 

Steven Matles, Indian Health Board of Nevada, Deputy Director 

Jackie McCormick, Northwest Portland Area Indian Health Board

Ruth Ojanen, Board Member, Norton Sound Health Corporation 

Michael Peercy, Choctaw Nation of Oklahoma, Epidemiologist 

Geoffrey Roth, National Council of Urban Indian Health, Executive Director

Paul Saufkie, Hopi Tribe, Public Health Emergency Preparedness Coordinator 

Audrey Solimon, NIHB, Senior Advisor, Public Health Programs

Berda Willson, Norton Sound Health Corporation, Board Secretary 

Centers for Disease Control and Prevention

Thomas Frieden, Director, CDC; Administrator, ATSDR

Larry Alonzo, Commander, US Public Health Service

Annabelle Allison, Environmental Health Specialist, NCEH / ATSDR

Ileana Arias, Principal Deputy Director, CDC

Samra Ashenafi, Health Communications Specialist, Global Health

Lynn Austin, Chief Management Official for Terrorism Preparedness and Emergency Response

Mark Austin, Plans Chief, Office of Public Health Preparedness and Response

Aneel Advani, Associate Director for Informatics

Stephen Babb, Public Heath Analyst, NCCDPHP / OSH / OD

Mick Ballesteros, Associate Director for Science, National Center for Injury Prevention and 

Control

Ursula Bauer, Director, National Center for Chronic Disease Prevention and Health Promotion

Holly Billie, Senior Injury Prevention Specialist, National Center for Injury Prevention and 

Control

Lisa Briseno, Health Communication Specialist, NCEH / ATSDR Office of Communication

Kristen Brusuelas, Chief of Government Relations, State and Local Services

Ralph Bryan, Senior Tribal Liaison for Science and Public Health

Nick Burton, Public Health Analyst, OD / NCCDPH
CDC TCAC Meeting and Consultation Session Executive Summary January 26-28, 2010

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Maggie Byrne, Public Health Analyst, NCEH / ATSDR

Jay Butler, Director 2009 H1N1 Influenza Vaccine Task Force

Sabrina Chapple, Project Officer, Wisewoman Program / NCCDPHP

Daniel Chapman, Psychiatric Epidemiologist, NCCDPHP

Pyone Cho, Epidemiologist, NCCDPHP

Monique Colbert, Office of Public Health Preparedness and Response

Janet Collins, Associate Director for Program

Alex Crosby, Epidemiologists, Division of Violence Prevention, NCIPC

Larry Cseh, ATSDR, Environmental Health Scientist

Sean Cucchi, Associate Director for Policy, NCCDPHP

Rob Curlee, Deputy Director, Financial Management Office

Scott Damon, Health Communications Lead, Air Pollution and Respiratory Disease, NCEH / 

ATSDR

Veronica Davison, Public Health Advisory, NCCDPHP

Lori de Ravello, IH S / Division of Epidemiology & Disease Prevention, Public Health Advisor

Clark Denny, Health Scientists, Birth Defects Center

Bill Dietz, Director, Division of Nutrition, Physical Activity, and Obesity / NCCDPHP

Henry Falk, Director, National Center for Environmental Health / ATSDR

Sherry Farr, Epidemiologist, NCCDPHP

Roseanne Farris, NCCDPHP / DNPAO, Branch Chief

Kevin Fenton, Director, National Center for HIV, Viral Hepatitis, STD, and TB Prevention

Helen Flowers, Science Team Leader, NCEH / ATSDR

Divia Patrick Forbes, NCHHSTP / OD / OHE, Public Health Analyst

Constance Harrison Franklin, NIOSH / OD, Public Health Analyst

Michael Franklin, Senior Public Health Analyst, Financial Management Office

Wendee Gardner, ORISE Fellow, NCHHSTP

Donna Garland, Acting Associate Director for Communications

Larry Gilbertson, Public Health Advisory, NCCDPHP

Wayne Giles, Acting Deputy Director, National Center for Chronic Disease Prevention and 

Health Promotion

Lauren Green, Health Analyst, NCHHSTP

Yvonne Green, Director, Women’s Health

Ingrid Hall, Team Lead, NCCDPHP

Robin Hamre, Public Health Analyst

Tom Hearn, Deputy Director, National Center for Infectious Diseases

John Hustedt, Prevention Specialist

Robin Ikeda, Acting Deputy Director, National Center for Injury Prevention and Control

Sakina Jaffer, Public Health Analyst

Valerie Kokor, Public Health Advisory, Office of Public Health Preparedness and Response

Christine Kosmos, Director, Division of State and Local Readiness

John Krebs, Health Scientist, Vector Borne Diseases

Crayton Lankford, Director, Financial Management Office

Kari Leech, Water Engineer, NCEH / EHSB / Global Water, Sanitation, and Hygiene

Sarah Lewis, Health Communications Specialist, Diabetes Programs

Colleen Martin, Epidemiologist, NCEH / ATSDR

Kathleen McDavid Harrison, Associate Director for Health Equity, NCHHSTP

Judith McDivitt, Director, National Diabetes Education Program

Marian McDonald, Associate Director for the Office of Minority and Women’s Health

Matthew Murphy, Epidemiologist, NCEH / ATSDR
CDC TCAC Meeting and Consultation Session Executive Summary January 26-28, 2010

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Pamela Myers, Surveillance Partners Coordinator

James Nelson, Diversity Officer

Demetrius Parker, Marketing Communications Lead for Cultural Communications

Patricia Patrick, Public Health Advisory

Peter Penny, Procurement Analyst, DHHS/CDC/OD/OCOO/PGO/OPOE

Zina Peters, Health Marketing Communications Specialist, Global Health

Steve Redd, Director, Influenza Coordinating Unit

Bob Ruiz, Acting Director, EEO and Diversity

Dan Rutz, Global Health Communication Team Lead, Center for Global Health

Marjorie Santos, Health Education Specialist, NCCDPHP

Dawn Satterfield, Native Diabetes Wellness Program

Magon Saunders, Public Health Advisor, DDT

Puja Seth, Post-Doctoral Fellow, NCHHSTP

Tanya Sharpe, Deputy Director, NCHHSTP, Office of Health Equity

Arlene Sherman, Committee Management Specialist

Dana Shelton, Acting Director, Office of Health and Smoking

Tom Sinks, Deputy Director, National Center for Environmental Health / ATSDR

Mike Snesrud, Senior Tribal Liaison for Policy and Evaluation

Daniel Sosin, Acting Director, Office of Public Health Preparedness and Response

Stephen Thacker, Acting Deputy Director, Office of Surveillance, Epidemiology, and Laboratory 

Services

Jennifer Tucker, Team Lead LEG and Partnership, CCHP / NCCDPHP / OD / OP

Myra Tucker, Tribal Liaison

Karen White, Acting Deputy Director, Office of State and Local Support

Lorraine Whitehair, Division of Nutrition, Physical Activity, and Obesity / NCCDPHP

Walter Williams, Office of Minority Health and Health Disparities

Other Federal Guests

Karen Ashton, Executive Officer, Region IV

Admiral Clara Cobb, OS / HHS Region IV Director

Stacey Ecoffey, Principal Advisory for Tribal Affairs, Intergovernmental Affairs, HHS

Ronald Demaray, IH S, Acting Director, Office of Direct Service and Contracting with Tribes

Deric Gilliard, Region IV, Intergovernmental Affairs

Lawrence Shorty, Public Health Advisor, US Department of Agriculture, Office of Tribal 

Relations