21st Biannual CDC/ATSDR Tribal Advisory Committee (TAC) Meeting 

February 3, 2021 

1:00–7:00 pm (EST) 

Virtual Zoom Platform 

The Centers for Disease Control and Prevention (CDC) and the Agency for Toxic Substances and Disease 

Registry (ATSDR) hosted their TAC Meeting on February 3, 2021. 

Table of Contents 

21st Biannual CDC/ATSDR Tribal Advisory Committee (TAC) Meeting ....................................................................1 

CDC/ATSDR TAC Meeting Participants and Attendees...........................................................................................3 

TAC Member Attendees .....................................................................................................................................3 

Absent TAC Members.........................................................................................................................................3 

CDC Attendees....................................................................................................................................................3 

Nonfederal Attendees ..................................................................................................................................... 10 

1:00 pm—Opening Blessing, Welcome, and Introductions ................................................................................ 10 

1:20 pm—TAC Business....................................................................................................................................... 10 

Facilitator......................................................................................................................................................... 10 

Nominations for TAC Co-Chair......................................................................................................................... 10 

Fall 2021 TAC Meeting..................................................................................................................................... 10 

Fall 2021 TAC Meeting Discussion................................................................................................................... 10 

CDC/ATSDR TAC Charter.................................................................................................................................. 11 

CDC/ATSDR TAC Charter: Discussion............................................................................................................... 11 

CDC/ATSDR October TAC Letter to CDC .......................................................................................................... 11 

CDC/ATSDR October TAC Letter to CDC: Discussion ....................................................................................... 11 

2:10 pm—National Institute for Occupational Safety and Health (NIOSH) Worker and Safety Health Strategic 

Plan Update ......................................................................................................................................................... 12 

Presenter ......................................................................................................................................................... 12 

Opening Remarks ............................................................................................................................................ 12 

2:30 pm—CDC/ATSDR Updates........................................................................................................................... 12 

Presenter ......................................................................................................................................................... 12 

Opening Remarks ............................................................................................................................................ 13 

TAC Questions and Discussion......................................................................................................................... 13 

3:00 pm—Technical Assistance Discussion ......................................................................................................... 13 

Presenter ......................................................................................................................................................... 13 

Opening Remarks ............................................................................................................................................ 13 

1 
 

 

 

 

 

 

 

 

 

 

 

 

 

TAC Questions and Discussion......................................................................................................................... 14 

3:30 pm—COVID-19 Response Update and Discussion ...................................................................................... 15 

Presenters........................................................................................................................................................ 15 

Opening Remarks ............................................................................................................................................ 15 

TAC Questions and Discussion......................................................................................................................... 15 

5:20 pm—Tribal Testimony ................................................................................................................................. 17 

6:30 pm—Summary, Closing Prayer, and Adjournment ..................................................................................... 18 

Presenters........................................................................................................................................................ 18 

Closing Remarks............................................................................................................................................... 18 

Appendices .......................................................................................................................................................... 19 

Appendix A: Tribal Testimony.......................................................................................................................... 19 

Appendix B: Acronym List................................................................................................................................ 25 

Appendix C: Roster (As of February 3, 2021) .................................................................................................. 27 

2 
 

 

 

 

 

 

CDC/ATSDR TAC Meeting Participants and Attendees 

TAC Member Attendees 

President Alicia L. Andrew 

Native Village of Karluk 

Alaska Area Delegate 

Secretary Vickie Bradley, MPH, BSN, RN 

Eastern Band of Cherokee Indians 

Tribes At-Large Authorized Representative 

Jill Jim, PhD, MHA/MPH 

The Navajo Nation 

Navajo Area Authorized Representative 

Councilman Stephen Kutz, RN, BSN, MPH 

Cowlitz Indian Tribe 

Portland Area Delegate 

Councilwoman Teresa Sanchez 

Morongo Band of Mission Indians 

California Area Delegate 

Deputy Principal Chief Bryan Warner (TAC Co-Chair) 

Cherokee Nation 

Oklahoma Area Delegate 

Absent TAC Members 

Legislator Connie Barker 

The Chickasaw Nation 

Tribes At-Large Delegate 

Secretary Doreen Fogg-Leavitt 

Inupiat Community of the Arctic Slope 

Tribes At-Large Delegate 

Trinidad Krystall 

Torres Martinez Desert Cahuilla Indians 

Tribes At-Large Delegate 

Byron Larson, MHA 

Northern Cheyenne Nation 

Billings Area Delegate 

Representative Robert TwoBears (TAC Chair) 

Ho-Chunk Nation of Wisconsin 

Bemidji Area Delegate 

Affiliation/Tribal Area Name Title 

Ute Mountain Ute Tribe/Albuquerque Area Selwyn Whiteskunk Tribal Councilman 

Eastern Band of Cherokee Indians/Tribes AtLarge Richard Sneed Principal Chief 

The Navajo Nation/Navajo Area Myron Lizer Vice President 

Mandan, Hidatsa, and Arikara Nation/Great 

Plains Area 

Monica Mayer Councilwoman 

CDC Attendees 

Ronnesha Addison, MPH 

Public Health Advisor, Health Department Program 

Branch (HDPB), Division of Program and Partnership 

Services (DPPS), Center for State, Tribal, Local, and 

Territorial Support (CSTLTS) 

Dayna Alexander, DRPH, MSPH 

Health Scientist, Epidemiology Branch, Office on 

Smoking and Health, National Center for Chronic 

Disease Prevention and Health Promotion (NCCDPHP) 

Romana Allison, MPH 

Public Health Advisor, Office of the Director (OD), 

CSTLTS 

Annabelle Allison 

Public Health Advisor, OD, Division of Population 

Health (DPH), NCCDPHP 

3 
 

 

 

 

Brittany Anderson 

Public Health Advisor, OD, CSTLTS 

Danielle Arellano, MPH 

Public Health Advisor, State, Local and Tribal Support 

Team (SLTST), Program Implementation and 

Evaluation Branch (PIEB), Division of Injury 

Prevention (DIP), National Center for Injury 

Prevention and Control (NCIPC) 

Coretta Bailey 

Public Health Analyst, Office of Appropriations (OA), 

OD, Office of Financial Resources (OFR), Office of the 

Chief Operating Officer (OCOO) 

Gregory Bautista, MPH 

Health Scientist, OD, National Center for HIV/AIDS, 

Viral Hepatitis, STD, and TB Prevention (NCHHSTP) 

Herlynn Benoit, MPH 

Communications Specialist, Emergency Preparedness 

and Response Branch, Division of Preparedness and 

Emerging Infections (DPEI), National Center for 

Emerging and Zoonotic Infectious Diseases (NCEZID) 

Dimple Bhat, MPH 

Oak Ridge Institute for Science and Education (ORISE) 

Fellow, OD, Division of Overdose Prevention, NCIPC 

Michael Bruce, MD, MPH 

US Public Health Service (USPHS), Medical 

Epidemiologist, Arctic Investigations Program, DPEI, 

NCEZID 

Sharunda Buchanan, PhD 

Director, OD, NCEH, DDNID 

Tonia Burk, PhD 

Environmental Health Scientist, Associate Director for 

Science, OCHHA, Office of the Associate Director 

Brittany Argotsinger, MPH 

Associate Service Fellow, Performance 

Development, Evaluation and Training Branch 

(PDETB), Division of Performance Improvement and 

Field Services (DPIFS), CSTLTS 

Gustavo Aquino, MPH 

Senior Public Health Advisor, OD, CSTLTS 

Famata Barrie 

Operational Support Specialist, Infant Outcomes 

Monitoring, Research and Prevention Branch 

(IOMRPB), Division of Birth Defects and Infant 

Disorders (DBDID), National Center on Birth Defects 

and Developmental Disabilities (NCBDDD) 

James Beck 

Information Technology Specialist, OD, CSTLTS 

Leann Bing 

Environmental Health Scientist, Central Section, 

Office of Community Health Hazard Assessment 

(OCHHA), Office of the Associate Director, OD 

Patrick Breysse, PhD 

Director, OD, National Center for Environmental 

Health (NCEH), Deputy Director for Non-Infectious 

Diseases (DDNID) 

Joan Brunkard, PhD 

Epidemiologist, Waterborne Disease Prevention 

Branch, Division of Foodborne, Waterborne and 

Environmental Diseases, NCEZID 

Rebecca Bunnell, PhD, MEd, ScD 

Director, OD, Office of Science, Deputy Director for 

Public Health Science and Surveillance 

Rachel Burke, PhD, MPH 

Epidemiologist, Division of Viral Diseases (DVD), 

National Center for Immunization and Respiratory 

Diseases (NCIRD) 

4 
 

 

 

 

 

 

 

 

 

 

 

 

Ashley Busacker, PhD 

Field Assignee, Field Support Branch, Division of 

Reproductive Health (DRH), NCCDPHP 

Kimberly Cantrell 

Public Health Advisor, OD, CSTLTS 

Sarah David Carrigan, MPH 

Health Communications Specialist, OD, DRH, 

NCCDPHP 

Karen Cobham-Owens, MPA 

Public Health Advisor, HDPB, DPPS, CSTLTS 

Anne-Marie Coleman, Contractor (CTR) 

HDPB, DPPS, CSTLTS 

Meredith Cooney 

Public Health Associate, Field Services Branch, DPIFS, 

CSTLTS 

James B. Crockett, MPA 

Deputy Division Director, OD, DPPS, CSTLTS 

Shivani Dama, MPH 

Public Health Analyst, Office of Planning and 

Evaluation, OD, NCCDPHP 

Gabrielle Davidheiser 

Public Health Associate, Field Services Branch, DPIFS, 

CSTLTS 

Heather Dennehy, MPP 

Public Health Analyst, Meeting and Advance Team 

Management Activity, OD, Office of the Chief of Staff 

Sonal Doshi, MPH, MS 

Health Scientist, Evaluation Team Lead, PDETB, DPIFS, 

CSTLTS 

Audrey Dowling, MPA, MRE 

Public Health Analyst, Budget Performance and 

Evaluation Team, Office of Policy Partnerships, and 

Planning (OPPP), OD, NCEH 

CDR Renee Calanan, PhD, MS 

USPHS, Office of the Director, NCEZID 

Russ Cantrell, MPA 

Director, OD, DPIFS, CSTLTS 

Karla Checo 

Public Health Advisor, National Partnership Branch, 

DPPS, CSTLTS 

CAPT Amanda Cohn, MD 

USPHS, Medical Officer, OD, NCIRD 

Elizabeth Conrey, PhD, MS 

Senior Service Fellow, Field Support Branch, DRH, 

NCCDPHP 

Julie Cox-Kain 

Public Health Analyst, HDPB, DPPS, CSTLTS 

Elizabeth Dalsey 

Health Communications Specialist, Western State 

Division (WSD), National Institute for Occupational 

Safety and Health (NIOSH) 

Teresa Daub, MPH 

Public Health Advisor, HDPB, DPPS, CSTLTS 

Alyson Davis, MPH 

Public Health Analyst, Program Development and 

Services Branch, Division of Heart Disease and 

Stroke Prevention, NCCDPHP 

Yvette Diallo 

Emergency Management Specialist, OD, Division of 

Emergency Operations, Center for Preparedness and 

Response (CPR) 

Jillian Doss-Walker, MPH 

Public Health Advisor, Program Operations Branch, 

Immunization Services Division, NCIRD 

Grisy Escoto, BSHA 

Program Specialist, OD, CSTLTS 

5 
 

 

 

 

 

David Espey, MD 

Director, Healthy Tribes Program, NCCDPHP 

Taleria Fuller, PhD 

Health Scientist, Field Support Branch, DRH, 

NCCDPHP 

Cynthia Garcia 

Public Health Associate, Field Services Branch, DPIFS, 

CSTLTS 

Amy Groom, MPH 

Public Health Advisor, OD, DPH, NCCDPHP 

Keira Hall 

Public Health Analyst, IOMRPB, DBDID, NCBDDD 

Amy Watson Hardnett, PhD, MS 

Senior Service Fellow, Emergency Response Branch, 

Division of Laboratory Sciences, NCEH 

Tara Ramanathan Holiday, JD, MPH 

Public Health Analyst, OA, OD, OFR, OCOO 

CDR David Hunter, MPH, MSW 

USPHS, Branch Chief, PIB, DSLR, CPR 

Tracy Ingraham 

Associate Director for Communication, OD, CSTLTS 

Mica Jamison 

Management Analyst, OPPP, OD, NCEH 

Heather Jones, DrNP, MN 

Nurse Consultant, Prevention and Response Branch, 

Division of Healthcare Quality Promotion, NCEZID 

Sherry Jones, PhD, JD, MPH 

Health Scientist, School-Based Surveillance Branch, 

Division of Adolescent and School Health, NCHHSTP 

Julia Kibunja, MPH 

Public Health Analyst, EPB, Influenza Division, NCIRD 

CDR Molly Evans, MD, MPH 

USPHS, Medical Officer, HIV Care and Treatment 

Branch, Division of Global HIV and TB, Center for 

Global Health (CGH) 

Sundak Ganesan, MD 

Health Scientist, Program Implementation Branch 

(PIB), Division of State and Local Readiness (DSLR), 

CPR 

Dave Goodman 

Lead Health Scientist, Maternal and Infant Health 

Branch, DRH, NCCDPHP 

Nancy Habarta, MPH 

Branch Chief, PDETB, DPIFS, CSTLTS 

Mary Hall, MPH 

Health Scientist, OD, DPH, NCCDPHP 

Veda Harrell, MPA 

Public Health Advisor, HDPB, DPPS, CSTLTS 

Margaret Honein, PhD, MPH 

Director, Division of Congenital and Developmental 

Disorders, NCBDDD 

Stacey Hurst, MPH 

Associate Service Fellow, Women’s Health and 

Fertility Branch, DRH, NCCDPHP 

Ikovwaiza Irune (CTR) 

OD, CSTLTS 

Stacey Mattison Jenkins, MPH 

Director, OD, DPPS, CSTLTS 

Shaakira Jones, MPH 

Public Health Analyst, Office of Policy, Performance, 

and Communications, OD, OFR, OCOO 

Marisa Kanemitsu 

ORISE Fellow, SLTST, PIEB, DIP, NCIPC 

Alison Kelly, MPIA 

Director, Office of Appropriations, Office of the 

Director, Office of Financial Resources 

6 
 

 

 

 

 

 

 

 

 

Samantha Kessler, JD (CTR) 

Health Marketing/Communication Specialist, OD, 

CSTLTS 

Laura M. Mercer Kollar, PhD 

Behavioral Scientist, Division of Violence Prevention, 

NCIPC 

Tamara Lamia, MPH 

Health Scientist, OD, CSTLTS 

Karina Lifschitz, MPH, MAIA 

Public Health Analyst, OD, CSTLTS 

Gerda Louizi 

Grants Management Specialist, OD, Office of Grants 

Services (OGS), OFR, OCOO 

Victoria McBee, MPH 

Grants Management Specialist, HDPB, DPPS, CSTLTS 

Temet McMichael, PhD 

EIS Officer, Epidemiology Workforce Branch, Division 

of Scientific Education and Professional 

Development, Center for Surveillance, Epidemiology, 

and Laboratory Services (CSELS) 

Nancy Messonnier, MD 

Director, OD, NCIRD 

CDR Jenna Meyer, MPH, RN 

USPHS, Acting Director, OTASA, CSTLTS 

Jessica Miller, MA, MPH 

Public Health Advisor, OTASA, CSTLTS 

Georgia Moore, MS 

Associate Director for Policy, OD, CSTLTS 

Karen Mumford, MEd, PhD 

Behavioral Scientist, OD, CSTLTS 

Stephanie Neitzel 

Lead Public Health Advisor, OD, CSTLTS 

Stephanie Koh, MPH, MPA 

Associate Service Fellow, OD, CSTLTS 

Rachel Kossover-Smith, MPH 

Public Health Analyst, SLTST, PIEB, DIP, NCIPC 

Jessie Legros, EdD, MPH 

Public Health Educator, Field Services Branch, DPIFS, 

CSTLTS 

Kelsey Linzell 

Public Health Associate, Field Services Branch, DPIFS, 

CSTLTS 

Katherine Luce 

Public Health Advisor, Office of Tribal Affairs and 

Strategic Alliances (OTASA), CSTLTS 

Donna McCree, PhD, MPH 

Associate Director for Health Equity, OD, Division of 

HIV/AIDS Prevention-Intervention Response and 

Support (DHPIRS), NCHHSTP 

RADM Jonathan Mermin, MD 

USPHS, Director, NCHHSTP 

Erika Meyer, MPH 

Health Scientist, Polio Eradication Branch, Global 

Immunization Division, CGH 

Lydia Mezenghie, MPH (CTR) 

Public Health Analyst, OTASA, CSTLTS 

José Montero, MD, MHCDS 

Director, CSTLTS 

Mitch Morris 

Public Health Advisor, HDPB, DPPS, CSTLTS 

Ranell Myles, PhD, MPH 

Epidemiologist, OD, NCHHSTP 

Stephanie Nguyen (CTR) 

OD, CSTLTS 

7 
 

 

 

 

 

 

 

Joanne Odenkirchen, MPH 

Public Health Advisor, OTASA, CSTLTS 

Matt O’Shea, MPH 

Public Health Advisor, HDPB, DPPS, CSTLTS 

CAPT Monica Parise, MD 

USPHS, Medical Officer, OD, Division of Parasitic 

Disease Malaria (DPDM), CGM 

Chelsea Payne, MPH 

Management Officer, OD, CSTLTS 

Chandra Pendergraft, MPA 

Public Health Analyst, OD, CSTLTS 

Victoria Phifer, MPH 

Public Health Analyst, OD, CSELS 

Lori Phillips, MPH 

Health Scientist, OTASA, CSTLTS 

Gemille Purnell, MPH 

Public Health Associate, Field Services Branch, DPIFS, 

CSTLTS 

Nicole Richardson-Smith, PhD, MA 

Health Communication Specialist Lead, OD, CSTLTS 

Davie Rickenbacker (CTR) 

Public Health Analyst, OTASA, CSTLTS 

LCDR Shannon Saltclah, PharmD, CPH 

USPHS, Healthy Tribes Program, NCCDPHP 

Anne Schuchat, MD 

Principal Deputy Director CDC, OD 

Karen Simon, MPA (CTR) 

HDPB, DPPS, CSTLTS 

Nathaniel Smith, MD, MPH, MA 

Deputy Director of Public Health Service and 

Implementation Science, OD 

William Kerry Osborne (CTR) 

OD, CSTLTS 

Eli Painter, PhD, MBA 

Public Health Analyst, Office of Policy, OD, NCIRD 

Stacy Parker, MPH 

Health Marketing Specialist, OD, CSTLTS 

Amy Peeples, MPA 

Deputy Director for Management and Operations, 

OD, NCIPC 

Laquetta Peters 

Grants Management Specialist, OD, OGS, OFR, 

OCOO 

Celeste Philip, MD, MPH 

DDNID, OD 

Lindsay Prescod, MS 

Public Health Advisor, OD, CSTLTS 

Karen Remley 

Distinguished Consultant, OD, NCBDDD 

Steve Reynolds, MPH 

Deputy Director, OD, CSTLTS 

Tekerri Rivers 

Public Health Advisor, HDPB, DPPS, CSTLTS 

Delight Satter, MPH 

Senior Health Scientist, OTASA, CSTLTS 

Julia Simon 

Deputy Associate Director for Communication, OD, 

CSTLTS 

Sabrina Shivji 

ORISE Fellow, OD, DVD, NCIRD 

Gregory Smith, MPA 

Public Health Advisor, PIB, DSLR, CPR 

8 
 

 

 

 

David Sullivan 

Public Health Advisor, STLTS, PIEB, DIP, NCIPC 

Alice Sutcliffe, MS 

Biologist, Entomology Branch, DPDM, CGH 

Craig Thomas, PhD, MS 

Division Director, OD, DPH, NCCDPHP 

Stacy Thorne, PhD, MPH 

Public Health Advisor, PIB, DSLR, CPR 

Rhea-Lanee Lansang Tran, MPH, CHES 

Public Health Advisor, OD, CSTLTS 

Rochelle Walensky, MD, MPH 

CDC Director/ATSDR Administrator 

Nicole Wachter, MPH 

Public Health Advisor, OD, CSTLTS 

Alleen Weathers, MEd, MPH 

Public Health Advisor, HDPB, DPPS, CSTLTS 

Seh Welch, PhD, MBA 

Public Health Analyst, Strategy, Policy and 

Communications Branch, Division of Global HIV and 

TB, CGH 

Craig Wilkins 

Senior Advisor, OD, Office of Minority Health and 

Health Equity 

Yves Wilkerson 

Grants Management, OD, OGS, OFR, OCOO 

Stacey Ann Willocks, MS 

Behavioral Scientist, Evaluation Team, PIEB, DIP, 

NCIPC 

Ciera Woods 

Public Health Associate, Field Services Branch, DPIFS, 

CSTLTS 

Celeste Smalls Sumpter 

HR Specialist, Customer Staffing Activity 2, Client 

Services Office, Human Resources Office, OCOO 

Leigh Swaim 

Public Health Advisor, Parasitic Disease Branch, 

DPDM, CGH 

Hope Thompson 

Analyst, OD, Office on Smoking and Health, 

NCCDPHP, DDNID 

Ana Maria Toro 

Public Affairs Specialist, OD, Division of Public 

Affairs, Office of the Associate Director for 

Communications 

Melissa Victor 

ORISE Fellow, DBDID, NCBDDD 

Jessica Washington 

ORISE Fellow, Environmental Epidemiology Branch, 

Division of Toxicology and Human Health Sciences, 

OD 

Charisse Walcott 

Public Health Advisor, PDETB, DPIFS, CSTLTS 

Paul Weidle, PharmD, MPH 

Research Officer, OD, DHPIRS, NCHHSTP 

Corinne Wigington, MPH 

Health Scientist, OD, CSTLTS 

Kelly Wilkinson (CTR) 

Health Marketing and Communication Specialist, 

OD, CSTLTS 

Rebecca Willis 

Public Health Advisor, HDPB, DPPS, CSTLTS 

Alison Winstead, MD 

Medical Officer, Malaria Branch, DPDM, CGH 

Debbie Yembra 

Health Scientist, Office of Planning and Evaluation, 

OD, NCCDPHP 

9 
 

 

 

 

 

Andrea Zekis MPS, MGIS, MS Carlos Zometa, PhD, MSPH 

Health Communications Specialist, OD, CSTLTS Behavioral Scientist, PDETB, DPIFS, CSTLTS 

Nonfederal Attendees 

Andria Apostolou Angela Haynes Ferere Megan O’Neil 

Nicolas Barton Joshua Gregory Gene Perry 

Nicole Barron Kate Grismala Lisa Pivec 

Rhonda Beaver Candice Jimenez Laura Platero 

Stacey Bohlen Karrie Joseph Ellen Provost 

Bridget Canniff Andrew Kalweit Dean Seneca 

Vanesscia Cresci Alfred Koroma Margaret Snead 

Tyler Dougherty Monique Martin Sharon Stanphill 

Julia Dreyer Nina Martin Sunny Stevenson 

Jessica Elm Erin Morris Sue Steward 

Kimberly Fowler Kelly Njike Annie Tran 

Travis Noland Victoria Warren-Mears 

1:00 pm—Opening Blessing, Welcome, and Introductions 

• Deputy Principal Chief Bryan Warner provided the opening blessing. 

• José Montero, MD, MHCDS, Director, CSTLTS, CDC, welcomed everyone to the 21st Biannual CDC/ATSDR 

TAC Meeting and introduced the new TAC members, nonfederal partner guests, and CDC leader 

attendees. 

• Commander Jenna Meyer, MPH, BSN, RN, USPHS; Acting Director, OTASA, CSTLTS, CDC, conducted the 

roll call. A quorum was present to conduct necessary business. 

1:20 pm—TAC Business 

Facilitator 

• Representative Robert TwoBears (Ho-Chunk Nation): Legislative Representative, Ho-Chunk Nation; 

Chair, TAC 

Nominations for TAC Co-Chair 

• Chairman TwoBears asked TAC members for nominations regarding new co-chairs. 

• Two nominations were received: Deputy Principal Chief Bryan Warner and Councilman Stephen Kutz. 

• Chairman TwoBears passed a motion to open the vote for TAC co-chair. Deputy Principal Chief Bryan 

Warner was confirmed as the new TAC co-chair position. 

Fall 2021 TAC Meeting 

• Representative TwoBears and Dr. Montero advised the TAC that, despite the uncertainty regarding the 

location of the next TAC Meeting, a TAC Meeting will still be held with an initial recommendation for the 

month of August. 

• Representative TwoBears suggested the TAC will identify additional recommendations and dates for the 

Fall 2021 TAC Meeting and provide updates to CDC. 

Fall 2021 TAC Meeting Discussion 

Comment from Councilman Kutz: 

• I would like to propose for the next TAC Meeting to occur in October 2021 for the possibility that CDC 

and the TAC could meet face to face. 

10 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Comment from Mr. Larson: 

• I would like to thank CDC for hosting the TAC Meeting during the 2019 Novel Coronavirus Disease 

(COVID-19) pandemic. I agree with Councilman Kutz, to push the meeting back to October as this will 

also allow time for the TAC to reengage the workgroup. 

Comment from Dr. Montero: 

• CDC is aware of the request from the TAC to have a workgroup, and the agency is supportive of this. CDC 

staff are currently working with the National Indian Health Board (NIHB) regarding the workgroup. 

Comment from Commander Meyer: 

• Workgroup information was shared on the January 15, 2021, planning call with the TAC, and we will 

share it again following this meeting. I would expect any information following this meeting to come 

from NIHB. 

Comment from Representative TwoBears: 

• The TAC will work on gathering a recommendation for the next TAC Meeting time and date and follow 

up with CDC. 

CDC/ATSDR TAC Charter 

• Mr. Larson proposed the idea that a subcommittee would help TAC members develop input on the TAC 

charter and return concise comments back to CDC/ATSDR. Deputy Principal Chief Warner seconded Mr. 

Larson’s proposal. Dr. Montero agreed to the development of a subcommittee to provide input on the 

TAC charter. 

• TAC members that volunteered to be included in the subcommittee included Representative Robert 

TwoBears, Byron Larson, Deputy Principal Chief Bryan Warner, Councilman Stephen Kutz. 

• A motion passed to develop a subcommittee to review the draft TAC Charter and have results back to 

share at the next TAC meeting. There were nine affirmative votes and no votes against. 

CDC/ATSDR TAC Charter: Discussion 

Comment from Mr. Larson: 

• We would like to give the revised TAC charter to our subcommittee for further review, so the 

subcommittee can have a thorough discussion and review the TAC’s edits and recommendations with 

CDC. 

Comment from Dr. Montero: 

• There is no legal deadline for when the TAC Charter needs to be completed, but I would like for us to 

come to a consensus that we will complete the TAC charter discussion and finalize the TAC charter 

during the next meeting. 

Comment from Mr. Larson: 

• I agree with coming to a consensus regarding the TAC charter during our next meeting. 

Comment from Commander Meyer: 

• It might be helpful to have specific comments from TAC within the draft TAC Charter to allow CDC to 

easily identify comments from the TAC. 

CDC/ATSDR October TAC Letter to CDC 

• Dr. Montero provided a formal response to the TAC regarding the October letter verbally during the 

meeting. The TAC letter provided input on the remaining $14 million from the Coronavirus Aid, Relief, 

and Economic Security (CARES) Act funding set aside for Indian Country. 

• Dr. Montero’s response provided additional information on how CSTLTS will be moving forward on 

allocating the remaining funding. 

CDC/ATSDR October TAC Letter to CDC: Discussion 

Question from Ms. Bradley: 

11 
 

 

 

 

 

 

 

 

 

 

• The funding mechanism, OT20-2004, funds a portion of the tribes. How does this funding help those 

tribes who are not funded under this mechanism? 

Comment from Dr. Montero: 

• CDC is funding the same recipients that got awarded in the past. Several tribes decided to apply to other 

funding opportunities. Under the current mechanism, CDC is funding close to 500 tribes. CDC found this 

funding method to be more effective and efficient given that tribes can continue to work with various 

organizations under their current funding mechanism. 

Comment from Ms. Bradley: 

• Formal public health infrastructure is limited, and various tribes do not have the administrative 

capacity to apply for funding given the COVID-19 pandemic and allocation of resources and staff. I 

believe future considerations for tribes that have limited infrastructure need to be considered when 

structuring funding mechanisms. 

Comment from Dr. Montero: 

• I agree with your recommendations to consider tribes with limited infrastructure. For applicants that 

experience difficulties with the process, there are staff within CSTLTS who can assist. Please refer tribes 

that you know are having difficulty to CSTLTS so we can make sure that whoever is eligible and wants to 

apply can apply. 

Comment from Ms. Bradley: 

• I think it would be great if CDC had a list of those tribes that were not funded and maybe reached out to 

them to offer technical assistance 

Comment from Dr. Montero: 

• Thank you for that recommendation. I will take it to the team and figure out how we can do that. 

2:10 pm—National Institute for Occupational Safety and Health (NIOSH) Worker and Safety Health 

Strategic Plan Update 

Presenter 

• Elizabeth Dalsey, NIOSH, Western States Division, CDC 

Opening Remarks 

• Elizabeth Dalsey presented on current plans for a strategic plan, which will outline the current needs of 

American Indian/Alaska Native (AI/AN) workers to ensure their safety and health and identify priority 

research and outreach activities related to AI/AN workers. 

• There are four focus areas within the plan: research, practice, policy, and capacity building. 

• NIOSH is currently conducting internal review and plan to engage relevant partners before moving on to 

developing the second draft of the plan, publication, and utilization. The strategic plan will be published 

in the Federal Register for 60–90 days. 

• The strategic plan can be used to guide efforts at the tribal, local, state, federal, or organizational levels, 

as well as to steer partner development and collaboration. 

• If TAC members are interested in reviewing the strategic plan to provide feedback on the content and 

approach described in the plan, please contact Elizabeth Dalsey. 

2:30 pm—CDC/ATSDR Updates 

Presenter 

• Rochelle P. Walensky, MD, MPH, Director, CDC; Administrator, ATSDR 

• Nathaniel Smith, MD, MPH, MA, Deputy Director for Public Health Service and Implementation Science, 

CDC 

• Alison Kelly, MPIA, Director, Office of Appropriations, Office of Financial Resources, CDC 

12 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Opening Remarks 

• CDC Director Dr. Rochelle Walensky and Dr. Nate Smith emphasized that the COVID-19 response and 

addressing health inequities are two critical priorities for CDC/ATSDR this year. 

• CDC provided $208.7 million to tribal nations, consortia, and organizations for responding to COVID-19 

across tribal communities. This included $140.2 million to 346 tribal recipients through a new 

noncompetitive grant for COVID-19 response. 

• To address COVID-19 in tribal communities, CDC deployed 240 employees to the field in support of 

Indian Country to provide hands-on technical assistance, in addition to 12 remote deployments and 15 

hybrid deployments in support of COVID-19 response in tribal communities. 

• Within the budget updates portion of the meeting, Alison Kelly, director of CDC’s Office of 

Appropriations, stated that the overall funding level for CDC is at an increase of $127 million or 2% 

above the fiscal year 2020 enacted level, when adjusted to exclude the one-time nonrecurring expenses 

transfer funding received in fiscal year 2020. 

• Additional information on fiscal year 2022 information and formulation process is limited at this time, 

but additional details are to be provided to CDC in the next several weeks. 

TAC Questions and Discussion 

Comment from TAC Members: 

• TAC members thanked Dr. Walensky for her participation in the TAC meeting and for highlighting CDC’s 

priorities. The TAC identified several of CDC’s priorities that encompassed tribal nations’ concerns and 

expressed interest in continuing meaningful tribal consultation with CDC in upcoming months. 

Question from Representative TwoBears: 

• When was the last time CDC received a nonrecurring expenses fund? 

Response from Ms. Kelly: 

• In 2018, CDC received it for construction of a high containment continuity laboratory for one of the CDC 

campuses. 

3:00 pm—Technical Assistance Discussion 

Presenter 

• Georgia Moore, MS, Associate Director for Policy, CSTLTS, CDC 

Opening Remarks 

• Georgia Moore, Associate Director for Policy, presented on recent congressional language directing CDC 

to develop guidelines for CDC technical assistance and programmatic inclusion of tribes. 

• Ms. Moore asked TAC members two questions to guide CDC in its work with Indian Country. 

o How and at what points does the TAC want to be engaged by CDC? 

 Draft ideas for key engagement points 

• Provide input to the approach and timeline for guideline development 

• Review and provide feedback on reported activity progress 

• Review and provide input on draft products 

• Provide input/feedback on guideline implementation 

• Provide input to a process for updating the guidelines over time 

o How should CDC get started? 

 Draft ideas 

• CSTLTS collects any immediate input the TAC has during and after this meeting 

o Deadline for TAC input after the meeting? 

• CSTLTS shares the consolidated input with the TAC and possible ideas for next 

steps 

o Deadline for CSTLTS to provide this information? 

13 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

• Initial thoughts, preferences, and recommendations from TAC members were requested specifically for: 

o TAC engagement 

o Content of guidance 

o Stakeholders to engage 

o Sources of information to inform the effort (e.g., best or model practices) 

o Immediate next steps 

• During the discussion portion of this presentation, the TAC members passed a motion to modify the 

subcommittee membership—originally developed to discuss just the draft TAC charter—to also discuss 

the technical assistance recommendations policy. Dr. Montero agreed to the change for the 

subcommittee and the motion passed unanimously. More context can be found below in the discussion. 

• TAC members volunteering to join the subcommittee to discuss both the draft TAC charter and the 

technical assistance recommendations include Chair Representative Robert TwoBears, Mr. Byron Larson, 

Councilwoman Teresa Sanchez, Co-Chair Deputy Principal Chief Bryan Warner, Councilman Stephen 

Kutz, Legislator Connie Barker, and Ms. Trinidad Krystall. 

TAC Questions and Discussion 

Comment from Deputy Principal Chief Warner: 

• Deputy Principal Chief Warner made a motion to develop a subcommittee to review the guidance 

questions asked by Georgia Moore during the technical assistance discussion. 

Comments from Councilwoman Sanchez: 

• Councilwoman Sanchez seconded the motion made by Deputy Principal Chief Warner. Councilwoman 

Sanchez inquired if this should be part of the already developed subcommittee from the earlier portion 

of this meeting. 

Comments from Mr. Larson: 

• Mr. Larson suggested that the two subcommittees be combined so that the subcommittee developed 

during this TAC meeting can review both the draft charter as well as the technical assistance discussion 

questions. 

• He added that additional members could be added to this subcommittee to address the added task. 

Response from Dr. Montero: 

• Dr. Montero restated the motion suggested by TAC members to modify the subcommittee and opened 

the vote to TAC members. Dr. Montero reiterated that based on the Unfunded Mandates Reform Act 

(UMRA) exemption to the Federal Advisory Committee Act (FACA), urban Indian organization leaders 

and Indian health board members are not authorized to sit on an UMRA FACA-exempt group in their 

own right because they are not elected officials of tribal governments acting in their official capacities 

on behalf of their tribe. Also, technical advisors cannot participate in subcommittees except to advise 

members on the subcommittee. 

• During the vote, ten TAC members were in favor and none against. 

Comments from Mr. Larson: 

• Mr. Larson suggested that performance measures be included in the technical assistance 

recommendations so the TAC can monitor and track progress. 

• He added that in terms of budget, it would also be good to look back on previous requests from the TAC 

and bring them forward to see what has and has not been accomplished. Moreover, it would be good to 

look at those previous requests and see if they are still relevant. Specifically, Mr. Larson referenced 

older TAC requests regarding 5% of CDC’s budget and using the US AI/AN population as a 51st state for 

directing funding. While CDC did state that those requests were not feasible, it would be good to have 

direct conversations with CDC’s centers, institutes, and offices to discuss their individual budgets and 

work to make a portion of their budgets more relevant to Indian Country. 

14 
 

 

 

 

 

 

 

 

 

 

 

 

• For distribution of budget, we also want to see the resources allocated for AI/AN populations within the 

OT18-1802: Strengthening Public Health Systems and Services through National Partnerships to Improve 

and Protect the Nation’s Health and make sure that those resources are allocated appropriately. 

3:30 pm—COVID-19 Response Update and Discussion 

Presenters 

• Margaret Honein, PhD, MPH, STLT Task Force Lead, COVID-19 Response, CDC 

• Amanda Cohn, MD, NCIRD, CDC 

Opening Remarks 

• Dr. Honein discussed the COVID-19 response and reviewed four different themes: increasing emergency 

response capacity, building COVID-19 surveillance capacity, increasing testing capacity in remote areas, 

and health communications support. 

• Dr. Honein emphasized the need to continue an open line of communication between CDC and tribal 

nations for allocation of resources and understanding unique challenges/concerns tribal nations face in 

addressing COVID-19. 

• Dr. Cohn provided updates to the COVID-19 vaccination program, information on vaccine safety, and 

available resources for communicating vaccine confidence. 

• Information on the latest COVID-19 vaccination data in the United States is available through the COVID19 Data Tracker. 

• CDC is focused on equitable access, reducing barriers, and increasing engagement to build trust in 

communities. 

• The safety profile of COVID-19 vaccines in the recipients is consistent with that observed during clinical 

trials. 

• COVID-19 Vaccination Toolkits are available to help build confidence in the COVID-19 vaccine and 

provide healthcare professionals with the tools they need to answer questions. 

TAC Questions and Discussion 

Question from Representative TwoBears: 

• How have tribal nations been managing the COVID-19 response during religious events? Especially when 

there is a contrast between state and tribal restrictions. 

Response from Dr. Honein: 

• This is something we encounter a lot, trying to find a balance of following mitigation measures while 

trying to prevent transmission and still honoring important traditions. I would like to turn this question 

over to my colleague who has experience with this in the COVID-19 response. 

Response from Commander Evans: 

• In the case of the Hopi Tribe as it was discussed in the presentation, the Hopi villages, as other tribal 

nations, are autonomous and have sovereignty to determine restrictions. My colleague was on this 

deployment, and CDC worked closely with the tribal council on the recommendations, which was crucial 

in gaining the respect of the surrounding community concerning these recommendations. 

Question from Representative TwoBears: 

• Do you have any stories of challenges where one member of a household was positive and there were 

multiple people in that household? 

Response from Dr. Honein: 

• In a variety of settings, this is often a challenge when one household member is positive. We try to 

ensure that we provide options that would support the different variations that families might 

experience in a household (ability to self-isolate or not). CDC works with tribal nations that have 

requested assistance for support for isolating individuals who are unable to self-isolate at home. 

Response from Commander Evans: 

15 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

• Isolation facilities or alternate care sites are an option for family members not able to self-isolate in the 

home. Some tribal nations also use tents which can and have in some instances been provided through 

the Federal Emergency Management Agency. 

Question from Representative TwoBears: 

• What are your recommendations for communities that might have conflicting isolation and quarantine 

periods (from tribal land versus county) for positive and exposed people? 

Response from Dr. Honein: 

• Our primary recommendation is still 14 days of quarantine, and isolation requirements have not 

changed. CDC guidance from time of positive test for asymptomatic individuals is 10 days of isolation. 

Question from Legislator Barker: 

• Can you speak to the new variants we are seeing for COVID-19 and how that might be affecting tribal 

nations? 

Response from Dr. Honein: 

• CDC is monitoring the three variants of concern identified and the cases announced by Maryland, South 

Carolina, and Minnesota in a couple of ways. CDC is monitoring all of the variants through national strain 

surveillance, where health departments are submitting to CDC a small number of positive samples, 

adding up to around 750 samples a week. CDC has also entered into contracts with three large 

commercial labs, where thousands of samples are being sequenced, to look for variants of concern. 

Question from Councilman Kutz: 

• We are starting to see that more people are flying more frequently, and I was wondering if you had any 

recommendations or guidance for us to implement before they come back into our communities and 

workplaces. We have different workplace guidance here that will not let people come back to work until 

they have a negative test. Is there a criteria maybe that we can follow? 

Response from Dr. Honein: 

• CDC does have guidance and recommendations available on our website. The first recommendation is 

asking people not to travel right now. However, if people do travel, we recommend that they be tested 

before travel and after travel. For international travel, testing is required, but it is only recommended 

for domestic travel. 

Question from Councilwoman Sanchez: 

• Is there any way to know how many of the vaccines are going to AI/AN populations per state? 

Response from Dr. Cohn: 

• We are working to provide you that, however, there is an issue with the system in calculating it. But we 

just have to work through the data. We anticipate being able to make that information available as soon 

as we have analyzed the data. 

Comment from Deputy Principal Chief Warner: 

• The level of trust, especially in Indian Country, is paramount to everything. Cherokee Nation has an 

accredited public health department with public health authority. We had some issues early in the 

pandemic, and that is why we went through the Indian Health Service (IHS) to get our vaccines. Last 

week we administered our 10,000th vaccination, so we are trying to ramp up more of those movements 

and build infrastructure. In the future, we need to look at funding that is awarded and how we can get it 

directly to the tribal nations. Each of us is unique in our culture and traditions, but that level of trust, 

and seeing our faces on some of the messaging, is very important. 

Comment from Councilman Kutz: 

• IHS never focused on building public health infrastructure, and so in the northwest we have been 

working on getting up to speed. Most of the CDC funding for public health infrastructure goes to states, 

which under most circumstances does not reach the tribal nations. I will be advocating for CDC to really 

work on building a more robust public health system in Indian Country. 

Comment from Mr. Larson: 

16 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

• I want to reiterate the points that my colleagues made. One of the concerns that I have is that the 

distribution of resources as it relates to tribes, tribal organizations, and urban Indian programs is skewed 

more heavily towards the latter two. I am looking at the total amount of resources that have been 

expended under the OT18-1802: Strengthening Public Health Systems and Services through National 

partnerships to Improve and Protect the Nation’s Health and OT18-1803: Tribal Public Health Capacity 

Building and Quality Improvement Umbrella cooperative agreements, as well as other direct funding to 

tribes. It is not consistent with what tribal nations should be advocating for. 

Question from Councilwoman Sanchez: 

• When will more vaccines be rolling out? 

Response from Dr. Cohn: 

• This is something we are carefully monitoring. We have our distribution numbers right now and 

anticipate we will be steady for the next three weeks overall in the country (between 10 to 11 million 

doses). But we really need a new vaccine product, and so when the Johnson and Johnson vaccine is 

approved, we will be able to increase the number of doses pretty rapidly. 

Question from Councilman Kutz: 

• The President has signed the Defense Production Act. Is that going to authorize vaccine producers aside 

from Moderna and Pfizer to bring more production capacity available to us, or are we stuck with the 

production capacity that they have internally to their systems? 

Response from Dr. Cohn: 

• I do not have enough visibility to see where this will go, but I do know that changing production capacity 

is an option that is being explored. 

5:20 pm—Tribal Testimony 

Testimony from Deputy Principal Chief Warner: 

• I want to thank everyone for the opportunity to offer comments on behalf of Cherokee Nation. Chief 

Hoskin and I took oaths to protect and preserve culture, traditions, and language. We feel that once we 

lose our language, we lose what it is to be Cherokee. For the first vaccine distribution, Cherokee Nation 

has distributed the vaccine to elders and those who are fluent in Cherokee. More than 1,000 of those 

people are vaccinated today, so I would like to say thank you to IHS, as well as those who helped 

distribute the vaccine. 

• CDC and ASTDR are essential for advancing public health in Indian Country. As a main part of US trust 

responsibility, I want to continue to urge the CDC to strengthen funding and resources supplied directly 

to the tribes. We feel that direct federal funding is essential to expanding public health. CDC and ASTDR 

funding to tribes is well below what is needed to address the public health needs of AI/AN. Although our 

public health systems in Indian Country are continually being built up, there are still gaps, thus we are 

looking towards the future. 

• I offer some solutions, one of which is to urge the CDC to allocate 2–4% of the budget of all the centers, 

institutes, and offices as direct funding to the tribe’s public health infrastructure. New funding streams 

should go directly to tribes by formulas that are vetted through strong tribal consultation. Tribes should 

be given an equal opportunity to receive competitive funding through funding opportunities currently 

open only to the tribal epidemiology centers. Tribal epidemiology centers play an important role, but 

they are not tribal governments. Tribal governments should decide how to best build public health 

infrastructure. All funding opportunity announcements should state that the federally recognized tribal 

governments are eligible for direct funding except where specifically prohibited by statute. When direct 

funding to tribal governments is restricted, an explanation as to why it should be provided. States that 

receive funds should also be required to interface with tribes as part of the funded activities. 

• The pandemic has created more regular and open communication than in the past, and it is important to 

continue that communication though annual updates from the CDC director and senior CDC employees. 

17 
 

 

 

 

It is paramount that there is government-to-government tribal-based consultation moving forward to 

discuss public health infrastructure across Indian Country. 

• I want to also urge TAC committee members to take full advantage of the opportunity to be a venue for 

discussion, collaboration, and meaningful participation in CDC decisions. Although, we have all been 

overworked, it is important to have effective, positive change in Indian Country. The global COVID-19 

pandemic has magnified the need for strong public health infrastructure, but even before the pandemic, 

this has been one of the greatest needs for improving wellbeing in Indian Country. Public health is what 

protects all of us, and today we see that more than ever with the pandemic. 

6:30 pm—Summary, Closing Prayer, and Adjournment 

Presenters 

• Dr. Montero, MD, MHCDS, Director, CSTLTS, CDC 

• Representative TwoBears (Ho-Chunk Nation of Wisconsin), Legislative Representative District V, HoChunk Nation of Wisconsin; Chair, TAC 

• Deputy Principal Chief Bryan Warner (Cherokee Nation), Deputy Principal Chief, Cherokee Nation; CoChair, TAC 

Closing Remarks 

• Dr. Montero provided summary highlights of the meeting and thanked everyone for their participation. 

• Representative TwoBears expressed thanks to the TAC for participating and providing input during the 

meeting. 

• Deputy Principal Chief Bryan Warner closed the meeting with a prayer. 

• Representative TwoBears called the meeting adjourned. 

18 
 

 

 

 

 

 

 

 

 

 

Appendices 

Appendix A: Tribal Testimony 

Testimony from Governor J. Michael Chavarria, Santa Clara Pueblo: 

Virtual Roundtable Written Testimony Centers for Disease Control and Prevention (CDC) and the Agency for 

Toxic Substances and Disease Registry (ATSDR), 21st Biannual CDC/ATSDR Tribal Advisory Committee (TAC) 

Meeting, February 3, 2021 

Written Comments Submitted by: 

J. Michael Chavarria, Governor 

Ph: at 505-929-2120 

Email: governor@santaclarapueblo.org 

Submitted: January 21, 2020 

On behalf of Santa Clara Pueblo located in northern New Mexico, I submit the following written comments 

related to the Centers for Disease Control and Prevention (CDC) and the Agency for Toxic Substances and 

Disease Registry (ATSDR), 21st Biannual CDC/ATSDR Tribal Advisory Committee (TAC) Meeting scheduled for 

February 3, 2021. 

Trust and Treaty Responsibility: 

The United States Federal Government has a trust and treaty responsibility to protect the health, safety, 

welfare, housing and interests of the Pueblos, Tribes and Nations. As that responsibility extends to every federal 

agency and Department, it is the job of Congress to help fulfill this obligation by ensuring that American Indian 

and Alaska Natives (AI/ANs) have access to critical programs and services based on our political status as 

sovereign Tribal Nations/governments engaged in a government-to-government relationship with the United 

States. Members of Congress, federal agencies and federal officials each serve as trustees of that federal trust 

responsibility. It is their solemn duty to ensure that tribal interests are protected as part of any action, 

legislation, programming, or policy undertaken by the Federal Government, including in the federal budgeting 

process and national emergency relief efforts. As the urgency, infection rate, and death toll of the COVID-19 

pandemic intensifies, it has become increasingly clear that more funding resources are needed to protect and 

preserve our tribal communities pursuant to these federal trust and treaty responsibilities. 

With the onset of a new Administration, we hope that this will be the beginning of a new era for the federal 

government’s relationship with Tribal Nations, and indeed, we are encouraged by many positive developments 

so far. At the CDC, there are numerous opportunities to improve the interaction and public health system in 

tribal communities. In the following testimony we discuss key opportunities for enhancement and future 

collaboration. 

COVID-19 Challenges: 

Among the many things we have learned from the COVID-19 pandemic is that basic public health functions are 

critical to preserving life and the overall health of Americans. However, this crisis is especially acute in Indian 

19 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

Country and for our community in particular. According to CDC’s own data, COVID-19 death rates among AI/ANs 

are 2.6 times the rate for non-Hispanic Whites.1 

As you are aware, AI/ANs also face serious health disparities for diseases such as type 2 diabetes and respiratory 

illness, which leads to an increased risk of severe COVID-19 illness and death. 

During this pandemic, the CDC has disappointed tribal communities because it has failed to hold national virtual 

listening sessions to solicit feedback, guidance and recommendations from tribal leaders. Decisions that CDC 

makes every day are critical to the health and well-being of AI/AN people. CDC should engage regularly with 

tribal leaders to ensure that the needs of Indian Country are met in response to the pandemic. The latest round 

of supplemental funding made available through the (P.L. 116-260) (Act) for testing, vaccine distribution and 

related activities was transferred to the Indian Health Service (IHS), who then distributed it to the Indian health 

system. We hope that CDC works closely with IHS to ensure a seamless approach to data and activities that 

would be complementary—not duplicative of efforts in other areas. 

The same Act provides CDC with $300 million “for high-risk and underserved populations, including racial and 

ethnic minority populations and rural communities.” The agency should work closely with tribes to ensure that 

their communities are addressed as part of this targeted funding. AI/AN communities, especially those in remote 

areas like ours, are especially vulnerable to COVID-19 and experience some of the greatest logistical challenges 

when it comes to vaccine distribution. Further, the law requires that CDC provide “an updated and 

comprehensive coronavirus vaccine distribution strategy...” to Congress and requires the plan to include the 

Indian health system. We request that in the development of this plan you engage in robust, meaningful 

consultation with Tribal Nations, and also work collaboratively with the IHS so that Indian Country’s unique 

challenges are appropriately incorporated into this document. 

As in many areas of the United States, vaccine hesitancy is a serious concern in Indian Country. CDC should also 

work closely with IHS to develop culturally appropriate messaging that will help AI/ANs feel comfortable taking 

the COVID-19 vaccine. 

Future Funding: 

We are encouraged by the Biden Administration’s proposal to provide $20 billion to “support Tribal 

governments' response to the pandemic.” This much-needed investment will save AI/AN lives, but we must also 

ensure that it is provided appropriately, with maximum flexibility for Tribal Nations so that they can respond 

effectively to the unique needs of their communities. We hope to engage with CDC as partners to advance this 

request in Congress and ensure that any legislative text developed fully honors Tribal Nations’ sovereignty and 

addresses urgent needs. 

Interdepartmental Coordination: 

The pandemic has made indisputably clear the importance of inter- and intra-governmental cooperation in 

addressing unmet needs. Coordinating supply chain distributions and targeting response actions are essential to 

protecting community welfare. It is the mission of the U.S. Department of Health and Human Services (HHS) to 

1 Centers for Disease Control and Prevention. COVID-19 Hospitalization and Death by Race/Ethnicity. Retrieved from 

www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization-death-by-raceethnicity.html#footnote03 

20 
 

 

 

 

 

 

 

 

 

 

 

 

enhance and protect the health and well-being of all Americans. We fulfill that mission by providing for effective 

health and human services and fostering advances in medicine, public health, and social services for Pueblo 

people – a mission that is based on the trust responsibilities flowing from the political government-togovernment relationship between federal and tribal sovereigns. 

Too often, agencies designated as the administering entities for tribal funds lack the institutional knowledge and 

funding distribution networks for working effectively with Indian Country. This has contributed, among other 

challenges, to significant delays in delivering funds to Tribal Nations. This is unacceptable at a time when every 

day counts in meeting the needs of our people. Whenever there are funding opportunities available, we 

encourage you to work closely with IHS to ensure that the funds reach the places they are needed most. 

CDC Funding for Tribal Communities: 

COVID-19 has underscored how persistent gaps in funding for the Indian health system have contributed to 

negative health outcomes for Native peoples and the under-resourcing of IHS, tribal, and urban Indian 

healthcare facilities. Planning for future fiscal years must address not only the immediate needs of the Indian 

health system, but also its long-term preparedness and financial sustainability. This is especially true of CDC’s 

budget for Tribal Nations. 

For too long, CDC has not provided significant resources to tribal communities, yet it continues to provide 

significant funding to states and localities. This leaves dangerous gaps in responding to key public health 

functions and will only continue to worsen if Tribal Nations are not empowered to develop the robust public 

health systems they deserve. Up until the COVID-19 pandemic, the only set-aside funds for Tribal Nations was 

the Good Health and Wellness in Indian Country (GHWIC) program, which is funded at only $22 million in FY 

2021. Still, CDC proposed in consecutive budgets to eliminate this funding and replace it with America’s Health 

Block grant and focus funds on Tribal Epidemiology Centers (TECs). While TECs provide a valuable service to 

Tribal Nations, they are not tribal governments—they are regional nonprofits. Instead, CDC should fund Tribal 

Nations directly, as it does for states. Where the law requires funding only to state governments, CDC should 

require states to demonstrate how they will work collaboratively with tribes within their borders for any funding 

that is provided. 

As CDC finalizes its budget request for FY 2022, we request that CDC include increased direct funding to tribal 

communities across its Centers. In the longer term, we reiterate requests of the CDC/ATSDR TAC to develop an 

annual budget consultation with Tribal Nations. 

Cultural and Traditional Practices: 

The CDC should include language in their Funding Opportunity Announcements (FOAs) that recognizes the value 

and applicability of cultural and traditional practices as viable grantee activities. Unfortunately, Tribal Nations 

often experience barriers when seeking to implement or incorporate traditional and cultural practices and 

activities. We should not have to explain or defend the benefit of our cultural practices and the positive impact 

that it can have on behaviors and community identity. As we have seen with the Special Diabetes Program for 

Indians, and the GHWIC program, infusing cultural practices with public health interventions leads to greater 

success. 

Data Sovereignty and Improvement: 

21 
 

 

 

 

 

 

 

 

CDC should ensure Tribal Nations are equipped with the necessary public health data to operate public health 

programs and improve health outcomes within their communities by clarifying the Secretary of HHS’s role in 

collection and availability of health data with respect to Tribal Nations. In the 116th Congress, H.R.7948 – the 

Tribal Health Data Improvement Act – passed the House by voice vote but was not considered in the Senate. 

This bill would have ensured that Tribal Nations are equipped with the necessary public health data to operate 

public health programs and improve health outcomes within their communities by clarifying the Secretary of 

HHS’s role in the collection and availability of health data with respect to Tribal Nations. As noted in in the 

Committee report, “[i]t also mandates ways of improving health statistics reporting with respect to Indian Tribes 

such as requiring the Secretary to release all applicable public health data to TECs ... and requiring the CDC to 

expand and improve their assistance to States with respect to sharing data with Tribal entities” (H. Rept. 116-

546). As we continue to battle the COVID-19 pandemic and enhance public health in our communities, we hope 

that CDC and HHS can continue to support this legislation should it be reintroduced in the 117th Congress. 

Conclusion. Thank you for the opportunity to provide comments to the CDC/ATSDR TAC. We believe there are 

many wonderful opportunities for collaboration in the coming months and year. 

We look forward to addressing the matters raised in this testimony with you and your staff. Kuunda; thank you. 

22 
 

 

 

 

 

 

 

 

 

 

 

 

Testimony from Deputy Principal Chief Bryan Warner, Cherokee Nation: 

February 3, 2021 

Rochelle P. Walensky, MD, MPH Director, Centers for Disease Control and Prevention Administrator, Agency for 

Toxic Substances and Disease Registry 1600 Clifton Rd Atlanta, GA 30329 

Dear Dr. Walensky, 

On behalf of Cherokee Nation and the Oklahoma City Indian Health Services area, thank you for this opportunity 

to offer comments to the Centers for Diseases Control and Prevention and Agency for Toxic Substances and 

Disease Registry (CDC/ATSDR). 

The CDC/ATSDR is essential for advancing public health in Indian Country, as part of the United States’ trust 

responsibility to provide health care to American Indians and to meet its obligations to tribal governments. In 

line with that responsibility, I submit the following comments. 

First, I urge the CDC/ATSDR to strengthen funding and resources supplied directly to Tribes. As Tribes do not 

have a local tax base on par with states to support public health activities, direct federal funding is essential for 

high quality tribal disease prevention and public health promotion activities. Both historically and at present, 

CDC/ATSDR funding to Tribes has fallen well below what is needed for sustainable and effective public health 

programs and infrastructure. 

To close this gap, I urge the CDC/ATSDR to adopt regular policy of allocating 2-4% of the budget of its Centers, 

Institutes, and Offices to direct funding of Tribes for public health infrastructure. In the case of any new funding 

opportunities, I urge that those funding streams go directly to Tribes by formulas that are vetted through strong 

tribal consultation. For any existing competitive funding opportunities that are currently open only to Tribal 

Epidemiology Centers (TECs), Tribes should be given equal opportunity to receive funding. While TECs may play 

an important role in some areas, they are not federally recognized tribal governments. Each area should be 

given the opportunity to decide at the tribal government level how best to build long term public health 

infrastructure. 

Going forward, I urge CDC/ATSDR to make proactive efforts to ensure strong Tribal inclusion and consultation on 

all funding opportunities. In addition, all funding opportunity announcements should include language that 

clearly includes all federally recognized tribal governments as eligible for direct funding, except where 

specifically prohibited by statute. When direct funding to Tribal governments by CDC/ATSDR is restricted, an 

explanation as to why should be provided. States that receive CDC/ATSDR funds should be required to actively 

interface with federally recognized tribes within their state boundaries as part of funded activities. 

23 
 

 

Besides strengthening direct funding to Tribes, the CDC/ATSDR can benefit from full utilization of CDC/ATSDR 

Tribal Advisory Committee (TAC). While the CDC/ATSDR TAC does not replace the need for Tribal consultation, it 

is an effective means for gathering additional input from Tribal leaders and tribal public health experts. The 

CDC/ATSDR can encourage full engagement of TAC members by committing to regular, open communications 

with the TAC, including at least annual updates from the CDC Director and senior CDC/ATSDR employees. 

Likewise, I urge TAC members to take full advantage of the opportunity of the TAC to be a venue for discussion, 

collaboration, and meaningful participation in CDC/ATSDR decisions. 

Cherokee Nation is a leader in developing progressive public health strategies and interventions for our citizens. 

We value the CDC/ATSDR as an effective partner in advancing public health for Cherokees and all American 

Indians and Alaska Natives. The global COVID-19 pandemic has magnified the need for strong public health 

programs and infrastructure, but even before the pandemic, this development has been one of the greatest 

needs for improving well-being in Indian Country. Thank you again for this opportunity to provide feedback, and 

we look forward to making these a reality alongside CDC/ATSDR leadership. 

Sincerely, 

Bryan Warner 

Cherokee Nation Deputy Principal Chief 

CDC/ATSDR Tribal Advisory Committee Oklahoma City Area Delegate 

24 
 

 

 

Appendix B: Acronym List 

AI/AN American Indian/Alaska Native 

ATSDR Agency for Toxic Substances and Disease Registry 

CDC Centers for Disease Control and Prevention 

CGH Center for Global Health 

COVID-19 2019 Novel Coronavirus Disease 

CPR Center for Preparedness and Response 

CSELS Center for Surveillance, Epidemiology, and Laboratory Services 

CSTLTS Center for State, Tribal, Local, and Territorial Support 

CTR Contractor 

DBDID Division of Birth Defects and Infant Disorders 

DDNID Deputy Director for Non-Infectious Diseases 

DHPIRS Division of HIV/AIDS Prevention-Intervention Response and Support 

DIP Division of Injury Prevention 

DPDM Division of Parasitic Disease Malaria 

DPEI Division of Preparedness and Emerging Infections 

DPH Division of Population Health 

DPIFS Division of Performance Improvement and Field Services 

DPPS Division of Program and Partner Services 

DRH Division of Reproductive Health 

DSLR Division of State and Local Readiness 

DVD Division of Viral Diseases 

FACA Federal Advisory Committee Act 

FSB Field Support Branch 

HDPB Health Department Program Branch 

HHS Health and Human Services 

IHS Indian Health Service 

IOMRPB Infant Outcomes Monitoring, Research and Prevention Branch 

NCBDDD National Center on Birth Defects and Developmental Disabilities 

NCCDPHP National Center for Chronic Disease Prevention and Health Promotion 

NCEH National Center for Environmental Health 

NCEZID National Center for Emerging and Zoonotic Infectious Diseases 

NCHHSTP National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention 

NCIPC National Center for Injury Prevention and Control 

NCIRD National Center for Immunization and Respiratory Diseases 

NIHB National Indian Health Board 

NIOSH National Institute for Occupational Safety and Health 

OA Office of Appropriations 

OCHHA Office of Community Health Hazard Assessment 

OCOO Office of the Chief Operating Officer 

OD Office of the Director 

OFR Office of Financial Resources 

OGS Office of Grants Services 

OPPP Office of Policy, Partnerships, and Planning 

ORISE Oak Ridge Institute for Science and Education 

OTASA Office of Tribal Affairs and Strategic Alliances 

PDETB Performance Development, Evaluation and Training Branch 

PIB Program Implementation Branch 

PIEB Program Implementation and Evaluation Branch 

SLTST State, Local and Tribal Support Team 

25 
TAC Tribal Advisory Committee 

TEC Tribal Epidemiology Center 

UMRA Unfunded Mandates Reform Act 

USPHS United States Public Health Service 

WSD Western State Division 

26 
Appendix C: Roster (As of February 3, 2021) 

Area Office Delegate Authorized Representative 

Alaska Area 

Term Expires: 

February 28, 2021 

Alicia L. Andrew 

President, Karluk IRA Tribal Council 

Native Village of Karluk 

VACANT 

Albuquerque Area 

Term Expires: 

August 31, 2021 

Selwyn Whiteskunk 

Tribal Councilman 

Ute Mountain Ute Tribe 

Alston Turtle 

Council Delegate 

Ute Mountain Ute Tribe 

Bemidji Area 

Term Expires: 

November 30, 2022 

Robert TwoBears (TAC Chair) 

Legislative District V Representative 

Ho-Chunk Nation of Wisconsin 

Wally Apland 

Director of Finance, Department of Health 

Ho-Chunk Nation of Wisconsin 

Billings Area 

Term Expires: 

August 31, 2021 

Byron Larson, MHA 

Rocky Mountain Tribal Leaders Council 

Northern Cheyenne Nation 

VACANT 

California Area 

Term Expires: 

November 30, 2022 

Teresa Sanchez 

Tribal Council Member 

Morongo Band of Mission Indians 

VACANT 

Great Plains Area 

Term Expires: 

November 30, 2022 

Monica Mayer 

Councilwoman, North Segment 

Representative 

Mandan, Hidatsa, and Arikara Nation 

VACANT 

Nashville Area VACANT VACANT 

Navajo Area 

Term Expires: 

August 31, 2021 

Myron Lizer 

Vice President 

The Navajo Nation 

Jill Jim, PhD, MHA/MPH 

Executive Director, Department of Health 

The Navajo Nation 

Oklahoma Area 

Term Expires: 

October 31, 2021 

Bryan Warner (TAC Co-Chair) 

Deputy Principal Chief 

Cherokee Nation 

Lisa Pivec, MS 

Senior Director of Public Health, Cherokee 

Nation Health Services 

Cherokee Nation 

Phoenix Area VACANT VACANT 

Portland Area 

Term Expires: 

August 31, 2021 

Stephen Kutz, RN, BSN, MPH 

Tribal Council Member 

Cowlitz Indian Tribe 

Sharon Stanphill, MD 

Chief Health Officer 

Cow Creek Band of Umpqua Tribe of 

Indians 

27 
Tucson Area VACANT VACANT 

Tribes At-Large 

Term Expires: 

August 31, 2021 

Doreen Fogg-Leavitt 

Secretary, Inupiat Community of the 

Arctic Slope Council 

Inupiat Community of the Arctic Slope 

VACANT 

Tribes At-Large 

Term Expires: 

August 31, 2021 

Connie Barker 

Tribal Legislator 

The Chickasaw Nation 

Darcy Morrow 

Tribal Council Member 

Sault Ste. Marie Tribe of Chippewa Indians 

Tribes At-Large 

Term Expires: 

August 31, 2022 

Trinidad Krystall 

Riverside San Bernardino County Indian 

Health Clinic Inc. 

Torres Martinez Desert Cahuilla Indians 

VACANT 

Tribes At-Large 

Term Expires: 

August 31, 2021 

Richard Sneed 

Principal Chief 

Eastern Band of Cherokee Indians 

Vickie Bradley, MPH, BSN, RN 

Secretary of Public Health and Human 

Services 

Eastern Band of Cherokee Indians 

28