This practice describes the process of engaging the 22 Native American tribes in New Mexico in pandemic influenza preparedness activities.
Context
Tribal sovereignty has wide-reaching effects on pandemic planning, including isolation and quarantine policies,mass casualty and burial practices. However, funding streams to cover the expenses of planning aren’t always built in. This project represents New Mexico’s approach to funding and empowering tribes in New Mexico to enhance their pandemic preparedness and align it with existing efforts at the county and state levels.
Outreach and training 2006/2007
Joe Baca, the Native American Planner in the Bureau of Health Emergency Management (BHEM), Epidemiology and Response Division,New Mexico Department of Health, developed an outreach project to enable tribes to plan and enhance training at the community level in emergency and public health preparedness.
Baca helped create a train-the-trainer manual for pandemic influenza. To help market it, the Bureau hired a very popular and well-known Native American artist, Vincent Craig, to draw a cartoon for use on materials about community pandemic influenza planning and home health care. Using such an iconic artist drew the attention of the intended audience.
Five training sessions occurred throughout Indian country in the first wave of training, four of them on reservations. The intended audience was Native Americans, but many non-Indiansattended. More than 423 people who work directly with Native American community members attended the free training. This wave of training reached representatives from tribes in New Mexico, Colorado, Arizona, and Utah. Those trained individuals will in turn train and others and educate the tribal communities.
An educational slide show and a training booklet (not available electronically) were used in the training sessions. Small groups of community members then practiced presenting the material as part of the training session.
The train-the-trainer project has been popular outside of New Mexico as well, Baca said: Tribes in Arizona, California,Oregon, Washington, South Dakota and Oklahomahave requested the course outline.
Grants 2007
The BHEM developed a Memorandum of Agreement as a mechanism to share pandemic planning money with New Mexico tribes. Each of the 22 tribes received $8,000 and technical assistance to conduct:
- Tribal council briefings
- Stakeholder meetings
- Tabletop exercises
- Response capacity assessments
- Pandemic planning
In addition, the grant required tribes to provide reports on outcomes and provide the personnel and material necessary to support the activities of the MOA.
Tribal participation was 100%, Baca said.
Grants 2008
In funding for 2007, the DOH updated its approach by contracting with one agency to handle the second round of $8,000 grants to 18 of the 22 tribes instead of having the state handle all 22 contracts.
The deliverables for the second round of funding are as follows:
- Each tribe should review its pandemic influenza plan to date and identify gaps using the Centers for Disease Control and Prevention assessment tools. They should analyze the gaps and write a plan to address the gaps.
- The state is providing a template to mesh tribal pandemic influenza planning with county and state approaches. The state’s suggestion is that tribes follow the template to try to complement the state’s pandemic influenza plan.
- Tribes must participate in their tribal or county or state pandemic exercise – a functional or full-scale exercise is preferred. (Tabletops are discouraged.)
Eight tribes will have their own mass vaccination clinics (MVC). The remaining tribes must work with their county or with other tribes. The Navajo Nation will repeat a large-scale MVC exercise it initiated in 2006. There were 15 sites in 2006; this year there will be approximately 11 more for the Navajo Nation, which encompassed an area of four states. This exercise includes complementary events in Indian Health Service regions outside of New Mexico and Arizona as well. Exercises are scheduled to occur in November and December 2007. Baca said he anticipates about 11 MVC PODS in New Mexico, which will result in about 18,000 people being vaccinated for seasonal influenza in New Mexico alone. Another 26,000-30,000 people are expected to be vaccinated in Arizona through these exercises as well, Baca added.
- Of the $8,000 second-year funding, about $3,000 can be spent for Personal Protective Equipment (PPE), with the understanding that the state may then contribute to a second round of PPE purchasing through a third party.
Training late 2007/2008
On a separate track, a 4-state summit is scheduled forAug. 6-7 for Native Americans to focus on the disease mitigation/nonpharmaceutical intervention guidance proposed by CDC. It will include three components, Baca said in July:
- A CDC representative providing an overview of the guidance;
- A focus on home healthcare provision;
- A school closure workshop.