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A Menu of Suggested Provisions for Public Health Mutual Aid Agreements

Special Note Relating to Tribes

Tribes represent an array of culturally rich and diverse communities spread across the country. There are over 560 federally recognized Indian tribes located in over 30 states. Tribal governments are sovereign entities with inherent authority to protect the health, safety and welfare of their communities. Jurisdictional authorities in Indian country, however, are complex because the delivery of public health services is often distributed across tribal, county, state, and federal public health service providers. Tribal communities are generally not subject to state public health laws and the extent to which tribal governments have codified public health authority within tribal law is not clear.


Public health legal preparedness is an emerging issue in Indian country that is gaining broader recognition by a wide array of tribal leaders. In response to requests from these tribal leaders, CDC established a Tribal Public Health Law Work Group. The Work Group recently coordinated a Tribal Forum on Legal Foundations for Public Health Practice in Indian Country. Mutual aid agreements were recognized as an essential component of public health legal preparedness, and development of such agreements will certainly be among the Forum-related “next steps” to be taken by the Work Group.


There are some recent examples of collaborative efforts demonstrating that agreements between tribes and other governmental entities can effectively facilitate the sharing of information, resources, equipment, or personnel for the purpose of protecting the public’s health. As state and local governments continue their mutual aid efforts, and as they work to cultivate similar working relationships with tribes, the number of agreements between tribes and other levels of government (and perhaps Mexican states, Canadian provinces and First Nations as well) will undoubtedly increase.


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