Preliminary Assessment Tribal Emergency Response Preparedness Dean S. Seneca, MPH, MCURP Agency for Toxic Substances and Disease Registry Centers for Disease Control and Prevention

Project Objectives To assess Tribal emergency preparedness and response capabilities, with special focus on radiological hazards. To identify support and training needs of Tribes related to emergency preparedness.

Project Objectives (continued) To engage Tribal communities in emergency preparedness response activities. To help establish criteria and mechanisms for improving, enhancing, or possibly developing integrated Tribal programs related to emergency response.

Project Triggers Tribal lands are often in rural settings and/or cover large areas. If chemical, biological, or radiological release occurs, Tribes may be the primary government entity to respond. Outside agencies need to understand how well prepared Tribes are and what support needs exist.

Accomplishments to Date Set up pilot assessment to obtain data from a cross-section of Tribes. Identified and selected nine Tribes to participate in the pilot assessment. Conducted in-person interviews with the nine Tribes during the summer-fall 2003.

Accomplishments to Date (continued) Conducted follow-up with Tribes as needed to ensure completeness and accuracy of Tribe-specific data. Compiled findings, prepared Tribe-specific reports. Developed a summary report of overall findings.

Methods Criteria for Selecting Tribes Proximity to major transportation routes. Proximity to nuclear/chemical facilities or Department of Defense or Energy sites. Potential presence of unregulated landfills (radioactive waste). Proximity to U.S. borders.

Methods Data Collection Interviewed Tribal representatives one-on- one or in small group settings. Topics discussed: - Overall knowledge and understanding - Infrastructure and equipment - Emergency preparedness planning - Communications - Training - Support needs

Methods Data Compilation Extracted and compiled the information recorded during interviews and follow-up communications. Prepared Tribe-specific reports and compiled aggregate data in single summary report, identifying overall observations and trends.

Participating Tribes

Size of Participating Tribes < 5,000 (3 Tribes) 5,001-15,000 (2 Tribes) 15,001-30,000 (1Tribe) >30,000 (3 Tribes)

Overall Findings Tribes are generally aware of the types of hazards and response scenarios that may arise on Tribal lands, but lack specific knowledge. A wide range of response preparedness was observed. Some Tribes are better equipped and have more comprehensive emergency response programs than others.

Overall Findings (continued) Some Tribes are aware that other state, county, or local emergency response plans exist, but desire more information about where the Tribes fit in. Tribal readiness for radiological hazards is limited. Virtually none of the Tribes have the capabilities to identify orphan sources, and most do not have equipment or training for radiological emergencies.

Overview: Support Needs Tribes report that they need Training/technical support. Funding for dedicated staff and equipment. Improved communications within Tribal Nations and with local, county, and state agencies serving their Tribal areas.

Breakdown of Findings

Infrastructure Few Tribes are completely self-sufficient in terms of personnel, equipment, and resources to respond to various emergency situations. Most Tribes have law enforcement groups; 4 of the 9 Tribes interviewed have fire departments; others rely on outside first responder services or a combination of Tribal and outside services.

Infrastructure (continued) Most Tribes rely on outside or contract medical services. Most facilities serving Tribes are equipped to handle at least 6-20 patients in an emergency; some can treat 50 or more patients.

Infrastructure (continued)

Equipment Less than half the Tribes report having emergency response equipment. Tribes with equipment are more prepared for chemical and biological emergencies. No relationship was observed between equipment inventory and the Tribal size or land mass.

Emergency Response Planning Most Tribes interviewed have some form of an emergency response plan completed or under development. All but one of these incorporates measures to respond to radiological hazards. Tribes report cooperation among their first responders and with outside agencies in developing response plans. Still, Tribes expressed interest in fostering more coordination with outside agencies.

Communications Most Tribes have a system to communicate with other agencies in an emergency. More than half the Tribes have a communications system used by first responders. Fewer Tribes have a system to notify the public of an emergency. Those that do often rely on radios and television, among other means.

Support Needs Overall At least a third of the Tribes interviewed requested that EPA/ATSDR share information about funding sources, technical support providers, and training tools available to Tribes (for emergency planning and increasing general knowledge about hazards faced).

Training Training in emergency response readiness varies among the Tribes. Some Tribes receive extensive training in emergency response readiness, participate in mock drills, and even train others responders. Most training has focused on chemical and biological hazards. Fewer responders are trained in radiological hazards or to recognize orphan sources.

Needed Training/ Technical Assistance How to safely respond to emergencies, such as the proper use of equipment, particularly for radiological and biological hazards. How to develop or improve emergency response plans. Assistance with mock drills.

Needed Training/ Technical Assistance Templates for emergency response plans. Useful Web sites. Names of training resources and providers.

Other Needs Additional funding and staff dedicated to emergency response planning and training. Mechanisms for enhanced information sharing with IHS, the Tribes, and other agencies (How to achieve greater coordination). Improved equipment and supplies.

Other Requests Inclusion of Tribes in other governmental agencies’ notification procedures. Demonstrated commitment from federal agencies to support Tribes.

Next Steps Use pilot assessment results as a basis for assessing all the tribes ER capabilities in the U.S. Expand the assessment of training/ educational needs. - Supplement findings with other similar studies, if available. - Refine pilot questionnaire, based on Tribal input and consider more widespread distribution.

Future Considerations Establish training implementation strategies. Raise awareness of identified issues across states and Tribes. Form partnerships; foster collaboration among government agencies and Tribes. Define role of Federal agencies in the process. Identify funding mechanisms for staff, equipment, etc.