Tribal Diagnostics Takes on COVID-19 Testing While Guarding Tribal Sovereignty

A Tribal Diagnostic lab tech conducts COVID-19 testing on April 23, 2020. (Courtesy Tribal Diagnostics)

Native-owned Tribal Diagnostics recently shifted to conduct COVID-19 testing in its Oklahoma City lab. While the company counts clients across the nation, founder and CEO Cory Littlepage (Chickasaw) is ensuring Tribal Diagnostics supports Tribes in particular. “COVID hits and impacts everybody, but is more prevalent with vulnerable populations which is Indian Country,” Littlepage told Native Business. “It makes sense for us to do our part from a moral perspective to be a part of the solution.”

By playing a role in the COVID-19 crisis, Tribal Diagnostics is essentially fulfilling the destiny envisioned by Littlepage from its founding in 2015. “The health outcomes facing our communities and our people are just sad — life expectancy, diabetes, substance abuse, cardiovascular disease,” he explains. “We’re the definition of a vulnerable population. Most medical decisions are based on the result of a laboratory test. In Indian Country, there wasn’t any reference lab that had been established on our communities. We said, we’re going to go all in here and build Tribal Diagnostics to do that.”

Affordable Testing For All

The company aims to provide the most accurate testing available to all who need it, and has priced the testing at Medicare rates. “Price should not be an issue,” Littlepage says. Working with nationwide logistics partners, Tribal Diagnostics is able to receive the samples from all over the country at its facility and report test results the morning after the test was taken.

Tribal Diagnostics CEO Cory Littlepage (Courtesy Tribal Diagnostics)

Beginning in April, the company applied its expertise and resources to testing for antibodies. With the capacity to do over 1,000 antibody tests per day, Tribal Diagnostics’ first phase was crucial to unraveling the mystery of immunity to COVID-19, a puzzle that has yet to be solved. It’s going to take a massive number-crunch to get there. “If we can get an idea of what the exposure rate looks like, what the recovery rate looks like, and how we can start getting more refined with our data to help understand what immunity may look like, or how long antibodies would stay in somebody’s system and what does that immune response look like?” Littlepage explains. “Being armed with that [data] can help us make good and stronger decisions around safety or getting back to work.”

This week, Tribal Diagnostics entered its second phase of coronavirus response, administering the nasal swab molecular polymerase chain reaction test that detects the presence of the virus and identifies if a person currently has COVID-19. Littlepage explains that his facilities are starting out doing about 200 tests per day, but could quickly “scale up” if not for the supply shortage: “The sheer difficulty is in getting access to not just tests but the supplies that run the tests. So when I say the nasal swabs, it’s the supplies to run the tests. Those have been really difficult to come by, because everybody in the world is trying to get access to those.”

It’s Tribal Diagnostics’ policy to provide the supplies to the health centers that do the testing, so the company is sourcing what it can find from a variety of suppliers. They’re having success, with help from IHS and Tribes, but the patchwork solution presents its own challenge — because they’re dealing with multiple suppliers, each supplier’s products must be tested for accuracy, which Tribal Diagnostics is doing itself.

An Expanding Presence in Indian Country

Within Indian Country, Tribal Diagnostics works with Tribes all over the country, in a network that is getting even bigger during the pandemic. “We work with the United Keetoowah Band of Cherokee Indians and the Absentee Shawnee Tribe,” Littlepage says. “The Ottawa Nation just said yes. We partnered with Cheyenne and Arapaho Tribes yesterday, because they’re looking to open their casinos this weekend and wanted to test all their employees to make sure that nobody had COVID, so we ran 400 tests on their employees yesterday in collaboration with Indian Health Services and the State Department, because they’re looking to open. We work with Keweenaw Bay up in Michigan; we work with Penobscot up in Maine; we work with Native Lifelines, it’s the Baltimore urban clinic. Muckleshoot has a facility that we work with up in Washington.”

Littlepage says that his company has an “about 100%” retention rate with its partner Tribes. “A response that we hear a lot is, ‘oh my goodness, I had no idea that a Native option existed.’ … Our team has been in Indian Country for decades, we’ve been in almost every single one of the 573 federally recognized Tribes. So, we have that infrastructure in place to be a value-added partner for Tribal communities. That’s a really happy place for us to be in, because we know that we’re making a difference.”

Image of lab work (Courtesy Tribal Diagnostics)

An Approach That Promotes Tribal Sovereignty

Tribal Diagnostics’ testing takes a distinctly Native approach to its work, seeing health testing services through the lens of sovereignty. “From a Tribal perspective, knowing that we protect their sovereign rights is received very favorably [in Indian Country]” Littlepage says. “A lot of times in Indian Country, data is underrepresented, or Native lives are underrepresented. …

“We use modern systems, modern technology, modern cyber security, to protect data, and we can provide data back to the Tribes then that ultimately helps them with funding opportunities to help their people and communities. A lot of what we hear right now is, Why are Natives not represented? or Why don’t we have Native data?, which impacts Tribal communities’ ability to get subsequent funding and supplies. We help with that.”

The Future of Tribal Diagnostics

Getting his company off the ground wasn’t easy. “I put in everything that I had, and left a good paying job, and went all in on Tribal Diagnostics,” Littlepage recalls. “I went two and a half years without taking a salary, and put everything back into the operation in order for us to grow.” The work paid off. “Slowly but surely you pick up one account here, you pick up another account here, you pick up another account here. We’ve had triple digit growth every year that we’ve been in operations.”

The company currently has 56 employees, but its founder predicts it will have over 75 by year’s end, and well over 100 by 2022. In October 2016, Tribal Diagnostics stopped taking outside capital.

There are many ways to measure success for a Tribal business such as this one. “We built the business around the moral case,” Littlepage says. “Because of our experience working in distressed environments, we operate very lean and we operate off low rates, just so we can make sure that Tribal communities get access to the lab tests they need at low cost — which makes me really proud. We’re growing while doing it off of Medicaid and Medicare type of rates.”

Pictured: Tribal Diagnostics’ lab workers. Tribal Diagnostics’ full 56-member team is roughly 50% Native American and 70% female. (Courtesy Tribal Diagnostics)

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