The Department of Veterans Affairs is creating a new umbrella office to manage health care for all American Indian and Alaska Native veterans and expanding a new program to help rural Native American veterans more easily access VA health care, officials announced last week.
Both moves are part of VA Secretary Denis McDonough's effort to do "everything in our power to help tribal nations through the remainder of the pandemic," he told the first session of a multi day meeting of the VA's new Advisory Committee on Tribal and Indian Affairs on Jan. 25. McDonough acknowledged that the agency fell short in providing adequate care for native veterans in the first two years of the coronavirus pandemic.
McDonough added that he wants "to make sure that what happened over the last 22 months never happens again."
"As a part of that effort, we have vaccinated more than half of American Indian and Alaskan Native veterans and cared for them with almost 90,000 telehealth visits," he said.
VA officials said they are creating the Office of Tribal Health within the Veterans Health Administration to manage health care for all American Indian and Alaska Native veterans, from those who live in urban environments to those on rural reservations.
The department also plans to expand its Rural Native Veteran Health Care Navigator Program, which began in 2020, to several new VA facilities.
The pilot program aims to decrease barriers to health care services in rural areas by partnering native veterans with peers in their communities -- similar to case managers -- who can help them reach culturally competent care, according to Jay Shore, a population specialist at the VA Office of Rural Health, who spoke to the advisory committee on Jan. 26.
A 2018 Government Accountability Office report found that the Indian Health Service, which is part of the Department of Health and Human Services, faces ongoing challenges to recruiting and retaining its clinical care providers, leading to "a negative effect on patient access, [and] quality of care." Approximately 25% of positions remain unfilled, including at rural IHS facilities.
VA advisory committee member Angela Pratt, an Army veteran and speaker of the Osage Nation Congress, said creating new programs and offices won't be enough if the current programs can't be better coordinated.
"A lot of times, my frustration with things is because there is so much information coming out through all these tribes, and there are so many layers of groups and things. And it is like, this isn't quite working well," she said.
A memorandum of understanding, or MOU, between the Veterans Health Administration and the Indian Health Service that establishes a framework to coordinate programs and communicate between the federal agencies was last renewed in October, VA officials noted.
"We are committed to tribal consultation and, really, this MOU is going to be, and is, an organic document. We anticipate it will change," said Benjamin Smith, deputy director for intergovernmental affairs for the IHS.
Chief William Smith, vice president of the Valdez Native Tribe in Alaska, praised the effort to coordinate Native American health care issues across government agencies.
"I want to commend the Indian Health Service and the VA for being together in the same rooms, to tear down their silos to work together to help veterans. This has been a dream for a long time," he said.
-- Jonathan Lehrfeld is a reporter for Medill News Service.