Thank you for that kind introduction.
NCAI President (Jefferson) Keel and the NCAI Executive Committee – thank you for this opportunity to meet with you. Tribal Leaders, Veterans, Ladies and Gentlemen –
Good afternoon and welcome to Washington, D.C! I am pleased to join you to discuss actions VA is taking to improve the health and well-being of American Indian and Alaska Native Veterans.
For more than two centuries, American Indians and Alaskan Natives have served our Nation in uniform in every war fought by the United States — with loyalty, patriotism, honor, courage, and sacrifice.
America owes an immense debt of gratitude to Veterans who are American Indian and Alaskan Natives … and to all the Veterans who served and sacrificed for our country.
That's why we at VA are determined to provide these men and women with the very best in compassionate care and expert treatment.
Last year, we provided outstanding care to six million Veterans. In the next five years –as America turns the page on a decade of war – we expect that more than 1 million active-duty personnel will join the ranks of America's 22 million Veterans.
To enable us to provide the best possible health care to our newest Veterans – and Veterans of all eras – the President's proposed budget seeks $52.7 billion for medical care. That's a 4.1 percent increase over the $50.6 billion approved by Congress for the current fiscal year.
That funding will enable us to continue to provide "the best care anywhere" to America's Veterans.
As you might know, almost 40 percent of American Indian and Alaska Native Veterans live on dispersed reservations or tribal lands, which are often geographically isolated.
Studies show that -- compared to urban Veterans – these rural and highly rural Veterans have lower health-related quality-of- life scores and a higher prevalence of physical illness. At the same time, rural Veterans are less likely to have access to mental and physical health services they desperately need -- especially for chronic conditions such as hypertension and Post Traumatic Stress Disorder.
Office of Rural Health
One of the actions we took several years ago was to establish the Office of Rural Health, which has funded more than 700 innovative and effective projects. The office is led by Mary Beth Skupien, a member of the Sault Ste. Marie Tribe of Chippewa Indians. Before joining VHA, she worked for the Indian Health Service for 28 years.
Last year, our Office of Rural Health funded more than $35 million dollars worth of projects specifically for Native Veterans. That includes a new community based outpatient clinic in South Dakota on Tribal land … expansive telehealth programs … and initiatives to address the unique health care needs of Native Veterans.
What's more, we're funding a national resource center focused on Native American issues …providing Home Based Primary Care in rural Indian Health Services and tribal clinics. … and supporting eight PTSD Telemental Health Clinics, which serve Northern Plains Tribes in Montana, Wyoming and South Dakota.
Office of Tribal Government Relations
In another important step forward for American Indian and Native Alaskan Veterans, VA created the Office of Tribal Government Relations in January 2011. The Director of the office is Stephanie Birdwell, an enrolled member of the Cherokee Nation.
The office serves as a resource for tribal governments on cross-cutting issues affecting Veterans in Indian Country. In the short time since the office was created, it has already created a resource guide for Tribal Courts working with justice-involved Veterans … launched a Web site … and hired four regional tribal government relations specialists.
The office is also helping to implement the VA tribal consultation policy signed by VA Secretary Eric Shinseki a year ago. Our goal is to enhance government-to-government relations between VA and all federally recognized Indian Tribes.
MOU Between IHS and VA
Finally, let me take a moment to discuss the important progress we're making as a result of the Memorandum of Understanding signed by VA and Indian Health Services in October 2010.
In the MOU, VA and IHS agreed to work together to improve access and quality of care to American Indian and Alaska Native Veterans. This wide-ranging agreement covers areas from improving the delivery of care by sharing programs … and increasing cultural awareness and competent care … to developing health information and technology … and increasing efficiency through purchasing agreements.
I am pleased to say that the MOU is already resulting in success for Native Veterans. For example, we recently conducted a successful pilot to improve the delivery of prescription drugs to the Phoenix Indian Health Service – dispensing nearly 20,000 medications to IHS through VA's Consolidated Mail Outpatient Pharmacy program. We hope to soon expand the program to Claremore, OK, and Yakama, WA.
In addition, VA's Suicide Prevention Office conducted 157 tribal outreach activities … and conducted a suicide prevention photo shoot that will feature Native American women Veterans.
There are many other examples, and I am confident the MOU will continue to bring long-lasting improvements to Native Veteran health care.
Recently, VA established its first Community Based Outpatient Clinic on tribal land. The CBOC is on Yankton Sioux tribal land in Wagner, South Dakota, next to a tribal outpatient clinic.
I would like to tell you a short story that illustrates how the interactions between a tribe, the VA and the IHS can benefit Native Veterans.
A 57-year-old Veteran, a member of the Yankton Sioux Tribe, walked into the new CBOC in Wagner, South Dakota, and announced he had lung cancer. To protect his privacy, I will call him Sam. Sam was an Army Veteran, and homeless, and had never tried to access VA health care before. He wasn't in the system.
VA Nurse Manager Marylou Morrow, herself a Yankton Sioux, dropped what she was doing, sat down with Sam, and together they filled out his paperwork to get him registered with VA. Marylou received valuable logistical help from Roy Farabee, the Veterans Service Officer for Charles Mix County; and Dennis Rucker, the Veterans Service Officer for the Yankton Sioux Tribe. They were instrumental in helping her locate Sam's discharge papers and other records. It was a team effort.
By 10 o'clock the next morning, they found out Sam was eligible for VA medical services. Marylou wanted to contact Sam right away and tell him the good news, but first she had to find him.
So she phoned a friend of his to find out where he was. Once she located him, she had someone from the Indian Health Service drive out to get him.
You see, the IHS, the tribe and the VA in Wagner, South Dakota, work together. It's a small community, so they all know each other.
Sam arrived at the Wagner clinic around noon, and got all his basic lab work done.
Our doctor there, Tim O'Shea, gave him a complete physical and then contacted all the VA specialty services, like oncology and social services, which would need to be involved in Sam's treatment program.
Early the next day, Sam was driven to the Sioux Falls VA Medical Center. Who drove him? Sharon Haar, the mayor of Wagner, South Dakota, population 1,700.
Mayor Haar also happens to be a volunteer driver for the Disabled American Veterans transportation program as well as at the VA clinic.
Sam spent the next few days at the Sioux Falls VA undergoing tests. Sadly, the diagnosis was not a good one. Sam's lung cancer was advanced ––and not treatable.
VA's goal now was to make him comfortable, to keep his pain under control, to make sure he wasn't suffering.
He stayed with some friends in Wagner. Members of our Home-Based Primary Care Team, including a social worker, went to check on him often.
And Sam always knew Marylou was just a phone call away.
Marylou was there for Sam. And when he died in January of last year, he did not die alone.
You have my promise that VA will always try to be there for America's Native Veterans — to care for those who shall have borne the battle.