Native American Veterans Falling through Cracks Between VA, IHS Healthcare Services

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By Sandra Basu

WASHINGTON — The VA and IHS need to better coordinate services for American Indian and Alaska Native veterans, federal officials acknowledged at a recent Senate Indian Affairs Committee hearing.

“For some AI/ANs, navigating the two healthcare systems may prevent optimal use of health services for which they are eligible. VA and IHS will continue to work together to address the input we receive from tribes and to improve services for American Indians and Alaska Natives. And, we are making progress,” Indian Health Service Deputy Director Randy Grinnell told the committee.

Grinnell and Stephanie Elaine Birdwell, director of VA’s Office of Tribal Government Relations, were among panelists testifying before the Senate Committee on Indian Affairs on programs serving AI/AN veterans.


Members of the National American Indians Veterans group pose for a photo on Memorial Day 2010 at Arlington National Cemetery. U.S. Army Photo by Command Sergeant Major (Ret) Anthony Walker

AI/ANs participate in the military more than any other ethnic group as a percentage of the population, according to IHS. Both VA and IHS provide care to these veterans, but at issue has been whether these veterans are falling between the cracks. At a 2009 Senate Veterans’ Affairs Committee hearing, Sen. Daniel Akaka (D-HI) said, despite dual-eligibility for VA and IHS healthcare, “American Indian and Alaska Native veterans report unmet healthcare needs at four times the rate of other veterans.”

At the recent hearing, Akaka, who also chairs the Senate Committee on Indian Affairs, noted it is important that the nation meet its “dual responsibility to [American Indian and Alaska Natives] as veterans and as indigenous people.”

AI/AN Veterans

Grinnell told the committee that American Indian and Alaska Native veterans have said they want better coordination of services between VA and the IHS. He pointed out some of the challenges these veterans face.

“IHS is primarily a rural health system; therefore, in some locations, our facilities may be a significant distance from VA facilities. In addition, the eligibility rules for IHS and VA healthcare services differ, which may cause confusion about coverage of services,” he said.

IHS and VA are committed to improving access to services, Grinnell added, pointing out that in 2010 the agencies renewed a memorandum of understanding (MOU) to establish coordination, collaboration and resource-sharing between the two departments and to improve care for these veterans.

Birdwell told the committee during her testimony that VA is embarking on a robust outreach and consultation effort with tribes. She said her office was established by the VA last year to develop partnerships with American Indians and Alaska Natives to “enhance access to services and benefits” for native veterans. She said the VA continues to work on earning the trust of Native American veterans.

“I know it will take time, but I believe it is a goal VA will achieve,” she told the Senate Indian Affairs Committee.

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