National Congress of American Indians

Good morning, everyone. I want to first acknowledge that I am on the ancestral homeland of the Nacotchtank and Piscataway people—tribal land. In fact, all this country is tribal land. So let me recognize tribal leaders, tribal elders, and Veterans. It is my honor to be here with you today.

President Maccarro, thank you for that kind introduction. Distinguished members of the Executive Committee and the Veterans Committee—good morning. And Larry Wright [NCAI Exec. Dir.]—it’s always good to see you. Last December—just before President Biden’s Tribal Nations Summit—Larry and some tribal leaders joined us at VA to share their ideas for improving Native Veteran benefits and services. So, Larry, thanks for helping make that happen, and for our strong partnership. Most importantly, thank you for your courageous service to the nation.

Last July, I was honored to visit the Gila River Indian Community and meet some heroic Native American Veterans. One of them is a Navy Veteran, Phillip Morales, a member of Akimel O’odham and White Mountain Apache tribes.

Now, Phillip didn’t grow up connected to his tribes. But the path he walked and the challenges he overcame connected him with his people, and his culture. And I’m proud VA was a part of Phillip’s journey.

Phillip served with honor as a Navy Seabee, a builder. And while serving, he suffered traumatic events. Like many Veterans, when he left service he carried some deep, invisible scars. And after coming home, Phillip had growing mental health challenges. Those challenges cost him his job, his family, and his home.

Then—a turning point. At his lowest, Phillip said, “I couldn’t think of anyone else who could help me … except VA.” So, he went to the Phoenix VA. “They understood,” Phillip said, “and VA provides a place where Vets can talk, feel safe, feel stronger.” There, among his fellow Veterans, Phillip got the help he needed—housing support and excellent mental health services.

And Dino Haley out at VA Phoenix has been a big part of Phillip’s journey. You see, Dino is a VA social worker—and he’s a Navajo ceremony practitioner. When it comes to serving American Indian Vets like Phillip, Dino provides care that honors their culture, that honors their warrior traditions like healing ceremonies and talking circles.

Today—thanks to Dino and so many others—Phillip has a home. He has his tribe. He’s a part of his community. And he’s living a life he’s proud of. Now, I’m sharing Phillip’s story of courage and strength for a few reasons: because I’m so proud of him and Dino Haley and the kind of work he’s doing, because I’m so thankful Phillip came to VA for help, and because it’s an example of the promise our country makes whenever someone signs up to serve in the military.

That promise—if you serve us, we’ll serve you when you come home. If you take care of us, we’ll take care of you. If you fight for us, we’ll fight for you. Our whole country makes that promise. But at VA, it’s our solemn duty to uphold it. And keeping that promise, that’s why I made some commitments to you the last time we met.

I told you we’d continue making every effort to respect tribal sovereignty—to consult with tribes before we make decisions that may affect tribal members. And I told you that every decision I make would be determined by a simple principle—whether it increases Veterans’ access to care and benefits and improves outcomes for them. Now, we’ve not always done well enough by Veterans—especially American Indians and Alaska Natives. We’re fighting like hell to do better.

And we’ve made some progress, thanks to you and good people like Chief Bill Smith of the Valdez Native Tribe and our whole Tribal Advisory Committee led by Army Vet Sonya Tetnowski of the Makah tribe; Clay Ward of the Choctaw Nation of Oklahoma, and the team in VA’s Office of Tribal Government Relations; Dr. Prairie Chicken, a Traditional Lakota, leading the Office of Tribal Health team.

So, I want to spend a few minutes touching on some of the most important work we’ve done—together.

Last year, VA delivered more care and more benefits to more Veterans than ever before. And this year, we’re going to keep fighting to reach even more Vets … to continue building trust … to meet Veterans where they are, rather than asking them to come to us. That’s our goal, always. More care and more benefits for more Veterans than ever before.

A few examples.

We signed our revised reimbursement agreement with Indian Health Service in December—after consultation with tribal leaders. It’s about providing American Indian and Alaska Native Vets the high-quality, affordable health care they deserve—no matter where they live. Here’s what that agreement means for Native Veterans.

At no cost to the Veteran, they can choose to get their care at VA. They can choose one of the 74 Indian Health Services facilities, the 120 Tribal Health Program facilities, or the 6 Urban Indian Organizations covered in the reimbursement agreement. We’re working with 13 other Urban Indian Organizations to see about getting them on board, too.

And this new agreement covers long-term care. It covers home health services. And it covers Purchased Referred Care, something I know tribal leaders have been asking about for a long time. And we are in consultation with Alaska Native leaders. We look forward to renewing our Alaska Sharing Agreement and Tribal Health Reimbursement Agreement soon.    

We’re expanding Native Veterans’ access to health care in highly rural areas across Indian Country. In November, we entered an agreement for a VA clinic inside the Vinita Health Center on Cherokee land in eastern Oklahoma. And we’re going to do the same on the Hopi Nation in Polacca, and the Navajo Nation in Kayenta and Tuba City. And we are working with the Navajo Nation and IHS to expand VA services in the Chinle, Arizona, IHS facility. These shared spaces mean new access to VA care for hundreds of Native Veterans. It’s about meeting our Native Veterans where they live, rather than asking them to come to us.

And last spring, thanks in large part to your help, we implemented the copay exemption for American Indian and Alaska Native Veterans. This exemption honors our treaties with sovereign nations. It addresses health care access and disparities. It provides more health care options. And it builds on our work to strengthen our partnerships and trust.

Today, I can report that since we implemented that policy, VA has exempted or reimbursed more than 143,000 copayments totaling approximately $2.5 million for over 3,800 eligible American Indian and Alaska Native Veterans. And we are now collecting validated tribal affiliations for the purpose of the copay exemption.

Now, we know that there are still many who haven’t applied for the copay exemption. Here’s what we’ve learned. Historically, we have not had sufficient data to capture the full number of American Indian and Alaskan Native Veterans. Just a year ago, we believed there were only 10-20 thousand Native Americans enrolled in VA health care. Today, we estimate that there are more than 60,000 enrolled.

And that’s great news. We’ve standardized Race and Ethnicity demographic data—and that includes for Native populations. And we’re going to begin applying consistent collection standards to all VA forms and surveys, including the enrollment application for health benefits—the 1010-EZ. So, we encourage all eligible Native Veterans to apply for VA health care.

Now, let me touch on Veterans benefits.

First, we’re processing Veterans’ claims faster and providing more earned benefits than ever before. Last year, we received over 22,000 claims from American Indians and Alaska Natives—that’s more than a 40% increase over the previous year. For Native Vets and their families, that meant nearly $70 million in benefits—a 23% increase over 2022. That’s good news, and we’re going to fight to do even better this year.

And it’s so important that Native Vets have VA accredited Tribal Veterans Service Officers representing them, helping them get the benefits they’ve earned. That’s what the Navajo Nation Veterans Administration and the Gila River Indian Community have done—become VA-recognized Veterans Service Organizations with accredited representatives. And they started filing their Veterans’ claims for benefits immediately. We want—and Veterans need—more tribal governments to get that same VA recognition as a Veterans Service Organization.

That’s one reason it’s so important that two months ago President Biden signed the law granting a federal charter to the National American Indian Veterans service organization—NAIV. That charter gives Native Americans a seat at the congressional table with other Veteran Service Organizations like the American Legion, VFW, and AMVETS. And we’re ready to work on the VA recognition process with Commander Loudner and NAIV so that even more Native American Vets can have access to qualified tribal representation on their VA benefits claims.

Now, it was just over a year ago, August 2022, that President Biden signed legislation to care for Veterans exposed to toxins in Vietnam and in the last 30 years of war—the PACT Act. Thanks to your partnership, last year we held 40 toxic exposure claims clinics in Indian Country. The outcome—more than 6,400 toxic exposure claims granted to Native Veterans resulting in over $38 million in earned benefits for them and their families. And it’s a big reason why nearly 3,500 more American Indian and Alaska Native Vets have enrolled in VA health care since that law was signed.

We want to enroll more. Starting in March—thanks to the PACT Act—any Vet who served in Iraq, in Afghanistan, or any other combat zone after 9/11 can enroll in VA health care. Our biggest challenge—spreading the word … making sure every Veteran knows about this new eligibility.

And I’m asking for your help on this. Come March, let’s get as many of our Native Vets as possible to apply. If they’ve ever been denied before, let’s encourage them to re-apply. Because, listen—if they don’t need VA health care today, they might need it tomorrow, or the next day, or 30 years from now.

Phillip Morales understands this. His urgent message to his fellow Native American Veterans is this—“Tell people,” he said, “to go [to VA] sooner.” And he’s right. We need to get every Native Veteran the benefits they’ve earned, get every one of them enrolled in VA health care, long before there’s a crisis. Together, we can help avoid a crisis.  

Here’s what I mean.  

First point. Last year we permanently housed over 46,500 homeless Veterans. Over 1,000 [1,066] were Native American and Alaska Native Vets. But to any homeless Veteran right now, those numbers don’t mean much. So, I’m asking for your help. If you know of any Veterans who are homeless—or at risk of homelessness—let us know, and let us help. Get them to VA. You can call VA. Call the National Call Center for Homeless Veterans anytime day or night. The number is 877-424-3838. We’ll get them connected to VA services. We need everyone spreading the word, helping get those Vets to VA.

Second point. In November, we released our report on Veteran suicide, and from 2020 to 2021 the suicide rate for Native American and Alaskan Native Veterans increased 53%. That constitutes a horrible tragedy. It’s absolutely unacceptable. And, it’s preventable.

Dr. Prairie Chicken and the Office of Tribal Health are collaborating with the Office of Mental Health and Suicide Prevention to continue expanding and customizing suicide prevention tools so they’re culturally compatible with tribal communities.  

And we know we have to reach more Native Americans and Alaska Native Veterans when it comes to suicide prevention. So, we are working with our partners at the Department of Health and Human Services and the Substance Abuse and Mental Health Services Administration to expand our suicide prevention efforts in Native Veterans’ communities. This will be a new, tribally driven approach that’s informed by your wisdom, your insights, and your traditions.

With the Staff Sergeant Parker Gordon Fox Suicide Prevention Grant Program, we’ve expanded access to local, community-based services providing suicide prevention for Veterans and their families. And we’ve provided nearly $5 million in grants to 21 community organizations providing suicide prevention services to Veterans within tribal nations.

And, now, the doors of emergency care at any health care facility are open to Vets in suicidal crisis—whether they are enrolled in VA care, or not. And it’s free.

But here’s the bottom line. No single organization can fix this. And, again, I’m asking for your help. If you know of a Veteran in a mental health crisis, call the Veterans Crisis Line—9-8-8, press 1. That connects Veterans quickly and directly to the Veterans Crisis Line. Please, help us make sure all your people know that number. 988, Press 1.

And get any Veteran in crisis to VA or the emergency room. If you have challenges with emergency care access for Veterans on your tribal lands, tell us so we can work closely with you and fix that.

A few final words. We depend on—and I’m so grateful for—all the good work you’re doing to help us serve American Indian and Alaska Native Veterans as well as they have served this county. And if there’s ever a case where we’re coming up short, tell me, so we can get it fixed.

When I was in Anchorage last year, an Alaska Native Vet told me about the challenges they face having to travel to Anchorage or Fairbanks to get their benefits exams. Now, we’re working with the Kodiak Area Native Association and the Maniilaq Tribal Health Center in Kotzebue to see about using their space to conduct benefits examinations. And we’re also working to hold Alaska Veteran claims clinics outside of Fairbanks and Anchorage, closer to where many Alaska Native Veterans live.

Here’s my point. I want you to hold us accountable—accountable to you and, most importantly, accountable to the Vets we serve. I welcome that. It only makes us better.

And, in closing, I want to renew my commitment to you. We respect your tribal sovereignty. And at VA, we will not make decisions about you, without you.

Thank you for your leadership. Thank you for your partnership. And thank you for all that you’re doing to help our nation’s Tribal Veterans, their families, caregivers, and survivors.

May God bless them, and may we always give them our very best.