National Council of Urban Indian Health

Thank you, Robyn Sunday-Allen for that kind introduction and, more importantly, for your exemplary leadership and service to Native people.

I’m thrilled to join you and Tribal leaders, elders, and Veterans for the 25^th Anniversary of the National Council of Urban Indian Health, an organization committed to holding this country accountable to the promise of the United States’ Trust Obligation to American Indians and Alaska Natives.

That’s 25 years helping preserve cultural values; 25 years of securing the rights and benefits to which Native people have always been entitled; and 25 years of providing thousands upon thousands of Native people and Native Vets with empowering and often life-changing services.

Let me also take a moment to thank all of you for presenting me with the first ever Native Veteran Health Ally Award. I am privileged to accept this award on behalf of an incredible VA team, the best workforce in the federal government. They are deeply devoted to the fundamental and enduring nature of the work we do at VA: to fight for all Vets, their families, caregivers, and their survivors—no matter who they are, where they’re from, or who they love.

You know, there’s nothing more important at VA than providing world-class health care and benefits to Veterans. And since President Biden took office, VA has provided more care and more benefits to more Vets than ever before.

The results speak for themselves. Since the pandemic began, we’ve:

• Cared for more than 750,000 Vets with COVID-19;
• Vaccinated more than 4.5 million Veterans, 340,000 employees, 130,000 Veteran caregivers, family members, and dependents, as well as 61,000 others;
• Conducted 23 million virtual home visits;
• Supported all 50 states and territories during the pandemic, as well as the Navajo Nation, Hopi Tribe, and White Mountain Apache Tribe;
• Completed more than 1.7 million claims in the past year;
• And opened seven new national cemeteries serving over 500,000 Veterans.

Now those numbers are impressive, but they don’t even begin to capture the breadth, depth, and effectiveness of the work of VA’s great public servants over these past two years.

Back in April of 2021, I visited Hunter Health, an Urban Indian Organization—or UIO—in Wichita, Kansas.  I’m told that was the first time a VA Secretary had ever visited a UIO.

And let me tell you, what I saw of the clinic was truly impressive. That clinic served Native people from over 50 Tribal Nations and served them well.

On that visit, I learned that because of the federal government’s relocation policies of the 1950s and 60s, 70% of American Indian and Alaska Native people live in urban areas. And I was reminded of the painful sacrifices Native people endured when the federal government persuaded American Indians and Alaska Natives—including many Vets of World Wars I and II—to leave their home communities with empty promises of jobs, education, and housing in certain cities.

For far too long, our nation has broken promises to Native Vets living in urban and rural areas.

Now, none of us can change that painful history. But we can, together, make sure we don’t repeat it. That’s what you’re all about. Holding this country accountable to its promises.

You’re a shining example of American Indian and Alaska Native resilience—community hubs formed by Native people for Native people in the face of the federal governments’ relocation policies. You’re a leading voice for Native people and their fight to retain their culture, their language, their land.

Now it is clear that the promises have yet to be fulfilled, but we’ve made significant steps toward that progress.

For this Administration, listening to and learning from Tribal leaders and Tribal Veteran advocates is a priority.

In fact, during his first few months in office, President Biden convened a Tribal Nations Summit—listening sessions with Cabinet Officials and forums where tribal leaders outlined the challenges they face in securing access, rights, and benefits to which they are entitled and so richly deserve.

One of the policy initiatives resulting from the Tribal Nations summit focuses on strengthening the collaboration, communications, and partnerships between UIOs and VA to end Native Veteran homelessness. We launched the initiative in November of last year.

My point: you make us better at caring for Native Vets.

A few examples.

I learned from the field during a couple back-to-back trips to Tribal Nations. One was to Bemidji, Minnesota, where I got to meet with Veterans from the White Earth Band of Chippewa Indians. And the other was to Navajo Nation in New Mexico, where I met with President Nez and Ms. Roselyn Tso, the Director of Indian Health Services.

In both visits, Tribal leaders, Vets, and Veteran advocates expressed concerns about culturally-relevant care, questioning whether clinicians understood and respected the needs of the Native Vet population. These concerns on cultural competency are why in 2021 we established and convened the first ever advisory committee on Tribal and Indian Affairs.

We intended to give a seat at the table to those who could best inform decisions affecting Native Vets before they were made. To borrow a phrase, our commitment was clear that VA wouldn’t make decisions about you, without you.

So far we’ve received 13 recommendations from that committee of 15 tribal Vets who served this great nation in uniform.

One of those recommendations we agree with means Tribes in each regional system of care will develop a cultural awareness training curriculum. This training will be specific to those local tribes and Native communities.

That’s just one critical lesson. A deficient cultural competency leads to the health disparities we all know exist. And those concerns led directly to action.

Specifically, VA is implementing the whole-health model of care across VHA, which will promote and support traditional approaches to healing.

We understand that there’s a culturally informed component to care that Native Vets want to receive at a UIO, IHS, or Tribal health facilities.

At VA, we’re experts on health care.

We’re experts on benefits and services.

But we’re not experts on the Native traditions of healing. And we want to be informed in ways that are culturally sensitive and respectful. 

That’s the kind of good we can do at VA when we listen to you, listen to each other, and work together. Our commitment is reflected in change.

Here’s another important change.

We’ve waived co-payments for Native Veteran health care. Now, I know it has been a long wait for the implementation of this legislation.

But last September I stated before the NIHB that I would put this legislation into effect by the end of the calendar year and eliminate copays for Veterans before 2023 arrives.  We didn’t make the target date but we got it done. The final rule on the co-pay exemption is an excellent example of listening to you, of not making decisions about you, without you.

One more example.

The reimbursement agreement with UIOs is just a little over a year old. Thanks to the fierce advocacy and staunch support of many of you in this room, it’s a promising indicator of VA’s faithfulness to Native Vets, of VA working to keep our promises. Understandably, there’s a lot of interest among UIOs about signing up for this program. Please know that the process takes time—so stick with it.

VA wants to work with you because we know that Native Vets—just like all Vets—want to have the freedom to choose where they receive their care, whether it’s at VA where they’ve earned that care through their military service, or at a Tribal facility, a UIO, or HIS.

The point here is we’re working to make the system more flexible so that Native Vets can get care where they want it.

Now before I close, I need your help to make sure the more than 3,000 Native Vets who served in the Gulf War file a claim under the new toxic exposure benefits.

This past August, President Biden signed legislation recognizing new presumptions of service connection for more than 20 health conditions related to toxic exposures—including exposures like Agent Orange, burn pits, and more.

This new law has an opportunity for VA to try to start a new relationship with the Vets, families, caregivers and survivors of these wars.

And this new law will ensure Vets who live with those conditions get the care and benefits they earned.

It’s empowered VA to deliver the care that millions of toxic-exposed Veterans need, and the benefits that they and their survivors deserve. This includes many of you here, today, and many Vets you know.

It’s going to be one of the largest expansions of Veteran benefits in history.

It’s going to bring generations of new Vets into VA health care and increase the health care benefits of many more.

Now I said it can be the largest expansion of VA care and benefits in history. But that will only be so if we get Vets to come apply for these benefits that they have earned and so richly deserve.  So, five quick points on the new law.

First, we want Vietnam Vets and Vets who fought over the last thirty years of war to apply for their toxic exposure benefits right now. Don’t wait. Apply today. And re-apply if you’ve been denied before.

Second, apply on or before August 9th this year to have benefits backdated to August 10 of last year—the day President Biden signed the bill into law.

I challenge every representative of a UIO in this room to reach out to your local VA and schedule an outreach event related to PACT Act, and soon, well before August 9^th. We stand ready to assist.

Call Stephanie Birdwell, from the VA Office of Tribal Government Relations and her team and get something lined up as soon as possible. Stephanie, where are you? Let’s make this happen. Call her at 202-344-9107. Again, that’s 202-344-9107.

Third, any Vets who are already enrolled in VA health care should get a toxic exposure screening at your VA medical center. It’s quick. It’s easy. And nearly 2.5 million Vets already have. And if the Vets you’re serving are not enrolled in VA health care, please, help them get them enrolled.

Fourth, some Vets worry that applying for toxic exposure benefits will impact their current benefits. The truth is that with the PACT Act, they’re 32 times more likely to have their benefits increase or stay the same than to see a decrease.

And fifth, there are people out there who’ll try to convince Vets they need to pay somebody or use a lawyer to apply for their VA benefits. That’s simply not true—just work with VA or a VSO.

This is a really pivotal time in our history at VA and we cannot miss this opportunity to work together, to get changes in place. The new toxic exposure legislation is an opportunity—an invitation—for Vets to build a new relationship with VA.

It’s one important way we can keep our sacred promise to those who served and sacrificed. It’s one tangible way we can serve Vets as well as they served us, especially Vets who may have tried VA in the past, but didn’t feel welcome, didn’t feel heard, didn’t feel seen.

We haven’t always kept that promise well enough, especially when it comes to delivering care and benefits to Native Vets. We need to do more to fulfill the promise our nation made to Native Vets.

On the day I was sworn into office, President Biden charged me to fight like hell for Veterans, their families, caregivers, and survivors. And to me, that fight goes back to that fundamental promise our Nation makes to everyone who signs up for military service.

If you fight for us, we’ll fight for you. If you take care of us, we’ll take care of you. If you have our backs, we’ll have your backs when you leave the service.

Native Veterans have kept their part of that promise. Now, it’s time for us—as a country and at VA—to uphold our end of the bargain. We will not rest until every Veteran gets access to equitable, world-class care and benefits.

I look forward to continuing this work, keeping our sacred promise to Native Vets, together.

Thank you for your time today.