On September 28, 2016 the U.S. Department of Veterans Affairs (VA) held an in-person Tribal consultation session at the National Museum of the American Indian in Washington, DC to discuss amending the current VA Memorandum of Understanding (MOU) status to consolidate multiple community care programs, previously known as non-VA care, into one standard program with standard rates. The meeting was announced on September 12, 2016 through a Dear Tribal Leader Letter. NCUIH Board member Kerry Lessard and NCUIH Policy Analyst and Congressional Relations Liaison Francys Crevier emphasized the need to work with the VA to allow Urban Indian Health Programs the ability to have MOUs to better serve Native veterans. These MOUs would reimburse UIHPs for services provided to Native veterans who often prefer going to a UIHP for service rather than the VA because of shorter wait times and culturally competent care.

During the consultation, Tribal Leaders emphasized that the VA to fully implement the VA-IHS Memorandum of Understanding (MOU) that was implemented in 2012.  Many Tribal leaders expressed their disappointment of the MOU process taking over four years for approval, and others were concerned that VA’s consolidation plan would end  the current IHS/Tribal – VA MOU structure and would result a lengthier process and would most importantly infringe on the government-to-government relationship with the federal government.

At the National Indian Health Board’s conference in Scottsdale last month, the VA hosted a workshop on the MOU process. When the Ms. Crevier requested that the VA work with UIHPs as an integral part of the Indian Health system, the VA responded there was no need to work with UIHPs because there are VA offices in urban areas. NCUIH vehemently disagrees and strongly suggested that because of shorter wait times and cultural competency as well as the vital support UIHPs can bring to the VA, MOUs are necessary. A recent report from the Office of Inspector General showed that 215 VA patients died waiting for specialty care at the Phoenix VA, while Native Health, the Phoenix UIHP, resides in the same neighborhood and is willing to help alleviate that burden. Working together is the only way to make sure veterans do not fall through the cracks.

Tribal Consultation on the VA’s plan for consolidation is open until November 5, 2016. Click here to view the Federal Register Notice and submit comments.