Office of Public and Intergovernmental Affairs
Remarks by Secretary Robert A. McDonald
National Congress of American Indians
October 27, 2014
Good afternoon, everyone, and thank you for the opportunity to speak with you today.
First, I would like to publicly acknowledge—to you, to all Veterans who bring such honor to your communities, and to every Native American and Alaskan Native—the important government-to-government relationship between the United States and Indian Tribes.
Further, I want to express my commitment to honoring that relationship and ensuring VA collaborates as equal partners with Indian Country. We respect tribal governments, and you deserve assurance that we’ll make every effort to respect your tribal sovereignty and consult you before we make decisions that may affect Native Americans.
We share a noble goal. That is, helping all eligible Veterans access the VA services and benefits they’ve earned and deserve through their courageous service to the Nation. And the feats of Native American warriors are legend. Their names echo and their actions reverberate in history. They give us lessons on duty, courage, and selflessness.
They fought with honor during World War I, even before being recognized as citizens.
In World War II, they were the famed “Code Talkers” from more than 30 tribes and men like Marine Lieutenant Colonel Greg Boyington—“Pappy” Boyington, of Sioux heritage. After shooting down 26 enemy aircraft, fighter ace Pappy Boyington was shot down. He endured 20 months as a POW and, for his extraordinary heroism and determination as a fighter, President Roosevelt presented him the Medal of Honor.
They served in Korea. Among them were former U.S. Senator and Northern Cheyenne Ben Nighthorse Campbell and Master Sergeant Woodrow Keeble of the Sisseton Wahpeton Oyate tribe, who received the Medal of Honor posthumously in 2008.
They served with great courage in Vietnam and Operation Iraqi Freedom. Hopi Indian and Army Specialist Lori Piestewa gave her life in Iraq. She was the first Native American woman to die in combat. But she was the third generation in her family to serve. Lori Piestewa’s example endures as a reminder of the courage and sacrifices of all women who serve.
So, President Cladoosby, members of the NCAI Board and Executive Committee, and all tribal leaders and elders, thank you for welcoming me.
Let me recognize Veterans Committee Co-Chairs Mr. Daniel King and Mr. Larry Townsend.
Other distinguished guests, ladies and gentlemen:
My name is Bob, and taking care of Veterans is very personal to me.
My wife, Diane, and I come from families with strong traditions of military service.
Diane’s father was shot down over Europe and survived harsh treatment as a POW. My father served in the Army Air Corps after World War II. Diane’s uncle served in Vietnam, where he was exposed to Agent Orange. He still receives VA care. And today, my nephew serves in the Air Force and flies missions over the Middle East.
I graduated from the United States Military Academy in 1975. My time at West Point and then as an Airborne Ranger with the 82d Airborne Division instilled in me strong values and a lifelong sense of duty to country. Even after nearly four decades, simple words from West Point’s Cadet Prayer still guide me. That prayer encourages us “to choose the harder right instead of the easier wrong.”
I worked at Procter & Gamble for 33 years. Those experiences taught me about the importance of effective management. I learned about strong leadership. And I learned about being responsive to the needs of customers. Those lessons are important today. VA’s Strategic Plan makes clear: “VA is a customer-service organization. . . . We serve Veterans.”
You know the Department of Veterans Affairs is overcoming problems involving access to health care. Let me offer my personal apologies to Veterans living on tribal lands, and to all Veterans, who have experienced delays in receiving care. Our mission is to serve and care for those who have borne the battle and for their families and survivors. And the problems we face are serious.
We own them. And we are fixing them.
But right now we have before us the greatest opportunity we’ve ever had to improve care for Veterans. My sole purpose as we take advantage of that opportunity is to put Veterans at the center of everything we do at VA.
We are engaged in immediate reform at VA so we can achieve three important goals that we set over two months ago on our “Road to Veterans Day.”
- Rebuild trust with Veterans and all of our stakeholders.
- Focus completely on Veterans’ outcomes to improve delivery of our services.
- And set a course for long-term excellence and reform.
To achieve that third goal, we’ve wasted no time developing a health care “Blueprint for Excellence.” The Blueprint for Excellence describes four broad themes and supporting strategies for transforming VA health care.
First, we have to improve the performance of health care, right now.
Second, it’s imperative that we re-set VA’s culture. We have to put a high premium on our employees’ job performance and the good VA values that support their performance: Integrity, Commitment, Advocacy, Respect, and Excellence. These values are the heart of our mission. They dictate how employees must act, must relate to Veterans and to each other, and how they will treat nearly 6.5 million patients we see each year. For every Veteran, these values mean we will not be presumptuous. We will not marginalize Veterans in your communities. We will not be condescending. We will be staffed with sincere, good-hearted people who help Veterans access the health care and benefits available to them.
Third, VA has to change from “sick care” to “health care” in the broadest sense.
And fourth, VA has to develop efficient, transparent, accountable, and agile practices to support the broad span of care, services, and programs we offer Veterans.
In short, VA’s vision for change is not only Veteran-centric, but also Veteran-driven. We mean to put Veterans, our customers, in control of the VA experience. That patient-centric, Veteran-centric solution is called “MyVA”—another element of the Road to Veterans Day strategy. It’s called “MyVA” because Veterans should view VA as their organization—an organization that belongs to them and provides quality care and benefits in the ways they need and want to be served.
To ensure our course is right, I’ve been on the road the last two-and-a-half months. And I’m staying on the road. I’ve visited 35 VA facilities in 19 cities listening to Members of Congress, to Veterans, to VA employees and their unions, to Veterans Service Organizations, and many other partners. Last week in a White House-sponsored conference call, 60 tribal leaders and representatives participated in a candid discussion about challenges affecting Veterans across Indian Country. Later today, I sit down with your Veterans Committee. I want to hear first-hand from them about their experiences with VA.
Let me ask the director of VA’s Office of Tribal Government Relations, Ms. Stephanie Birdwell, to stand. Stephanie and her regional specialists are singularly committed to facilitating VA's Tribal Consultation Policy, increasing access to health care, and promoting economic sustainability. If you have questions about anything related to your Veterans, call Stephanie—202-461-7400. I want to make sure your questions are answered so we keep moving forward in tangible ways.
And we are moving forward. Since President Obama signed his Memorandum on Tribal Consultation in 2009, Stephanie and VA have worked closely with tribal leaders and others to improve outcomes in Indian Country. That’s especially important: your people serve the Nation in uniform at higher rates than any other population. We owe them every honor we can extend.
To honor your warriors and cultures, we are helping provide new tribal Veterans cemeteries. We want all Veterans to take their final rest according to their own traditions. Over the last three years, VA has granted over $20 million to the Rosebud Sioux, the Yurok, the Pascua Yaqui, the Oglala Sioux, the Seminole Nation of Oklahoma, and the San Carlos Apache Tribes. Next year, four additional grant proposals may exceed $5 million in Montana, Oklahoma, California, and South Dakota.
To help Native Americans more easily access home loans on tribal lands, VA’s Native American Direct Loan Program has signed 87 agreements with tribal governments. We’ve made nearly 1000 loans to Veterans living on trust lands. That’s over $40 million in mortgages financed directly by VA since the program’s inception.
We discovered in 2012 that many were not aware of this benefit. So Stephanie Birdwell and her office made Direct Loan outreach a priority. Since then, VA has coordinated dozens of regional and national outreach events to spread the word. We’ve signed agreements with tribes across the country, from the Mohawk in New York to the Metlakatla in Alaska. Eleven more agreements are underway.
But I need you to help spread the word so every eligible Native American Veteran has the opportunity to own a home on tribal land.
Because of the rural nature of many tribal lands, VA’s Office of Rural Health has provided over $53 million to fund 119 initiatives across Indian Country. They help with transportation. They help deliver mental health care and PTSD treatment. And they help deliver telehealth projects. Telehealth projects increase access and minimize long commutes, especially for chronically ill Veterans. And for the chronically ill, Home Based Primary Care teams on tribal lands and co-located at IHS hospitals and tribal clinics provide services at home. One example: VA-funded Home Based Primary Care teams collaborated with the Choctaw Health Center in Jackson, Mississippi, and with the Eastern Band of Cherokee Indians in North Carolina. They are ensuring fragile tribal Veteran patients receive primary care without leaving home.
Thanks to the inter-agency work of Dr. Roubideaux and Indian Health Services on reimbursement agreements, we have made progress delivering quality health care to these Veterans. Today, VA has 83 reimbursement agreements covering 108 IHS sites. We have 63 reimbursement agreements with Tribal Health Programs—60 more are in process. Altogether, we’ve reimbursed $12.5 million dollars for direct care to 4,000 eligible American Indians and Alaskan Natives.
But we’re coming up short. Our estimates show we could cover 28,000 more American Indian and Alaskan Native Veterans. We have to do better.
Let me say a few words about President Obama’s Affordable Care Act—the A-C-A—as it applies to Veterans and you. VA health care or the ACA may cover programs the Indian Health Service doesn’t—things like medical specialists, tests, emergency room visits, and hospital care. So, it’s important that American Indians and Alaskan Native Veterans, and all of us, consider a few options.
First, for Veterans enrolled in VA health care there’s nothing more to do. VA care meets ACA standards. Veterans not in VA health care can enroll in ACA at any time. And if you already enrolled in VA health care or purchased ACA coverage, you can still receive IHS services.
Second, Veterans and family members not eligible for VA health care, and who do not have employer-provided health insurance, should use the ACA marketplace to get coverage. Veterans and members of federally recognized tribes can enroll in ACA Marketplace plans at any time. And you can change health plans up to once per month.
The Choice Act that the President signed into law expands collaboration between VA and the Indian Health Service. So that’s a more robust program of care for Native American Veterans. We’re working on that now.
All these benefits are tremendous. In the Billings area, one patient purchased an ACA plan for himself and his wife: they pay just $7 a month. They have zero out-of-pocket costs. Another patient in Oklahoma reported a premium of 12 cents per month. Help us get these options out to all your people.
We are making progress. We have a lot of work to do. But, VA cannot do it alone.
There are over 150,000 Native American Veterans. Over 21,000 American Indian and Alaskan Natives are serving today. They bring great honor to your people and follow the path of Native American war heroes who are their forebears. And it will take the collaboration and work of VA and every tribal leader and elder to serve them and honor our Nation’s commitment to them.
So, let me ask for your help in spreading the word about what VA has to offer and how to get it. That means going to the VA or inviting the VA to your communities for out-reach.
Let me ask you to get updates about the economic impact Veterans Affairs resources have in your community. Ask how many VA dollars are going to services and benefits in your tribe’s county. Ask if every resource is getting to Veterans and families in tribal communities.
Help us ensure Veterans have the opportunity to receive the care and benefits they’ve earned. And if you have any questions, or your representatives simply do not know where best to begin, well, call Stephanie—202-461-7400.
Hold us accountable. And let me hear from you.
Thank you for your time.