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Office of Public and Intergovernmental Affairs

Remarks by Secretary Denis R. McDonough

National Indian Health Board
Washington, DC
September 27, 2022

Good morning, everyone!

Thank you, Chief Bill Smith for that kind introduction, for your steadfast leadership as the Alaska representative of our VA Advisory Committee on Tribal and Indian Affairs, and for your continued service to the nation.

Vice-Chairman Nick Lewis: Thank you for giving me this opportunity to share a few thoughts with NIHB.

I’m thrilled to join CEO Stacy Bohlen, Tribal leaders, Tribal elders, and Veterans who have joined us today—to celebrate the 50th anniversary of the NIHB.

That’s 50 years of devotion 50 years of fulfilling obligations 50 years of great service and promise—including so much great work for Native Vets.

You know, to me, this work all comes back to that fundamental promise our nation makes to anyone who signs up for military service.

If you take care of us, we will take care of you.

If you fight for us, we will fight for you.

If you have our backs, we will have your backs when you leave the service.

Our country as a whole makes that promise. But it’s our job, yours and mine, to keep it—for Native Veterans, and all Veterans.

And that’s what I want to talk about today—how we’re keeping that promise, together.

Since the last time I met with you—and let me just say I’m really happy to be back with you—I want to give you a quick read-out of the some of the lessons learned from my own time in the field.

Back in April of 2021—shortly after I became Secretary of VA—I, along with Senator Moran of Kansas visited Hunter Health, an Urban Indian Organization, or UIO, based in Wichita, Kansas.

I’m told this 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.

And during that trip, I learned that 70% of American Indian and Alaska Native people live in urban areas, so Hunter Health—and UIOs like it—are essential to the urban Indian community.

But I also learned, disappointingly, that VA’s working relationship with UIOs was limited.

So, in the year since, we’ve worked to fix that—because we are committed to reaching and serving American Indian and Alaska Native Veterans, in perpetuity, no matter where they are. 

So, right now...

  • We have UIOs onboarding as VA reimbursement sites.
  • VHA has initiated purchased care agreements with several UIO facilities, and we hope to expand this partnership further in the coming year.
  • And 42 UIOs are now receiving I-H-S funds.

Bottom line: UIOs are important part of providing care to Tribal Vets, and we’re going to continue to expand our relationships with them to continue delivering for the Vets who rely on them.

Now, on an important, related note, I know it has been a long wait for the implementation of legislation that will exempt American Indian and Alaska Natives from making co-pays for VA health care.

And I commit to you now: VA will put this legislation into effect by the end of this calendar year and eliminate copays for these Veterans before 2023 arrives. 

Now, another lesson from the field came from a couple back-to-back trips to Tribal Nations ... one to Bemidji, Minnesota, where I got to meet with Veterans from the White Earth Band of Chippewa Indians ... and another to Navajo Nation in New Mexico, where I met with President Nez, Native Veterans, and Ms. Roselyn Tso, the fantastic incoming Director of I-H-S.

In both visits, Tribal leaders, Vets, and Veteran advocates expressed many of the same concerns including concerns about culturally-relevant care—questioning whether clinicians understood and respected the needs of the Native Vet population. 

And those concerns have led directly to action.

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

And we’ve established a partnership to assess what resources might be needed and available to support culturally-relevant care.

And look, that’s just one example of what happens when we work together: things change, and change quickly, for the better.

And that’s why, under your direction, my staff has been hitting the ground and traveling to Indian country.

Over the past year, Raphael Chavez-Fernandez, VA’s Deputy Assistant Secretary of Intergovernmental Affairs, has been to Cherokee, Blackfeet, and Navajo Nations.

And over the course of the next year, I commit to engaging in joint tribal consultation with Roselyn and IHS. 

This has been something Chief Bill and the VA Advisory Committee on Indian Affairs has advocated for—for quite some time.

And the time is right to make it happen.

Through this joint tribal consultation process—and I say process because it won’t be a one-time event—there will be work sessions and accountability metrics established to ensure promises that we make to our Native Veteran population are the promises we keep for our Native Veteran population.

And next year—when I come back here—I will report out what we’ve changed, together, for the better.  

Now the other big thing I want to update you on is the PACT Act—the bill that President Biden signed into law two months ago that paves the way for VA to deliver care and benefits to millions of toxic-exposed Veterans and their survivors.

This is a monumental moment for you, for VA, and most importantly, for all those we serve together.

And I want to make sure everybody is getting access to the benefits they’ve earned.

As you know, more than 3,000 Native Vets served in the Gulf War.

That means we want to see that many claims filed—more than 3,000—because each one of those Native Vets has earned those benefits.

But we’re going to need your help to make that happen especially in communicating to Native Vets what this bill means for them and their families.

So, please, share these messages with any Veteran or survivor you know.

First, we at VA want Veterans and survivors to apply for their PACT Act benefits right now.

Second, we will begin processing PACT Act benefits for Veterans and survivors on the earliest date possible, which is January 1st.

And third, any Veteran or survivor can learn more about the PACT Act at by visiting or calling 1-800-MY-VA-411. 

That’s, and 1-800-MY-VA-411. Because we want every Veteran—every single one—to get the care they need and the benefits they deserve.

Now, before I close, I want to share a story about one of the Veterans who we at VA and NIHB serve together.

It’s the story of Dwight Birdwell, whom the President awarded the Medal of Honor back in July.

I know that many of you work frequently with Mr. Birdwell’s daughter, Stephanie, who does a fantastic job running VA’s office of Tribal Government Relations.

But you might not know her dad, and his story is simply incredible.

Mr. Birdwell joined the Army in May of 1966, and he was on the front lines of Vietnam not long after that. His first significant action came on the very first day of the Tet Offensive, when his unit responded to an attack on a local US Airbase.

Mr. Birdwell’s unit was told the attacking Vietnamese force would only be one squad, but when they got on site, they found something far worse.

It was 100 men trying to take on 1000. They were surrounded.

Mr. Birdwell’s tank commander was immediately hit, so Birdwell took over command—risking his life to lay down suppressive fire. He went through weapon after weapon, continuing to fight even after his M-60 was hit by enemy fire, causing it to explode and send shrapnel into his face, chest, arms, and hands.

When Mr. Birdwell was ordered to load onto the Medevac helicopter, he complied, only to crawl right back off the other side and keep on fighting. 

Now, I tell Mr. Birdwell’s story today not only because he’s a hero, though he is and not just because he’s a citizen of the Cherokee Nation.

No, I wanted to call attention to Mr. Birdwell because his story and sacrifice are experiences shared by other Veterans in this room with us today—by Veterans in your families, communities, and tribal nations.

And because now, it’s our job—together—to those Veterans with just as much integrity, honor, and respect as they served us. That’s our shared mission. It’s a job you do so very well, and we at VA are honored to do it with you. So, thank you again for having me here this morning, and for your partnership in serving Veterans.

I look forward to your questions.