Reaching Out to Tribal Governments

This week, Ms. Stephanie Birdwell joins VA as the Director for the Office of Tribal Government Relations. I initiated this new program within The Office of Public and Intergovernmental Affairs (OPIA) because there is a real need to enhance communication with tribal governments about services available to American Indian and Alaskan Native Veterans. Our initiative to Enhance Partnerships with Tribal Governments will see immediate, significant impact for these Veterans.

Collaborating with federally recognized tribes, many of which are located in rural and underserved areas remains a critical task of the Department. As the nation moves forward with healthcare reform and economic recovery, VA already has funded programs that could bring immediate relief to this population. American Indians, Alaska Natives (AIANs) and Pacific Islanders are second to none in their military service but are among the least likely to benefit from opportunities found in the continental states. Twelve percent of AIANs in the US are Veterans, one of the highest per capita populations of Vets in any ethnic group. Despite their high rates of military service, AIANs are also one of the most vulnerable populations. Approximately 25 percent of AIANs live in poverty and they have higher obesity (nine percent) rates than any other racial/ethnic group, according to the Center for Disease Control. 33 percent of Native Americans had no health insurance coverage in 2007, and of those with coverage, 24 percent relied on Medicaid.

With the Office of Tribal Government Relations under Ms. Birdwell’s leadership, VA has an opportunity to practice good government. If we can increase access to VA healthcare, we can reduce AINA Veterans’ reliance on Medicaid as well as increase preventative care that reduces later VA medical costs. For example, one of OPIA’s current efforts is to jointly coordinate access for VA’s mobile clinics and mobile Vet Centers to tribal lands. This is key to fighting obesity among American Indians, which is associated with diseases such as diabetes, cardiovascular disease, hypertension, coronary heart disease and cancer. A 2003 study on diabetes estimates that it costs $13,243 per patient to treat diabetes, compared to $2,560 for patients without diabetes. If 91,920 AINA Vets are suffering from obesity (24 percent of the 383,000 existing AINA Vets), VA is faced with a potential cost of $1.2 billion just to treat these Veterans for diabetes alone.

If we can increase access for VA preventative healthcare and keep just one percent of the 91,920 AINA Vets who are at risk from obesity-related illness from developing diabetes, VA will save $12 million. Most importantly, however, we will be improving the lives of a population of Veterans who have shown their bravery and dedication to this nation. It’s only right that we make sure that they have access to the services and benefits that they have earned.

L. Tammy Duckworth is a former VA Assistant Secretary for Public and Intergovernmental Affairs.

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