Letter to VA in re: Proposed Amendments to 38 CFR14; RIN 2900-AP51 Recognition of Tribal Organizations for Representation of VA Claimants

Submitted via: http://www.regulations.gov


September 19, 2016


William I. Russo, Director,
Regulations Policy and Management (00REG),
Department of Veterans Affairs,
810 Vermont Avenue, NW, Room 1068,
Washington, DC, 20420

RE: Proposed Amendments to 38 CFR14; RIN 2900-AP51 Recognition of Tribal Organizations for Representation of VA Claimants


Dear Director Russo:

On behalf of National Council of Urban Indian Health (NCUIH), I write to you today to submit comments on the proposed rule, published in the Federal Register on July 20, 2016, entitled “RIN 2900-AP51 Recognition of Tribal Organizations for Representation of VA Claimants.” NCUIH supports the purpose of this proposed rule, but asks that our recommendations be incorporated to truly further the spirit of this rule.

The National Council of Urban Indian Health was founded 18 years ago to represent the interests of Urban Indian Health Programs (UIHPs) before Congress and Federal agencies, and to influence policies impacting the health conditions experienced by urban American Indians and Alaska Natives (AI/AN).The National Council of Urban Indian Health is a 501(c)(3), membership-based organization devoted to support the development of quality, accessible, and culturally sensitive health care programs for AI/AN living in urban communities. NCUIH fulfills its mission by serving as a resource center providing advocacy, education, training, and leadership for urban Indian health care providers. NCUIH strives for healthy American Indians and Alaska Natives living in urban settings, which comprise over 70% of the AI/AN population, supported by quality, accessible health care centers and governed by leaders in the Indian community. NCUIH represents urban Indian Health Programs receiving grants under Title V of IHCIA and the American Indian and Alaska Natives they serve.

Recommendations

The purpose of this rule is to attract Native American populations who are geographically isolated from current Veteran Service Organizations, or who do not utilize their services due to lack of cultural competency, cultural barriers or lack familiarity with those organizations. With a vast majority of American Indians living in urban areas due
to the federal government’s relocation policy as well as other economic factors, the organizations that urban Indians are comfortable with that the spirit of this proposed rule tries to address, are Urban Indian Organizations (UIOs) and/or Urban Indian Health Programs (UIHPs). These organizations not only provide healthcare to the urban Indian community, but social services as well.

As Congress has many times acknowledged that their trust responsibility does not end at the borders of the reservation, policies and regulations should always reflect that of the urban Indian population as well. The following recommendations are to help the Department of Veterans Affairs accurately uphold their trust obligation to all of Indian Country.

1. Definition of Tribal Organization

The proposed rule would amend §14.628(b) to include “Tribal Organization,” which would allow for “one or more Tribal governments.” We recommend revising that definition to “one or more Tribal governments and urban Indian organizations/urban
Indian health programs.”

2. Funded by a Tribal Government

While defining “Tribal Organizations,” one of the requirements of the proposed rule would require them to be “funded and controlled, sanctioned, or chartered by one or more tribal governments.” This would exclude UIOs/UIHPs. We would recommend
instead to allow funding from “one or more Tribal governments or UIOs/UIHPs.”

3. Access for only Native Americans

The proposed rule states that the primary purpose of the office is to serve “Native American veterans.” American Indian veterans often marry non-American Indians or unenrolled American Indians, and have children that fall into similar categories. By restricting services to Native Americans, you are denying veteran families services that their loved one dedicated their lives for. The rule should allow “tribal organizations” to also serve non-American Indians veteran family members.

A. Tribal member/government employee requirements

The amendment to 38 CFR 14.629(a)(2) would allow a Tribal member or Tribal government employee to become an accredited representative. This would leave out UIOs and UIHPs, which service a large portion of the AI/AN community. We recommend amending the eligible employees to include UIO/UIHP employees as well. The amendment also requires the employee to be paid no less than 1,000 hours annually, which may not reflect the limited funding and resources Tribal governments and UIOs/UIHPs face. We recommend a lower requirement or eliminating the 1,000 hour requirement altogether.

B. Urban Confer

NCUIH greatly respects Tribal sovereignty and wishes for needs to be met for all of Indian Country. We strongly urge you to consult with Tribes in order to improve the AI/AN veteran community. We also ask that the Department of Veterans Affairs have a consulting mechanism for UIOs/UIHPs. UIOs/UIHPs serve a large AI/AN veteran community, and while urban Indians and Tribal Indians face a lot of the same issues, there are sometimes different issues that urban Indians face that are not addressed. We recommend that the Department of Veteran Affairs initiate a confer policy that is similar to the consultation policy so that urban Indians have a voice as well.

C. Other Recognition Changes

Under proposed rule §14.628(d), “an organization requesting recognition must: (1) Have as a primary purpose serving veterans, (2) demonstrate a substantial service commitment to veterans either by showing a sizable organizational membership or by showing performance of veterans’ services to a sizable number of veterans, (3) commit a significant portion of its assets to veterans’ services and have adequate funding to properly perform those services…”
1) Tribes and UIOs/UIHPs serve AI/ANs in many ways, and cannot be limited to the primary purpose of serving veterans.
2) Like most of the other Tribal submitted comments reflect, “sizable” is arbitrary. Tribes and UIOs/UIHPs serve all of their tribal members. Even if it was only 10% of their services, that 10% is entitled to their earned veterans benefits and should not be excluded for any reason.
3) “Significant portions of its assets,” should be removed. Tribes and UIOs provide a various amount of services to their members and should have not this restriction, as it is would extremely limit the amount of Tribes and UIOs to participate, if at all, thus being against the spirit of the proposed rule change.

Conclusion

NCUIH hopes that the Department of Veterans Affairs, in the spirit of improving AI/AN access to its resources and services, will work with Tribes and UIOs/UIHPs to advance access to veteran services through community-based organizations. We would like to reiterate our request for UIOs to be included in the final proposed rule, as it is of the utmost importance to uphold both the federal government’s trust responsibility to American Indians and their families as well as to veterans for serving our country. We appreciate the opportunity to provide our comments and recommendations and look forward to further engagement on this proposed rule. Please contact Francys Crevier, Policy Analyst and Congressional Relations Liaison at FCrevier@ncuih.org, if there are any additional questions or comments on the issues addressed in these comments.


Sincerely,

Ashley Tuomi President
National Council of Urban Indian Health