Promotion of Good Health Care for American Indian/Alaska Native Veterans

Memoranda of Understanding (MOU) are often used to promote high-quality, culturally-competent health care for American Indian/Alaska Native (AI/AN) people.

“Many UIHPs develop and implement Memorandums of Understanding (MOU) with local public and private health services organizations to refer urban AI/AN people for health and specialty care services…Examples of cultural practices include sweat lodges, smudging, traditional medicine men, powwows, drum groups, and AI/AN language. These traditional cultural practices are important for health, as well as dealing with grief and emotional issues such as traumatic experiences.” (Indian Health Service, IHS)

In 2010, IHS and the Department of Veterans Affairs (DVA) signed an MOU to promote inter-agency collaboration which

 “recognize(d) the importance of a coordinated and cohesive effort on a national scope, while also acknowledging that the implementation of such efforts requires local adaptation to meet the needs of individual tribes, villages, islands, and communities, as well as local VA, IHS, Tribal, and Urban Indian health programs.”  (Emphasis added.)

On January 17, 2017, it was announced that the MOU was extended through June 30, 2019.

While this MOU has been implemented for IHS and Tribal providers, it has not for urban Indian health programs (UIHPs), which means that UIHPs aren’t reimbursed for providing treatment to AI/AN veterans to the same extent as IHS and Tribal programs.

Given the significant numbers of AI/AN people who live in U.S. urban areas— more than 70%, according to the most recent U.S. census—and the disproportionate sacrifices borne by AI/AN veterans, the federal government should make it easy for AI/AN veterans to receive high-quality, culturally competent health care. AI/AN veterans are more likely to receive adequate health care when they can more easily determine how, when, where, and by whom they are served.

It is well-known that DVA sometimes experiences surges in demand which understandably outstrip its ability to serve, and these surges can often be satisfactorily addressed through the use of UIHPs. In addition to providing culturally-competent health care, UIHPs often include non-health care-related social services that are important to AI/AN veterans.

Both the legislative and executive branches have strongly supported recent efforts to increase timely access of veterans to health care, and implementation of the MOU for AI/AN veterans would be eminently consistent with those efforts.