Mission Statement
Veterans Rural Health Resource Center-Western Region-Native Domain

The Native Domain’s specific functions include evaluation, cataloging and coordination of past and ongoing programs and projects targeted to help identify, delineate and then disseminate models of best practices for rural Native Veterans.

Native Veterans from American Indian, Alaska Native, Native Hawaiian and Pacific Islander populations have a proud tradition of military service and sacrifice. Native Veterans serve at the highest rate per capita of any ethnic group in the U.S. Armed Forces. Studies demonstrate they also disproportionately suffer the consequences of service, including higher rates of disorders related to combat exposure (e.g., PTSD and substance disorders). Native Veterans also represent the highest proportion of rural Veterans. The often isolated and dispersed nature of rural Native Veterans presents significant barriers for access and quality of care. In response to these challenges, the Office of Rural Health established the Veterans Rural Health Resource Center-Western Region (VRHRC-WR) Native Domain to serve as a national resource on healthcare issues for Native rural Veterans.

Given the considerable cultural, social and geographic diversity of rural Native Veterans, it is important to stress that while the Veterans Health Administration (VHA) is national in scope by its very nature, VHA programs

and activities targeted at this population may benefit from policy strategies that embrace a national scope while maintaining a local focus.

A national scope involves the VHA engaging at a system-wide level in a collaborative, coordinated and cohesive effort to attend to the needs of these populations. A local focus refers to the adaptation of national efforts—including policy, best practices, partnerships, programs and dissemination—to the environments of rural Native Veterans at the level of individual tribes, villages, islands and communities. Thus, all work produced from the Native Domain will be considered with regards to a national scope with a local focus.

The Native Domain’s goals are to conduct policy analysis; collect best practices; foster clinical demonstration projects; coordinate and partner with agencies and Native communities; and disseminate information about these populations.

The three core focus areas are:

▪ Population Science—to understand the scope of Native Veteran demographics, healthcare utilization and patterns within the VA.
▪ Policy—to collect and review existing policies and research affecting Native Veterans for the development of strategic recommendations and policy planning based on existing data.
▪ Programs—to support the implementation, identification and dissemination information on culturally-competent best practices for Native Veteran clinical care and outreach.

Throughout this website there are numerous references and documents, including articles and web sites, providing information and data on issues of importance to rural Native Veterans and the people who work and interact with them. There are various resources available to aide and assist Veterans in obtaining access to health care and traditional healing services and programs, as well as information on population statistics and demographics, and policy and legislation that affects this population.

General Resources

Collaborations between the Veterans Administration and the Indian Health Service
The Indian Health Service (IHS) Director Yvette Robideaux, and Robert Pretzel, VA Under Secretary for Health signed a new Memorandum of Understanding (MOU) on October 1, 2010. The purpose of the MOU is “to establish coordination, collaboration, and resource-sharing between the Department of Veterans Affairs (VA) and Indian Health Service (IHS) to improve the health status of American Indian and Alaska Native Veterans. The goal of the MOU is to foster an environment that brings together the strengths and expertise of each organization to actively improve the care and services provided by both. The MOU establishes mutual goals and objectives for ongoing collaboration between VA and IHS in support of their respective missions and to establish a common mission of serving our nation's American Indian (AI) and Alaska Native (AN) Veteran. The MOU is intended to provide authority for a broad range of collaboration between the agencies that facilitate development of additional agreements around specific activities. It is the intent of this MOU to facilitate collaboration between IHS and VA, and not limit initiatives, projects, or interactions between the agencies in any way. The MOU recognizes 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.”

The Indian Health Service (IHS)/Veterans Health Administration (VHA) previously signed a collaborative agreement on February 25, 2003. “The Department of Health and Human Services (HHS) and the Department of Veterans Affairs (VA) entered into a Memorandum of Understanding (MOU) to encourage cooperation and resource sharing between the Indian Health Service (IHS) and the Veterans Health Administration (VHA). The goal of the MOU is to use the strengths and expertise of both organizations to deliver quality health care services and enhance the health status of American Indian and Alaska Native veterans. ”

Severity of combat-related posttraumatic stress disorder versus noncombat-related posttraumatic stress disorder: a community-based study in American Indian and Hispanic veterans.
Brinker M, Westermeyer J, Thuras P, and Canive J.
J Nerv Ment Dis. 2007 Aug; 195 (8):655-61.

American Indian and Alaska Native Veterans: Lasting Contributions.
Lindsay F. Holiday, Gabriel Bell, Robert E. Klein and Michael R. Wells.
VA Office of Policy Assistant Secretary for Policy, Planning, and Preparedness. September 2006

Websites and Other Resources

The vision of the Department of Veterans Affairs (VA) is “to provide veterans the world-class benefits and services they have earned - and to do so by adhering to the highest standards of compassion, commitment, excellence, professionalism, integrity, accountability, and stewardship.”

The VAs Office of Rural Health (ORH) is designed “to improve access and quality of care for enrolled rural and highly rural veterans by developing evidence-based policies and innovative practices to support the unique needs of enrolled veterans residing in geographically remote areas.”
The VA Facility Listing Report page allows the user to search for VA medical facilities throughout the country by state, region, division, central offices, or all VA facilities.

The mission for the VAs National Center for PTSD “is to advance the clinical care and social welfare of America's Veterans through research, education, and training in the science, diagnosis, and treatment of Posttraumatic Stress Disorder and stress-related disorders.

The VAs Center for Minority Veterans (CMV) acts as a mediator and facilitator, assisting eligible Veterans in their efforts to receive benefits and services from the VA.

Disabled American Veterans (DAV) operates a nationwide transportation network to transport sick and disabled Veterans to VA medical facilities for needed treatment.

The National Resource Directory is an online partnership for wounded, ill and injured service members, Veterans, their families and those who support them. The directory “provides access to services and resources at the national, state and local levels that support recovery, rehabilitation and community reintegration”

The mission of the Department of Health and Human Services (HHS) Office of Minority Health (OMH) “is to improve and protect the health of racial and ethnic minority populations through the development of health policies and programs that will eliminate health disparities.”

The Department of Health and Human Services (HHS) Administration for Native Americans (ANA) mission is “to promote the goal of self-sufficiency and cultural preservation for Native Americans by providing social and economic development opportunities through financial assistance, training, and technical assistance to eligible Tribes and Native American communities, including American Indians, Alaska Natives, Native Hawaiians, and other Native Pacific Islanders organizations.”

The ANA Storytelling for Healing features Native American Veterans from World War II, Vietnam, the Gulf War and Operation Iraqi Freedom. It is a website providing resources and covering many topics important to Native American Veterans, and includes access to a DVD that has interviews with individual Veterans discussing various issues they face every day.

Veterans’ stories are available on the Veterans History Project website provided by the Indian Prairie Public Library. On October 27, 2000, Public Law 106-380 was passed which called upon the American Folklife Center at the Library of Congress in Washington, D.C., to collect and preserve oral histories of America's war Veterans.

The Department of Health and Human Services (HHS) Indian Health Service (IHS) "is responsible for providing federal health services to American Indians and Alaska Natives. The provision of health services to members of federally-recognized tribes grew out of the special government-to-government relationship between the federal government and Indian tribes…The IHS is the principal federal health care provider and health advocate for Indian people, and its goal is to raise their health status to the highest possible level. The IHS provides a comprehensive health service delivery system for approximately 1.9 million American Indians and Alaska Natives who belong to 562 federally recognized tribes in 35 states.”

The Indian Health Services (IHS) Community Health Representative (CHR) program provides quality outreach health care services and health promotion/disease prevention services to American Indians and Alaska Natives within their communities through the use of well-trained healthcare providers. The program “was implemented to improve the health knowledge, attitudes and practices of Indian people by promoting, supporting, and assisting the IHS in delivering a total health care program…The goal of the CHR Program is to address health care needs through the provision of community-oriented primary care services, including traditional Native concepts in multiple settings, utilizing community-based, well-trained, medically-guided health care workers.”

The National Library of Medicine provides an information portal on issues affecting the health and well being of American Indians. This web resource on American Indian Health is “designed to bring together health and medical resources pertinent to the American Indian population including policies, consumer health information, and research. Links are provided here to an assortment of documents, web sites, databases, and other resources.”

The National Library of Medicine/National Institutes of Health PubMed service “comprises more than 19 million citations for biomedical articles from MEDLINE and life science journals. Citations may include links to full-text articles from PubMed Central or publisher web sites.” It offers searches of journal citations and abstracts in medicine, nursing, dentistry, veterinary medicine, the health care system and preclinical sciences. It is a free resource from the National Center for Biotechnology Information (NCBI), at the National Library of Medicine (NLM) located at the National Institutes of Health (NIH).

MedlinePlus Native American Health provides links to health issues that affect Native Americans or American Indians. “MedlinePlus will direct you to information to help answer health questions. MedlinePlus brings together authoritative information from NLM [National Library of Medicine], the National Institutes of Health (NIH), and other government agencies and health-related organizations.”

The mission of the Centers for Disease Control and Preventions (CDC) Office for State, Tribal, Local and Territorial Support (OSTLTS) “is to achieve a healthier United States through a public health system comprising the CDC/Agency for Toxic Substances and Disease Registry CDC/ATSDR); state, territorial, and local health departments; and tribal governments (proposed).”

The National Rural Health Association (NRHA) “is a national nonprofit membership organization with more than 20,000 members. The association’s mission is to provide leadership on rural health issues. NRHA membership consists of a diverse collection of individuals and organizations, all of whom share the common bond of an interest in rural health”

The Office of Hawaiian Affairs (OHA) is under the direction of nine elected trustees and functions operationally as both a government agency with a strong degree of autonomy and as a trust. The purpose of OHA is “to provide the opportunity for a better life and future for all Hawaiians.” The OHA Mission Statement is “to mālama (protect) Hawai'i's people and environmental resources and OHA's assets, toward ensuring the perpetuation of the culture, the enhancement of lifestyle and the protection of entitlements of Native Hawaiians, while enabling the building of a strong and healthy Hawaiian people and nation, recognized nationally and internationally.”

The Native Hawaiian Healthcare website is dedicated to improving Native Hawaiian wellness by providing information on health and wellness. It is facilitated by Papa Ola Lokahi, whose mission is “to improve the physical, mental and spiritual health status and wellbeing of Native Hawaiians and others by advocating for, initiating and maintaining culturally appropriate strategic actions aimed at improving the physical, mental and spiritual health of Native Hawaiians and their ‘ohana (families) and empowering them to determine their own destinies.” The Hawaii Primary Care Association (HPCA) established in 1989, “is non-profit organization dedicated to fostering primary health care—basic medical, dental, and behavioral health, and health education services for all Hawaii residents. HPCA represents health organizations and providers focused on primary care for medically underserved populations.”

The Alaska Native Knowledge Network (ANKN) is an Alaska Rural Systemic Initiative (AKRSI) “partner designed to serve as a resource for compiling and exchanging information related to Alaska Native knowledge systems and ways of knowing. It has been established to assist Native people, government agencies, educators and the general public in gaining access to the knowledge base that Alaska Natives have acquired through cumulative experience over millennia.”

The Alaska Native Tribal Health Consortium (ANTHC) “is a non-profit health organization owned and managed by Alaska Native tribal governments and their regional health organizations. The Consortium was created in 1997 to provide statewide Native health services. To achieve its goals, ANTHC works closely with tribes, Native health organizations, the state of Alaska, and municipalities.“

The National Indian Health Board (NIHB) advocates on behalf of American Indians and Alaska Natives. NIHB “represents Tribal governments—both those that operate their own health care delivery systems through contracting and compacting, and those receiving health care directly from the Indian Health Service (IHS)… The NIHB continually presents the Tribal perspective while monitoring federal legislation, and opening opportunities to network with other national health care organizations to engage their support on Indian health care issues.”

National American Indian Veterans, Inc. (NAIV) “is devoted to the representation, advocacy and support of American Indians, Alaska Natives, Native Hawaiians, and American Samoan Veterans in improving their quality of life and that of their families.”