VA OTGR Update for the Northwest Portland Indian

VA OTGR Update for the Northwest Portland Indian Area Health Board - Quarterly Board Meeting - hosted by Lummi Nation January 20, 2016

VA ~ Office of Tribal Government Relations Terry Bentley Terry. Bentley@va. gov 541 -440 -1271 2 Mary Culley Mary. Culley@va. gov 405 -456 -3876 Clay Ward David. Ward@va. gov 202 -461 -7445 Homana Pawiki Lo. Rae. Pawiki@va. gov 928 -445 -4860 x 5306 Peter Vicaire Peter. Vicaire@va. gov 651 -405 -5676 http: //www. va. gov/tribalgovernment/

VA ~ Office of Tribal Government Relations

VA ~ Office of Tribal Government Relations (VHA) Veterans Health Administration (VBA) Veterans Benefits Administration (compensation; pension; education; insurance; home loan guarantees; vocational rehabilitation) (NCA) National Cemetery Administration (national cemeteries; burials; plots; tombstones) 4

VA ~ Office of Tribal Government Relations • VHA is one of the largest integrated healthcare systems in the world: 150 VA Medical Centers (VAMCs); 819 Community Based Outpatient Clinics (CBOCs); 135 Community Living Centers (nursing homes); 47 Residential Rehabilitation Programs; 300 Readjustment Counseling Centers (Vet Centers) • 56 VBA Regional Offices • 131 VA National Cemeteries / 5 Tribal Cemeteries • It employs over 21, 000 mental health professionals and over 300, 000 employees (2 nd largest cabinet agency) • 9. 11 M total enrolled Veterans in VA healthcare 5

VA ~ Office of Tribal Government Relations 6

VA ~ Office of Tribal Government Relations 7

VA ~ Office of Tribal Government Relations Alaska Native/American Indian Contribution The American Revolution Initially, neither side wanted to use Native warriors who they believed did not kill in “civilized” ways. But George Washington recognized their value, stating to the Continental Congress that they could “be made of excellent use as scouts and light troops. ” In 1776, Congress authorized him to enlist 2000. Eventually, 5, 500 (of 250, 000 – 2. 2%) fought. The War of 1812 Indigenous warriors again fought for and against Britain and the United States. The American Civil War Almost 20, 000 Indians served in Confederate and Union forces on both the land sea. More than 15, 000 fought for the Confederates while over 4000 fought for the Union. World War I About 13, 000 Native Americans served in the U. S. military during the war. 75% were volunteers. 8

VA ~ Office of Tribal Government Relations Alaska Native/American Indian Contribution World War II 44, 000 Native Americans (more than 10% of population) saw active duty and for every one drafted, one and a half volunteered. In some tribes up to 70% of the men were in the military Korean War Over 10, 000 American Indians served – again at a rate that far exceeded their percentage of the overall American population. Four were awarded the Congressional Medal of Honor Vietnam War Over 42, 000 American Indians served – more than 90% of them, volunteers OEF/OIF/OND In November 2012, DOD reported that 22, 861 were serving in the armed forces. 9

VA ~ Office of Tribal Government Relations 10 Total Estimated American Indian/Alaska Native Population 154, 305 Male 137, 335 Female 16, 970

VA ~ Office of Tribal Government Relations Key Concerns Access: Access to healthcare continues to be a major concern. Homelessness: On a single night in January 2015, more than one in ten homeless adults was a Veteran – 47, 725 homeless Veterans. The majority suffer from substance abuse, mental illness, or co-occurring disorders. Unemployment – unemployment rate for post 9/11 Veterans is 10%, which is higher than the national average of 5. 1% - August 2015. Veteran Suicide - 22 veterans commit suicide every day in the United States. Military Sexual Trauma (MST) In 2010, over 19, 000 sexual assaults were reported in the military - 108, 121 male and female veterans screened positive for military sexual trauma. Substance Abuse: One in six post 9/11 veterans (345, 000) has a substance abuse problem. Veteran Mental Health Disorders - Of the over 2. 4 million veterans of the wars in Iraq and Afghanistan, approximately 460, 000 (20%) suffer from post-traumatic stress disorder (PTSD) or major depression. 11

VA ~ Office of Tribal Government Relations Women Veterans • Serving in higher numbers than ever before – approximately 14% of all active duty soldiers. • VA is seeing a great influx as a result. • Women Veteran Program Coordinators are at each VA site to help facilitate care for Women Veterans. • Native Women Veterans proportion is higher than that of female Veterans of other races (11. 5% vs. 8. 0% respectively) 12

VA ~ Office of Tribal Government Relations OTGR Update VA / THP / IHS Reimbursement Agreement: 85 THP Agreements; $30 M in reimbursement impacting 6, 500 unique Veterans. 2015 VA Executive Summary Report: VA will release in 2016 highlighting the agency’s work with tribal governments in 2015. HUD/VASH Homeless Vouchers Released to Indian Country: 500 Vouchers, approximately $5. 9 million dollars distributed to tribal grantees. Tribal Veteran Representative (TVR) Training: OTGR continues to provide engagement with TVR’s and hosted training in September 2015. Another training scheduled for April 2016 hosted by Confederated Tribes of Umatilla. Veterans Summits: OTGR continues to engage with tribal communities to bring services about VA benefits and services to Indian Country. National / Regional Engagement: NCAI, ATNI, NIHB, NPIAHB and other boards. 13

VA ~ Office of Tribal Government Relations Contact Info Stephanie Birdwell - Director VA Office of Tribal Government Relations: Stephanie. Elaine. Birdwell@va. gov (202) 461 -4851 Terry Bentley- Tribal Government Relations Specialist, VA Office of Tribal Government Relations: Terry. Bentley@va. gov (541) 440 -1271 14