VA Update Northwest Portland Area Indian Health Board Quarterly Meeting Portland, OR January 16, 2018 Introduction

VA Secretary’s Five Priorities - VA’s Strategic Framework

Community Care Coordination Existing reimbursement agreements will expire on June 30th 2019 – discussions on follow-on agreements will be conducted. Care coordination is largely a local matter – we need to know where this is not working well. Building relationships between tribes/IHS and VA is key. Only direct care is reimbursed under existing agreements. Future ability to reimburse for purchased care is unknown; we welcome collaboration with one or more tribes to improve coordination of VA purchased care.

Tribal Health Program Contract with Cerner to purchase a new Electronic Health Record is being pursued (no estimated award date) Eligibility for VA healthcare benefits is defined in legislation; we can only apply those criteria to assess whether a Veteran is eligible. Enrollment staff at the local VA Medical Center can assist with this www.va.gov is a good resource Pharmacy billing questions

Tribal Health Program (continued) GAO reports on VA-IHS MOU VA training for coordinating services - addressed at local levels Cultural Competency – OTGR office working on training module Veterans Choice Program (VCP) – describe and update On Dec 22nd VCP funding was extended ($2.1 billion); should last until mid-2018 Emergency MH care expanded to OTH-discharged Vets last spring Latest EO offers 1 year MH care to all newly discharged Vets Pending legislation: CARE Act Congressional interest in expanding VA Caregiver Support Program to earlier Vet cadres (earlier than 9/11 gen)

VA Office of Tribal Government Relations Update VA releasing their 2017 Executive Summary Report regarding engagement with Indian Country Going through concurrence process now Nationwide Outreach Campaign in Indian Country for Veterans with presumptive disabilities DTLL sent out October 30, 2017 20 Tribes responded – 6 within my region (AK, CA, NV, OR, WA) VA OTGR engaging in 2018 outreach across Indian Country Veteran Summits, Regional Tribal Meetings, Veteran Training, Tribal Site Visits

Questions Regarding Reimbursement Agreements Bill Murray, VISN 20 Strategic Planner, William.Murray3@va.gov, 360-567-4684 Terry Bentley, Tribal Government Relations Specialist, Pacific District (OR, WA, CA, ID, NV, CA, AK) Terry.Bentley@va.gov, 541-440-1271 VHA Chief Business Office for Purchased Care, tribal.agreements@va.gov It’s been our pleasure to go over this presentation with you today. Here’s our contact information. I’ll now open it up for any questions.