1. OFFICE OF TRIBAL GOVERNMENT RELATIONS Mary Culley Tribal Government Relations Specialist Southern Plains and Southeastern Region June 5, 2013

2. History Timeline on OTGR EO 13175 signed Nov 2000 and 2009 2009 EO resulted in VA Solicitation for Tribal Consultation 5 Milestones occurred as a result: –VA-IHS MOU 2010 –Creation of OTGR –VA Tribal Consultation Policy 2011 –VA-THP Reimbursement DTLL 2012 –VA-IHS Reimbursement Agreement 2012 2

3. 3 Training Summit Objectives Specifically, OTGR goals are: Increase Veteran Access to healthcare and benefits Economic Sustainability Tribal Consultation OTGR holds 3 to 4 training summits annually The goal of these meetings is to increase access to VA healthcare and benefits through informative presentations and interactive discussions about VA’s efforts to reach military Veterans in Indian Country. Western Region April 9-10, 2013, San Diego, CA Central Region, April 30-May 1, 2013, Rapid City, SD Eastern Region, May 7-8, 2013, Cherokee, NC

4. VA Organizational Chart 4 W. Scott Gould Deputy Secretary John R. Gingrich, Chief of Staff Dr. Thomas Sowers, Assistant Secretary Office of Public & Intergovernmental Affairs John M. Garcia, Deputy Assistant Secretary Office of Intergovernmental Affairs Stephanie E. Birdwell, Director Office of Tribal Government Relations Erika D. Moott Executive Officer Mary Culley OTGR Specialist Southern Plains/ Eastern Region Peter Vicaire OTGR Specialist Central / Eastern Region Terry Bentley OTGR Specialist Western Region L.HoMana Pawiki OTGR Specialist Southwest Region Eric K. Shinseki Secretary

5. Government to Government Partnership 5 American Indian/ Alaska Native Tribal Governments Office of Tribal Government Relations (OTGR) Veterans Benefits Administration (VBA) National Cemetery Administration (NCA) Veterans Health Administration (VHA)

6. Regional Listing 6 Peter Vicaire, OTGR Specialist, Minneapolis, MN Maine, Massachusetts, Connecticut, Rhode Island, New York, Michigan, Wisconsin, Iowa, Minnesota, North Dakota, South Dakota, Nebraska, Montana, Wyoming Mary Culley, OTGR Specialist, Oklahoma City, OK North Carolina, South Carolina, Florida, Alabama, Mississippi, Louisiana, Texas, Oklahoma, Kansas L. HoMana Pawiki, OTGR Specialist, Prescott, AZ New Mexico, Colorado, Utah, Arizona Terry Bentley, OTGR Specialist, Roseburg, OR Washington, Oregon, Idaho, Nevada, California, Alaska

7. 2013 Public Engagements April 17, 2013, Oklahoma City Area Inter-Tribal Health Board 5 th Annual Public Health Conference, Tulsa, OK April 26, 2013, VHA & VBA Enrollment session with Ponca Nation and surrounding tribes May 7-8, 2013, OTGR Eastern Region Training Summit, Cherokee, NC May 14-15, 2013, CMS Training Session, Dallas, TX May 17, 2013, HUD-VASH Lawton Stand Down State sponsored Veterans Representative Training tentatively set for May 2013 7

8. 2013 Public Engagements June 5, 2013, SAIGE National Training Program June 5, 2013, Sovereignty Symposium – Presenting on VA’ Veteran & Diversion Court Programs June 17-19, NIHB Public Health Summit, Hollywood, Florida June 27, 2013, Shawnee Tribal Stand Down (in connection with State, federal agencies, local community organizations and Tribal Nations/Health facilities) Oct 13-18, 2013, NCAI Annual Convention & Marketplace, Tulsa Convention Center, Tulsa, OK November 2013, Sarasota Chalk Festival, Sarasota, FL 8

9. VA-IHS Reimbursement Where are we now? Aug 24, 2012, VA sent Dear Tribal Leader Letter encouraging Tribal Health Programs to move forward with establishing agreements with VA. As a result: 42 Tribal Health Programs have submitted Letters of Interest and received orientation. –26 agreements in tribes in Alaska and Creek Nation entered into an agreement with VA in 2012 Since the IHS Agreement was signed Dec 5, 2012, 14 IHS facilities have received orientation –The first IHS site implementation plan was signed March 8, 2013 between Ft. Harrison VAMC, Montana and the Blackfeet (Billings) IHS Service Unit Totaling 83 Indian and Tribal Health Programs initiating collaboration and reimbursement discussions between their agencies (includes agreements with Alaska tribes and Creek Nation) 9

10. What is the Process? Step 1: Submit your letter of interest to the OTGR Tribal website: Tribal.agreements@va.gov Tribal.agreements@va.gov Step 2: The Department of Veterans Affairs Chief Business Office will pull your requests and respond back to you regarding your request Step 3: The Chief Business Office will contact the appropriate VA Medical Center to initiate the process 10

11. Examples of How Tribes are Working with local VAMCs OKC VAMC collaborating with Clinton Indian Clinic to provide physician direct consult capability Oklahoma, IHS and Tribal Health staff working with VA, State, and local agencies on Homeless Stand Down Programs Touring VA Medical Centers, then inviting VAMC staff to tour their health facilities Chinle and VA collaborated to build a VA clinic within the Chinle IHS Clinic VAMC providing a staff person once a week to assist and enroll veterans into VHA programs Tribes inviting Veterans Benefits administration to do enrollments in their community centers Oneida Nation Tribal Veteran Rep processed approximately $1 million worth of claims in one year for veterans in his tribe Cherokee Tribe, NC, and the Asheville VAMC, share salary costs for a position to service Indian veterans out of the Cherokee Indian Hospital There are approximately 4 National Tribal Cemeteries as a result of awarded grants: 1) Rosebud Sioux, 2) Oglala Sioux, 3) Kurek Tribe of California and 4) Pasqui Yaqui Tribe 11

12. Statistics 12 Active Duty, Reserve, and National Guard Service members by Age and Race Age Group AIAN Percent All Other Races Percent 17 to 24 years 15,230 48.9 773,368 34.6 25 to 34 years 10,997 35.3 826,361 37.1 35 to 44 years 3,790 12.2 456,799 20.4 45 to 54 years 1,006 3.2 156,974 7.0 55 to 64 years 131 0.4 19,900 0.9 65 to 74 years 1 0.0 113 0.0 Unknown 0 0.0 19 0.0 Total 31,155 100.0 2,235,534 100.0 Source: Department of Defense, Active Duty Master Personnel File; Reserve Components Common Personnel Data System (RCCPDS), 2010. Prepared by the National Center for Veterans Analysis and Statistics.

13. Statistics 13 AI/AN Active Duty, Reserve, and National Guard Service members by Sex and Race Sex AIAN Percent All Other Races Percent Male 25,128 80.7 1,886,043 84.4 Female 6,027 19.3 349,487 15.6 Unknown 0 0.0 4 0.0 Total 31,155 100.0 2,235,534 100.0 Source: Department of Defense, Active Duty Master Personnel File; Reserve Components Common Personnel Data System (RCCPDS), 2010. Prepared by the National Center for Veterans Analysis and Statistics.

14. Statistics 14 Veterans by Age and Race Age Group AIAN Percent All Other Races Percent 17 to 24 years 3,305 2.1 343,416 1.6 25 to 34 years 10,386 6.7 1,383,808 6.4 35 to 44 years 20,946 13.6* 2,188,407 10.1 45 to 54 years 35,234 22.8* 3,315,765 15.3 55 to 64 years 42,542 27.6* 5,297,053 24.5 65 to 74 years 24,838 16.1* 4,281,345 19.8 75 years and older 17,054 11.1* 4,811,086 22.3 Total 154,305 100.0 21,620,880 100 Source: U.S. Census Bureau, American Community Survey, Public Use Microdata Sample, 2010. Prepared by the National Center for Veterans Analysis and Statistics

15. Statistics 15 Source: U.S. Census Bureau, American Community Survey, Public Use Microdata Sample, 2010. Prepared by the National Center for Veterans Analysis and Statistics

16. How Can you Help Us Help You? 16 If you are a Veteran consider enrolling in the VA Healthcare System and local Veterans Benefits Administration Office Support coordination of outreach Native American Direct Loan Programs – spread the word Veteran Database – support tribes in identifying their Veteran population Knowledge of Homeless Veteran Population Know your Veterans and seek to learn about their needs

17. Contact Information Southern Plains & Eastern Regions Department of Veteran Affairs Office of Tribal Government Relations 921 N.E. 13 th Street Oklahoma City, OK 73104 Mary.Culley@va.gov Phone (405) 456-3876 www.va.gov/tribalgovernment 17