Johnson Calls for More Collaboration between IHS, VA

Native American veterans should be able to seek health care through either the Department of Veterans Affairs or Indian Health Service instead of being bounced between the two federal agencies, Sen. Tim Johnson said Tuesday.

Johnson, speaking at a field hearing at the Journey Museum in Rapid City, called on representatives from both agencies to work harder to collaborate and provide care to Native Americans.

“Too often I hear stories from Native American vets that they show up at IHS facilities only to be told they should be going to the VA and that there isn’t any communication,” Johnson said at the meeting. “A new federal memorandum of understanding is supposed to address this issue.”

Johnson sought specific answers about turning away patients from Randy Grinnell, deputy director of IHS, who testified at the hearing.

“That’s the most challenging aspect we’re trying to improve on. The (Veterans Health Administration) is considered an alternate resource for IHS, if they have to be referred out for care we have to exhaust other opportunities first,” Grinnell said. “We’ve continued to address training with IHS and VHA staff in terms of what services are available.”

When asked by reporters to provide more details about rules for admission at IHS facilities, Grinnell said he could not comment without permission from the Department of Health and Human Services.

Robert Jesse, principal deputy secretary for health for the VHA, said access to care is often based on enrollment in the VA’s medical program. He said although the country has 24 million veterans, only 8 million are enrolled for the benefits and 6.2 million get care through VHS.

Donald Loudner, national commander of the National American Indian Veterans Inc., called IHS “woefully underfunded” since its creation. At the same time, he pointed to transportation challenges since VA hospitals are hundreds of miles from reservations.

“In an attempt to stretch the health-care dollar, both the IHS and DVA hospitals have denied services to our veterans insisting they go to the other agency for treatment,” Loudner said. “These proud veterans in some instances use their very last dollar to travel to a facility for care.”

Although he hoped the new agreement signed last November would change the culture of denying care, Loudner said he has been disappointed with the slow progress.

Johnson and others addressed the notion that “you better get sick before June in Indian Country.” The phrase comes from the IHS budget that begins with the fiscal year in October and generally has dried up by June, leaving many without funds for care.

This year’s funding should last until September, but the entire program still has an $860 million shortfall, according to testimony from Grinnell.

“It’s terribly frustrating. We’re making progress on collaboration – they’re trying but they have a long ways to go,” Johnson said. “The current effort is to try to arrange coordination between payments and reimbursements that goes to one or the other.”

John Yellow Bird Steele, president of the Oglala Sioux Tribe, attended the hearing and said he was happy with the progress made by the two agencies.

He said several years ago a man attempted to get care at and IHS clinic on Pine Ridge and was directed to the VA but died of a heart attack while making the trip.

“Sen. Johnson bringing this hearing to Rapid City and getting the Indian Health Service and the VA to voice what they’re doing in public puts the pressure on them to continue and really get it done,” Yellow Bird Steele said. “I know that it’s not going to happen at the snap of a finger, but I’m encouraged to hear they’re trying to work together.”

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