Reaching Out to Tribal Governments


This week, Ms. Stephanie Birdwell joins VA as the Director for the Office of Tribal Government Relations. I initiated this new program within The Office of Public and Intergovernmental Affairs (OPIA) because there is a real need to enhance communication with tribal governments about services available to American Indian and Alaskan Native Veterans. Our initiative to Enhance Partnerships with Tribal Governments will see immediate, significant impact for these Veterans.

Collaborating with federally recognized tribes, many of which are located in rural and underserved areas remains a critical task of the Department. As the nation moves forward with healthcare reform and economic recovery, VA already has funded programs that could bring immediate relief to this population. American Indians, Alaska Natives (AIANs) and Pacific Islanders are second to none in their military service but are among the least likely to benefit from opportunities found in the continental states. Twelve percent of AIANs in the US are Veterans, one of the highest per capita populations of Vets in any ethnic group. Despite their high rates of military service, AIANs are also one of the most vulnerable populations. Approximately 25 percent of AIANs live in poverty and they have higher obesity (nine percent) rates than any other racial/ethnic group, according to the Center for Disease Control. 33 percent of Native Americans had no health insurance coverage in 2007, and of those with coverage, 24 percent relied on Medicaid.

With the Office of Tribal Government Relations under Ms. Birdwell’s leadership, VA has an opportunity to practice good government. If we can increase access to VA healthcare, we can reduce AINA Veterans’ reliance on Medicaid as well as increase preventative care that reduces later VA medical costs. For example, one of OPIA’s current efforts is to jointly coordinate access for VA’s mobile clinics and mobile Vet Centers to tribal lands. This is key to fighting obesity among American Indians, which is associated with diseases such as diabetes, cardiovascular disease, hypertension, coronary heart disease and cancer. A 2003 study on diabetes estimates that it costs $13,243 per patient to treat diabetes, compared to $2,560 for patients without diabetes. If 91,920 AINA Vets are suffering from obesity (24 percent of the 383,000 existing AINA Vets), VA is faced with a potential cost of $1.2 billion just to treat these Veterans for diabetes alone.

If we can increase access for VA preventative healthcare and keep just one percent of the 91,920 AINA Vets who are at risk from obesity-related illness from developing diabetes, VA will save $12 million. Most importantly, however, we will be improving the lives of a population of Veterans who have shown their bravery and dedication to this nation. It’s only right that we make sure that they have access to the services and benefits that they have earned.

L. Tammy Duckworth is a former VA Assistant Secretary for Public and Intergovernmental Affairs.


Tammy Duckworth


  1. Robert L. Primeaux, Ph.D.    

    I’m sorry but I did not mention the following: I’m an enrolled of the Standing Rock Sioux Tribe of Fort Yates, North Dakota. I served in Vietnam with Delta Troop, 2nd/17th Cavarly, 101st Airborne Division in 1969-1970.

  2. Robert L. Primeaux, Ph.D.    

    I and many other American Indian Veterans around the country want Stephanie Birdwell-Bighorn replaced. She has no exerpience working with Indian Veterans and Veterans in general,and no financial or administrative experience. She was on the verge of being fired by the Department of Indian Education for incompetence, then hired by the VA.
    Thank you.

  3. Bill Ferguson    

    Sounds like another Obama social justice program to me.

  4. Lana Gravatt    

    I am Dakota and this is good yet we must think as a whole, all veterns deserve free health care and freedom of medicine, along with education and housing,the effects of war on the spirit are great, a soldier not only puts his physical existance at risk but his spiritual as well, why is it so hard for western thought to not recognize the spirit is what matters. After all my people have survived through it amazes me that even now I speak english and when I say the earth is alive in all its property, most people cant grasp it, this knowledge and way of life is why the Native Americans return home and are able to live again after war…

  5. Roanld Burgess    

    I am a veteran and native american. My question is , if a veteran becomes diabetic, can a claim be filed for disability.

    1. Tammy Duckworth    

      It depends on whether the diabetes is linked to your military service. For example, if you served in country in Vietnam, you may have a claim as diabetes is now a presumptive illness from Agent Orange exposure. your best bet is to speak with a Veterans Service Officer either at a VA regional office or at a veterans organization.

  6. Paula Wisdom Snow, LCSW    

    Congratulations to my friend Stephanie, she will be an excellent resource for our Tribal Veterans and an asset to the VA!
    From Paula
    Member: American Legion Ladies Auxillary Unit 300, New Town ND
    (Little Shell Unit)

  7. Glenn Sawinski    

    Re: Norman Peacock. I agree. I have also been waiting for a long time as well as my father who is a WWII Vet!

  8. Dan McGregor    

    What are the plans to assist the Native Hawaiians and other Pacific Islanders?

    1. Tammy Duckworth    

      Hi Dan

      As a kama’aina myself, the needs of our Pacific Islander and Hawaiian Veterans are close to my heart. I actually deployed to Iraq along with the Hawaii National Guard, which also included our Samoan brothers. This office will also work to support our Pacific Islander Veterans. We are already reaching out to both Governor Abercrombie and to the Office for Hawaiian Affairs.


      Nana na moe

  9. WIL Rachor    

    I’m a Police Officer and the Chairman of the Native American Veterans Advisory Council/Native American EEO Special Emphasis Program Manager at the Roseburg VAMC. I have been working with my tribe (Cow Creek Band of the Umpqua Indians Roseburg, Oregon) and other 8 Oregon tribes. We are just re-starting our program here. Do they have any information or training that I could add to my program here ( Thank you

    1. Tom Blankenship    

      I am a Native American because I have my roll number that the federal government manufactured but now I’m not a Native American because the federal government doesn’t aknowledge its own rules and regulations (federally recognized)???????????

    2. Tammy Duckworth    

      Please reach out to Stephanie Birdwell. She is in VA’s global. i am sure she would be happy tochat with you about your concerns.

  10. Norman Peacock    

    Thats all well and fine but a lot of vets have been waiting long periods of time on pending disability claim,including myself.Should we noy clear up the back-log first!!!

    1. Tammy Duckworth    

      First, I agree that the backlog is simply unacceptable. We’ve made a lot of headway in the past 24 months since Secretary Shinseki has been in office but we still have a long way to go. This office will help us to keep our nation’s promise to our native American Veterans. They have also earned benefits from their service and deserve to have access also.

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