Dear Tribal Leader and Urban Indian Organization Leader:

The Veterans Health Administration (VHA) and the Indian Health Service (IHS) are writing to initiate Tribal Consultation and Urban Confer to seek your input and recommendations on the first-ever Draft Annual Operational Plan for fiscal year (FY) 2022 for the VHA-IHS Memorandum of Understanding (MOU) (PDF, 6 pages).

By letter dated October 21, 2021, we jointly informed you that VHA and IHS have signed a new MOU aimed at improving the health status of American Indian and Alaska Native (AI/AN) Veterans. Built on nearly 2 decades of experience, the MOU establishes a framework for coordination and partnership between VHA and IHS to leverage and share resources and investments in support of each organization’s mutual goals.

We take great pride in our progress and accomplishments to date as result of these collaborations. Going forward, on an annual basis, we seek to further refine our efforts through the use of an Operational Plan to guide our work. An Operational Plan focused approach also allows us to incorporate the recommendation from the U.S. Government Accountability Office (Publication No. GAO 19-291) to develop successful performance measures to track the success of this interagency collaboration to improve care for AI/AN Veterans. This ongoing commitment will also be demonstrated by actively engaging in Tribal Consultation and Urban Confer each year to ensure your recommendations and input update the Operational Plan.

Now that we have completed an initial Draft Annual Operational Plan for FY 2022, we welcome your perspective and guidance. We have enclosed a copy for your reference. Your input will assist us in making improvements to the activities, initiatives and metrics of the Draft Annual Operational Plan for FY 2022 that align with the mutual goals and objectives of the MOU.

Please send your written comments and recommendations on the Draft Annual Operational Plan for FY 2022 no later than 60 days from the date of this letter:

By E-mail to both addresses with the subject line of Draft Annual Operational Plan:

By Postal Mail to both addresses:

  • Ms. Elizabeth A. Fowler
    Acting Director
    ATTN: Draft Annual Operational Plan
    Indian Health Service
    5600 Fishers Lane, Mail Stop: 08E86
    Rockville, MD 20857
  • Office of Intergovernmental Affairs (075F)
    Department of Veterans Affairs
    ATTN: Draft Annual Operational Plan
    810 Vermont Avenue, NW, Suite 915G
    Washington, DC 20420

VHA and IHS will host an upcoming tribal consultation webinar to solicit feedback on the Draft Annual Operational Plan. Once a date and time are confirmed, we will announce the details for the tribal consultation webinar in the federal register.

Thank you for helping advance this partnership and enhance care delivery for AI/AN Veterans. We look forward to your input on the Draft Annual Operational Plan for FY 2022.


Shereef Elnahal, M.D.
Under Secretary for Health

Elizabeth A. Fowler
Acting Director Indian Health Service


Draft Operational Plan to the MOU dated April 2022 (PDF, 18 pages)

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Published on Aug. 31, 2022

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