Abstract: Introduction: Native Americans enlist in the military at the highest per capita rate among racial or ethnic groups. Approximately 49% of Native Veterans live in rural areas, facing multiple barriers to health care and a high prevalence of mental health concerns. Video telehealth can improve access to care, and Veterans Health Administration has developed a culturally centered telehealth model for native Veterans. Personalized Implementation of Virtual Treatments for Rural Native Veterans (RNVs), an approach emphasizing cultural safety, helped expand the impact of existing telehealth clinics. Methods: Recent efforts included a systematic program review and mixed-methods evaluation to identify logistical and administrative considerations for implementation and outreach. Results: Key lessons emphasize protected clinical time for specific regions, building sustained community partnerships, collaborating with leadership, and streamlining messaging to improve patient engagement. Conclusions: These practices expand care access and quality for RNVs, with potential application to other populations.