Rural, American Indian Veterans Health Care Improvement Act of 2009

Rural, American Indian Veterans Health Care Improvement Act of 2009 - Directs the Secretary of Veterans Affairs (VA) to assign an Indian Veterans Health Care Coordinator for each of the ten VA facilities that serve communities with the greatest per capita number of Indian veterans. Includes among Coordinator duties: (1) improving outreach to tribal communities; (2) coordinating the medical needs of Indian veterans on Indian reservations with the Veterans Health Administration (VHA) and the Indian Health Service (IHS); and (3) acting as an ombudsman for Indian veterans enrolled in the VHA health care system.

Directs the Secretary to enter into a memorandum of understanding with the Secretary of the Interior to ensure the electronic transfer of health records of Indian veterans between IHS and VA facilities.

Requires the VA Secretary and the Secretary of Health and Human Services (HHS) to report jointly to Congress on the advisability of the joint VHA-IHS establishment and operation of health clinics to serve populations of Indian reservations, including Indian veterans.