1. VETERANS HEALTH ADMINISTRATION (VHA) OFFICE OF RURAL HEALTH (ORH) - 1 PTSD Telemental Health Clinics for Northern Plains American Indian Veterans

2. VETERANS HEALTH ADMINISTRATION (VHA) OFFICE OF RURAL HEALTH (ORH) - 2 Technology for Rural Veterans : The Bridge One of the biggest telemedicine/telemental health systems in the world – Videoconferencing – In-home monitoring and treatment (care coordination) – Growing web resources – Involved in developing technologies

3. VETERANS HEALTH ADMINISTRATION (VHA) OFFICE OF RURAL HEALTH (ORH) - 3 VISN 19 American Indian Telemental Health Clinics Video-conferencing based VA PTSD treatment for Rural Native Veterans Began in 2001 as multi- organizational pilot project (VA, University, Tribal) Partners: VRHRC-WR Native Domain, VISN 19, Office of Telemedicine Services, and Tribal Partners From Denver 9 sites serving 16 tribes

4. VETERANS HEALTH ADMINISTRATION (VHA) OFFICE OF RURAL HEALTH (ORH) - 4 Telemental Health Clinics Shared Model Weekly clinics offering medication management, individual and group psychotherapy with PTSD focus VA Electronic Medical Record Providers at Central Location Telehealth/Tribal Outreach Worker (TOW) Telehealth/Tribal Outreach Worker (TOW) - Patient recruitment, operation of videoconferencing equipment, liaison for patient needs Collaboration with Tribal Veterans (TVR) Representative Program

5. VETERANS HEALTH ADMINISTRATION (VHA) OFFICE OF RURAL HEALTH (ORH) - 5 Clinic Models Patient Site Models VA Outreach Clinic Tribal Veterans Center Indian Health Service Tribal Program Linked Programs/Services Traditional Healing Veteran Center Support TVR Medical Services

6. VETERANS HEALTH ADMINISTRATION (VHA) OFFICE OF RURAL HEALTH (ORH) - 6 Clinical Treatment Offered Medications – Mail order pharmacy – Medication monitoring (lab coordination) Individual Psychotherapies – Evidence based, supportive and dynamic Family Therapy – Education, marriage counseling, evidence-based Case Management – Resource and benefit linkage Group Therapy – Educational, supportive and dynamic – Content = community events, grief, environmental challenges

7. VETERANS HEALTH ADMINISTRATION (VHA) OFFICE OF RURAL HEALTH (ORH) - 7 Administrative Lessons Learned Multi-system collaborations are possible but need “right” collaborations Adaptation to specific community Understanding local resources and relationships with local personnel Attention to cultural issues, including rural

8. VETERANS HEALTH ADMINISTRATION (VHA) OFFICE OF RURAL HEALTH (ORH) - 8 Tribal Veterans Representative (TVR) Program Director, Buck Richardson Established in 2001 National Model for Community Outreach TVRs are outreach workers who function as liaisons between Veterans, the Veterans Administration (VA), and other state and local community organizations Appointed and supported by their Tribal governments Formally trained by the VA as volunteers, not VA employees

9. VETERANS HEALTH ADMINISTRATION (VHA) OFFICE OF RURAL HEALTH (ORH) - 9 Tribal Veterans Representative (TVR) Program Generally American Indian and Alaska Native Veterans who live in the communities they serve Help Veterans access their VA benefits and assist them with filing claims and any other VA services they may need Provide information, outreach and assistance to Veterans and their families Annual training is provided by the VA at Ft. Harrison in Helena, Montana

10. VETERANS HEALTH ADMINISTRATION (VHA) OFFICE OF RURAL HEALTH (ORH) - 10 CONTACT INFORMATION Jay H. Shore, MD, MPH | Native Domain Lead Veterans Rural Health Resource Center_Western Region Department of Veterans Affairs Office of Rural Health www.ruralhealth.va.gov/native Centers for American Indian and Alaska Native Health Mail Stop F800, 13055 East 17th Avenue, Room 347 Aurora, CO 80045 | Phone: 303-724-1465, Fax: 303-724-1474 E-mail: james.shore@va.gov and jay.shore@ucdenver.edujames.shore@va.govjay.shore@ucdenver.edu WJ 'Buck' Richardson Jr | Minority Outreach Coordinator VA Rocky Mtn Healthcare (VISN 19 ) 3687 Veterans Dr. |PO Box 1500 Ft. Harrison, MT 59636 | Phone: 406.447.7547, Fax: 406.447.7771