1. VJ Periyakoil Productions presents

3. Nancy Dailey, MSN, RN-BC Deputy Director, Veterans Rural Health Resource Center—Western Region, Salt Lake City, Utah VJ Periyakoil, MD Course Director & Producer Partnering with the Rural Community

4. Rural Health VJ Periyakoil, MD, Course Director http://ruralhealth.stanford.edu “Community as Partner” Model

5. Rural Health VJ Periyakoil, MD, Course Director http://ruralhealth.stanford.edu Elko, Nevada 250 miles from SLC VA Different time zone Adverse winter weather

6. Rural Health VJ Periyakoil, MD, Course Director http://ruralhealth.stanford.edu Elko, Nevada High mountain passes Estimated veteran population in area = 4,000 Enrolled veteran population = 211 Agriculture and mining

7. Community Engagement

8. Rural Health VJ Periyakoil, MD, Course Director http://ruralhealth.stanford.edu Elko County Community-Based Partnership Veteran Service Organizations (VFW, American Legion) Elko County Commission Great Basin College

9. Rural Health VJ Periyakoil, MD, Course Director http://ruralhealth.stanford.edu University of Nevada, Reno Elko County Community-Based Partnership Nevada Health Systems

10. Rural Health VJ Periyakoil, MD, Course Director http://ruralhealth.stanford.edu Town Hall Meetings Community members Veteran Service Organizations Local medical providers: private and public Local and state policy makers Academic institutions Salt Lake VA Health Care System leadership

11. Rural Health VJ Periyakoil, MD, Course Director http://ruralhealth.stanford.edu Agenda Focus Care for Veterans Care for: Uninsured Underinsured Medically-needy

12. Rural Health VJ Periyakoil, MD, Course Director http://ruralhealth.stanford.edu “Negotiation with VA” Proposal for a CBOC Feasibility assessment Evaluation of Telehealth as a delivery mechanism (home and facility based) Identified gaps/barriers Develop a joint business plan with community leadership

13. Rural Health VJ Periyakoil, MD, Course Director http://ruralhealth.stanford.edu Shared Resource Allocation VA Subject matter expertise Curriculum development Provider Telehealth technology CPRS Office supplies/equipment TV/DVD Utilities Community Space, IT, nurse faculty Great Basin College Furniture University of Nevada Marketing VSOs, policy makers, local media, community Draw Station, Exam Room Local public healthcare clinic

14. Rural Health VJ Periyakoil, MD, Course Director http://ruralhealth.stanford.edu Elko Telehealth Clinic

15. Rural Health VJ Periyakoil, MD, Course Director http://ruralhealth.stanford.edu Evaluation Improved access for original 211 enrollees Increased unique veteran enrollment to >400 Improved patient satisfaction

16. Rural Health VJ Periyakoil, MD, Course Director http://ruralhealth.stanford.edu Evaluation Expansion of services: Mental Health Specialty Consultations

17. Rural Health VJ Periyakoil, MD, Course Director http://ruralhealth.stanford.edu Increased space (400 sq. ft. to 1200 sq. ft.) Jobs in the community Evaluation

18. Examples of Community Resources

19. Rural Health VJ Periyakoil, MD, Course Director http://ruralhealth.stanford.edu National Organization of State Offices of Rural Health Mission Statement NOSORH promotes the capacity of state offices of rural health to improve health care in rural America through leadership development, advocacy, education, & partnerships. www.nosorh.org Purpose Support the development of state and community leadership for rural health Facilitate partnerships at the national and state levels to enhance sharing and collaboration Help communities promote a healthy rural America through enhanced access to quality healthcare services

20. Rural Health VJ Periyakoil, MD, Course Director http://ruralhealth.stanford.edu State Community Resources State Offices of Veteran Affairs http://www.va.gov/statedva.htm Rural Assistance Center http://www.raconline.org/ Rural Healthy People 2010 http://www.srph.tamhsc.edu/centers/rhp2010 /

21. Rural Health VJ Periyakoil, MD, Course Director http://ruralhealth.stanford.edu VA Rural Health Resources Office of Rural Health http://vaww.ruralhealth.va.gov/

22. Rural Health VJ Periyakoil, MD, Course Director http://ruralhealth.stanford.edu VA Rural Health Resources Veterans Rural Health Resource Centers Eastern Region (VISNs 1–10) Director: Ryan Lilly, ryan.lilly@va.gov Deputy Director: Alan West, PhD, alan.west@va.gov

23. Rural Health VJ Periyakoil, MD, Course Director http://ruralhealth.stanford.edu VA Rural Health Resources Veterans Rural Health Resource Centers Central Region (VISNs 11–17, 23) Director: Peter Kaboli, MD, peter.kaboli@va.gov Deputy Director: Mary Charlton, PhD, nancy.daily@va.gov

24. Rural Health VJ Periyakoil, MD, Course Director http://ruralhealth.stanford.edu VA Rural Health Resources Veterans Rural Health Resource Centers Western Region (VISNs 18–22) Director: Byron Bair, MD, byron.bair@va.gov Deputy Director: Nancy Dailey, MSN, RN-BC nancy.dailey@va.gov

25. For more information on rural veterans, contact: VJ Periyakoil, MD periyakoil@stanford.edu ruralhealth.stanford.edu