1. Department of Veterans Affairs Office of Rural Health HRSA / ORHP All Programs Meeting August, 2007Kara Hawthorne

2. Focus Areas 1. Legislation 2. What Rural Looks Like 2. Enrollees / Patients 4. OHR 5. VA System of care delivery

3. Legislation – The Office PL 109-461 Section 212. Congress Passed Late December ’06 VHA ADUSH for PP began work 2/07

4. PL 109-461 Section 212. –Establish the Office of Rural Health –Develop, refine, and promulgate policies, best practices, lessons learned, and innovative and successful programs to improve care and services –Research –To designate in each VISN a rural consultant –Perform an Assessment of Fee-Basis Health-Care Program –Plan To Improve Access and Quality of Care: Develop a plan to improve the access and quality of care for enrolled veterans in rural areas; including measures for meeting the 1) long term care and 2) mental health needs of rural veterans

5. Legislation – Congress Congress has the vision of outcomes, ORH is in the current phase of process development Additional Bills have included: S. 1146, S. 1233 (markup). HR 5524, HR 315, HR 1527, HR 2005, HR 2874 (markup), draft bill HR 2623. –General themes include: Establishing Rural research centers of excellence Providing grants for VSO’s to establish transportation Partnering with Community Health Clinics. (everyone know what those are? Federally Qualified Health Canters funded in part by HHS) Partner with IHS Consider Fee-based care Outreach Recently some collaboration with MH/Vet centers on MH services in rural areas. on outreach And of course, expand, expand, expand Services VAH leadership has testified on RH multiple times this year

6. Across the nation, this is the U/R/HR picture:

7. Veterans EOY 2006 38% of Enrollees are rural or highly rural 40% of patients are rural or highly rural Estimated 8.3% of the population are Veterans.

8. Distribution  States with the highest numbers of enrollees:  California, Florida, New York, Texas, Pennsylvania  States with the lowest numbers of enrollees:  Vermont, Wyoming, Alaska, N.Dakota, Rhode Island

9. ORH VHA has been providing care to rural veterans The ORH will coordinate services to enhance delivery of care, create greater access, engage in research, promulgate best practices….

10. How VHA Provides Care VHA System of Facilities –153 Hospitals –882 Outpatient Clinics (including CBOCs) –207 Vet Centers –135 VA Nursing Homes * Data as of Second Quarter FY07 – March 30, 2007

11. Telehealth VHA’s office of Care Coordination has programs that brings care into the veterans home – Care Coordination Home Telehealth –Telemental Health

12. Contact Information: Kara Hawthorne VHA Office of Rural Health Tele: (202) 273-8389 Kara.Hawthorne@va.gov