Mission

The mission of ORH is to improve access and quality of care for enrolled rural and highly rural Veterans by developing evidence-based policies and innovative practices to support the unique needs of enrolled Veterans residing in geographically remote areas.

Background

About 3.4 million Veterans (41% of total) enrolled in the Department of Veterans Affairs (VA) Health Care System live in rural or highly rural areas of the country. These Veterans make up a disproportionate share of service members and comprise about 39% of the enrolled Veterans who served in Iraq and Afghanistan, many of whom are returning to their rural communities.

Individuals living in rural areas have traditionally been underserved with regard to health care access. The reasons for this are multiple and varied, but mainly stem from the need to travel long distances to health care facilities, lack of health insurance, lack of specialized care and an inadequate number of health care providers working in rural areas. As a result, rural populations tend to be in poorer health; in fact, a study by the Office of Health and Human services estimates that half of the adults living in rural areas suffer from a chronic health condition. With regard to rural Veterans, there are the additional health complications associated with combat exposure such as PTSD, depression, and traumatic brain injury.

In order to better serve rural Veterans, the VA created the Office of Rural Health in 2007. Located in the Office of the Assistant Deputy Undersecretary for Policy and Planning of the Veterans Health Administration (VHA), the mission of ORH is to improve access and quality of health care for all Veterans through a combination of community based clinic expansion, increased partnerships with non-VA rural providers, increased use of telemedicine and information technology and a new effort to recruit and retain health care providers to rural areas.

ORH Organizational Structure

The Office of Rural Health is headquartered in Washington, DC. It is organizationally located in the VHA Office of the Assistant Deputy Under Secretary for Policy and Planning. Acting Director Byron Bair, MD and Deputy Director Sheila Warren, MPH, RN, CPHQ along with their staff, both at headquarters and in the field, direct National ORH activities and communications as well as oversee the budget and performance of all ORH-funded programs across the VA system.

Veterans Rural Health Resource Centers

Eastern Region (VRHRC - ER)

The Eastern Region Center is located in three different VA medical centers: Gainesville, FL; Togus, ME; and White River Junction, VT and is currently under the direction of Dr. Paul Hoffman. The work of the VRHRC-ER has been focused on the education and training of VA and non-VA service providers caring for rural Veterans and bringing specialty care to community-based clinics via telehealth technology.

Central Region (VRHRC - CR)

The Central Region Center, based at the VA medical center in Iowa City, IA, is under the direction of Dr. Peter Kaboli. This center’s work has been focused on evaluating existing rural health clinical programs and testing of novel strategies to overcome barriers to access and quality.

Western Region (VRHRC - WR)

The Western Region Center, under the direction of Dr. Byron Bair, is located at the VA medical center in Salt Lake City. Their current work is focused on improving access to care for rural Native Veterans through outreach activities, piloting of best care models and deployment of telemental health. In addition, they are focusing on the care of rural, elderly Veterans through the development of a web-based tool kit designed to support their caregivers.

VISN Rural Consultants

Each VISN has either a full or part-time rural consultant (VRC) whose main functions are to enhance service delivery to Veterans residing in rural and highly rural areas, and to facilitate information exchange and learning within and across each VISN, as well as support a stronger link between ORH and each VISN. In practical terms, the VRCs work closely with internal and external stakeholders in their respective VISNs to introduce, implement and evaluate ORH-funded projects, as well as monitor the budget and report on the effectiveness of each. In addition, VRCs conduct outreach to develop strong relationships with the community, including State Offices of Rural Health, local health care providers, advocacy groups, Veterans groups and academic institutions. Further, each VRC is responsible for the development of a rural strategic plan that must incorporate outcomes of periodic needs assessment for their respective VISN.

Veterans Rural Health Committee (VRHAC)

The Veterans Rural Health Advisory Committee (VRHAC) consists of 12 members, appointed by former VA Secretary Dr. James B. Peake. The VRHAC is tasked with examining ways to enhance health care services for Veterans in rural areas. The committee, chaired by James F. Ahrens, former head of the Montana Hospital Association, includes Veterans; rural health experts in academia; state and Federal rural health professionals; state-level Department of Veterans Affairs officials; and leaders of Veterans Service Organizations. The VRHAC hosts a minimum of two face-to-face meetings a year and provides a written summary of committee activities to the VA Secretary on an annual basis.