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VHA Office of Rural Health • http://www.ruralhealth.va.gov
DEPARTMENT OF VETERANS AFFAIRS Veterans Health Administration
Office of Rural Health (ORH)
STRATEGIC PLAN REFRESH
Fiscal Years 2012-2014
Mary Beth Skupien, PhD, MS, RN ORH Director
Sheila M. Warren, MPH, RN, CPHQ ORH Deputy Director
“Using Innovation and Technology to Improve Access and Quality”“Using Innovation and Technology to Improve Access and Quality”
Office of Rural Health – FY 2010-2014 Strategic Plan Refresh 1
VHA Office of Policy and Planning Office of Rural Health (ORH)
Fiscal Years 2012-2014
ORH Strategic Plan Refresh
Introduction
The VHA Office of Rural Health (ORH) was created in March 2007 to enhance access and quality of health care to nearly 3.4 million Veterans (41% of total enrolled Veterans) residing in rural and highly rural areas of the country. We know that these Veterans are increasingly made up of soldiers returning from Operation Enduring Freedom and Operation Iraqi Freedom and that 15% of them have at least one service connected disability.
Prior studies indicate that Veterans who live in rural settings have greater healthcare needs than their urban counterparts. Specifically, rural Veterans have lower health-related quality-of-life scores and experience a higher prevalence of physical illness compared to urban Veterans. While prevalence of most mental health disorders is lower for rural compared to urban Veterans, rural Veterans with mental health disorders are sicker as measured by lower health-related quality-of-life compared with urban Veterans. These differences in health-related quality-of-life scores, which equate to lower self-rated health status, among rural dwelling Veterans, are substantial, clinically meaningful and associated with increased demand for healthcare services. Despite greater health care needs, rural veterans are less likely to access health services for both physical and mental illness, either through the VA or the private sector. In particular, rural Veterans have lower access to care for chronic conditions such as hypertension and post-traumatic stress disorder.
To ensure that ORH programs and initiatives are meeting the health care needs of rural Veterans, ORH developed a profile of rural Veterans using several different sources. First, ORH conducted a geographical needs assessment to determine VA facility gaps in rural areas and then, a clinical needs assessment to better understand unmet clinical needs. ORH leadership has participated in numerous town hall meetings and listening sessions to better understand the perspective of rural Veterans on accessing VA health care and has met with the Veterans Rural Health Advisory Committee (VRHAC) 10 times to discuss their recommendations on how to improve the ORH program. This information, together with the Secretary’s priorities on improving care for homeless Veterans, reducing the back log of claims, and improving access to care provided the framework for the refresh of the ORH 2012 strategic plan.
In FY11, ORH formed a committee of internal and external stakeholders to refresh the ORH strategic plan for FY12 through FY14. The committee had members representing the following groups: the Veterans Rural Health Advisory Committee (VRHAC), VISN rural consultants (VRCs), the Veterans Rural Health Resource Centers (VRHRC), ORH Central Office, Medical
Office of Rural Health – FY 2010-2014 Strategic Plan Refresh 2
Center Directors, the Office of Telehealth Services (OTS), the Office of Mental Health Services (OMHS), the Office of Geriatrics and Extended Care (GEC), State VA Offices, the Office of Health Informatics, the Office of Academic Affiliations (OAA), the Employee Education System (EES) and the Healthcare Retention and Recruitment Office (HRRO). Six workgroups were created from the committee to refresh the initiatives and action items associated with the strategic goals of ORH. The draft compilation of all recommendations was disseminated to a broad spectrum of VA field and program offices including all VISN directors, and VISN planners.
Each of the six ORH strategic goals have been updated with broadly agreed upon initiatives and associated action items that provide a path forward for ORH to continue to succeed in its mission. Many initiatives involve continuing to support existing collaborations, rural clinics, programs and projects that are clearly impacting rural Veterans. New initiatives have emerged to address the urgent need to recruit and retain health care providers to rural areas; determine gaps in telehealth services and infrastructure; evaluate new promising telehealth technologies; collaborate with VA research; expand partnerships with other private and public rural entities and expand specialty care services to rural areas.
Geographical Needs Assessment
A geographical needs assessment for each VISN was conducted by analysts from the Eastern Region – Veterans Rural Health Resource Center to identify potential geographic access gaps in primary, acute, and tertiary care in rural areas of the Veterans Health Administration. A met need is a service within a specific target population; in this case, Veterans outside of prescribed travel times to levels of care that is currently being addressed through existing resources that are available and accessible. An unmet need is a service within a specific target population that is not currently being addressed through existing services and activities because no services are currently available or available services are inaccessible. The access assessment focused on areas outside of 30 minutes travel time to VHA primary care, 90 minutes to VHA acute care, and 240 minutes (4 hours) to VHA tertiary care in FY10. In areas outside of VHA travel time bands, community resources were examined. More specifically, it was investigated (1) whether there are any Federally Qualified Health Centers, Community Health Centers, or community hospitals where partnerships might be forged to provide health care services to VHA enrollees in these areas; and (2) whether there are any Military Treatment Facilities or Indian Health System facilities in these areas that might be candidates for Federal sharing arrangements.
For the drive time to a tertiary facility analysis, all VISNs met the VHA FY10 access standard, with 92.4% of all enrollees within 240 minutes travel time. For the 90 minute drive time analysis, only two VISNs (19 and 23) did not meet the FY10 access standard to secondary care; however 79% of all enrollees meet the access standard to secondary care. For the 30 minute drive time analysis, 9 VISNs (6, 7, 9, 11, 15, 16, 19, 20, and 23) did not meet the VHA FY10
Office of Rural Health – FY 2010-2014 Strategic Plan Refresh 3
access standard to primary care. However, 77% of enrollees are within the VA standard for travel time to VHA primary care services.
Clinical Needs Assessment
VISN Rural Consultants (VRC) conducted clinical needs assessments for rural Veterans in each of the 21 VISNs. The goal of the clinical needs assessments was to identify the challenges and barriers for rural Veterans receiving healthcare at the VA. The data for the clinical needs assessments were collected in a variety of ways, including: Veteran comment cards collected from Veterans using rural community-based outpatient (CBOCs) clinics; rural Veteran focus groups; CBOC clinical staff focus groups; in-person interviews with rural Veterans; in-person informal surveys of rural Veterans, and in-person interviews of CBOC clinical staff. Many of the data collection tools that were used in the clinical needs assessments were adapted from examples that Veterans Rural Health Resource Center –Central Region (VHRC-CR) provided. The data collected was then complied by each VRC and reported as part of the VISN’s overall rural health needs assessment.
Individual responses (n= 547) from all VISNs were compiled into a report. As compared to urban Veterans, rural Veterans are older; however there are a disproportionate number of younger Veterans and women Veterans from recent conflicts returning to rural areas. There appears to be a decline in the demand for inpatient services from rural Veterans, but an increase in demand for outpatient services. The most important barriers to care continue to be transportation to VA facilities, distance to VA facilities, a lack of telehealth services in rural VA facilities, a lack of specialty care and urgent care at rural VA facilities, inadequate knowledge of VA eligibility, benefits and services, and difficulties in recruitment and retention of health care providers.
VRHAC FY11 Recommendations
In the VRHAC’s FY11 Annual Report, the committee focused on rural provider workforce issues and rural Veteran outreach. They recommended that VHA-ORH work in collaboration with Health and Human Services Health Resources Service Administration-Office of Rural Health Policy (HRSA-ORHP) to assess the rural health provider needs of the VHA in its outreach and CBOC clinics in rural areas as well as any other programs or facilities located in rural and highly rural areas that provide direct services to Veterans; and the impact of such needs on the Health Professional Shortage Areas (HPSA) designations for primary care and mental health in these rural areas. The Committee would like to see efforts made to collaborate and partner with existing rural health providers in sharing limited workforce resources through contracting or other means. Given that the VHA and HRSA fund services in these areas and provide training resources for health care providers, a joint effort to study the policies and resources available for these critically underserved rural areas could lead to increased access to
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quality rural health providers for both the of rural and highly rural Veterans and to broaden their understanding of VA benefits and programs.
Town Hall Meetings/Listening Sessions with Rural Veterans
In FY11, a variety of events including town hall meetings, listening sessions, outreach events and round table discussions with Veterans have been held in many areas of the country to increase VA/ORH awareness and understanding of Veteran needs and issues. The ORH Director and staff have participated in town hall events and listening sessions in Montana, Texas, South Dakota and Florida and one is planned in Maine on October 13th, 2011. The ORH Veterans Rural Health Resource Centers (VRHRCs) have conducted outreach events and have held numerous Veteran focus groups in Utah, California, Nevada, Iowa and Illinois and more are planned.
ORH FY12 Portfolio
ORH recently concluded its proposal review cycle for FY12 funding. Members of the ORH review committee were instructed to take into account results from the clinical needs assessment, the geographic needs assessment, town hall meetings, and the Secretary’s priorities, as well as project quality and access measures when reviewing each individual proposal. Approximately 41% of ORH FY12 funding will continue to support the CBOCs and outreach clinics recently established in rural areas, as well as transportation systems that deliver rural Veterans to VHA facilities. Nearly 14% of ORH funding will support the delivery of primary care in the homes of rural Veterans through the home-based primary care (HBPC) program. In order to continue and expand telehealth services in rural areas, 13.3% of ORH funding will support telehealth programs in CBOCs and outreach clinics. The remainder of ORH funding will support mental health initiatives, specialty care, rural Veteran outreach, women Veterans’ programs, and Project Access Received Closer to Home (ARCH) - a pilot program intended to improve access for eligible Veterans by connecting them to non-VA health care providers in their communities.
Office of Rural Health – FY 2010-2014 Strategic Plan Refresh 5
ORH Strategic Plan Refresh
Fiscal Years 2012-2014
A. Goal One: Improve access and quality of health care delivery for rural and highly rural Veterans.
Initiative 1.1: Understand obstacles/barriers/disparities and issues that impact the access and quality of health care delivery in rural and highly rural areas.
Understanding and identifying how barriers to care affect access to and the delivery of quality health care are critical for the establishment of programs that directly impact the specific needs of rural and highly rural Veterans. ORH supports efforts to study these issues in order to improve evidence-based rural and highly rural Veteran health care. This initiative may lead to the modification of existing rural health care delivery efforts and identify new areas for expansion and development of clinical services to rural and highly rural Veterans based on the actions delineated below.
Action 1.1.1: Continue to support the identification, evaluation and measurement of access and quality obstacles/barriers/disparities in health care delivery for rural and highly rural Veterans. This effort includes examining policies and procedures that affect both VA and non-VA access issues.
Action 1.1.2: Support the dissemination of the information gathered in above efforts to ORH partners, VHA leadership, and other stakeholders.
Initiative 1.2: Promote innovative solutions to identified barriers to access and quality health care.
These efforts support the establishment and expansion of clinical programs to improve access and quality related to health care delivery for rural and highly rural Veterans. Included in these efforts are implementation and sustainment strategies for new and innovative clinical pilots. Special attention in the development and evaluation of new and innovative clinical pilots should focus on telehealth, mental health; special populations such as Native, women, and homeless Veterans, home based solutions, transportation strategies, and collaborative efforts between the VA and non-VA entities.
Action 1.2.1: Continue to support the development and implementation of new and innovative pilot programs that address the identified barriers to access and quality of health care delivery for rural and highly rural Veterans.
Action 1.2.2: Continue to support the development and implementation of ongoing evaluation strategies that specifically target new and innovative clinical pilots. The evaluations will include recommending sustainment, expansion and/ or exportation of new and innovative clinical pilots.
Action 1.2.3: Support the dissemination, adoption, and education efforts concerning successful pilot programs and best practices for rural and highly rural Veterans to other VISNs.
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B. Goal Two: Optimize the use of available and emerging health information technologies (Health IT) to improve access to care to Veterans residing in rural and highly rural areas.
Initiative 2.1: - Identification of gaps in tele-communications infrastructure, telehealth services, equipment in rural and highly rural communities.
The rural health program supports VA’s transformation to an integrated delivery system that emphasizes a full continuum of care in a patient-centered environment by providing care that will specifically address the needs of rural and highly rural Veterans in part through the use of telehealth technology. Clinical need assessments conducted by ORH indicate that there are telecommunications infrastructure gaps, and uneven distribution of telehealth services, personnel training and equipment.
Action 2.1.1: Support/participate in a baseline assessment of tele-communications (broadband) infrastructure in rural areas in collaboration with U.S. Federal Communications Commission, U.S. Department of Health and Human Services, Health Resources and Services Administration and Indian Health Services, and the National Rural Health Association and State Offices of Rural Health, as appropriate in order to ensure full telehealth capabilities at all VHA rural facilities.
Action 2.1.2: Document and monitor existing and emerging external telehealth network infrastructure resources and collaborate where feasible.
Action 2.1.3: In collaboration with OTS, inventory rural CBOC and outreach clinics regarding telehealth use, services, training, equipment and infrastructure needs.
Initiative 2.2: - Work with private and public counterparts to leverage new and existing technologies addressing priority areas of care for rural and highly rural Veterans.
ORH continues to partner with stakeholders to identify and improve technology adoption in an effort to expand services to Veterans living in rural and highly rural areas.
Action 2.2.1: Identify priority areas of care in rural and highly rural areas that could be significantly impacted by instituting new telehealth services.
Action 2.2.2: Continue to identify through collaboration with private and public counterparts new and innovative telehealth technologies that could be adopted to address rural Veterans health care needs.
Initiative 2.3: Streamline access to new and existing technological platforms.
In order to be successful in applying new technological platforms, it is vital to partner with appropriate VA and non-VA partners. As many as seven out of 10 Veterans receive some portion of their health care from private sector providers, often utilizing both the VHA and private sector systems. As a result, there is a need for being able to streamline sharing relevant medical information between various systems.
Action 2.3.1: Create a multi-disciplinary committee which includes ORH, VA Office of Information Technology, VA Office for Informatics and Analytics, Office of Telehealth Services and other program offices as appropriate to focus on leveraging Health IT solutions.
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Action 2.3.2: Support health information exchange efforts (Virtual Lifetime Electronic Record) in rural areas with state and local partners.
Initiative 2.4: Support existing and new telehealth initiatives.
Expansion of telehealth programs within VA has been a significant national effort. ORH has provided funds to support telehealth programs such as tele-retinal, tele-dermatology, tele-mental health, tele-pharmacy, tele-polytrauma, and tele-radiology in remote areas of the country. The Office of Telehealth Services (OTS) is a strong partner with ORH, working to expand existing telehealth programs and pilot new and innovative telehealth programs in the field. ORH has also funded telehealth projects through the Veterans Rural Health Resource Centers. Efforts include the tele-rehabilitation program in the Eastern Region that provides rehabilitation assessments and interventions in rural areas via video conferencing, and the mobile tele-retinal imaging pilot project that provides retinal imaging services in a convenient and cost-effective manner for rural Veterans served by CBOCs.
Action 2.4.1: Continue to work with VHA OTS to expand the availability of telemedicine services at VA facilities that serve rural and highly rural Veterans.
Action 2.4.2: Continue to support and evaluate demonstration projects of new models of care (especially specialty care) using telemedicine technologies.
C. Goal Three: Maximize utilization of existing and emerging studies and analyses to improve care delivered to rural and highly rural Veterans.
Initiative 3.1: Expand access to and use of VA studies and data.
ORH supports existing processes and initiates new processes to provide easier access to VA studies and data so that internal and external stakeholders can best take advantage of information for new analysis and program development.
Action 3.1.1: Continue to promote the use of the Rural Health Briefing Book and Rural Health Profile containing rural Veteran enrollee and utilization data.
Action 3.1.2: Continue to monitor and report quarterly on a national set of core performance measures that quantify access and quality of care delivered to rural and highly rural Veterans.
Action 3.1.3: Continue to disseminate information gathered from ORH-sponsored pilot projects, studies and programs to external stakeholders through the new ORH website, electronic newsletter, fact sheets, social media, conferences, publications and email alerts. The ORH materials are distributed electronically to contacts maintained in an access database. In addition, ORH staff will publish in peer-reviewed journals and will establish a presence at national rural health care and research meetings.
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Action 3.1.4: Review and utilize best practices of communication with rural Veterans (e.g., radio, town hall, local clergy, community organizations) to disseminate information regarding ORH program developments and impacts.
Initiative 3.2: Collaborate with VA Research and Development.
Action 3.2.1: Form an ad hoc committee consisting of personnel from ORH and the VHA Office of Research and Development (ORD) that meets periodically for information exchanges. These exchanges will inform the development of important research questions regarding the health disparities and clinical needs among rural Veterans, as well as health service delivery and cost-effectiveness issues in rural areas.
Action 3.2.2: Continue to partner with VA Health Services Research and Development (HSR&D) researchers for Collaborative Research to Enhance and Advance Transformation and Excellence (CREATE) applications
D. Goal Four: Improve availability of education and training for VA and non-VA service providers to rural and highly rural Veterans.
Initiative 4.1: Expand the use of distance learning technologies and other modalities for rural education program delivery to provide targeted training to address specific needs of rural providers.
ORH supports expanded use of distance education for VA and non-VA providers. ORH supports the continued use and expansion of satellite broadcast methods for reaching broad audiences. Additionally, ORH will provide targeted training opportunities and venues that will be selected to ensure maximum reach and utility to address specific needs as identified in the needs assessments. In addition, ORH will explore additional methods such as web-streaming to promote maximum flexibility in providing access to training for rural and highly rural providers.
Action 4.1.1: The VHA Employee Education System (EES) will conduct a rural health training/education needs assessment to help inform ORH on future education/training needs in rural health.
Action 4.1.2: In collaboration with the VHA Ethics Office and EES, ORH will develop an educational video entitled “Rural Health Ethics”.
Action 4.1.3: Develop new distance learning rural health training/educational modules based on needs assessment.
Action 4.1.4: In collaboration with OTS, ORH will expand telemedicine training to rural CBOC and outreach clinic personnel. In collaboration with the PACT Office, ORH will expand Patient Aligned Care Teams (PACT) training to CBOC and outreach clinic personnel.
Action 4.1.5: Continue expansion of the use of distance technology in order to provide education to staff at CBOCs.
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Initiative 4.2: Develop new education resources for health-care professionals.
ORH will expand available training for rural health providers. ORH will work to better integrate the topic of rural and highly rural Veterans into rural providers’ education and training and bring to their attention the challenges and opportunities in rural and highly rural communities.
Action 4.2.1: Continue and expand the Rural Health Training Program (RHTP). The RHTP is directed at medical students, nurse practitioners, and other allied health professionals. OAA will collaborate as needed regarding affiliation relationships and policies governing trainees in accredited programs.
Action 4.2.2: ORH will collaborate with OAA in developing a new VA Training Initiative directed at rural VA interdisciplinary teams, such as those at rural CBOCS, hub sites for rural telehealth services, or HBPC teams caring for rural Veterans.
Action 4.2.3: Develop and implement an education program on diagnostic procedures that will require physicians to complete pre-readings and knowledge assessments, view instructional videos, practice using procedure-specific simulation equipment, and undergo a full skill assessment using current practice standards and evidence based criteria under the evaluation of an appropriate medical peer. Provide a training model that could be applied at all VAMCs serving rural populations.
Action 4.2.4: Participate in the ‘HRSA Telehealth Resource Center Grant Program: CFDA 93.211, Northeast Telehealth Resource Center.
E. Goal Five: Enhance existing and implement new strategies to improve collaborations and increase service options for rural and highly rural Veterans.
VA’s collaborative efforts to improve access and quality of services available to rural and highly rural Veterans can take place through public-public and public-private partnerships. Internally VA program offices represent the primary platforms for collaboration and expansion of existing supportive initiatives for ORH.
Initiative 5.1: Continue existing and begin new collaborations with VA program offices.
Action 5.1.1: Maintain existing collaborations with the Office of Geriatrics and Extended Care, the Office of Mental Health, the Homeless Office, and the Women Veterans Health Strategic Health Care Group, by closely monitoring the performance of existing collaborative projects and by expanding/maintaining successful programs if funding allows.
Action 5.1.2: Conduct an assessment of rural outreach efforts and identify efforts that could be jointly coordinated with local facility’s My HealtheVet Coordinator to allow for immediate in-person authentication during an outreach event.
Action 5.1.3: Identify and engage other VA program offices for possible collaborations.
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Initiative 5.2: Continue to partner with various entities within the rural health community to establish or build upon existing outreach networks for rural Veterans.
ORH will take advantage of existing expertise and talent within the rural health community and build upon existing rural health networks to improve access and care for rural and highly rural Veterans through institutional collaborations. Potential collaborators include State Offices of Rural Health, HRSA Office of Rural Health Policy, HRSA Network Development and Outreach grantees, rural health programs sponsored by academic institutions, rural health researchers, and others.
Action 5.2.1: Inventory and assess effectiveness of current ORH –funded outreach activities using criteria developed by ORH leadership.
Action 5.2.2: Participate as a member of the VA National Veterans Outreach (NVO) Office outreach workgroups to provide representation for ORH, the VRC’s, and VRHRC’s; and to share information about the outreach needs of rural Veterans and ORH-supported outreach initiatives.
Action 5.2.3: Utilize the new (FY12) NVO Outreach Database and Outreach guide in order to identify VA outreach program and partners currently conducting outreach (such as OEF/OIF outreach), Yellow Ribbon events, etc.) in rural areas and collaborate (where possible and appropriate); to guide the planning and implementation of ORH – sponsored outreach initiatives, and to evaluate and analyze the effectiveness of outreach efforts.
Action 5.2.4: Identify additional rural areas of the country to target in rural Veteran outreach efforts to ensure that all rural Veterans have been contacted regarding their benefits and new local services.
Action 5.2.5: Identify State and local organizations in rural communities for outreach partnerships and collaborate where feasible.
Action 5.2.6: Facilitate partnerships between rural CBOCs and outreach clinic personnel with community health entities by helping to streamline process for contracting.
Action 5.2.7: To improve communications between ORH and its partners, further develop outreach contacts database including individuals from State Offices of Rural Health, HRSA Office of Rural Health Policy, and rural health researchers.
Initiative 5.3: Expand and develop public-public collaborations.
ORH will seek to expand public-public partnerships with agencies such as State Departments of Veterans Affairs, Department of Defense, HRSA, IHS, Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Medicare and Medicaid Services (CMS), and others. Given the role of these organizations in providing access to health care services and health care coverage, ORH will seek to expand initiatives to address issues of co-managed care, information sharing and provider training, and related issues.
Action 5.3.1: Establish ongoing liaison with Strategic Action groups relevant to rural issues that are part of the DOD/VA Integrated Mental Health Strategy (IMHS). The IMHS centers on a coordinated public health model to improve the access, quality, effectiveness, and efficiency of mental health
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services. Recipients of these services include active duty service members, National Guard and Reserve Component members, Veterans, and their families.
Action 5.3.2: Establish and formalize relationship with the Substance Abuse and Mental Health Services Administration (SAMHSA) for information sharing and provider training.
Action 5.3.3: Establish relationship with US Department of Agriculture (USDA) cooperative extension for outreach to rural Veteran caregivers.
Action 5.3.4: Participate in the newly established White House Rural Council.
Initiative 5.4: Institutionalize public-private collaborations.
ORH will support ongoing collaborations with private sector health care providers to specifically address the needs of rural and highly rural Veterans. ORH will solicit input from private sector stakeholders on best practices and approaches.
Action Item 5.4.1: Collaborate with the National Rural Health Association (NRHA) to assist in the planning of their annual meeting; including organization of workshops, speakers and topics of interest.
Action Item 5.4.2: Organize regional virtual meetings with private sector providers and ORH staff to gain insight from private sector providers on health care needs of rural Veterans.
F. Goal Six: Develop innovative methods to identify, recruit and retain health care professionals and requisite expertise in rural and highly rural communities.
Another barrier to accessing services facing rural Veterans is the lack of health care providers available in rural communities. ORH will undertake several initiatives to ensure the development and deployment of highly trained professionals to meet the current and emerging health care needs of rural Veterans.
Initiative 6.1: Develop programs to increase health professionals’ awareness of rural practice.
The Student Educational Employment Program (SEEP) provides Federal employment opportunities to those who are enrolled or accepted for enrollment as degree seeking students taking at least half-time academic, technical, or vocational course load in an accredited high school, technical, vocational, 2- or 4-year college or university, graduate or professional school. The VA Learning Opportunities Residency (VALOR) nursing program provides opportunities for outstanding students to develop competencies in clinical nursing while at an approved VA health care facility. Increasing the use of the SEEP and VALOR programs in rural VA facilities will subsequently increase the awareness of VA educational/employment opportunities among college and university students.
HRRO’s VHA Marketing and Advertising section has proposed a comprehensive rural health marketing campaign, including the creation of web sites, pages, and banner ads specifically designed
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for individuals considering rural VA employment opportunities. A rural VA recruitment advertisement and tabletop has been distributed to and displayed at numerous national recruitment events, including the 2011 NRHA Conference. Other suggestions include the promotion of rural opportunities on social networking sites, including Facebook and YouTube.
Action.6.1.1: Increase use of SEEP and VALOR programs in areas designated rural and highly rural. VHA HRRO, who is responsible for administering these programs, will earmark funding specifically for use in facilities designated rural and highly-rural. VHA Placement Services will also develop an award to be presented to VALOR students upon graduation.
Action 6.1.2: Increase presence at colleges and universities with close proximity to rural VA health care facilities. HRRO will develop awards/recognition programs for presentation to students committed to rural practice at commencement ceremonies; identify and attend events in rural communities and upcoming rural health conferences, including the National Rural Health Conference in May 2012.
Action 6.1.3: HRRO Marketing and Placement Services will develop rural community awareness campaign to be rolled out at rural locations identified by HRRO to help develop rural provider workforce. HRRO will extend marketing scope to include additional demographics groups (high school students, families) with a vested interest in rural practice.
Initiative 6.2: Support existing and new workforce recruitment and retention efforts.
Identifying pertinent baseline information related to rural recruitment and retention is critical in developing effective workforce strategies. VHA Placement Recruitment Consultants provided HRRO leadership qualitative information on top occupational priorities, challenges, and opportunities in rural and highly rural VA health care facilities. VHA Placement Recruitment Consultants identified physicians, mental health and telemedicine professionals as high demand rural occupations. Positions such as Clinical Psychologists and Physical Therapists are considered more difficult to place in the rural HBPC/PACT settings. The identification of the challenges and opportunities will considerably improve rural recruitment efforts.
Many of the current strategies intended to increase recruitment and retention in rural health care facilities are aimed primarily at colleges, universities and established practitioners. Research has indicated that individuals who originate from rural areas are more likely to consider rural practice and employment than those from urban areas. Therefore, a more comprehensive approach to recruitment is needed. By extending its marketing scope, VHA Placement Services will be able to recruit strategically for the placement in rural and highly rural VA facilities. Targeting individuals with embedded interest in rural practice will improve both recruitment and retention efforts within rural VA facilities. However, recruitment strategies have to be developed in such a way to not destabilize or disrupt existing health provider resources in rural communities.
Significant collaborative opportunities also exist between VHA Placement Services and other local, state, and federal entities specializing in rural health needs and issues. Such opportunities include joint research efforts with colleges and universities, and collaborative opportunities with local and state offices of rural health. Establishing relationships with entities specializing in addressing rural health
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issues will significantly increase the awareness of potential collaborative research and placement opportunities with the VA.
Action 6.2.1: ORH will foster ongoing dialogue between VHA Placement Recruitment Consultants in HRRO and VISN Rural Consultants (VRCs) and HR and form a workgroup to identify top occupational priorities, challenges and opportunities for recruitment and retention at rural and highly rural VA health care facilities in order to develop a rural health workforce strategy.
Action 6.2.2: ORH will conduct a joint national rural health workforce study with Health Resources Service Administration –Office of Rural Health Policy (HRSA-ORHP) to examine shared workforce strategies and specific needs in order to gain evidence of existing ad hoc models and support needed for joint contracting of providers.
Action 6.2.3: ORH will evaluate regional and state models of rural provider retention strategies program.
Action 6.2.4: HRRO will establish relationships with community and state offices of rural health, rural program offices of colleges and universities. OAA will assist as needed in vetting accredited programs or schools and in establishing affiliation relationships.
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Appendix A
Table of Action Items, Person(s) Responsible, Quarterly Milestones
App
endi
x A
Tab
le o
f Act
ion
Item
s, Pe
rson
(s) R
espo
nsib
le, Q
uart
erly
Mile
ston
es
Init
iati
ves
Act
ion
Item
sP
erso
n o
r O
rgan
izat
ion
R
esp
on
sib
le
Act
ion
Item
PO
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Initi
ativ
e 1.
1: U
nder
stan
d ob
stac
les
/ ba
rrie
rs/ d
ispa
ritie
s an
d is
sues
that
impa
ct
the
acce
ss a
nd q
ualit
y of
hea
lth c
are
deliv
ery
in r
ural
and
hig
hly
rura
l are
as.
Act
ion
1.1.
1: C
ontin
ue to
sup
port
the
iden
tific
atio
n,
eval
uatio
n an
d m
easu
rem
ent o
f acc
ess
obst
acle
s / b
arrie
rs
/ dis
parit
ies
in h
ealth
car
e de
liver
y fo
r ru
ral a
nd h
ighl
y ru
ral
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eran
s. T
his
effo
rt in
clud
es e
xam
inin
g po
licie
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d pr
oced
ures
that
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ct b
oth
VA
and
non
-VA
acc
ess
and
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ity is
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.
VR
HR
C D
eput
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irect
ors,
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VA
CO
Mar
y C
harlt
on
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ion
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2: S
uppo
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ssem
inat
ion
of th
e in
form
atio
n ga
ther
ed in
abo
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taff,
OR
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Com
mun
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ions
Nan
cy M
aher
Kris
ten
Win
g
Act
ion
1.2.
1: C
ontin
ue to
sup
port
the
deve
lopm
ent a
nd
impl
emen
tatio
n of
new
and
inno
vativ
e pi
lot p
rogr
ams
that
add
ress
the
iden
tifie
d ba
rrie
rs to
acc
ess
and
qual
ity o
f he
alth
car
e de
liver
y fo
r ru
ral a
nd h
ighl
y ru
ral V
eter
ans.
OR
H V
AC
O
Al W
est
M
ary
Cha
rlton
AL
Wes
t
Act
ion
1.2.
2: C
ontin
ue to
sup
port
the
deve
lopm
ent a
nd
impl
emen
tatio
n of
ong
oing
eva
luat
ion
stra
tegi
es th
at
spec
ifica
lly ta
rget
new
and
inno
vativ
e cl
inic
al p
ilots
. T
he
eval
uatio
ns w
ill in
clud
e re
com
men
ding
sus
tain
men
t, ex
pans
ion
and/
or
expo
rtat
ion
of n
ew a
nd in
nova
tive
clin
ical
pilo
ts.
OR
H V
AC
O
Al W
est
Mar
y C
harlt
on
Al W
est
S
heila
War
ren
Act
ion
1.2.
3: S
uppo
rt th
e di
ssem
inat
ion,
ado
ptio
n, a
nd
educ
atio
n ef
fort
s co
ncer
ning
suc
cess
ful p
ilot p
rogr
ams
and
best
pra
ctic
es fo
r ru
ral a
nd h
ighl
y ru
ral V
eter
ans.
VR
HR
C s
taff
OR
H
Com
mun
icat
ions
Nan
cy M
aher
Kris
ten
Win
g
FY
201
2 M
ilest
on
es1s
t Q
uar
ter
(Oct
-Dec
)
Initi
ativ
e 1.
2: P
rom
ote
inno
vativ
e so
lutio
ns
to id
entif
ied
barr
iers
to a
cces
s an
d qu
ality
he
alth
car
e.
Dev
elop
eva
luat
ive
crite
ria to
fa
cilit
ate
the
dete
rmin
atio
n of
and
th
e de
gree
to w
hich
an
OR
H-
fund
ed p
ilot p
rogr
am/
dem
onst
ratio
n pr
ojec
t ach
ieve
s su
cces
s or
failu
re.
Sub
mit
the
deve
lope
d ev
alua
tive
crite
ria to
the
OR
H P
ropo
sal
Rev
iew
Com
mitt
ee fo
r re
view
.
Stra
tegi
c G
oal O
ne: I
mpr
ove
acce
ss a
nd q
ualit
y of
hea
lth c
are
deliv
ery
for r
ural
and
hig
hly
rura
l Vet
eran
s.
FY
201
2 M
ilest
on
es3r
d Q
uar
ter
(Ap
r-Ju
n)
FY
201
2 M
ilest
on
es2n
d Q
uar
ter
(Jan
-Mar
)F
Y 2
012
Mile
sto
nes
4th
Qu
arte
r (J
ul-
Sep
)
Rel
ease
rev
ised
eva
luat
ive
crite
ria
to O
RH
Pro
posa
l Rev
iew
C
omm
ittee
to a
id in
del
iber
atio
ns.
Acc
ess/
Qua
lity
wor
kgro
up w
ill
prov
ide
FY
pro
posa
l rev
iew
as
sist
ance
to e
nsur
e th
at a
cces
s an
d qu
ality
are
add
ress
ed in
FY
13
OR
H p
ortfo
lio.
Est
ablis
h an
Acc
ess/
Qua
lity
Wor
kgro
up (
Lead
s: V
eter
an R
ural
H
ealth
Res
ourc
e C
ente
rs
(VR
HR
Cs)
Dep
uty
Dire
ctor
s,
incl
udes
add
ition
al V
RH
RC
sta
ff an
d V
ISN
rur
al c
onsu
ltant
s (V
RC
)).
Wor
kgro
up w
ill e
valu
ate
the
Offi
ce
of R
ural
Hea
lth (
OR
H )
Ann
ual
Rep
ort(
s) to
iden
tify
how
ob
stac
les/
barr
iers
/dis
parit
ies
have
be
en a
ddre
ssed
by
OR
H p
ortfo
lio
proj
ects
. Ide
ntify
Bes
t Pra
ctic
es.
Acc
ess/
Qua
lity
wor
kgro
up w
ill
exam
ine
exis
ting
polic
ies
and
proc
edur
es th
at a
ffect
VA
and
non
V
A a
cces
s/qu
ality
issu
es.
Wor
kgro
up w
ill r
epor
t fin
ding
s to
O
RH
VA
CO
.
Acc
ess/
Qua
lity
wor
kgro
up w
ill
addr
ess
the
gaps
inde
ntifi
ed in
the
eval
uatio
n to
info
rm a
nd g
uide
the
Act
ion
item
s fo
r in
itiat
ive
1.2.
and
to
set
the
prio
ritie
s/to
pics
for
FY
13
OR
H p
ortfo
lio.
Sup
port
the
OR
H C
omm
unic
atio
ns
lead
with
con
tent
for
and
part
icip
atio
n in
edu
catio
n,
diss
emin
atio
n, a
nd e
xpor
tatio
n ef
fort
s. D
evel
op tr
acki
ng fo
r va
rious
con
tent
and
par
ticip
atio
n su
ppor
t fro
m V
RC
s an
d V
RH
RC
s.
Dis
sem
inat
e a
man
agem
ent b
rief
base
d on
Q1
Act
ion
1.1.
1 to
OR
H
part
ners
, VH
A le
ader
ship
and
ot
her
stak
ehol
ders
.
Dis
sem
inat
e a
man
agem
ent b
rief
base
d on
Q2
Act
ion
1.1.
1 to
OR
H
part
ners
, VH
A le
ader
ship
and
oth
er
stak
ehol
ders
.
Dis
sem
inat
e a
man
agem
ent b
rief
base
d on
Q3
Act
ion
1.1.
1 to
OR
H
part
ners
, VH
A le
ader
ship
and
ot
her
stak
ehol
ders
.
Dis
sem
inat
e a
man
agem
ent b
rief
base
d on
Q4
Act
ion
1.1.
1 to
OR
H
part
ners
, VH
A le
ader
ship
and
ot
her
stak
ehol
ders
.
Pos
t pro
posa
l Dev
elop
men
t Too
lkit
and
Pro
posa
l Writ
ing
trai
ning
m
ater
ials
to O
RH
Kno
wle
dge
Man
agem
ent S
yste
m (
KM
S)
and
diss
emin
ate
link
to V
RC
s,
VR
HR
Cs,
and
VH
A p
rogr
am
offic
es. D
isse
min
ate
non
VA
st
akeh
olde
r id
eas
to V
RC
s,
VR
HR
Cs,
and
VH
A p
rogr
am
offic
es. S
uppo
rt th
e O
RH
C
omm
unic
atio
ns le
ad w
ith c
onte
nt
for
and
part
icip
atio
n in
edu
catio
n,
diss
emin
atio
n, a
nd e
xpor
tatio
n ef
fort
s. T
rack
con
tent
and
pa
rtic
ipat
ion
supp
ort f
rom
VR
Cs
and
VR
HR
Cs.
Pos
t cal
l for
FY
13 P
ortfo
lio
Con
cept
Pap
ers
to O
RH
KM
S a
nd
OR
H in
tran
et s
ite. S
uppo
rt th
e O
RH
Com
mun
icat
ions
lead
with
co
nten
t for
and
par
ticip
atio
n in
ed
ucat
ion,
dis
sem
inat
ion,
and
ex
port
atio
n ef
fort
s. T
rack
con
tent
an
d pa
rtic
ipat
ion
supp
ort f
rom
V
RC
s an
d V
RH
RC
s.
Sup
port
the
OR
H C
omm
unic
atio
ns
lead
with
con
tent
for
and
part
icip
atio
n in
edu
catio
n,
diss
emin
atio
n, a
nd e
xpor
tatio
n ef
fort
s. T
rack
con
tent
and
pa
rtic
ipat
ion
supp
ort f
rom
VR
Cs
and
VR
HR
Cs.
Ref
ine
the
deve
lope
d ev
alua
tive
crite
ria.
VR
HR
C s
taff
will
cre
ate
a
prop
osal
dev
elop
men
t too
lkit,
in
clud
ing
a pr
opos
al w
ritin
g tr
aini
ng w
orks
hop.
Intr
oduc
e th
e pr
opos
al
deve
lopm
ent t
oolk
it an
d co
nduc
t th
e pr
opos
al w
ritin
g w
orks
hop
at
the
OR
H B
iann
ual M
eetin
g.
Dis
sem
inat
e ca
ll fo
r F
Y13
OR
H
port
folio
con
cept
pap
ers.
Rev
iew
C
once
pt P
aper
s an
d in
vite
ap
prov
ed c
once
pts
to s
ubm
it a
full
prop
osal
(M
ay).
Rev
iew
FY
13 p
ortfo
lio
subm
issi
ons.
Pro
vide
ass
ista
nce
for
cond
ition
ally
app
rove
d pr
opos
al
subm
issi
ons
in o
rder
to m
eet
eval
uativ
e cr
iteria
, inc
ludi
ng
crite
ria fo
r in
nova
tion,
su
stai
nmen
t, an
d ex
pans
ion.
Off
ice
of R
ural
Hea
lth
– F
Y 2
010-
2014
Str
ateg
ic P
lan
Ref
resh
15
App
endi
x A
Tab
le o
f Act
ion
Item
s, Pe
rson
(s) R
espo
nsib
le, Q
uart
erly
Mile
ston
es
Init
iati
ves
Act
ion
Item
sP
erso
n o
r O
rgan
izat
ion
R
esp
on
sib
le
Act
ion
Item
PO
C
FY
201
2 M
ilest
on
es1s
t Q
uar
ter
(Oct
-Dec
)F
Y 2
012
Mile
sto
nes
3rd
Qu
arte
r (A
pr-
Jun
)F
Y 2
012
Mile
sto
nes
2nd
Qu
arte
r (J
an-M
ar)
FY
201
2 M
ilest
on
es4t
h Q
uar
ter
(Ju
l-S
ep)
Act
ion
2.1.
1: S
uppo
rt/p
arti
cipa
te in
a b
asel
ine
asse
ssm
ent
of te
le-c
omm
unic
atio
ns in
fras
truc
ture
in r
ural
are
as in
co
llab
orat
ion
wit
h U
.S. F
eder
al C
omm
unic
atio
ns
Com
mis
sion
, U.S
. Dep
artm
ent o
f H
ealt
h an
d H
uman
S
ervi
ces,
Hea
lth
Res
ourc
es a
nd S
ervi
ces
Adm
inis
trat
ion
and
Indi
an H
ealt
h S
ervi
ces,
and
the
Nat
iona
l Rur
al H
ealt
h A
ssoc
iati
on a
nd S
tate
Off
ices
of
Rur
al H
ealt
h, a
s ap
prop
riat
e in
ord
er to
ens
ure
full
tele
heal
th c
apab
ilit
ies
at
all V
HA
rur
al f
acil
itie
s.
Nan
cy D
aile
yN
ancy
Dai
ley
Act
ion
2.1.
2: D
ocum
ent a
nd m
onit
or e
xist
ing
and
emer
ging
ex
tern
al te
lehe
alth
net
wor
k in
fras
truc
ture
res
ourc
es a
nd
coll
abor
ate
whe
re f
easi
ble.
Tom
Klo
buca
rT
om K
lobu
car
Act
ion
2.1.
3: –
Inv
ento
ry r
ural
Com
mun
ity
-Bas
ed
Out
pati
ent C
lini
cs (
CB
OC
s) a
nd o
utre
ach
clin
ics
as
rega
rdin
g te
lehe
alth
use
, ser
vice
s, tr
aini
ng, e
quip
men
t and
in
fras
truc
ture
nee
ds.
Tom
Klo
buca
rT
om K
lobu
car
Act
ion
2.2.
1: I
dent
ify
prio
rity
are
as o
f ca
re in
rur
al a
nd
high
ly r
ural
are
as th
at c
ould
be
sign
ific
antl
y im
pact
ed b
y in
stit
utin
g ne
w te
lehe
alth
ser
vice
s.
Tom
Klo
buca
rT
om K
lobu
car
Act
ion
2.2.
2: C
onti
nue
to id
enti
fy th
roug
h co
llab
orat
ion
wit
h pr
ivat
e an
d pu
blic
cou
nter
part
s ne
w a
nd in
nova
tive
te
chno
logi
es th
at c
ould
be
adop
ted
to a
ddre
ss r
ural
V
eter
ans
heal
th c
are
need
s.
Byr
on B
air
Byr
on B
air
Act
ion
2.3.
1: C
reat
e a
mul
ti-d
isci
plin
ary
com
mit
tee
whi
ch
incl
udes
OR
H,
VA
Off
ice
of I
nfor
mat
ion
and
Tec
hnol
ogy,
V
HA
Off
ice
of H
ealt
h In
form
atio
n, O
ffic
e of
Tel
ehea
lth
Ser
vice
s an
d ot
her
prog
ram
off
ices
as
appr
opri
ate
to f
ocus
on
leve
ragi
ng H
ealt
h IT
sol
utio
ns to
impr
ove
acce
ss to
car
e fo
r ru
ral V
eter
ans.
Tom
Klo
buca
r
K
atie
Dzi
akK
atie
Dzi
ak
Act
ion
2.3.
2: E
xpan
d he
alth
info
rmat
ion
exch
ange
eff
orts
(V
irtu
al L
ifet
ime
Ele
ctro
nic
Rec
ord)
wit
h st
ate
and
loca
l pa
rtne
rs.
Byr
on B
air
Byr
on B
air
Act
ion
2.4.
1 :
Con
tinu
e to
wor
k w
ith
VH
A O
ffic
e of
T
eleh
ealt
h S
ervi
ces
(OT
S)
to e
nsur
e th
e av
aila
bili
ty o
f te
lem
edic
ine
equi
pmen
t at V
A f
acil
itie
s an
d co
rres
pond
ing
outr
each
cli
nics
that
ser
ve r
ural
and
hig
hly
rura
l Vet
eran
s.
Mar
y B
eth
Sku
pien
S
heila
War
ren
Mar
y B
eth
Sku
pien
Act
ion
2.4.
2: C
onti
nue
to s
uppo
rt a
nd e
valu
ate
dem
onst
rati
on p
roje
cts
of n
ew m
odel
s of
car
e us
ing
tele
med
icin
e m
odal
itie
s.
OR
H V
AC
O, V
RC
, an
d V
RH
RC
sK
atie
Dzi
ak
She
ila W
arre
n
Initi
ativ
e 2.
4: S
uppo
rt e
xist
ing
and
new
te
lehe
alth
initi
ativ
es.
Initi
ativ
e 2.
2 -
Wor
k w
ith p
rivat
e an
d pu
blic
co
unte
rpar
ts to
leve
rage
new
and
exi
stin
g te
chno
logi
es a
ddre
ssin
g pr
iorit
y ar
eas
of
care
for
rura
l and
hig
hly
rura
l Vet
eran
s.
Per
form
GIS
map
ping
of n
atio
n w
ide
tele
com
mun
icat
ions
in
fras
truc
ture
and
res
ulta
nt g
aps
Ass
ess
pote
ntia
l im
pact
of
VH
A/D
oD in
itiat
ive
OS
EH
RA
, the
O
pen
Sou
rce
Ele
ctro
nic
Hea
lth
Rec
ord
Age
nt o
n ru
ral V
eter
ans
Iden
tify
part
icip
atin
g of
fices
and
da
ta s
ourc
es fo
r co
mpi
latio
n of
a
base
line
repo
rt o
f tel
e co
mm
unic
atio
ns in
fras
truc
ture
in
rura
l Am
eric
a
Obt
ain
GIS
map
ping
ser
vice
s fo
r ba
selin
e as
sess
men
t dat
a
Con
duct
rev
iew
of a
vaila
ble
info
rmat
ion
from
VH
A a
nd n
on-
VH
A s
ourc
es to
iden
tify
new
te
lehe
alth
mod
els
of c
are
Usi
ng e
xtan
t VH
A d
ata
sour
ces,
as
sess
diff
eren
ces
in u
rban
and
ru
ral v
eter
ans'
hea
lth s
ervi
ces
need
s
Det
erm
ine
num
ber
and
curr
ent
disp
ositi
on o
f rur
al C
BO
Cs
and
Out
reac
h C
linic
s. C
reat
e m
aste
r lis
t of c
linic
s to
be
inve
ntor
ied.
Stra
tegi
c G
oal T
wo:
Opt
imiz
e th
e us
e of
ava
ilabl
e an
d em
ergi
ng h
ealth
info
rmat
ion
tech
nolo
gies
(Hea
lth IT
) to
impr
ove
acce
ss to
car
e to
Vet
eran
s re
sidi
ng in
rura
l and
hig
hly
rura
l are
as.
Ass
ess
exis
ting
tele
heal
th n
etw
ork
reso
urce
s, in
clud
ing
thos
e cr
eate
d by
sta
te a
nd fe
dera
l rur
al
band
wid
th e
xpan
sion
pro
gram
s.
Pre
sent
rep
ort t
o O
RH
of f
indi
ngs
Ass
ess
exis
ting
stat
e an
d lo
cal n
on-
VH
A te
lem
edic
ine
prog
ram
s in
rur
al
area
s.
Dev
elop
sub
grou
ps to
acc
ompl
ish
task
s.
Pre
sent
find
ings
to V
HA
le
ader
ship
Upd
ate
and
resu
bmit
the
deve
lope
d te
mpl
ate
as a
rep
ort o
f te
chno
logi
es fo
r po
ssib
le u
se in
cl
inic
al p
ilots
Ass
ess
tele
med
icin
e tr
aini
ng n
eed
in r
ural
CB
OC
s an
d ou
trea
ch
clin
ics
and
wor
k w
ith O
TS
to
ensu
re a
vaila
bilit
y of
trai
ning
re
sour
ces
to r
ural
CB
OC
and
ou
trea
ch c
linic
per
sonn
el.
Cre
ate
whi
te p
aper
on
the
stat
e of
cu
rren
t tel
ehea
lth n
etw
ork
infr
astr
uctu
re a
nd o
ppor
tuni
ties
for
colla
bora
tion
with
non
-VH
A
entit
ies
Pre
sent
fina
l com
mitt
ee r
epor
t to
OR
H a
nd V
HA
lead
ersh
ip.
Det
erm
ine
feas
ibili
ty o
f tra
ckin
g te
lehe
alth
use
in C
BO
Cs
and
outr
each
clin
ics
usin
g ex
tant
dat
a so
urce
s. D
eter
min
e ra
nge
of
spec
ialty
car
e se
rvic
es d
eliv
ered
or
capa
ble
of b
eing
del
iver
ed u
sing
te
lem
edic
ine
tech
nolo
gies
.
OR
H p
rogr
am a
naly
sts
will
ov
erse
e ex
pend
iture
s an
d re
port
on
pro
ject
mile
ston
es a
nd
perf
orm
ance
on
a qu
arte
rly b
asis
.
Inve
stig
ate
need
s as
sess
men
t in
form
atio
n fr
om 3
Q F
Y 2
012
and
the
abili
ty o
f ope
n so
urce
rec
ords
ex
chan
ges
and
new
tele
heal
th
mod
els
to im
pact
thos
e ne
eds.
OR
H is
fund
ing
102
stud
ies
eval
uatin
g m
odel
s of
car
e de
liver
y us
ing
tele
med
icin
e m
odal
ities
in
FY
12.
OR
H p
rogr
am a
naly
sts
will
ove
rsee
ex
pend
iture
s an
d re
port
on
proj
ect
mile
ston
es a
nd p
erfo
rman
ce o
n a
quar
terly
bas
is.
OR
H p
rogr
am a
naly
sts
will
ov
erse
e ex
pend
iture
s an
d re
port
on
pro
ject
mile
ston
es a
nd
perf
orm
ance
on
a qu
arte
rly b
asis
.
Ass
ess
infr
astr
uctu
re a
nd
equi
pmen
t nee
ds a
fter
impl
emen
tatio
n of
OT
S te
lehe
alth
ex
pans
ion
and
T21
initi
ativ
es in
ru
ral a
reas
.
Will
col
labo
rate
with
nat
iona
l IT
pr
ogra
m d
irect
or /
Tim
Cro
mw
ell
and
sta
te o
f Uta
h O
ffice
of
Vet
eran
Affa
irs d
irect
or T
erry
S
chow
on
upda
tes
on n
atio
nal
pilo
t pro
gram
s an
d re
port
.
Dev
elop
a te
mpl
ate
to a
llow
the
docu
men
tatio
n of
new
te
chno
logi
es w
hich
can
be
used
in
rura
l hea
lthca
re
Pilo
t the
tem
plat
e w
hich
was
de
velo
ped
to a
llow
the
docu
men
tatio
n of
new
tech
nolo
gies
w
hich
can
be
used
in r
ural
he
alth
care
Sub
mit
the
deve
lope
d te
mpl
ate
as
a re
port
of t
echn
olog
ies
for
poss
ible
use
in c
linic
al p
ilots
Hol
d a
kick
off
mee
ting
to in
trod
uce
com
mitt
ee m
embe
rs a
nd r
evie
w
char
ter.
Fin
aliz
e ch
arte
r.
Will
col
labo
rate
with
nat
iona
l IT
pr
ogra
m d
irect
or /
Tim
Cro
mw
ell
and
sta
te o
f Uta
h O
ffice
of
Vet
eran
Affa
irs d
irect
or T
erry
S
chow
on
upda
tes
on n
atio
nal p
ilot
prog
ram
s an
d re
port
.
Will
col
labo
rate
with
nat
iona
l IT
pr
ogra
m d
irect
or /
Tim
Cro
mw
ell
and
sta
te o
f Uta
h O
ffice
of V
eter
an
Affa
irs d
irect
or T
erry
Sch
ow o
n up
date
s on
nat
iona
l pilo
t pro
gram
s an
d re
port
.
Dev
elop
dra
ft ch
arte
r fo
r co
mm
ittee
; Id
entif
y ap
prop
riate
le
ad fr
om e
ach
VA
pro
gram
offi
ce
to in
vite
to c
omm
ittee
OR
H le
ader
ship
mee
ts q
uart
erly
w
ith O
TS
lead
ersh
ip to
dis
cuss
te
lehe
alth
nee
ds a
nd in
itiat
ives
in
rura
l are
as.
OR
H le
ader
ship
mee
ts q
uart
erly
w
ith O
TS
lead
ersh
ip to
dis
cuss
te
lehe
alth
nee
ds a
nd in
itiat
ives
in
rura
l are
as.
OR
H le
ader
ship
mee
ts q
uart
erly
w
ith O
TS
lead
ersh
ip to
dis
cuss
te
lehe
alth
nee
ds a
nd in
itiat
ives
in
rura
l are
as.
OR
H le
ader
ship
mee
ts q
uart
erly
w
ith O
TS
lead
ersh
ip to
dis
cuss
te
lehe
alth
nee
ds a
nd in
itiat
ives
in
rura
l are
as.
Will
col
labo
rate
with
nat
iona
l IT
pr
ogra
m d
irect
or /
Tim
Cro
mw
ell
and
sta
te o
f Uta
h O
ffice
of
Vet
eran
Affa
irs d
irect
or T
erry
S
chow
on
upda
tes
on n
atio
nal
pilo
t pro
gram
s an
d re
port
.
Initi
ativ
e 2.
1 -
Iden
tific
atio
n of
gap
s in
tele
-co
mm
unic
atio
ns in
fras
truc
ture
, tel
ehea
lth
serv
ices
, equ
ipm
ent i
n ru
ral a
nd h
ighl
y ru
ral
com
mun
ities
.
Initi
ativ
e 2.
3: S
trea
mlin
e ac
cess
to n
ew a
nd
exis
ting
tech
nolo
gica
l pla
tform
s.
Off
ice
of R
ural
Hea
lth
– F
Y 2
010-
2014
Str
ateg
ic P
lan
Ref
resh
16
App
endi
x A
Tab
le o
f Act
ion
Item
s, Pe
rson
(s) R
espo
nsib
le, Q
uart
erly
Mile
ston
es
Init
iati
ves
Act
ion
Item
sP
erso
n o
r O
rgan
izat
ion
R
esp
on
sib
le
Act
ion
Item
PO
C
FY
201
2 M
ilest
on
es1s
t Q
uar
ter
(Oct
-Dec
)F
Y 2
012
Mile
sto
nes
3rd
Qu
arte
r (A
pr-
Jun
)F
Y 2
012
Mile
sto
nes
2nd
Qu
arte
r (J
an-M
ar)
FY
201
2 M
ilest
on
es4t
h Q
uar
ter
(Ju
l-S
ep)
Initi
ativ
e 3.
1 E
xpan
d A
cces
s to
and
Use
of
VA
stu
dies
and
dat
aA
ctio
n 3.
1.1
: C
onti
nue
to p
rom
ote
the
use
of th
e R
ural
H
ealt
h B
rief
ing
Boo
k an
d R
ural
Hea
lth
Pro
file
con
tain
ing
rura
l Vet
eran
enr
olle
e an
d ut
iliz
atio
n da
ta.
Kat
ie D
ziak
Kat
ie D
ziak
Act
ion
3.1.
2 :
Con
tinu
e to
mon
itor
and
rep
ort q
uart
erly
on
a na
tion
al s
et o
f co
re p
erfo
rman
ce m
easu
res
that
qua
ntif
y ac
cess
and
qua
lity
of
care
del
iver
ed to
rur
al a
nd h
ighl
y ru
ral
Vet
eran
s .
She
ila W
arre
n
Kat
ie D
ziak
She
ila W
arre
n
Act
ion
3.1.
3: C
onti
nue
to d
isse
min
ate
info
rmat
ion
gath
ered
fr
om O
RH
-spo
nsor
ed p
ilot
pro
ject
s, s
tudi
es a
nd p
rogr
ams
to e
xter
nal s
take
hold
ers
thro
ugh
the
new
OR
H w
ebsi
te,
elec
tron
ic n
ewsl
ette
r, f
act s
heet
s, s
ocia
l med
ia,
conf
eren
ces,
pub
lica
tion
s an
d em
ail a
lert
s. T
he O
RH
m
ater
ials
are
dis
trib
uted
ele
ctro
nica
lly
to c
onta
cts
mai
ntai
ned
in a
n ac
cess
dat
abas
e. I
n ad
diti
on, O
RH
sta
ff
wil
l pub
lish
in p
eer-
revi
ewed
jour
nals
and
wil
l est
abli
sh a
pr
esen
ce a
t nat
iona
l rur
al h
ealt
h ca
re a
nd r
esea
rch
mee
ting
s.
OR
H
com
mun
icat
ions
Nan
cy M
aher
K
riste
n W
ing
Act
ion
3.1.
4: R
evie
w a
nd u
tili
ze b
est p
ract
ices
of
com
mun
icat
ion
wit
h ru
ral V
eter
ans
(e.g
., ra
dio,
tow
n ha
ll,
loca
l cle
rgy,
com
mun
ity
orga
niza
tion
s) to
dis
sem
inat
e in
form
atio
n re
gard
ing
OR
H p
rogr
am d
evel
opm
ents
and
im
pact
s.
OR
H
com
mun
icat
ions
Nan
cy M
aher
K
riste
n W
ing
Act
ion
3.2.
1: F
orm
an
ad h
oc c
omm
itte
e co
nsis
ting
of
pers
onne
l fro
m O
RH
and
the
VH
A O
ffic
e of
Res
earc
h an
d D
evel
opm
ent (
OR
D)
that
mee
t per
iodi
call
y fo
r in
form
atio
n ex
chan
ges.
The
se e
xcha
nges
wil
l inf
orm
the
deve
lopm
ent
of im
port
ant r
esea
rch
ques
tion
s re
gard
ing
the
heal
th
disp
arit
ies
and
clin
ical
nee
ds a
mon
g ru
ral V
eter
ans,
as
wel
l as
hea
lth
serv
ice
deli
very
and
cos
t-ef
fect
iven
ess
issu
es in
ru
ral a
reas
.
Nan
cy M
aher
Ser
ena
Chu
A
lan
Wes
t
Pet
er K
abol
i
Pet
er K
abol
i
Act
ion3
.2.2
: Con
tinu
e to
par
tner
wit
h V
A H
ealt
h S
ervi
ces
Res
earc
h an
d D
evel
opm
ent (
HS
R&
D)
rese
arch
ers
for
Col
labo
rati
ve R
esea
rch
to E
nhan
ce a
nd A
dvan
ce
Tra
nsfo
rmat
ion
and
Exc
elle
nce
(CR
EA
TE
) ap
plic
atio
ns
OR
HN
ancy
Mah
er
Cre
ate
and
diss
emin
ate
3 O
RH
fa
ct s
heet
s fo
r m
onth
ly d
istr
ibut
ion.
C
reat
e an
d di
ssem
inat
e a
quar
terly
O
RH
new
slet
ter.
Sen
d em
ail a
lert
s to
sta
keho
lder
s re
gard
ing
new
O
RH
pub
licat
ions
as
need
ed.
Con
tinue
to u
pdat
e O
RH
web
site
.
Hav
e a
conf
eren
ce c
all w
ith O
RD
le
ader
ship
and
rur
al h
ealth
in
vest
igat
ors
to r
evie
w p
riorit
ies
in
rura
l hea
lth. S
peci
fical
ly, r
evie
w
the
Sta
te o
f the
Art
Con
fere
nce
Rec
omm
enda
tions
for
Res
earc
h on
Acc
ess
to c
are.
Dev
elop
a p
lan
for
the
com
ing
year
.
Initi
ativ
e 3.
2: C
olla
bora
te w
ith V
A R
esea
rch
and
Dev
elop
men
tH
ave
a m
eetin
g at
the
Nat
iona
l VA
H
ealth
Ser
vice
s R
esea
rch
and
Dev
elop
men
t mee
ting
(Feb
. 201
2)
incl
udin
g th
e ke
y st
akeh
olde
rs in
V
A r
ural
hea
lth r
esea
rch.
D
eter
min
e w
hat s
houl
d be
don
e ov
er th
e ne
xt tw
o qu
arte
rs a
nd
repo
rt b
ack
to O
RH
.
Cre
ate
and
diss
emin
ate
3 O
RH
fa
ct s
heet
s fo
r m
onth
ly
dist
ribut
ion.
Cre
ate
and
diss
emin
ate
a qu
arte
rly O
RH
ne
wsl
ette
r. S
end
emai
l ale
rts
to
stak
ehol
ders
reg
ardi
ng n
ew O
RH
pu
blic
atio
ns a
s ne
eded
. Con
tinue
to
upd
ate
OR
H w
ebsi
te.
Fin
aliz
e V
SS
C w
eb b
ased
sys
tem
. P
rovi
de tr
aini
ng to
VR
Cs
on h
ow
to u
tiliz
e w
eb b
ased
sys
tem
. C
ontin
ue d
iscu
ssio
ns w
ith O
ffice
of
Info
rmat
ion
and
Tec
hnol
ogy
(OI&
T)
to d
evel
op w
eb-b
ased
sy
stem
. Pro
vide
qua
rter
ly r
epor
t su
mm
ary
to O
RH
lead
ersh
ip.
Orie
nt a
ny n
ew s
taff
to V
SS
C w
eb-
base
d sy
stem
. Pro
vide
qua
rter
ly
repo
rt s
umm
ary
to O
RH
le
ader
ship
. F
inal
ize
OI&
T w
eb
data
base
dev
elop
men
t. P
repa
re to
la
unch
for
FY
13
proj
ects
.
Cre
ate
and
diss
emin
ate
3 O
RH
fa
ct s
heet
s fo
r m
onth
ly
dist
ribut
ion.
Cre
ate
and
diss
emin
ate
a qu
arte
rly O
RH
ne
wsl
ette
r. S
end
emai
l ale
rts
to
stak
ehol
ders
reg
ardi
ng n
ew O
RH
pu
blic
atio
ns a
s ne
eded
. Con
tinue
to
upd
ate
OR
H w
ebsi
te. O
RH
sta
ff w
ill a
ttend
and
hav
e a
boot
h at
the
Nat
iona
l Rur
al H
ealth
Ass
ocia
tion
Ann
ual M
eetin
g in
Den
ver,
C
olor
ado.
Orie
nt a
ny n
ew s
taff
to V
SS
C w
eb-
base
d sy
stem
. P
rovi
de q
uart
erly
re
port
sum
mar
y to
OR
H le
ader
ship
. B
egin
OI&
T w
eb d
atab
ase
deve
lopm
ent.
Orie
nt a
ny n
ew s
taff
to V
SS
C w
eb-
base
d sy
stem
. P
rovi
de q
uart
erly
re
port
sum
mar
y to
OR
H
lead
ersh
ip. C
ontin
ue O
I&T
web
da
taba
se d
evel
opm
ent.
Rev
iew
lite
ratu
re fo
r be
st p
ract
ices
fo
r he
alth
com
mun
icat
ion
with
ol
der
gene
ratio
ns o
f Vet
eran
s
Dev
elop
a w
hite
pap
er o
n to
pic
and
diss
emin
ate
to r
ural
hea
lth te
ams
and
part
ners
.
Con
tinue
to d
isse
min
ate
mat
eria
ls
to p
artn
ers.
Con
tinue
to d
isse
min
ate
mat
eria
ls
to p
artn
ers,
eva
luat
e im
pact
Pro
vide
qua
rter
ly tr
aini
ng
oppo
rtun
ities
for
VR
Cs
and
Pro
gram
Offi
ce p
erso
nnel
. O
rient
ne
w V
RC
sta
ff as
app
licab
le.
Incl
ude
in O
RH
lead
ersh
ip
pres
enta
tions
as
appl
icab
le.
Pro
vide
qua
rter
ly tr
aini
ng
oppo
rtun
ities
for
VR
Cs
and
Pro
gram
Offi
ce p
erso
nnel
. Orie
nt
new
VR
C s
taff
as a
pplic
able
. In
clud
e in
OR
H le
ader
ship
pr
esen
tatio
ns a
s ap
plic
able
.
Pro
vide
qua
rter
ly tr
aini
ng
oppo
rtun
ities
for
VR
Cs
and
Pro
gram
Offi
ce p
erso
nnel
. Orie
nt
new
VR
C s
taff
as a
pplic
able
. In
clud
e in
OR
H le
ader
ship
pr
esen
tatio
ns a
s ap
plic
able
.
Pro
vide
qua
rter
ly tr
aini
ng
oppo
rtun
ities
for
VR
Cs
and
Pro
gram
Offi
ce p
erso
nnel
. O
rient
ne
w V
RC
sta
ff as
app
licab
le.
Incl
ude
in O
RH
lead
ersh
ip
pres
enta
tions
as
appl
icab
le.
Cre
ate
and
diss
emin
ate
3 O
RH
fa
ct s
heet
s fo
r m
onth
ly d
istr
ibut
ion.
C
reat
e an
d di
ssem
inat
e a
quar
terly
O
RH
new
slet
ter.
Sen
d em
ail a
lert
s to
sta
keho
lder
s re
gard
ing
new
O
RH
pub
licat
ions
as
need
ed.
Con
tinue
to u
pdat
e O
RH
web
site
.
Mee
t with
VA
HS
R &
D
inve
stig
ator
s as
req
uest
ed to
di
scus
s O
RH
par
tner
ship
in
CR
EA
TE
app
licat
ions
.
Dep
ende
nt o
n re
port
.D
epen
dent
on
repo
rt.
Mee
t with
VA
HS
R &
D
inve
stig
ator
s as
req
uest
ed to
di
scus
s O
RH
par
tner
ship
in
CR
EA
TE
app
licat
ions
.
Mee
t with
VA
HS
R &
D
inve
stig
ator
s as
req
uest
ed to
di
scus
s O
RH
par
tner
ship
in
CR
EA
TE
app
licat
ions
.
Mee
t with
VA
HS
R &
D
inve
stig
ator
s as
req
uest
ed to
di
scus
s O
RH
par
tner
ship
in
CR
EA
TE
app
licat
ions
.
Stra
tegi
c G
oal T
hree
: Max
imiz
e ut
iliza
tion
of e
xist
ing
and
emer
ging
stu
dies
and
ana
lyse
s to
impr
ove
care
del
iver
ed to
rura
l and
hig
hly
rura
l Vet
eran
s
Off
ice
of R
ural
Hea
lth
– F
Y 2
010-
2014
Str
ateg
ic P
lan
Ref
resh
17
App
endi
x A
Tab
le o
f Act
ion
Item
s, Pe
rson
(s) R
espo
nsib
le, Q
uart
erly
Mile
ston
es
Init
iati
ves
Act
ion
Item
sP
erso
n o
r O
rgan
izat
ion
R
esp
on
sib
le
Act
ion
Item
PO
C
FY
201
2 M
ilest
on
es1s
t Q
uar
ter
(Oct
-Dec
)F
Y 2
012
Mile
sto
nes
3rd
Qu
arte
r (A
pr-
Jun
)F
Y 2
012
Mile
sto
nes
2nd
Qu
arte
r (J
an-M
ar)
FY
201
2 M
ilest
on
es4t
h Q
uar
ter
(Ju
l-S
ep)
Act
ion
4.1.
1: T
he V
HA
Em
ploy
ee E
duca
tion
Sys
tem
(E
ES
) w
ill c
ondu
ct a
rur
al h
ealt
h tr
aini
ng/e
duca
tion
nee
ds
asse
ssm
ent t
o he
lp in
form
OR
H o
n ed
ucat
ion/
trai
ning
gap
s in
rur
al h
ealt
h.
EE
S
S
eren
a C
huS
eren
a C
hu
Act
ion
4.1.
2:
In c
olla
bora
tion
wit
h E
ES
, OR
H w
ill d
evel
op
‘Rur
al H
ealt
h E
thic
s’.
EE
S
K
riste
n W
ing
Kris
ten
Win
g
Act
ion
4.1.
3:
Dev
elop
new
dis
tanc
e le
arni
ng r
ural
hea
lth
trai
ning
/edu
cati
onal
mod
ules
bas
ed o
n ne
eds
asse
ssm
ent.
Ser
ena
Chu
P
aul H
offm
anS
eren
a C
hu
Act
ion
4.1.
4: In
col
labo
ratio
n w
ith O
TS
, OR
H w
ill e
xpan
d te
lem
edic
ine
trai
ning
to r
ural
CB
OC
and
out
reac
h cl
inic
pe
rson
nel.
In c
olla
bora
tion
wit
h th
e P
AC
T O
ffic
e, O
RH
w
ill e
xpan
d P
atie
nt A
lign
ed C
are
Tea
ms
( P
AC
T)
trai
ning
to
CB
OC
and
out
reac
h cl
inic
per
sonn
el.
Pau
l Hof
fman
R
HP
I P
aul H
offm
an
Act
ion
4.1.
5: C
onti
nue
expa
nsio
n of
the
use
of d
ista
nce
tech
nolo
gy in
ord
er to
pro
vide
edu
cati
on to
sta
ff a
t C
BO
Cs.
Pau
l Hof
fman
Son
ya S
tarli
ng
Jaso
n Z
ullo
Pau
l Hof
fman
Iden
tify
EE
S s
taff
that
can
ass
ist i
n co
mpl
etin
g th
is a
naly
sis.
Dev
elop
an
actio
n pl
an w
ith
timel
ines
for
com
plet
ing
this
an
alys
is.
Impl
emen
t the
act
ion
plan
and
co
nduc
t the
fron
t end
ana
lysi
s.F
inal
ize
the
fron
t end
ana
lysi
s an
d co
mm
unic
ate
the
resu
lts w
ith
OR
H.
Stra
tegi
c G
oal F
our:
Im
prov
e av
aila
bilit
y of
edu
catio
n an
d tr
aini
ng fo
r VA
and
non
-VA
ser
vice
pro
vide
rs to
rura
l and
hig
hly
rura
l Vet
eran
s.
Dis
cuss
pot
entia
l OR
H p
roje
cts
with
EE
S a
nd d
evel
op a
n ac
tion
plan
for
acco
mpl
ishi
ng th
ese
proj
ects
Beg
in p
rodu
ctio
n of
EE
S p
roje
cts,
w
hich
will
incl
ude
a m
ixtu
re o
f co
nfer
ence
sup
port
, bro
adca
st
prog
ram
s, a
nd e
duca
tion/
mar
ketin
g vi
deos
.
Con
tinue
pro
duct
ion
of E
ES
pr
ojec
ts, w
hich
will
incl
ude
a m
ixtu
re o
f con
fere
nce
supp
ort,
broa
dcas
t pro
gram
s, a
nd
educ
atio
n/m
arke
ting
vide
os.
Com
plet
e th
e pr
oduc
tion
of a
ll E
ES
pro
ject
s.
Con
tinue
to d
evel
op th
e co
nten
t fo
r th
e E
thic
s vi
deo
and
secu
re a
ll th
e fa
culty
that
will
be
invo
lved
in
the
prod
uctio
n of
this
vid
eo.
Fin
aliz
e th
e co
nten
t and
slid
es fo
r th
e E
thic
s vi
deo.
Sec
ure
facu
lty
and
plan
ning
com
mitt
ee
info
rmat
ion
so th
e pr
ogra
m c
an b
e ac
cred
ited.
Film
this
bro
adca
st in
Sal
t Lak
e C
ity. B
road
cast
will
be
repe
ated
ly
aire
d on
EE
S' s
ite.
Rur
al H
ealth
Pro
fess
ions
(R
HP
I)
Inst
itute
will
par
tner
with
VR
HR
C-
ER
.D
evel
op m
odul
es fo
r T
elem
edic
ine
( T
M )
trai
ning
.
Fin
aliz
e m
odul
es fo
r T
M tr
aini
ng.
Sel
ect l
ocat
ions
for
TM
trai
ning
. P
rom
ote
trai
ning
ava
ilabi
lity
and
sche
dule
dat
es.
Impl
emen
t TM
trai
ning
at C
BO
Cs.
Col
lect
pro
gram
/mod
ule
feed
back
.
Clin
ical
Vid
eo-T
eleh
ealth
(C
VT
)-N
euro
logy
Fol
low
-up
Car
e fo
r V
eter
ans
with
Pro
gres
sive
Mul
tiple
S
cler
osis
, Liv
ing
in R
ural
Are
as’
Wor
kgro
up in
Bal
timor
e to
es
tabl
ish
natio
nwid
e si
tes.
E
xpan
d D
ME
to 1
CB
OC
in V
ISN
8.
Est
ablis
h N
orth
Flo
rida'
s te
lere
habi
litat
ion
mod
el a
t the
W
hite
Riv
er J
unct
ion
VA
incl
udin
g st
anda
rdiz
ed c
linic
s, p
roce
sses
an
d m
easu
rem
ent s
yste
ms.
Tel
e-N
euro
will
fina
lize
list o
f pa
tient
s at
eac
h si
te,
verif
y pr
ofile
s, s
ched
ule
and
cond
uct f
irst
TM
vis
its a
t eac
h si
te.
Exp
and
DM
E to
1 C
BO
C in
VIS
N 8
.E
xpan
d F
lorid
a's
tele
reha
bilit
atio
n m
odel
to in
clud
e sp
ecia
lized
focu
s ar
eas
such
as
TB
I, H
BP
C, a
nd
post
sur
gica
l pat
ient
s.
Con
tinue
to c
ondu
ct T
ele-
Neu
ro
visi
ts a
t eac
h si
te.
Rev
iew
the
Tel
e-N
euro
Pt a
nd
Pro
vide
r ev
alua
tions
. E
xpan
d D
ME
to 1
CB
OC
in V
ISN
8.
Initi
tiate
trea
tmen
t of V
eter
ans
with
the
spec
ializ
ed fo
cus
and
begi
n tr
acki
ng o
utco
mes
.
Con
duct
follo
w-u
p w
orkg
roup
for
'Clin
ical
Vid
eo-T
eleh
ealth
(C
VT
)-N
euro
logy
Fol
low
-up
Car
e fo
r V
eter
ans
with
Pro
gres
sive
Mul
tiple
S
cler
osis
, Liv
ing
in R
ural
Are
as’.
Col
labo
rate
with
GIS
team
to m
ap
patie
nts
at e
ach
site
nat
ionw
ide.
E
xpan
d D
ME
to 1
CB
OC
in V
ISN
8. C
ontin
ue tr
eatm
ent o
f spe
cial
ized
fo
cus
area
s an
d tr
acki
ng o
f ou
tcom
es. I
nclu
de tr
endi
ng d
ata
and
expa
nsio
n of
num
bers
of
patie
nts
serv
ed.
Stra
tegi
c G
oal F
our C
ontin
ued
Nex
t Pag
e
Initi
ativ
e 4.
1: E
xpan
d th
e us
e of
dis
tanc
e le
arni
ng te
chno
logi
es a
nd o
ther
mod
aliti
es
for
rura
l edu
catio
n pr
ogra
m d
eliv
ery
to
prov
ide
targ
eted
trai
ning
to a
ddre
ss s
peci
fic
need
s of
rur
al p
rovi
ders
.
Off
ice
of R
ural
Hea
lth
– F
Y 2
010-
2014
Str
ateg
ic P
lan
Ref
resh
18
App
endi
x A
Tab
le o
f Act
ion
Item
s, Pe
rson
(s) R
espo
nsib
le, Q
uart
erly
Mile
ston
es
Init
iati
ves
Act
ion
Item
sP
erso
n o
r O
rgan
izat
ion
R
esp
on
sib
le
Act
ion
Item
PO
C
FY
201
2 M
ilest
on
es1s
t Q
uar
ter
(Oct
-Dec
)F
Y 2
012
Mile
sto
nes
3rd
Qu
arte
r (A
pr-
Jun
)F
Y 2
012
Mile
sto
nes
2nd
Qu
arte
r (J
an-M
ar)
FY
201
2 M
ilest
on
es4t
h Q
uar
ter
(Ju
l-S
ep)
Act
ion
4.2.
1: C
onti
nue
and
expa
nd th
e R
ural
Hea
lth
Tra
inin
g P
rogr
am (
RH
TP
). T
he R
HT
P is
dir
ecte
d at
m
edic
al s
tude
nts,
nur
se p
ract
ione
rs, a
nd o
ther
all
ied
heal
th
prof
essi
onal
s. O
AA
wil
l col
labo
rate
as
need
ed r
egar
ding
af
fili
atio
n re
lati
onsh
ips
and
poli
cies
gov
erni
ng tr
aine
es in
ac
cred
ited
pro
gram
s.
Pau
l Hof
fman
Son
ya S
tarli
ng
Pen
elop
e M
arkl
e
Pau
l Hof
fman
Act
ion
4.2.
2: O
RH
wil
l col
labo
rate
wit
h O
ffic
e of
A
cade
mic
Aff
ilia
tion
s (O
AA
) in
dev
elop
ing
a ne
w V
A
Tra
inin
g In
itia
tive
dir
ecte
d at
rur
al V
A i
nter
disc
ipli
nary
te
ams,
suc
h as
thos
e at
rur
al C
BO
CS
and
Ext
ensi
on
Cli
nics
, hub
sit
es f
or r
ural
tele
heal
th s
ervi
ces,
or
HB
PC
te
ams
cari
ng f
or r
ural
Vet
eran
s.
OR
H V
AC
O O
AA
Nan
cy M
aher
Act
ion
4.2.
3: D
evel
op a
nd im
plem
ent a
n ed
ucat
ion
prog
ram
on d
iagn
osin
g di
agno
stic
pro
cedu
res
that
wil
l req
uire
ph
ysic
ians
to c
ompl
ete
pre-
read
ings
and
kno
wle
dge
asse
ssm
ents
, vie
w in
stru
ctio
nal v
ideo
s, p
ract
ice
usin
g pr
oced
ure-
spec
ific
sim
ulat
ion
equi
pmen
t, an
d un
derg
o a
full
ski
ll a
sses
smen
t usi
ng c
urre
nt p
ract
ice
stan
dard
s an
d ev
iden
ce b
ased
cri
teri
a un
der
the
eval
uati
on o
f an
ap
prop
riat
e m
edic
al p
eer.
Pro
vide
a tr
aini
ng m
odel
that
co
uld
be a
ppli
ed a
t all
VA
MC
s se
rvin
g ru
ral p
opul
atio
ns.
Al W
est
Al W
est
Act
ion
4.2.
4: T
he T
ogus
VA
MC
and
the
VR
HR
C -
Eas
tern
R
egio
n w
ill a
ctiv
ely
part
icip
ate
in th
e ‘H
RS
A T
eleh
ealt
h R
esou
rce
Cen
ter
Gra
nt P
rogr
am: C
FD
A 9
3.21
1, N
orth
east
T
eleh
ealt
h R
esou
rce
Cen
ter’
Son
ya S
tarli
ng
Pen
elop
e M
arkl
eS
onya
Sta
rling
Initi
ativ
e 4.
2: D
evel
op n
ew e
duca
tion
reso
urce
s fo
r he
alth
-car
e pr
ofes
sion
als
VR
HR
C-E
R s
taff
part
icip
atio
n in
T
eleh
ealth
Adv
isor
y C
omm
ittee
m
eetin
gs. S
eek
to d
evel
op a
nd
man
age
colla
bora
tive
trai
ning
pr
ojec
ts w
ith N
ET
RIC
team
.
VR
HR
C-E
R s
taff
part
icip
atio
n in
T
eleh
ealth
Adv
isor
y C
omm
ittee
m
eetin
gs. S
eek
to d
evel
op a
nd
man
age
colla
bora
tive
trai
ning
pr
ojec
ts w
ith N
ET
RIC
team
.
Fin
aliz
e fir
st r
otat
ion
of A
RN
P, P
T,
and
3 m
edic
al s
tude
nts.
R
ecru
it ne
xt P
T s
tude
nt a
t Nor
th
Flo
rida/
Sou
th G
eorg
ia V
eter
ans
Hea
lth c
are
syst
em (
NF
/SG
VH
S).
E
xpan
d th
e R
HT
P w
ith a
co
llabo
ratio
n m
eetin
g w
ith D
r. L
ori
Dav
is a
nd D
r. H
ugh
Myr
ick
for
Pub
lic P
sych
iatr
y an
d T
ele-
Men
tal
Hea
lth.
Tel
epha
rmac
y P
roje
ct-M
aine
VA
:In
itiat
e an
d es
tabl
ish
Tel
epha
rmac
y M
edic
atio
n R
econ
cilia
tion
Clin
ics
Pro
ject
at
VA
Mai
ne in
acc
orda
nce
with
OT
S
Con
ditio
ns o
f Par
ticip
atio
n an
d lo
cal p
olic
y. E
stab
lish
form
at in
R
ES
ITR
AC
K to
rec
ord
Pha
rmac
y R
esid
ent e
xper
ienc
e. C
ertif
y P
harm
acy
Res
iden
ts (
2) a
s O
TS
-ap
prov
ed C
VT
pro
vide
rs. O
rient
P
harm
acy
Stu
dent
s (6
th y
ear)
to
proj
ect.
Orie
nt a
nd tr
ain
CB
OC
st
aff.
Dev
elop
ano
nym
ous
patie
nt
satis
fact
ion
surv
ey. I
nitia
te
Pha
rmac
y R
esid
ent T
elep
harm
acy
Med
icat
ion
Rec
onci
liatio
n cl
inic
vi
sits
for
CB
OC
pat
ient
s D
ecem
ber
2011
.
Pla
ce P
T s
tude
nt a
t NF
/SG
VH
S.
Est
ablis
h re
latio
nshi
p w
ith o
ther
sc
hool
s fo
r A
RN
P a
nd P
T s
tude
nts.
Tel
epha
rmac
y P
roje
ct-M
aine
VA
:C
ontin
ue P
harm
acy
Res
iden
t T
elep
harm
acy
Med
icat
ion
Rec
onci
liatio
n cl
inic
vis
its fo
r C
BO
C p
atie
nts
with
ong
oing
rev
iew
of
pro
cess
es o
f ser
vice
del
iver
y.
Pha
rmac
y st
uden
ts (
6th
year
) ob
serv
e cl
inic
as
adva
nced
pr
actic
e ph
arm
acy
CV
T
expe
rienc
e. M
ake
adju
stm
ents
to
oper
atio
n of
Tel
epha
rmac
y M
edic
atio
n R
econ
cilia
tion
Clin
ics,
if
need
ed.
Fin
aliz
e ro
tatio
n of
PT
and
med
ical
st
uden
ts.
Tel
epha
rmac
y P
roje
ct-M
aine
VA
:D
evel
op a
sta
ff sa
tisfa
ctio
n su
rvey
an
d ob
tain
nec
essa
ry lo
cal
appr
oval
s to
adm
inis
ter.
Con
tinue
Pha
rmac
y R
esid
ent
Tel
epha
rmac
y M
edic
atio
n R
econ
cilia
tion
clin
ic v
isits
for
CB
OC
pat
ient
s w
ith o
ngoi
ng
revi
ew o
f pro
cess
es o
f ser
vice
de
liver
y. P
harm
acy
stud
ents
(6t
h ye
ar)
obse
rve
clin
ic a
s ad
vanc
ed
prac
tice
phar
mac
y C
VT
ex
perie
nce.
Mak
e ad
just
men
ts to
op
erat
ion
of T
elep
harm
acy
Med
icat
ion
Rec
onci
liatio
n C
linic
s,
if ne
eded
.
Rev
iew
stu
dent
and
pre
cept
or
eval
uatio
n fo
rms.
A
ttend
and
dis
trib
ute
recr
uitm
ent
pack
ets
at s
tude
nt o
rient
atio
n da
y.
Tel
epha
rmac
y P
roje
ct-M
aine
VA
:C
ontin
ue P
harm
acy
Res
iden
t T
elep
harm
acy
Med
icat
ion
Rec
onci
liatio
n cl
inic
vis
its fo
r C
BO
C p
atie
nts
with
ong
oing
re
view
of p
roce
sses
of s
ervi
ce
deliv
ery.
Pha
rmac
y st
uden
ts (
6th
year
) ob
serv
e cl
inic
as
adva
nced
pr
actic
e ph
arm
acy
CV
T
expe
rienc
e.
Adm
inis
ter
staf
f sat
isfa
ctio
n su
rvey
.S
umm
ariz
e pa
tient
sat
isfa
ctio
n su
rvey
info
rmat
ion.
Eva
luat
e pi
lot a
nd p
rovi
de
prog
ram
rec
omm
enda
tions
Con
tinue
mee
tings
bet
wee
n O
RH
te
am a
nd O
AA
team
. D
evel
op, r
evie
w a
nd a
ppro
ve
Req
uest
for
Pro
posa
ls (
RF
P)
Dis
trib
ute
RF
P a
nnou
ncem
ent.
Fie
ld w
ill s
end
in L
OIs
to O
RH
and
O
AA
. Fie
ld w
ill d
evel
op p
ropo
sals
. O
RH
and
OA
A w
ill m
eet a
s ne
eded
.
Ful
l pro
posa
ls d
ue. P
ropo
sals
are
re
view
ed b
y O
AA
rev
iew
team
. O
RH
and
OA
A w
ill m
eet a
s ne
eded
.
App
lican
ts a
re n
otifi
ed o
f rev
iew
re
sults
. Pro
gram
beg
ins
Fal
l of
A
cade
mic
Yea
r 20
12-2
013.
Acq
uire
pre
-inte
rven
tion
mea
sure
s of
pat
ient
wai
t tim
es a
nd d
elay
ed
care
, and
cou
nts
of m
edic
al s
taff
qual
ified
to p
erfo
rm p
roce
dure
s.
Pur
chas
e si
mul
ator
s an
d "t
rain
the
trai
ners
" to
put
them
into
use
, the
n st
art t
rain
ing
med
ical
sta
ff w
ith
them
.
Con
tinue
trai
ning
sta
ff an
d co
llect
ing
data
.C
ontin
ue s
taff
trai
ning
, and
beg
in
follo
w-u
p da
ta c
olle
ctio
n.C
ompl
ete
data
col
lect
ion
and
anal
ysis
, and
writ
e fin
al r
epor
t.
HR
SA
aw
arde
d gr
ant f
undi
ng fo
r N
ew E
ngla
nd T
eleh
ealth
Res
ourc
e C
ente
r (N
ET
RC
) P
roje
ct o
n 9/
1/20
11 H
RS
A G
rant
#
G22
RH
2269
9
VR
HR
C-E
R s
taff
part
icip
atio
n in
T
eleh
ealth
Adv
isor
y C
omm
ittee
m
eetin
gs. S
eek
to d
evel
op a
nd
man
age
colla
bora
tive
trai
ning
pr
ojec
ts w
ith N
ET
RC
team
.
VR
HR
C-E
R s
taff
part
icip
atio
n in
T
eleh
ealth
Adv
isor
y C
omm
ittee
m
eetin
gs. S
eek
to d
evel
op a
nd
man
age
colla
bora
tive
trai
ning
pr
ojec
ts w
ith N
ET
RC
team
Off
ice
of R
ural
Hea
lth
– F
Y 2
010-
2014
Str
ateg
ic P
lan
Ref
resh
19
App
endi
x A
Tab
le o
f Act
ion
Item
s, Pe
rson
(s) R
espo
nsib
le, Q
uart
erly
Mile
ston
es
Init
iati
ves
Act
ion
Item
sP
erso
n o
r O
rgan
izat
ion
R
esp
on
sib
le
Act
ion
Item
PO
C
FY
201
2 M
ilest
on
es1s
t Q
uar
ter
(Oct
-Dec
)F
Y 2
012
Mile
sto
nes
3rd
Qu
arte
r (A
pr-
Jun
)F
Y 2
012
Mile
sto
nes
2nd
Qu
arte
r (J
an-M
ar)
FY
201
2 M
ilest
on
es4t
h Q
uar
ter
(Ju
l-S
ep)
Act
ion
5.1.
1:
Mai
ntai
n ex
isti
ng c
olla
bora
tion
s w
ith
the
Off
ice
of G
eria
tric
s an
d E
xten
ded
Car
e, th
e O
ffic
e of
M
enta
l Hea
lth
Ser
vice
, the
VA
Hom
eles
s O
ffic
e, a
nd th
e W
omen
Vet
eran
s H
ealt
h S
trat
egic
Hea
lth
Car
e G
roup
by
clos
ely
mon
itor
ing
the
perf
orm
ance
of
exis
ting
co
llab
orat
ive
proj
ects
and
by
expa
ndin
g/m
aint
aini
ng
succ
essf
ul p
rogr
ams
if f
undi
ng a
llow
s.
OR
H V
AC
OS
eren
a C
hu
Chr
istin
a W
hite
Act
ion
5.1.
2: C
ondu
ct a
n as
sess
men
t of
rura
l out
reac
h ef
fort
s an
d id
enti
fy e
ffor
ts th
at c
ould
be
join
tly
coor
dina
ted
wit
h lo
cal f
acil
ity’
s M
y H
ealt
heV
et (
MH
V)
Coo
rdin
ator
to
allo
w f
or im
med
iate
in-p
erso
n au
then
tica
tion
dur
ing
an
outr
each
eve
nt
Kris
ten
Win
gK
riste
n W
ing
Act
ion
5.1.
3:
Iden
tify
and
eng
age
othe
r V
A p
rogr
am
offi
ces
that
impa
ct r
ural
hea
lth
for
poss
ible
col
labo
rati
ons.
O
RH
VA
CO
Ser
ena
Chu
N
ancy
Mah
er K
riste
n W
ing
Act
ion
5.2.
1: I
nven
tory
and
ass
ess
effe
ctiv
enes
s of
cur
rent
O
RH
–fu
nded
out
reac
h ac
tivi
ties
usi
ng c
rite
ria
deve
lope
d by
OR
H le
ader
ship
.
Nan
cy D
aile
yN
ancy
Dai
ley
Act
ion
5.2.
2: P
arti
cipa
te a
s a
mem
ber
of th
e N
atio
nal
Vet
eran
s O
utre
ach
(NV
O)
Off
ice
outr
each
wor
kgro
ups
to
prov
ide
repr
esen
tati
on f
or O
RH
, the
VR
C’s
, and
V
RH
RC
’s; a
nd to
sha
re in
form
atio
n ab
out t
he o
utre
ach
need
s of
rur
al V
eter
ans
and
OR
H-s
uppo
rted
out
reac
h in
itia
tive
s.
Kris
ten
Win
gK
riste
n W
ing
Act
ion
5.2.
3: U
tili
ze th
e ne
w (
FY
12)
NV
O O
utre
ach
Dat
abas
e an
d O
utre
ach
guid
e in
ord
er to
iden
tify
VA
ou
trea
ch p
rogr
am a
nd p
artn
ers
curr
entl
y co
nduc
ting
ou
trea
ch (
such
as
OE
F/O
IF o
utre
ach)
, Yel
low
Rib
bon
even
ts, e
tc.)
in r
ural
are
as a
nd c
olla
bora
te (
whe
re p
ossi
ble
and
appr
opri
ate)
; to
guid
e th
e pl
anni
ng a
nd im
plem
enta
tion
of
OR
H –
spo
nsor
ed o
utre
ach
init
iati
ves,
and
to e
valu
ate
and
anal
yze
the
effe
ctiv
enes
s of
out
reac
h ef
fort
s.
Kris
ten
Win
gK
riste
n W
ing
Initi
ativ
e 5.
2: C
ontin
ue to
par
tner
with
va
rious
ent
ities
with
in th
e ru
ral h
ealth
co
mm
unity
to e
stab
lish
or b
uild
upo
n ex
istin
g ou
trea
ch n
etw
orks
for
rura
l V
eter
ans.
Stra
tegi
c G
oal F
ive:
Enh
ance
exi
stin
g an
d im
plem
ent n
ew s
trat
egie
s to
impr
ove
colla
bora
tions
and
incr
ease
ser
vice
opt
ions
for r
ural
and
hig
hly
rura
l Vet
eran
s.
Fol
low
-up
with
VR
HR
Cs
and
VR
Cs
to id
entif
y re
mai
ning
gap
s in
M
HV
par
tner
ship
s.
Con
tact
VR
HR
Cs
and
VR
Cs
to
begi
n bu
ildin
g an
inve
ntor
y of
sc
hedu
led
Out
reac
h ev
ents
, di
ssem
inat
e lis
t of M
HV
C
oord
inat
ors
to V
RH
RC
s an
d V
RC
s.
Par
ticip
ate
in a
MH
V C
oord
inat
or
mon
thly
Poi
nt-o
f-C
onta
ct (
PO
C)
call
to in
form
the
MH
V
Coo
rdin
ator
s ab
out R
ural
Hea
lth
Out
reac
h ef
fort
s.
Con
duct
web
inar
to e
duca
te
VR
HR
Cs
and
VR
Cs
abou
t the
In-
Per
son
Aut
hent
icat
ion
(IP
A)
Pro
cess
and
Sec
ure
Mes
sagi
ng.
FY
12 O
RH
fund
ing
of s
usta
ined
H
ome
Bas
ed P
rimar
y C
are
(HB
PC
)
and
E R
AN
GE
pro
ject
s w
ill b
e di
sbur
sed.
FY
12 O
RH
fund
ing
of
new
pro
ject
s di
rect
ed b
y th
e O
ffice
of
Wom
en's
Hea
lth w
ill b
egin
. O
RH
pro
gram
ana
lyst
s w
ill m
onito
r ex
pend
iture
s an
d re
port
qua
rter
ly
on p
erfo
rman
ce m
easu
res.
OR
H p
rogr
am a
naly
sts
will
mon
itor
expe
nditu
res
and
repo
rt q
uart
erly
on
per
form
ance
mea
sure
s.
OR
H p
rogr
am a
naly
sts
will
mon
itor
expe
nditu
res
and
repo
rt q
uart
erly
on
per
form
ance
mea
sure
s.
OR
H p
rogr
am a
naly
sts
will
mon
itor
expe
nditu
res
and
repo
rt q
uart
erly
on
per
form
ance
mea
sure
s.
1. P
artic
ipat
e in
Nat
iona
l Vet
eran
s O
utre
ach
Offi
ce w
orkg
roup
co
nfer
ence
cal
ls.
2. P
artic
ipat
e in
m
onth
ly P
hysi
cal M
edic
ine
and
Reh
abili
tatio
n S
ervi
ce A
dvis
ory
Boa
rd c
onfe
renc
e ca
lls. 3
. Mee
t qu
arte
rly w
ith th
e O
ffice
of T
ribal
G
over
nmen
t Rel
atio
ns.
1. P
artic
ipat
e in
Nat
iona
l Vet
eran
s O
utre
ach
Offi
ce w
orkg
roup
co
nfer
ence
cal
ls.
2. P
artic
ipat
e in
m
onth
ly P
hysi
cal M
edic
ine
and
Reh
abili
tatio
n S
ervi
ce A
dvis
ory
Boa
rd c
onfe
renc
e ca
lls. 3
. Mee
t qu
arte
rly w
ith th
e O
ffice
of T
ribal
G
over
nmen
t Rel
atio
ns.
1. P
artic
ipat
e in
Nat
iona
l Vet
eran
s O
utre
ach
Offi
ce w
orkg
roup
co
nfer
ence
cal
ls.
2. P
artic
ipat
e in
m
onth
ly P
hysi
cal M
edic
ine
and
Reh
abili
tatio
n S
ervi
ce A
dvis
ory
Boa
rd c
onfe
renc
e ca
lls. 3
. Mee
t qu
arte
rly w
ith th
e O
ffice
of T
ribal
G
over
nmen
t Rel
atio
ns.
1. P
artic
ipat
e in
Nat
iona
l Vet
eran
s O
utre
ach
Offi
ce w
orkg
roup
co
nfer
ence
cal
ls.
2. P
artic
ipat
e in
m
onth
ly P
hysi
cal M
edic
ine
and
Reh
abili
tatio
n S
ervi
ce A
dvis
ory
Boa
rd c
onfe
renc
e ca
lls. 3
. Mee
t qu
arte
rly w
ith th
e O
ffice
of T
ribal
G
over
nmen
t Rel
atio
ns.
Sup
port
the
VR
Cs
and
VIS
Ns
with
th
eir
actio
n pl
ans
for
rura
l ou
trea
ch w
ith c
omm
unity
par
tner
s,
usin
g be
st p
ract
ices
doc
umen
ted
and
Out
reac
h T
oolk
it de
velo
ped
by
WR
.
Initi
ate
mee
ting
with
VR
Cs
to
defin
e th
eir
outr
each
act
ivity
act
ion
plan
s w
ithin
thei
r V
ISN
. Doc
umen
t ac
tion
plan
s an
d tim
elin
e fo
r in
itiat
ion.
Beg
in p
opul
atin
g th
e da
shbo
ard
mon
thly
with
met
rics.
Beg
in
docu
men
tatio
n of
inve
ntor
y of
pa
rtne
rs. I
nitia
te w
orkg
roup
to
iden
tify
best
pra
ctic
es a
nd b
egin
do
cum
enta
tion
of s
ame.
VR
HR
C-
WR
will
hos
t the
OR
H m
eetin
g,
them
e of
whi
ch is
col
labo
ratio
ns
with
rur
al c
omm
uniti
es. E
duca
tion
prov
ided
to a
ll V
RC
s an
d ot
hers
at
tend
ing
this
con
fere
nce.
Iden
tify
OR
H c
riter
ia fo
r de
term
inin
g ef
fect
iven
ess
of
outr
each
act
iviti
es v
ia th
orou
gh
revi
ew o
f pro
pose
d pr
ogra
m g
oals
an
d de
liver
able
s. D
evel
op d
ata
gath
erin
g to
ol a
nd d
ashb
oard
on
OR
H w
ebsi
te fo
r re
port
ing.
Tes
t da
shbo
ard
by id
entif
ying
pro
gram
le
ads
and
educ
atin
g th
em o
n th
e re
port
/pur
pose
. col
lect
and
co
mpi
le a
list
of e
ntiti
es th
at a
re
pres
entin
g w
orki
ng w
ith V
A in
rur
al
loca
tions
to s
uppo
rt o
utre
ach
to
Vet
eran
s w
ithin
thei
r co
mm
unity
.
Par
ticip
ate
in O
utre
ach
Wor
kgro
up
conf
eren
ce c
alls
. P
artic
ipat
e in
Out
reac
h W
orkg
roup
co
nfer
ence
cal
lsP
artic
ipat
e in
Out
reac
h W
orkg
roup
co
nfer
ence
cal
lsP
artic
ipat
e in
Out
reac
h W
orkg
roup
co
nfer
ence
cal
ls
Whe
n da
taba
se is
rel
ease
d,
cond
uct a
web
inar
to in
trod
uce
VR
HR
Cs
and
VR
Cs
to th
e N
VO
O
utre
ach
Dat
abas
e an
d su
ppor
t its
im
plem
enta
tion
Ana
lyze
use
of N
VO
Out
reac
h D
atab
ase
by V
RH
RC
s/V
RC
s, v
erify
th
at o
utre
ach
even
ts id
entif
ied
in
Act
ion
Item
2.2
.3 h
ave
been
en
tere
d, id
entif
y pl
anne
d ou
trea
ch
even
ts in
rur
al a
reas
and
sha
re
info
rmat
ion
with
VR
HR
Cs/
VR
Cs
Iden
tify
plan
ned
outr
each
eve
nts
in r
ural
are
as a
nd s
hare
in
form
atio
n w
ith V
RH
RC
s/V
RC
s
Iden
tify
plan
ned
outr
each
eve
nts
in r
ural
are
as a
nd s
hare
in
form
atio
n w
ith V
RH
RC
s/V
RC
s
Initi
ativ
e 5.
1: C
ontin
ue e
xist
ing
and
begi
n ne
w c
olla
bora
tions
with
VA
pro
gram
offi
ces.
Off
ice
of R
ural
Hea
lth
– F
Y 2
010-
2014
Str
ateg
ic P
lan
Ref
resh
20
App
endi
x A
Tab
le o
f Act
ion
Item
s, Pe
rson
(s) R
espo
nsib
le, Q
uart
erly
Mile
ston
es
Init
iati
ves
Act
ion
Item
sP
erso
n o
r O
rgan
izat
ion
R
esp
on
sib
le
Act
ion
Item
PO
C
FY
201
2 M
ilest
on
es1s
t Q
uar
ter
(Oct
-Dec
)F
Y 2
012
Mile
sto
nes
3rd
Qu
arte
r (A
pr-
Jun
)F
Y 2
012
Mile
sto
nes
2nd
Qu
arte
r (J
an-M
ar)
FY
201
2 M
ilest
on
es4t
h Q
uar
ter
(Ju
l-S
ep)
Act
ion
5.2.
4: I
dent
ify
addi
tion
al r
ural
are
as o
f th
e co
untr
y to
targ
et in
rur
al V
eter
an o
utre
ach
effo
rts
to e
nsur
e th
at a
ll
rura
l Vet
eran
s ha
ve b
een
cont
acte
d re
gard
ing
thei
r be
nefi
ts
and
new
loca
l ser
vice
s.
Nan
cy D
aile
yN
ancy
Dai
ley
Act
ion
5.2.
5: I
dent
ify
Sta
te a
nd lo
cal o
rgan
izat
ions
in r
ural
co
mm
unit
ies
for
outr
each
par
tner
ship
s an
d co
llab
orat
e w
here
fea
sibl
e.
Byr
on B
air
Nan
cy D
aile
yN
ancy
Dai
ley
Act
ion
5.2.
6: F
acil
itat
e pa
rtne
rshi
ps b
etw
een
rura
l CB
OC
s (a
nd o
utre
ach
clin
ic p
erso
nnel
) w
ith
com
mun
ity
heal
th
enti
ties
by
help
ing
to s
trea
mli
ne p
roce
ss f
or c
ontr
acti
ng.
Byr
on B
air
Nan
cy D
aile
yN
ancy
Dai
ley
Act
ion
5.2.
7: T
o im
prov
e co
mm
unic
atio
ns b
etw
een
OR
H
and
its
part
ners
, fur
ther
dev
elop
out
reac
h co
ntac
ts d
atab
ase
incl
udin
g in
divi
dual
s fr
om S
tate
Off
ices
of
Rur
al H
ealt
h,
Hea
lth
Res
earc
h S
ervi
ce A
dmin
istr
atio
n (H
RS
A)
Off
ice
of
Rur
al H
ealt
h P
olic
y, a
nd r
ural
hea
lth
rese
arch
ers.
OR
H
com
mun
icat
ions
Kris
ten
Win
g
Initi
ativ
e 5.
3: E
xpan
d an
d de
velo
p pu
blic
-pu
blic
col
labo
ratio
ns.
Act
ion
5.3.
1: E
stab
lish
ong
oing
liai
son
wit
h S
trat
egic
A
ctio
n gr
oups
rel
evan
t to
rura
l iss
ues
that
are
par
t of
the
DO
D/V
A I
nteg
rate
d M
enta
l Hea
lth
Str
ateg
y (I
MH
S).
The
IM
HS
cen
ters
on
a co
ordi
nate
d pu
blic
hea
lth
mod
el to
im
prov
e th
e ac
cess
, qua
lity
, eff
ecti
vene
ss, a
nd e
ffic
ienc
y of
m
enta
l hea
lth
serv
ices
. Rec
ipie
nts
of th
ese
serv
ices
incl
ude
acti
ve d
uty
serv
ice
mem
bers
, Nat
iona
l Gua
rd a
nd R
eser
ve
Com
pone
nt m
embe
rs, V
eter
ans,
and
thei
r fa
mil
ies.
Mar
y B
eth
Sku
pien
She
ila W
arre
nM
ary
Bet
h S
kupi
en
Act
ion
5.3.
2: E
stab
lish
and
for
mal
ize
rela
tion
ship
wit
h th
e S
ubst
ance
Abu
se a
nd M
enta
l Hea
lth
Ser
vice
s A
dmin
istr
atio
n (
SA
MH
SA
) fo
r in
form
atio
n sh
arin
g an
d pr
ovid
er tr
aini
ng.
Mar
y B
eth
Sku
pien
She
ila W
arre
nM
ary
Bet
h S
kupi
en
Act
ion
5.3.
3: E
stab
lish
rel
atio
nshi
p w
ith
US
Dep
artm
ent o
f A
gric
ultu
re (
US
DA
) co
oper
ativ
e ex
tens
ion
for
outr
each
to
rura
l Vet
eran
car
egiv
ers.
Mar
y B
eth
Sku
pien
She
ila W
arre
nM
ary
Bet
h S
kupi
en
Act
ion
5.3.
4: P
arti
cipa
te in
the
new
ly e
stab
lish
ed W
hite
H
ouse
Rur
al C
ounc
il t
hat w
ill c
ulm
inat
e in
a R
ural
Sum
mi t
in W
ashi
ngto
n, D
C.
Mar
y B
eth
Sku
pien
She
ila W
arre
nM
ary
Bet
h S
kupi
en
Act
ion
Item
5.4
.1: C
olla
bora
te w
ith th
e N
atio
nal R
ural
H
ealth
Ass
ocia
tion
(NR
HA
) to
ass
ist i
n th
e pl
anni
ng o
f the
ir an
nual
mee
ting
incl
udin
g or
gani
zatio
n of
wor
ksho
ps,
spea
kers
and
topi
cs o
f int
eres
t.
Nan
cy D
aile
yN
ancy
Dai
ley
Act
ion
Item
5.4
.2: O
rgan
ize
regi
onal
virt
ual m
eetin
gs w
ith
priv
ate
sect
ors
prov
ider
s an
d O
RH
sta
ff to
gai
n in
sigh
t on
he
alth
car
e ne
eds
of r
ural
Vet
eran
s .
Col
lette
Alv
arez
Col
lette
Alv
arez
Det
erm
ine
cont
act a
t SA
MH
SA
an
d m
eet w
ith in
divi
dual
in fi
rst
quar
ter
FY
12. D
evel
op p
artn
er
stra
tegy
for
prov
ider
trai
ning
.
US
DA
rep
rese
ntat
ive
notif
ied
of
repr
esen
tativ
e fo
r th
e V
RH
AC
. O
RH
Dire
ctor
will
be
wor
king
cl
osel
y w
ith h
e an
d hi
s co
unte
rpar
ts o
n ru
ral
issu
es/c
once
rns
and
oppo
rtun
ities
.
Mee
t on
quar
terly
bas
is if
req
uire
d.M
eet o
n qu
arte
rly b
asis
if r
equi
red.
Eva
luat
e if
actio
n pl
an h
as b
een
met
and
det
erm
ine
new
act
iviti
es
for
FY
13.
Mee
t on
quar
terly
bas
is if
req
uire
d.
Rep
ort l
esso
ns le
arne
d an
d em
ergi
ng s
trat
egie
s fo
r fu
rthe
r ex
port
atio
n of
rur
al c
olla
bora
tion
tool
kit.
Rep
ort l
esso
ns le
arne
d an
d em
ergi
ng s
trat
egie
s fo
r fu
rthe
r ex
port
atio
n of
rur
al c
olla
bora
tion
tool
kit
Fin
al r
epor
t on
less
ons
lear
ned
and
emer
ging
str
ateg
ies
from
ex
port
atio
n of
rur
al c
olla
bora
tion
tool
kit
and
defin
e ne
xt s
teps
for
natio
nal e
xpor
tatio
n
Use
too
l kit
to h
elp
VA
site
s
iden
tify
key
rura
l par
tner
s fo
r
outr
each
, par
tner
ship
and
co
llabo
rativ
e ef
fort
s by
VA
sta
tions
Rep
ort l
esso
ns le
arne
d fr
om u
sing
th
e to
ol k
it to
iden
tify
rura
l par
tner
s fo
r ou
trea
ch, p
artn
ersh
ips,
and
co
llabo
rativ
e ef
fort
s
Rep
ort l
esso
ns le
arne
d fr
om u
sing
th
e to
ol k
it to
iden
tify
rura
l par
tner
s fo
r ou
trea
ch, p
artn
ersh
ips,
and
co
llabo
rativ
e ef
fort
s
Pro
vide
a fi
nal r
epor
t on
less
ons
lear
ned
from
usi
ng th
e to
ol k
it to
id
entif
y ru
ral p
artn
ers
for
outr
each
, pa
rtne
rshi
ps, a
nd c
olla
bora
tive
effo
rts
Mon
itor
cont
ract
ing
proc
esse
s in
id
entif
ied
site
s an
d re
port
less
ons
lear
ned
Fin
al r
epor
t on
mon
itor
cont
ract
ing
proc
esse
s in
iden
tifie
d si
tes
Rev
iew
OR
H C
onta
cts
Dat
abas
e fo
r ex
istin
g ou
trea
ch p
artn
ers,
id
entif
y ga
ps in
col
labo
ratio
ns,
rese
arch
add
ition
al c
onta
cts
and
add
thei
r in
form
atio
n to
Con
tact
s D
atab
ase
Dis
sem
inat
e a
list o
f pla
nned
VA
ou
trea
ch e
vent
s to
out
reac
h co
ntac
ts, i
nqui
re a
bout
op
port
uniti
es to
col
labo
rate
on
outr
each
with
con
tact
s.
Dis
sem
inat
e a
list o
f pla
nned
VA
ou
trea
ch e
vent
s to
out
reac
h co
ntac
ts, i
nqui
re a
bout
op
port
uniti
es to
col
labo
rate
on
outr
each
with
con
tact
s.
Dis
sem
inat
e a
list o
f pla
nned
VA
ou
trea
ch e
vent
s to
out
reac
h co
ntac
ts, i
nqui
re a
bout
op
port
uniti
es to
col
labo
rate
on
outr
each
with
con
tact
s.
Con
tinui
ng v
irtua
l mee
tings
with
H
uman
a an
d C
ary
Med
ical
Cen
ter
on a
mon
thly
bas
is to
gai
n in
sigh
t fr
om p
rivat
e se
ctor
pro
vide
rs o
n he
alth
car
e ne
eds
of r
ural
V
eter
ans
Con
tinue
mee
ting
mon
thly
with
H
uman
a an
d C
ary
Med
ical
Cen
ter.
Con
tinue
mee
ting
mon
thly
with
H
uman
a an
d C
ary
Med
ical
Cen
ter.
Atte
nd p
lann
ing
mee
ting
Upd
ate
from
IMH
S in
firs
t qua
rter
. D
iscu
ss o
ngoi
ng p
artn
ersh
ips
in
this
are
a. M
eet w
ith K
aren
M
alen
bran
che
and
staf
f to
disc
uss
VA
/DO
D p
riorit
ies
and
OR
H
invo
lvem
ent i
n th
e pr
oces
s.
Mon
itor
prog
ress
and
act
ion
step
s af
ter
initi
al m
eetin
g qu
arte
rly.
Mon
itor
prog
ress
and
act
ion
step
s af
ter
initi
al m
eetin
g qu
arte
rly..
Eva
luat
e if
actio
n pl
an h
as b
een
met
and
det
erm
ine
new
act
iviti
es
for
FY
13.
Atte
nd n
atio
nal m
eetin
gP
rovi
de fi
nal r
epor
t and
nex
t ste
ps
Act
ive
mem
ber
of th
e P
resi
dent
's
Rur
al C
ounc
il Q
ualit
y of
Life
W
orkg
roup
. Mee
ts 2
tim
es p
er
mon
th. F
ollo
w u
p ac
tion
plan
s w
ill
be m
onito
red
Mee
t on
a m
onth
ly b
asis
as
requ
ired
Mee
t virt
ually
on
a m
onth
ly b
asis
an
d ev
alua
te if
act
ion
plan
has
be
en m
et a
nd d
eter
min
e ne
w
activ
ities
for
FY
13.
Initi
ativ
e 5.
4: In
stitu
tiona
lize
publ
ic-p
rivat
e co
llabo
ratio
ns.
Mee
t on
a m
onth
ly b
asis
and
ev
alua
te th
e V
A O
RH
OR
H p
lan
of
actio
n fo
r th
e W
H R
ural
Cou
ncil
activ
ities
. Rem
ain
activ
e on
this
co
unci
l.
Eva
luat
e if
actio
n pl
an h
as b
een
met
and
det
erm
ine
new
act
iviti
es
for
FY
13.
Mee
t on
quar
terly
bas
is if
req
uire
d.
Mon
itor
cont
ract
ing
proc
esse
s in
id
entif
ied
site
s an
d re
port
less
ons
lear
ned
Impl
emen
t pla
nnin
g ag
enda
Mee
t on
a m
onth
ly b
asis
as
requ
ired
Mon
itor
cont
ract
ing
proc
esse
s in
id
entif
ied
site
s an
d re
port
less
ons
lear
ned
Iden
tify
6 ne
w s
ites
for
test
ing
of
rura
l col
labo
ratio
n to
ol k
it
Off
ice
of R
ural
Hea
lth
– F
Y 2
010-
2014
Str
ateg
ic P
lan
Ref
resh
21
App
endi
x A
Tab
le o
f Act
ion
Item
s, Pe
rson
(s) R
espo
nsib
le, Q
uart
erly
Mile
ston
es
Init
iati
ves
Act
ion
Item
sP
erso
n o
r O
rgan
izat
ion
R
esp
on
sib
le
Act
ion
Item
PO
C
FY
201
2 M
ilest
on
es1s
t Q
uar
ter
(Oct
-Dec
)F
Y 2
012
Mile
sto
nes
3rd
Qu
arte
r (A
pr-
Jun
)F
Y 2
012
Mile
sto
nes
2nd
Qu
arte
r (J
an-M
ar)
FY
201
2 M
ilest
on
es4t
h Q
uar
ter
(Ju
l-S
ep)
Act
ion
6.1.
1: I
ncre
ase
use
of th
e S
tude
nt E
duca
tion
al
Enr
ollm
ent P
lan
(SE
EP
) an
d V
A L
earn
ing
Opp
ortu
niti
es
Res
iden
cy (
VA
LO
R)
prog
ram
s in
are
as d
esig
nate
d ru
ral
and
high
ly r
ural
. VH
A H
ealt
hcar
e R
ecru
itm
ent a
nd
Ret
enti
on O
ffic
e (H
RR
O),
who
is r
espo
nsib
le f
or
adm
inis
teri
ng th
ese
prog
ram
s, w
ill e
arm
ark
fund
ing
spec
ific
ally
for
use
in f
acil
itie
s de
sign
ated
rur
al a
nd h
ighl
y-ru
ral.
VH
A P
lace
men
t Ser
vice
s w
ill a
lso
deve
lop
an a
war
d to
be
pres
ente
d to
VA
LO
R s
tude
nts
upon
gra
duat
ion.
HR
RO
Ant
hony
Ach
ampo
ng
Act
ion
6.1.
2: I
ncre
ase
pres
ence
at c
olle
ges
and
univ
ersi
ties
w
ith
clos
e pr
oxim
ity
to r
ural
VA
hea
lth
care
fac
ilit
ies.
H
RR
O w
ill d
evel
op a
war
ds/r
ecog
niti
on p
rogr
ams
for
pres
enta
tion
to s
tude
nts
com
mit
ted
to r
ural
pra
ctic
e at
co
mm
ence
men
t cer
emon
ies;
iden
tify
and
att
end
even
ts in
ru
ral c
omm
unit
ies
and
upco
min
g ru
ral h
ealt
h co
nfer
ence
s,
incl
udin
g th
e N
atio
nal R
ural
Hea
lth
Con
fere
nce
in M
ay
2012
.
HR
RO
Ant
hony
Ach
ampo
ng
Act
ion
6.1.
3: H
RR
O M
arke
ting
and
Pla
cem
ent S
ervi
ces
wil
l dev
elop
rur
al c
omm
unit
y aw
aren
ess
cam
paig
n to
be
roll
ed o
ut r
ural
loca
tion
s id
enti
fied
by
HR
RO
to h
elp
deve
lop
rura
l pro
vide
r w
orkf
orce
. HR
RO
wil
l ext
end
mar
keti
ng s
cope
to in
clud
e ad
diti
onal
dem
ogra
phic
s gr
oups
(hig
h sc
hool
stu
dent
s, f
amil
ies)
wit
h a
vest
ed in
tere
st in
ru
ral p
ract
ice.
HR
RO
A
ntho
ny A
cham
pong
Act
ion
6.2.
1: O
RH
will
fos
ter
ongo
ing
dial
ogue
bet
wee
n V
HA
Pla
cem
ent R
ecru
itmen
t Con
sulta
nts
in H
RR
O a
nd
VIS
N R
ural
Con
sulta
nts
(VR
Cs)
and
HR
and
form
a
wor
kgro
up to
iden
tify
top
occu
patio
nal p
riorit
ies,
cha
lleng
es
and
oppo
rtun
ities
for
recr
uitm
ent a
nd r
eten
tion
at r
ural
and
hi
ghly
rur
al V
A h
ealth
car
e fa
cilit
ies
in o
rder
to d
evel
op a
ru
ral h
ealth
wor
kfor
ce s
trat
egy.
HR
RO
, VR
Cs
Ant
hony
A
cham
pong
Ant
hony
Ach
ampo
ng
Act
ion
6.2.
2: C
ondu
ct a
join
t nat
iona
l rur
al h
ealt
h w
orkf
orce
stu
dy w
ith
Hea
lth
Res
ourc
es S
ervi
ce
Adm
inis
trat
ion
–Off
ice
of R
ural
Hea
lth
Pol
icy
(HR
SA
-O
RH
P )
to e
xam
ine
shar
ed w
orkf
orce
str
ateg
ies
and
spec
ific
nee
ds in
ord
er to
gai
n ev
iden
ce o
f ex
isti
ng a
d ho
c m
odel
s an
d su
ppor
t nee
ded
for
join
t con
trac
ting
of
prov
ider
s.
Mar
y B
eth
Sku
pien
Mar
y B
eth
Sku
pien
Act
ion
6.2.
3: E
valu
ate
regi
onal
and
sta
te m
odel
s of
rur
al
rete
ntio
n st
rate
gies
.C
entr
al R
egio
n -
VR
HR
CM
ary
Cha
rlton
Wor
k w
ith lo
cal a
nd n
atio
nal
expe
rts
to d
evel
op a
n in
vent
ory
of
rura
l ret
entio
n st
rate
gies
.
Ana
lyze
the
outc
omes
of e
ach
of
thes
e m
odel
s an
d de
term
ine
if th
ey
wer
e su
cces
sful
.
Eva
luat
e th
e fe
asib
ility
for
use
of
each
mod
el b
y th
e V
HA
.S
umm
ariz
e be
st p
ract
ices
and
fo
rmul
ate
reco
mm
enda
tions
for
rura
l ret
entio
n st
rate
gies
in th
e V
HA
in a
whi
te p
aper
.
Stra
tegi
c G
oal 6
: Dev
elop
inno
vativ
e m
etho
ds to
iden
tify,
recr
uit a
nd re
tain
med
ical
pro
fess
iona
ls a
nd re
quis
ite e
xper
tise
in ru
ral a
nd h
ighl
y ru
ral c
omm
uniti
es.
Con
tinue
dev
elop
men
t and
in
crea
se p
rese
nce
of ta
rget
ed
mar
ketin
g m
ater
ials
enc
oura
ging
in
divi
dual
s to
con
side
r pr
actic
e in
ru
ral c
omm
uniti
es id
entif
ied
in
Qua
rter
1. D
isse
min
ate
TV
/Rad
io
publ
ic s
ervi
ce a
nnou
ncem
ents
to
rura
l com
mun
ities
.
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duct
ass
essm
ent.
Con
duct
m
onth
ly c
onfe
renc
e ca
lls.
Rev
ise
the
end
boar
d to
pus
h tr
affic
to a
soo
n to
be
crea
ted
Web
pa
ge o
r em
ail o
f V
Aca
reer
s@va
.gov
that
hig
hlig
hts
rura
l pro
vide
r ca
reer
s in
VA
. T
arge
t rad
io s
tatio
ns a
nd T
V
stat
ions
with
in 1
00 m
ile v
icin
ity o
f B
lack
Hill
s S
outh
Dak
ota
and
For
t M
eade
ND
with
mar
ketin
g m
ater
ials
enc
oura
ging
the
use
of
PS
As
high
light
ing
rura
l pro
vide
r ca
reer
s in
VA
. Ide
ntify
add
ition
al
28 r
ural
com
mun
ities
to ta
rget
. F
urth
er r
efin
e m
edia
cam
paig
n.
Dev
elop
a p
lan
of a
ctio
n an
d fo
llow
up
quar
terly
.
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aliz
e re
port
.
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luat
e pr
ogre
ss a
nd r
epor
t fin
ding
s an
d fo
llow
up
as
nece
ssar
y.
Initi
ativ
e 6.
2: S
uppo
rt e
xist
ing
and
new
w
orkf
orce
rec
ruitm
ent a
nd r
eten
tion
effo
rts.
Dis
cuss
with
HR
SA
the
poss
ibili
ty o
f thi
s jo
int s
tudy
in
the
first
qua
rter
. D
evel
op a
pl
an o
f act
ion
if fe
asib
le a
nd
agre
eabl
e by
join
t par
ties.
Dev
elop
a p
lan
of a
ctio
n an
d fo
llow
up
qua
rter
ly.
Invo
lve
the
appr
opria
te p
artie
s.
For
m a
wor
kgro
up c
onsi
stin
g of
V
HA
Nat
iona
l Rec
ruite
rs ,
HR
and
V
ISN
rur
al c
onsu
ltant
s. C
ondu
ct
mon
thly
con
fere
nce
calls
.
Dev
elop
a p
lan
of a
ctio
n fo
r co
nduc
ting
a ru
ral h
ealth
pro
vide
r ne
eds
asse
ssm
ent.
Con
duct
m
onth
ly c
onfe
renc
e ca
lls.
Con
tinue
dev
elop
men
t and
in
crea
se p
rese
nce
of ta
rget
ed
mar
ketin
g m
ater
ials
enc
oura
ging
in
divi
dual
s to
con
side
r pr
actic
e in
ru
ral c
omm
uniti
es id
entif
ied
in
Qua
rter
1. D
isse
min
ate
TV
/Rad
io
publ
ic s
ervi
ce a
nnou
ncem
ents
to
rura
l com
mun
ities
.
Bas
elin
e da
ta fo
r hi
stor
ical
and
cu
rren
t fun
ding
allo
cate
d to
SE
EP
an
d V
ALO
R p
rogr
ams
in r
ural
ar
eas
iden
tifie
d.
Iden
tific
atio
n of
targ
eted
col
lege
s an
d un
iver
sitie
s un
derw
ay. B
rand
aw
aren
ess
actio
n pl
an fo
r op
en
hous
e un
der
deve
lopm
ent,
will
be
forw
arde
d to
mar
ketin
g an
d ad
vert
isin
g; H
RR
O r
epre
sent
ativ
es
atte
ndin
g 3R
Net
Ann
ual
conf
eren
ce in
Sep
tem
ber,
201
1.
Dev
elop
men
t of m
edia
pla
n co
mpl
ete,
pla
n im
plem
ente
d in
ta
rget
ed a
reas
. V
HA
Hea
lthca
re
Pla
cem
ent S
ervi
ces
part
icip
ates
in
Ope
n H
ouse
eve
nts
in r
ural
VA
fa
cilit
ies.
App
rove
add
ition
al V
ALO
R/S
EE
P
stud
ent o
ppor
tuni
ties
in r
ural
and
hi
ghly
rur
al fa
cilit
ies.
Pre
sent
atio
n of
VA
LOR
aw
ard
to
rura
l stu
dent
coh
ort.
Con
tinue
dev
elop
men
t and
in
crea
se p
rese
nce
of ta
rget
ed
mar
ketin
g m
ater
ials
enc
oura
ging
in
divi
dual
s to
con
side
r pr
actic
e in
ru
ral c
omm
uniti
es id
entif
ied
in
Qua
rter
1. D
isse
min
ate
TV
/Rad
io
publ
ic s
ervi
ce a
nnou
ncem
ents
to
rura
l com
mun
ities
.
Con
tinue
mon
itorin
g of
V
ALO
R/S
EE
P h
iring
qua
ntiti
es.
HR
RO
rep
rese
ntat
ives
will
atte
nd
NR
HA
ann
ual m
eetin
g in
Den
ver,
C
olor
ado;
aw
ards
/rec
ogni
tion
prog
ram
s im
plem
ente
d.
Con
tinue
d ap
pear
ance
at r
ural
O
pen
Hou
se e
vent
s, r
ural
co
mm
unity
eve
nts,
and
rur
al
colle
ge a
nd u
nive
rsity
car
eer
fairs
.
Initi
ativ
e 6.
1: D
evel
op p
rogr
ams
to in
crea
se
heal
th p
rofe
ssio
nals
’ aw
aren
ess
of r
ural
pr
actic
e
Off
ice
of R
ural
Hea
lth
– F
Y 2
010-
2014
Str
ateg
ic P
lan
Ref
resh
22
App
endi
x A
Tab
le o
f Act
ion
Item
s, Pe
rson
(s) R
espo
nsib
le, Q
uart
erly
Mile
ston
es
Init
iati
ves
Act
ion
Item
sP
erso
n o
r O
rgan
izat
ion
R
esp
on
sib
le
Act
ion
Item
PO
C
FY
201
2 M
ilest
on
es1s
t Q
uar
ter
(Oct
-Dec
)F
Y 2
012
Mile
sto
nes
3rd
Qu
arte
r (A
pr-
Jun
)F
Y 2
012
Mile
sto
nes
2nd
Qu
arte
r (J
an-M
ar)
FY
201
2 M
ilest
on
es4t
h Q
uar
ter
(Ju
l-S
ep)
Act
ion
6.2.
4: H
RR
O w
ill e
stab
lish
com
mun
ity
and
stat
e of
fice
s of
rur
al h
ealt
h, r
ural
pro
gram
off
ices
of
coll
eges
and
un
iver
siti
es. O
AA
wil
l ass
ist a
s ne
eded
in v
etti
ng a
ccre
dite
dpr
ogra
ms
or s
choo
ls a
nd in
est
abli
shin
g af
fili
atio
n re
lati
onsh
ips.
HR
RO
A
ntho
ny A
cham
pong
T
BD
HR
RO
will
mee
t with
3R
Net
to
disc
uss
futu
re c
olla
bora
tion.
R
epre
sent
ativ
es fr
om H
RR
O w
ill
atte
nd 3
RN
et A
nnua
l Con
fere
nce
in F
all o
f 20
11 to
net
wor
k w
ith
othe
r or
gani
zatio
ns a
nd a
genc
ies
com
mitt
ed to
impr
ovin
g ru
ral
recr
uitm
ent a
nd r
eten
tion.
TB
DT
BD
Off
ice
of R
ural
Hea
lth
– F
Y 2
010-
2014
Str
ateg
ic P
lan
Ref
resh
23
Office of Rural Health – FY 2010-2014 Strategic Plan Refresh 24
Appendix B
FY 12 Veterans Rural Health Resource Center (VRHRC) Projects
Western Region (WR)
1. Does co-management of veterans’ health through VA and non-VA care improve outcomes? This study will be the first to document the extent to which Veterans use VA care in combination with Medicare and VA contract care, for both rural and urban Veterans. It will also be the first study to compare VAMC and CBOC utilization between rural and urban patients. Finally, this study will evaluate the effect of dual use (VA and non VA care) on patient health outcomes.
2. Model Development, Population Comparison and Programmatic Information for Native Veterans. Year two of a 2 year study that will: 1) Model factors affecting service utilization and healthcare trends among Native populations including, but not limited to, the impact of traumatic brain injury, age/period of service, and gender; 2) Document methodological issues in procedures and definitions for utilizing the VA Medical SAS Datasets for Native-focused analyses; 3) Create GIS maps of the Native veteran population characteristics, service options and co-morbidities; 4) Collect, systematize, and disseminate Native-specific VA programmatic information provided by each VISN.
3. ORH Collaborative Training Model for Community Agencies – This is an initiative to provide training to community agencies operating in rural areas with the aim of helping them to understand the services and benefits available to Veterans.
4. Rural Native Veteran Telehealth Collaborative Education and Consultation Services – This is year two of a 3 year project to establish a collaborative National Native Telehealth Training and Consultative Service to aid in the dissemination and replication tele-mental health clinics targeted at rural Native veterans.
5. Rural Native Veterans Promising Programs Initiative - This project will develop and evaluate a process for implementing promising programs that are responsive to specific cultural and health challenges of rural Native Veterans.
6. Rural Veteran Outreach Program – This training program involves multiple community leaders in a rural community and facilitating the initiation and solidification of collaborative relationships between the community at large and the local VAs in supporting their Veterans. The goal is to VA's presence in rural communities by enlisting existing community agencies and leaders, as well as informal leaders, to outreach to Veterans.
7. Rural Women Veterans Demographic and Service Needs -This project is dedicated to understanding population demographics, healthcare utilization, and perceived service gaps from the perspective of the rural female Veteran. This study will be focused on the use of outpatient care by women Veterans.
8. Strengthening Existing VA Community Partnerships in Rural Areas - This project aims to systematically build community partnerships that form through natural operational processes into formal VA/rural community partnerships and to help VA staff engaged in these natural partnerships to reframe their role to include the concept of being a champion in forming these partnerships.
9. Using Community Hotlines for Rural Needs Assessment - This project will be conducted in collaboration with staff from the National Caregiver Hotline, located at the Canandaigua VA Medical Center in Canandaigua, NY. The project has the several objectives: 1). Estimate the frequency that rural caregivers utilize the caregiver hotline and identify their reasons for calling; 2). Compare urban and rural
Office of Rural Health – FY 2010-2014 Strategic Plan Refresh 25
caregivers in terms of caregiving needs as recorded by the caregiver hotline, 3). Examine local follow-up to caregiver queries to determine outcomes and identify barriers to addressing rural caregivers' needs.
10. Using Rural Veterans’ Perspectives on Access Issues and Satisfaction with VA Healthcare to Improve VA Patient Care ‐ The objective of this project is to summarize Veteran input on their healthcare
access issues and healthcare experiences and to distribute that information to: 1). Appropriate VA staff in VISNs and patient services, 2). Rural community healthcare specialists, and 3). Professionals interested in rural health.
11. Collaboration between the National State Office of Veterans Affairs and ORH for outreach to non enrolled Veterans – The purpose of this project is to facilitate development of a relational data base that can be used to help rural veterans obtain VA benefits within the state where they live.
Central Region (CR)
12. Tele-mental Health Care of OEF/OIF /OND Veterans at Western Illinois University- Macomb Campus – Year two of a 2 year project to assess and address the mental health needs of OEF/OIF student veterans attending a rural University.
13. Virtual Team Based Care for Rural Veterans with HIV: A Model for the Generalist-Specialist Interface in the Rural Patient-Centered Medical Home – Year two of a 2 year project to pilot the development and evaluation of “virtual HIV care teams” capable of providing accessible, high quality, comprehensive care for rural veterans with HIV.
14. The Implementation and Process Evaluation of a Home-Based Stroke Tele-Rehabilitation (SteleR) Program – This project will systematically evaluate the implementation fidelity and other factors of a home-based stroke tele-rehabilitation program (SteleR) into clinical care at the Roudebush and Iowa City VAMCs.
15. Mobile Teleretinal Imaging for Rural Veterans Served by Community Based Outpatient Clinics – The ORH funded Mobile Teleretinal Imaging Project (MTRIP) at the Iowa City VAMC is up and running, and in the course of 6 weeks has screened 119 patients (a rate of nearly 1000 Veterans per year) at CBOCs serving rural veterans. In year two of a 2 year project, the program will be evaluated in terms of patient satisfaction, cost savings and cost avoidance as well as a return on investment analysis.
16. Pilot Intervention to Improve Annual Colorectal Cancer Screening Rates Among Average Risk Veterans and in Veterans with Diabetes – This project will determine the feasibility and effectiveness of incorporating a colorectal cancer education and screening intervention into a diabetes case management program in order to significantly increase the rate of screening in this at-risk population.
17. Tailored Tobacco Quitline for Rural Veterans - The project is designed to help increase access to tobacco cessation services among rural veterans and to develop more effective treatment services that better address comorbid issues commonly experienced by rural smokers. The objectives are: 1). Study the feasibility of an individually-tailored telephone intervention for rural smokers, 2). Examine the impact of the intervention on tobacco use outcomes, and 3). Evaluate the effect of the intervention on issues commonly experienced by rural smokers including depressive symptoms, alcohol use, and weight gain.
18. Adapting Quality Improvement Tools for Patient Self Management by Rural Veterans- The purpose of this project is to develop and evaluate patient centered tools to facilitate symptom recognition and patient-provider communication among rural veterans to support timely treatment adjustment and avoid unnecessary travel to clinic visits and/or hospitalizations.
Office of Rural Health – FY 2010-2014 Strategic Plan Refresh 26
19. Evaluating the Introduction of the First Official VA Blog: VAntage Point and Implications for the Rural Health Community - This project is part of a larger collaborative effort in FY12 to address the issue of access as it relates to rural Veteran outreach and post-deployment transition.
20. Mixed Methods Evaluation of Case Management and Home Telehealth (CM/HT) Programs for Rural Veterans -This project will study the effectiveness of interactive voice response (IVR) technology compared with the older, landline dependent home tele-monitoring equipment. It will also evaluate the content of the communication between case managers and their rural Veterans. Many of those who conducted evaluations of Case Management/Home Telehealth interventions, while finding the interventions effective, call for closer evaluation of the frequency and content of communication between case manager and patient.
21. Targeted Outreach to Rural Veterans: Qualitative Message Testing Using Marketing Techniques -This project will allow for the synthesis of existing data with a specific focus on issues related to rural Veteran access to VA services and care, followed by a collaborative effort to develop VA outreach messages directed at specific populations (e.g., Veteran-students on a rural university campus, rural women Veterans, rural OEF/OIF Reserve and National Guard (R/NG) service members, and rural Veterans who are not students, women, or R/NG). The project will include testing messages through a process of qualitative marketing practices.
22. Primary Investigation of Patterns of Dual Healthcare System Use in Rural Veterans - The objective of this project is to characterize Veterans (both rural and non-rural) who are dual users—i.e., who choose to access both VA and non-VA healthcare services—and their perceptions of dual use in terms of satisfaction, care coordination, and their role in facilitating information exchange.
Eastern Region (ER)
23. Clinical Video Telehealth (CVT)-Neurology for Follow-Up Care of Veterans with Progressive Multiple Sclerosis Living in Rural Areas - VRHRC-ER staff and the Multiple Sclerosis Center of Excellence-East (MSCoE-East) are collaborating on a multi-site demonstration project to exhibit the effectiveness of Clinical Video Telehealth (CVT) for the neurological follow-up of rural Veterans who are disabled by the symptoms of progressive Multiple Sclerosis.
24. CVT- Rehabilitation (PT/RT) for long term stabilization/ improvement in function for Patients with Multiple Sclerosis living in rural areas - This study is being undertaken to determine the benefit of long-term exercise participation with initially begun as a therapeutic rehabilitation program, directed by a licensed physical therapist, and then progressed to a wellness program, directed by a certified / licensed recreational therapist. The uniqueness of this study is that the rehabilitation program and wellness program will be provided through distance technology, i.e., tele-video units, with transmission from clinic to individuals' homes.
25. CVT-Rural Caregiver Assistance Program - A rehabilitation clinical professional (nurse or physical therapist) will provide caregiver assistance including: (1) problem-solving skills development; (2) resource education; and (3) supportive problem solving via videophone technology to a caregiver of a rural Veteran in a demonstration project designed to improve caregiver self –efficacy and reduce strain and burden.
26. Delivery of Primary Care to Veterans with Spinal Cord Injury (SCI/D) by CVT to home or Community-based outpatient clinic (CBOC): Expanding Telehealth Services to SCI Rural Veterans –This one year demonstration will determine the feasibility of home telehealth and CVT- primary care delivered to the closest CBOC for the treatment of intercurrent acute illness and other urgent situations that occur in a disabled SCI/D population. This aspect of the study will be primarily descriptive (qualitative)
Office of Rural Health – FY 2010-2014 Strategic Plan Refresh 27
and will allow us to focus on the effectiveness of the delivery system for particular illnesses and situations in subsequent studies. We have specifically selected patients suffering from ALS, progressive MS and SCI who are at high risk for having these events.
27. Rural Telehealth Veteran Independence Initiative – This program will provide distance assessment and management for highly rural Veterans at risk for reduction in functional independence due to traumatic brain injury (TBI), high frequency/high complexity diagnoses, and home safety/fall risk.
28. Public Psychiatry Fellowship Program – This is a collaborative training program between the Tuscaloosa VAMC (TVAMC) and the University of Alabama School of Medicine (UASOM) Tuscaloosa Campus. The program includes two tracks: (1) Family Medicine and (2) Psychiatry, with clinical rotations and didactics for each located at the TVAMC (25% of time), a state public clinic, and the UASOM. The fellowship is a one year full-time training program for psychiatrists and family physicians who have completed an accredited psychiatric and family medicine residency program, respectively, and who plan to devote their careers to working with high risk populations in the public sector in a rural area. The project aim is to train physicians to be more competent in delivering mental health services in rural areas that rely on public funds. In addition, the project’s objective is to recruit and retain high caliber physicians to serve as leaders in the provision of mental health services in the public sector of Rural Alabama, including the VA setting.
29. Rural Health Training Program for Medical, Nursing and Associated Health Professions Students - The sustainment of the 2010 Rural Health Training Program (RHTP) will be continued at North Florida/South Georgia Veterans Health System (NF/SGVHS) and expand to a National Training Program with collaboration and support from the Office of Academic Affiliations (OAA).
30. Telepharmacy – Brown Bag Clinics for Rural Maine CBOCs -The purpose of this project is to provide access for patients to pharmacy Brown Bag Medication Clinics via Clinical Video Telehealth (CVT) at the rural CBOCs in Rumford, Calais, Caribou and Lincoln.
Office of Rural Health – FY 2010-2014 Strategic Plan Refresh 28
Appendix C
FY2012 ORH-Sponsored VISN Projects
Appendix BFY2012 ORH-Sponsored VISN Projects
VISN/ PO Category Proposal name
1 Tele & Models of Care ACT Chronic Pain Treatment/Bangor CBOC2 Geriatrics HBPC Western New York2 Geriatrics HBPC - Indian Health Service Collaboration -Mohawk2 Geriatrics HBPC at Rome, NY2 Mental Health Behavioral Health Care Line - Watertown2 Mental Health E-Range2 Geriatrics HBPC Pennsylvania Connection2 Mental Health Behavioral Health Care Line - Rome2 Mental Health Behavioral Health Care Line - Tompkins/Cortland2 Specialty Care Space and Staff for Physical Therapy at Ft. Drum3 Tele & Models of Care Riverhead CBOC - Expansion of 5 integrated programs3 Geriatrics HBPC/Harris/Monticello CBOC and Community Collaboration4 Tele & Models of Care Expansion of Home Telehealth 4 Access & Quality Rural Mobile Clinic 4 Mental Health E Range 4 Access & Quality OEF/OIF Outreach Clinic4 Training & Education Virtual Collaboration5 Tele & Models of Care Rural Health Initiative - PT/OT to selected CBOCs5 Women Veterans Women's Health, Education and Training in Rural Areas, Mental Behavioral Health5 Tele & Models of Care Lifestyle Intervention for Veterans (LIVe)5 Homelessness Rural Homeless and Homeless Prevention Services Extension5 Mental Health MHICHM Range for Eastern Shore5 Tele & Models of Care Community Coaching6 Collaboration & Outreach Effective Rural Health Communications and Low Health Literacy Program6 CBOC Staunton, Wytheville and Lynchburg CBOC6 CBOC Rutherfordton CBOC6 CBOC Emporia CBOC6 CBOC Edenton/Elizabeth City CBOC (Albermarle CBOC)6 CBOC Greenbrier County CBOC6 CBOC Robeson County CBOC6 Geriatrics HBPC Expansion to Greenbriar6 Geriatrics HBPC Expansion to Robeson CBOC6 Geriatrics HBPC Franklin CBOC6 Women Veterans Women's Health Training: Providers and Nursing Staff Mini Residencies6 Tele & Models of Care Telemental Health to Rural Areas7 Tele & Models of Care New Project-Access & Quality (Statesboro)-VISN 7 5097 CBOC Blairsville CBOC7 Mental Health Rural Telemental Health Initiative
7 Collaboration & Outreach Alabama Veterans Rural Health Initiative and Long Term Evaluation Assessing Rural Need7 Access & Quality Community Outreach Clinic Milledgeville, GA7 Geriatrics Jasper HBPC7 Geriatrics HBPC Selma Outreach Clinic and Athens CBOC
Office of Rural Health – FY 2010-2014 Strategic Plan Refresh 29
Appendix BFY2012 ORH-Sponsored VISN Projects
VISN/ PO Category Proposal name
7 Tele & Models of Care Enhancing Services for Rural Veterans- A novel approach using VA-PACE Partnership7 Geriatrics HBPC Conway SC7 Geriatrics Selma HBPC and Podiatry Clinic7 Geriatrics HBPC Milledgeville7 Geriatrics Oakwood HBPC Rural Health Team7 Mental Health Imp MH/BH - 508 SUD and PTSD7 Geriatrics Health Watch for Heroes7 Tele & Models of Care Tuscaloosa Rural Mobile Clinic7 Tele & Models of Care Telehealth Expansion7 Mental Health MICHM E-Range7 Geriatrics Orangeburg HBPC7 Tele & Models of Care Rural HT8 Access & Quality Waycross Outreach Clinic8 CBOC Palatka Rural CBOC8 CBOC Marianna CBOC8 CBOC St. Mary's CBOC8 Tele & Models of Care Rural Veterans Tele=Rehabilitation Initiative Phase III8 Access & Quality Taylor County Outreach Clinic8 Geriatrics HBPC CBOC and Community Collaboration8 Access & Quality Comerio Rural Clinic8 Access & Quality Utuado Rural Clinic8 Access & Quality Vieques Rural Clinic8 Access & Quality St. John Outreach Clinic9 Training & Education Rural Health Professions Institute9 Geriatrics HBPC Community Collaboration - Norton CBOC9 Specialty Care Rural CBOC Physical Therapy Clinics9 Access & Quality Gallipolis Rural Outreach Clinic9 Mental Health Community Based Mental Health Services for Veterans living in Rural Areas9 Access & Quality Rural Outreach Clinics9 Specialty Care Clarksville Teleretinal Screening and Image Reading9 Specialty Care Rural CBOC Radiology Services9 Access & Quality Rural Transportation Coordinator9 Specialty Care Rural CBOC Occupational Therapy Clinics
10 Geriatrics VISN 10 HBPC and CCHT Expansion 10 Mental Health CBOC Mental Health Service Expansion10 Tele & Models of Care Care Coordination Store and Forward Telehealth10 Tele & Models of Care Clinical Pharmacists Expansion10 Specialty Care Optometry and Podiatry in CBOCs10 Tele & Models of Care Video Consultation Services10 Access & Quality Wilmington Outreach Clinic10 Access & Quality Georgetown Outreach Clinic10 Access & Quality Cincinnati Mobile Unit Outreach10 Women Veterans Women Diagnostic Coordinator
Office of Rural Health – FY 2010-2014 Strategic Plan Refresh 30
Appendix BFY2012 ORH-Sponsored VISN Projects
VISN/ PO Category Proposal name
11 CBOC Peru, Indiana CBOC
11 Collaboration & Outreach Farm Initiative for Illinois11 CBOC Cadillac CBOC (Saginaw VAMC)11 CBOC Badaxe CBOC (Saginaw VAMC)11 Access & Quality RH Transportation Program
11 Tele & Models of Care Improving Chronic Disease Management in Rural CBOC Clinics: The Care Partner Program11 Access & Quality Transportation11 Tele & Models of Care Telehealth12 Tele & Models of Care Telemedicine in the Northern and Central Markets12 Geriatrics HBPC 12 Geriatrics HBPC -LaSalle CBOC12 Specialty Care Providing opthalmological and ENT Services Locally at Oscar Johnson VAMC12 Access & Quality Outreach Clinic Manistique, Michigan12 Mental Health Improve Mental Health - Establish E-Range at Hancock CBOC12 Mental Health MICHM E- RANGE Manistique12 CBOC Expand Manteno CBOC12 Specialty Care Expand LaSalle CBOC12 Access & Quality Transportation12 Specialty Care Implementation of Audiology Services at Wisconsin Rapids Outpatient Clinic12 CBOC Sault Saint Marie CBOC Lease 12 CBOC Hancock CBOC15 Geriatrics Marion VAMC HBPC Expansion15 CBOC Carbondale CBOC15 CBOC Harrisburg CBOC15 Geriatrics Wichita HBPC15 CBOC Washington/Sullivan CBOC15 CBOC Sedalia CBOC15 Tele & Models of Care Expansion of CCHT for patient centered alternatives to Institutional Care15 Mental Health MICHM Range15 CBOC Sikeston CBOC15 Tele & Models of Care Care Coordination Home Telehealth sustainment15 Tele & Models of Care CCHT Expansion Eastern Kansas15 Access & Quality John J. Pershing Sleep Study Lab15 Tele & Models of Care Marion VAMC Tele-Pharmacy15 Mental Health Collaborative Discharge Planning for Veterans Returning to Rural Areas16 CBOC VISN 16 Rural CBOC sustainment - Fort Polk16 CBOC VISN 16 Rural CBOC sustainment - Vinita16 CBOC VISN 16 Rural CBOC sustainment - Natchitoches16 CBOC VISN 16 Rural CBOC sustainment - Bogalusa16 CBOC VISN 16 Rural CBOC sustainment - Jay16 CBOC VISN 16 Rural CBOC sustainment - Franklin16 CBOC VISN 16 Rural CBOC sustainment - Russellville
Office of Rural Health – FY 2010-2014 Strategic Plan Refresh 31
Appendix BFY2012 ORH-Sponsored VISN Projects
VISN/ PO Category Proposal name
16 CBOC VISN 16 Rural CBOC sustainment - Conway16 CBOC VISN 16 Rural CBOC sustainment - Ozark16 Geriatrics HBPC Expansion for Vinita and Hartshorne CBOC16 Geriatrics Rural Native American Veteran Outreach HBPC16 Tele & Models of Care Improving Cancer Care for Rural patients with Malignancy16 Mental Health MIRECC Clergy-Mental Health Partnership to Improve Care for Rural Veterans 16 Mental Health MHICM E-RANGE Muskogee16 Tele & Models of Care Biloxi Rural Access and Home tele-health Expansion16 Specialty Care Improving Access to Sleep Medicine Care Using Telehealth
17 CBOC Expansion and Enhancement of Medical Care provided in rural CBOCs - South New Braunfels
17 Mental Health Tele-Psychiatry within Central Texas Veterans Health Care System Project Expansion17 Specialty Care Tele-Rehabilitation Clinic - Amputee and TBI Polytrauma17 Specialty Care VISN 17 Teleretinal Imaging Program Improvement Project17 Mental Health MHICM E-range
17 CBOC Expansion and Enhancement of Medical Care provided in rural CBOCs - South Del Rio
17 CBOC Expansion and Enhancement of Medical Care provided in rural CBOCs - South Beeville
17 CBOC Expansion and Enhancement of Medical Care provided in rural CBOCs - South Uvalde
17 CBOC Expansion and Enhancement of Medical Care provided in rural CBOCs - South Seguin17 Specialty Care North Texas Teleretinal Program 17 Specialty Care Texas Valley Coastal Bend Teleretinal Imaging Program 17 Women Veterans South Texas Mobile Mammography Unit17 Tele & Models of Care Rural Telehealth Support and Expansion17 Mental Health Central TX Telemental Health Expansion17 Specialty Care South Texas Teleretinal Program Expansion at Victoria and Kerrville18 Homelessness Homeless Grant and per diem Program for rural Veterans18 Tele & Models of Care Telehealth Expansion18 Tele & Models of Care Telemedicine Expansion18 Geriatrics Albuquerque VA HBPC/IHS Rural Health Sustainment18 Tele & Models of Care Telemedicine Expansion18 Tele & Models of Care Compensation and Pension18 CBOC Payson/Buckeye CBOC18 CBOC Show Low & Globe CBOC18 Tele & Models of Care Pharmacy Disease Management Services in CBOC18 Mental Health Enhance Mental health Services for Rural Veterans at the NAVAHCS CBOCs
18 Mental HealthEnhance Mental health services and PTSD outreach for rural Veterans on the Navajo/Hopi Nation
18 Access & Quality Mobile Health Clinic18 Mental Health Mental Health Services at Hobbes, CBOC18 CBOC Hobbs CBOC lease18 CBOC Fort Stockton CBOC lease
Office of Rural Health – FY 2010-2014 Strategic Plan Refresh 32
Appendix BFY2012 ORH-Sponsored VISN Projects
VISN/ PO Category Proposal name
19 Access & Quality Primary Care for Rural Vets (PCTOC)19 Access & Quality Primary Care for Rural Veterans: Telehealth Outreach Clinic Expansion Initiatives19 Access & Quality Mobile Telehealth Clinic 19 Tele & Models of Care Primary Care Telehealth For Rural Veterans19 Collaboration & Outreach Cheyenne CCHT (Patient Education)19 Access & Quality Rawlins PCTOC 19 Access & Quality Burlington Telehealth Outreach clinic19 Specialty Care General Telehealth Specialty Services19 Mental Health MHICM E-RANGE Cheyenne19 Access & Quality AMB: Salida Primary Care Telephone Outreach Clinic19 Specialty Care Prosthetic Treatment Center Mobile Lab 19 Access & Quality Primary Care for Rural Vets (PCTOC)19 Access & Quality Primary Care Telehealth Outreach Clinics19 Specialty Care Tele-Pain Management19 Specialty Care Tele-Specialty – Sheridan VAMC
19 Specialty Care Extended Education and Wellness Strategies for Veterans in Rural Communities (Tele-Move)19 Specialty Care Cheyenne Specialty (Telehealth)
19 Specialty CareEnhancement of PTSD treatment in the transition from residential care to rural outpatient settings
19 Specialty Care Tele-Endocrine19 Collaboration & Outreach Partnership and Enhancement of the Casper Based Mobile Veterans Center19 Specialty Care Cardiology outreach clinics in Cheyenne and Grand Jct VAMCs19 Specialty Care Tele-Dementia 19 Collaboration & Outreach Mild Traumatic Brain Injury / Posttraumatic Stress Disorder Psychoeducation 19 Specialty Care Tele-Dermatology20 Tele & Models of Care VISN 20 Rural Teledermatology Project
20 Geriatrics Sustainment of Portland VAMC HBPC rural Health Grand Ronde, Newport, North Coast20 CBOC South Sound CBOC20 Access & Quality Rural Health Community Partnerships - Spokane20 Access & Quality Newport Outreach Clinic20 CBOC North Coast Community Based Outpatient Clinic20 Access & Quality Dalles Outreach Clinic20 Geriatrics HBPC Caldwell ID CBOC20 Geriatrics HBPC : Indian Health Service Collaboration Warm Springs Tribe
20 Collaboration & OutreachBuilding Collaboration in Rural Alaska with Tribal Organizations for Increased access to care and services utilizing the VA Tribal Consultative Process
20 Geriatrics Sustainment Grants Pass Satellite HBPC team 20 Tele & Models of Care Rural Sleep program20 Access & Quality Primary Care Telehealth Outreach Clinics20 Tele & Models of Care Remote Telemedicine Amputee Clinic20 Geriatrics HBPC - Mtn Home Outreach Clinic20 Geriatrics HBPC - Boise20 Mental Health MHICM E-RANGE White City
Office of Rural Health – FY 2010-2014 Strategic Plan Refresh 33
Appendix BFY2012 ORH-Sponsored VISN Projects
VISN/ PO Category Proposal name
20 Access & Quality Partnering with Primary Care Providers
20 Tele & Models of CareSouthern Oregon Rehabilitation Center & Clinic Telehealth Patient Consultants/Telehealth Subspecialty Clinic
20 Specialty Care Contract Speech and Language Pathology Services
20 Tele & Models of Care VA Southern Oregon Rehabilitation Center & Clinics Home Telehealth Care Manager20 Specialty Care Horses to Heroes21 CBOC Eureka CBOC transition to VA staffed model21 Access & Quality Pacific Western Insular Area Veteran Travel21 CBOC Lake County CBOC21 CBOC Expansion of Yuba City Outpatient Clinic21 Geriatrics HBPC Indian Health Service Collaboration21 CBOC Diamond View CBOC21 Collaboration & Outreach Thrive Expansion: THRIVE Everywhere/THRIVE OEF/OIF21 Tele & Models of Care NCHCS CCHT Expansion21 Geriatrics HBPC Eureka21 Tele & Models of Care Primary Care Telemedicine Outreach21 Geriatrics HBPC Expansion: CBOC and Community Collaboration21 Access & Quality Saipan Outreach Clinic/Rural Health Coordinator PIHSC21 Geriatrics HBPC to Guam21 Access & Quality Yreka Outreach Clinic21 Access & Quality Winnemucca Outreach Clinic
21 Mental Health Community Based Mental Health Services for Veterans living in Rural Areas: Honolulu, HI21 Collaboration & Outreach The Health Resource Initiative for Veterans Everywhere -Online21 Access & Quality Central California Transportation Program 21 Collaboration & Outreach Rural Health Initiatives Project Coordinator21 Tele & Models of Care San Francisco Telepharmacy Pathway21 Tele & Models of Care RN Care Coordination at Ukiah CBOC21 Tele & Models of Care Telehealth Care Coordination at Clearlake CBOC21 Tele & Models of Care PACT Clinical Pharmacist at Clearlake CBOC21 Collaboration & Outreach Identifying and Overcoming Barriers to Care for Rural Veterans21 Collaboration & Outreach Rural Health Initiative Project Coordinator21 Access & Quality Transportation to Yreka Outreach Clinic21 Tele & Models of Care Anticoagulation Pharmacist to Monitor Patients on Warfarin at the Ukiah CBOC21 Specialty Care Telehealth closing the Teledermatology loop at Clearlake CBOC21 Specialty Care Telehealth Closing the Teledermatology loop at Ukiah CBOC21 Collaboration & Outreach Enhancing Patient Health Education at Rural Sites21 Specialty Care Management of Nail Care in High and Moderate Risk Veterans at Clearlake CBOC21 Specialty Care Management of Nail Care in High and Moderate Risk Veterans at Ukiah CBOC21 Specialty Care Horses to Heroes22 Access & Quality Expansion ORH Strategic Plan22 Access & Quality Sustainment-ORH Strategic Plan22 Tele & Models of Care Designing Veteran Centric Care
Office of Rural Health – FY 2010-2014 Strategic Plan Refresh 34
Appendix BFY2012 ORH-Sponsored VISN Projects
VISN/ PO Category Proposal name
23 CBOC Decorah, IA CBOC23 CBOC Sterling, IL CBOC 23 CBOC Ottumwa, IA23 Geriatrics Rural Expansion of HBPC23 Geriatrics HBPC Expansion at Alexandria CBOC23 Tele & Models of Care Minneapolis Office of Rural Co management23 Geriatrics Wagner Streamlined Model HBPC23 Geriatrics HBPC Mille Lacs Band of Ojibwe23 Tele & Models of Care CCHT-SCI, TBI and Wound
1, 19, 20 Mental Health Mental Health Rural Pilots20/OHMS Mental Health Oregon Rural Mental Health Implementation
7 & 8 Training & Education Rural Health Training InitiativeChaplain Service Collaboration & Outreach Educating Rural Clergy to Recognize & Respond to Veterans Health Care NeedsGEC/19 Geriatrics Providing Rural Veterans Access to Proactive Dementia Care GEC/19 Tele & Models of Care Veteran Centric Healthcare Model-Geriatrics and Extended CareGEC/19 Geriatrics Fighting immobility in rural Veterans with Exercise and TechnologyGEC/22 Training & Education Geriatric Scholars ProgramGEC/8 Geriatrics A Lifeline for Stroke Caregivers: Addressing Rural Health DisparitiesOAA Training & Education Rural Health Training
Tele & Models of Care VHA National Teleradiology Program Rural Support and Expansion Proposal
1,6,15,18, 19 Access & Quality Project ARCH
Office of Rural Health – FY 2010-2014 Strategic Plan Refresh 35