department of veterans affairs office of rural health hrsa / orhp all programs meeting august,...
TRANSCRIPT
Department of Veterans Affairs Office of Rural Health
HRSA / ORHP All Programs Meeting
August, 2007Kara Hawthorne
Focus Areas
1. Legislation1. Legislation
2. What Rural Looks Like2. What Rural Looks Like
2. Enrollees / Patients2. Enrollees / Patients
4. OHR4. OHR
5. VA System of care delivery5. VA System of care delivery
Legislation – The Office
• PL 109-461 Section 212.
• Congress Passed Late December ’06
• VHA ADUSH for PP began work 2/07
PL 109-461 Section 212.
– Establish the Office of Rural Health– Develop, refine, and promulgate policies, best
practices, lessons learned, and innovative and successful programs to improve care and services
– Research– To designate in each VISN a rural consultant– Perform an Assessment of Fee-Basis Health-Care
Program– Plan To Improve Access and Quality of Care:
Develop a plan to improve the access and quality of care for enrolled veterans in rural areas; including measures for meeting the 1) long term care and 2) mental health needs of rural veterans
Legislation – Congress
• Congress has the vision of outcomes, ORH is in the current phase of process development
• Additional Bills have included: S. 1146, S. 1233 (markup). HR 5524, HR 315, HR 1527, HR 2005, HR 2874 (markup), draft bill HR 2623.– General themes include:
• Establishing Rural research centers of excellence• Providing grants for VSO’s to establish transportation• Partnering with Community Health Clinics. (everyone know what those are?
Federally Qualified Health Canters funded in part by HHS)• Partner with IHS• Consider Fee-based care• Outreach• Recently some collaboration with MH/Vet centers on MH services in rural
areas. on outreach • And of course, expand, expand, expand Services
• VAH leadership has testified on RH multiple times this year
Across the nation, this is the U/R/HR picture:
19 23
18
16
20
15
21
17
07
0922
11
06
12
01
08
04
02
1005
03
VISN
Rural
Highly Rural Counties
Census Urban Area
Highly Rural Counties, Rural Areas and Census Defined Urban Areas
Map generated by VHA Planning Systems Support Group, field unit for the VHA Office of Assistant Deputy Under
Secretary for Health for Policy & Planning, April 6, 2007
Veterans EOY 2006
Total EOY06 Patient
Urban patient
Rural patient
Highly rural
patient4,877,733 2,919,645 1,878,624 79,464
59.9% 38.5% 1.6%
Total EOY06
EnrolleeUrban
EnrolleeRural
Enrollee
Highly rural
Enrollee7,848,282 4,879,424 2,850,173 118,685
62.2% 36.3% 1.5%
38% of Enrollees are rural or highly rural
40% of patients are rural or highly rural
Estimated 8.3% of the population are Veterans.
Distribution
States with the highest numbers of enrollees: California, Florida, New York, Texas, Pennsylvania
States with the lowest numbers of enrollees: Vermont, Wyoming, Alaska, N.Dakota, Rhode Island
ORH
• VHA has been providing care to rural veterans
• The ORH will coordinate services to enhance delivery of care, create greater access, engage in research, promulgate best practices….
How VHA Provides Care
VHA System of Facilities
– 153 Hospitals
– 882 Outpatient Clinics (including CBOCs)
– 207 Vet Centers
– 135 VA Nursing Homes
* Data as of Second Quarter FY07 – March 30, 2007
Telehealth
VHA’s office of Care Coordination has programs that brings care into the veterans home
– Care Coordination Home Telehealth– Telemental Health
