Veterans Rural Health Resource Centers–Western Region (VRHRC-WR): Six-year Summary Report

Ono SS, Laman-Maharg B, Dailey N, Bair BD. Veterans Rural Health Resource Centers–Western Region (VRHRC-WR): Six-year Summary Report. Portland, OR: VRHRC-Western Region; 2015 Jun 1. 40 p.

In July 2008, the Veterans Rural Health Resource Centers-Western Region (VRHRC-WR) was established as a satellite office to the Veterans Health Administration's (VHA) Office of Rural Health (ORH) to accomplish four main objectives for VRHRCs. VRHRC-WR builds our annual portfolio of studies, analyses, and demonstration projects in accordance with these objectives. Section 1: VRHRC-WR and Core Activities Narrative All VRHRH-WR projects have been selected to support the ORH Mission (To improve the health and well-being of rural Veterans by increasing their access to care and services) and ORH Goals (1. Promote health and well-being in the rural Veteran Population, 2. Strengthen community health care infrastructure where rural Veterans reside, 3. Generate and diffuse knowledge regarding rural Veteran health, and 4. Inform healthcare policy that impacts rural Veterans and rural healthcare delivery). Early on, VRHRC-WR developed an organizational structure to facilitate accomplishing these high-priority VA goals with flexible domains to complement ORH goals and objectives. VRHRC-WR developed four Domains of Excellence (Domains) each led by an expert in the field: Rural Geriatrics Rural Native Populations (American Indians, Alaska Natives, and Pacific Islanders) Education and Dissemination Policy and Analysis These Domains were chosen to synergistically and collaboratively generate realistic, multi-dimensional solutions that address health care delivery issues in rural areas. The Native and Geriatric domains were developed to address specific, documented needs in specific rural populations and supported an expanded focus of ORH. To address the goal of improving rural Veteran health and delivery of care, each Domain employed strategies and methodologies to: analyze existing data collect new relevant data via clinical pilots evaluate and interpret data suggest areas for further inquiry disseminate knowledge share data with partners Section 2: Synthesis of 6 Years of VRHRC-WR Activities and Vision of the Future VRHRC-WR has become a regional and national resource for rural Veterans' issues. It has also demonstrated great flexibility to adapt to the dynamic environments of VHA and the challenges of rural health care access. While the Center has established excellence with regards to achieving the mission, goals and strategic plans of ORH, not every project has yielded the expected outcomes. These lessons learned may be more important than the successes, in that they continue to shape and guide continued growth towards serving rural Veterans in an ever improving way. IMPACT: Each year, VRHRC-WR reported the number of rural Veterans directly and indirectly affected by each portfolio project. Reports of direct Veteran impacts range from 16 to 6,203 (Rural Veteran Outreach Program) annually, while the indirect estimates typically number in the thousands. None of the available data account for rural Veterans impacted in the time that has elapsed since the projects ended or the period of ORH support was discontinued. PARTNERSHIPS: With over 250 partnerships established since 2009, VRHRC-WR has made community collaboration and working with VA operational and clinical stakeholders a priority. The full list includes VA Partners (88+), community Partners (198+), and Tribal Partners (25+). Section 3: Summary of Projects by Category The VRHRC-WR portfolio since 2008 has successfully targeted the goals set forth for VRHRCs, along with ORH's mission, goals, and strategic areas of focus. The Western Region's population Domains were established in recognition of the preponderance of older Veterans in rural communities as well as the underserved minority Veterans that exist in rural communities. These rural population foci not only allow a broad support of the mission, goals, and strategies of ORH, they also become a paradigm for improving service to all underserved Veterans in general. In addition, lessons learned from the population foci for VRHRC-WR has resulted in generating projects addressing the general needs of rural Veterans regardless of population status. Each of the VRHRC-WR projects also aligns with at least one ORH goal. Target areas, such as access and technology, are incorporated into the projects listed in each of the categories. The following projects highlight and evidence how the VRHRC-WR portfolio strengthens and supports not only the mission, goals, and strategies of ORH but also fulfills the charge for VRHRCs contained in the PL. In 2008, PL 112-154 named the Veterans Rural Health Resource Centers (VRHRC) as satellite offices to ORH with the following purposes: 1. To improve the understanding of the Office of the challenges faced by veterans living in rural areas. 2. To identify disparities in the availability of health care to veterans living in rural areas. 3. To formulate practices or programs to enhance the delivery of health care to veterans living in rural areas. 4. To develop special practices and products for the benefit of veterans living in rural areas and for implementation of such practices and products in the Department system wide. Each VRHRC-WR project was designed to address one or more of these purposes and to respond to identified gaps in rural Veteran care and VA priorities for underserved populations. Section 4: VRHRC-WR Moving Forward Promising Practices will grow out of VRHRC-WR's areas of strength: outreach and community partnership, applications for technology to increase access, and work targeting Native Veterans, women Veterans, and aging Veterans. In addition to our continued work in these areas of demonstrated strength, VRHRC-WR will also expand our collaborating efforts to include additional VA and non-VA partners in new and innovative efforts that support ORH's mission and goals as well as the congressional mandates to improve the care of rural Veterans.