Legion issues report on VA rural health care

The American Legion released its final report May 9 on the quality of rural health care being provided by the Department of Veterans Affairs. To view the report, click here. 

The report is based on information collected by the Legion’s System Worth Saving (SWS) Task Force, which evaluated VA medical centers across the country from last November to February.

Verna Jones, director of the Legion’s Veterans Affairs & Rehabilitation Division, said the Legion wanted to take a close look at VA health care in more remote locations because the number of veterans living in rural areas continues to grow.

“Our rural veterans have fewer primary-care and specialty-care services provided by VA,” Jones said. “It also takes a lot longer for them to cover all those extra miles to health-care facilities. If you live in Gallup, N.M., but need treatment at the VA hospital in Albuquerque, that means a three-hour drive along Interstate 40.”

Task force staff interviewed a variety of administrators, staff and patients at VA medical centers, community-based outpatient clinics, rural health resource centers and sites for Project ARCH (Access Received Closer to Home). They conducted several focus groups with rural veterans to discuss the quality of VA health care, and also visited the Navajo and Pueblo nations to get a better understanding of health-care challenges faced by American Indian veterans.

Jacob Gadd, deputy director of health in the VA&R Division, said that several concerns were raised in the report, such as VA’s definition of veterans who live in rural and highly rural areas. “Veterans tell us they aren’t really concerned whether they are classified as rural or highly rurai,” he said. “They only care about how far away primary care or specialty care is from their front door.”

According to statistics published in 2010, the Veterans Health Administration (VHA) classified 36.4 percent of its enrolled veterans as “rural” and 1.5 percent as “highly rural.” The 2010 Journal of Rural Health said that VHA’s rural category “is very large and broadly dispersed; policy makers should supplement analyses of rural veterans’ health care needs with more detailed breakdowns. Most of VHA’s highly rural enrollees live in the western United States, where distances to care are great and alternative delivery systems may be needed.”

The Legion’s report made several recommendations to VA on how to improve the delivery of medical care to rural veterans, including:

• Improve incentive programs to recruit and retain top talent in rural health-care facilities.
• Implement a Veterans Transportation Service Department for each of the 152 VA medical centers.
• Create new criteria for defining rural and highly rural veterans, rather than using the Census Bureau’s definition.
• Continue the expansion of community-based outpatient clinics and mobile clinics.
• Identify successful ARCH locations and continue services in these areas after completion of the pilot program
• Expand telehealth capabilities for veterans without phone lines or Internet access in their homes.

Printed copies of the report are being delivered to members of Congress on the Appropriations and Veterans Affairs committees in the House and Senate. Copies will also be delivered to President Obama, VA Secretary Eric Shinseki and other VA officials.

SWS task force members evaluated VA facilities in 13 states: Vermont, New Hampshire, Massachusetts, Illinois, Missouri, Kansas, Idaho, Montana, Colorado, Wyoming, Arizona, Utah and New Mexico.