Veterans Health Administration Office of Rural Health (VHA ORH) investments in North and South Carolina

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1 Veterans Health Administration Office of Rural Health (VHA ORH) investments in North and South Carolina For More Information: Gina L. Capra, MPA, Director, Office of Rural Health Thomas F. Klobucar, PhD, Deputy Director, Office of Rural Health Fiscal Year 2014 North Carolina Projects and Pilots ORH funded 14 projects totaling $7.6 million in Fiscal Year 2014 Project highlights: o Telehealth based Rural Provider and Staff Training Initiatives o In-Home Video- Based Tele-Occupational Therapy for Rural Veterans o Home Based Primary Care for Home-Bound Rural Veterans o Community Collaboration To Deliver Services To Veterans In Non-VHA Facilities Fiscal Year 2014 South Carolina Projects and Pilots ORH funded 11 projects totaling $2.6 million in Fiscal Year 2014 Project highlights: o Telehealth based Stroke Rehabilitation o Rural Veteran Transportation to VA treatment facilities o Mobile Heart and Vascular Care in Rural Areas o Rural Expansion of Home Telemonitoring for Chronic Disease Care Fiscal Year 2015 North Carolina Projects and Pilots ORH funded in 19 projects totaling $9.6 million in Fiscal Year 2015 Sustained 11 projects funded in Fiscal Year 2014, and added 8 new projects including o Expanded Rural Access to Geriatric Care o Home Based Mental Health Evaluation for Rural Veterans o Enhance Access to Oncology Services via Telehealth o Rural Geriatric Physical Fitness Program Fiscal Year 2015 South Carolina Projects and Pilots

2 Veterans Health Administration Office of Rural Health (VHA ORH) Page 2 of 11 ORH funded 11 projects totaling $2.4 million in Fiscal Year 2014 Sustained three projects from Fiscal Year 2014, and added one new project o Study of Rural Urban Disparities in Chronic Disease Burden and Care

3 Veterans Health Administration Office of Rural Health (VHA ORH) Page 3 of 11 Fayetteville, ORH North Carolina Investments Fiscal Year 2014 Tele-OT/PT for Provision of DME to Rural Veterans COACH Greenville Rural Provider and Staff Training Initiative Rural Osteoporosis Evaluation Service (ROPES) Robeson Co MH Community Outreach Program Telehealth program for rural Veterans to provide OT/PT for purposes of evaluation, fitting and training to enhance functional mobility in the home The Caring for Older Adults and Caregivers at Home (COACH) model, a home-based dementia care program serves Veterans with moderate to severe dementia living at home with an unpaid caregiver and within a 50-mile radius from Greenville Staff will identify palliative care needs for the Veterans they serve and be able to apply basic palliative care principles within their scope of practice as well as the ability to recognize when a specialized palliative care consult is needed In order to further improve osteoporosis care following a fracture, the Rural Osteoporosis Evaluation Service (ROPES) the project expands the scope of this service and specifically target the rural population who is at greatest risk to receive sub-optimal care. The specific objective of this project is to increase access to VA mental health care and related services through a culturally competent, community based outreach program which is fully integrated into an dedicated Rural Veteran Mental Health Clinic 353, , , ,888 82,000

4 Veterans Health Administration Office of Rural Health (VHA ORH) Page 4 of 11 Fayetteville, ORH North Carolina Investments Fiscal Year 2014 Tele Gynecology, Consultation Rutherfordton HBPC Integrated-Adaptive Community Collaborative of Enhanced Support Services (I-ACCESS) Rural Provider and Staff Training Initiative Cherokee HBPC Tele-Consultation between the gynecologist and primary care providers enables primary care providers to review complex cases to ensure proper patient care management. The gynecologist will lead monthly tele-gynecology grand rounds on diverse case presentations available to all providers. The project s primary goal is to enroll eligible and at-risk Veterans into the Home Based Primary Care program utilizing a new team which will be located at the Rutherfordton CBOC With the development of outreach efforts by Rural Health teams across VISN-6, collaborative relationships have now been established. Thus creating an opportunity for building an Integrative Adaptive Community Collaborative Enhanced Services Support (I-ACCESS) program. Staff will identify palliative care needs for the Veterans they serve and be able to apply basic palliative care principles within their scope of practice as well as the ability to recognize when a specialized palliative care consult is needed The Cherokee HBPC program serves Veterans who live in an underserved area of the Charles George VAMC catchment area. 165,709 1,753, , ,500 1,365,716

5 Veterans Health Administration Office of Rural Health (VHA ORH) Page 5 of 11 ORH North Carolina Investments Fiscal Year 2014 Telemedicine to Improve Chronic Kidney Disease HBPC Rural Expansion at Salisbury Integrated-Adaptive Community Collaborative of Enhanced Support Services (I-ACCESS) Rural Health Training and Education Initiative Telemedicine is an effective tool to increase the awareness about chronic kidney disease (CKD) and empower the veterans with advanced CKD with an alternate choice of home dialysis for renal replacement therapy (RRT) Serve an increased number of Veterans (unique) who have not accessed the VA Medical Center services in the past due to their remote rural residence and thus increase the number of unique Veterans served. With the development of outreach efforts by Rural Health teams across VISN-6, collaborative relationships have now been established. Thus creating an opportunity for building an Integrative Adaptive Community Collaborative Enhanced Services Support (I-ACCESS) program. The goals and objectives of this project are to train health care providers to deliver quality healthcare to rural, underserved populations of Veteran patients 260, , , ,192 Fiscal Year 2014 Total 7,657,057 STATION ORH North Carolina Investments Fiscal Year 2015 Tele-OT/PT for Provision of DME to Rural Veterans To implement a telehealth program for rural Veterans to provide OT/PT for purposes of evaluation, fitting and training in use of DME and related interventions to enhance functional mobility in the home 353,000

6 Veterans Health Administration Office of Rural Health (VHA ORH) Page 6 of 11 STATION ORH North Carolina Investments Fiscal Year 2015 COACH Greenville Rural Osteoporosis Evaluation Service (ROPES) VISN 6 Geriatric Rural Access to Care Expansion (GRACE) EQUIPPED Gerofit Dissemination and Implementation Home Based Mental Health Evaluation Program with Rural Veterans at Risk for Suicide The Caring for Older Adults and Caregivers at Home (COACH) model, a home-based dementia care program serves Veterans with moderate to severe dementia living at home with an unpaid caregiver and within a 50-mile radius from Greenville In order to further improve osteoporosis care following a fracture, the Rural Osteoporosis Evaluation Service (ROPES) the project expands the scope of this service and specifically target the rural population who is at greatest risk to receive sub-optimal care. Enhance access to geriatric care for rural Veterans across VISN 6 by establishing a coordinated system of regionalized outreach programs. EQUiPPED is a quality improvement initiative aimed at changing prescribing practices of Emergency Department (ED) providers in order to decrease the use of potentially inappropriate medications (PIMs) in Veterans age 65 and older discharged from the ED This project focuses on using established technologies to deliver a personalized exercise program to older Veterans living in rural areas and address the unique needs of Veterans unable to attend CBOC based programs 484, , ,150 68, , ,956

7 Veterans Health Administration Office of Rural Health (VHA ORH) Page 7 of 11 STATION Fayetteville, Fayetteville, ORH North Carolina Investments Fiscal Year 2015 Robeson Co MH Community Outreach Program Tele Gynecology, Consultation Rutherfordton HBPC Integrated-Adaptive Community Collaborative of Enhanced Support Services (I-ACCESS) EQUIPPED The specific objective of this project is to Increase access to VA mental health care and related services through a culturally competent, community based outreach program which is fully integrated into an dedicated Rural Veteran Mental Health Clinic Tele-Consultation between the gynecologist and primary care providers enables primary care providers to review complex cases to ensure proper patient care management. The gynecologist will lead monthly tele-gynecology grand rounds on diverse case presentations available to all providers. The project s primary goal is to enroll eligible and at-risk Veterans into the Home Based Primary Care program utilizing a new team which will be located at the Rutherfordton CBOC With the development of outreach efforts by Rural Health teams across VISN-6, collaborative relationships have now been established. Thus creating an opportunity for building an Integrative Adaptive Community Collaborative Enhanced Services Support (I-ACCESS) program. EQUiPPED is a quality improvement initiative aimed at changing prescribing practices of Emergency Department (ED) providers in order to decrease the use of potentially inappropriate medications (PIMs) in Veterans age 65 and older discharged from the ED 82, ,968 1,772,539 1,107,647 59,500

8 Veterans Health Administration Office of Rural Health (VHA ORH) Page 8 of 11 STATION ORH North Carolina Investments Fiscal Year 2015 Rural Provider and Staff Training Initiative (RPSTI) Telemedicine to Improve Chronic Kidney Disease HBPC Rural Expansion at Salisbury Integrated-Adaptive Community Collaborative of Enhanced Support Services (I-ACCESS) High Quality Patient Centered Care for Rural Vets with Cancer Staff will identify palliative care needs for the Veterans they serve and be able to apply basic palliative care principles within their scope of practice as well as the ability to recognize when a specialized palliative care consult is needed Telemedicine is an effective tool to increase the awareness about chronic kidney disease (CKD) and empower the veterans with advanced CKD with an alternate choice of home dialysis for renal replacement therapy (RRT) Serve an increased number of Veterans (unique) who have not accessed the VA Medical Center services in the past due to their remote rural residence and thus increase the number of unique Veterans served. With the development of outreach efforts by Rural Health teams across VISN-6, collaborative relationships have now been established. Thus creating an opportunity for building an Integrative Adaptive Community Collaborative Enhanced Services Support (I-ACCESS) program. The goal is to implement a cancer delivery model that integrates key cancer center pathways while utilizing oncology navigators and tele-medicine for the purpose of providing timely and compassionate cancer care. 125, , , , ,013

9 Veterans Health Administration Office of Rural Health (VHA ORH) Page 9 of 11 STATION ORH North Carolina Investments Fiscal Year 2015 HBPC Rural Expansion Salisbury Rural Health Training and Education Initiative The team provides Home Based Primary Care services for rural Veterans who are essentially homebound, have multiple comorbidities, and have difficulties in accessing VA healthcare Trains health care providers to deliver quality healthcare to rural, underserved populations of Veteran patients 763, ,627 Fiscal Year 2015 Total $9,663,037 ORH South Carolina Investments Fiscal Year 2014 Charleston, Charleston, Charleston, VISN 7 Stroke Rehabilitation Identifying Rural Urban Disparities in Chronic Disease Burden and Care VTS Partnership The proposed demonstration project directly addresses VISN 7 needs by improving capacity and access to care of local VA facilities, while decreasing the drive distance for veterans with limited transportation The purpose of this project is to inform the VHA Office of Rural Health (ORH) about rural-urban disparities in chronic disease burden and care. The information provided by sustainment of the project will be used by the ORH to help allocate resources and inform their strategic plan. Funds and supports transportation needs of rural Veterans through partnership with Veteran Transportation Program 11,031 59, ,755 Promoting Rural Outreach, Veteran Enrollment & The overall program objectives of PRO-VET are to provide outreach, build collaborations, enroll and 70,069

10 Veterans Health Administration Office of Rural Health (VHA ORH) Page 10 of 11 ORH South Carolina Investments Fiscal Year 2014 Treatment (PRO- VET) assess new Veterans to VA. HOME TELEHEALTH (HT) RURAL EXPANSION Dorn s Mobile Heart and Vascular Unit Rural Sumter-Pee Dee HBPC/HT VTS Partnership This proposals specific objectives and aims are to increase Rural and Highly Rural admissions to all TH programs in specific rural CBOC geographic locations Ensures Veterans and their families receive high quality specialty cardiac care in a timely manner. Primary care and mental health services will be provided to enhance access to care, reduce hospitalizations/emergency room visits, reduce travel time, maximize the use of scarce human resources and increase the quality of care. Funds and supports transportation needs of rural Veterans through partnership with Veteran Transportation Program 376,985 1,051, ,600 3,100 Fiscal Year 2014 Total 2,635,710 Charleston, ORH South Carolina Investments Fiscal Year 2015 Identifying Rural Urban Disparities in Chronic Disease Burden and Care The purpose of this project is to inform the VHA Office of Rural Health (ORH) about rural-urban disparities in chronic disease burden and care. The information provided by sustainment of the project will be used by the ORH to help allocate resources and inform their strategic plan. 230,000

11 Veterans Health Administration Office of Rural Health (VHA ORH) Page 11 of 11 ORH South Carolina Investments Fiscal Year 2015 HOME TELEHEALTH (HT) RURAL EXPANSION Dorn s Mobile Heart and Vascular Unit Rural Sumter-Pee Dee HBPC/HT This proposals specific objectives and aims are to increase Rural and Highly Rural admissions to all TH programs in specific rural CBOC geographic locations Ensures Veterans and their families receive high quality specialty cardiac care in a timely manner. Primary care and mental health services will be provided to enhance access to care, reduce hospitalizations/emergency room visits, reduce travel time, maximize the use of scarce human resources and increase the quality of care. 394, ,169 1,123,600 Fiscal Year 2015 Total 2,418,730

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