According to the Veterans Administration's Northwest News, VISN 20 has a number of ongoing projects. VISN 20 is expanding telehealth, examining the patient centered medical home concept, expanding outreach clinics, expanding rural healthcare services, improving behavioral health efforts, and partnering with providers in local communities where it is not feasible to establish a VA staffed clinic.
VISN 20 includes the states of Alaska, Washington, Oregon, most of the state of Idaho, and one county in Montana and in California. The 135 counties cover 23 percent of the U.S. land mass while 17 percent are classified as health professional shortage areas and 67 percent of these counties had a 2001 per capita income below $25,000.
The VHA’s Office Telehealth Services has been awarded funding to enhance telemedicine programs in VISN 20. The funding provides for the purchase of additional teleretinal imaging equipment, expansion of the Care Coordination Home Telehealth program, plus expansion of other specialty services using telehealth technology.
Today rural veterans can receive quality dermatology care at a VA clinic near their home through a telemedicine link to dermatologists at VA Puget Sound. Providers and technicians from 23 sites in VISN 20 have been trained in the process and over 1,000 consults have been completed.
The VA is interested in the Patient Centered Medical Home concept. Last spring, close to 130 VISN employees attended a Summit on the topic. An important part of the Patient Centered Medical Home will be to expand the services available to veterans via MyHealtheVet. The veterans will eventually be able to see their lab work and use secured messaging to communicate with their healthcare team. As a next step, an 18 month collaborative will begin soon and each VISN 20 facility will send teams to learn more about the concept.
To expand home-based primary care, VISN 20 is setting up programs in Newport, Camp Rilea, Warm Springs, Grand Ronde, and Grants Pass Oregon and in Boise, Twin Falls, Caldwell and Mountain Home Idaho. These facilities are recruiting staff and will have programs up and running by the end of September 2010.
Plans are to expand outreach clinics particularly in clinics offering Primary Care and Mental Health services. New clinics have opened in Burns and Grants Pass Oregon and in Crescent City, California. Two more clinics will be opening in Newport, Oregon and Mountain Home Idaho.
Over the last several months, VISN 20 has been phasing in some new projects to improve access and quality of care for rural veterans with funding provided by the VHA Office of Rural Health. The VISN Central Office recently provided an additional $14 million of dedicated funding to improve rural health care delivery.
The VISN 20 Behavioral health Committee (BHC) continues to improve mental health care. The BHC is developing a framework for mental health service delivery across all eight VISN 20 primary access points.
Where it is not feasible to establish a VA staffed clinic, facilities are entering into agreements with providers in local communities to offer primary care services. Contracts are being sought in several locations. Solicitations for offers have been posted and these agreements will be finalized over the next three to four months. A contract has already been awarded to a provider in Libby Montana who will begin seeing VA patients soon.