Increasing Access to Care: Reaching Out to Rural Veterans

Something which many people don’t realize is that 41 percent of Veterans enrolled in VA health care live in rural areas. And that figure represents more than three million Vets. With respect to our newest Vets, 30 percent of Iraq and Afghanistan service members return to rural communities upon discharge. Over the past several years, we’ve seen a 15 percent jump in rural Veteran health care enrollment—a trend we expect to continue.

As we work to provide health care closer to where today’s Veterans live, we are happy to announce VA’s plans to open thirteen new community-based outpatient clinics throughout the country, including eight clinics in rural areas. Below is a list of where the eight new rural clinics will open.

Georgia – Tifton (Tift County)

Maryland – St. Mary’s

Missouri – Marshfield (Webster County)

North Carolina – Sanford (Lee County)

Ohio – Georgetown (Brown County)

Oregon – Grants Pass (Josephine County)

Pennsylvania – Huntingdon and Indiana

With so many of our Veterans living in rural areas, VA’s Office of Rural Health has worked to improve their health care access. Since 2009, we’ve implemented over 1,000 projects—from setting up new community-based outpatient clinics, funding more outreach clinics, and reducing the need for Vets to travel long distances by increasing the use of telehealth technology. In the past three years alone, more than 600,000 Vets lives have been impacted by our new programs.

For Veterans living in rural areas with complex, chronic and disabling conditions, we have partnered with the VHA Geriatrics and Extended Care Office to expand the Home Based Primary Care programs. Essentially, a health care team—supervised by a VA physician—provides services in the Veterans home. This significantly decreases travel and ensures that Vets receive the care they need. Nationally, this program is available around the country at 144 medical centers and 116 CBOCs. This year, the Office of Rural Health will spend $43 million to expand this program to even more rural Veterans.

Aside from health care services, VA has established more partnerships with rural community organizations and services. As you may have recently read, VA has trained hundreds of rural clergy. Not only have these community leaders been trained on issues facing returning Veterans and their families—they have learned about VA services and benefits so they can help Vets get the care and services they need. ORH is also supporting several outreach initiatives that focus on creating partnerships with local community entities like law enforcement, faith-based organizations, Veterans Service Organizations, and health care providers to help reach rural Veterans. The goal is to inform as many rural Vets about their VA benefits and services, as well as how to access and navigate the VA system. This year alone, 1,700 rural Veterans have attended outreach events. Since August 2011, Project ARCH (Access Received Closer to Home), a pilot program implemented by VA to provide non-VA contract care in local communities, has served over 2500 rural Veterans.

Throughout the next year, the Office of Rural Health plans to train and educate medical residents, dental, nursing and allied health professions students from affiliated institutions to introduce them to rural health care—with the expectation of recruiting and retaining them in rural areas of the country. We will also support the expansion of the Women Veterans Health Strategic Health Care Group. The Office hopes to improve access to care for rural women Veterans through provider education and telehealth technologies. Finally, ORH is supporting an expansion of the new Specialty Care Access Networks-Extension for Community Healthcare Outcomes into rural VA clinics. This program is designed to assist other VA facilities by providing specialty care and services—with the highest quality possible—to the greatest number of Veterans by utilizing innovative technology and services.

To learn more about the Office of Rural Health visit our website. You’ll find more information on our programs and services.

Mary Beth Skupien, PhD, MS, RN, is the Director of the Office of Rural Health for the U.S. Department of Veterans Affairs.


Mary Beth Skupien


  1. timothy hooey    

    When I was reading this ,I could not be leave it . I had to buy AARP, ins.over$300.00 a month. I am 100% vietnam vet…..P.S.CALL ME!

    1. Stacy Wittrock    

      Mr. Hooey,
      There are many ways that you can find out if you are eligible for VA health care benefits. Most counties have Veteran Service Officers who are trained to help Veterans apply for benefits. If you do not know who your country veteran service officer is, you can contact your state office of Veterans Affairs and they can provide that contact information for you.

      You can also go to the VA web page to see if you are eligible for VA benefits:
      You can apply for VA benefits by completing the 1010 ez form online available here:
      You can also apply for VA benefits by calling 1-877-222-VETS (8387).

      Although I am not an expert in VA eligibility, If you would like to email me (, I might be able to direct you to specific resources to help determine your eligibility for VA health care.

      Thank you for your service!
      Stacy Wittrock
      Program Analyst, Veterans Rural Health Resource Center – Central Region (VRHRC-CR)
      Iowa City VA Health Care System (152)
      601 Highway 6 West, 52246

  2. Uncle Vinny    

    These clinics are a definite step in the right direction. The past decade has exacted terrible toll on many of our comrades, and more readily available care, strategically located in rural areas will prove their worth many times over.
    I do not know what present policy is, but until these (and other clinics) are brought online, is there any way that severely injured or traumatized vets that do not have ready access to VA care can be served by private practitioners in their own community?
    I am sure that many Vet’s in this situation have family doctors that have treated them since birth, and would take great interest in treating them post deployment. Granted, specialized care at clinics is sometimes a necessity, but even that often can be minimized by consult from a Specialist to a General Practitioner, which I suspect the majority of rural Dr.s are.
    When you factor in travel pay, hassle and all the other variables, in many cases, I believe the VA would find itself in the plus column, not to mention the reality of more accessible care for severely wounded or traumatized warriors.
    These are just a few thought, but in this Vets opinion, a plausible solution to some specific problems for specific veterans. What do you think?

    1. Stacy Wittrock    

      The majority of Veterans that use the VA for healthcare also have a non-VA health care provider or physician. In fact, one study estimated that approximately 80% of dually eligible Veterans chose to use health care services both in the VA and outside of the VA. The reasons for using both the VA and non-VA health care providers are varied and studies examining the use of both systems are on-going. In some of the work that we have done at the Veterans Rural Health Resource Center – Central Region, rural Veterans have said that they choose to have providers in both systems because of things like an established relationship with a local provider (as you mentioned). Also, if a VA clinic is not in a Veteran’s community they also like to have a local doctor for acute illness or emergencies (e.g. the cold, the flu, a broken leg).

      In terms of Veterans from the most recent wars OEF/OIF/OND (Operations Enduring Freedom, Iraqi Freedom, and New Dawn), they may be eligible for VA benefits (it depends on the details of their service). They need to apply for VA benefits (see my reply to the previous comment for the different ways to do this) within five years of separation from the military.

      Additionally, for Veterans in crisis there are several resources:
      The Veteran Crisis Line 1-800-273-8255, press 1
      Also there are Vet Centers in many communities and some mobile Vet Centers that travel to rural areas. To find out more about the Vet Centers go to their webpage: or call 1-877-WAR-VETS. A Veteran does not need to be enrolled in the VA to use a Vet Center and most Vet Centers have walk-in appointment available.

      Petersen LA, Byrne MM, Daw CN, Hasche J, Reis B, Pietz K. Relationship between
      clinical conditions and use of Veterans Affairs health care among Medicare-enrolled
      Veterans. Health Serv Res. Jun 2010;45(3):762-791.

  3. Diane Craig    

    Please allow me to offer yet another program for our veterans living in the rural areas. I am a Home Telehealth nurse for V.A. Our program is free and helps to connect the veteran more easily to his health care provider and clinic. We monitor diseases such as Diabetes, Congestive Heart Failure, COPD, Hypertension, Depression, PTSD and obesity. The symptoms of these diseases alone send hundreds of veterans many times to the clinics and hospitals which are sometimes hundreds of miles from their residence. We monitor through Telehealth devices and even the telephone to keep you informed about the disease and how to stay healthy. You have a nurse who is available for you to call with questions and concerns. This service has saved countless time, energy and money to keep our veterans healthy and at the house. Please ask your primary care provider or mental health provider to consult the Care Coordinator for Home Telehealth. I personally have patients who have enjoyed this program for years and have far fewer visits to the emergency rooms and being in the hospital. I am proud to serve in this capacity and want every veteran to be aware we are all about improving your healthcare.

  4. Lynda Dokken    

    I am one hundred percent service connected; saw my VA health provider in April of this year; I needed to see eye doctor for blood spot in eye and also renew glasses if needed and wanted to see dentist.. I was told that I had to go almost 300 miles just to get exam for glasses and almost as far to go to dentest. Even though in past I was alloed to see them both here; so not sure what is going on; but I have PTSD and diffiuclty in getting out in small town I live in and have a car that cannot drive that far. So to me it is very misleading with all talk about clinics for rural communites even though we do have one here to get any kind of help. I am not able to travel that far for these simple kind of things we should be able to get help for.

    1. Stacy Wittrock    

      The clinics that Dr. Skupien was talking are community based outpatient clinics (CBOCs) which generally only offer primary care services (i.e. things that an individual might go to a local family doctor to have checked). The services offered at CBOCs vary, but generally speaking eye care and dental care are considered specialty services which usually are taken care of at the outpatient clinics at the VA medical center.

      Generally speaking, there are a couple of things you may be able to try:
      You may want to consult one or more of the following people:
      1) the patient advocate at VA medical center or healthcare system. The patient advocate is there to advocate for your needs and may be able to help you with your specific situation.
      2) the veteran service officer in your county (see my response to the first comment for more information on how to find out who this is in your area).
      3) the VISN rural consultant in your area. If you go to the Office of Rural Health web page: , click on VISN Rural Consultants above the map, a list of contact information will appear.

      Thank you for your service!
      Stacy Wittrock
      Program Analyst, Veterans Rural Health Resource Center – Central Region (VRHRC-CR)
      Iowa City VA Health Care System (152)
      601 Highway 6 West, 52246

      1. Stacy Wittrock    

        I received an email from a VA program manager in Michigan who had some additional suggestions that might be helpful to you.

        4) you may want to ask your VA physician if your needs scan be addressed through Telehealth, which may reduce travel for you.
        5) you may want to see if there is home-based primary care (HBPC) in your area where VA staff can come to you.

        While I am only able to give you general information, I would also suggest contacting your VISN rural consultant; because they can connect you with specific people and resources in your area (see the update to the post that follows this one).

        Thank you for your service!
        Stacy Wittrock
        Program Analyst, Veterans Rural Health Resource Center – Central Region (VRHRC-CR)
        Iowa City VA Health Care System (152)
        601 Highway 6 West, 52246

  5. Carole Cilento    

    I live in NM. The clinic I must use is an hour away. Have to wait weeks for apps. I have ongoing problems. One requires Cipro when it flares. I had to pay for the Rx at a local store because I couldn’t get an appt! Did I mention I’m 100% service connected?
    The Albuquerque va is 3 hours one way and rather than getting testing at a local hospital I’m forced to go on a 6 hour trip for a test. Many I miss due to my problems that prevent me leaving my home. Recently the fee basis turned my psy. Care down saying I could make the 6 hour trip to Albuquerque . As a result I am not receiving the care I need. I’m being refused care as I see it.
    Please contact me. I have no place to turn.

    1. PJ    

      As the spouse of a very ill veteran who is 100% service connected , one of the fears i have is getting my husband to and from his apts which are many and his medical facility is an hour away..As he gets more ill, these trips become even harder..But my worst fear of all is that of knowing what is and isn;t a medical emergency that the VA allows me to get him care at a local hospital for and the 24 hour nurseline which directs us to a local hospital then tells us although she believes it to be an emergency she cannot guarantee the VA will coverage the charges of an outside hospital..In his delicate condition many things are life threatening .. It isn’t right that things must be preapproved on a 100% veteran with the constant worry of having to fight and wait for things to be covered…And I the spouse am also disabled (not a veteran) but am having trouble getting my spouse to a place for care so far away. And when he has to go to a VA hospital for care , it is three hours away, which i can’t drive everyday and have to pay for a hotel to be close to him in his crisis… If the VA needs for an ill veteran to go to a VA hospital then they need to build more hospitals.. Yes the local veterans office can provide a ride , if we give them enough notice, and if we want to sit from morning to night as all the other vets on the ride complete their visits., and these ill veterans can’t sit around and wait that long……This is just not right!

    2. Stacy Wittrock    

      Update: This Veteran has been contacted by the VISN Rural Consultant in her area. Telehealth services and case management services have been arranged to assist the Veteran and reduce travel to the VAMC.

      Thank you for your service!
      Stacy Wittrock
      Program Analyst, Veterans Rural Health Resource Center – Central Region (VRHRC-CR)
      Iowa City VA Health Care System (152)
      601 Highway 6 West, 52246

  6. Ky Niem Chuong Gia Re    

    Great infomation for me, thank you a lot.

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