Thursday, November 12, 2009

Better healthcare for rural veterans? SB 1963 is trying.

I was recently watching the Rachel Maddow Show and was interested to hear that a bill currently in the Senate regarding veteran’s healthcare directly speaks to healthcare for rural veterans. Upon reading the sections in SB 1963 specific to rural veterans two specific points stand out.

One, Section 304 requires the Secretary of Veterans Affairs to create a program for teleconsultation of mental health and traumatic brain injury assessments in veteran’s facilities that don’t currently have them (i.e., rural facilities). The section also requires the Secretary to submit annual reports in FY2010 through FY 2015 to Congress describing the specific efforts taken by the program on both the extension and implementation of the program to rural veteran’s facilities. What I like about the program is that it seems not only to require that teleconsultation be made available but that efforts are made to create the infrastructure for its use. Does this, however, bring up a general infrastructure problem of rural areas, in that many may not have the necessary high-speed/DSL internet cabling infrastructure necessary for this type of program?

Second, Section 305 allows (the lovely ‘may’, rather than the draconian ‘shall’) the Secretary, through the Director of the Office of Rural Health (which I didn’t even know existed and is probably worth its own blog) to create demonstration projects to examine the “feasibility and advisability” of those projects in expanding healthcare to rural veterans. The Act allocates $5,000,000 starting in FY2010 for what essentially seems a research and development program to expand healthcare to rural veterans. While the Act does suggest some possibilities, it gives the Secretary pretty wide discretion for these programs save that the ‘demonstration projects’ must be geographically distributed. What an interesting concept. Congress seems to be saying “We don’t know how to fix this. So, Veteran’s Affairs, you create R&D to see what might work and report back to us.” The allocation seems rather low, however.

Given that many of the problems of healthcare for rural veterans are the same as those who are non-veterans, the possibility of cross-over seems fairly promising. Does the limited allocation, however, cap the possibility before it even begins?

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