Veterans in rural areas screwed out of care for PTSD

President Trump loves to say that his administration is giving veterans a choice on their care. For some strange reason, veterans would rather have the VA to be there for them.

This was on the Huffington Post and it shows what veterans are expected to merge into! A system that cannot even take care of the civilians. The difference is that the Congress is responsible for the way veterans get, or are denied, their healthcare.

Remember, these veterans became disabled serving our country. This is the equivalent of turning their backs on our veterans!!

And now you may have  a clue as to why this "Choice" thing is shafting veterans. 

Rural areas have the highest suicide rate and the fewest mental health

There isn’t a single psychiatrist in 65 percent of nonmetropolitan counties, and there’s no psychologist in almost half of them.

Rural areas have the highest suicide rates, according to the Centers for Disease Control and Prevention, as well as a high concentration of veterans, who experience higher rates of suicide than nonveterans. Rates of drug overdoses in rural areas have surpassed those in metropolitan areas. There are also more elderly people, who are often socially isolated and at risk for depression, said Ron Manderscheid, executive director of the National Association for Rural Mental Health.

Elderly veterans are the majority of veterans committing suicide! 65% are over the age of 50!

So, if you're a veteran and live in a rural area of the country, the government told you that the VA cannot help you, so you have to go to a private practice. Oops! Did they think of checking on that one first?

Google Maps Will Get Rural Veterans Care They Need, Yahoo! (Joy)

VA rule change could double number of vets eligible for health care 
CBS
March 24, 2015

Under the new interpretation, the distance veterans must travel will be calculated through commercial products such as Google maps or other websites, rather than a straight line.

WASHINGTON -- Responding to pressure from Congress and veterans groups, the Department of Veterans Affairs is relaxing a rule that makes it hard for some veterans in rural areas to prove they live at least 40 miles from a VA health site.

The change comes amid complaints from lawmakers and advocates who say the VA's current policy has prevented thousands of veterans from taking advantage of a new law intended to allow veterans in remote areas to gain access to federally paid medical care from local doctors.

The VA said it will now measure the 40-mile trip by driving miles as calculated by Google maps or other sites, rather than as the crow flies, as currently interpreted. The rule change is expected to roughly double the number of eligible veterans. "We've determined that changing the distance calculation will help ensure more veterans have access to care when and where they want it,"

Veterans Affairs Secretary Robert McDonald said in a statement. The change will be unveiled at a hearing Tuesday before the Senate Veterans Affairs Committee.
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UPDATE from the VA

VA Works to Expand Choice Program Eligibility
03/24/2015

Eligibility criteria for 40 miles calculation would change to driving distance

Washington -- In order to expand eligibility for the Veterans Choice Program, the Department of Veterans Affairs (VA) today announced that it will change the calculation used to determine the distance between a Veteran’s residence and the nearest VA medical facility from a straight line distance to driving distance. The policy change will be made through regulatory action in the coming weeks. The Veterans Choice Program was authorized by the Veterans Access, Choice, and Accountability Act of 2014 (VACAA).

“VA has worked very quickly to implement the Veterans Choice Program and we appreciate the constructive feedback shared by Veterans and our partners to help us improve service to Veterans,” said Secretary Robert McDonald. “We’ve determined that changing the distance calculation will help ensure more Veterans have access to care when and where they want it. VA looks forward to the ongoing support of our partners as we continue to make improvements to this new program.”

The method of determining driving distance will be through distance as calculated by using a commercial product. The change is expected to roughly double the number of eligible Veterans.

The Veterans Choice Program is a new, temporary benefit that allows eligible Veterans to receive health care in their communities rather than waiting for a VA appointment or traveling to a VA facility. Veterans seeking to use the Veterans Choice Program should call 1-866-606-8198 to confirm their eligibility and to schedule an appointment. Since the Choice Program went into effect on November 5, 2014, more than 45,000 medical appointments have been scheduled.

Using expanded authorities from VACAA, VA continues to expand access to care through increased staffing and enhanced collaboration with both the Indian Health Service and Native Hawaiian Health Care Systems. See the VACAA progress fact sheet here:

VA is enhancing its health care system and improving service delivery to better serve Veterans and set the course for long-term excellence and reform. VA has made significant progress in various areas of the legislation, such as extending the Assisted Living/Traumatic Brain Injury Pilot program and Project Arch, to expand timely access to high-quality health care for Veterans.

A fact sheet on the 40-mile-rule change can be found at VA 40 Mile Rule.

VA PTSD Counselor Position Unfilled for 5 Years in Washington

In Remote Washington, Veterans Services Are Ferry Ride Away
NPR
Patricia Murphy
JANUARY 15, 2015

"But even vets who may want help, including some who struggle with post-traumatic stress disorder, can't get VA counseling. A VA contract position for a counselor to serve the county has been unfilled for five years."

The ferry pulls in to Friday Harbor, the only incorporated city in San Juan County, Wash. Veterans will often travel the hourlong ferry ride to reach VA services here. Patricia Murphy/KUOW

NPR — along with seven public radio stations around the country — is chronicling the lives of America's troops where they live. We're calling the project "Back at Base." This story is part of a three-part series about veteran benefits (Part 1 / Part 2).

For veterans in San Juan County, Wash., getting health care from the U.S. Department of Veterans Affairs almost always begins with an hourlong ferry ride. 

Even routine bloodwork requires a three-hour one-way trip.

Friday Harbor, Wash., is one of four island stops on this ferry ride, and the only incorporated city in San Juan County.

Travel to the west side of the island, and your cellphone pings you that you're in Canada, even though you're still in the U.S. Just a short walk from the ferry terminal is American Legion Post 163, where Peter DeLorenzi, a veterans service officer, helps area vets.

"Unless you get out," he says, "then you don't know what you have out here."

What you have are hard-to-reach vets missing out on their benefits. And until recently, the burden to sign up was mostly on them.

Then in November, for the first time, two VA employees drove a camper-sized mobile vet center 137 miles from another vet center in Tacoma, Wash., to Friday Harbor. The visit was part of a national effort to provide outreach to rural communities.

The VAB advertised and word got around. About 20 vets showed up, some were lined up when the doors opened. Most inquired about benefits, but none were willing to speak with the on-board counselor. Building that trust takes time.
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Missoula State VA office cuts back rural outreach effort

There is what the Department of Veterans Affairs does on a national level and then there is what the states do. This is one of those cases.

Missoula VA office cuts back rural outreach effort
Missoulian
Martin Kidston
September 27, 2014

“We’re advertising the position, but since it’s a state job, the hiring process is very slow,” Blanche said. “We were able to do our outreach for September, but we’re giving vets notice about October. I’m hoping to have a position filled by the end of the year.”

A lack of staffing at an outreach program operated by the Montana Veterans Affairs Division has prompted the Missoula office to scale back its rural outreach efforts until the issue is resolved.

Roxanne Blanche, the regional services officer for the Montana VA’s Missoula office, said she is now the only employee available to meet veterans across a large western swath of the state.

“What we’re doing is asking vets to give us a call and file for medical benefits,” said Blanche. “Since I don’t have the staffing, those vets in outlying areas, if they live too far away, will have to schedule a phone appointment.” The number to call is 542-2501.
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John McCain forgot about $22 million already spent on "new plan" for VA

What is John McCain up to?

Senate GOP presses new bill to overhaul VA
Stars and Stripes
By Travis J. Tritten
Published: June 3, 2014

WASHINGTON — Senate Republicans led by Sen. John McCain, R-Ariz., on Tuesday unveiled their plan to repair the troubled Department of Veterans Affairs health care system by weeding out wrongdoing and expanding access to private care.

The bill allows veterans to choose a private provider if they live far from VA facilities or have difficulty getting timely care. It also gives the VA secretary more leeway to fire senior executives and forces the department to set new punishments for employees who falsify records, according to McCain and co-sponsors Sens. Tom Coburn, R-Okla., Richard Burr, R-N.C., and Jeff Flake, R-Ariz.

The Republicans floated the legislation just a day after Sen. Bernie Sanders, I-Vt., who caucuses with the Democrats, filed a wide-ranging VA reform bill that would also provides wider access to private care and more authority for the VA secretary to remove incompetent executives.

“Unlike Sen. Sanders’ bill, this addresses the root cause of the current VA scandal,” which is long waiting times for patients to receive care, and employee wrongdoing, McCain said.

The senators claimed their bill is more focused than Sanders’ legislation, which also covers physician hiring, facility leases, scholarships, software upgrades, cost-of-living assistance adjustments for servicemembers, tuition assistance and a raft of other issues.
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While this may sound like a really good idea, it has been done before, way back in 2009 with a pricetag of $22 million!

VA Announces $22 Million for Rural Veterans
Peake: Down Payment on Expansion of Services
WASHINGTON (January 9, 2009) -- The Department of Veterans Affairs (VA) has provided $21.7 million to its regional healthcare systems to improve services specifically designed for veterans in rural areas.

"This special allocation is the latest down payment on VA's commitment to meet the needs of veterans living in rural areas," said Secretary of Veterans Affairs Dr. James B. Peake. "VA will take to our rural veterans the health care services they have earned."

Within the last year, VA has launched a major rural health initiative. The Department has already created a 13-member committee to advise the VA secretary on issues affecting rural veterans, opened three rural health resource centers to better understand rural health issues, rolled out four new mobile health clinics to serve 24 predominately rural counties, announced the opening of 10 new rural outreach clinics in 2009 and launched a fleet of 50 new mobile counseling centers.

The extra funding is part of a two-year VA program to improve the access and quality of health care for veterans in geographically isolated areas. The program focuses on several areas, including access to health care, providing world-class care, the use of the latest technology, recruiting and retaining a highly educated workforce and collaborating with other organizations.

More specifically, the new funds will be used to increase the number of mobile clinics, establish new outpatient clinics, expand fee-based care, explore collaborations with federal and community partners, accelerate the use of telemedicine deployment, and fund innovative pilot programs.

The new funds will be distributed according to the proportion of veterans living in rural areas within each VA regional healthcare system, called VISNs, for "Veterans Integrated Service Networks." VISNs with less than 3 percent of their patients in rural areas will receive $250,000. Those with population of rural veterans between 3 percent and 6 percent will receive $1 million each. And VISNs with more than 6 percent of their veterans population in rural areas will receive $1.5 million.

Special VA Funding for Rural Health
(By VISN number and VISN Headquarters)
#1. Bedford, Mass., $1 million
#2. Rochester, N.Y., $1 million
#3. New York, N.Y., $250,000
#4. Wilmington, Del., $1 million
#5. Baltimore, Md., $250,000
#6. Durham, N.C., $1.5 million
#7. Atlanta, Ga., $1.5 million
#8. Bay Pines, Fla., $1 million
#9. Nashville, Tenn., $1.5 million
#10. Cincinnati, Ohio, $1 million
#11. Ann Arbor, Mich., $1 million
#12. Chicago, Ill., $1 million
#15. Kansas City, Mo., $1.5 million
#16. Jackson, Miss., $1.5 million
#17. Arlington, Texas, $1 million
#18. Mesa, Ariz., $1 million
#19. Denver, Colo., $1 million
#20. Vancouver, Wash., $1 million
#21. Palo Alto, Calif., $1 million
#22. Long Beach, Calif., $250,000
#23. Lincoln, Neb., $1.5 million

Rural Veterans Access to Care Act

As for tuition assistance, McCain was against it before he got credit for it. Ask Jim Webb on the fight he had with McCain over the GI Bill.

McCain says the legislation is too expensive and has proposed his own version, which would increase the monthly benefit available to most veterans to $1,500 from $1,100. It would not offer the equivalent of a full scholarship.

The ad by VoteVets.org Action Fund, features Iraq and Afghanistan veterans noting that both McCain and President Bush oppose the bill. "McCain thinks covering a fraction of our education is enough," one veteran says. Another one, pictured recovering from head wounds, adds in a voiceover: "We didn't give a fraction in Iraq. We gave 100 percent."

Church and VA team up to help veterans heal

Church, VA partner to help rural veterans tackle PTSD, other problems
Arkansas Times
by Evin Demirel
December 26, 2013

For some veterans, reintegrating into civilian life is a rocky process. Many suffer from PTSD (Post Traumatic Stress Disorder), estimated to afflict 400,000 veterans of Iraq and Afghanistan conflicts.

Sometimes, depression and even suicide follow (It's estimated 22 veterans commit suicide daily). Some return with brain injuries. Vets in rural areas may have a tougher time getting help. They tend to be uncomfortable contacting mental health care providers, preferring instead to share problems with VA clergy or their church's pastor.

Enter the VA/Clergy Partnership for Rural Veterans, a North Little Rock-based program that aims to reconcile science-and spirituality-based approaches to treating mental illness. It began with a pilot program in El Dorado and has expanded to Russellville, Pine Bluff, Searcy, Mountain Home and Jonesboro. At each site, clergy, representatives of non-profit organizations, veterans and mental health providers meet monthly to discuss ways to help veterans in their area of the state.

Most who take part, such as William Flynn, pastor of Grace Chapel Pentecostal Church in Russellville, are volunteers. Flynn came aboard in 2010 after hearing about the suicide of a local veteran who had returned from Afghanistan. "It's just sickening to think that a person who sacrificed that way would come home and feel that there was no hope for them," Flynn said.
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VA Grants Will Expand Transportation in Highly Rural Areas

VA Grants Will Expand Transportation in Highly Rural Areas

Veterans to Have Easier Access to Health Care

WASHINGTON (July 10, 2013)– Veterans will have improved access to health care under a Department of Veterans Affairs initiative that supports new transportation services for those living in highly rural areas.

VA began accepting applications this month for grants to help state Veterans Service Agencies and Veterans Service Organizations (VSOs) operate or contract for transportation services to transport Veterans to VA medical centers and other facilities that provide VA care. A new regulation establishes the program that will administer these grants. Transportation will be provided at no cost to Veterans.

“VA wants to be sure that all Veterans, including those who live in rural and remote areas, can receive the health care they have earned through service to our country,” said Secretary of Veterans Affairs Eric K. Shinseki. “State Veterans Agencies and VSOs will now be able to employ innovative approaches to transportation services for Veterans in our highly rural areas. The end results will include better service and better health care for Veterans.”

VSOs and State Veterans Service Agencies may apply for grants up to $50,000 to fund transportation of Veterans to and from VA medical centers and other facilities that provide VA care. If specified in the application, the services may be provided under agreements with contractors, such as private bus or van companies.

A highly rural area is defined as a county or counties with a population of fewer than seven persons per square mile. Many highly rural areas are found in the western and southwestern United States but at least half of the states have at least one highly rural area.

One of Secretary Shinseki’s top three priorities is increasing access to VA care and services for Veterans wherever they live. VA is expanding access in a three-pronged effort that includes facilities, programs and technology.

Veterans who served in Iraq or Afghanistan are eligible for an extended period of eligibility for health care for 5 years after they have left the service.

Mobilizing counseling services for rural veterans

Mobilizing counseling services for rural veterans
By ABBIE TUMBLESON West Yellowstone News
Posted on July 10, 2011

Department of Veterans Affairs Vet Center employees John Viviano and Douglas Bell spend their days working with veterans visiting their office.

Their office has helped servicemen and women cut down on travel costs and the time it takes to attend counseling services.

Simply put, their office comes to the veterans.

Viviano is the proud driver and operator of MVC 0829, one of 50 Mobile Vet Centers in the lower 48 states.

Montana is home to two of the centers based out of Billings and Missoula.

The large motor coaches act as offices on wheels and come equipped with a comfortable seating area, a satellite system, laptop computers and an onboard readjustment counselor to assist veterans coping with Post Traumatic Stress Disorder.

"The units were originally purchased to supply Vet Centers so they could provide outreach to warzone veterans with PTSD," Viviano said. "Each unit has a two-person crew."
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Mobilizing counseling services for rural veterans

Petitions seeking locally based care for veterans to VA office in Washington

Rep. Frank LoBiondo to deliver stack of petitions seeking locally based care for veterans to VA office in Washington

By ROB SPAHR Staff Writer
SOMERS POINT - Leigh Hartshorn Jr. must still wear a bandage on his right leg from a fragment wound he suffered in the Vietnam War. The 63-year-old Northfield resident needs the assistance of a cane to walk, but once a week he is forced to make the long trek to Wilmington, Del., for wound care treatments.

Wilmington and Philadelphia are the closest places that Hartshorn - and thousands of other South Jersey veterans - can receive significant medical treatments through the Department of Veterans Affairs.

Yet the VA has repeatedly insisted that there is "no need" for more substantial health care services for veterans in the region.

Hartshorn called that "frustrating," considering he was injured fighting for his country.

"You just have to make the best of it," he said.
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Petitions seeking locally based care for veterans to VA office in Washington

For veterans in rural areas, health care can be a battle

For veterans in rural areas, health care can be a battle

Associated Press
Posted: Sunday, June 12, 2011

WASHINGTON • Frank Munk earned his veteran's medical benefits more than four decades ago in Quang Tri province, a hard-fought, bloody piece of ground in Vietnam. Yet he doesn't always choose to use them.

Munk, 64, a truck mechanic from western Kansas, instead spends $2,500 out of his own pocket on a private doctor for such things as hearing tests. It's either that or drive nearly 300 miles to a Department of Veterans Affairs hospital in Wichita or Denver.

"I can't afford to take two days off," said Munk, who's self-employed. "The VA care is getting cost-prohibitive for people in the rural areas because of the time, and a lot of them can't drive themselves."

Other veterans who live beyond America's cities and suburbs share Munk's dilemma. Long distances and restrictive rules have become obstacles to health care for many of the more than 3 million rural veterans enrolled in the VA health system. They account for 41 percent of enrollees.
But the agency's effort to aid rural veterans has other problems as well. An April internal VA audit found that it couldn't determine whether much of the money spent on rural health care in recent years did any good.

The VA Office of Inspector General, the agency's internal watchdog, concluded that the VA "lacked reasonable assurance" that its use of $273 million of the $533 million in rural health funding it received in 2009 and 2010 had "improved access and quality of care" for veterans.

"We basically couldn't tell how effective each of these projects was because of the lack of project performance measures," said Gary Abe, a director in the inspector general's office who oversaw the audit. "The report's message was the VA couldn't determine if it was money well spent."
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For veterans in rural areas health care can be a battle

For veterans, getting to the VA is a big problem too

Veterans committee hosts town hall forum
By SANJAY TALWANI Independent Record
Some veterans come to the Veterans Administration Hospital at Fort Harrison for treatment, only to have no money for gasoline for the return trip.

Fortunately, thanks to a private fundraising effort, the VA can give gas cards to those without the money, and more and more have needed the help.

“The number of gas cards we have given out in the last six months has doubled,” Robin Korogi, Montana Health Care Services director for the VA, said at a town hall-style discussion at the VA Wednesday. The event was organized by the Veterans Rural Health Advisory Committee, a nationwide group chaired by Jim Ahrens of Helena, former president of the Montana Hospital Association.

That committee makes one visit as a group to rural areas each year, and aims to bring the concerns of rural veterans to VA leadership in Washington.

Dr. Mary Beth Skupien, director of the VA Office of Rural Health, is also in Helena, visiting from Washington.
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Veterans committee hosts town hall forum

Rural West Virginia Vets have higher rate of trauma risk

Study: Rural W.Va. vets at higher trauma risk

The Associated Press
Posted : Tuesday Nov 11, 2008 9:37:31 EST

CHARLESTON, W.Va. — A new study shows that rural West Virginia veterans who served in Iraq and Afghanistan are more likely to suffer from mental health problems than their urban counterparts.

The analysis is based on the ongoing West Virginia Returning Soldiers Study, which has surveyed more than 930 veterans.

The study shows that about 56 percent of returning soldiers from rural counties suffer from post-traumatic distress and other mental health problems, compared to 32 percent of soldiers in urban areas and 34 percent of those living on out-of-state military bases.

Rural veterans are also at greater risk for suicide.

Hilda Heady, a rural health specialist at West Virginia University, says part of the problem is a lack of mental health care facilities in rural areas.
http://www.armytimes.com/news/2008/11/ap_wvruralvets_111108/

VA press release about mobile health care

Recent VA News Releases
To view and download VA news release, please visit the following Internet address: http://www.va.gov/opa/pressrel


VA Mobile Health Care Clinics Reach Rural Veterans Service Coming to 24 Counties in Six States
WASHINGTON (Aug. 27, 2008) -- The Department of Veterans Affairs (VA) isrolling out four new mobile health clinics outfitted to bring primarycare and mental health services closer to veterans in 24 predominatelyrural counties, where patients must travel long distances to visit theirnearest VA medical center or outpatient clinic."VA is committed to providing primary care and mental health care forveterans in rural areas," said Secretary of Veterans Affairs Dr. JamesB. Peake.
"Health care should be based upon the needs of patients, nottheir ability to travel to a clinic or medical center."The pilot project is called Rural Mobile Health Care Clinics. It features a recreational-type vehicle equipped to be a rolling primarycare and mental health clinic.
VA is currently in the process of procuring and outfitting the vehicles,and officials expect the mobile clinics to be operational by early 2009.
Rural areas in Colorado, Nebraska and Wyoming will share a single mobilevan, while Maine, Washington state and West Virginia will each have a VAmobile van.
The clinics are planned to serve:
* Colorado: Larimer, Jackson, Logan, and Weld counties;
* Maine: Franklin, Somerset and Piscataquis counties;
* Nebraska: Cheyenne, Kimball, and Scottsbluff counties;
* Washington state: Greys Harbor, Mason, and Lewis;
* West Virginia: Preston, Randolph, Upshur, Wetzel, Roane, andTaylor counties; and,
* Wyoming: Albany, Carbon, Goshen, and Platte counties.
Factors considered in the selection of the participating sites includeda need for improved access in the area, the degree to which clinics willexpand services and collaborations with communities the clinics serve.

Rural Veterans Access to Care Act

Kaiser Daily Health Policy Report

Capitol Hill Watch House Veterans' Affairs Committee Approves Veterans' Health Care Bills
[Jul 17, 2008]
The House Veterans' Affairs Committee on Wednesday approved several bills related to health care services for veterans, CQ HealthBeat reports. One of the bills (HR 1527), sponsored by Rep. Jerry Moran (R-Kan.), would establish a three-year pilot program that would allow "highly rural" veterans enrolled in four of the Department of Veterans Affairs' 21 health care networks to receive health services through outside providers. The bill defines highly rural as veterans seeking primary care who live more than 60 miles from the nearest veterans' facility; veterans seeking acute hospital care who live more than 120 miles from a facility; and those seeking tertiary care who live more than 240 miles from a facility (Lubbes, CQ HealthBeat, 7/16). The bill also would allow veterans to access care at other facilities if VA determines that travel would be difficult for veterans or is "not in the best interest of the veteran" (Povich, CongressDaily, 7/17).

Rural Veterans Access to Care Act (Introduced in House)

HR 1527 IH


110th CONGRESS

1st Session

H. R. 1527
To amend title 38, United States Code, to allow highly rural veterans enrolled in the health system of the Department of Veterans Affairs to receive covered health services through providers other than those of the Department, and for other purposes.


IN THE HOUSE OF REPRESENTATIVES

March 14, 2007
Mr. MORAN of Kansas (for himself and Mr. LATHAM) introduced the following bill; which was referred to the Committee on Veterans' Affairs


--------------------------------------------------------------------------------


A BILL
To amend title 38, United States Code, to allow highly rural veterans enrolled in the health system of the Department of Veterans Affairs to receive covered health services through providers other than those of the Department, and for other purposes.


Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the `Rural Veterans Access to Care Act'.

SEC. 2. ENHANCED CONTRACT CARE AUTHORITY FOR HEALTH CARE NEEDS OF VETERANS IN HIGHLY RURAL AREAS.

(a) Contract Care for Highly Rural Veterans- Section 1703 of title 38, United States Code, is amended by adding at the end the following new subsection:

`(e)(1) A highly rural veteran who is enrolled in the system of patient enrollment established under section 1705(a) of this title may elect to receive covered health services for which such veteran is eligible through a non-Department health-care provider. Such an election shall be made by submission to the Secretary of an application in accordance with such regulations as the Secretary prescribes. The Secretary shall authorize such services to be furnished to such veteran pursuant to contracting with such a provider to furnish such services to such veteran.

`(2) For purposes of this subsection, a highly rural veteran is one who--

`(A) resides in a location that is--

`(I) more than 60 miles driving distance from the nearest Department health-care facility providing primary care services, if the veteran is seeking such services;

`(ii) more than 120 miles driving distance from the nearest Department health-care facility providing acute hospital care, if the veteran is seeking such care; or

`(iii) more than 240 miles driving distance from the nearest Department health-care facility providing tertiary care, if the veteran is seeking such care; or

`(B) in the case of a veteran who resides in a location less than the distance indicated in clause (i), (ii), or (iii) of subparagraph (A), as applicable, experiences such hardship or other difficulties in travel to the nearest appropriate Department health-care facility that such travel is not in the best interest of the veteran, as determined by the Secretary pursuant to regulations prescribed for purposes of this subsection.

`(3) For purposes of this subsection, a covered health service is any hospital care, medical service, rehabilitative service, or preventative health service authorized to be provided by the Secretary under this chapter or any other provision of law.

`(4) For purposes of this subsection, a health-care provider is any qualified entity or individual furnishing a covered health service.

`(5) In meeting the requirements of this subsection, the Secretary shall--

`(A) consult with the Secretary of Health and Human Services to establish a partnership to coordinate care for rural veterans conducted at critical access hospitals, community health centers, and rural health clinics; and

`(B) expand the use of fee-basis care through which private hospitals, health-care facilities, and other third-party health-care providers are reimbursed.'.

(b) Effective Date- The Secretary of Veterans Affairs shall implement the amendment made by subsection (a) not later than October 1, 2008.

SEC. 3. AUTHORITY OF DEPARTMENT OF VETERANS AFFAIRS PHARMACIES TO DISPENSE MEDICATIONS TO HIGHLY RURAL VETERANS ON PRESCRIPTIONS WRITTEN BY NON-DEPARTMENT PRACTITIONERS.

Section 1712 of title 38, United States Code, is amended by adding at the end the following new subsection:

`(f) Subject to section 1722A of this title, the Secretary shall furnish to a highly rural veteran, as described in section 1703(e)(2) of this title, such drugs and medicines as may be ordered on prescription of a duly licensed physician in the treatment of any illness or injury of the veteran. Such drugs and medicines shall be furnished in the same manner and subject to the same conditions as apply to a prescription written by a Department physician.'.
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