This competitive funding opportunity announcement serves as the program guidance for the Flex Rural Veterans Health Access Program (RVHAP).  This funding opportunity is also based on the requirements set forth in Public Law 112-74, providing fiscal year (FY) 2012 RVHAP appropriations.  The CFDA number

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for this program is 9 3. 24 1.   RVHAP goals are as follows:
1)  To utilize telehealth and health information technology to enhance access and quality of mental health service and other healthcare services, to veterans residing in rural areas, including the provision of crisis intervention services detection of post-traumatic stress disorders (PTSD), traumatic brain injury (TBI), muscular skeletal, and other signature injuries deemed necessary to meet the needs of rural Veterans of Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF); 2)  To utilize telehealth and health information technology, including electronic health records, to help improve care coordination for Veterans who are seen by both the Veterans Administration (VA) and private providers.

3)  To expand existing networks to provide access to mental health and other services to rural veterans via partnerships and coalitions with other healthcare entities such as:
critical access hospitals, federally qualified health centers, rural health clinics, home health agencies, community mental health clinics and other providers of mental health services, pharmacists, local government, private practice physicians, and other providers deemed necessary to provide access to services and meet the needs of rural veterans; and 4)  To consult with the state hospital association, rural hospitals, providers of mental health services and other stakeholders for the provision of services in the development of program activities.

This program provides funding to meet the goals described including the referral of these veterans to medical facilities operated by the Department of Veterans Affairs (VA), and for the delivery of these services to other residents of such rural areas.

The RVHAP is intended to improve access and services to rural Veterans of Operation Iraqi Freedom and Operation Enduring Freedom living in rural areas affected by poor accessibility and availability of mental health services and other health care services in rural areas of the United States.  A key component of the RVHAP is to facilitate coordination by the Department of Health and Human Services (HHS) Secretary with the Department of Veterans Affairs (VA) as required in Section 121 (a)(C) of the RVHAP authorizing legislation.  Through this announcement the Health Resources and Services Administration (HRSA) will provide support to eligible entities to coordinate activities to provide rural Veterans access to services for needed mental health care via the use of networks, electronic communication and telehealth networks.

 HRSA will make grants to up to three states to test innovative technological approaches to improve access to mental health and other healthcare services for rural Veterans and other residents of rural areas.

 While the primary beneficiaries for this program are OIF and OEF veterans, other veterans and other residents in rural areas may benefit from the increased access to services.  Additionally, this program is targeting all veterans lacking access to services regardless of their enrollment status with the VA.

In accordance with Public Law 112-74, grant funds are to be used for the purchase and implementation of telehealth services, including pilots and demonstrations on the use of electronic health records to coordinate rural veterans care between rural providers and the Department of Veterans Affairs electronic health record system.

Projects funded under this announcement must, to the extent possible, facilitate and/or strengthen coordination by rural healthcare networks with the VA.  Grant funds may also be used to help upgrade existing equipment and software in rural facilities to meet VA privacy standards essential to allowing for interoperability between the VA and non-VA providers.

Further, projects funded under this announcement will be required to develop demonstration and pilot initiatives that make the VA health system accessible to Veterans in remote areas without access to quality healthcare, by coordinating care with the VA through sharing of clinical information compatible with VA privacy and security standards.

IMPORTANT:  Funding under this announcement shall not be used to duplicate efforts in respective applicants’ states, nor will funding be used to reimburse expenses already incurred locally for the purposes of this program.

Note:
The Health Resources and Services Administration (HRSA) acting through Office of Rural Health Policy (ORHP) will be collecting annual performance data and, on an ongoing basis, request information concerning funded projects’ progress in fulfilling RVHAP goals and objectives.  Grantees will be expected to provide timely responses to HRSA requests for data on grantee activities and program outcomes.

2.   Background This program is authorized by Title XVIII, Section 1820 (g)(6) of the Social Security Act (42 U.S.C.

1395i-4), as amended by Sec.

121 of the Medicare Improvement for Patients and Providers Act of 2008, P.L.

110-27 5.   This program guidance supports the RVHAP collaborative objectives, as well as to facilitate the larger objectives of providing better health care to veterans.  The success of the RVHAP is enhanced by broader collaborative efforts as follows:
On August 24, 2012, the VA  Veterans Health Administration  (VHA) Office of Rural Health, the HHS Office of the National Coordinator for Health Information Technology and the HHS Office of Rural Health Policy in the Health Resources and Services Administration signed a memorandum of agreement (MOU) to promote and train an effective health IT workforce to meet health care needs and improve health information exchange and interoperability between VA and rural health providers to ensure coordinated, high-quality care for U. S. veterans living in rural areas.  As members of the White House Rural Council, partners from the VA and HHS will collaborate to increase the number of trained health IT and information professionals and ensure that training programs available are sufficiently diverse to meet a wider range of health care needs through targeted outreach to potential workers and employers to place students and graduates where they are most needed.

Further, on August 31, 2012, the President issued an Executive Order (EO), “Improving Access to Mental Health Services For Veterans, Service Members, and Military Families” which, in part, mandates  “Enhanced Partnerships Between the Department of Veterans Affairs and Community Providers” through which the VA and HHS shall establish pilot projects whereby the VA contracts or develops formal arrangements with community based providers, such as community mental health clinics, community health centers, substance abuse treatment facilities, and rural health clinics, to test the effectiveness of community partnerships in helping to meet the mental health needs of veterans in a timely way.  The EO also requires HHS and VA to develop a plan for a rural mental health recruitment initiative to promote opportunities for the VA and rural communities to share mental health providers when demand is insufficient for either the VA or the communities to independently support full time health care providers.  For additional information see http://www.whitehouse.gov/the-press-office/2012/08/31/executive-order-improving-access-mental-health-services-veterans-service.