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Specialized Care Centers and Settings-II

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Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
Healthcare Agencies I01:18

Healthcare Agencies I

Healthcare agencies provide healthcare services to people. In the United States, voluntary agencies are often non-profit centers sponsored by donations, grants, or fundraisers. One such organization is Meals on Wheels, which provides meals to the elderly and homebound. The American Heart Association and the American Lung Association are other non-profit community organizations. Doctors and nurses are frequently active members of these organizations, which offer health checks and educational...
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Related Experiment Video

Updated: Jul 4, 2026

Introduction of an Integrated Pathology Image Management, Artificial Intelligence, and Reporting System
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Published on: July 11, 2025

Expanding Home- and Community-Based Service Access in the Veterans Health Administration.

Heather Davila1, Mary K Good2, Daniel D Ball3

  • 1Center for Access & Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, Iowa City, IA, USA; VHA Office of Rural Health, Veterans Rural Health Resource Center-Iowa City, Iowa City VA Health Care System, Iowa City, IA, USA; Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA.

Journal of the American Medical Directors Association
|July 2, 2026
PubMed
Summary

Veterans

Keywords:
Agingaccess to carehome- and community-based servicesqualitativeveterans

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Published on: February 8, 2019

Area of Science:

  • Gerontology
  • Health Services Research
  • Public Health

Background:

  • The US Department of Veterans Affairs (VA) provides home- and community-based services (HCBS) to support aging veterans.
  • Many HCBS are delivered through community-based contracted agencies, posing access challenges.
  • Understanding VA staff strategies is crucial for improving HCBS access for veterans.

Purpose of the Study:

  • To explore strategies VA staff employ to facilitate veterans' access to home- and community-based services (HCBS).
  • To identify barriers and facilitators to HCBS access within the VA system.
  • To inform improvements in HCBS coordination and delivery for veterans.

Main Methods:

  • A qualitative descriptive study utilizing semistructured interviews with VA staff.
  • A purposeful sample of 34 staff from 11 geographically diverse VA health care facilities were interviewed.
  • Interview data were analyzed thematically to identify strategies for facilitating HCBS access.

Main Results:

  • Significant variation exists in HCBS organization and coordination across VA facilities.
  • Common barriers include limited service availability, difficulty identifying specialized services (e.g., dementia care), inadequate nonmedical support (e.g., transportation), and coordination issues.
  • Key facilitators identified were education and outreach, collaborative partnerships, and adequate staffing for HCBS coordination.

Conclusions:

  • Veterans' access to HCBS is influenced by service availability and VA staff capacity for outreach and coordination.
  • Effective strategies involve education, fostering collaborations, and ensuring stable staffing.
  • Disseminating best practices is vital to meet the growing national demand for veteran HCBS.