The quality of health care for rural veterans was the focus of an April 21 field hearing held by the Senate Committee on Veterans’ Affairs in Billings, Mont. American Legion National Vice Commander Merv Gunderson testified at the hearing and also submitted written testimony.

The Legion’s testimony at the hearing, chaired by Sen. Jon Tester, D-Mont., was based on findings of its System Worth Saving Task Force. This past February, task force members evaluated the quality of rural health care for Montana veterans at the Fort Harrison VA Medical Center and Community-Based Outpatient Clinics (CBOCs) in Billings and Anaconda.

Concerns expressed by the Legion at the hearing included:

• Long-distance travel remains a substantial problem for many veterans, especially those who are elderly or seriously disabled.

• Transportation to VA medical facilities places a burden on veterans and volunteer drivers. VA medical centers need to improve their communication and coordination to triage the needs of volunteer transportation drivers, veterans enrolled in the VA health-care system, and volunteer travel services.

• Although CBOCs are an excellent resource, they are usually limited to primary care. Veterans who use such facilities often need more specialized care. CBOCs are helpful, but they are not a cure-all for veterans’ medical needs in rural areas.

• Many staff vacancies still exist at VA facilities, especially in the area of mental health care. Filling these vacancies to ensure full staffing should be a major priority.

The Legion then made the following recommendations to the committee:

• VA should develop its own definition of rural and highly rural veterans, independent of the Census Bureau’s definition and including more consideration of distance and driving times for veterans seeking health care.

• VA should move swiftly to fill all vacancies in VAMCs and rural communities, especially for mental health services; two days before the hearing, VA announced it was adding 1,600 mental-health clinicians and 300 support staff to its health-care system nationwide.

• Incentive programs should be enhanced by VA, in order to recruit and retain top talent in rural facilities.

• VA medical centers should develop transportation departments to oversee volunteer transportation driver programs, beneficiary travel and VA transportation service initiatives.

To view the full testimony, go to

For more information about the Legion’s efforts to improve rural health care for veterans, contact Jacob Gadd at