The former CEO of the Montana Hospital Association on Wednesday called for an expanded telemedicine program and a stronger relationship between the VA and Indian Health Services while testifying before the Senate Committee on Veterans Affairs.

James Ahrens, who now chairs the Veterans Rural Health Advisory Committee in Montana, delivered his testimony in Washington, D.C., at the invitation of committee member Sen. Jon Tester, D-Mont.

“They wanted to know what the best approach was to get Indian Health Services and the VA working together,” Ahrens said Wednesday, speaking by phone from a D.C. sidewalk. “I told them it’s got to start from the top down, and in Montana, the local IHS people and the VA have to start meeting.”

The disconnect between the VA and Indian Health Services has been a point of discussion now for several years. It remains at the top of the list among those looking for ways to improve rural care for vets — a population that includes American Indians.

In his testimony, Ahrens, who lives in Cascade, also said access to VA health care remains a critical issue. With the U.S. still waging a war on two fronts, and with America’s veteran population aging, the need will continue to grow, he said.

“A new and sustained effort is needed to bridge the services of the VA and the private, rural health care system,” Ahrens said. “Rural providers need help in learning how to navigate through the VA, and the VA needs more information on the quality of care delivered by rural providers.”

During his three years with the Veterans Rural Healthcare Advisory Committee, Ahrens said, the VA has made progress in bringing healthcare to rural veterans.

Last July, for example, the VA Medical Center at Fort Harrison contracted the services of four mental-health clinics in Missoula, Billings, Great Falls and Miles City, making it easier for vets to access treatment.

Also last year, the Rural Veterans Health Care Improvement Act, sponsored by Tester, was passed into law. Sen. Max Baucus and Rep. Denny Rehberg, both of Montana, have also drafted bills aimed at improving the quality of life for Montana vets.

Despite the progress, however, Ahrens said the need remains to deliver physical and mental-health services to rural vets through local access points. It’s a challenge in rural states as large as Montana, where vets may travel hours for care.

“I have a brother who’s a Vietnam vet, and he said many of the issues going on today with vets returning from Iraq and Afghanistan are the same,” Ahrens said. “The VA ought to do more contracting with local providers. The VA can’t set up all these remote clinics on its own, so there should be contracts entered into.”