Goals and Objectives

The main goal of RANGE and E-RANGE is to provide Assertive Community Treatment (ACT) to rural Veterans with serious mental illness. ACT is a team-based model of care that offers mental health treatment, rehabilitation, and support services in the community rather than only in clinic settings.

ACT is especially helpful for Veterans who have trouble staying connected to traditional clinic-based care. These Veterans may miss appointments, have limited transportation, or feel uncomfortable in clinic environments. ACT brings services to Veterans where they live and spend their time, which can improve engagement and outcomes.

Through RANGE and E-RANGE, rural Veterans receive:

• Regular contact with a multidisciplinary mental health team.
• Medication support and symptom monitoring.
• Help with daily living skills, such as managing money or shopping.
• Support with housing and employment.
• Assistance with substance use treatment when needed.

These programs aim to increase access to intensive mental health services, reduce symptoms, and improve quality of life for rural Veterans.

Key Features of ACT

RANGE and E-RANGE follow the Assertive Community Treatment model, which has several important features:

• Low client-to-staff ratio. Each team supports a limited number of Veterans so staff can spend more time with each person and respond quickly when needs arise.
• Community-based services. Services take place in Veterans’ homes or community locations instead of only in clinics or hospitals.
• Comprehensive and individualized care. Each Veteran receives a care plan based on personal needs, goals, and preferences.

ACT teams in RANGE and E-RANGE can provide:

• Medication management and monitoring for side effects and effectiveness.
• Therapy and counseling to support recovery and coping skills.
• Housing support, including help finding and keeping stable housing.
• Employment support and help with education or job training.
• Substance use treatment and recovery services.

The ACT model used by RANGE and E-RANGE helps rural Veterans stay in their communities, avoid crises, and work toward long-term recovery and stability.

Methodology

The RANGE and E-RANGE Enterprise-Wide Initiative began in 2018 to improve access to mental health intensive case management for rural Veterans. Earlier reviews of VA data showed that many Veterans who use VA services live in rural or highly rural areas, but fewer of them receive mental health intensive case management (MHICM) compared to Veterans in urban areas.

Studies also found that only a small percentage of Veterans in the MHICM program lived in rural or isolated rural areas. This showed that Veterans in these areas had limited access to intensive case management services, despite having serious mental health needs.

To address this problem, the Office of Rural Health (ORH) funded 53 three-year start-up programs focused on rural intensive case management, including RANGE and E-RANGE teams. VA medical centers that received funding agreed to continue the programs after the three-year start-up period.

The Northeast Program Evaluation Center (NEPEC) and the Office of Mental Health were asked to train staff, support implementation, and monitor how the programs used funds and delivered care.

Over time, ORH has funded 34 RANGE programs and 8 E-RANGE programs. Together, these programs have served 6,411 Veterans, including 5,859 rural Veterans, and have provided 67,747 encounters. This growth shows the strong impact of RANGE and E-RANGE in expanding intensive mental health services into rural and highly rural communities.

RANGE Teams Composition

RANGE teams are built to deliver intensive case management and ACT-style services in rural settings. A typical RANGE team includes:

• Two full-time case managers. These staff members coordinate care, visit Veterans in their homes and communities, help with daily living needs, and support recovery goals.
• One nurse. The nurse provides medication support, monitors physical health, and offers health education to help Veterans manage both mental and physical health conditions.
• One social worker. The social worker delivers case management, psychosocial support, evidence-based psychotherapy, and connections to community resources such as housing, financial assistance, and social services.
• One psychiatrist or advanced practice provider. This provider dedicates at least 20% of their time to the RANGE team, oversees psychiatric care, and prescribes and adjusts mental health medications.

By working together, RANGE team members provide coordinated, team-based services that can follow Veterans over time and across different settings. This structure helps the team respond quickly when Veterans are in crisis or need extra support.

E-RANGE Teams Composition

E-RANGE teams are similar to RANGE teams but are designed with additional capacity and a specific focus on homeless outreach. A typical E-RANGE team includes:

• Three full-time case managers. The extra case manager allows the team to serve more Veterans, especially Veterans who are homeless or at high risk of homelessness in rural areas.
• Dedicated prescriber time. As in RANGE, a psychiatrist or advanced practice provider spends at least 20% of their time supporting the team and its Veterans.

In addition to providing intensive case management and ACT services, E-RANGE teams:

• Identify rural Veterans who are homeless or at risk of losing housing.
• Help Veterans connect to housing programs and resources.
• Support Veterans in finding and keeping employment.
• Link Veterans to VA and community services, including food assistance, transportation, and benefits support.

By combining intensive mental health care with homeless outreach, E-RANGE helps some of the most vulnerable rural Veterans become more stable and stay engaged in treatment.

Impact on Rural Veteran Health

RANGE and E-RANGE have had several important impacts on rural Veteran health. These programs have shown that bringing intensive mental health services directly into rural communities can improve outcomes and reduce health risks.

Key impacts include:

• Improved access to mental health care. Rural Veterans who previously had limited or no access to intensive case management now receive ongoing support, regular visits, and crisis response from trained teams.
• Reduced hospitalizations and emergency department visits. With better support in the community, some Veterans can avoid emergency room visits and hospital stays through early intervention and consistent follow-up.
• Better housing stability and homelessness prevention. E-RANGE teams, in particular, help Veterans find and maintain stable housing, which supports recovery and reduces health risks linked to homelessness.
• Targeted outreach to rural areas. Teams travel long distances and work around challenges such as severe weather and limited cell coverage to reach Veterans in isolated communities.
• Lower suicide risk. Close, ongoing contact with high-risk Veterans and strong links to mental health services support suicide prevention efforts in rural areas.
• Support for chronic health conditions. RANGE and E-RANGE teams help Veterans connect to primary care and manage chronic physical conditions alongside mental health needs.

By scaling RANGE and E-RANGE, VA narrows the gap in mental health access and outcomes between rural and urban Veterans and supports better long-term health for Veterans living in rural and highly rural areas.

Key Takeaways

RANGE and E-RANGE are intensive case management programs designed for rural Veterans with serious mental illness. They use the Assertive Community Treatment model to provide comprehensive, team-based care in the community.

These programs:

• Expand access to intensive mental health services for rural Veterans.
• Provide team-based care that includes case management, nursing, social work, psychiatry, and other supports.
• Help prevent homelessness and support stable housing, especially through E-RANGE’s homeless outreach focus.
• Reduce the need for hospitalizations and emergency department visits by offering strong community-based support.
• Address both mental and physical health needs, improving overall quality of life for rural Veterans.

Overall, RANGE and E-RANGE help rural Veterans remain in their communities while receiving the intensive mental health care and support they need to live as independently and safely as possible.

Download the Printable PDF for Healthcare Providers and Researchers.

References

• Mohamed S. Adaptation of intensive mental health intensive case management to rural communities in the Veterans Health Administration. Psychiatric Quarterly. 2013;84(1):103–114.
• Mohamed S. Can small intensive case management teams be as effective as large teams? Community Mental Health Journal. 2015;51(2):161–164.
• Mohamed S. Dual diagnosis among intensive case management participants in the Veterans Health Administration: correlates and outcomes. Journal of Dual Diagnosis. 2013;9(4):311–321.

Contact

• Somaia Mohamed, MD, PhD, Associate Director, Northeast Program Evaluation Center, Rural Access Network for Growth Enhancement, West Haven VA Connecticut Healthcare System, West Haven, CT. Somaia.Mohamed@va.gov
• Funding Acknowledgement: Department of Veterans Affairs, Veterans Health Administration, Office of Rural Health, NOMAD #PRFY-00549.
• Suggested Citation: Mohamed, S., B. (2025). Rural Access Network for Growth Enhancement (RANGE). Department of Veterans Affairs, Veterans Health Administration. Washington, DC: Office of Rural Health.

Rural Health - Navigation

• Office of Rural Health Home page:
  https://www.ruralhealth.va.gov/index.asp
• Enterprise-Wide Initiatives (EWI) page:
  https://www.ruralhealth.va.gov/Enterprise-Wide-Initiatives-EWI.asp
• Veterans Rural Health Resource Centers (VRHRC) page:
  https://www.ruralhealth.va.gov/Veterans-Rural-Health-Resource-Center-VRHRC.asp