The VA Pacific Islands Health Care System (VAPIHCS) mission is to provide integrated and innovative health care services and benefits to eligible veterans and their beneficiaries. VAPIHCS provides a broad range of medical care services, serving an estimated 34,000 veterans throughout Hawaii and the Pacific Islands.

VAPIHCS provides outpatient medical and mental health care through the main Ambulatory Care Clinic on Oahu (Honolulu) and through eight Community Based Outpatient Clinics (CBOCs) including: West Oahu, Hawaii (Hilo and Kona), Maui, Kauai, American Samoa, Saipan and Guam. Traveling clinicians also provide episodic care on Lanai and an Internist residing on Molokai provides medical care 4 days a week at the Molokai Rural Health Center. Mental health care is provided by traveling clinicians from the Maui CBOC to Lanai and Molokai.

Long term and transitional rehabilitative care services are provided by the VA 60 bed Center for Aging, located on the Tripler Army Medical Center (TAMC) grounds. VA staffed inpatient psychiatric care provided within a 20 bed VA operated ward in Tripler Army Medical Center.

A 12 bed VA Post Traumatic Stress Disorder Residential Rehabilitation Program operates in its temporary site within Tripler Army Medical Center. Medical inpatient care for veterans is provided by VA hospitalists and Department of Defense (DoD) physicians in TAMC and Guam Naval Hospital through a VA/DoD sharing agreement, or through non-VA care providers in the community.

UH Manoa Nursing has been an active partner with VAPIHCS since 2009 when we joined the Veterans Affairs Nursing Academy initiative, funded by the U.S. Department of Veterans Affairs, to facilitate stronger and mutually beneficial partnerships between the Department of Veteran Affairs and schools of nursing across the nation. The VA Nursing Academy (VANA) incentivized the development of new models of academic partnerships based on strong and trusting relationships, shared faculty and trainees, innovation in education and patient care, and an emphasis on scholarship and inquiry. Through a unified effort by VAPIHCS and UH Manoa Nursing leadership, the multi-year effort is one of 18 partnerships awarded by the VA Office of Academic Affiliations in 2009. In 2012, VANA evolved as the VA Nursing Academic Partnership (VANAP) Enhancing Academic Partnerships Program that enables stronger, mutually beneficial relationships between nursing schools and VA facilities by:

  1. Expanding faculty and professional development.
  2. Increasing nursing student enrollment, primarily in baccalaureate programs although some increases in graduate programs may also occur,
  3. Providing opportunities for educational and practice innovations, and
  4. Increasing recruitment and retention of VA nurses as a result of enhanced roles in nursing education.


The program focused on building an academic partnership to sustain capacity for nursing practice and education in Hawaii and the Pacific Islands with outcomes focused to improve access and quality of care for veterans in the Pacific Region. Initial goals of the program included increasing the numbers of baccalaureate nursing students to meet the needs of the workforce, expand educational opportunities for UH Manoa Nursing students through the development of new clinical practicum sites, expand faculty and professional development of VA staff and increase recruitment and retention of VA nursing staff. The framework for the partnership was based on E.T. Anderson’s Community-as-Partner model [1] which embraces four central concepts: person, environment, health and nursing.

[1] Anderson, E.T. (2008). A Model to Guide Practice in Community as a Partner Theory and Practice for Nursing, 5th ed Lippincott, Philadelphia.


Outcomes of the program have far exceeded the expectations of the initial three-year program which extended to five years and since 2014, has been sustained with continued positive results. Hundreds of students have mastered key concepts necessary to compassionately care for veterans through understanding of mission, the impact of military service and veteran culture. Experiences in community care, mental health, case management, specialty care, hospice & palliative care, rehab and long term care, homelessness and tele-health have added value to student’s clinical experiences.

Highlights of the partnership include:

  • The “military/veteran family” scenario that follows a soldier and family from deployment through reintegration is integrated within the BS curriculum.
  • Students consistently rate VA experiences as highly rewarding and gaining an understanding of the meaning of service to country and value of caring for “America’s heroes”.
  • The graduate programs have VA Rural Health Initiative funding for clinical experiences in American Samoa and Guam.
  • Clinical opportunities for capstone projects on Oahu and Neighbor Islands providing a rich opportunity for student growth while supporting improvement in veteran care and staff development.
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