Rural Veterans Health Care Improvement Act of 2009 - Authorizes the Secretary of Veterans Affairs to pay travel expenses for veterans receiving treatment at Department of Veterans Affairs (VA) facilities at the rate of 41.5 cents per mile. (Under current law the rate is that provided to federal employees in connection with the performance of official duties.)
Directs the Secretary to: (1) establish and operate at least one and up to five centers of excellence for rural health research, education, and clinical activities; (2) establish a grant program to provide innovative transportation options to veterans in highly rural areas; (3) carry out demonstration projects to examine alternatives for expanding care for veterans in rural areas; (4) establish a program to provide peer support, readjustment, and mental health services to veterans who served in Operations Iraqi Freedom and Enduring Freedom (and related services to their family members); (5) assign an Indian Veterans Health Care Coordinator for each of the ten VA facilities that serve communities with the greatest per capita number of Indian veterans; (6) report to Congress jointly with the Secretary of Health and Human Services on the advisability of the joint establishment and operation by the VA's Veterans Health Administration and the Indian Health Service of health clinics to serve populations of Indian reservations, including Indian veterans; and (7) report annually to Congress on matters related to VA care for veterans residing in rural areas.