I think Noygonnadit simple and sarcastic comment is actually quite right. I am asking how to fly the approach as depicted.

I would have flown to the IAF and turned around outbound, which as noygonnadoit pointed out simply what the approach chart says.

It just seemed that their would be some guidance on the almost 180 degree turn in the opposite direction to get established after flying to the VOR.

Or if a DPE asked me what altitude and what navigation method am I using during the 180 degree maneuver, I would definetly be fudging the answer a bit. Something to the effect of im flying the MEA or MSA whichever is higher and plan on a 180 ish degree turn to intercept the outbound course.