VRHA Weekly Update
In this Issue April 14-20, 2014

VRHA News Virginia News National News Mark your calendar
Funding Opportunities

National Organization of State Offices of Rural Health

April newsletter




Spring Webinars

Four more webinars are scheduled for this spring:

The Rural Social Determinants of Health - Noon May 6  Click here to register
The health of rural communities is shaped by a multiple factors.  Limited access to medical care and providers in many rural communities is justifiably of significant concern.  But our health starts long before we need to see a doctor, in the places where we live, work, learn, and play.  Behavioral choices play an important role as well, but the choices individuals make are shaped by the choices they have.  This webinar will focus on the social, economic, and environmental factors that influence health outcomes, known as the social determinants of health (SDOH).  SDOH  include income, educational attainment, systems of discrimination,  housing, transportation, and other aspects of the neighborhood environment. Research shows that SDOH are the most important factors in determining the health, but they are often out of the control of individuals, and require collaboration across many sectors to change.  The webinar will highlight best and promising practices for rural communities to effectively address SDOH and create opportunities for all of their residents to be healthy.

Improving Health Care for Veterans Begins With You - 10am May 7 Click here to register
Veterans live in every community in our country, with many of them returning home to rural areas after their military service. Veterans in rural areas access health care through a variety of providers and agencies. It is important as a health care provider to be knowledgeable about Veterans issues and resources available. Veterans face different health care concerns, such as Agent Orange exposure, Traumatic Brain Injury, Post Traumatic Stress Disorder and many times have a propensity for other illnesses. This webinar will review common concerns that Veterans have and will provide you with screening tools to use when providing care to Veterans. It will also provide basic information about Veterans benefits and review existing resources.
Project REVIVE!  - 2pm May 21  Click here to register
DBHDS, working with its partners, has designated the metropolitan Richmond area and the far southwestern area of the state as pilot regions and is working to implement Project REVIVE!
Project REVIVE! is utilizing the nasal administration method for naloxone, alleviating any issues concerning the dangers of needles or infection at the injection site. Virginia law provides ‘Good Samaritan’ protection for lay rescuers administering naloxone to individuals who are experiencing an overdose, so long as those individuals are participating in the pilot project.

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Take the Survey

A message from the VDH Office of Minority Health and Health Equity

Dear Virginia Rural Stakeholder,
In today’s digitally-driven world, there are endless ways of sharing and receiving information instantaneously.  You can have status updates appear on Facebook, follow individuals and organizations on Twitter or be notified of a blogger’s latest posts to remain updated on the information that allows you to better serve Virginia’s rural communities.  Which methods do you prefer?  
In order to better understand the Virginia rural stakeholder communication preferences, the VDH Office of Minority Health and Health Equity (OMHHE) is conducting a brief survey (about 5 -10 minutes) regarding your preferred communication sources.  The results of this survey will be used to create a strategic communication plan with best practices for communicating with Virginia’s rural stakeholders. 

  • Please note that your response to the survey will remain anonymous unless you choose to complete the optional contact information at the end of the survey. 
  • By agreeing to be included and adding the optional contact information, you are indicating that you want your organization’s preferences  identified as an attachment to the final state communication document available for public usage.

Thank you  for taking the time to complete this valuable survey as it will help improve our support of your essential work in rural Virginia.  For questions, please contact Sarahbeth Jones.
The survey will be available from April 1-30. Start the survey.

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Members in the News

By Jason Ruiter - News & Advance

Mired in the Virginia legislature, Medicaid expansion is more controversial in politics than it is in the health care business. The Virginia Health & Hospital Association, which represents 100 percent of private Virginia hospitals, speaks for all its members in its support of the expansion, including Lynchburg’s Centra and [VRHA member] Blue Ridge Medical Center, said Jay Andrews, VHHA vice president of financial policy.

“I wish our legislators could really talk to some of the patients we have where needs are so high,” said Peggy Whitehead, executive director of Blue Ridge Medical Center, in Nelson County.

Read the full article.  There are other newsreports about Medicaid expansion and VRHA members Carilion Franklin Memorial Hospital, Central Virginia Health Services,

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Virginia News

CBS & The Health Wagon

By Scott Pelley - 60 Minutes

President Obama announced last week that more than 7 million people have signed up for Obamacare. But what went unsaid is that almost as many people have been left out. Millions of Americans can't afford the new health insurance exchanges. For the sake of those people, Obamacare told the states to expand Medicaid, the government insurance for the very poor. But 24 states declined. So, in those states, nearly five million people are falling into a gap they make too much to qualify as "destitute" for Medicaid, but not enough to buy insurance.

We met some of these people when we tagged along in a busted RV called the Health Wagon -- medical mercy for those left out of Obamacare.

View the full story and a related article by the Bristol Herald Courier.

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Resisting Expansion

By Colleen M. Grogan - Journalist's Resource

Like all the arguments about Affordable Care, debates about the Medicaid expansion are polarized along partisan and ideological lines. Almost all states with a Democratic governor have decided to move forward with the expansion, while most states with Republican governors and legislative majorities are not moving forward so far.

The states doing the expansion encompass over half of the U.S. population. One large state, Virginia, saw the governorship and one chamber of the legislature recently switch from Republican to Democratic control and is likely to move soon toward some kind of expanded Medicaid. Other states may move forward for 2015.

Ironically, in the states refusing to implement the Medicaid provisions of health reform, many lower-middle income people will be able to get federal subsidies to purchase private insurance plans, but their poorer neighbors who would have been included in the Medicaid expansion fall into the gap and will have no options.

Read the full article.

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Senate Passes Budget

By Michael Martz and Jim Nolan - Richmond Times-Dispatch

The Virginia Senate has approved its version of the state budget with a plan for extending health coverage to hundreds of thousands of uninsured Virginians, but the spending plan is not likely to go anywhere in the House of Delegates.

The 22-15 vote on Tuesday sends the Senate budget to the House and substitutes the Marketplace Virginia plan for the two-year Medicaid expansion pilot Gov. Terry McAuliffe proposed after the General Assembly adjourned without a budget on March 8.

However, House Appropriations Chairman S. Chris Jones, R-Suffolk, made clear that the Senate budget will not emerge from his committee because the House budget remains the traditional vehicle for negotiating a state spending plan. “That’s the way it’s always been done and that’s the way it always will be done,” Jones said on the House floor.

Read the full article.

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South Hill to VCU

By the News & Observer

Community Memorial Healthcenter in South Hill plans to become part of Virginia Commonwealth University Health System. The agreement to join operations is expected to be complete by June 30, pending approval by federal and state regulators.

The university says in a news release that the hospital will be renamed VCU Community Memorial Hospital. The health system plans to invest at least $75 million in the hospital, including construction of a new facility. Community Memorial Healthcenter serves Southern Virginia and northern North Carolina.

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National News

ACA Enrollment Over 7 Million

By the Association of Clinicians for the Underserved

March 31 marked the official end of open enrollment on the exchanges, though the Obama administration has granted a reprieve for those who have attempted to obtain coverage by the deadline. Last-minute registrants experienced long waits on HealthCare.gov, at enrollment centers and on phone lines. Regardless, the White House reported that enrollment surpassed the 7 million mark, which was the original estimate for enrollment before the early website problems reduced those projections.

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Approval of Zohydro

From the Office of Senator Tim Kaine

U.S. Senator Tim Kaine sent a letter to U.S. Food and Drug Administration (FDA) Commissioner Margaret Hamburg expressing concern that recent FDA approval of Zohydro ER could have a negative impact on Virginia communities. Zohydro is the first drug approved by the FDA with a formulation of hydrocodone not combined with an analgesic, making it the purest form of the product.
“As you know, there has been a significant economic and public health impact due to opioid prescription drug abuse on communities throughout the Commonwealth of Virginia and the nation,” Kaine wrote. “While all prescription opioid drugs present a risk of abuse, there is particular concern about Zohydro entering the marketplace due to its formulation.”
“I understand the importance of fulfilling clinical need for new pharmaceuticals and appreciate the FDA’s commitment to patient safety, but I am concerned about the potential of this drug to have negative and unintended consequences on communities and individuals.  I believe the FDA must recognize these risks and work with communities and appropriate government agencies to develop strategies to deal with the potential consequences that could occur with the approval of this drug.”

Read the full letter text.

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Sebelius to Resign

By Juliet Eilperin and Amy Goldstein - Washington Post

Health and Human Services Secretary Kathleen Sebelius is resigning, ending a tumultuous tenure as the public face of the Affordable Care Act. President Obama will nominate his budget director on Friday as her successor, according to White House officials.

Sebelius entered the Cabinet in 2009, three months into Obama’s presidency, as a well-regarded former governor of conservative Kansas. She is leaving after months of intense criticism over the botched rollout in the fall of the insurance marketplace.

Read the full article.

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When Rural Hospitals Close

By Adam Ragusea - Marketplace
There’s a healthcare crisis in America that you might not have heard about: Rural hospitals are closing at a rate that’s starting to get some politicians’ attention. Republicans blame Obamacare, while Democrats blame some states’ refusal to expand Medicaid. In reality, the problem started years before all that.

What's clear is that rural hospitals and the rural economy rise and fall together.

Hancock Memorial Hospital in the tiny town of Sparta, Georgia was among the first of nine rural hospitals that have closed across Georgia since 2000. Today, it’s overgrown with weeds and vines, while the roof caves on the gurneys and computers still inside.

Read the full story.

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Mark Your Calendar

For more information about these and other events, visit the VRHA Calendar.

April  22: Developing Quality Health Center Programs and Proposals -Henrico
April 22: NRHA's Rural Medical Educator's conference - Las Vegas, NV
April 22-25: NRHA's Annual Conference - Las Vegas, NV
April 22-24: National Rx Drug Abuse Summit - Atlanta, GA
May 6: The Rural Social Determinants of Health - webinar
May 7: Improving Health Care for Veterans Begins With You - webinar
May 12-16: Behavioral Health and Integration Training Institute - Radford
May 21: Project REVIVE! - webinar
June 20-21: Dental Care Approaches for Adults with Disabilities - Lynchburg
June 26: Addressing Disaster Preparedness in Rural Communities - Richmond & videoconference
July 16-18 Rural Quality & Clinical Confernce - Atlanta, GA

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Easter Seals
Whether you know someone with a disability or are simply interested in learning more, the following information will help you learn something new about living with a disability, and help overcome misunderstandings and misinformation.  Information on living with autism, living with disability, facts about disability, making life accessible, and services for caregiver.

Health Data Interactive Tutorials 
Presents tables with national health statistics for infants, children, adolescents, adults, and older adults. Tables can be customized by age, gender, race/ethnicity, and geographic location to explore different trends and patterns. These new tutorial videos demonstrate how to use the detailed tables and drill into data to display the information you want the way you want.  Part I explains how to access the site, how to open the data tables, and how the tables are oriented.  Part II shows how to select categories among the variables, and how to change the rows and columns variables.  Part III shows how to sort columns, and how to “nest” your variables.  To use the tutorial, you can either start from Part I and move through the tutorials in chronological order, or pick and choose topics of interests.

Integration of Oral Health and Primary Care Practice
Reaffirms oral health as a necessary component of primary care and outlines simple steps for integration, including:

  • Apply oral health core clinical competencies, such as oral health assessments, within primary care practices; 

  • Develop an infrastructure that enhances adoption of the oral health core clinical competencies and acts as a conduit for interprofessional care; and,

  • Modify payment policies to efficiently address the costs of implementing oral health competencies and provide incentives to health care systems and practitioners.

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Funding Opportunities

Inez Duff Bishop Charitable Trust Grants
Deadline: 4/1/15 
Funding to support organizations that assist the visually impaired and underprivileged individuals in need of hospital and medical care. The Trust distributes 28 grants per year that have an average value of $1,000 to $3,000, mainly in the Charlottesville and Albemarle areas.

Grants for Transportation of Veterans in Highly Rural Areas
Awards grants to organizations that assist veterans in rural areas with transportation to VA medical centers and other VA and non-VA facilities for medical care.
Sponsor: U.S. Department of Veterans Affairs

W.K. Kellogg Foundation
The W.K. Kellogg Foundation supports children, families, and communities as they create conditions that propel vulnerable children to achieve success as individuals and as contributors to their larger community and society. The Foundation’s approach is one of whole child development: ensuring the emotional, social, cognitive, physical, cultural, and civic development of young children, ages 0-8, within the context of families and communities. The Foundation’s work focuses on three goals: Educated Kids – Increasing the number of children who are reading and math proficient by third grade. Healthy Kids – Increasing the number of children born at a healthy birth weight and who receive the care and healthy food they need for optimal development. Secure Families – Increasing the number of children and families living at least 200% above the poverty level. Within and around each goal are commitments to Community and Civic Engagement and Racial Equity. Geographic priority areas in the United States include the states of Michigan, Mississippi, and New Mexico, and the city of New Orleans; however, promising programs throughout the U.S. are also supported.

Presbyterian Committee on the Self-Development of People
The Presbyterian Committee on the Self-Development of People (SDOP) participates in the empowerment of economically poor, oppressed, and disadvantaged people who are seeking to change the structures that perpetuate poverty, oppression, and injustice. SDOP currently supports groups in the United States who are oppressed by poverty and social systems, want to take charge of their own lives, are organizing to do something about their own conditions, and have decided that what they are going to do will produce long-term changes in their lives or communities. Supported projects must be presented, owned, and controlled by the groups of people who will directly benefit from them and must address long-term corrections of the conditions that keep people bound by poverty and oppression. Applications may be submitted throughout the year.

Virginia Environmental Endowment
The mission of the Virginia Environmental Endowment is to improve the quality of the environment by using its capital to encourage all sectors to work together to prevent pollution, conserve natural resources, and promote environmental literacy. The Endowment provides grants to nonprofit organizations for programs conducted in the state of Virginia and in the Kanawha and Ohio River Valleys of Kentucky and West Virginia. The Virginia Program focuses on water quality, land conservation, Chesapeake Bay environmental issues, and environmental education. The Kanawha and Ohio River Valleys Program focuses on research, education, and community action on water quality and the effects of water pollution on public health and the environment. The upcoming deadline for both programs is June 15, 2014.

The Kresge Foundation Grants
Deadline: 4/1/15
Funding to support high-performing human-services organizations that demonstrate the ways different resources and promising approaches can add capacity, enhance performance, and increase resilience.
Rita and Alex Hillman Foundation: Hillman Innovations in Care Program
The Hillman Innovations in Care Program, an initiative of the Rita and Alex Hillman Foundation, supports new models of healthcare delivery that are rooted in nursing's holistic approach to care.

The Rockefeller Foundation
The mission of the Rockefeller Foundation is to promote the well-being of humanity throughout the world. Grants are provided to nonprofit organizations that fit within one of the following four core issue areas: advancing health, including creating incentives for better nutrition and wellness; revaluing ecosystems, including accounting for nature's role in people's economic and social well-being; securing livelihoods, including expanding opportunity and creating inclusive markets in the changing global economy; and transforming cities, including embracing urbanization to catalyze equity. Funded organizations must also address one or more of the Foundation's current initiatives. Online inquiries are accepted throughout the year.

M·A·C AIDS Fund: U.S. Community Grants Program
The M·A·C AIDS Fund supports nonprofit organizations that are providing vital services to people affected by HIV/AIDS. The Fund's U.S. Community Grants Program provides support to service providers for U.S.-based programs that offer food and nutrition or housing services to people living with HIV/AIDS. Online applications for Food and Nutrition Programs grants are currently available on the Fund’s website and must be submitted by May 2, 2014. The Housing Programs online grant application will be available on the website at the beginning of August and applications will be due on September 5, 2014.

Department of Health and Human Services 
The Cooperative Agreements for State-Sponsored Youth Suicide Prevention and Early Intervention program supports states and tribes in developing and implementing youth suicide prevention and early intervention strategies, grounded in public/private collaboration. The application deadline is May 19, 2014.

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