VRHA Weekly Update
In this Issue January 27, 2017

VRHA News Virginia News National News Mark your calendar
Funding Opportunities

Newsletter available





In Memory

VRHA is sad to announce the passing of former Board Member Rod Manifold.  He had been the Executive Director for Central Virginia Health Services since 1992 and had been with that organization since 1985.  Rod, along with his wife, and mother-in-law will be greatly missed by their family, the CVHS staff, and the community.

A memorial for Rod can be found on the CVHS website.  The Virginia General Assembly passed a resolution in celebration of his life.

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Members in the News

From the Augusta Free Press 

Several Virginia legislative leaders have expressed a preference for waiting to see what Washington does before pursuing significant state healthcare policy changes. The Virginia hospital community believes that is a well-reasoned approach given the present uncertainty about the potential impacts of decisions made in Washington.

“Health care policy decisions made in Washington could have a dramatic impact on hospitals, our health care networks here in Virginia, and patients’ access to care,” said Mary N. Mannix, President and CEO of [VRHA member] Augusta Health in Fishersville and Chair of the Virginia Hospital & Healthcare Association (VHHA) Board of Directors. “Virginia hospitals already face $1 billion in annual cuts under the Affordable Care Act (ACA), and are likely to continue even if the law is repealed. If the law is repealed without a full replacement, one estimate suggests Virginia stands to lose $2.6 billion in health care spending associated with people newly insured under the Affordable Care Act, and of that amount, hospitals could lose nearly $986 million. Those are significant sums which can have far-reaching implications for patients’ access to health care, and for Virginia’s economy. That is one reason why Virginia’s hospital community is asking lawmakers to ‘Do No Harm’ as they consider health care policy change.”

While uncertainty abounds, this session still presents an opportunity to make meaningful enhancements to Virginia’s health care system. Virginia’s hospitals this session have put forward a robust behavioral health package – to enhance the pre-admission screening process, to create an emergency psychiatric patient registry, and to establish a 24-hour stabilization period prior to a commitment hearing – and support efforts to strengthen cybersecurity standards to safeguard sensitive medical data. Virginia’s hospitals also continue to work with stakeholders on a range of other health care issues, such as combating the opioid epidemic, and enhancing graduate medical education funding.

Read the full article and watch the related video from Blue Virginia.

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Virginia News

Tipping Point

Dan Heyman - Public News Service

It's been a long time coming, but advocates in Virginia hope the time is ripe for mental health reform at the General Assembly. The shooting at Virginia Tech, the assault and suicide by the son of state Sen. Creigh Deeds and the death of Jamycheal Mitchell in jail - a series of tragedies in Virginia - were all the result of individuals with mental illness falling through the cracks.

Mira Signer, executive director at the National Alliance on Mental Illness of Virginia, said she hopes the issue has reached a tipping point for action at the General Assembly this year.

"If somebody picks up the phone and says, 'I need help,' that person needs to be seen then and there,” Signer said. "If they're told, 'I don't have the staff' or, 'The wait time is one-to-two weeks,' it's too late."

Read the full article.

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Merger Comments

Nathan Baker - Johnson City Press

Federal Trade Commission staff has fired another salvo in the debate over the benefits of a merger between the area’s two hospital systems. The agency’s staff puts the burden of proof of showing that creating a dominant regional health system will be beneficial to residents on the health care organizations — and says such a system would be too big to control.

Health officials in two states are currently considering the merits of Wellmont Health System’s and Mountain States Health Alliance’s request for a cooperative agreement in Virginia and a certificate of public advantage, or COPA, in Tennessee. If approved, the health organizations would be protected from federal antitrust laws used to prevent and break up health care monopolies.

But, as detailed in other released comments from FTC staff, the agency doesn’t believe the merger would be in the best interest of patients, and warns it could lead to higher costs for health care, despite the systems’ assurances and pledged pricing controls.

Read the full article.

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ACA Concerns

By Nick Shepherd - Times News

Citizens from all across Scott County — including a college student, a retired teacher and a coal miner with black lung disease — descended on Gate City to express their concerns about Republican plans to repeal the Affordable Care Act.

The group of 13 citizens made their voices known to Cody Mumpower, a field representative for Rep. Morgan Griffith. Mumpower was holding staff traveling office hours for Griffith, R-Va., in Scott County Thursday morning at the Scott County Community Services Building.

Mumpower listened and took notes while nearly every citizen present discussed aspects of the Affordable Care Act that would directly affect them if repealed. Topics discussed ranged from rural health care and black lung benefits to pre-existing conditions and Medicare.

Read the full article.

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National News

The Opioid Epidemic and Infrastructure

By Eillie Anzilotti - City Lab

In 2016, the opioid epidemic in America continued to persist at crisis level: Each day, 91 people died of a drug overdose, and the number of opioid-related deaths has quadrupled since 2000. Rural towns and small cities have been hit especially hard. According to research from the National Institutes of Health, people in non-metropolitan areas have higher rates of drug poisoning deaths, and opioid poisonings in nonmetropolitan counties have increased at more than three times the rate in urban areas.

At the recent HAC Rural Housing Conference, national policymakers proposed a decidedly urban solution to the addition epidemic: infrastructure. Tom Vilsack, the secretary of the U.S. Department of Agriculture, cited a lack of housing as a critical driver and perpetuator of the epidemic. In August, the USDA laid out a plan to finance transitional housing for people in treatment for opioid addiction in 22 states; other speakers called on federal agencies to invest in developing more affordable housing in rural communities.

CityLab spoke with Alan Morgan, the director of the National Rural Health Association, about why housing infrastructure will be a key player in solutions to the opioid epidemic in the years to come.

Read the full article and related article from NET.

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The Risk of Repeal

Alan Morgan - Morning Consult

Plans are being laid in Washington to repeal the Affordable Care Act. Hidden inside the law is a little-known provision unrelated to the health insurance expansion that helps rural hospitals across America stay open.

It’s called the 340B drug discount program. The ACA made 1,100 rural hospitals eligible and it requires drug companies to supply these remote providers with discounted medications. These discounts can be passed along to patients unable to afford expensive medications or the savings can help fund essential medical services for their communities such as emergency rooms and labor and delivery.

Rural hospitals across the country face daunting economic challenges. Eighty have closed since 2010 and 673 — fully one third of rural hospitals — operate at a loss and are at risk of closure. These are often the only medical facilities for hundreds of miles in any direction

Read the full editorial and related article from Newsweek.

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Aging in Place

By Michael Schroeder - US News & World Report

Looking out the window of her home in the small, coastal city of Manzanita, Oregon -- where only about 600 people permanently reside, and many more vacationers visit -- Leila Salmon describes the scene before her: "I'm looking right now at Neahkahnie Mountain, which goes right down to the ocean and the rainbow that just came out over the ocean and the mountain."
For many like Salmon, there are health challenges associated with aging in place in a rural community, including limited access to a range of health care services. And yet, as America grays, many older adults are choosing to age in place where they grew up -- or in places they have since come to call home -- outside of major cities, in the broad patchwork of rural, wide open spaces that stitch the country together from sea to shining sea. But to tackle challenges and ensure older adults receive the care they need while living in more remote places, additional foresight and coordination is required, experts say.

Read the full article.

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Housing for Rural Veterans

From the US Department of Housing and Urban Development

In a continuing effort to help end veteran homelessness, the U.S. Department of Housing and Urban Development (HUD) and the U.S. Department of Veterans Affairs (VA) announced $2.9 million to local public housing agencies across the country to provide a permanent home to 529 veterans and their families who are experiencing homelessness in rural areas.

The supportive housing assistance announced is provided through the HUD-Veterans Affairs Supportive Housing (HUD-VASH) Program which combines rental assistance from HUD with case management and clinical services provided by VA. See local funding chart below. This year, HUD awarded approximately $60 million to support more than 8,000 veterans and their families. HUD-VASH ensures that veterans experiencing homelessness receive both the housing and services to live stably in their own homes.

Read the full article.

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Mark Your Calendar

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

February 3: Utilizing Virginia Medicaid's Addiction and Recovery Treatment Services (ARTS)  - Harrisonburg
February 5-8: Rural Healthcare Leadership Conference - Phoenix, AZ
February 7-9: 28th NHRA Rural Health Policy Institute​ - Washington, DC
February 9: Utilizing Virginia Medicaid's Addiction and Recovery Treatment Services (ARTS)  - Radford
February 9: Health Care Rally - Abingdon
February 13: Utilizing Virginia Medicaid's Addiction and Recovery Treatment Services (ARTS)  - Wise
February 15: Utilizing Virginia Medicaid's Addiction and Recovery Treatment Services (ARTS)  - Abingdon
February 16: Opioid Epidemic in Rural America - Blacksburg
February 17: Utilizing Virginia Medicaid's Addiction and Recovery Treatment Services (ARTS)  - Danville
February 18: REVIVE! Opioid Overdose Education - Marion
February 21: Utilizing Virginia Medicaid's Addiction and Recovery Treatment Services (ARTS)  - Lynchburg
March 1: Livability in Action Regional Exchange - Christiansburg
​March 29-30: 2017 Population Health Summit - Charlottesville
April 2-4: MATRC Telehealth Summit - Leesburg

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Top 10 Rural Monitor Articles of 2016
Articles on the opioid epidemic, new service delivery models, and a variety of innovative approaches to support health all made it onto the year’s most-read list. 

Model Program: Lutheran Social Services of North Dakota Abound Counseling
Lutheran Social Services of North Dakota provides telehealth counseling through its offices and communities' Lutheran churches. 

Keep Vision in Your Future: Glaucoma Toolkit
Complete with a speaker's guide, handouts, and a presentation with an animation. Don't have much knowledge in eye health? Don't worry! Don't have much experience conducting group discussions? Don't worry! The toolkit provides you with all the guidance you need on leading an engaging presentation and providing the most important facts about glaucoma in a way that is easy to explain and understand.

Getting Ready for Your Health Care Visit
Adapted from “Module 8—Working with Your Doctor,” of NDEP’s New Beginnings Guide, this mini-lesson focuses on helping people with diabetes get ready for visits with their health care team. It includes a short video, discussion, and activity. Consider using this mini-lesson in 2017 for education or support activities in your practice. 

Repealing Federal Health Reform: Economic and Employment Consequences for States
Findings and Conclusions: Repeal results in a $140 billion loss in federal funding for health care in 2019, leading to the loss of 2.6 million jobs (mostly in the private sector) that year across all states. A third of lost jobs are in health care, with the majority in other industries. If replacement policies are not in place, there will be a cumulative $1.5 trillion loss in gross state products and a $2.6 trillion reduction in business output from 2019 to 2023. States and health care providers will be particularly hard hit by the funding cuts. 

Cardinal Health Foundation: Generation Rx Program
The Cardinal Health Foundation is committed to helping communities address prescription drug misuse. The goal of the Foundation’s Generation Rx Program, Best Practices in Pain Medication Use and Patient Engagement, is to engage patients and their healthcare providers in reducing the number of opioids prescribed for pain management, while producing better patient outcomes and better pain management. Applications will be accepted from nonprofit organizations throughout the U.S., and are encouraged from community health centers; federally qualified health centers; hospitals or other healthcare institutions; pharmacy, prescriber, or healthcare provider associations; and substance misuse prevention groups. Grants will range up to $35,000. Online applications are due February 27, 2017.

Department of Justice
The Rural Sexual Assault, Domestic Violence, Dating Violence, and Stalking Program seeks to enhance the safety of rural victims and supports projects uniquely designed to address and prevent these crimes in rural areas. The application deadline is February 23, 2017. 

Regional and Statewide Infographics
Each infographic represents a region of the Commonwealth, and gives a snapshot of how children are faring in both the region, and its localities. The statewide infographic allows you to look at how children in your area are faring compared to children in the Commonwealth as a whole.

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Funding Opportunities

For funding opportunities without a specific deadline, please visit the VRHA Resources page

2017 Day of Service Grants
Grants for day of service projects in observance of September 11th and/or Martin Luther King, Jr. Day. Projects may focus on child welfare, safety, and health; healthcare access; assistance to veterans and active duty military families; and human services such as the provision of housing and emergency food.
Letter of Intent (Optional): Feb 8, 2017
Application Deadline: Feb 22, 2017 

Kresge Foundation: Emerging Leaders in Public Health
The Kresge Foundation’s Emerging Leaders in Public Health (ELPH) initiative equips local public health officers with knowledge and skills to transform the role of public health in their communities. Selected pairs of public health leaders embark on the 18-month, action-oriented experience to undertake projects designed to enhance organizational and leadership competencies in business, planning, and public health systems development. In addition to receiving leadership coaching, each team receives a grant up to $125,000 to develop and implement a transformative concept designed to deliver a new model of public health for the local community. The first step in the application process is to submit the Statement of Interest Form. Applicants will then receive an email with a unique link to begin the application process, with a deadline of February 6, 2017. 

Cardinal Health Foundation: Generation Rx Program
The Cardinal Health Foundation is committed to helping communities address prescription drug misuse. The goal of the Foundation’s Generation Rx Program, Best Practices in Pain Medication Use and Patient Engagement, is to engage patients and their healthcare providers in reducing the number of opioids prescribed for pain management, while producing better patient outcomes and better pain management. Applications will be accepted from nonprofit organizations throughout the U.S., and are encouraged from community health centers; federally qualified health centers; hospitals or other healthcare institutions; pharmacy, prescriber, or healthcare provider associations; and substance misuse prevention groups. Grants will range up to $35,000. Online applications are due February 27, 2017. 

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