Virginia Rural Health Association - Weekly Update
VRHA Weekly Update
In this Issue  April 13, 2015

VRHA News Virginia News National News Mark your calendar
Funding Opportunities


OMHHE would like to wish you a 

Happy National Minority Health Month!





Seeking Student Reps

VRHA is accepting applications from students who wish to serve as a representative on the VRHA Board of Directors.  Up to five students will be selected for a one year appointment. 
Application Criteria:

  • Full-time undergraduate or post-graduate student in good academic standing in any health-related program (e.g. public health, nursing, medicine, etc.)
  • Member of VRHA for the current academic year
  • Willingness to serve as a liaison between the VRHA board and other student members
  • Willingness to participate in board conference calls as class schedule allows
  • Willingness to engage in regular e-mail and telephone dialogue with other board members
  • Vision for the development of an enhanced role for students within VRHA
  • Willingness to work with academic programs that do not have a strong VRHA student membership to recruit new members
  • Commitment to serve the people of rural Virginia 

Nominations must be submitted no later than May 8, 2015 - download nomination form
Visit the Student Representatives webpage for more details.

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Research shows that community health services provide more than medical care. Rural health providers have a reciprocal effect on the community’s jobs, commerce, and overall economy.

How do you demonstrate that effect?  Through Rural Health Works!

VRHA is partnering with the National Center for Rural Health Works to provide a FREE webinar series on the economic impact of healthcare in rural communities.  Webinar schedule is:

  • April 30: Impact of a Community Health Center (FQHC) or Rural Health Clinic
  • May 28: Impact of a Small Rural Hospital

Visit the VRHA webinar page for details and registration.

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Members in the News

By [VRHA member] Sarah Bedard Holland, Margaret Nimmo Crowe and Samuel Bartle

If there’s one issue upon which most people should be able to agree, it’s the importance of good health care for children. Fortunately, Republicans and Democrats in the House of Representatives, including almost all of Virginia’s congressional delegation, have found a common-sense agreement to ensure that kids in low-income, working families continue to have health insurance next year.

Now, we urge the Senate to agree to the same compromise when it returns to Washington on April 13. Without action by Congress, funding for the Children’s Health Insurance Program (CHIP) will expire at the end of September, leaving many families to enter the next school-year with uncertainty about their children’s health care.

Read the full editorial.

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Virginia News

$1.6M for Lee Hospital

By Kylie McGivern - WJHL

The Lee County Hospital Authority has agreed upon a price to purchase the former Lee Regional Medical Center building from Wellmont Health System for $1.6 million - a milestone achievement on the road to reopening the shuddered Southwest Virginia hospital closed the hospital in October 2013, citing federal reimbursement cuts and low community use among the reasons. Ever since, the community has worked tirelessly to reopen its doors.

LCHA is now working with Lee County's three banks and Board of Supervisors to coordinate financing of the purchase. LCHA's attorney Jeff Mitchell says they will close as quickly as possible in April.

Read the full article.

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Misdiagnosing the Problem 

By Massey Whorley - Richmond Times-Dispatch

In his recent Commentary column, “Obamacare is a federal problem,” Del. John O’Bannon, a doctor from Henrico, misdiagnoses the problem of health care in Virginia. He asserts that the state made the right move by hitching its wagon to the federal health care marketplace rather than developing a state health insurance exchange that meets the unique needs of Virginia.

The fact is, states that were proactive were able to secure funding to create their own marketplace. Meanwhile, Virginia lawmakers deferred to the federal government to decide what is best. That meant Virginians had to use the federal marketplace, and it meant less financial help for the state to connect people with coverage. But state lawmakers didn’t intend for it to be this way. In fact, in 2011, they passed legislation laying the groundwork for a state-based marketplace and then never followed through.

Read the full editorial and related commentary and editorial by the Washington Post.

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Wellmont/MSHA Merger

By the Rogersville Review

Wellmont Health System and Mountain States Health Alliance have agreed to exclusively explore the creation of a new, integrated and locally governed health system designed to address the serious health issues affecting the region and to be among the best in the nation in terms of quality, affordability and patient satisfaction.

In a term sheet, the boards of directors of both organizations agree to explore combining the assets and operations of Wellmont and Mountain States into a new health system. This decision follows more than a year of merger discussions, internal analysis within each system, thoughtful conversations in the community and unanimous votes by both boards to examine this option.

The systems now enter a due diligence period and will work toward developing a definitive agreement. The definitive agreement will be followed by a process to obtain, among other regulatory requirements, Tennessee and Virginia approvals of the merger, which will likely take through the end of 2015.

Read the full article and related articles from WCYB and Market Watch.

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National News

More Rural Attacks

By John Commins - HealthLeaders Media

A federal audit that recommends cutting payments to rural hospitals for skilled nursing swing beds is being panned by hospital advocates and the federal government. The Department of Health and Human Services' Office of the Inspector General released a report on Monday that estimates that the federal government overpaid critical access hospitals about $4.1 billion over six years to provide skilled nursing services using hospital swing beds.

Former CMS Administration Marilyn Tavenner, agreed that swing bed use was on the rise, and that new efficiencies and cost savings must be identified for rural care delivery. She sharply disagreed with the OIG recommendations, however, faulted the study methodology, and suggested that OIG doesn't understand rural healthcare.

Alan Morgan, CEO at the National Rural Health Association, says the landscape in rural healthcare has shifted greatly since OIG began its study several years ago.  The problem at OIG, Morgan says, is that they apply an urban mindset to rural healthcare. "You see this time and again. They view rural as simply a small version of urban. They don't recognize that it is a different healthcare delivery system."

Read the full article and related articles from the New York Times and Modern Healthcare and the Rural Assistance Center.

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2015 Rural Health Awards

By Lindsey Corey - National Rural Health Association

The National Rural Health Association is proud to announce its 2015 Rural Health Award recipients. The following organizations and individuals will be honored April 16 during NRHA’s 38th Annual Rural Health Conference, which will attract more than 650 rural health professionals and students to Philadelphia.

“We’re proud of this year’s winners,” says Alan Morgan, NRHA CEO. “They have each already made tremendous strides to advance rural health care, and we’re confident they will continue to help improve the lives of rural Americans.”

And the winners are…

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Building Strong Foundations

By Jami Schumacher - Rural Assistance Center

The Healthy Clinic Assessment (HCA) program is helping rural clinics build stronger foundations and focus on quality improvements, according to Jennifer Dunn, director of programs for the Colorado Rural Health Center (CRHC), which runs the HCA.

This voluntary and free process begins with on-site interviews of clinic staff and partners. The HCA looks at basic business operations (telephone protocol, check-in, check-out, visit preparation, accounts receivable and accounts receivable follow-up), compares current clinic operations to industry-accepted best practices, and identifies gaps in operations. At the end of the workday, CRHC staffers provide a de-briefing about what they have heard and learned.

Later CRHC staffers return with findings. “We put together an action plan on where they need to make improvements, and what they are doing well,” explained Michelle Mills, CRHC CEO. “This strengthens the foundation of the clinic and allows them to focus on bigger, greater things like quality improvement, collecting data in disease registries or working on gaining Patient Centered Medical Home status.”

Read the full article.

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Rural Publications

Rural Provider Perceptions of the ACA: Case Studies in Four States
The Affordable Care Act (ACA) expanded health insurance coverage to previously uninsured populations by allowing states to expand Medicaid coverage to adults with incomes up to 138% of the federal poverty level (FPL) as well as by creating health insurance marketplaces to subsidize affordable coverage. However, states with a higher number or proportion of rural residents were less likely to expand Medicaid than were more urban states. In addition, rural residents eligible for insurance coverage through the new health insurance market place were less likely to enroll in coverage compared to eligible urban residents. 

Cardiovascular Disease Prevention Programs and Health Outcomes in a Rural County
Resident participation; hypertension and hyperlipidemia detection, treatment, and control; smoking quit rates; hospitalization rates from 1994 through 2006, adjusted for median household income; and mortality rates from 1970 through 2010, adjusted for household income and age.

Developmental Strategies and Challenges of Rural Accountable Care Organizations
This Policy Brief shares insights into initial strategic decisions and challenges of four Accountable Care Organizations (ACOs) with a rural presence, one from each census region (West, Midwest, Northeast, and South).

Perspectives of Rural Hospice Directors
Rural hospice care, as it is currently configured, is under pressure by a variety of factors (e.g., policy and regulation, economic and financial, and organizational and structural) which are reviewed in this document. This policy brief is the result of a national phone survey of rural hospice directors or key staff in 47 states. Fifty-three directors or key staff members were interviewed during a three month period in 2013.

General and Specialist Surgeon Supply and Inpatient Procedural Content
This report addresses rural/urban differences in surgical practices in commonly performed inpatient surgical procedures that are typically handled by general surgeons. National Inpatient Sample data from rural and urban hospitals in 24 states were used to examine the frequency of general surgical procedures, complications during hospitalizations and predicted resource demand.

Hospital Views of Factors Affecting Telemedicine Use
This Policy Brief expands previous research examining hospital-based use of telemedicine by 1) determining the type of use by hospitals, whether it be providing services as a hub or receiving services as a spoke; and 2) then identifying factors from the hospitals’ perspective that affect use. Key informants at 36 hospitals were interviewed. The hospitals were evenly split between urban/rural and hub/spoke in 22 states, representing all four U.S. Census Regions. Respondents reported factors that initiated telemedicine use at their hospitals, such as a variety of start-up funding from federal, state, and foundation sources. They reported benefits, such as meeting hospital missions and improving patient access, as well as challenges, such as reimbursement procedures and clinician buy-in. They also discussed barriers to expansion, such as licensing and credentialing policies. While challenges and barriers are significant, both hub and spoke hospital respondents state considerable benefits for continued telemedicine use. 

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Mark Your Calendar

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

April 22: Value-Based Modifier: Act Now to Avoid Payment Adjustments - webinar
April 30: Impact of a Community Health Center (FQHC) or Rural Health Clinic - webinar
May 28: Impact of a Small Rural Hospital - webinar
May 27: What Suicide Interventions Outside of Health Care Settings Reduce Risk? - webinar
June 24: What Research Infrastructure Do We Need to Reduce Suicidal Behavior - webinar


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VA Fact Sheet
Provides information on the new eligibility guidelines for the Veterans Choice Program and the changes in the mileage requirements.

The 21st Century Rural Hospital: A Chart Book
This Chart Book uses available data to present a broad profile of the 21st century rural hospital and includes such descriptors as: Where are they located? Whom do they serve? What traditional hospital services do they provide? How do they ensure outpatient services for their community? What other community benefits do they provide or enable for citizens in their area? How are they doing financially? How are they supported by federal programs?  The pages of The 21st Century Rural Hospital: A Chart Book are each designed as a pull-out document and describe many aspects of today’s rural hospital. Each page includes charts comparing rural hospitals to each other and to urban hospitals across different dimensions such as levels of rurality, US Census region, and hospital size. Important data points are emphasized and an illustrative rural hospital is highlighted. Those who are unfamiliar with today’s rural hospital may be surprised by many data points shown here; others may use this document to research a particular data point.

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Funding Opportunities

RxRelief Virginia Request for Proposals
The Virginia Health Care Foundation (VHCF) is delighted to announce the availability of new funds to establish or expand local Medication Assistance Programs (MAPs) via VHCF's RxRelief Virginia initiative. This opportunity is made possible via a new appropriation by Virginia's General Assembly. The announcement of the Request for Proposals and guidelines can be found here or at Proposals are due on June 19, 2015. A prerequisite for submitting a proposal is attendance at a mandatory pre-proposal workshop on April 29, 2015 in Richmond. Click here to register. 

Questions? Please contact:
Sarah Jane Stewart
RxRelief Virginia Coordinator
804-828-5804 / 434-361-0331 

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, 2015.

American Academy of Pediatrics: Community Access to Child Health Program
The Community Access to Child Health (CATCH) Program, a national initiative of the American Academy of Pediatrics, is designed to improve access to healthcare by supporting pediatricians who are involved in community-based efforts to enhance the health of children. CATCH Planning and Implementation Grants of up to $10,000 are awarded to pediatricians and fellowship trainees to plan innovative community-based child health initiatives that will ensure all children have medical homes and access to healthcare services not otherwise available in their community. Outreach must be to the community at large, not to practice or clinic patients only. (Grants of up to $2,000 are awarded to pediatric residents addressing the same issues.) The application period will open on May 4 and close on July 31, 2015.

J.M. Kaplan Fund: J.M.K. Innovation Prize
The J.M.K. Innovation Prize, an initiative of the J.M. Kaplan Fund, is awarded to U.S.-based individuals or teams addressing our country’s most pressing needs through social sector innovation.

Department of Health and Human Services
The Personal Responsibility Education Program is funding education programs in Florida, Indiana, North Dakota, Texas, Virginia, Guam, American Samoa, the Northern Mariana Islands, the Marshall Islands, and Palau. Funds will support the design, implementation, and sustainability of teen pregnancy prevention and adulthood preparation for youth between the ages of 10 and 21. The application deadline is May 5, 2015.

Lowe's Charitable and Educational Foundation: Community Partners
The Lowe's Charitable and Educational Foundation is dedicated to enhancing the quality of life in the communities where Lowe's operates stores and distribution centers throughout the United States. The Foundation’s Community Partners grant program supports nonprofit organizations and local municipalities undertaking high-need projects such as building renovations/upgrades, grounds improvements, technology upgrades, and safety improvements. Most grants range from $10,000 to $25,000. The application deadline for the spring funding cycle is May 29, 2015; the fall funding cycle will be open from June 29 to August 28, 2015.

Action for Healthy Kids: School Grants for Healthy Kids
Action for Healthy Kids fights childhood obesity, undernourishment, and physical inactivity by helping schools become healthier places so kids can live healthier lives. School Grants for Healthy Kids, administered by Action for Healthy Kids, provides support to K-12 schools throughout the U.S. for school breakfast and physical activity programs. The following grant opportunities are available: School Breakfast Grants support programs that help schools pilot or expand their school breakfast programs. Three grant types are offered; two are nationwide and one targets selected states. Every Kid Healthy Grants support physical activity programs at schools in selected states with an optional nutrition component to promote becoming recognized as a health-promoting school. The application deadline for each of the grant programs is May 1, 2015. 

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Virginia Rural Health Association
2265 Kraft Drive
Blacksburg, VA 24060

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