VRHA Weekly Update
In this Issue  May 27, 2014

VRHA News Virginia News National News Mark your calendar
Funding Opportunities


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Did You Miss Out?

The VRHA Spring Webinar Series has ended, but you aren't out of luck.  Slides and recordings of all our webinars have been archived in the webinar section of our website.

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Members in the News

By Katie Demeria - NV Daily

A baby's brain doubles in size between the 36th and 39th weeks of the pregnancy, according to March of Dimes Community Director Lynn Downs.  Dr. Russell White of Shenandoah Valley OB/GYN said the lungs are not fully developed before the 39 week mark, either.

Some parents, however, choose to induce labor before 39 weeks, sometimes for convenience or because the mother is especially uncomfortable. [VRHA member] Warren Memorial Hospital has been working to reduce the rate of early elective deliveries since 2009. March of Dimes recognized Warren Memorial for reducing its early elective delivery rates to zero. 

Read the full article.

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More Members in the News

By Northern Neck News

On a bright, beautiful Saturday in Tappahannock, local residents, civic groups and officials from all levels of government came out celebrate two major milestones for [VRHA member] Riverside Tappahannock Hospital.

This year marks the hospital’s 50th anniversary of serving the community as well as the 25th anniversary of its partnership with Riverside Health System (RHS).

Elizabeth Martin, Riverside Health System’s Vice President for Quality who for many years served as administrator of RTH, said that being part of the hospital’s legacy was “one of the things I’m proudest of when I look back on anything I’ve accomplished in life.”

Read the full article.

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Virginia News

Virginians in ACA

By Laurence Hammack - Roanoke Times

A final, six-week surge in enrollment has more than doubled the number of Virginians who obtained health insurance through the Affordable Care Act.  A total of 216,356 people in the state purchased coverage through Healthcare.gov, an online marketplace that is a key part of the new federal health care law.

A large majority of the newly insured in Virginia — 82 percent — received financial assistance. Private insurance sold through the government-run website comes with subsidies for people with incomes between the federal poverty guideline and four times that level.

Read the full article.

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Community Paramedicine 

Susan Nicol - Firehouse.com News    

While sending trained EMS personnel into a patient’s home to do basic preventative care may seem like a perfect fit, there are still many challenges that agencies need to overcome.

In the past few weeks, Ohio and Virginia have come out with statements about the issue, and other organizations are weighing in as well, Dr. Lori Moore-Merrell told a group attending a session during the Congressional Fire Service Institute's meetings.

In Virginia, EMS agencies interested in providing community paramedicine may be required to obtain licenses by the state’s health office.

But, fire departments and EMS folks aren’t the only ones jumping to get in on the action. Some private EMS companies are dropping emergency responses so they can concentrate on community medicine.

Read the full article.

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Hospital Profits

By Laurence Hammack - Roanoke Times

Opponents of Medicaid expansion have seized on a new argument: If hospital systems like Carilion Clinic can make multimillion-dollar profits, do they need more federal funds? Sen. Ralph Smith, R-Bedford County, posed that question Thursday during a news conference with other Republican legislators and Roanoke-area officials.

Smith referred to a recent news report showing that Carilion, the dominant health care provider in the Roanoke and New River valleys, finished the past fiscal year with a $20.3 million profit.

Carilion President and CEO Nancy Agee responded in a written statement.

“These characterizations of Carilion’s financial position are a politically self-serving and completely inaccurate depiction of our fiscal position. Frankly, I am chagrined that the Republican delegation is using an operating margin from the previous year as justification for a disappointing position to NOT meet the growing and worrisome health and economic needs in our region.”

After losing money from 2008 to 2011, Carilion has returned to what Agee called “modest profitability.” The $20.3 million made off revenues of $1.4 billion in the last fiscal year amounts to a profit margin of 1.4 percent. A sustainable margin for a nonprofit health system like Carilion should be upwards of 3 percent, Agee said.

Read the full article and related editorial.

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National News

Rural Hospital and Provider Equity Act

By David Lee - National Rural Health Association

Senators Franken, Roberts, Harkin, and Barrasso introduced the Craig Thomas Rural Hospital and Provider Equity Act (R-HoPE) May 20th.  The comprehensive rural health care legislation (S. 2359) would address a number of workforce, payment, and regulatory policies in an effort to facilitate the delivery of primary, acute, and emergency care across rural America.  

NRHA commends the Senators for their efforts and encourages the Senate to act on this legislation quickly. 

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Waiting for Care

By Jonna McKone - Marketplace

The Affordable Care Act is intended to provide insurance for America’s poorest. It was supposed to control healthcare costs by getting people to doctors for routine visits. But for many low-income -- and especially rural -- Americans, healthcare needs are still not being met.

At a fairground just outside downtown Knoxville, Tennessee, hundreds of people wait in line. They come from nearby cities and small towns with names like "Coalfield" and "Deer Lodge". Inside a giant auditorium converted to a mobile clinic for the day, dozens of dentists clean teeth. The two-day clinic, called Remote Area Medical, offers free medical services -- from dental to vision to yearly checkups. A number of people came the night before -- sleeping in their cars for the services offered today.

“I don’t know a whole lot of people who would stand in a line for 24 hours if they had a better plan, if they had an easier way to get what they needed,” says Amy Smith, a nurse and volunteer here.

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Rural Telepsychiatry


North Carolina is facing a very big mental health care challenge — 28 counties across the state do not have a single psychiatrist. That's despite the fact that in recent years, emergency rooms in the state have seen more patients with mental health, developmental disability or substance abuse problems.

So the state is trying telepsychiatry. When a patient comes into an emergency room, they can be connected via a two-way video connection with a psychiatrist. A recent study by the nonpartisan North Carolina Center for Public Policy Research found that the method is having some success in providing more timely treatment.

One of the psychiatrists, Dr. Sy Atezaz Saeed, told NPR's Robert Siegel that that's very much like being face-to-face with a patient.

"When you ask patients about this experience, most of them will tell you that after a few minutes of some hesitation, they even forget that they are talking to the doctor via this monitor," Saeed, the chairman of the psychiatry department at the Brody School of Medicine at East Carolina University, says.

Read the full article.

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Will Your Hospital Close?

By Mike Oliver - AL.com

It's a long list with some familiar names: Chilton Medical Center, Cooper Green Mercy Hospital, Hartselle Medical Center, Infirmary West. All gone. Joined by ... Florala Memorial, Elba General, Searcy, Greil Memorial Psychiatric, Randolph Medical Center, and Southwest Alabama Medical Center:

Ten hospitals shuttered in the last three years.

Glenn Sisk, CEO of Coosa Valley Medical Center, said the three biggest factors stressing hospital budgets in Alabama are no Medicaid expansion, $220 billion in Medicare cuts to hospital services and Alabama's low wage index which helps determine Medicare reimbursement rates.

"It's well documented Governor Bentley will not expand Medicaid," Sisk said. "The problem associated with that goes back to the passage of the (Affordable Care Act) bill several years ago. It imposed cuts of $225 billion nationwide to hospitals.

Read the full article.

Don't let Virginia turn into Alabama!  Contact your members of the General Assembly and remind them that refusing to expand Medicaid is the same as refusing to support Virginia's rural hospitals.

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Mark Your Calendar

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

June 2: Cutting Edge Breakthroughs for Aging with Lifelong Disabilities - Richmond
June 11: 
SW VA Managed Care Provider Meeting - Abingdon
June 12: The  State Street Project: Health Across Borders - Bristol
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
September 30-October 1: Rural Health Clinic Conference - Kansas City, MO
October 1-3: Critical Access Hospital Conference - Kansas City, MO

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Profile of State Public Health
ASTHO has created a set of five infographics to provide an advance look at key data from the forthcoming third edition of the ASTHO Profile of State Public Health. Each infographic focuses on an important aspect of the third edition's findings: the state public health workforce, state health agency activities, accreditation and quality improvement in the states, and trends in health information exchange. The final infographic provides a high-level overview of state public health. The third edition of the ASTHO Profile of State Public Health will be available at www.astho.org/Profile in June. 

Rural Community Health Gateway
Build programs that work with toolkits from the Rural Community Health Gateway. These evidence-based toolkits provide ideas and methods compiled from innovative community health and human services programs across rural America.

Health Information Technology Toolkit
Federal HIT resources for rural health care providers.

Rural Training Tracks 
Rural Training Track (RTT) residency programs are proven to produce physicians who choose rural practices. This section offers information and resources for students, RTT staff and policymakers.

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Funding Opportunities

Community Health Partnerships
Opportunities from the Kresge Foundation.  Known as the “Triple Aim,” the objectives are to: improve the health of the population; enhance the patient experience of care, including quality, access and reliability; reduce, or at least control, the per capita cost of care. 

Healthy Environments
Opportunities from the Kresge Foundation to invest in efforts to make the places where low-income families live, learn, work and play safe and healthy. Support is focused on housing, food, transportation and the built environment as key determinants of health. 

FY14 Partnerships to Increase Coverage in Communities Initiative
Application deadline:June 16, 2014
Award ceiling: $250,000
Department of Health and Human Services, Office of the Assistant Secretary for Health
The purpose of the Partnerships to Increase Coverage in Communities Initiative is to identify and assist minority populations, to educate them about the Health Insurance Marketplace (Marketplace) and to assist them with enrollment, completion of the application to determine their eligibility and purchase of health insurance offered through the Marketplace. Activities will include: utilizing coalitions and partnerships to maximize outreach and education of the underserved population(s); developing and providing comprehensive information and education sessions to consumers relative to the Health Insurance Marketplace; disseminating CMS or state developed information that will increase awareness of the Marketplace and, where necessary, appropriately updating materials to more effectively provide culturally competent services specific to the underserved population, including translation services; assisting individuals from underserved and hard to reach minority populations and help them apply for health insurance coverage offered through the Health Insurance Marketplace; and monitoring and adapting strategies to reach enrollment targets.

Robert Wood Johnson Foundation Unsolicited Proposals
Deadline: Applications accepted on an ongoing basis.
The Robert Wood Johnson Foundation Pioneer Portfolio accepts unsolicited proposals for projects that pursue innovative approaches to solving problems in health and health care.

Rural Community Facility Financing Available through USDA Rural Development
Deadline: Applications accepted on an ongoing basis
The Community Facilities Direct and Guaranteed Loans Program provides support to develop essential community facilities for public use in rural areas. Loan funds may be used to construct, enlarge, or improve community facilities.

Community Facility Grants through USDA Rural Development
Deadline: Applications accepted on an ongoing basis.
Grants are available to assist in the development of essential community facilities in rural areas and towns of up to 20,000 in population.

Bureau of Primary Health Care Loan Guarantee Program
Deadline: Applications accepted on an ongoing basis.
Loan program offered to Section 330 health centers to obtain a loan guarantee for the financing of a medical facility construction, renovation and modernization. 

Virginia Environmental Endowment
Deadline: June 15h, 2014
Funding to support improvement in 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.  
Do Something Seed Grants
Deadline: Ongoing
Funding to support community action projects or programs that are just getting started or to jump-start a new program.

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