VRHA Weekly Update
In this Issue March 5, 2018

VRHA News Virginia News National News Mark your calendar
Funding Opportunities





RHC Spring Summit!

Virginia Rural Health Clinic Coalition Spring Summit - April 18 & 19  Blacksburg, VA

Registration fees are $25 for VRHCC members and $150 for non-members.  Fees include lunch both days.

Click here to register for the event.  More details can be located on the event webpage.

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Members in the News

From UVA-Wise

Students at The University of Virginia’s College at Wise will have an opportunity in the fall to pursue a minor in public health, a curriculum designed to help them develop intellectual and practical skills, personal and social responsibility, and to participate in interdisciplinary and applied learning. The minor is aligned with the mission of [VRHA member] College’s Healthy Appalachia Institute, and gives UVa-Wise and HAI an opportunity to grow and become leaders in public health education, research and practice.

The interdisciplinary field of public health combines natural and social science to prevent diseases, prolong life and promote health through organized community effort. The minor will bridge biology, criminal justice, psychology, sociology, education and humanities to address the biological, sociocultural, political and economic issues that influence population health across the lifespan.

Read the full article.

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Many Members in the News

From Delta Dental of Virginia

The Delta Dental of Virginia Foundation has awarded $370,500 in grants to support 40 organizations committed to improving oral health across the Commonwealth.  VHRA recipients include:

  • Central Virginia Health Services, Inc., New Canton: $7,500 for dental equipment. 
  • Eastern Shore Rural Health System, Inc., Onancock: $15,000 for dental chair for wheelchair patients. 
  • Olde Towne Medical & Dental Center, Williamsburg: $5,000 for dental equipment and supplies. 
  • Virginia Oral Health Coalition, Glen Allen: $7,500 for online toolkits for medical and dental

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Virginia News

Budget Battle

By Michael Martz - Richmond Times-Dispatch 

The battle of the budgets intensified on Tuesday, as the House Appropriations Committee took aim at a Senate proposal to expand services in Virginia’s Medicaid program without paying for them, rather than use additional federal money to fully expand the program for more than 300,000 uninsured Virginians under the Affordable Care Act. 

The House Appropriations Committee released an analysis of the Senate proposal to amend an existing Medicaid waiver. It estimates the full cost at $441.5 million to serve almost 61,000 Virginians with mental illness, substance use disorders or life-threatening, complex medical conditions. If capped at 20,000 people, as the Senate has proposed, the state cost would be $186 million for two years. 

The Senate plan is based on legislation sponsored by Sen. Siobhan Dunnavant, R-Henrico, to create a “Priority Needs Program” under Medicaid. The plan also would serve 2,300 people with developmental or intellectual disabilities who are waiting for services under Medicaid waivers for people outside of state institutions, and require screening of almost 500,000 children for childhood trauma. 

But the plan does not include funding for the services or the required application to the Centers for Medicare & Medicaid Services, or CMS, for approval of the partial expansion and federal matching funds to pay for it.

Read the full article and related story from the Washington Post.

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Patient Transport

By CJ Fairfield - Franklin News-Post

A free non-emergency transportation program has been up and running for a year in Franklin County but hopes to expand its reach to people in need throughout the area.
Franklin Rides is a program through the Disability Rights and Resource Center that provides free, accessible, non-emergency rides for people with disabilities to and from their medical appointments.

“If they have made a doctor’s appointment or they have a dialysis appointment or therapy and they have made it in advance and gave us the time and date, we’ll go pick them up, take them to the appointment, we’ll wait for them and then return them home free of charge,” said Tom Mason, executive director of DRRC who heads Franklin Rides.

Read the full article.

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Healthcare Crisis

By Joe Dashiell - WDBJ7

You don't have to walk far in downtown Stuart to find some strong opinions about the loss of the local hospital. 

"So many old people here, worried that all of a sudden something will happen," Cecil Akers told WDBJ7.

​Carilion Franklin Memorial Hospital administrator Bill Jacobsen [a VRHA member] says continued cuts to Medicaid and Medicare reimbursements, and no Medicaid expansion have taken a toll on many hospitals.

​Read the full article.

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National News

Rebuild Rural

Jessica Seigel - National Rural Health Association

Last week, we received further details on President Donald Trump’s infrastructure plan. We were happy to see that rural infrastructure investments are a key component of this Administration’s commitment to growing our national economy. It is essential that we build rural priorities into this massive investment in our nation’s future, and it is even more important that we recognize the special role that health care plays in our country’s infrastructure.

Rural communities have not recovered from the Great Recession the way that metropolitan and suburban counties have. 200,000 jobs are still lost annually in rural communities, and as a result, 749 rural counties experience increasing unemployment. In most rural communities, the hospital is the first or second largest employer, but only if the hospital can keep its doors open. More than 44% of rural hospitals operate at a loss and 30% operate below a -3% margin. 83 rural hospitals have closed since 2010, and 674 are vulnerable to closure. If all 674 vulnerable hospitals close, we will lose 99,000 direct health care jobs, 137,000 community jobs, and $277 billion in GDP. Per-Capita annual income in rural communities will decrease by $703, while rural unemployment would increase by 1.6 percentage points. We need investments in rural infrastructure, and especially in health care, to ensure the future of our rural communities.

​Read the full article.

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Milk Prices and Suicide

By Tovia Smith - NPR

As the nation's dairy farmers struggle through their fourth year of depressed milk prices, concerns are rising that many are becoming depressed themselves. The outlook for the next year is so bleak, it's heightening worries — especially in the Northeast — about farmer suicides.

Agri-Mark Inc., a dairy cooperative with about 1,000 members, saw three farmers take their own lives in the past three years. The most recent was last month. It's a very small sample, but very sharp and disturbing increase.

"It's tough to keep your head up with all of what's going on," says 55-year-old Will Rogers, a ruddy-faced white-haired farmer who has 75 cows on his farm in Warren, Mass. Out in his barn milking cows at the crack of dawn, as he does every single day, Rogers says farming is his calling, just as it was for his father. It's hard to reconcile such a wholesome way of life, he says, with farmers taking their own lives.

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The Cost of Opioid Jobs

By Emily Popek - Daily Yonder

The small community of Hobart, New York, is a village divided. The West Branch of the Delaware River splits it in two — Main Street along the north, and the “industrial district” of Railroad Avenue trailing along to the south. Between the historic Main Street storefronts, you can catch a glimpse of the Mallinckrodt plant, where generic oxycodone tablets are produced in massive quantities.

The pill factory employs hundreds of people, more than Hobart’s population of 441. The factory is easily overlooked and ignored by those in the village, but, to some, its presence there is troubling. Some in the area are thankful for the jobs the pill factory provides — but others worry that a plant that manufactures oxycodone is more curse than blessing. 

Read the full article.

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Mark Your Calendar

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

March 8-9: The Virginia Cancer Conference - Williamsburg
March 29: Interprofessional Summit on Addition Education - Charlottesville
April 13-14: Collaborative Conference on Rural Mental Health - Wytheville
April 15-17: MATRC Annual Telehealth Summit - Hershey, PA
May 8: Health Equity Conference - New Orleans, LA
May 8: Rural Medical Education Conference - New Orleans, LA
May 8-11: Annual Rural Health Conference - New Orleans, LA
May 8-11: Rural Hospital Innovation Summit - New Orleans, LA

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Best Practices for Medication-Assisted Treatment
The Substance Abuse and Mental Health Services Administration (SAMHSA) published clinical guidance explaining use of the three medications approved by the Food and Drug Administration to treat opioid use disorders:  methadone, naltrexone, and buprenorphine.  

Key Budget Policy Choices
The Commonwealth Institute has released a new easy-to-read table, providing key information on proposed investments of the Commonwealth over the next two years.  This analysis highlights key policy choices in the newly released budget amendment proposals by the House Appropriations and Senate Finance committees alongside the governor's introduced budget. 

Improving Access to Transportation in Rural Communities
In case you missed it: a recording of last week's webinar, Improving Access to Transportation in Rural Communities, is available online. 

Economic Impact Analysis Tool
As of January 8, 2018, the EIA Tool is now using updated population estimates, multipliers, and industry codes. Scenarios you’ve already created will continue to use the previous population projections, multipliers, and industry codes, so any reports you have stored will be unchanged. If you’d like to re-run a scenario using the updated information, you can re-enter your spending and other information in a new scenario, which will take advantage of the updates.
Learn more:

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Funding Opportunities

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

Enhancement and Expansion of Treatment and Recovery Services for Adolescents, Transitional Aged Youth, and their Families
Grants to enhance and expand comprehensive treatment, early intervention, and recovery support services for adolescents, transitional aged youth, and their families/primary caregivers with substance use disorders and/or co-occurring substance use and mental disorders.
Application Deadline: Apr 10, 2018 

Senior Medicare Patrol Projects
Funding to provide local outreach, education, and assistance to Medicare beneficiaries through a volunteer workforce that is trained to empower and assist Medicare beneficiaries, their families, and caregivers to prevent, detect, and report health care fraud, errors, and abuse.
Application Deadline: Apr 16, 2018 

Nurse Scholar Program
A free distance learning opportunity available to rural nurses working for nonprofit organizations, government agencies, or educational institutions designed to increase knowledge base in prevention, identification, and assessment of diseases related to agricultural work exposures.
Application Deadline: May 3, 2018 

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