Virginia Rural Health Association - Weekly Update
VRHA Weekly Update
In this Issue September 21. 2015

VRHA News Virginia News National News Mark your calendar
Funding Opportunities


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VRHA Annual Conference is only 3 weeks away - 

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Eleven applications were accepted to make Poster Presentations at the VRHA Conference, we look forward to seeing:
  • Factors Associates with Diabetes among Diabetics Seeking Care at OTMDC
  • Medical Review Process to Determine Disease Prevalence in Rural Virginia 
  • Impact of Incorporating Dental Care into Routine Prenatal Care and Diabetes Management
  • Diabetes, Mild Mental Conditions and Behavior in Virginia Coal Workers
  • Cancer Death Rates in Coal Production Counties in Southwest Virginia 
  • Lifestyle Factors, Diabetes Mellitus, and Hypertension in Virginia Coal Counties
  • Cancer Survivorship in Southwest Virginia
  • Implementation of a School-based HPV Immunization Program
  • Smoking in Southwest Virginia: Spreading a Solution
  • Understanding Skin Cancer in Southwest Virginia
  • Preventing Colorectal Cancers for Virginia’s Most Vulnerable


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Members in the News

By Amy Trent - News & Advance

[VRHA member] Blue Ridge Medicial Center received $262,518 in federal funding Tuesday to help increase local residents’ access to primary care including medical, oral, behavioral, pharmacy and vision care services. The grant funds are part of $350 million in Affordable Care Act funding distributed by the department of Health and Human Services Tuesday; $8.9 million came to Virginia.

Read the full article.

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Virginia News

Financial Pressure

By Tammie Smith - Richmond Times-Dispatch

Some Virginia hospitals are financially struggling, threatening the delivery of medical services especially in rural areas, hospital executives warned Wednesday. Government decisions, such as 2 percent cuts to Medicare payments, failing to expand Medicaid, and penalizing hospitals for readmissions that are beyond their control, are driving some facilities, particularly those in rural areas, to financial insolvency, the executives said at a news conference convened at a hospital in Richmond’s East End.

To get that message out and warn of other possible reprecussions, such as reductions in serivces, the hospital lobbying group Virginia Hospital and Healthcare Association has launched a statewide campaign to alert businesses, consumers, policymakers and others to financial pressures on hospitals.

Read the full article.

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Hot Spots

crc 2 Although the risk of death from colorectal cancer in the United States has dropped dramatically in recent decades, there are three "hot spots" in Appalachia and the rural South where death rates are "unnecessarily high," researchers said.

The highest colon cancer death rates are in the lower Mississippi Delta, where rates were 40 percent higher than the rest of the country during 2009 to 2011, according to a study published Wednesday in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research. The other two hot spots are western central Appalachia and eastern Virginia/North Carolina, where rates were 18 percent and 9 percent higher, respectively, than elsewhere in the country for that same time period.

Read the full article.

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Close to Home

By Taylor Sisk - North Carolina Health News

Expanding Medicaid, said Duke University health economist Don Taylor, “is the simplest, most effective way to support rural hospitals that exists.” But North Carolina’s legislators – and those in 19 other states, each with significant rural populations – have declined to do so.

“I actually think that expanding Medicaid is one of the most devastating things you can do to rural health,” Sen. Ralph Hise (R-Spruce Pine), co-chair of the Senate Health Care committee, said during a press conference at the General Assembly in mid-August. Hise argued that having more patients on Medicaid would guarantee “there is no opportunity for [rural hospitals] to ever operate in a profitable manner.” 

Maggie Elehwany, the National Rural Health Association’s vice president for government affairs and policy, doesn’t see it that way. It’s “undeniable” that more rural hospitals have closed in states that haven’t expanded Medicaid, she said. “It’s more than a coincidence,” Elehwany asserted. “You can’t deny that it’s a contributing factor.”

A 2014 Robert Wood Johnson Foundation study determined states that have elected not to expand Medicaid (24 states at the time) “are foregoing $423.6 billion in federal Medicaid funds from 2013 to 2022, which will lessen economic activity and job growth.”

Read the full article.

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National News

Rural Policy Platforms

By Rick Cohen - Non Profit Quarterly

Writer Isaac Boone Davis and essayist and NPR commentator Dee Davis, founder of the Center for Rural Strategies, decided to look for the rural platforms of the multitude of men—and two women—nominally running for President of the United States. Not surprisingly, they didn’t find much. In fact, other than the “Plan for a Vibrant Rural America” released by the Hillary Clinton campaign, none of the candidates have a rural platform. Despite the Republicans’ national electoral success with rural voters, not one of the Republican candidates has a specific rural platform or bothered to utter the word “rural” in their first debate—though, in fairness, national political reporters rarely think about rural any more than the candidates do.

Given how rarely current national officeholders mention rural (except as part of a litany honoring where Americans might live: urban, suburban, rural, etc.), the two Davises might have had a very brief article had they simply summarized the Clinton plan. Instead, they chose to ask rural activists what they hoped for as components of the presidential candidates’ rural platforms should substantive rural platforms ever emerge. Davis and Davis got some interesting responses on issues that have specific applicability to nonprofits.

Read the full article.

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58th Rural Hospital Closure

From Modern Healthcare and the National Rural Health Association

The upcoming closure of a hospital in the southeast Kansas community of Independence has highlighted the problems faced by rural medical providers in states that have refused to expand their Medicaid programs.

"The climate of health care these days is very challenging, and particularly for small rural hospitals like ourselves," said Joanne Smith, spokeswoman for Mercy Hospital in Independence. "We are facing decreased reimbursement; the fact that Kansas did not expand Medicaid has been a significant factor in our reimbursement, and declining population here in our corner of Kansas, as well as a lot of outmigration of patients to other communities for their health care."

NRHA CEO Alan Morgan recently stated that the number of rural hospital closures will soon increase to 58 with the impending closure of Mercy Hospital. NRHA has identified 283 other rural hospitals that are in danger of shutting down, representing 10 percent of all rural hospitals in the nation. 

Read the full article.

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Telehealth Payments


Medicare only covers telehealth for a limited number of patients in designated rural areas, and those patients must still travel to a clinic to complete a session rather than log in directly from home. As a result, only 1 percent of Medicare beneficiaries use telehealth each year.
And since Medicare coverage is used as a benchmark for grant funding and private insurers to set their own rates, investment has been limited since telehealth debuted in the 1990s.
"How do you expect a provider to provide these services through telehealth if they don't get paid for it?" Mei Wa Kwong, senior policy associate at the Center for Connected Health Policy, says. "It kind of holds it back."
But that may soon change, as multiple federal campaigns aim to relax Medicare's restrictions and provide patients with greater access to telehealth services. If successful, these changes could have a domino effect by demonstrating the value of these services more broadly as support for telehealth builds in the private sector and among consumers.

Read the full article.

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Digital Divide

By Roberto Gallardo - Daily Yonder

More and more applications and services are available online only. That sounds great, as long as you are connected. Remember the time when not knowing how to read and write put you behind? Well, being on the wrong side of the digital divide is similar.

The digital divide is a gap between those who are online and those who are not. Being online means more than just having service available in your location. It also means being able to pay for the service and knowing how to use it.

Notice the big difference between the access levels of rural people with access to DSL living in the county seat (“DSL seat”) versus those living in the (“DSL-county”). Frequently, people speak of DSL as a technology that is “everywhere.” But there’s a 25 percentage point difference (92.6% versus 68.3%) between rural county-seat residents and rural residents who live outside the county seat.

Read the full article and related article from Becker's Hospital Review.

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Mark Your Calendar

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

September 29-30: Rural Health Clinic Conference - Kansas City, MO
September 30-October 2: Critical Access Hospital Conference - Kansas City, MO
October 13-14: VRHA Annual Conference - Staunton
October 15: REVIVE! Training of Trainers - Staunton
December 3: TCI Policy Summit - Richmond
February 2-4: Rural Health Policy Institute - Washington, DC

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Rural Data Portal 
On-line resource that provides essential information on the social, economic, and housing characteristics of communities in the United States. The RURAL DATA PORTAL is targeted toward rural communities, but a wide range of information is presented for the nation, states, and counties for rural, suburban and urban areas. Most of the information provided in the RURAL DATA PORTAL come from Housing Assistance Council (HAC) tabulations of various public use data sets such as the 2010 Census of Population and Housing, the American Community Survey (ACS) and Home Mortgage Disclosure Act Data.

10 Vital Steps to Successful Grant Writing
Grant funding could be part of the answer to starting programs; however, for many healthcare organizations, grant writing can seem like a cumbersome task with confusing processes and time-consuming research. Where do you start and how do you navigate the complicated grant landscape?

Ten Tips to Support Advocacy Initiatives at Health Centers
Review this post from the Campaign for America’s Health Centers’ blog for tips to promote advocacy at your community health center. 

Working with Veterans
The Rural Health Initiative Lecture Series by the U.S. Department of Veterans Affairs is a collection of trainings for primary care professionals, designed Series for non-VA primary care professionals to help them work with rural patients. Each of these trainings are available to view on a PC or a mobile device.

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Funding Opportunities

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

Benefits Enrollment Centers Request for Proposals
Deadline: Friday, November 13, 2015
Up to 8 grants of $100,000 each will be awarded.
The National Council on Aging is accepting applications for qualified organizations and agencies to become Benefits Enrollment Centers (BECs). BECs help low-income seniors and persons with disabilities find and enroll in all the benefits programs for which they are eligible, and create coordinated, community-wide systems of benefits access.

Griswold Cares Foundation
The Griswold Cares Foundation provides grants to nonprofit organizations throughout the country that enhance the quality of life for low-income seniors and adults with disabilities who choose to age in place. The Foundation's funding priorities focus on support for programs that provide respite care and short-term home care. The Foundation also supports local community and grassroots organizations that provide other programs and services with the intent of helping those of limited financial means to age in place. Most grants are in the $500 to $2,000 range. Applications will be accepted from September 14 through October 12, 2015.

Whole Kids Foundation: School Garden Grant Program
The Whole Kids Foundation is dedicated to supporting schools and inspiring families to improve children’s nutrition and wellness.The Foundation's School Garden Grant Program provides support for edible gardens at K-12 schools in the U.S. and Canada. These grants of $2,000 are awarded to schools as well as nonprofit organizations working in partnership with schools. Consideration is given to new or existing garden projects at any stage of development that help children engage with fresh fruits and vegetables. Applications for U.S. projects must be submitted by October 31, 2015.

NIH Health Disparities Research Loan Repayment Program
Offers loan repayment assistance for health professionals who commit to research projects related to health disparities.
Geographic coverage: Nationwide
Application Deadline: Nov 16, 2015

Nurse Anesthetist Traineeship Program (NAT)
Provides funding to support traineeships for licensed nurses who are enrolled in a nurse anesthesia program, with preference given to projects that will benefit rural and underserved populations.
Geographic coverage: Nationwide
Application Deadline: Nov 20, 2015

AmeriCorps State and National Grants
Funding for programs that are designed to strengthen communities and solve local problems. Funds may be used for programs that utilize AmeriCorps member in the following areas: disaster services, economic opportunity, healthy futures, environmental stewardship, education, and veterans and military families.
Geographic coverage: Nationwide
Letter of Intent (Required): Dec 9, 2015
Application Deadline: Jan 20, 2016

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Blacksburg, VA 24060

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