Virginia Rural Health Association - Weekly Update
VRHA Weekly Update
In this Issue  May 16, 2016

VRHA News Virginia News National News Mark your calendar
Funding Opportunities


Newsletter available





VRHA in the News

By WSLS 10

Senators Mark Warner and Tim Kaine just introduced The Fair Medicare Hospital Payments Act of 2016. It’s designed to help rural hospitals recover full costs of service from Medicare and Medicaid. Right now, rural medical centers get about 66 cents on the dollar from Medicaid and 89 cents on the dollar from Medicare.

Roughly 74 percent of rural hospital patients are insured through Medicare, Medicaid or another government program. This bill would impact 29 hospitals in Virginia, the majority of which are in the Southwest region. Six rural Virginia hospitals are considered high risk for closure due to financial struggles.

Watch the video - including exerpts from an interview with VRHA Executive Director Beth O'Connor.

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Members in the News

By Nastassia Walsh & Charles Taylor - County News

Four southwest Virginia counties are serving as a model for how rural law enforcement and behavioral health can work together to keep mentally ill individuals out of jail. Floyd, Giles, Montgomery and Pulaski counties are among 14 separate law enforcement agencies — ranging in size from two officers to 100 officers — in the New River Valley region that participate in Crisis Intervention Training (CIT). 

It’s a pre-booking diversion program created to prevent “inappropriate incarceration,” according to Patrick Halpern, the program’s coordinator through [VRHA member] New River Valley Community Services. CIT is designed to teach law enforcement officers to recognize the signs and symptoms of mental illnesses when responding to crisis situations and refer rather than arrest.

In 2004, the first group of 10 law enforcement officers and 10 civilians traveled to Memphis for training — and later became the nucleus of the New River Valley program. It would go on to become the first rural, multi-jurisdictional CIT programs in the nation, according to Halpern. It was also the first of its kind in Virginia. The southwestern Virginia CIT provides law enforcement officers with 40 hours of specialized training that includes nine hours of role-playing exercises based on actual police interactions with mentally ill persons. 

Read the full article.

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More Members in the News

By Jim Talbert - SWVA Today

[VRHA member] 
Carilion Tazewell Community Hospital is expanding its clinic and will add a new doctor to the staff. The clinic is moving to the former Intensive Care Unit on the west side of the hospital.  Work is underway to renovate that space and the surrounding area allowing for 12 exam rooms and office area for the staff.

Read the full article.

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Virginia News

Premium Increases

By Dave Ress - Daily Press

he cost of covering Virginians who buy their own health insurance is set to jump this year, though for many, the checks they write will not. Double-digit increases in prescription drug costs and the end of two Affordable Care Act programs meant to stabilize insurers' finances mean insurers are seeking bigger rate increases for next year than they'd won for this year and the year before.

Rate requests filed by the five largest Virginia insurers this week with the State Corporation Commission's Bureau of Insurance show average increases ranging from 9.4 percent to 37.1 percent for individual coverage. About 300,000 Virginians are covered by these policies.

But the federal Obamacare subsidies that help most buyers pay for part of this coverage should shield many from any price shock. Last year, more than 80 percent of Virginians received some federal subsidy.

Read the full article.

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Merger & Expansion 

By Scott A. Surovell - Richmond Times Dispatch 

With the end of the 2016 General Assembly session, Virginians are receiving updates from their legislators about our accomplishments. What Virginians are not hearing about is our failure to expand Medicaid for many of the commonwealth’s 400,000 most vulnerable patients — or what we plan to do to prevent the impending mergers of four of the nation’s largest health insurers from driving up premiums for all Virginians and the cost of doing business in Virginia. 

But make no mistake, both of these issues should have everyone concerned. It is too late for the Medicaid expansion bill this session. But we can still take action on the insurance mergers. That is why hearings and public review processes for both of these mergers are needed.

History proves to us that massive mergers have not had positive outcomes for consumers. Previous mergers of leaders in other industries are one indicator. Virginians have seen what happens when airlines and drug companies consolidate: Far from shrinking bills for consumers, these deals paved the way for them to skyrocket.

Read the full editorial.

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Home Birth

In a tiny basement living room in southwestern Virginia, two women and their husbands listen to Joanna Davis talk about what might go wrong during their births.  Davis is a home birth midwife based in southwestern Virginia, but serves a significant swath of central Appalachia. Several months ago, she held a birthing class for two families interested in using her services.

During the class, Davis and an apprentice went over every instrument and scenario - both good and bad - that could possibly occur during a birth. Davis says she requires all families to attend the classes so they know exactly what they are getting into.

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National News

Award Recipients

The National Rural Health Association is proud to announce its 2016 Rural Health Award recipients.  And the winners are…

Outstanding Rural Health Program
Disparities Elimination Summer Research Experience, Statesboro, Ga.
Outstanding Rural Health Organization
Richard G. Lugar Center for Rural Health, Terre Haute, Ind.
Rural Health Practitioner of the Year
Dustin Hager, Heart of America Medical Center physician assistant, Rugby, N.D.
Louis Gorin Award for Outstanding Achievement in Rural Health Care
Lynn Barr, National Rural ACO founder, Nevada City, Calif.
Outstanding Researcher Award
Jacob Warren, PhD, Mercer University Center for Rural Health and Health Disparities endowed chair and director, Macon, Ga.
Student Achievement Award
Matt Workman, East Tennessee State University Quillen College of Medicine student, Johnson City, Tenn.
Student Leadership Award
Hallie Foster, University of Toledo College of Medicine and Life Sciences student, Toledo, Ohio
President’s Award
Alana Knudson, PhD, NORC at the University of Chicago program area director and co-director of the Walsh Center for Rural Health Analysis
Volunteer of the Year
Janice Probst, PhD, South Carolina Rural Health Research Center director, Columbia, S.C.

View the press release for more information on the honorees.

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Rural LGBTQ Healthcare

By Zachary Toliver - RHIhub

Access to healthcare is a challenge for many in rural communities, but for rural LGBTQ individuals, those challenges are multiplied. Nicole Flemmer can attest to that. For the last year and a half, Flemmer has worked in Seattle as a nurse practitioner specializing in gynecologic oncology, but previously lived in the more rural town of Walla Walla. In 2013, Flemmer launched the We Belong Project as a place to start conversations around healthcare partnerships. Flemmer commonly focuses on women of a sexual minority because of “my own experience with healthcare.”

Those conditions in Walla Walla echo the reality of small towns across America. While lesbians, gays, bisexuals, or transgendered population differ in their needs, these populations commonly suffer from healthcare disparities stemming from systematic, social disadvantages.

“We commonly group LGBTQIA together. But, each population has many different populations within each representation, so it’s difficult to do sweeping generalizations,” stated Flemmer. “But we do know that all of these populations put together have been historically marginalized and at times still are.”

Read the full article.

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Chew Tobacco Campaign

By Matthew Perrone - Bozeman Daily Chronicle

Government health officials will team up with minor league baseball as part of a new $36 million campaign to discourage rural teenagers from using chewing tobacco. Baseball stadiums will feature the campaign’s central message this summer — "smokeless doesn’t mean harmless” — via advertising and promotions with players. Ads will also run on local television, radio and online in 35 markets across the U.S., including cities in Michigan, Montana, South Carolina and Tennessee. 

The Food and Drug Administration says its latest effort targets white, rural males who are more likely to use dip, chew and other smokeless tobacco products. Roughly 32 percent of rural males ages 12 to 17, or roughly 629,000 Americans, are at-risk for using chewing tobacco, according to the agency.

Read the full article.

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Net Loss

By Roberto Gallardo - Daily Yonder

The gig economy has been around for a long time, but it’s getting new attention, especially during the presidential campaign season. One reason is that the gig economy has received a steroid shot thanks to technology.
Because of digital advancements, the “traditional” gig economy of contract workers, temps, freelancers, and other self-employed workers has converged with the sharing economy. The sharing economy includes “services and goods that employ under-utilized assets via online marketplaces or decentralized networks for both monetary and non-monetary benefits,” according to the American Action Forum.
A recent research study by Princeton University found that alternative work arrangements in the U.S. increased significantly between 2005 and 2015. Those hired out through contract companies showed the highest increase during the same period.

What about rural communities? How is their gig economy doing?  Small city and rural counties actually lost nonemployer establishments, declining by 2.2 and 0.5 percent respectively during this period.

Read the full article.

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Mark Your Calendar

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

June 9: 2016 Health Care Conference - Richmond
July 13-15: Rural Quality & Clinical Conference - Oakland, CA
September 20-21: Rural Health Clinic Conference - Kansas City, MO
September 21-23: Critical Access Hospital Conference - Kansas City, MO

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CDC’s NCCCP Launches Updated Web Site
The National Comprehensive Cancer Control Program (NCCCP) Web site on features all-new content and an updated look. Visitors to the site can search for their state’s comprehensive cancer control plan, learn about NCCCP’s ongoing work and research, and view the latest success stories from awardees. There are resources for comprehensive cancer control programs available, and you can find contact information for all programs, as well as information on partners and specific grants.

Adverse Childhood Experiences in Rural and Urban Contexts
Reports on a study analyzing the rural prevalence of individual adverse childhood experiences (ACEs), the level of exposure to ACEs in rural regions, and the rural-urban differences of exposure to ACEs by adults using data from the Behavioral Risk Factor Surveillance System (BRFSS).

Systematic Review: Rural Healthcare Workforce
Management brief describing literature review of 59 publications from 2005-2015, identifying need for rural healthcare providers, exploring provider geographic choices, synthesizing evidence on interventions to increase recruitment and retention, and documenting efficacy of student training for rural healthcare.

The Economic Impact of Rural Broadband
Provides an estimate of the direct and indirect economic activities of the rural broadband industry on the Gross Domestic Product (GDP), and their effect on other rural industries, including healthcare.

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Funding Opportunities

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

Kendal Charitable Funds: Promising Innovations
Kendal Charitable Funds is dedicated to supporting improvements in serving older adults that are reflective of a pioneering spirit in the field of aging. Kendal’s Promising Innovations grants are intended for nonprofit organizations that work to meet the needs of a burgeoning population of elders. In 2016, the program will support projects that identify and respond to challenges faced by individuals aging in place in rural areas. New initiatives to serve these individuals, as well as the expansion of current programs, will be considered. Grants will range up to $25,000. Several smaller requests may be granted rather than one or two larger ones. Priority is given to projects that have significant potential for change and replication.
Letters of intent must be submitted by May 22, 2016; invited proposals will be due on August 5, 2016.

CareFirst BlueCross BlueShield Giving Program
The CareFirst BlueCross BlueShield Giving Program supports nonprofit organizations that improve the health and wellness of the citizens in Maryland, northern Virginia, and Washington, DC. CareFirst’s philanthropic focus areas include the following: Improving Maternal and Child Health, Expanding Access to Behavioral Health, Empowering the Region’s Safety Net Clinics, Addressing the Region’s Shortage of Nurses, and Promoting the Patient-Centered Medical Home Concept. The upcoming grant application deadline is June 13, 2016.

American Dental Association Semi-Annual Grant Program: Access to Care
Due: July 29, 2016
Award ceiling: $10,000
The American Dental Association awards funding to projects that improve access to oral healthcare. Examples include screening programs, treatment programs, and dental clinics within a community healthcare facility.

Rides to Wellness Demonstration and Innovative Coordinated Access and Mobility Grants
Due: May 31, 2016
The Federal Transit Administration (FTA) will provide approximately $5.3 million of funding from two programs to support the Rides to Wellness Demonstration and Innovative Coordinated Access and Mobility Grants (R2W Demonstration Grants). R2W Demonstration Grants are part of a series of activities to support FTA’s Rides to Wellness Program that seeks to address challenges for the transportation disadvantaged in accessing health and wellness services. 

KaBOOM! Play Everywhere Challenge
The Play Everywhere Challenge, administered by KaBOOM!, is a national competition that will support innovative, replicable ideas that make play available and fun for kids and families. The Challenge is looking for creative solutions to make play a way of life in everyday and unexpected places – sidewalks, vacant lots, bus stops, open streets, etc. The Challenge is open to U.S. nonprofit organizations, for-profit organizations, individuals, and governments with a great idea that will help ensure that kids and families get the active play they need to thrive. However, prize funds can only be paid to 501(c)(3) nonprofit organizations, government agencies, and schools, so finalists not falling under these categories will be asked to identify a qualifying entity as a partner or fiscal sponsor. Finalist and challenge winners will be offered coaching from experts along with $500 to refine their ideas. Winning ideas will receive a share of $1 million; prize amounts will fall within the following ranges: Small Scale ($500-$5,000), Medium Scale ($5,001-$25,000), and Large Scale ($25,001-$50,000).
The application period will be open through May 31, 2016.

State Health Access Reform Evaluation (SHARE)
States continue to play a critical role in the implementation of health reform. States have made different choices in the rollout of the Affordable Care Act (ACA), including whether to establish a State-Based Marketplace, use a Federal-State Partnership Model, or participate in the Federally Facilitated Marketplace. States also have made different decisions regarding Medicaid expansion, with several states opting to implement an early (pre-2014) expansion for adults without dependent children, some states expanding in 2014, and several states negotiating unique Medicaid expansion approaches post-2014. Further, some states are experimenting with new payment and delivery systems that integrate health care services, and exploring opportunities to bridge health and social sectors to improve population health.

This solicitation from the Robert Wood Johnson Foundation seeks to fund timely policy-relevant studies with strong empirical designs that will inform policy and health reform implementation. Eligible studies may be of a single state, groups of states, or national analyses that use state-level data. We are primarily interested in timely studies which have policy relevance.

Up to $1.3 million will be available under this CFP. Project funding will range from $50,000 to $150,000 to accommodate studies of six to 12 months. Preference will be given to rapid-turnaround projects that can be completed within six months. Projects lasting longer than six months must provide strong justification for the grant period. Eight to 12 studies will be funded.
Deadline: June 1, 2016 

Family Violence Prevention and Services Discretionary Grants: Specialized Services for Abused Parents and Their Children
Funds demonstration projects to expand the capacity of family violence, domestic violence, and dating violence service programs to prevent future violence by addressing the needs of children exposed to violence.
Letter of Intent (Optional): May 26, 2016
Application Deadline: Jun 27, 2016 

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Virginia Rural Health Association
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Blacksburg, VA 24060

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