Virginia Rural Health Association - Weekly Update
VRHA Weekly Update
In this Issue  November 9, 2015

VRHA News Virginia News National News Mark your calendar
Funding Opportunities


 Newsletter available





VRHA in the News 

By Daniel Parker and Allison Simmons - VCU iPadJournos

​Both the House and Senate rejected McAuliffe’s proposal to expand Medicaid earlier this year, eliminating the plan from the state budget. The proposal would have expanded Medicaid through an optional provision in the Affordable Care Act, something that some Virginia health organizations believe could benefit local hospitals feeling the financial strain of providing discounted care to uninsured patients.

“Not only does it hurt their health, but it hurts our rural hospitals and our rural health clinics and our community health centers,” said Beth O’Connor, executive director at the Virginia Rural Health Association, about the failed attempt to expand the program. “They’re having to provide a service to that group of people, who should have insurance through Medicaid expansion, but don’t.”

The mixture of discounted care and lack of patients is a factor hurting rural acute care hospitals in Virginia, said O’Connor. In order to handle these budgetary struggles, hospitals are cutting corners by hiring fewer staff members and holding out on buying new equipment. Those kinds of cuts can negatively impact hospitals’ abilities to operate, O’Connor added.

Read the full article.

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VRHA Presentations

Don't forget that the slides from the 2015 VRHA are available for review on the conference website.  Recently uploaded are:

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Members in the News

VRHA Board Member R. Neal Graham, CEO of the Virginia Community Healthcare Association has been appointed by Governor McAuliffe to serve on the board of [VRHA member] Virginia Health Workforce Development Authority.  

See the full list of appointees.

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Virginia News

Context on Medicaid Numbers

By Massey Whorley - Commonwealth Institute

After a report last week from Virginia’s Joint legislative Audit and Review Commission showed state spending on Medicaid is up 79 percent over the past decade, opponents of closing the coverage gap jumped on this number as evidence that denying coverage to thousands who need it is justified.It isn’t. And here’s why.

Even with Virginia’s rigid eligibility levels, the number of people enrolled in Medicaid over the past decade rose by nearly 50 percent, which is the primary reason spending went up. Three factors drove this increase: the economy, an aging population, and more waivers approved by the General Assembly. 

Virginia Medicaid is an efficient public insurance program that forms the backbone of the health care safety net. Lawmakers know this. That’s why they’ve opened Medicaid to some of the most vulnerable Virginians time and again. They need to finish the job, and close the coverage gap all the way. 

Read the full article and related article by the Daily Press.

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Behavioral Health Clinics

From the Office of the Governor

Governor Terry McAuliffe announced that Virginia’s Department of Behavioral Health and Developmental Services (DBHDS) has been awarded a $982,400 federal grant from the U.S. Substance Abuse and Mental Health Services Administration to help establish Certified Community Behavioral Health Clinics (CCBHCs) across the state. CCBHCs are a component of Virginia’s long-term strategy to reform the state’s behavioral health system.  

The CCBHC grant has two phases.  Phase I provides funds for CCBHC Planning Grants for up to 24 states.  For Phase II, eight states will be selected from among the Phase I states to participate in a two-year demonstration program in which CCBHCs will receive a financial incentive of enhanced payments to provide the high quality, comprehensive services required by the certification process.  

Read the full press release and related article from the Roanoke Times.

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PTs for the Future

By Kaylan Brickey - Bristol Herald Courier

After a number of setbacks, Emory & Henry College’s long-awaited School of Health Sciences opened this fall and is training its first class of future physical therapists. The school is now in a building behind the old Smyth County Community Hospital in Marion, but will eventually move to the former hospital building, which is undergoing renovations. When the renovations are completed, the current building will become the Mel Leamon Free Clinic.

One of E&H’s core values is to address issues of public concern and the School of Health Sciences will focus on the need for rural health care.

Read the full article.

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National News

Action Alert!

From the National Health Association

NRHA is launching a campaign to gather signatures for an important letter to congressional leaders to save rural hospitals. The letter explains the importance of H.R. 3225, the Save Rural Hospitals Act, and asks Congress to support this important legislation.

Please share with other hospitals and providers in your community that might be interested in signing the letter. To sign on, please click here. Deadline is Friday, November 13.

We are also encouraging each of you to send your own letter of support directly to your members of Congress. Visit our Save Rural Hospitals toolkit for more information on this important bill.

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Turning to Telemedicine

By Virginia Anderson - AJC

Hancock County, home to 9,000 or so Georgians, has long been known in the state for being at the bottom in many measures of well-being.  Its county seat, Sparta, just over 100 miles southeast of Atlanta by way of I-20, is so decimated by economic decline and an aging population that it has more funeral homes (two) than hospitals (zero).

But a grand experiment is underway in Sparta, one that health care experts, state legislators, local leaders, Mercer University School of Medicine officials and concerned citizens hope will become a model for the nation.

The Hancock Rural Healthcare Initiative, an ambitious telemedicine program, equips ambulances with computers, cameras, electrocardiogram leads and 4G cards that allow EMTs to share patient information in real time with hospital emergency room doctors in neighboring counties.

Read the full article.

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Fearing for the Future

By Mitch Smith & Abby Goodnough - New York Times

The rooms in the intensive care unit are filled with folded-up walkers and moving boxes. In the lobby, plaques and portraits have been taken off the wall. By this weekend, the last patients will be discharged and Mercy Hospital Independence will close, joining dozens of rural hospitals around the country that have not been able to withstand the financial and demographic challenges buffeting them.

Whether in Yadkinville, N.C.; Douglas, Ariz.; or Fulton, Ky., all of whose hospitals were also shuttered this year, these institutions are often mainstays of small communities, providing not just close-to-home care but also jobs and economic stability.

Read the full article

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The Population Health Challenge       

By John Commins - HealthLeaders Media

Population health management is being pursued by many healthcare leaders, but it's a hard strategy to manage when the population is small and spread out. That's the difficulty facing rural healthcare providers, who have long dealt with an older and sicker demographic, difficulty in finding physicians, and economic constraints, and are now pushed to the brink by healthcare reform.

Yet many rural healthcare leaders are embracing population health as their future—not because it offers economic salvation (it doesn't), but because it makes perfect sense for their mission: to provide care for the community.

Read the full article.

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Mark Your Calendar

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

November 13: VOHC Conference, Achievable Wellness: Engaging Communities and Clinicians for Better Health - Richmond
November 30: Veterans' Choice Program - webinar
December 3: TCI Policy Summit - Richmond
February 2-4: Rural Health Policy Institute - Washington, DC

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Veterans Choice Program
Information for rural healthcare providers and stakeholders to learn more about the program, ask questions if you are already a Choice Program provider, and discuss concerns that you have with serving Veterans through this important program. 

Profile of Virginia's Uninsured  
Provided by the Virginia Healthcare Foundation using data from the U.S. Census, the American Communities Survey, and estimates from an analytical approach developed by the Urban Institute.

Changing Patterns in Hospitalization and Inpatient Surgery of Rural and Urban Residents
Slides from a presentation given at the 2015 National Conference on Health Statistics. Describes rural and urban hospital patients, hospitalizations, and procedures, comparing data from 2001 and 2010. Includes information on challenges facing rural hospitals.

Results from the 2014 National Survey on Drug Use and Health: Detailed Tables
Provides data on illicit drug, alcohol, and tobacco use and attitudes, as well as access to substance abuse treatment. Rural-specific information is available in the detailed tables that list "geographic characteristics."

National Vaccine Injury Compensation Program (VICP)
Established to ensure an adequate supply of vaccines, stabilize vaccine costs, and establish and maintain an accessible and efficient forum for individuals found to be injured by certain vaccines.  

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Funding Opportunities

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

Primary Care Training and Enhancement Program (PCTE), HRSA-16-042
The deadline to apply for this opportunity is December 16, 2015.

The purpose of the Primary Care Training and Enhancement program is to strengthen the primary care workforce by supporting enhanced training for future primary care clinicians, teachers, and researchers, and to promote primary care practice in rural and underserved areas. The focus of this grant is to produce primary care providers who are well-prepared to practice in and lead transforming health care systems aimed at improving access, quality of care, and cost effectiveness. Applicants for the PCTE program must focus on training for transforming healthcare systems, particularly enhancing the clinical training experience of trainees.

Eligible applicants include accredited public or nonprofit private hospitals, schools of medicine or osteopathic medicine, academically affiliated physician assistant training programs, or public or private nonprofit entities which have been determined capable of carrying out grant activities.

HRSA’s Primary Care Training and Enhancement Program will award up to 37 grants totaling $14.9 million annually for five years (fiscal years 2016-2021). The maximum award to recipients will be up to $250,000 per year for single grants, and up to $500,000 per year for collaborative projects. Collaborative projects must include activities targeted at more than one training level and more than one primary care discipline. This year the PCTE has expanded the disciplines that qualify through collaborative projects.

Captain Planet Foundation 
Deadline: 01/31/2016
Grants are intended to serve as a means of bringing environment-based education to schools and to inspire youth and communities to participate in community service through environmental stewardship activities.

Academy of General Dentistry Foundation Grant Program
Due: December 1, 2015
Award ceiling: $5,000
The AGD Foundation Grant Program offers financial support for oral cancer education and research, and
sup­ports nonprofit community-based programs that provide quality oral health care/oral cancer screenings for underserved populations. 

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