Virginia Rural Health Association - Weekly Update
VRHA Weekly Update
In this Issue  June 29, 2015

VRHA News Virginia News National News Mark your calendar
Funding Opportunities


June newsletter available





Advocacy 101

One person can make a difference. A coordinated group of people have a voice. Join VRHA Executive Director Beth O'Connor for a hands-on  workshop where you will learn how to be a successful rural health care advocate. Learn invaluable tips for communicating with your elected officials and become skilled in how to advance your legislative goals in Congress. 

SNEAK PEEK! Starting in 2016, VRHA will be offering this educational opportunity for $250/group.  This is your chance to preview the session and see if it is the right fit for your board of directors, advocacy group or other entity. Participation in this session will be included in your conference registration fees at no additional charge - this is your chance!
GIF logo
VRHA Annual Conference
October 13 & 14
Staunton, VA

Click the conference logo for event details.

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Telehealth Webinars

VRHA has partnered with WeCounsel to offer you a 3-part webinar series on telehealth.  This series will provide a high level understanding of what it takes to effectively implement a successful telehealth program.  The last session in the series will be: 

  • July 20: will outline effective use cases and how to develop an effective business model for a Telehealth initiative. This webinar will cover exactly how to plan, develop and implement a successful telehealth initiative. 

The webinars are free to all Virginia rural health stakeholders, regardless of VRHA membership status - so feel free to pass this information along!

Visit the VRHA webinar page for details, registration and an archive of the May 19th presentation on regulations.

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Members in the News

By Nadia Singh - WDBJ7

Work is underway to expand [VRHA member] LewisGale Hospital's emergency room in Pulaski. The project includes over 2,000 square feet of new space, three additional treatment rooms, a trauma room and a bariatric facility.

Read the full article.

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Virginia News

Medicaid Waiver Overhaul

By than 10,000 Virginia residents with disabilities are on waiting lists for needed services. Almost half are designated by the state's Department of Behavioral Health and Developmental Services as in "urgent" need.

To meet this need and to comply with a 2012 U.S. Department of Justice settlement that ordered the state to provide more services in the community, Virginia has started a redesign of the Medicaid waiver system. ("Waiver" is the term applied to the provision of services.) The phase-in would start in mid-2016 and lead to full implementation in 2019.

A central change would restructure waivers for those with intellectual disabilities and developmental disabilities, combining them under three broad categories. These, in turn, would be divided into four tiers and seven levels of need with corresponding, graduated reimbursements. Going forward, waivers will be "based on assessed intensity of need for residential/day services," according to the report.

Read the full article.

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The Political Battle 

By Michael Martz - Richmond Times-Dispatch

The Affordable Care Act has survived its second and likely its last constitutional challenge in the U.S. Supreme Court, but the political battle lines over health care reform haven’t changed in Virginia. The ruling is not likely to dissipate opposition to the law as a presidential election looms next year or persuade Virginia lawmakers to expand the state’s Medicaid program for hundreds of thousands of uninsured Virginians.

Gov. Terry McAuliffe, a Democrat, hailed the court ruling in King v. Burwell as “a victory for the 286,000 Virginians who will now keep affordable health care that is essential to economic success” and called on legislators to “put partisan politics aside” and expand health insurance coverage under the law.

But Virginia House Speaker William J. Howell, R-Stafford, quickly made clear that House Republicans would “remain committed to strengthening our health care safety net without expanding our broken Medicaid system.”

Read the full article and related stories from Public News Service and the Free Lance Star.

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National News

ACA Stands

By Diane Calmus - National Rural Health Association

The Supreme Court decided the case of King v. Burwell, permitting subsidies for the purchase of insurance in states that rely on the federally run health insurance marketplace. A little bit about the case: This case (or actually cases, the court put together a number of cases asking the same question) asked whether the Affordable Care Act (ACA) allows for subsidies for the purchase of insurance when a state relied on the federally run exchange. The language in the law allows subsidies in exchanges “established by the state;” however, IRS rules provided for subsidies in the federally operated exchange (

It will take some time before we fully know what the decision will mean for rural health. But we do know rural Americans tend to be older, sicker and poorer than their urban counterparts. So they are more likely to be in need of health care and less likely to have employer-provided insurance to help pay for that care.

While the National Rural Health Association did not take a position on ACA, we have continued to fight to ensure access to health care in rural America. Because so many rural Americans live in states with state exchanges and are in the income bracket eligible for subsidies, NRHA is pleased these vulnerable rural Americans can continue to receive the subsidies necessary to allow them to afford health insurance.

Read the full article.

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Dentist Visit Via Video 

Six-year old Jason Green squirms in a dental chair at a clinic in Sodus, New York while a hygienist probes his mouth with an unusual instrument. It looks like an electric toothbrush, but it is a camera and it’s capturing images that allow Jason’s dentist to inspect his teeth in detail--from 30 miles away. The dentist, Dr. Sean McClaren, practices at the Eastman Institute for Oral Health in Rochester, NY, but he sees several patients a week in this rural community, via a secure internet connection and a video call. 

For Jason’s mom Melissa Green, this set-up is a lifesaver. Without Dr. McClaren’s services, she would have been dependent on a friend to drive her, her son and infant daughter an hour west from their home in Wayne County, NY every time Jason needed an appointment. 

Read the full article.

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Rural Emergency Hospital

By Diane Calmus - National Rural Health Association

The Rural Emergency Acute Care Hospital Act of 2015 (S.1648) was introduced today by Sen. Chuck Grassley (R-IA), to establish a new Medicare payment designation, the Rural Emergency Hospital to sustain emergency services in rural communities.

NRHA applauds the forward thinking of Sen. Grassley by introducing a new model of rural health care to provide rural hospitals and communities a path forward to provide local care.  NRHA remains committed to advancing legislation that will also stabilize the rural health care safety net by stopping the numerous Medicare cuts that are significantly harming the financial viability of many rural hospitals.

Read the full article.

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No Expansion = At Risk Hospitals

By the Advisory Board Company

Chas Roades—chief research officer at The Advisory Board Company—told NPR's "All Things Considered" that rural hospitals have struggled financially as a result of changing payment models, declining federal reimbursements, and the decision by some states not to expand Medicaid through the Affordable Care Act.
"It's really a tale of two cities," Roades explains. "If you look at states that did expand Medicaid, the closure rate for rural hospitals ... has been significantly lower."
About 80% of the hospitals identified by the NRHA as being at risk of closing are in states that have not expanded Medicaid, Will Huntsberry reports for NPR.

Read the full article.

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Mark Your Calendar

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

June 30: Call to Action: Healthcare as a Moral Imperative - Richmond
July 15-17: Rural Quality & Clinical Conference - Minneapolis, MN
July 20: Effective Business Models for Telehealth - webinar
August 24-27: Arthritis, AgrAbility, and Rural Health Conference - Knoxville, TN
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

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CMS MLN Connects™ Weekly Provider eNews 

Rural Taxonomy of Population and Health-Resource Characteristics
Provides a systematic tool for classifying and identifying similar rural communities and places.  Ten distinct types of rural places are classified based on characteristics related to both demand (population) and supply (health resources) sides of the health services market.  This website contains the following information to assist policy makers, rural communities, healthcare organizations and providers, and researchers to utilize the taxonomy and to identify similar rural communities and places.

Health Demographic Analysis
The Virginia Atlas of Community Health has launched the latest enhancement to the Atlas, the Health Demographic Analysis Tool - the second generation of the Atlas' High Priority Target Area Analysis Tool.  It will allow the user to:
•  Mix a variety of different indicators - income, education, age, HPSA designations, and more
•  Adjust indicators to values pertinent to your work -- for example, if you are examining at risk Medicare populations, you can view census tracts with a population percentage of seniors of greater than 10%, a percentage of low income households of greater than 25%, and designated as a Medically Underserved Area/Population.
•  Overlay with one of the Ready Maps, a Custom Map, or combined with Community Based Health Providers.

ICD-10 Quick Start Guide
Tips to prepare for the October 1st deadline.

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Funding Opportunities

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

Gannett Foundation: Community Action Grant Program
The Gannett Foundation provides support to nonprofit organizations that serve the communities where Gannett Co., Inc., owns a newspaper or broadcast station (Staunton, VA & Northern Virginia). The Foundation’s Community Action Grant Program’s priorities include education and neighborhood improvement, economic development, youth development, community problem-solving, assistance to disadvantaged people, environmental conservation, and cultural enrichment. Grants are generally in the $1,000 to $5,000 range. Grant requests are considered twice each year; the upcoming postmark deadline is August 29, 2015

Advancing Health Disparities Interventions through Community-Based Participatory Research (U01)
Letter of Intent (optional, but strongly encouraged): July 3, 2015
Proposal due: Aug 3, 2015 
Award ceiling: estimated $500,000
The National Institute on Minority Health and Health Disparities awards funding for research on approaches to addressing health disparities and community engagement strategies in addressing health disparities in socially disadvantaged populations groups. These groups include Blacks/African Americans, Hispanics/Latinos, American Indians/Alaska Natives, Asian Americans, Native Hawaiians and Other Pacific Islanders, socioeconomically disadvantaged populations, and rural populations.

Department of Agriculture
The Rural Community Development Initiative provides financial and technical assistance to recipients in developing their capacity and ability to undertake projects related to housing, community facilities, or community and economic development. The application deadline is August 13, 2015.

Walmart Foundation State Giving Program
Due: July 17, 2015
Award ceiling: $250,000
Their Community Engagement Giving Program provides grants to programs working to meet the unmet needs of low-income, underserved populations. This focus area includes health care access.  

American Dental Association Semi-Annual Grant Program: Access to Care
Due: July 31, 2015
Award ceiling: $10,000
Awards funding to projects that improve access to oral health care. Examples include screening programs, treatment programs, and dental clinics within a community healthcare facility.

CATCH Planning, Implementation, and Resident Grants
Due: July 31, 2015
Award ceiling: $10,000
The American Academy of Pediatrics funds the Community Access to Child Health (CATCH) Planning and Implementation Funds programs which support pediatricians in the initial and/or pilot stage of planning or implementing a community-based child health initiative. The program is designed to help increase children’s access to a medical home or specific health services not otherwise available.

Healthy Smiles, Healthy Children Access to Care Grants
Due: Aug 3, 2015 
Award ceiling: $20,000 per year
The American Academy of Pediatric Dentistry offers matching grants to support community-based initiatives that provide dental homes to children whose families cannot afford dental care. 


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