VRHA Weekly Update
In this Issue July 31, 2017

VRHA News Virginia News National News Mark your calendar
Funding Opportunities


Newsletter available



2017 VRHA Awards

All Virginia Rural Health Association members and member organizations are invited to submit nominations for the 2017 Virginia Rural Health Association Awards.  Nominees are not required to be members of the association.  Commitment and service to the advancement of rural health in Virginia may be in the form of direct provision of health care services, governmental or educational advocacy, activities or research that improves the health of communities or populations.
Award Categories:

Lawmaker of the Year - special recognition to an elected official at any level who has demonstrated support for improving health in rural Virginia.
Charles Crowder, Jr. Award - to recognize outstanding individual commitment and service to the advancement of rural health in Virginia.
Best Practices in Rural Health Award - to recognize a program or institution that exemplifies commitment and service to the advancement of rural health in Virginia.
Ken Studer Friend of the Association Award -  to recognize a program, institution or individual that has advocated for or aided the Association in support of the Association’s mission.

Click here to download the nomination form.
Nomination Deadline: September 2, 2017
Honorees will be recognized during the Awards Luncheon on October 25th, 2017 at the Virginia Rural Providers Conference in South Boston.

You can also read about past honorees.

October 25 & 26
South Boston, VA

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Members in the News

VRHA member Edward Via College of Osteopathic Medicine (VCOM) was recently ranked as #2 in the nation for students going to their first residency choice. This ranking from US News and World Report is based on the 2016 graduating classes.

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More Members in the News

Recently, the National Rural Health Association announced its slate of 2017 Top 20 Critical Access Hospitals, selecting overall “Top 20 Winners” and “Top 20 Best Practice Recipients” in the areas of Quality and Patient Satisfaction.

VRHA member Dickenson Community Hospital was among the honorees in the Quality and Patient Satisfaction category.

Read the full press release and related article in the Dickenson Star.

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Virginia News


Trip Gabriel - New York Times

As the sun set in the mountains of southwest Virginia, hundreds of hurting souls were camped out or huddled in vehicles, eager for an early place in line when the gates swung open at 5 a.m. for the nation’s largest pop-up free clinic.

The Remote Area Medical Expedition, held at a county fairground in Appalachia over three days ending Sunday, drew more than 2,000 people who endured high heat and long waits for basic health services. It was a dispiriting reminder that as Congress flails around for health plans that could cost millions of people their insurance, many more don’t have much or any insurance or access to medical care to lose.

Read the full article and related articles from the Washington Post (second Post article), the Virginian-Pilot, the Southern Poverty Law Center, the Commonwealth Institute, and the Bristol Herald Courier.

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$71 Million in Avoidable Visits

Luanne Rife - Roanoke Times

Avoidable visits to emergency departments in 2015 contributed to more than $71 million in unnecessary spending, according to Virginia Health Information.  The organization collects health data from public and private sources and oversees an all payer claims database.

Through it, VHI determined more than 14 percent of the 1.3 million emergency room visits in 2015 might have been avoided and treated with a lower cost of care in a primary care physician’s office.

Read the full article.

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Close to Home

Catherine Saint Louis - New York Times

From 2003 to 2012, the last year for which statistics are available, the number of babies born dependent on drugs grew nearly fivefold in the United States. Opioids are the main culprit, and states like Kentucky are particularly hard-hit: 15 of every 1,000 infants here are born dependent on opioids.

Urban medical centers nationwide are scrambling to expand neonatal intensive care units or to build separate facilities to accommodate a tide of opioid-exposed babies arriving from rural communities. The result, many experts say, is an exercise in good intentions gone awry.

After their babies are moved, many new mothers, poor and still struggling with addiction, cannot find transportation or the resources to visit. Those who can travel find that some local charities decline to provide housing to addicts, as they do for other parents visiting sick children.

Read the full article.

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National News

No Skinny Repeal

By Erin Mahn Zumbrun - National Rural Health Association

The Health Care Freedom Act, also known as the "skinny repeal" bill that would have been a partial repeal of the Affordable Care Act failed in the Senate 49-51 early Friday morning. The bill would have removed the individual mandate, medical device tax and employee coverage requirement.

NRHA urges the Senate to work together to fix rural health care. Any repeal and replace efforts must provide improved access to care in rural America and ensure vulnerable and underserved rural Americans are not left without access to care. At minimum, Congress needs to address Medicaid, insurance market reform and stopping bad debt cuts to rural hospitals.

NRHA thanks you for your grassroots efforts. You made your voices heard!

Read also a statement from Governor McAuliffe.

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The Opioid Tide

Marty Stempniak - Hospitals and Health Networks

The epidemic of death and despair caused by heroin and prescription painkillers has hit every corner of the country, but it’s had a greater impact in poor, rural communities throughout the U.S.

As the American Hospital Association notes, rural hospitals provide services to more than 54 million people across the country, including about 9 million Medicare beneficiaries. Because they serve more patients on Medicare and have fewer resources, rural hospitals are hit hard by cuts in government spending.

“What we know, with respect to the incidence and prevalence of substance abuse, particularly opioids, in rural communities is that it’s reached crisis levels in many states,” says John Supplitt, senior director of the AHA’s Section for Small or Rural Hospitals. “And so, many are concerned that their intervention programs for substance abuse, mental health and addiction specialties are going to be cut. That would be devastating to the rural communities that already have scarce resources.”

Read the full article.

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Growing Doc Shortage

Kirk Siegler - NPR

For Heather Gijanto, going to the doctor means taking a day off work and driving at least 60 miles round trip from her home in McNeal, Ariz., to the town of Bisbee. And that is assuming there is a primary care doctor available in Bisbee to get her in.

Gijanto is frustrated and says she and her husband and their two young kids have had to change family doctors four times recently. Ideally, she says, the family would have one doctor who knew each member's medical history, so "I didn't have to explain my chart every single time or have to go over medications all the time with each new physician."

The shortage, especially of primary care providers, has grown steadily worse in recent years. According to the National Rural Health Association, rural areas could be short 45,000 doctors by 2020. And other trade groups warn those numbers of unfilled positions could loom even larger. Since 2010, more than 70 rural hospitals have closed.

Read the full article.

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Disparities & Rural Hospitals

Jeff Lagasse - Healthcare Finance

Rural hospitals are struggling. New Research from the Chartis Center for Rural Health, in conjunction with iVantage Health Analytics, confirms that rural healthcare providers serve populations which are not only socioeconomically disadvantaged, but suffer from numerous health disparities and poorer outcomes than those in urban settings -- making it difficult for them to operate in the black.

Seniors and veterans in particular are driving up demand. U.S. Census Bureau statistics show that adults in rural areas skew older, with a median age of 51 as compared to 45 in non-rural areas. That means higher hospitalization rates and lengths of stay, thereby increasing demand, and the report found most rural providers serve a greater population of patients older than 65 than two-thirds of all acute care hospitals. 

Especially challenging is that rural communities tend to have a higher burden of disease, including preventative diseases such as diabetes. Yet the supply of physicians is lower in these areas. This trend, according to the research, may be contributing to higher premature death rates and child mortality rates in rural communities.

Read the full article.

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Mark Your Calendar

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

August 10:Driving Individual and Population Health Improvements Using Data Analytics - webinar
August 16: A Focus on Suicide Prevention in Rural Communities  - webinar
September 7: Empowering a Rural Community to Create a Culture of Health - webinar
October 25 & 26: Virginia Rural Providers Conference - South Boston, VA

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Building Opportunity: A Toolkit for Virginia's Future
Which documents some of the key challenges facing Virginia and provides a toolkit of solutions to make progress.

CAH Finance 101 Manual 
Author: National Rural Health Resource Center (The Center)
This manual was developed for use by state Medicare rural Hospital Flexibility (Flex) Program personnel as well as staff and boards of CAHs. The content is designed to be as non-technical as possible and to provide answers to frequently asked questions.

Integrating Community Health Workers into Complex Care Teams: Key Considerations 
This technical assistance brief examines effective strategies for including community health workers (CHWs) in complex care teams drawing from the experiences of organizations participating in the Center for Health Care Strategies' (CHCS) Transforming Complex Care initiative and national experts in CHCS' Complex Care Innovation Lab. The brief provides recommendations related to recruiting and hiring, training and career progression, team integration, support and retention and maximizing the value of CHWs.

Food Insecurity and the Role of Hospitals  
Author: American Hospital Association (AHA)
Case studies in this guide highlight the innovative strategies and programs of several hospitals and health care systems to reduce food insecurity in their communities. This guide is one in a series of guides on how hospitals can address the determinants of health such as food, housing and education to improve the environment where people live, work and play.

Model Program: Telehealth Collaborative Care
The Telehealth Collaborative Care (TCC) study in Georgia and Texas connects rural veterans with HIV to specialists via telehealth.

National Strategy for the Opioid Epidemic
When approving a drug for use, the Food and Drug Administration (FDA) should go beyond determining its effectiveness and safety, and consider how disuse could impact individual and public health.  That’s the key recommendation in a new report from the National Academies of Sciences, Engineering and Medicine requested by the FDA to address the epidemic.  The report’s authors concluded that “years of sustained and coordinated efforts will be required by federal, state and local governments and health-related organizations.” The latest data from the CDC reports more than 90 opioid overdose deaths per day.  Rural communities are hit particularly hard with higher prescription rates for chronic pain and illness and limited resources for response and treatment.


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Funding Opportunities

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

Telehealth Network Grant for Substance Abuse
Established telehealth programs and networks can apply for $250,000 per year for a three-year program to improve access to health care services, particularly for substance abuse in rural, frontier and underserved communities.  Existing telehealth networks in counties with high rates of poverty and unemployment are encouraged to apply to expand and improve training of health care providers and quality of services.  For more information, contact Carlos Mena in the Federal Office of Rural Health Policy.
Applicant webinar: August 8, 2017, 2:00 - 3:00 p.m. Eastern, Call-In Number: 888.324.8132
Participant Code: 2444307 
Deadline: August 23 

Addressing the Gaps in Suicide Research 
The National Institutes of Health (NIH) will provide up to $300,000 to colleges and universities, local governmental bodies, nonprofit agencies, and other eligible organizations to uncover the risk factors for and the burden of suicide. This effort seeks to link health care system records of suicide attempts to suicide mortality data to better understand the type, severity and timing of risk factors and predictors of suicide. 
Deadline: November 2

Grants for Transportation of Veterans in Highly Rural Areas (HRTG)
Grants to organizations that assist veterans in rural areas with transportation to VA medical centers and other VA and non-VA facilities for medical care.
Application Deadline: Aug 20, 2017 

Funding for Buses and Transit Infrastructure  
The Federal Transit Administration (FTA) will make  $226 million available for fixed bus routes operated by state or local government and Indian tribes. The Bus and Bus Infrastructure Program finances the purchase or leasing of buses and/or construction or leasing of bus-related facilities. Transportation is a vital determinant of health in rural communities, impacting a person’s ability to access appropriate health care, purchase nutritious food, and more. Tribal communities are eligible to apply but proposals for projects in all other rural areas must be submitted as part of a consolidated state proposal. Also of note, the FTA requires matching funds depending on the type of project proposed.
Deadline: August 25

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