VRHA Weekly Update
In this Issue  February 8, 2016

VRHA News Virginia News National News Mark your calendar
Funding Opportunities


Newsletter now available!





Congratulations Officers!

The VRHA Board of Directors recently elected their officers for 2016:

  • President - Chuck Carr
  • Vice President - Maggie Bassett
  • Treasurer - Mike Zodun
  • Secretary - Ashley Kenneth
We would also like to thank outgoing officers Dr. Elizabeth Locke and Kate Lim for their service.

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Your Turn!

VRHA members and staff recently joined the Healthcare for All Virginias coalition in speaking to members of the General Assembly about the need to either expand Medicaid or find another way to close the coverage gap.

Now it's your turn.  Contact your GA members, submit editorals and letters to the editor. Here are some resources to get you started. 

Want some inspiration?  Check out this great editorial from the Richmond Times-Dispatch and the Faces of Virginia’s Coverage Gap.

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Members in the News

By Sara Owens - Farm Bureau Virginia

After suffering a carotid aneurysm in 1999 that made it difficult for him to walk, Dinwiddie County farmer Alvin Blaha needed a solution.

In 2003, he learned about [VRHA member] AgrAbility that helps farmers with disabilities continue to work. He was the second person in Virginia to receive help from AgrAbility Virginia, one of 24 state-level affiliates of the National AgrAbility Project.

Blaha was unable to pull himself up onto his farm equipment. AgrAbility Virginia helped find resources to retrofit angled steps on his combine so he could get on and off safely.  In addition to the steps on his combine, AgrAbility Virginia added steps to all of Blaha’s tractors. In 2015, the organization reached out to the Department for Aging and Rehabilitative Services for help installing a lift on Blaha’s cotton picker. The lift runs off the cotton picker’s battery and features a safety catch to prevent it from free-falling should a cable break.

Read the full article.

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Virginia News

Benefit for Parents

By Ashley Everette - Voices for Virginia's Children

While the U.S. has made significant progress in decreasing the rate of uninsurance for adults, many low-income working parents and families in Virginia still struggle to obtain health insurance coverage. In fact, there are estimated 400,000 uninsured adults, many of whom are parents in the health insurance “coverage gap,” meaning that their incomes are too high to qualify for Medicaid but but too low to afford insurance on the federal exchange.

The 2016 General Assembly session begins tomorrow, and once again, policymakers have the opportunity to close the health insurance coverage gap. As child advocates, we think it’s important for policymakers to understand the great extent to which this decision affects parent, families and their children.  To explore this, we teamed up with The Commonwealth Institute and Georgetown University Center for Children and Families to co-release a paper, “Many Working Parents and Families in Virginia Would Benefit from Medicaid Coverage.” Key findings include:

  • 29% of adults in the health insurance coverage gap are parents with dependent children living at home.
  • More than 2/3 of these parents work outside the home, primarily in the retail, restaurant, construction or medical sectors.
  • Most of the families have one or two children (72%), are white (53%), and have school aged children (63%).

Read the full articland related story from the Richmond Times-Dispatch.

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COPN and the Gap

By Jeff Connor-Naylor - Commonwealth Institute

Some state lawmakers mistakenly believe that building a new clinic or installing new medical equipment will help the hundreds of thousands of Virginians stuck in the health coverage gap. They said as much at a press conference last week, where they asserted that altering or eliminating the Certificate of Public Need (COPN) system will somehow provide more people with care even if they lack health insurance.

That’s like saying more restaurants is the answer to hunger. But if you can’t afford to eat in any of them, it doesn’t matter how many there are.Cutting or eliminating COPN regulations on building new health care facilities or adding new, expensive equipment may increase the number of places providing healthcare services, but it won’t help the 230,000 Virginians in the coverage gap. That’s because they still can’t afford the health care offered in those brand-new facilities. 

Read the full article along with related Commweath Institute articles, "What's it Going to Take?" and "Closing the Gap Helps People in Every Legislative District."

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Hospital Merger

By Luanne Rife - Roanoke Times

In advance of merger filings, executives at far Southwest Virginia’s dominant hospital systems said they are “absolutely committed” to improving the health of people in the Appalachian communities they serve and to satisfying regulators by holding prices below the national average.

In a presubmission report, the two systems outlined a plan to spend $450 million over the next decade on improving the health of the people they serve, and made the case for why a merger is more beneficial than separate systems or merging with conglomerates from outside the area.

While the health systems pledge to keep their three advanced-treatment hospitals open, the report said the community hospitals in operation at the date of the merger “will remain operational as clinical and health care institutions for at least five years. … The new health system may adjust scope of services or repurpose hospital facilities. No such commitment currently exists to keep rural institutions open.”

Read the full article.

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National News

Rx Prices

From the Office of Senator Warner

Just before the holidays Senator Warner led a group of his Senate colleagues in writing to Centers for Medicare & Medicaid Services (CMS) Acting Administrator Andrew Slavitt concerning the rise in drug costs.

The letter, which you can find here and is also attached, is focused on exploring CMS’ existing authorities, especially around efforts to contain prescription drug costs, improve transparency, and better assess the effectiveness of treatments.

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Rural NPs

From Montana State University

New research by Montana State University professor Peter Buerhaus and others has found that nurse practitioners are more likely than medical doctors to practice in rural areas.

As part of the study, the researchers identified the geographic location of people in the United States who were newly eligible for health insurance coverage under the Affordable Care Act. They also identified the geographic locations of where primary care clinicians practice just before the launch of the insurance expansions in 2014. Finally, the researchers investigated whether geographic accessibility to primary care clinicians differed across urban and rural areas and across states with more or less restrictive scope-of-practice laws that affect nurse practitioners.

Read the full article.

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Insurance Discrimination

By Carol Miller - Daily Yonder

Not again! That was my first reaction to being asked to comment on the rural impacts of new rules coming out of the Centers for Medicare and Medicaid Services (CMS) in an 85 page letter titled Draft 2017 Letter to Issuers in the Federally-facilitated Marketplaces (PDF). At first glance it seemed to be just a technical publication of requirements for Qualified Health Plans participating in the Affordable Care Act. Anyone who lives outside of a Large Metro or Metro area should have major concerns about Table 2.1 (page 25 of the report). The table undoes more than 40 years of access standards for health care in one fell swoop.

People who purchase insurance through the federally facilitated marketplaces will assume that they are covered and will have access to care. The standards in Table 2.1 fail to provide reasonable access to the beneficiary.

Despite the [expired] comment deadline, there are still ways to improve these standards:

  • At local and state levels, state insurance commissioners can establish their own access standards for certifying qualified health plans in their state. Advocates can organize for standards that are equitable and provide actual access to care at the state level.
  • Nationally, rural and CEAC communities need to educate, organize, and demand that their representatives and senators guarantee them access to health care for all plans being offered in the Marketplace.
Read the full editorial.

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Nominate Your Colleagues!

Each year NRHA honors outstanding individuals and organizations who have dedicated their time and talents to improving the health and wellbeing of others.

Previous recipients have forged innovative programs, services and solutions while improving rural health delivery, education and research.

Nominate your favorite rural health professionals and students or programs and organizations by Feb. 11 so that they may be honored nationally for their contributions to rural health.

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Mark Your Calendar

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

February 9: USDA Rural Development Distance Learning and Telemedicine - Cedar Bluff
February 9: USDA Community Connect Program - Cedar Bluff
March 23 & 24: Rural Health Clinic Capstone Meeting - Blacksburg.
April 6-8: National Health Outreach Conference - Roanoke
April 10-12: Mid Atlantic Telehealth Resource Center Annual Summit - Cambridge, MD
April 25-26: National Reduce Tobacco Use Conference - Washington, DC

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“From Coal Town to Coast Line” - Virginians in the coverage gap by legislative district
The Commonwealth Institute for Fiscal Analysis
This in-depth report breaks down the number of people in each General Assembly and Senate district that would benefit from expanding healthcare coverage to all Virginians by triggering the federal dollars to expand Medicaid in our state.

Faces of Virginia’s Coverage Gap 
Story bank from Healthcare for All Virginians with compelling stories from six people who are in the coverage gap and access the quality, affordable healthcare they need because our General Assembly has not expanded coverage.

Virginia Population Estimates
Official population estimates for Virginia and its counties and independent cities to illuminate population counts between decennial censuses. These estimates, generally released at the end of January, provide the best approximation of the population count on July 1st of the prior year. Population estimates are an important tool used by a variety of state agencies in their planning processes — from developing budgets to determining salaries for public officials.

Thrive 2015
U.S. Department of Veterans Affairs (VA) Office of Rural Health’s annual report, provides an introduction to VA's rural priorities that focus on the increased health and well-being of rural Veterans. 

Best Buy Drugs 
A series of easy-to-read fact sheets about the safest and most affordable medications to treat specific conditions or illnesses. Topics include diabetes, heart disease, menopause, depression, and many others. Generic medicines, if available, were included in the analysis as well.

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Funding Opportunities

For funding opportunities without a specific deadline, please visit the VRHA Resources page
Nelson County Community Fund
Deadline: 06/30/2016
Providing grants to support nonprofit organizations working to improve quality of life in Nelson County. 

Distance Learning & Telemedicine Grants
The Distance Learning and Telemedicine program helps rural communities use the unique capabilities of telecommunications to connect to each other and to the world, overcoming the effects of remoteness and low population density. For example, this program can link teachers and medical service providers in one area to students and patients in another. 
Deadline:  March 14,2016

Policy-Relevant Insurance Studies 
The Affordable Care Act (ACA) expanded public and private coverage options, created online Marketplaces to foster competition among health insurance plans, and stimulated payment and delivery system reform efforts in an attempt to make health care more affordable, more accessible and of higher quality. The online Marketplaces provide an opportunity for consumers to shop for health insurance and potentially receive a tax credit. Yet, despite a significant reduction in the uninsured rate, millions of eligible individuals remain uninsured, many with important concerns about affordability. At the same time, a number of carriers are experiencing financial difficulties in these new marketplaces, while impending mergers among large carriers create concerns about the price effects of further consolidation in health care.  This call for proposals (CFP) will focus on empirical and policy–relevant analyses that address the issue of affordability of health insurance.
Deadline: February 19, 2016

Building Ryan White HIV/AIDS Program Capacity
Applications due March 22, 2016.
Community-based, faith-based and tribal organizations are among those eligible to apply for funding intended to build national capacity for Ryan White HIV/AIDS Program (RWHAP) recipients and engage People Living with HIV/AIDS (PLWH) to increase their access to health care.  Funded organizations will work with HRSA, CMS, the Centers for Disease Control and Prevention (CDC) and the Substance Abuse and Mental Health Services Administration (SAMHSA) to assess and disseminate best practices culturally appropriate methods for improving health outcomes of PLWH.

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