VRHA Weekly Update
In this Issue  February 27, 2017

VRHA News Virginia News National News Mark your calendar
Funding Opportunities



February Newsletter





By Andrew Shedlock - Collegiate Times

Opioid abuse has become an epidemic throughout rural America in the past decade. In 2015, over 20,000 Americans died due to overdosing on prescription pain relievers out of the 50,000 who died due to drug overdose (via data provided by the Centers for Disease Control). Toward the end of November 2016, Gov. Terry McAuliffe declared that the opioid addiction crisis in Virginia had become a public health emergency.

On Thursday, Feb. 16, the Virginia Rural Health Association at Virginia Tech held a conference focused on the growing opioid epidemic in rural Virginia. The conference began with a personal anecdote written by a Virginia Tech student describing the pain and damage her family experienced caused by her father’s opioid addiction. 

Read the full article.

Congratulations to the VRHA @ VT Student Club on hosting a successful event!

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Members in the News

By Amy Trent - News & Advance

Centra plans to spend about $4 million to renovate [VRHA member] Bedford Memorial Hospital’s emergency department. Although the plans are not finalized, Centra expects to begin work in June 2017, according to Centra spokeswoman Diane Ludwig.

Speaking at a Bedford Hospice House fundraiser last week, Centra CEO E.W. Tibbs said Centra has been investing steadily in the hospital since taking full ownership in July 2014.

Read the full article.


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More Members in the News

By Bill Wadell - Virginia First

At his farm in Pulaski County, Bill Ray told WFXR News that he has no plans of slowing down at the age of 79. The farmer is still able to get around, even with glacoma, a heart condition and issues from Polio as a child.

Ray found some help from [VRHA member] AgrAbility Virginia, a program that helps farmers with illnesses, injuries or a disability.

Kirk Ballin and Dr. Kim Niewolny work on the AgrAbility team, which has helped 20 farmers across the commonwealth over the past year.

Read the full article.

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Virginia News

Studied to Death

By Chad Stewart - Commonwealth Institute

Today, from a national stand-point, Virginia is recognized as having a mental health system with results well below the national average. Mental Health America ranks Virginia 45th out of all states for mental health services and outcomes for youth, and 38th overall. Despite being a top 10 state for median household income, Virginia is stingy when it comes to mental health spending, ranking 31st in per capita expenditure out of all states.

Virginia has, however, done a good job studying its mental health system in recent decades. In fact, there have been at least 250 state-sponsored studies relating to the mental health system since 1970 that have been presented to the General Assembly. Major reports commissioned since 1970 have largely come to similar conclusions: the commonwealth’s mental health system has serious gaps and requires more funding to improve services and outcomes.

Responding to the recommendations from these studies would require consistent and sustained support from the state. And looking at the changes to mental health spending over the past decade, Virginia has had an inconsistent record. For example, one year after the 2007 Virginia Tech shooting, the legislature committed $42 million over the 2009 and 2010 biennium to expand community-based mental health services throughout the commonwealth. However, most of this funding was quickly rescinded when the recession hit. 

Read the full article.

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The Cost of Repeal

By Katie Demeria - Richmond Times-Dispatch

A blanket repeal of the Affordable Care Act could cause millions of dollars worth of public health funding to hit the chopping block, leaving the Virginia Department of Health more than $20 million short.

While most of the focus around the ACA’s repeal has been on what such a move would do to the country’s uninsurance rate, little attention has been placed on the public health dollars wrapped up in the 2010 health law.

“In the zest to repeal ACA, we uncovered, with a lot of our colleagues from around the country, that there were programs subsumed into the ACA that actually existed well back to the Reagan administration that supported this public health infrastructure,” Virginia’s Health Commissioner Dr. Marissa J. Levine told the House Appropriations Health and Human Resources subcommittee during a presentation recently.

Read the full article and related story from WSLS.

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OB Closure

From Tidewater News

Southampton Memorial Hospital announced that it will close obstetric services effective on Sunday, April 30.  According to Kimberly W. Marks, CEO, this decision will allow the hospital to remain a sustainable healthcar provider for both Franklin and the surrounding community it services.

There has been a stead decline in the number of  families who choose SMH as their provider for childbirth.  On average, there have been approximately 165 birth each year for the past five years at the hospital.  This equates to about one baby born every two days.  in 2016, only 140 babies were bord the SHM.

Read the full article and related story about the issue nation-wide.

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National News

Mega Guidance Withdrawal

By Diane Calmus - National Rural Health Association

The Office of Management and Budget (OMB) withdrew a pending regulations originally released in August of 2015 that included sweeping changes to the 340B drug program, known as the “Mega Guidance.” NRHA submitted comments to the proposed mega guidance in September of 2015 expressing multiple concerns with the guidance for rural providers and patients that rely on the 340B program.

The withdrawal of this guidance will provide relief to the 1,100 rural hospitals that are part of the 340B program and ensure vulnerable patients have greater access to necessary and affordable medications. NRHA is please the Administration removed these burdensome regulatory changes before they hurt rural hospitals that are already facing financial struggles in order to continue to serve their patients and communities.

This move is in light with President Trump’s campaign promise to reduce regulatory burdens. This week President Trump also signed an executive order requiring the elimination of two regulations for every one new one adopted. NRHA has been working with the Administration on eliminating a list of regulatory burdens specifically harming rural providers including the 96-hour rule and therapy supervision requirements.

However, the fight to ensure continued access for rural hospitals to the 340B program continues. NRHA and 340B health ask that you contact your lawmakers to protect rural hospital access to 340B in the event of an ACA repeal.

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Protecting Access

From the Office of Senator Wicker

U.S. Senators Roger Wicker, R-Miss., Jon Tester, D-Mont., Chuck Grassley, R-Iowa, and Heidi Heitkamp, D-N.D., were joined by 37 Senators in sending a letter to Department of Health and Human Services (HHS) Secretary Tom Price regarding health care in rural America.

The letter emphasizes the importance of rural health-care providers and their critical role in rural communities. The letter reads, in part, “As you take on this new leadership role at HHS, we request that you work with us to ensure that the federal government does not act as an impediment to providing health care in rural communities. Overreaching and onerous regulations from Washington disproportionately harm rural America. We believe that together we can enact and implement effective policies that help providers innovate in care delivery and enable them to make efficient use of available resources.”

Read the full press release.

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Selling Opioids

By Phil Galewitz - Kaiser Health News

Manchester, KY is an economically depressed city in the foothills of the Appalachian Mountains is an image of frozen-in-time decline: empty storefronts with faded facades, sagging power lines and aged streets with few stoplights. But there is one type of business that seems to thrive: pharmacies.

Eleven drug stores, mostly independents, are scattered about a tiny city of 1,500 people. Many have opened in the past decade — four in the past three years. And prescription pain drugs are one of the best-selling items — the very best seller at some.

Most pharmacies here and in surrounding Clay County (population 21,000) lack the convenience-store trappings of national chains like CVS or Walgreen’s. They sell few items over the counter, focusing on prescriptions and little else.

Read the full article.

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Did You Get a Turkey?

Edwin Leap - Daily Yonder

When physicians work in rural areas, we become comfortable with certain behaviors and patterns of injury. When a man walks in with dozens of tiny holes in his back, in April, the standard question is, “Did you get a Turkey?” Falls from tree-stands elicit appropriate queries like, “Were you knocked out, does your neck or back hurt?” and the slightly accusing, “Were you wearing a safety harness?”

Thanks to rural life and work, I know what a log-skidder is, and what it means to hear that a tree or saw “kicked back.” I know to be very worried when I hear that the local rodeo is sending someone kicked in the face by a horse, and I was not surprised to see a man who shot himself in the leg while re-holstering his .44 Magnum after killing a wild hog.

The challenges of the rural ER, however, extend beyond pathology and into problems with resources. We have few specialists. A rural hospital with a decent ER, some family physicians, an obstetrician and a general surgeon is rich indeed. Typically there is no cardiologist, no neurologist, no pediatrician, no trauma team; no heart center, no stroke center.

Read the full article.

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Mark Your Calendar

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

March 2: Livability in Action Regional Exchange - Christiansburg
​March 13: Utilizing Virginia Medicaid's Addiction and Recovery Treatment Services -    ​ Winchester​
March 15: Utilizing Virginia Medicaid's Addiction and Recovery Treatment Services - Harrisonburg​
March 16: Oral Health Care Access for Individuals with Special Health Care Needs - Woodbridge
March 17: Utilizing Virginia Medicaid's Addiction and Recovery Treatment Services  - Roanoke
March 20: Utilizing Virginia Medicaid's Addiction and Recovery Treatment Services  - Radford
March 22: Utilizing Virginia Medicaid's Addiction and Recovery Treatment Services  - Wise
March 24: Utilizing Virginia Medicaid's Addiction and Recovery Treatment Services  - Abingdon
March 27: Utilizing Virginia Medicaid's Addiction and Recovery Treatment Services  - Martinsville
​March 29: Utilizing Virginia Medicaid's Addiction and Recovery Treatment Services  - Richmond
March 29-30: 2017 Population Health Summit - Charlottesville
March 31: Utilizing Virginia Medicaid's Addiction and Recovery Treatment Services  - Charlottesville
April 2-4: MATRC Telehealth Summit - Leesburg
May 9-12: 40th Annual Rural Health Conference - San Diego, CA
May 9-12: Rural Hospital Innovation Summit - San Diego, CA

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New Beginnings: A Discussion Guide for Living Well with Diabetes  
Helps diabetes support group leaders facilitate discussions about the emotional aspects of living with diabetes. It uses stories about African Americans with diabetes to help identify family and social support needs and develop skills to address them. New Beginnings can be used to supplement diabetes self-management education sessions and in diabetes support groups.

Capital Funding for Rural Healthcare
This guide has been updated to include new information and frequently asked questions related to capital funding for rural facilities. Find resources to help you run a successful capital campaign, as well as funding sources that support capital projects.

Model Program: Addiction Recovery Mobile Outreach Team (ARMOT)
The Addiction Recovery Mobile Outreach Team provides case management and recovery support services to Pennsylvanians with substance use disorders and works to reduce stigma through education. The program, also featured in a brief video, has made 254 referrals in its first 18 months of service. 

Health-Related Behaviors by Urban-Rural County Classification – United States, 2013
This is the first documentation of differences in health behaviors between urban and rural populations in the U.S.  Rural residents are “recognized as a health disparity population because the prevalence of disease and rate of premature death are higher than the overall population of the United States.”  

Rural Healthcare Workforce
This recently updated guide covers a wide range of issues related to the healthcare workforce in rural areas, including supply and demand, workforce distribution, characteristics of the rural healthcare workforce, strategies to meet workforce needs, and more.   

CMS Medicare Learning Network:

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Funding Opportunities

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

Project ECHO© 
The Virginia Department of Health Office of Health Equity and Office of Family Health Services is accepting proposals from academic institutions for serving as a Project ECHO© teleconsultative site for a newly designed project ECHO for the Commonwealth.  This project will aim to build the capacity of providers in the Commonwealth to provide Medication Assisted Treatment and addiction disease management integrated care for patients and families, primarily in underserved and rural areas.   Required strategies will align with national and state priorities related to reducing deaths and hospitalizations related to opioid and substance misuse and resulting adverse health consequences.   
Deadline: March 1

Drug Free Communities Support Program
Awards funding to coalitions working to reduce substance abuse among youth and to establish and strengthen collaboration among communities.
Geographic coverage: Nationwide
Application Deadline: Mar 15, 2017 

Migrant Health Scholarship
Offers scholarships to individuals pursuing or continuing their career in the migrant health field, thus contributing to the development of Community/Migrant Health Center workforce.
Application Deadline: Mar 24, 2017 

NHSC Loan Repayment Program
Primary care medical, dental and behavioral health clinicians can get up to $50,000 to repay their health profession student loans in exchange for a two-year commitment to work at NHSC-approved sites in high-need, underserved areas.
Applications due April 6, 2017.

Broadband Service for Rural Communities
The U.S. Department of Agriculture (USDA) will grant ten rural communities awards ranging from $100,000 to $3 million to fund broadband services for public and private use.  Grant funds may be used to: (1) deploy service at the Broadband Grant Speed to critical community facilities, rural residents, and rural businesses, (2) construct, acquire, or expand a community center, and/or (3) equip a community center that provides free access to service to community residents for at least two years.   
Deadline: March 13

Policies for Action: Policy and Law Research to Build a Culture of Health
A RWJF program created to help build the evidence base for policies that can help build a Culture of Health. P4A seeks to engage long-standing health care, mental and behavioral health, and public health researchers, as well as experts in areas that we recognize have strong influence on health, well-being and equity—such as labor, criminal justice, education, transportation, housing, and the built environment.
Deadline: March 10

The Harold Amos Medical Faculty Development Program
Offers four-year postdoctoral research awards to increase the number of physicians, dentists, and nurses from historically disadvantaged backgrounds who are committed to: developing careers and achieving senior rank in academic medicine, dentistry, or nursing; fostering the development of succeeding classes of physicians, dentists, and nurses from historically disadvantaged backgrounds; improving the health of underserved populations; and/or working toward understanding and eliminating health disparities by achieving senior rank in academic medicine, dentistry, or nursing.
Deadline: March 15

Charles A. Frueauff Foundation Grants
Awards grants in the areas of education, human services, health, and hospitals. Specific project initiatives include food and hunger; economic development; daycare programs; hospital and healthcare agencies; health screenings; health education; AIDS/HIV prevention and education; and equipment for healthcare facilities.
Geographic coverage: Available in 27 states, including Virginia.
Application Deadline: Mar 15, 2017 

Hillman Innovations in Care Program
Provides funds for nurse-driven models of care focused on patient- and family-centered approaches that challenge conventional strategies, improve health outcomes, lower costs, and enhance patient and family caregiver experience.
Application Deadline: Mar 20, 2017 

Foster G. McGaw Prize for Excellence in Community Service
Honors healthcare delivery organizations that have demonstrated exceptional commitment to community service.
Application Deadline: Apr 7, 2017 

Prevention of Opioid Misuse in Women
welve public and/or private non-profit entities will be awarded up to $100, 000 for cooperative agreements with the U.S. Department of Health & Human Services (HHS) to develop programs that prevent the misuse of opioids by women.  Projects must include collaboration among local and regional organization and target gaps in reaching underserved populations, particularly girls aged 10-17 and women aged 50 and older. For projects targeting the health professional audience, applicants may want to consider using the Screening, Brief Intervention, and Referral to Treatment (SBIRT) approach to substance use disorders.
Deadline: April 7


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