VRHA Weekly Update
In this Issue October 9, 2017

VRHA News Virginia News National News Mark your calendar
Funding Opportunities


Newsletter available




Social Determinants of Health

Social determinants of health (SDOH) are, according to the World Health Organization,  
“the circumstances in which people are born, grow up, live, work and age, and the systems put in place to deal with illness. These circumstances are in turn shaped by a wider set of forces: economics, social policies, and politics.”
Income-level, educational attainment, race/ethnicity, and health literacy all impact the ability of people to access health services and to meet their basic needs, such as clean water and safe housing, which are essential to staying healthy. Rural residents are more likely to experience some of the contributing social factors that impact health, such as poverty. The impact of these challenges can be compounded by the barriers already present in rural areas, such as limited public transportation options and fewer choices to acquire healthy food.

Come to the SDOH session at the Virginia Rural Providers Conference to discuss how we can address these barriers in our home communities.

Click the logo to the right for full event details.

South Boston, Virginia
October 25 & 26

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VRHA in the News 

From the Office of the Governor

The Commonwealth Commission on Diversity, Equity and Inclusion will hold its first meeting Tuesday, October 10, 2017. Established by Executive Order Number 69, the Commission will identify policy changes that can be made at the state level to combat intolerance, expand opportunity for all, and make Virginia more open and inclusive to people from every walk of life. Created in the wake of the violent white supremacist events on August 11th and 12th in Charlottesville, the Commission will also examine how people become radicalized and what steps can be taken to prevent political violence in the future.

VRHA Executive Director Beth O'Connor has been chosen to serve on the Commission.

Read the full press release.

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Members in the News 

From the Office of the Governor

Governor Terry McAuliffe announced more than $8.8 million in Community Development Block Grant (CDBG) funding for 15 projects in Virginia. This funding will support projects that improve health care access, water and sewer infrastructure, downtown revitalization, public safety, and housing rehabilitation in localities across the Commonwealth.

Included in the CDBG funding is $700,000 for Northampton County for the Eastville Community Health Center, which will be part of the VRHA member Eastern Shore Rural Health system.

Read the full press release.

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Virginia News

Merger Delay

By David McGee - Bristol Herald Courier

The proposed merger of two area health systems is delayed until Oct. 30 in Virginia after officials  sought and received a one-month extension. Mountain States Health Alliance and Wellmont Health Systems were expected to hear from Virginia Department of Health Commissioner Marissa Levine on their planned merger to become Ballad Health by September 30.

Tennessee officials approved the plan September 19th. Instead, MSHA and Wellmont met with the Southwest Virginia Health Authority and asked for the extension.

Read related articles from Johnson City Press.

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Opioid Crisis Funding

From the Office of the Governor

Governor Terry McAuliffe announced that Virginia has received two federal grants totaling $596,000 to fight the prescription opioid and heroin abuse epidemic. The two grants come from the U.S. Department of Justice, Bureau of Justice Assistance.

The grants will fund the development of a statewide plan focused on collaboration and enhanced data sharing between criminal justice and health agencies and will create a model to quickly identify and respond to specific areas with spikes in opioid use and overdoses. The funding will be administered by the Department of Criminal Justice Services (DCJS).

Read the full press release.

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Virginia House Candidates

By Alex Koma - Inside NOVA

Lee Carter, a Democrat running for a Manassas-area seat in the House of Delegates, is leading a crop of House candidates pledging to push for a state-level, single-payer healthcare system if they reach Richmond. Carter joined 15 other Democratic hopefuls in announcing the new initiative Oct. 2, which is aimed at radically reforming Virginia’s healthcare system to cover all of the state’s 8.4 million residents.

Carter acknowledges that the proposal will be quite the uphill battle, as it requires a substantial reordering of the state’s economy, on top of the healthcare changes — his plan would build a “two-tiered system,” ensuring basic insurance access for all Virginians under a government system similar to Medicaid and leaving a private marketplace for people seeking more expensive elective procedures or clinic visits.

Read the full article and related story from Mother Jones.

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National News

New Payment Models

By Jessica Seigel - National Rural Health Association

NRHA has responded to the Centers for Medicare and Medicaid Service’s (CMS) request for information on potential new payment models to be implemented at the CMS Center for Medicare and Medicaid Innovation (CMMI).  NRHA has long advanced the need for rural-specific and rural relevant models.  Rural populations and their providers of care are faced with challenges that cannot be ignored and are uniquely well suited for demonstration projects through the CMMI.

NRHA’s comments are attached here. As CMMI continues to accept stakeholder comments and suggestions, we encourage others to submit their comments here or by email (CMMI_NewDirection@cms.hhs.gov) prior to the deadline on November 20th. CMMI is seeking ideas for models in eight areas: increased participation in advanced payment models (APMs); consumer-directed care and market-based innovation; physician specialty; prescription drug; Medicare Advantage Innovation; state-based and local (Medicaid); mental and behavioral health; and program integrity models.

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Maternal Health

By Walecia Konrad - CBS News

An alarming new study by the Rural Health Research Center at the University of Minnesota shows a huge gap in a vital area of health services -- maternity care. Giving birth is becoming more complicated and potentially more dangerous for the 28 million women of childbearing age who live in America's rural counties, according to the report, which looked at the availability of obstetric services in 1,984 rural counties over a 10-year period. 

What does it mean to not have a hospital with obstetric services relatively nearby? For many women, it can mean a two-hour-plus car ride in labor to get to the nearest hospital for delivery. It also means the same long transportation times for prenatal doctor visits. 

Read the full article and related stories from Alabama Public Radio, Daily World, and Huffington Post.

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Hospice Expenses

By Tim Marema - Daily Yonder

Expanding the use of hospice services among rural residents in the last six months of their lives could reduce patients’ need for more expensive and inconvenient medical treatments, a new report suggests. About 44% of rural Medicare patients who died in the second half of 2013 used hospice services, according to the study. By comparison, just over half of urban Medicare patients at the same stage of life used hospice services.

Patients who use hospice services are less likely to visit a doctor’s office, be admitted to hospitals, or require an ambulance, the study said. That can save money and allow patients to spend less time going to and from appointments and undergoing exams and treatments.

Read the full article.

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No CHIP Renewal

By Dan Heyman - Public News Service

As Congress debates renewing the Children's Health Insurance Program, almost 9 million kids are at risk of losing their health care. The program, called CHIP, has traditionally had bipartisan support. But this year, the House and Senate missed an October 1 deadline to reauthorize it, and advocates say efforts have stalled over partisan bickering.

Kim Robinson, a program manager with the Southern Regional Office of the Children's Defense Fund, said if CHIP is not renewed, states could begin running short of funds by the beginning of 2018.

News reports said as of late last week, a bill to re-fund CHIP had passed out of committee in the Senate. But in the House, Republican calls for changes in funding brought negotiations to a standstill. Democrats are refusing to support a GOP plan to take funds from the Affordable Care Act and Medicare to pay for CHIP.

Read the full article.

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Mark Your Calendar

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

October 24 & 25: Rural Health Documentation & Coding Bootcamp  - South Boston, VA
October 25 & 26: Virginia Rural Providers Conference - South Boston, VA
October 28: Rx Abuse Forum - Fishersville
October 29: Rx Abuse Forum - Lynchburg
November 2: 2017 Virginia Oral Health Summit - Richmond
November 12 & 13: Virginia Telehealth Network Summit - Richmond
November 15: Synthetic Narcotic & Opioid Abuse Prevention Summit - Abingdon

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Social Determinants of Health for Rural People
This guide focuses on the barriers and challenges that rural residents experience, discussing the impact of and documenting rural differences.

Opioid Prescribing: Pain Management in a New Era
Web based video course focuses on the management and current regulations associated with opioid prescribing in Virginia. All participants will need to register, then pay the registration fee of $50, watch the video presentation and complete the activity post test with a passing score of 80% in order to receive credit.

National Rural Oral Health Initiative 
The combined effort of the National Rural Health Association and the DentaQuest Foundation to improve oral health disparities in rural America through policy, communications, education and research. As oral health issues have long impacted those living in rural communities, the activities included in this initiative are designed to enhance access to quality oral health care.

Controlled Substance Public Disposal Locations
US Department of Justice searchable data base to determine where prescription medicals and other controlled substances can be discarded.

Rural Health Policy Topic Guide
How do we ensure access to affordable, high quality healthcare for our rural residents? How do we select Medicare and Medicaid reimbursement approaches that allow rural healthcare facilities to keep their doors open? How can we attract healthcare providers to rural communities? Questions like these, along with countless others, are the basis of rural health policy.

Opioid Use in Rural Areas
If you missed our Twitter chat on Opioid Use in Rural Areas,  a Storify that will allow you to catch up on what you missed. Gain insight and find resources shared by experts from around the country.

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Funding Opportunities

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

Home Depot Foundation
Accepting applications from nonprofit organizations using volunteers to address the physical needs of their communities. Through its Community Impact Grants program, the foundation will award grants of up to $5,000 (in the form of Home Depot gift cards that can be used to purchase tools, materials, and services) for projects aimed at repairing, modifying, weatherizing, or otherwise improving low-income and/or transitional housing or community facilities. Priority will be given to programs that use volunteers to serve veterans with home-improvement needs.  

Enhanced Training and Services to End Abuse in Later Life Program
Grants for training and services to address elder abuse, neglect, and exploitation, including domestic violence, dating violence, sexual assault, or stalking, involving victims who are 50 years of age or older.
Letter of Intent (Optional): Oct 25, 2017
Application Deadline: Nov 8, 2017 

Annie's Grants for Gardens
Offers grants to develop edible garden projects that help connect kids to nutritious food.
Application Deadline: Nov 11, 2017 

Community Food Projects Competitive Grant Program
Grants to plan or implement food projects designed to meet the needs of low-income individuals and increase community self-reliance concerning food and nutrition.
Application Deadline: Dec 4, 2017 

Building Trust and Mutual Respect to Improve Health Care
RWJF grant to fund empirical research studies to help us better understand how to build trust and mutual respect to meet vulnerable patients’ health care needs. For this CFP, we would define vulnerable populations in a number of different ways, including the economically disadvantaged, diverse racial and ethnic populations, the uninsured, older adults, homeless individuals, and people with complex health and social needs (including people with acute behavioral health needs or multiple chronic conditions). Proposals most closely aligned with the scope of this CFP will go beyond documenting the problem to generate findings that will be generalizable and have broad application across health systems and the field.
Deadline: October 13

NCOA Benefits Enrollment Centers
The National Council on Aging (NCOA) is currently accepting applications from qualified organizations to join their network of Benefits Enrollment Centers (BECs). BECs use person-centered strategies in a coordinated, community-wide approach to find and enroll Medicare beneficiaries—both seniors aged 65+ years and adults living with disabilities — who have limited income and resources into available benefits. Grants of up to $100,000 each will be awarded to selected organizations for an 18-month period beginning Jan. 1, 2018.
Proposals are due Wednesday, November 1, 2017

Healthy Places for Healthy People
Provides direct technical support for communities to work with healthcare facilities to promote preventive healthcare and help create vibrant, thriving communities.
Application Deadline: Oct 25, 2017 

Healthy Smiles, Healthy Children Access to Care Grants
Grants to support community-based initiatives that provide dental homes to children who are underserved and/or have limited access to oral healthcare.
Application Deadline: Dec 15, 2017 

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