VRHA Weekly Update
In this Issue October 16, 2017

VRHA News Virginia News National News Mark your calendar
Funding Opportunities


Newsletter available




Poster Picks!

Four student posters have been selected for presentation at the Virginia Rural Providers Conference. They are - 
  • Integration of Oral Health Care into Prenatal Care:
  • A Community Health Center Experience
  • Tobacco Smoking & Occupational Carcinogens Related to Prevalence of Lung Cancer in Southwest Virginia
  • Improving Incidence of HPV Vaccination Through Kinship Care Provider Educatio
  • Educational Strategies to Support Primary Care Providers to Improve Quality of Care

Posters will be on display and judged during the reception October 25th from 5:30-6:30.
Cash prizes will be awarded to the top three entries! 

October 25 & 26
South Boston, VA

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Bootcamp Deadline!

The registration for the Rural Health Documentation & Coding Bootcamp will close October 19th. 

  • With federal changesit has never been more important to make sure you are documenting and coding for 100% of what is done. Billing is not supposed to change – but if you aren’t documenting and coding correctly, revenue may be left on the table!  Increase revenue and reduce compliance risks.
  • We will present a detailed review of the AMA’s 2017 CPT Professional Edition from the perspective of rural health focusing on the services typically provided by rural providers. We will focus on the guidelines that appear before and after key coding sections that rarely are accessible to providers and coders/billers in their EHRs and encoder software.
  • We will limit the review of codes that will rarely or never be performed in community health – but will review the CPT cover to cover including guidelines, appendices, and modifiers with focus on level of visits and preventive services

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Members in the News

By Karlynn Wells - DVM.com

[VRHA member] Shenandoah Community Health Clinic has opened a much needed school-based clinic in Quicksburg. The clinic, located in Ashby Lee Middle School, will provide medical, dental and mental health services to children at no cost to families.  
The federal government has declared Shenandoah County an underserved area, meaning there aren't enough practitioners for those who need care. Clinic directors said they are excited to meet the needs of those who don't regularly see doctors due to cost and financial strains. 
"They didn't have transportation. They couldn't get to their medical appointments in Woodstock, so it worked out very well for us as a clinic as well, because we had been looking at this area and realizing there was a need here that we hadn't been able to meet," Pam Murphy, Executive Director, Shenandoah Community Health Clinic, said.

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Virginia News

CHC Funding Woes

By Kari Beal - WSET

Millions of low-income patients could be at risk of losing health care if Congress doesn’t act quickly.
“Around 3,000 of our patients are either under-served or are working poor,” Randy Pirtle, incoming CEO of [VRHA member] cBlue Ridge Medical Center said. “Those are the people that would be mostly affected.”
Congress missed the deadline earlier this week to re-authorize a funding bill for Community Health Centers. Those centers help serve patients who cannot afford coverage. If legislation isn’t passed soon, it could start impacting centers by the start of next year.

Read the full story and related article from the News & Advance.

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No Choice for Bedford

By Luanne Rife - Roanoke Times

Virginians who purchase individual health insurance not only will have fewer policy options at much higher prices, they might also need to switch doctors and hospitals. 

For people living in Bedford County who want to stay on the marketplace, there is only one insurer, Piedmont Community Health Plan. If you’re using doctors in Roanoke — say, Carilion or LewisGale — that’s going to be considered out of network.

When Anthem pulled out of Virginia and Optima announced it would provide coverage only where its Sentara-affiliated providers operate, Piedmont, a Centra Health affiliate, was left as the only insurer in its region for individual policies sold on and off the Affordable Care Act exchange. Anthem later agreed to re-enter the market but only to cover counties that would not have had any insurer, such as those in the Roanoke and New River valleys.

Read the full article.

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Insurance Costs

By Bill Bartel - Virginian-Pilot

The political brawls over the failed efforts to abolish key parts of the Affordable Care Act beg the question: How has the law – and the fight to repeal it – affected Virginians’ ability to obtain health insurance they can afford?

Should most Virginians worry that their health insurance is in jeopardy? Not according to multiple studies and experts.

Read the full article.

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National News

Executive Order

By Jessica Seigel - National Rural Health Association

President Donald Trump signed an executive order to allow small businesses to purchase what are known as “association health plans.” These plans are a form of insurance in which similar small businesses can group together through an association to negotiate health benefits. Association plans are not required to cover some serious medical conditions, and are overall less regulated than more traditional insurance plans.
The order also includes an expansion of short-term insurance policies, sometimes known as bridge policies, which are often available to individuals ineligible for other plans because of employment, age, or other factors. Under the Affordable Care Act (ACA), these plans only last 3 months; however, under President Trump’s Executive Order, they could be extended for up to a year. These plans often charge more to those who are very sick and need more coverage, and they are able to deny individuals with pre-existing conditions. Both association health plans and short-term policies have lower benefit requirements than are required under the ACA.
This is the administration’s largest step forward to change the market established under the ACA. NRHA is evaluating the effects this will have on the quality, affordability, and availability of healthcare on our members and on rural communities.

Read additional commentary from the American Hospital Association, Governor McAuliffe, The Hill

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Keeping Drugs in Stock

By Sarah Jane Tribble - NPR

Hospital pharmacist Mandy Langston remembers when Lulabelle Berry arrived at the emergency center of Stone County Medical Center in Mountain View, Ark., last year. Berry, 78, was having a severe ischemic stroke. So, Langston reached for the clot-busting drug Activase, which must be given within a few hours to work.

"If we don't keep this drug [in stock], people will die," Langston says.

Berry survived. But Langston fears others could die because of an unintended bias against rural hospitals built into the U.S. health law. An obscure Obamacare provision forces rural hospitals like Langston's to pay full price for drugs that many bigger hospitals buy at deeply discounted rates.

That has left rural hospital pharmacists and health care workers struggling to keep medicines in stock, and wondering if they will be able to adequately care for patients.

Read the full article.


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Rural Health Training Initiative 

From the National Rural Health Association

The VA’s Office of Academic Affiliations (OAA) and Office of Rural Health (ORH) are working together to conduct special education and training programs for health care students and residents to enhance the quality of care provided to veteran patients in its health system.

One signature program, the Rural Health Training Initiative (RHTI) was jointly developed by OAA and ORH. It enables health care professionals to spend part of their time at a rural VA facility working with patients under the supervision and guidance of a VA health care instructor. Through a mix of academic learning and hands-on in-person training at a VA medical center, students gain a better understanding of rural health care and the VA health care system. The interdisciplinary program’s focus includes geriatric health care, primary care, dental health, mental health and telehealth.

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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Sliding Fee Scale Discount Guide for Critical Access Hospitals and Rural Health Clinics 
In cooperation with the Federal Office of Rural Health Policy, the Sliding Fee Scale Discount Guide for Critical Access Hospitals and Rural Health Clinics has been updated with new information as well and details relevant to rural health clinics.

Webinar Recording Available: Financial Distress and Closures of Rural Hospitals
Since 2005, 122 rural hospitals have closed - 80 since 2010. George Pink, PhD, from the North Carolina Rural Health Research and Policy Analysis Center presented updated and new data about closed rural hospitals and their post-closure disposition. A model predicting financial distress and closure in rural hospitals was also described. Characteristics of hospitals at high risk of financial distress were identified and trends in risk of financial distress among rural hospitals analyzed.

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Funding Opportunities

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

Rural Health Care Services Outreach Grant Program
Grants to support projects that will enhance and sustain the delivery of effective healthcare in rural communities. The overarching goals for the program are to: Expand the delivery of healthcare services to include new and enhanced services exclusively in rural communities; Deliver healthcare services through a strong consortium, in which every consortium member organization is actively involved and engaged in the planning and delivery of services; Utilize and/or adapt an evidence-based or promising practice model(s) in the delivery of healthcare services; Improve population health, and demonstrate health outcomes and sustainability. Awards will be up to $200,000/year for 3 years.
Application Deadline: Dec 6, 2017

People With Disabilities Foundation
The mission of the People With Disabilities Foundation is to provide education and advocacy for people with psychiatric or developmental disabilities so that they can achieve equal opportunities in all aspects of life. The Foundation's pilot grant program aims to help nonprofit organizations in their work to integrate people with psychiatric or developmental disabilities into the whole of society by providing advocacy, education, vocational, or other services. Grants may be used for a specific program, project, or general operating expenses if related to a specific project or program. This pilot program will award smaller grants in the range of $5,000 to $12,500, with a goal of future program expansion.
The deadline for letters of interest is November 6, 2017. 

KidsGardening.org: Youth Garden Grants
KidsGardening.org, a national nonprofit dedicated to providing inspiration and support for parents and educators who are gardening with children, awards Youth Garden Grants to support school and youth educational garden projects that enhance the quality of life for students and their communities. Any nonprofit, school, or youth program planning a new garden program or expanding an established one that serves at least 15 youth between the ages of three and 18 is eligible to apply. The top five programs will receive award packages valued at $1,600. Twenty programs will receive award packages valued at $600. The selection of winners is based on demonstrated program impact and sustainability.
The application deadline is December 8, 2017. 

Southern Partners Fund: Discretionary Fund
The Southern Partners Fund was created to give voice and opportunity to marginalized and underserved communities and families in the rural south (including Virginia). To address this mission, grants are provided through the Discretionary Fund to facilitate grassroots community organizing for economic, social, and environmental justice in rural communities in the Southeastern states. Discretionary support includes grants of up to $1,500 for capacity building, community organizing events or activities, and voter engagement activities.
Applications are accepted via email at programs@spfund.org on the 28th of each month.

Community Food Projects Competitive Grants Program
Funds two types of grants, Community Food Projects and Planning Projects. The primary goals of the Community Food Projects Competitive Grants Program are to: Meet the food needs of low-income individuals through food distribution, community outreach to assist in participation in Federally assisted nutrition programs, or improving access to food as part of a comprehensive service; Increase the self-reliance of communities in providing for the food needs of the communities; Promote comprehensive responses to local food access, farm, and nutrition issues; and Meet specific state, local or neighborhood food and agricultural needs including needs relating to: Equipment necessary for the efficient operation of a project; Planning for long-term solutions; or The creation of innovative marketing activities that mutually benefit agricultural producers and low-income consumers.
Deadline: December 4

Rural Capacity Building for Community Development and Affordable Housing Grants
Grants to fund national organizations that can provide technical assistance to local communities. Assistance will be targeted to help communities create thriving community development and affordable housing strategies that will result in healthier homes and communities.
Application Deadline: Dec 7, 2017 

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