Virginia Rural Health Association - Weekly Update
VRHA Weekly Update
In this Issue  September 8, 2015

VRHA News Virginia News National News Mark your calendar
Funding Opportunities

GIF logo 2

VRHA Annual Conference
October 13 & 14
Staunton, VA





Deadline #1

The 2015 VRHA Conference will be held at the Stonewall Jackson Hotel & Conference Center in Staunton, VA

Rooms are set aside at the discounted (government) rate of $89/night (+ tax, fees & parking) for the conference. You must reserve by September 12th to ensure a room at this rate.

Reserve a room online or call 540-885-4848 and ask for the VRHA Conference rate.  Click the logo above for event details.

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Deadline #2

VRHA Conference Registration
Registration fees for the full event is $215 for VRHA members and $270 for the general public.

Note:  this rate will increase to $245 for members and $295 for the general public after September 14. Click here to register.

STUDENTS: If you are a current VRHA member, you are eligible for a discounted rate.$120 for the full conference, $80 for Thursday only and $40 for Friday only.  

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Members in the News

By Amy Trent - News & Advance

The last stroke victim brought to [VRHA member] Bedford Memorial Hospital had a complete brain scan in less than 20 minutes, and within 56 minutes they had been treated.

“I believe that word is getting out there that you can come to Bedford for this type of service,” Bedford Memorial Hospital’s Stacey Hopkins said last week, a little more than a year after Centra assumed full control of the hospital and began implementing a host of changes.

One resource in particular — telehealth technology — has significantly improved care for stroke victims and patients needing mental health services. The technology allows patients and providers to consult with off-site specialists live via video conferencing.

Read the full article.

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Virginia News

The Golden Years

By Rebecca Park - Commonwealth Institute

Kentucky and West Virginia are seeing huge drops in the number of people without health coverage while Virginia’s rate has barely budged, according to recent data. That’s because those states have taken the common sense approach of helping their residents - like those nearing retirement but not yet 65 - get the care they need to stay healthy and productive.
Meanwhile, in Virginia, 62,000 adults aged 50 to 64 are among those still stuck in the coverage gap, according to Virginia’s branch of AARP, because Virginia lawmakers stubbornly refuse to close that gap even though the health of their constituents and the state’s finances would be better off.

And as for those 62,000 Virginians nearing retirement age, by the time they reach 60, about 70 percent will have been diagnosed with one or more chronic health conditions and nearly half will have two or more. Closing the coverage gap would improve these adults’ ability to get such preventive care as routine doctor and dental visits as well as cancer screenings. By staying healthy and getting the care they need, they can continue to wear multiple hats as a worker, a community citizen, a parent or grandparent, a spouse, and a friend. But with declining health and being unable to afford medical treatment, they are instead at risk for severe financial stress and unmet health care needs as they prepare for their golden years. 

Read the full article.

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Take the Survey!

Supported by the Southwest Virginia Health Authority, Healthy Appalachia Institute is working with the Virginia Department of Health and regional partners to update the Blueprint for Health Improvement and Health – Enabled Prosperity. Originally published in 2009, the Blueprint has galvanized the region into action, increasing awareness and progress toward improving population health in Southwest Virginia. 
Please consider taking this 10 minute Community Themes and Strengths Assessment survey to identify strategic issues and inform the formation of goals and strategies to improve health in the region. Gathering input from community members throughout Southwest Virginia, this survey will be used to develop a strong understanding of community concerns, strengths, assets, and perception of quality of life.
Take the survey:

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Close to Home

By Mary Katherine Wildeman - News & Observer

At the height of her panic attacks, Mildred Fuller lay with her baby on the floor, hands pinned beneath her body and hearing voices. She was paralyzed by anxiety after giving birth to her fourth child 16 years ago. She had seen a news segment about a Durham woman who hurt her own children, and she was afraid she might do the same. Realizing she needed help, Fuller checked herself into a hospital.

The Mobile Medication Program, run by the behavioral healthcare provider Daymark Recovery Services and coordinated by the N.C. Hospital Association, ensures that people at risk of psychiatric hospitalizations understand and stay on track with their medications. The program is run by a team of three — one nurse and two technicians. They travel from home to home in Vance County, and specialize in helping people with mental illness with their medications.

Read the full article.

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National News

Hospitals Need Your Help!

The National Rural Health Association encourages you, and all rural health leaders across the country, to contact their member of Congress and urge them to cosponsor HR 3225, the Save Rural Hospitals Act.

HR 3225 will stop the flood of rural hospital closures by ending Medicare cuts to rural hospital and eliminating burdensome regulatory requirements. The bipartisan bill also offers a path forward for rural hospitals that may still continue to struggle by allowing them to transform into an innovative new payment model that fits the unique delivery needs of a rural community.

This is urgent. Fifty-seven rural hospitals have closed, and 283 additional hospitals on the brink of closure.

NRHA asks you to visit the district office, attend town hall meetings and invite your member of Congress to tour your rural facilities. Explain to them how important your hospital is to the patients you serve and the rural economy. Don’t wait. HR 3225 will eliminate millions in Medicare dollars that have been cut from your hospital. America’s rural safety net hospitals needs this bill passed now.

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Hospital #57 Closes

From the Washington Times

Nye Regional Medical Center in Tonopah, NV closed August 21st. The 10-bed hospital, the 57th rural hospital to close since 2010, was the only one in a 100-mile radius, providing emergency and inpatient care as well as laboratory, radiology, respiratory and outpatient services. 

Read the full article.

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Therapy by Phone

By Lisa Gillespie - Daily Yonder

Therapy provided over the phone lowered symptoms of anxiety and depression among older adults in rural areas with a lack of mental health services, a new study shows. The option is important, one expert said, because seniors often have increased need for treatment as they cope with the effects of disease and the emotional tolls of aging and loss.

Yet many seniors could face barriers getting that therapy because Medicare has stringent requirements for eligibility for these kinds of phone therapies, according to Eric Lenze, a psychiatrist and professor at the Washington University School of Medicine, who wrote an editorial accompanying the study. Lenze argued that phone therapy is a good alternative to drugs that are often prescribed for anxiety and depression but can make seniors sleepy and disoriented and lead to injuries.
He said he treats some geriatric patients who drive from 100 miles away and doesn’t offer phone sessions because of the payment issue. Medicare only pays for telehealth services done in rural areas with provider shortages; patients cannot do a phone call in their home, but must drive to a physician’s office or hospital to connect with the mental health professional at another site, he said.

Read the full article.

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Rural Publications

Adult Dental Benefits in Medicaid: Recent Experiences from Seven States 
Oral health is an important part of overall health, however, access to dental coverage for low-income adults remains a challenge, particularly since these benefits are optional for state Medicaid programs. This brief summarizes policy lessons from seven states (California, Colorado, Illinois, Iowa, Massachusetts, Virginia, and Washington) that have recently added, reinstated, or enhanced their Medicaid adult dental benefits. These states took a variety of approaches—including incrementally extending benefits to populations like pregnant women—and all attempted to do so in a fiscally sustainable way that provides meaningful access for program enrollees. Important factors in their decisions included funding opportunities through the Affordable Care Act, personal engagement by high-level state policymakers, building on lessons from improvements to children’s access to dental care, and strong partnerships with dental associations and oral health coalitions.

Breast Cancer Patients in Appalachia
Approximately 31 percent of patients were non-adherent to adjuvant endocrine therapy, and 30 percent were non-persistent during an average follow-up of 421 days. Overall, patients receiving catastrophic insurance coverage were three times more likely to adhere to their adjuvant endocrine therapy, and also had a 44 percent lower risk of discontinuing therapy.

Grandparent caregiving among rural African Americans in a community in the American South: challenges to health and wellbeing
The United States is a leader in grandparents raising children. What challenges are African American grandparents facing in rural America?

Impact of rurality on maternal and infant health indicators and outcomes in Maine
Do rural variations matter with regard to infant mortality? Researchers in Maine examine 11 years of data in the state of Maine by rurality tier.

Rural health activism over two decades: the Wonca Working Party on Rural Practice 
Rural health care faces serious, yet similar challenges around the world. This paper describes the international advocacy and leadership shown by the WONCA Working Party for Rural Practice to advance the health of the world's rural people. Much has been achieved in the past two decades, but there is still much more to do.

Portable power supply options for positive airway pressure devices
Sleep deprivation can be debilitating among CPAP users in remote areas with lack of electricity or in areas of frequent power outages. Knowledgeable primary care physicians can help sleep apnea patients improve treatment compliance to mitigate morbidity and long term complications.

Rural-urban difference in female breast cancer diagnosis in Missouri
Are place and race important considerations with regard to breast cancer outcomes?

Prehospital Emergency Medical Services Personnel in Rural Areas
This study uses a survey of all ground-based prehospital emergency medical services (EMS) agencies in nine states (AR, FL, KS, MA, MT, NM, OR, SC, WI) to examine supply and demand for emergency response personnel, the involvement of medical directors, and the availability of medical consultation, in rural and urban agencies. Compared with urban EMS agencies, rural agencies had lower staff skill levels, higher reliance on volunteers, higher vacancy ratios, and less access to oversight and skill maintenance through regular interaction with a medical director and online medical consultation during emergency calls. Agencies in isolated small rural areas were the most distinct from other rural and urban agencies, having the most volunteers (both EMS providers and medical directors) and paid staff vacancies. 

Do rural and urban women experience differing rates of maternal rehospitalizations?
Readmission rates are being used to measure "quality" but the measurements can vary due to other factors such as patient factors rather than care factors. Women's health care offers the opportunity to look at low risk and higher risk conditions. Do rural hospitals have higher or lower readmission rates?

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Mark Your Calendar

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

September 8-10: National Rural Assembly - Washington, DC
September 29-30: Rural Health Clinic Conference - Kansas City, MO
September 30-October 2: Critical Access Hospital Conference - Kansas City, MO
October 13-14: VRHA Annual Conference - Staunton
October 15: REVIVE! Training of Trainers - Staunton
December 3: TCI Policy Summit

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Prevalence of Opioids and the Workforce to Provide Treatment in Rural Settings
An overview of research on opioid use, workforce, and availability of treatment in rural and urban settings followed by a Q&A session.

National Center for Health Workforce Analysis
To produce a health care workforce of sufficient size and skill to meet the Nation’s health care needs requires complete data on the current health workforce and a profound understanding of how changes in population will affect future demand. The National Center for Health Workforce Analysis helps to build that body of knowledge by estimating the supply and demand for health workers in the U.S. and developing tools and resources to inform decision-making on health care workforce investments. 

Chartbook on Rural Health Care
The chartbook puts a rural lens on more than 250 measures – including access to health care, affordability, and leading causes of morbidity and mortality - found in the agency’s National Healthcare Quality and Disparities Report (QDR) released earlier this year.  

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Funding Opportunities

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

Cross-Jurisdictional Sharing Implementation and Impact Measurement Program
The Robert Wood Johnson Foundation will provide support for state and local government agencies, tribal groups, and nonprofit organizations to participate in the Cross-Jurisdictional Sharing Implementation and Impact Measurement Program. The goal of this initiative is to better understand the impact of cross-jurisdictional sharing among public health agencies.

AHRA and Toshiba Putting Patients First Program
The AHRA (Association for Medical Imaging Management) and Toshiba Putting Patients First Program seeks to improve pediatric and adult patient care and safety in diagnostic imaging. In 2015, the program will provide six grants of up to $7,500 each to single-site hospitals and imaging centers located in the United States. Three grants will be awarded for projects that improve the safety and comfort of pediatric imaging and three grants will be awarded for projects that improve overall patient care and safety in imaging. In addition, one grant of up to $20,000 will be awarded to an Integrated Delivery Network (IDN) or hospital system for projects that improve overall patient care and safety in imaging implemented across the IDN/hospital system. The projects funded by these grants will be used to create a best-practices tool to share with other hospitals and institutions. The application deadline is October 13, 2015.

Accelerating change in medical education
The American Medical Association has an open request for applications (RFA) from MD- and DO-granting medical schools in the United States. We’re looking for schools with the interest and capacity to promote and adopt new models in medical education.
Proposals are due Sept. 16, 2015

Exploratory and Developmental Grant to Improve Health Care Quality through Health Information Technology (IT) (R21)
Application deadline: Nov 17, 2016
Awards funding for research related to projects on health information technology projects. Funding may be used for pilot/feasibility studies, data analysis, or economic analysis.

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Blacksburg, VA 24060

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