Virginia Rural Health Association - Weekly Update
VRHA Weekly Update
In this Issue  July 11, 2016

VRHA News Virginia News National News Mark your calendar
Funding Opportunities


July newsletter





The Future of Rural Health

Featured speaker for the VRHA Annual Conference will be Brock Slabach, Senior Vice President of the National Rural Health Association

Health care is undergoing rapid change which presents significant opportunities and challenges for rural providers and the communities they serve. This session will review federal policy from a rural lens and present effective strategies for leaders to consider in response.

The VRHA Conference will be in Abingdon October 19 & 20.  Click the logo for event details.
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Members in the News

By Ashlie Walter - News & Advance

[VRHA member] Blue Ridge Medical Center wants to open an office in Appomattox County to serve its “high need” populations. It has operated a center in Nelson County, halfway between Lynchburg and Charlottesville, for about 45 years.

The center offers family practice, pediatrics, behavioral health services, dentistry, a pharmacy, physical therapy, x-ray services, laboratory testing and community-based services such as mobile clinics, home visits, case management, medication assistance, health education groups, transportation and a Latino Outreach Program. In a presentation to the Appomattox County Board of Supervisors, Chief Executive Officer Peggy Whitehead said if BRMC was to open a satellite office in Appomattox, it would offer the same services.

Read the full article and related story in the Times-Virginian.

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Virginia News

Opioid Epidemic Funding

From the USDA

Agriculture Secretary Tom Vilsack announced five Distance Learning and Telemedicine (DLT) grant awards to help provide treatment for the growing opioid epidemic in rural central Appalachia. Vilsack made the announcement as he hosted a town hall in Abingdon to address the opioid crisis in rural America, the first in a series. In January, President Obama tasked Secretary Vilsack, who is chair of the White House Rural Council, with leading a federal interagency effort focused on rural opioid use. 

USDA awarded over $587,000 to Virginia telemedicine projects that will provide health care services in rural areas, including mental health and drug addiction treatment. A grant of $434,182 will help the Carilion Medical Center deliver health care in 12 rural counties in southwest Virginia, including 18 sites—15 of which are in StrikeForce counties. A $153,082 grant will help the Rectors and Visitors of the University of Virginia invest in an advanced system to provide 11 rural community care centers with access to care that will serve 9 StrikeForce Counties. Two mobile health units will canvass 6 of these counties to provide on-site care and telemedicine video conferencing with doctors and specialists. 

Read the full article, related press release from the Office of the Governor and click here to find out more about USDA Rural Development's work to improve the health of rural Americans.

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Expansion Benefits

From Public News Service

States that expand Medicaid are seeing benefits across their health-care systems and beyond, according to new research.

Study co-author Jack Hoadley, a research professor at the Georgetown University Center for Children and Families, said they studied safety-net hospitals and clinics in seven states and confirmed that in the states that have expanded Medicaid, it's relieved a lot of the pressure on health-care providers that struggle to serve the working poor. Hoadley said they've seen dramatic evidence that the benefits extend beyond those doctors and patients.

Virginia is one of 19 states that have not expanded Medicaid under the Affordable Care Act. Republicans in the General Assembly have argued that the state can't afford the risk of extending health care to households below one-and-a-third times the poverty rate.

Read the full article and related story from KCUR.

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Medics and Corpsmen 

From the Office of the Governor

Governor McAuliffe  signed the Military Medics and Corpsmen bill, establishing the Virginia Military Medics and Corpsmen (MMAC) Pilot Program in the Commonwealth. Modeled after the U.S. Department of Veterans Affairs’ Intermediate Care Technician Program, SB 437 established Virginia’s MMAC Program, which is the first of its kind in the nation, creating pathways to employment to Virginia’s health care fields for highly skilled medical veterans.

The MMAC Program in Virginia is modeled after the highly successful Veterans Health Administration Intermediate Care Technician Pilot Program, which operated in 15 Federal Veterans Affairs Medical Centers across the United States. With the MMAC Program, Virginia is the first state in the nation to offer this kind of innovative pathway to employment for these highly skilled veterans. 

Read the full article.

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National News

Hospital Affiliations


Recent research shows almost a third of Appalachia’s rural hospitals are vulnerable to closure. Despite their history of independence, many of them are beginning to affiliate with larger systems, in an effort to keep their doors open.

Preston Memorial chose to affiliate with Mon General – a large community hospital based in Morgantown. Mon General served as financial backer for the loan on Preston’s new building. Preston also refers patients with complicated conditions there. Because Preston chose affiliation when it was doing well financially, it had the bargaining power to keep leadership local. It even gained membership on Mon General’s board.

In February, iVantage published new research on rural hospital vulnerability. It showed a third of rural hospitals in Appalachia are vulnerable to closure. To date, about half of rural hospitals in Appalachia have affiliated with larger systems.

Read the full article.

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Healthcare Innovation

By H. E. James - Daily Yonder

As the health-care industry continues to struggle to provide providing adequate services to patrons in rural settings, two solutions have already been successfully deployed in some areas: independent providers and health-care homes.Each rural place has unique needs and assets, but these health-care alternatives could be a good choice for some communities.
First, independent providers: In rural Idaho, where populations in some counties can be so small that a hospital isn’t viable, both independent and provider-based clinics, are the bread-and-butter of rural healthcare.

Another way of addressing rural medicine is the “health-care home” model. The Minnesota Department of Health wrote a report in 2009 that attempted to provide a model for reforming rural healthcare. The report defines rural as fluid. What is rural in one state, like Minnesota, may not be rural in another. The working definition of rural might even vary from county to county within a single state.

Read the full article.

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Remain Where They Train

By Michael Ollove - PBS 

Dignitaries gathered at Arkansas State University in Jonesboro to cut the ribbon on a new medical school, only the second in a state with a dire shortage of doctors. The Arkansas initiative is one of several that states are undertaking to address a doctor shortage that is going to get worse in much of the nation, especially in states with large rural areas or high concentrations of minorities.

Many states offer grants and stipends to medical students and residents willing to do clinical rotations in parts of their states where doctors are needed most. Some states have created branches of their medical schools in underserved areas to attract doctors and residents to the regions. The University of Kentucky College of Medicine, for instance, is creating satellite campuses in the southern and eastern part of the state.

Read the full article.

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By Alysa Landry - Today Media Network

In a 50-bed hospital in Bethel, where doctors treat a population of about 28,000 people—most of them Native Alaskans from nearby villages—nurses provide critical services in a remote location where medical emergencies can be catastrophic. The hospital, Yukon-Kuskokwim Health Corporation, employs a staff of Native nurses who pull double duty as care-givers and cultural interpreters for a team of non-Native doctors.
“We’re looking for those unspoken cues,” said Juanita Treat, a patient advocate with nearly half a century of experience in health care. “We tell doctors not to just listen, but to look.”
Treat, who is Yup’ik, represents a vital link between patients and doctors in this 58,000-square-mile region that is the traditional home of the Yup’ik, Cup’ik and Athabascan people. Although 82 percent of patients are Native, all of the doctors are transplants from the lower 48. That means doctors can miss much of the nonverbal cues and cultural nuances, Treat said.

Read the full article.

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Mark Your Calendar

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

July 20: Trauma Informed Care and the Health Care Safety Net​ - Richmond 
August 3: Opioid Prescribing: Safe Practice, Changing Lives ​- webinar
September 20-21: Rural Health Clinic Conference - Kansas City, MO
September 21-23: Critical Access Hospital Conference - Kansas City, MO
October 18: Rural Health Telecommunication Consortium Kick-Off Meeting - Abingdon
October 18-19:  Rural Health Coding & Billing Specialist Training  - Abingdon
October 19-20: VRHA Annual Conference - Abingdon

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Summer Food Service Program
Summer presents a number of challenges for vulnerable children and families – especially in the 3.3 million rural households with food insecurity.  USDA’s Summer Food Service Program (SFSP) ensures that low-income children aged 18 and under continue to receive nutritious meals when school is not in session.  This summer, they’re planning to serve more than 200 million free meals at approved sites all over the country.   The SFSP site locator maps all locations within range of a specific address; new sites will be added throughout the summer, so check back often for updated information.  SFSP also provides a range of resources for involvement, including fliers in English and Spanish, videos on how the program is started and managed in different communities and a toolkit for those interested in serving as Summer Meal champions.

Evidence-Based Toolkits for Rural Community Health
Current step-by-step guides in this resource from the Rural Health Information Hub include toolkits on obesity prevention, oral health, Community Health Workers and care coordination.  The evidence-based approaches in each can be adapted to your community’s needs, helping you learn what works for rural areas and how to get around common obstacles.  

Population Health for the Clinician – A Podcast Series from Practical Playbook.
Offering listeners CME credit, this new eight part podcast series for primary care clinicians defines the difference between individual and population health and explains the role of clinical practice in addressing health disparities.  

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Funding Opportunities

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

Optimizing Cost-of-Care Conversations 
This Robert Wood Johnson Foundation solicitation aims to fund studies that will test specific messages, best practices, and other principles to be incorporated in resources for improving the frequency and quality of cost-of-care conversations between clinicians and vulnerable patients. Funded studies will focus on testing a diverse range of approaches with diverse populations, which will ultimately help inform the development of tools, guides and resources to improve patient and clinician communication about costs and high-value care. Project funding can be up to $250,000 to accommodate studies of 12 months.
Deadline: July 27

Integrating Cost-of-Care Conversation Resources
This Robert Wood Johnson Foundation solicitation seeks to establish best practices for how tools/resources that support cost-of-care conversations (e.g., cost estimator tools, conversation guides, financial questions) can be better embedded into the clinical workflow and patient/caregiver “life flow.” Funded studies will thus explore these best practices for workflow integration, to ultimately help inform the development and refinement of tools, guides and resources for improving patient and clinician communication around costs and high-value care. Ultimately, RWJF seeks to understand what best practices are needed, how health systems may need to act to respond to such needs, and the adaptive challenges they might face when doing so. Project funding can be up to $250,000 to accommodate studies of 12 months.
Deadline: July 27

America’s Promise Job Driven Grant Program
Funding to create and implement regional, sector-based workforce development projects to meet the needs of both businesses and workers in industries that typically use a significant number of H-1B Visas, such as healthcare and IT.
Application Deadline: Aug 25, 2016 

Anthem Foundation
The Foundation’s grantmaking focus is on initiatives that positively affect the conditions addressed in its Healthy Generations program: heart health, cancer prevention and smoking cessation, maternal and newborn health, diabetes prevention and management, and active lifestyles. The Foundation also supports behavioral health efforts and programs that benefit people with disabilities.
Deadline is August 19, 2016

Healthy Tomorrows Partnership for Children Program
Promotes access to healthcare for children, youth, and their families. HTPCP funding supports projects that provide clinical or public health services, not research projects.  HTPCP applications MUST represent either a new initiative (i.e., project that was not previously in existence) within the community or an innovative new component that builds upon an existing community-based program or initiative. Additional information about the program can be found at the HTPCP web site.   
Estimated Average Size of Awards: $50,000.00  
Deadline is August 2, 2016.


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