VRHA Weekly Update
In this Issue  November 13, 2017

VRHA News Virginia News National News Mark your calendar
Funding Opportunities





VRHA Podcast

National podcast "Rural Matters" recorded live from the recent VRHA Rural Providers Conference.  The podcast features VRHA President Summer Sage as well as keynote speakers Robert Pack and Maggie Elehwany.

Take a listen!

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Members in the News

By Justin Ward - WDBJ7

A non-profit health clinic in Christiansburg now has more room for patients after a million dollar renovation. Leaders of [VRHA member] Community Health Center of the New River Valley officially revealed the new changes during an open house and ribbon cutting.

The center, which offers family medicine, behavioral health, and dental care, now has more exam rooms, an enhanced laboratory, and added more mental health counseling rooms.

"We've kept our free clinic roots in this community and we continue to see those people who really have no other health care provider to go to. And we're here for everyone. So we hope to be here for another 30 plus years," Michelle Brauns, the CEO of the health center.

A federal government grant helped pay for the renovations. The health center also hired new staff because of the need and growth in the area.

Watch the video.

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More Members in the News

From Times News

Tazewell Community Health, which began operations in 2006 with three staff members — a medical provider, a nurse and one clerical position — has broken ground for a new $3.2 million facility in Tazewell.

Since 2015, [VRHA member] Southwest Virginia Community Health Systems pursued building the new facility to better serve patients and the medically underserved. The new site seeks to increase the scope of services to include dental, pediatric, optometry and radiology services and employ eight additional health care professionals.

Read the full article.

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Virginia News

Playing Chicken

By Chad Stewart - Commonwealth Institute

Termination notices are scheduled to be sent to thousands of Virginia families on December 1 letting them know that health insurance for their children will end early next year; that is, unless Congress takes steps to mitigate an impending crisis of their own making that would see around 65,000 Virginia children and 1,100 pregnant women lose their health coverage.

On September 30 this year, Congress failed to take a vote on legislation extending federal funding for the Children’s Health Insurance Program (CHIP), which provides most of the funding for Virginia’s FAMIS, FAMIS MOMS, and MCHIP services. These services provide health coverage for Virginia children and pregnant mothers who have family incomes between $20,420 and $41,861 (for a family of three). 

State lawmakers are waiting for Congress to step up and pass legislation which would sustain and allow for expansion of CHIP funding for an additional five years. Doing so should not be controversial–CHIP has had bipartisan support since it was enacted in 1997. Unfortunately, debate has not even been scheduled yet for any of the CHIP extension bills in the Senate.  

Read the full article.

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More Premies

By Luanne Rife - Roanoke Times

The March of Dimes reported the rate of preterm births inched up in Virginia and in the nation during 2016. The organization said the rate went up after nearly a decade of decline in the number of babies born prematurely.

In Virginia, 9.6 percent of births were premature. The rate is slightly under the national rate of 9.8. The state mirrors the country’s trend in that black women are 49 percent more likely to give birth early.

Read the full article.

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Close to Home

By Vickie Conner - Kaiser Health News

Every other month, Tanya Nelson travels 32 miles from the heart of Appalachia’s coal country for an appointment with the nearest psychiatrist for therapy and to renew prescriptions. But the commute, which should take less than an hour through the winding mountain roads of southern West Virginia, consumes her entire day.

Nelson, 29, needs treatment for bipolar disorder, depression and anxiety. But she does not drive, so she must use a van service to keep her appointments. It makes numerous stops along the highway, picking up other travelers, and usually doesn’t return to her home in New Richmond, W.Va., until day’s end.

There are no psychiatrists in Wyoming County. A handful of small, general medical practices, a small telemedicine program and a few behavioral health specialists handle services for the 21,763 residents. Patients’ issues — ranging from depression, anxiety, addiction and other mental health concerns — are aggravated by the local economic downturn.

Read the full article.

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National News

Serving Those Who Served

By Jessica Seigel - National Rural Health Association

On Veterans Day, we remember and honor those rural veterans who have served our nation. More than a quarter of the country's veterans live in rural communities and a disproportionate number of those serving in the military hail from rural communities. 

The poverty rate for all rural veterans is 6.9 percent, and this rate increases to 8.6 percent for veterans in the most rural counties. The age of veterans increases as they move into more rural areas. Approximately 2.8 million Veteran Affairs (VA) health care patients are affected by a service-related injury, and 1,027,000 of those patients live in rural areas. Rural Americans are on average older, sicker, and poorer than their urban and suburban counterparts, and veterans in rural America are no different. Because of their service to our country, they often face health challenges and complications that their rural neighbors don’t have to consider.

3.2 million rural veterans are enrolled in the VA health care system, comprising 35% of total enrollees. Despite higher numbers of veterans in rural areas, VA facilities are scarce in rural America. Many veterans living in rural areas fail to get the help they need and are entitled to because of barriers to care. Unsurprisingly, the largest barrier is often the geographic distance to the nearest VA facility.

Read the full article.

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Drug Overdose Rates

By Robert Preidt - HealthDay

Drug overdose death rates in rural areas of the United States are now higher than in cities, a trend that worries federal health officials. In 2015, drug overdose was the leading cause of injury-related death in the United States -- with 52,000 fatalities attributed to opioid painkillers, heroin and other potentially deadly drugs, researchers said in a new report.

U.S. Centers for Disease Control and Prevention Director Dr. Brenda Fitzgerald said rising overdose death rates outside metropolitan areas warrant attention. Since rural residents are less likely to have access to substance abuse treatment services, the findings point to a need to beef up such services outside cities, the authors of the report said.

Read the full article.

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ACA Enrollment

By Aftyn Behn - Daily Yonder

Even before funding was available for “navigators” — the people who help individuals enroll in Obamacare — Meryl Rice trekked across rural Southwest Tennessee spreading the word about the Affordable Care Act.

Rice, who has served officially as an ACA navigator since 2015, now covers 10 counties in Southwest Tennessee. She’s determined to keep helping people enroll in Obamacare, even though the task is getting tougher.

In August, the Trump administration cut the advertising budget for this year’s ACA enrollment period by 90%. In addition, funding for navigators like Rice was cut by 41 percent. Along with fewer resources to do their jobs, navigators will also have less time to get people enrolled. The open enrollment period previously lasted into January of the next year. This year, insurees have only from November 1 to December 15 to sign up.

Read the full article.

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Disappearing Maternity Care

By Katy B. Kozhimannil and Austin Frakt - Washington Post

Life in rural America can be tough, with challenges starting right from birth. Increasingly, rural women lack access to maternity services, jeopardizing their health and that of their newborns at a time when U.S. maternal mortality is rising.
Giving birth is hard enough, but racing 100 miles to the nearest hospital down winding country roads is a particularly harrowing way to experience labor. Evidence confirms what common sense suggests: Drive time affects outcomes. A Canadian study shows that the babies of mothers who travel more than an hour to give birth are more likely to require intensive care or to die within their first year of life.
Anguishing personal stories underlie the aggregate data that signal pervasive problems. For Whitney Brown of rural Tennessee, hospital staff discovered an amniotic fluid embolism too late. She died after childbirth. Courtney Cross, a mother living in rural Alabama, fell into debt in part because of the cost of her lengthy trips to pregnancy care.

Read the full editorial.

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Mark Your Calendar

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

November 14: Social Determinants of Health, Patient Experience, and Value-Based Reimbursement - webinar
November 15: Synthetic Narcotic & Opioid Abuse Prevention Summit - Abingdon
November 15: The Truth Behind Real Cost Control for Rural Hospitals - webinar
November 29: Managing Major Depressive Disorder in Rural Primary Care Settings - webinar
February 6-8: Rural Health Policy Institute - Washington, DC
May 8: Health Equity Conference - New Orleans, LA
May 8: Rural Medical Education Conference - New Orleans, LA
May 8-11: Annual Rural Health Conference - New Orleans, LA
May 8-11: Rural Hospital Innovation Summit - New Orleans, LA

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Connecting Communities with Data: A Practical Guide for Using EHR Data to Support Community Health This toolkit shares the stories and experiences of three pioneering collaborations between local public health and health care agencies in Minnesota that are using electronic health record (EHR) and public health data to improve the health in their communities. The toolkit includes lessons learned and tools to encourage the application of data to knowledge and how to move the knowledge into practice to improve community health.

Behind the Scenes with Strategic Planning, Part 1Part 2
Meaningful strategic paths enable effective change by considering what actions are necessary in order to achieve an organization’s vision. In this webinar, the presenters describe how the product of strategic planning sets the stage for change and provide tips for effective strategic planning.

Stem the Tide: Addressing the Opioid Epidemic
Toolkit from the American Hospital Association which offers guidance and case examples to help hospitals and health systems work with their patients, clinicians and communities to tackle the opioid epidemic.

2017 Premature Birth Report Cards
The preterm birth rate in the United States has increased for the second year, rising 2 percent to 9.8 percent in 2016. This year’s Report Card also reveals major racial/ethnic and geographic disparities signifying that babies have a higher chance of a preterm birth based simply on race and ZIP code.  State by State reports available.

Rural Behavioral Health
The Rural Health Research Centers are committed to providing timely, quality national research on the most pressing rural health issues, often exploring the same topics from various perspectives. Gateway has developed Rural Health Research Recaps to identify the key findings from all of the research centers on specific rural health topics. This resource provides a summary of their most recent research on behavioral health. See the Additional Resources below for the complete list of Research Centers’ work cited in this Recap. 

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Funding Opportunities

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

Virginia Health Safety Net Grants
Funding for projects to grow and strengthen Virginia's healthcare safety net by developing or expanding patient capacity, establishing a broader scope of services, creating local systems of care, or strengthening infrastructure.
Letter of Intent (Required): Jan 19, 2018
Application Deadline: Mar 7, 2018

American Electric Power Foundation Grants
Supports nonprofits working in the areas of hunger; housing; health and safety; human services; education; and the environment.
Geographic coverage: Available in Arkansas, Indiana, Kentucky, Louisiana, Michigan, Ohio, Oklahoma, Tennessee, Texas, Virginia, and West Virginia.
Applications accepted on an ongoing basis

Appalachian Community Fund Technical Assistance Grants
Funding for technical assistance needs for community-based organizations that address underlying causes of economic and social distress in the Appalachian region.
Geographic coverage: Appalachian counties of Tennessee, Kentucky, Virginia, and West Virginia
Applications accepted on an ongoing basis

Healthiest Cities & Counties Challenge 
The Challenge is a partnership between the Aetna Foundation, the American Public Health Association and the National Association of Counties. The partnership empowers small to mid-size U.S. cities and counties to create a positive health impact. We're awarding more than $1.5 million in prizes to cities, counties and federally recognized tribes most able to show measurable changes in health and wellness over the next several years.

Bob Woodruff Foundation
The Bob Woodruff Foundation supports nonprofit organizations that offer programs for post-9/11 impacted veterans, service members, their families, and caregivers. Grants are provided in the following three core areas: Education and Employment focuses on education and employment initiatives that enrich the next chapter of service members' and veterans' lives. Rehabilitation and Recovery supports programs that heal both the physical and hidden wounds of war, with emphasis on the long-term effects of living with injury. Quality of Life gives priority to programs that offer service members a sense of purpose, a place to live, healthy family relationships, and outlets for socialization.
Applications for the Spring 2018 grant cycle will be accepted from November 13, 2017, through January 10, 2018

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