Virginia Rural Health Association - Weekly Update
VRHA Weekly Update
In this Issue July 27, 2015 

VRHA News Virginia News National News Mark your calendar
Funding Opportunities


Summer Newsletter






Balanced Living with Diabetes

Adult onset diabetes is a prevalent and increasing health issue.  Rural communities of Virginia are disproportionately suffering from the morbidity, mortality, and social and financial costs associated with this disease.  In recognition of the impact of this relatively preventable disease on the productivity and quality of the lives of rural Virginia residents and the gap in diabetes education in rural counties, a lifestyle intervention program specific for diabetes has been developed for Virginia. 

The Balanced Living with Diabetes program is grounded in social cognitive theory and incorporates the components of effective lifestyle intervention programs including behavior modeling.  It was developed through an iterative process of testing and modification in Virginia and has shown efficacy to modify dietary and physical activity behaviors that result in improved indicators of glucose control (hemoglobin A1c).

Carlin Rafie, PhD, RD of Virginia Tech will describe the development of the Balanced Living with Diabetes program, evidence for efficacy, and implementation in Virginia to date is proposed.   
GIF logo
VRHA Annual Conference
October 13 & 14
Staunton, VA

Click the conference logo for full event details.

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The Virginia Rural Health Association Board of Directors will have openings for up to six new members at the end of the year.  Board members serve to guide the development of VRHA and fulfill the mission to "improve the health of rural Virginians through education, advocacy, and fostering cooperative partnerships"

Read the board member guidelines, review the list of current members, and fill out the application form. Applications received will be reviewed by the nominating committee, then voted upon by the membership at the Annual Meeting October 13.

Not sure if you're ready to commit to serving on the board?  Volunteer for a committee!  The Advocacy, Membership, and Audit committees have immediate openings.  Contact VRHA Executive Director Beth O'Connor (540-231-7923) for additional information.

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Virginia News

Hospital Bed Tax?

new tax on hospital and other health care revenues could plow billions back into the industry in Virginia, both from the proceeds of the tax and the corresponding uptick in federal Medicaid payments.  A state working group on the concept met , kicking off a study called for in the state budget. These charges are often called "provider assessments" or "provider fees," or some times the less supportive "hospital bed tax." They're charged as a percentage of revenue at hospitals and nursing homes, or calculated based on the beds in a given facility.

The money can be spread out among all participating locations equally, or not so equally, with increased payments to hospitals that see more Medicaid patients, for example. Public hospitals could be exempt from paying the assessment, for example, or children's hospitals or small rural facilities. 

Read the full article.

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APN's for Rural Virginia

By Old Dominion University

In the rural areas of southwest Virginia, accessibility to quality health care professionals is often more of a hope than a reality. Little towns like Wise, with a population of 3,286, join a cluster of underserved communities in dire need of healthcare resources.

But these conditions are starting to change, and the latest collaboration between Old Dominion University's School of Nursing and the University of Virginia will sow the seeds of a more robust healthcare force in such areas.

ODU's School of Nursing recently received a three-year, $2.1 million Health Resources and Services Administration (HRSA) grant to develop the infrastructure for an increase of Advanced Practice Nurses (APNs) in rural and underserved areas of Virginia. APNs, such as nurse practitioners, are capable of doing referrals, prescribing medications, sending patients for X-rays and having and caring for their own patients.

Read the full article.

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The Need for Lee County

By Kylie McGivern - WJHL

"Ever since the hospital has closed, this day has always been in the back of my mind, this could occur. And today, as we’re sitting there, in a meeting, trying to reopen it, it hit. This is the day that it has happened,” Dr. Jill Couch, of Pennington Gap said.

Dr. Couch was talking about the massive U.S. Penitentiary fight that happened in Lee County July 8th – an incident she feared would happen, left with no hospital nearby.

Eight people had to be taken to Holston Valley Medical Center, 50 minutes away. The incident served as stark reminder, area doctors told News Channel 11, of the urgency the Lee County Hospital Authority feels to reopen the hospital shut down nearly two years ago.

Read the full article.

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Many articles were published on the recent Remote Area Medical event in Wise County: Back to the top

National News

Questioning MedPAC

By Erin Mahn - National Rural Health Association

At a U.S. House Committee on Ways & Means Subcommittee on Health hearing on the Medicare Payment Advisory Commission (MedPAC), several members of Congress expressed bipartisan concern on rural health issues and beneficiary access to care, in light of the 55 rural hospitals that have closed and 283 other rural hospitals on the brink of closure.

Rep. Lynn Jenkins (R-KS) raised many critical questions about the rural hospital closures, and cited the National Rural Health Association’s report by iVantage that 283 hospitals are on the brink of closure and the effect more closures would have on rural Americans’ access to care.

Read the full article.

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Hands-On Experience

By Julie Wootton - Magic Valley 

University of Washington medical student Kevin Stroschein spent four weeks getting a first-hand look at what it takes to be a surgeon.  He's participating in UW's Rural Underserved Opportunities Program, which aims to give students hands-on experiences in rural medical settings.

He has assisted with surgeries throughout the summer, including as a first assistant for a gallbladder surgery.  And for a community project, he worked at the Wellness Tree Clinic in Twin Falls, a nonprofit organization that serves uninsured and underinsured community members. 

Read the full article.

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Tiny Town Physicians

By Emily Rappleye - Becker's Hospital Review

Rural physicians are a rare breed. One fifth of Americans live in rural areas, but only about one tenth, or 9 percent, of physicians practice there, and the number of specialists per 100,000 residents in rural areas is half that of urban areas. Since rural physicians are so few and far between, they are entrusted to act as the family physician, the emergency physician, the obstetrician and the gastroenterologist, often all in one day's work.

We tracked down a few physicians who practice in some of America's tiniest towns, providing patients with a range of care. The following three family physicians are from towns with populations of 4,000 or less, and here they share how healthcare is different — and not so different — practicing in a rural community.

  • John Haynes Jr., MD.: a 78-year-old family physician who has practiced in Vivian, La., (pop. 3,671), since 1966
  • George Franklin, DO.: a board-certified family physician who has served residents of Western Arizona since 1998.
  • Robert Bosl, MD.: a family physician who serves in Starbuck, Minn., (pop. 1,302).

Read the full article.

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CAH Survival

A lot of the hospitals in rural Kansas are called “Critical Access Hospitals.” It’s an important designation, because Critical Access Hospitals were created by the federal government to maintain access to health care in rural areas. But  several factors are making it harder for those hospitals to survive.

Many Kansas Critical Access Hospitals are in financial trouble. Medicare requires them to offer 24-hour emergency services. But most don’t have enough ER patients to justify the cost of 24-7 service, says the Kansas Hospital Association’s Melissa Hungerford.

Hungerford is in charge of a new KHA initiative aimed at helping rural hospital administrators devise what might be called strategic survival plans. One idea is to allow small hospitals to give up some or all of their acute care services and become “primary health centers.”

Read the full article and a related article by the Council of State Governments.

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Mark Your Calendar

For more information about these and other events, visit the VRHA Calendar
August 24-27: Arthritis, AgrAbility, and Rural Health Conference - Knoxville, TN
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

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HPSA Lists
The Health Resources and Services Administration has released an updated list of all geographic areas, population groups, and facilities designated as primary medical care, mental health, and dental health professional shortage areas (HPSAs). Through use of a Shortage Area Location tool, users can quickly determine if their geographic area is a designated shortage area.

Local Foods, Local Places
Will provide direct technical support to selected communities. A team of experts will help community members develop action plans that use local foods to support healthy families and communities and to drive downtown and neighborhood revitalization. The assistance process features a community workshop that brings people together to develop shared goals and steps to achieve them.  The assistance process features a community workshop that brings people together to develop shared goals and steps to achieve them. This is not a grant program.

RAC Rural Health Models and Innovations Hub
The Rural Assistance Center collects and shares stories about rural health and human services programs and interventions. This collection includes approaches that have demonstrated success in research studies and program evaluations, as well as anecdotal accounts.

National Telehealth Policy Resource Center
Provides information about telehealth adoption and promotes policy and technology solutions to improve health outcomes.  

Public Health Preemption Legislation
In addition to the six health and safety movements documented on this map, federal and state preemption have been used to undermine dozens of other grassroots movements on issues ranging from fracking to fire prevention. Preemption is usually promoted by an industry to stop progress in public health because industry lobbyists have more influence in Washington, DC and the state capitols than at the community level. 

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Funding Opportunities

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

Robert Wood Johnson Foundation: Evidence for Action: Investigator-Initiated Research to Build a Culture of Health
Evidence for Action: Investigator-Initiated Research to Build a Culture of Health supports research on the impact of innovative programs, policies, and partnerships on health and well-being, and on novel approaches to measuring health determinants and outcomes.

Tom's of Maine 50 States for Good
The Tom's of Maine 50 States for Good initiative supports grassroots organizations throughout the country working to do good in their communities. In 2015, the program will provide grants of $20,000 each to a grassroots nonprofit organization in every state and the District of Columbia. Any individual 18 years of age or older is eligible to nominate a nonprofit organization for consideration. Eligible organizations must be valid 501(c)(3) tax-exempt organizations in good standing that are community-based.   
Deadline: August 26, 2015. 

Autism Speaks Family Services Local Grants
The goal of Autism Speaks is to change the future for all who struggle with autism spectrum disorders. The focus of Autism Speaks Family Services Local Grants is three-fold: to promote local services that enhance the lives of those affected by autism, to expand the capacity to effectively serve this growing community, and to increase the field of service providers across the country. Local Grants of up to $5,000 are provided to service providers throughout the United States addressing the areas of education and training, recreation and community activities, and young adult/adult services and technology. Both nonprofit and for-profit organizations are eligible to apply. Local Grants are divided into Chapter, Regional, and Neighborhood Grants, depending on the location of the service providers.
Deadline: September 28, 2015. 

Data Across Sectors for Health: Empowering Communities Through Shared Data and Information
Letter of Intent (Required): Jul 29, 2015
Application deadline: Oct 21, 2015
Offers grants to community collaborations and initiatives that have used shared data and information to increase their capacity for planning, implementing, and evaluating health improvement activities. These community collaborations would be part of a nationwide learning collaborative that would create a cadre of lessons learned and promising practices.

Wrigley Company Foundation Community Service Grant
Application deadline: Oct 1, 2015
Provides funding to dental hygienists for projects aimed at improving oral health or providing oral health education.

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