VRHA Weekly Update
In this Issue  August 4, 2014

VRHA News Virginia News National News Mark your calendar
Funding Opportunities


Summer edition now available





VRHA in the News

By Laurence Hammack - Roanoke Times

On the eve of national public hearings on a plan to curb carbon emissions from power plants, a group of clean-air advocates held their own forum Monday in Roanoke.

“Having clean air is of paramount importance to me,” said Stuart Tousman, who suffers from asthma that flares up on the days when smog hangs heavier in the air.

Tousman, who is president of the Virginia Asthma Coalition, was joined by representatives from the American Lung Association, the Virginia Rural Health Association and state Sen. John Edwards, D-Roanoke.

Read the full article and related article by the Roanoke Free Press.

If you want to weigh in on carbon pollution, submit your comments on the EPA’s website.

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Lee Hospital Closer to Reality

By Kyle Benjamin - WCYB

It has been almost a year since Wellmont Health System shuttered Lee Regional Medical Center in Pennington Gap, Virginia. In that time, the people of Lee county and the surrounding area have not had immediate access to emergency care.

Now though, there is more than a glimmer of hope for a hospital returning to the region. Members of the Lee County Hospital Authority gathered in Jonesville to share a progress update on what's been done since Lee Regional closed October 1, 2013.

Read the full article.

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It's Working

Dan Heyman - Public News Service 

Signs suggest Medicaid expansion is working much as promised where it's been tried. The numbers are still coming in, but Medicaid expansion states – including West Virginia and Kentucky – report health care and budget results in line with expectations.

A separate report from the White House Council of Economic Advisers says expansion should produce a net 400,000 jobs nationwide by 2017.Michael Cassidy, president, The Commonwealth Institute for Fiscal Analysis, says Virginia is projected to gain 13,000 of those jobs, mostly in the health-care industry.

"Doctors and nurses and office workers, who then turn around and spend that money at the dry cleaners, getting their car repaired," says Cassidy, "and that money flows through the economy."

Read the full report.

Time for Action!  Contact your members of the General Assembly and ask him or her to support Medicaid expansion to protect rural people, rural healthcare and the rural economy.

For talking points, click here.  Not sure who your GA members are? Look them up here.

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Virginia News

Conflicting Rulings

Conflicting rulings on a key component of Obamacare emerged from the Virginia Fourth Circuit Court of Appeals and the federal court of appeals in Washington, D.C., within hours of each other on Tuesday.
Both addressed the tax credit subsidies for lower- and middle-income consumers (up to $94,200 for a family of 4) buying health coverage through federally facilitated Affordable Care Act exchanges in 36 states, including Virginia, that chose not to establish state exchanges.

During the first open enrollment period through the exchange, which ended in April, 216,356 Virginians signed up for private health insurance. Of those, 82 percent, or 177,000, received some financial assistance in tax credits, said Jill Hanken, executive director of the Virginia Poverty Law Center. The center oversaw education and outreach through the patient navigator program.

"People should still use their tax credits and their insurance," Hanken said, emphasizing that the ruling handed down by the Fourth Circuit means that nothing has changed in Virginia.

As a precaution, [VRHA member]  Virginia Community Health Care Association, a Richmond-based nonprofit that provides training and technical assistance for federally qualified health centers and their network of application counselors statewide, issued a directive advising that nothing had changed.

Read the full article.

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More Work on Mental Health

By Brent Solomon - WWBT

After making critical changes to Virginia's response to mental health care, a group of lawmakers insists there's still much more work to be done. Now seven delegates and five senators are beginning a long-term dialogue to improve gaps in the system.

It's a comprehensive review. What is Virginia doing wrong? What are other states doing right and how can the Commonwealth get in line?

Read the full article and a related report from the Daily Progress.

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Eastern Shore Delay

By Carol Vaughn - DelmarvaNow

The new Riverside Shore Memorial Hospital will be smaller and will open months later than originally planned, according to a letter sent by hospital officials to Eastern Shore residents and hospital employees.  According to the July 22 letter, the facility will have 52 beds — down from the 69 announced when ground was broken in October 2013.

Construction should take 24 months, meaning the hospital will likely open in the latter part of 2016. A winter 2015 opening was anticipated at the time of the groundbreaking. Of the 52 beds in the redesigned hospital, 10 will be critical care beds for the sickest patients, the letter said. More than half the facility will be dedicated to outpatient care.

Read the full article.

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National News

Recess Assignment

Congress is entering their August recess, which means that YOU have work to do!

Congressional members will be at their home offices for 5 weeks.  This is the prime opportunity to catch their attention on the importantance of rural health issues.  Plan on attending town hall meetings, visiting district offices, making phone calls, sending e-mails (or even a 'real' letter!) and/or inviting your member of Congress and his staff to visit your facility.

Your message should be that rural health care:

  • Protects the patient
  • Protects the rural economy
  • Protects the taxpayer
​Some basic facts:
  • More rural hospitals have closed in the last year, than over the past decade.
  • More hospitals have closed in the last year than since the Critical Access Hospital program was fully implemented.
  • Why?  Wave after wave of federal cuts are eroding the rural health care net.
Click here for detailed talking points.

To address rural health issues, please use these talking points and encourage your members of Congress to support the following bills:
  • H.R.3991 & S.2037Critical Access Hospital Relief Act of 2014 
  • H.R.2801& S.1143: Protecting Access to Rural Therapy Services
  • S.2359: Craig Thomas Rural Hospital and Provider Equity Act of 2014 

ACT NOW!  Contact your member of Congress and let him know that rural people cannot afford to continue to suffer. Not sure who your member of Congress is?  Look it up here.

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Access Bill Falls Short

By Maggie Elehwany - National Rural Health Association

NRHA is disappointed that final language of the Veterans’ Access, Choice and Accountability Act does not do more to improve access for rural veterans across the nation.

Our nation’s veterans are disproportionately from rural America. The legislation had an opportunity to remove significant barriers and allow rural veterans the choice to access quality health care close to their home, yet fell short.

A significant barrier for many rural veterans is that there will be no ability to choose a local rural provider, even if they live well over 40 miles from a Veterans Health Administration hospital. This is due to the inclusion of Community-based Outpatient Clinics (CBOCs) in the definition of VA medical facility within the Act. There are over 800 CBOCs scattered across the county. These outpatient-only facilities offer varying degrees of limited primary care during limited operating hours.  Including these facilities within the bill virtually negates the intent of providing rural veterans true choice in their health care.

NRHA is also disappointed that language was not included to ensure appropriate rural representation on the Commission on Access to Care established within the Act. Rural veterans, like rural Americans in general, are older, poorer and sicker than their urban counterparts and have unique challenges accessing care. Both workforce shortages and sheer geography make the health care delivery in rural areas extremely challenging. Like other health commissions currently charged with reporting to Congress, there should be proper rural representation on the Commission in addition to a representative from the VA Office of Rural Health.

For more information on the health needs of rural veterans, please view NRHA’s recent policy paper:  Rural Veterans: A Special Concern for Rural Health Advocates


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Telemedicine: A Necessary Investment 

By Bryan Coffey - Modern Healthcare

Hamilton County Hospital is a 25-bed critical-access hospital serving about 3,000 people in southwest Kansas. Like many rural hospitals, a number of our service lines had been eroding because we couldn't make them financially viable. When I became CEO here, many patients had to travel four to five hours each way to either Wichita, Kan., or Denver to see specialists. For elderly patients, that usually meant a one-night stay in those cities, adding to the cost and inconvenience.

That's all changed now, thanks to telemedicine. Hamilton County now has a telemedicine robot that allows neurologists and other specialists to beam in from our tertiary-care partners: Swedish Medical Center in Englewood, Colo., and Wesley Medical Center in Wichita. With telemedicine, residents in our small community can get the same high-caliber care they would receive in large metropolitan hospitals. 

Before telemedicine, Hamilton County was a classic “stabilize and ship” hospital, where many patients were routinely transported to city hospitals. These facilities often got clogged with cases that really could have been handled locally. Now, for example, a remote neurologist can quickly determine whether a stroke patient can receive tPA treatment at our hospital or needs immediate transfer. It's a technology that will allow Medicare and private payers to save millions by eliminating unnecessary transport.

Read the full article.

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Rural Doc Shortage

By Chris Hassan - U.S. News University Connection

The physician shortage is already affecting communities nationwide. However, it's what the AAMC refers to as the "vulnerable and underserved population" that will be impacted the most. Inner city and rural locations are among these areas.

Dr. Rex Stroud of Indiana is among the physicians who understand just how bad conditions can get in rural parts of the country. According to the Washington Times Herald, Stroud, who two years ago opened a primary care practice in a town of 10,500 people, has seen the great demand for medical services.

What separates Stroud from many peers in the medical profession is that he wants to practice in a rural setting. The physician raises cattle on his family farm and said "you have to love it to want to be here."

Read the full article.

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Mark Your Calendar

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

August 7: Operations Approach to Certification of RHCs - webinar
August 19: Telemedicine in Rural Communities: An Innovative Approach to Delivering Healthcare - webinar
September 30-October 1: Rural Health Clinic Conference - Kansas City, MO
October 1-3: Critical Access Hospital Conference - Kansas City, MO
December 11 & 12: Virginia Rural Health Association Annual Conference - Staunton​

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Community Vitality and Rural Healthcare
This topic guide focuses on how community and economic development can complement health services in rural areas and how collaboration between the sectors can address issues such as population health.

Rural Health Policy Topic Guide
Visit the guide to learn more about key legislation and regulations that have an impact on the provision of rural healthcare and how to identify key stakeholders involved and the role they play in the process of policy formation. 

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Funding Opportunities

Medical-Dental Team Leadership Training Program
Deadline: August 22
The Virginia Oral Health Coalition (VaOHC) has partnered with the Medical Society of Virginia (MSV) Foundation to provide scholarship funding for two teams of medical and dental providers who wish to participate in MSV's innovative leadership program, evolve™. Now in its second year, evolve™ provides clinical teams an opportunity to enhance leadership, business and innovation skills to help them meet the challenges of a rapidly changing healthcare environment. Each scholarship will cover $2,500 of tuition costs for the program (if one team member is a member of MSV or the Virginia Nurses Association, the fee is discounted and the scholarship will cover the entire program cost). 

Wrigley Company Foundation Community Service Grant
Application deadline: Oct 1, 2014
Provides funding to dental hygienists for projects aimed at improving oral health or providing oral health education.

Environmental Protection Agency
The Training and Technical Assistance to Improve Water Quality and Enable Small Public Water Systems to Provide Safe Drinking Water program offers support to help improve small public water systems. The application deadline is September 2, 2014.

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