VRHA Weekly Update
In this Issue  March 12, 2018

VRHA News Virginia News National News Mark your calendar
Funding Opportunities

Virginia Rural Health Clinic Coalition

Spring Summit: April 18 & 19

Full agenda now available!




Contact Your Senator!

The Virginia General Assembly has come to an impass regarding the budget.

All Senators need to hear your voice in support of using federal Medicaid money in Virginia, instead of allowing it to remain in Washington, DC.

Please contact your Senator and ask him/her to support Medicaid expansion. Make a note of how many people in that Senate district could gain coverage if it joins the House in supporting Medicaid expansion.

Not sure who your Senator is?  Enter your address here

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Many Members in the News

By Jeffrey Maser - Dexur

Dexur analysts studied Medicare heart failure inpatient data for Virginia hospitals and found that Page Memorial Hospital in Luray accounted for the lowest average length of stay (LOS) for a 30-day episode of care with unplanned readmissions among all Virginia hospitals between 2013-2016 at 3.91 days. Page Memorial Hospital was the only facility in the state with an average LOS for a 30-day episode of care under 3 days.

Riverside Tappahannock Hospital in Tappahannock ranked 2nd at 4.02 days, Southampton Memorial Hospital in Franklin ranked 3rd at 4.24 days, Carilion Giles Community Hospital in Pearisburg ranked 4th at 4.3 days and Augusta Health in Fishersville ranked 5th at 4.42 days. These five hospitals were the only facilities in Virginia with a 30-day episode of care average LOS under four and a half days.

All facilities named in this article are VRHA members.  Read the full story.

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Members in the News

By Patricia Martellotti - 10 News

[VRHA member] Edward Via College of Osteopathic Medicine researchers are behind a groundbreaking blood test that will help diagnose traumatic brain injury.  It's the first of its kind -- a blood test for the brain.

“There was no blood test for the brain up until now. It really has been a clinical endeavor,” said Per Gunnar Brolinson, researcher at VCOM.

It’s an endeavor that has become a major topic of concern due to contact sports such as football, along with injuries suffered by military personnel. 

Read the full article and related story from WBDJ7.

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Virginia News

Budget Breakdown

Michael Martz - Richmond Times-Dispatch

State employees and school teachers will have to wait. So will university presidents, sheriff’s deputies, correctional officers and advocates for economic development. Virginia won’t have a new state budget anytime soon.

A breakdown in budget talks between the House of Delegates and Senate on Thursday ensures that the General Assembly won’t complete its most important job in time for its scheduled adjournment on Saturday.

The budget the House adopted is awash with money for public education, fueled by $371 million in estimated state savings from using enhanced federal Medicaid money for an array of services, such as indigent care at hospitals, local mental health services, and health care for prison inmates.

But those savings depend largely on a proposed tax on hospital services that would generate about $307 million over two years to pay Virginia’s share of the costs of expanding its Medicaid program on Jan. 1, as the House proposes and the Senate opposes.

Read the full article and related story.

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Merger Benefits

By Linda Burchette - SWVA Today

Patients won’t see much of an outward change but hospital officials believe they’ll notice a difference in enhanced services through the merger of Mountain States Health Alliance and Wellmont Health System into Ballad Health.

As part of the merger agreement, the health system has made enforceable commitments with the state of Tennessee and the commonwealth of Virginia that include the investment of $308 million over 10 years to improve population health, expand access to care, and support health research and medical education. 

This will include:

  • $85 million toward the opioid crisis for behavioral health to create new capacity for residential addiction recovery services and develop community-based mental health resources
  • $85 million in academics and research to educate and train healthcare providers that are in short supply in the region
  • $75 million to address key population health needs, with a focus on some of the most serious threats to the region’s health, like diabetes and infant mortality
  • $28 million toward rural health services, including improved access to same-day primary care services and support for maternal and prenatal health
  • $27 million directed toward children’s services to create pediatric emergency rooms in Kingsport and Bristol
Read the full article.

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Virginia Opioid Crisis Project

From the Office of the Governor

Governor Ralph Northam announced that the National Governor’s Association (NGA) selected Virginia to participate in a learning lab on state strategies for addressing infectious diseases related to substance use. This learning lab is an opportunity for state officials to receive technical assistance in developing and implementing a strategic action plan for reducing the incidence of infectious diseases related to substance use disorder (SUD), including opioid use disorder.

Virginia will be one of seven states traveling to Kentucky to learn about how that state is addressing the increased risk of infectious diseases through public health surveillance and community prevention efforts. Following the kick-off meeting in Kentucky, states will receive six months of technical assistance from NGA.

Read the full press release.

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National News

Maternity Care Shortages

By Jessica Seigel - National Rural Health Association

We’ve seen this title over and over, from the original Politico article by Lisa Rab, to our session at the 2018 Policy Institute. The number of rural hospitals without an obstetrics unit or any obstetrics care is growing at an alarming rate, placing expecting mothers at risk.

18 million reproductive-age women live in rural communities across the United States, and half a million babies are born in rural hospitals every year. Still, from 1985 to 2002, the number of rural hospitals without obstetric services grew from 24% to 44%.

Today, more than half of rural counties have no hospital-based obstetrics services, and the most vulnerable communities – those who are low-income, minority, remote – experience the most damaging impact. When distance to maternity care is directly correlated with outcomes, this care shortage has a devastating effect on the health of both the mother and the infant. Rural babies are being born outside of hospitals or in hospitals without obstetrics care, and infant mortality rates are rising. The loss of maternity care in rural America is the result of multiple factors including: workforce shortages, low birth volumes, and stingy Medicaid programs.

Read the full article.

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Making Do without a Hospital

By Blake Farmer - Nashville Public Radio

Rural hospitals in Tennessee have been some of the most stressed in the country. Eight communities are getting used to life after losing their only hospital, and more facilities are teetering. So health officials are exploring the options and pointing to the town of Hohenwald, which has made do without a hospital for two decades.

The old building languished for a time and has now become something shy of a hospital but more than a clinic. At the Lewis Health Center, patients can be seen as late as 10 o'clock. And some have stayed most of a day for observation. If a patient needs more attention, an ambulance is parked out back, ready to whisk them to Columbia or even Nashville, if the condition is serious enough.

For Tennessee, it’s a novel concept that has attracted the attention of Congress as rural communities prop up struggling hospitals.

Read the full article and related story from Healthcare Finance.

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340B Cuts

By Jon Reid - Morning Consult

Hospitals that treat large numbers of uninsured and low-income patients say critical patient services are in jeopardy after the Trump administration slashed $1.6 billion from a program that provides hefty discounts on certain drugs.

Cuts to the 340B drug discount program, initiated by the Centers for Medicare and Medicaid Services, went into effect Jan. 1. The program has been lucrative for thousands of eligible providers. According to the Health Resources and Services Administration, which oversees the program, 340B hospitals saved approximately $6 billion in 2015, while they bought roughly $12 billion in discounted drugs during the same time period.

 “It’s particularly difficult for small hospitals in smaller systems that have operating margins that are really tightly balanced,” Rod Hochman said.  Hochman sits on the board of the American Hospital Association, the first named plaintiff in the suit against the 340B cuts. Rural parts of the country could be hit hardest by the cuts, Hochman said.

Read the full article.

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Rapid Overdose Increase

From the Centers for Disease Control and Prevention

Data from emergency departments (EDs) show that the U.S. opioid overdose epidemic continues to worsen, according to the latest Vital Signs report by the Centers for Disease Control and Prevention (CDC).

The report examines the timeliest data available to CDC on ED visits for opioid overdoses across multiple states. Overall, ED visits (reported by 52 jurisdictions in 45 states) for suspected opioid overdoses increased 30 percent in the U.S., from July 2016 through September 2017. Opioid overdoses increased for men and women, all age groups, and all regions, but varied by state, with rural/urban differences. The findings highlight the need for enhanced prevention and treatment efforts in EDs and for greater access to evidence-based opioid use disorder treatments, including medication-assisted treatment and harm reduction services.

Read the full press release.

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Mark Your Calendar

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

March 29: Interprofessional Summit on Addition Education - Charlottesville
April 13-14: Collaborative Conference on Rural Mental Health - Wytheville
April 15-17: MATRC Annual Telehealth Summit - Hershey, PA
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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FREE! SWVA Telehealth Certification
Certified Telehealth Coordinator (CTC) or Certified Telehealth Clinical Presenter (CTC-P)
The online CTC/CTC-P course is supplemented by a one-time hands on training that will take place at the SWVA Higher Education Center in partnership with UVa-Wise Abingdon. Take advantage of this opportunity for continuing education, career advancement and professional development. Learn how telehealth technology is used to increase access to health care, decrease health disparities and how this certification can benefit your organization, career and community.

Critical Access Hospitals (CAHs)
This guide, which includes extensive information on CAHs, including reimbursement, eligibility, funding, legislation, and more, has been updated. 

Model Program: ARcare Aging Well Outreach Network
This outreach network helps rural Arkansas adults 50 or older age in place and manage any chronic diseases.

Opioid Misuse in Rural America
Webpage features information and resources pertaining to opioid misuse in rural communities. Includes USDA programs and examples of best practices.

New demographic data are now available in the UDS Mapper.  Data from the American Community Survey have been updated to the 2012-2016 data for ZCTAs.  Information Card and Data Table data as well as Main Maps and select Population Indicators maps have been updated. 

Comparing Poverty Rates
Scroll over the map to compare poverty rates under the official Census poverty measure and the Supplemental Poverty Measure, which takes into account health care and housing costs among other factors.

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Funding Opportunities

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

Rosemary McKenzie Legacy Award
Honors an individual who has mobilized his/her community and has dedicated his/her life to improving the health of underserved populations.
Application Deadline: Mar 22, 2018 

National Center for Farmworker Health Scholarship
Scholarships for individuals pursuing or continuing their career in the migrant health field, thus contributing to the development of the Community/Migrant Health Center workforce.
Application Deadline: Mar 30, 2018 

School-Based Health Center Capital Program
Grants to increase access to mental health, substance abuse, and childhood obesity-related services in operational school-based health centers by funding minor alteration/renovation projects and/or the purchase of movable equipment.
Application Deadline: Apr 17, 2018 

Evidence-Based Falls Prevention Program Financed by Prevention and Public Health Fund
Funding to develop capacity for, deliver, and sustain evidence-based falls prevention programs.
Letter of Intent (Optional): Mar 21, 2018
Application Deadline: Apr 30, 2018 

Empowering Older Adults and Adults with Disabilities through Chronic Disease Self-Management Education Programs Financed by the Prevention and Public Health Fund
Funds to develop capacity for, bring to scale, and sustain evidence-based self-management education programs that empower older adults and adults with disabilities to better manage their chronic conditions.
Letter of Intent (Optional): Mar 21, 2018
Application Deadline: Apr 30, 2018 

National Health Service Corps Loan Repayment Program
Provides loan repayment funding to primary healthcare professionals who agree to serve in Health Professional Shortage Areas.
Application Deadline: Apr 23, 2018 

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