VRHA Weekly Update
In this Issue  December 19, 2016

VRHA News Virginia News National News Mark your calendar
Funding Opportunities


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Take the Survey!

On October 18th, VRHA hosted a kick-off meeting for the Virginia Rural Health Telecommunications Consortium.  VRHTC will be working with rural providers to help them receive discounts on their telecommunications services through the FCC/USAC Healthcare Connect Fund.  You can review a webinar recording which reviews the process.

Now we are asking all hospitals, FQHCs, RHCs, other clinics, SNFs, CSBs, and Schools of Nursing to complete the eligibility form so we can determine needs and gage interest in the consortium.

We encourage you to complete the survey even if you do not think you will join the consortium as VRHA will also use this information to compile a report for the Secretary of Technology.

Take the Survey!

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Members in the News

By Stephanie Porter-Nichols - SWVA Today

[VRHA member] Smyth County Community Hospital is taking its role in confronting the drug abuse epidemic in this community seriously.
SCCH CEO James Tyler told the Marion Town Council Monday evening that the hospital is working to educate its physicians and pharmacists about the problem and what they can do. To help educate them, he said, a National Safety Council presenter was brought in to lead a training program. During the presentation, Tyler said, the care providers learned that often post-surgical pain is best addressed with a combination of Tylenol and ibuprofen. “That’s re-educating our doctors,” said Tyler.

Read the full article.

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VRHA Office Schedule

The VRHA offices will be closed December 23 through January 1 and will re-open January 2, 2017.

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Virginia News

Mental Health Pilot

From the Office of the Governor

Governor Terry McAuliffe announced the award of grants that will six fund pilot projects to provide services to inmates with mental illness in local or regional jails. The grants were approved by the Criminal Justice Services Board at its meeting on December 8th in the City of Richmond. The funds for the grants were appropriated to the Department of Criminal Justice Services (DCJS) by the General Assembly during the 2016 Session.

Governor McAuliffe included the appropriation in his two-year budget, to provide expanded services to individuals in the criminal justice system with mental illness. The Governor’s Task Force on Improving Mental Health Services and Crisis Response, chaired by Lt. Governor Ralph Northam, proposed the establishment of mental health pilot projects as a means of establishing evidence-based behavioral health services in local and regional jails. 

Secretary of Public Safety and Homeland Security Brian Moran said, “With this grant money, we will provide a robust and comprehensive continuum of care for individuals with mental illness who transition into and out of our jails. To ensure they receive proper treatment and safely transition into the community requires close cooperation between the jails and local mental health and behavioral health providers. Through these pilot programs, best practices will be developed to improve our services and facilities.”

Read the full press release.

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Opioid Executive Leadership Team

From the Office of the Governor

Governor Terry McAuliffe today signed Executive Directive 9, which creates an Executive Leadership Team to oversee Virginia’s continuing work to combat the opioid epidemic.

In 2014, Governor McAuliffe created the Governor’s Task Force on Prescription Drug and Heroin Abuse. Before it expired, the task force made over 50 recommendations on actions that can be taken to combat the opioid epidemic in Virginia. More than half of those recommendations have been or are in the process of being implemented. The Executive Leadership Team created today will continue that important work.

“I want to thank the dedicated experts and advocates who worked hard as part of our task force to develop an action plan for combating the prescription drug and heroin epidemic here in Virginia,” Governor McAuliffe said. “The Executive Leadership Team I created today will continue to turn those recommendations into action so that we can keep up the important work of saving lives in every corner of our Commonwealth. We have made strides, but our overdose deaths continue to rise, and we cannot relent.”

For the full text of Executive Directive 9, click here.

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Close to Home

By Gary Bentley - Daily Yonder

“We were working in low coal, ‘bout like this,” Thurman said to me. “None of the equipment had canopies. Nothing to shield us from the top. I was at my lowest of low points. I just pressed the lever to raise the deck, thinking I could bruise my shoulder, scrape myself up a little. I thought it would be a quick trip to the hospital to get me a fix [of pain pills] until my next appointment. Once I got myself wedged against the top I couldn’t move my arm enough to release the lever and if my buddy wouldn’t have walked around the corner I might have ended up dead. Instead, he was able to shut the pinner off and I only suffered a fractured shoulder blade and couple of broken ribs.”

Some men would break bones and never miss a day’s work. They would cut themselves underground and wrap the wound with old rags and electrical tape. Sometimes it would heal just fine, other times they would end up with a nasty infection. All to avoid missing a day’s work. The cycle of money, drugs, and hard work took its toll on the miner, his family, friends, and the people he came in contact with in the outside world.

Read the full article.

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National News

Action Alert: Protect 340B

From the National Rural Health Association

Hospital Administrators: NRHA and 340B health ask that you contact your lawmakers to protect rural hospital access to 340B in the event of an ACA repeal.

Both Congressional leadership and President-elect Trump have expressed interest in repealing provisions of the Affordable Care Act. The ACA expanded 340B eligibility to rural hospitals—critical access hospitals, sole community hospitals and rural referral centers. This expansion has allowed many rural hospitals to better serve their communities at a time when far too many rural hospitals are closing. Eighty rural hospitals have closed since 2010 and 673, fully one third of rural hospitals, are at risk of closure. We must ensure that repeal efforts do not unintentionally remove rural hospitals from the 340B program.

Please help educate your lawmakers about the importance of protecting the rural hospital participation in the 340B program as ACA repeal legislation is considered.  It is especially critical that your lawmaker understand how the 340B program helps your hospital serve vulnerable and low income patients and what the impact would be on your community if your hospital were no longer able to access 340B savings. Rural closures are already hurting the most vulnerable patients and the loss of the 340B program eligibility could further erode timely access to lifesaving care.

Here is a ready-to-send letter template.

Enter your contact information and hospital’s address below and hit “Submit” to access contact information for your lawmakers. You will have an opportunity to review the letter before clicking “Submit” again. You can send the letter as-is, but we urge you to personalize it with specific ways 340B savings help you provide care to low-income, rural, or otherwise vulnerable patients.

Additionally, please call your members of Congress and help NRHA and 340B Health educate Members of Congress and Congressional staff about the 340B program and its importance to YOUR rural community.

If you have any questions or need any assistance in preparing your letter, contact Diane Calmus at dcalmus@nrharural.org.

Opportunities with Trump

By John Commins - Health Leaders Media

More than any other demographic, rural American voters contributed to the unexpected election of Donald Trump. Alan Morgan, CEO of the National Rural Health Association, says Trump's election has put the issues facing rural America on the front burner after years as an afterthought. The following is a lightly edited transcript.
HLM: What was the message rural America sent in this election?
Morgan: It is the result of a lack of focus on a substantial population in America that's seen declining health, declining life expectancy, a rural hospital closure crisis that we are engaged in right now, and yet a lack of focus on how to bring access to high-quality healthcare services to 60 million Americans. We are hopeful, recognizing the importance that health and especially hospitals play in rural communities from an economic standpoint too, that we can start looking at what we can change and modify to ensure that we maintain access in rural communities.

Click here to read the full interview and review a different view from Quartz.

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Needle Exchange


Needle-sharing by opiate addicts is fueling an alarming rise in new HIV infections among injection drug users, and the United States doesn't have enough syringe programs in place to reduce that risk.
Although needle exchange programs have been politically controversial for decades, studies have demonstrated their public health benefits in dramatically reducing the rate of HIV transmission and risk of hepatitis infections among injection drug users without increasing the rate of illegal drug use.
The new report by the Centers for Disease Control and Prevention found that use of these programs has increased substantially during the past decade, but most people who inject drugs still don't always use sterile needles. Sharing needles and syringes is a direct route of transmission for HIV and hepatitis B and C viruses.
As a result, decades of progress in reducing HIV spread by dirty needles is being threatened. People who would not have been considered at risks for these infections are now vulnerable, especially white people living in predominantly rural areas of the country, including Appalachia, rural parts of New England, and the Ozarks.

Read the full article.

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By Eric Wicklund - mHealth Intellegence

A telemedicine program born at the University of New Mexico is set to become a national model for pushing healthcare into remote and underserved regions.
The Senate approved by a 97-0 vote S. 2873, the Expanding Capacity for Health Outcomes (ECHO) Act. The bill places UNM’s five-year-old groundbreaking Project ECHO (Extension for Community Healthcare Outcomes) on a national stage, setting the wheels in motion for a national network of hub-and-spoke telemedicine platforms to provide education and collaboration opportunities for healthcare providers in hard-to-reach areas.
The legislation calls on the Health and Human Services Department to prepare a report within two years on the various applications of Project ECHO around the country, examining their impact on, among other things: 

  1. mental and substance use disorders, chronic diseases and conditions, prenatal and maternal health, pediatric care, pain management and palliative care;
  2. healthcare workforce issues, such as specialty care shortages and primary care workforce recruitment, retention, and support for lifelong learning;
  3. the implementation of public health programs, including those related to disease prevention, infectious disease outbreaks, and public health surveillance; and
  4. the delivery of healthcare services in rural areas, frontier areas, health professional shortage areas and medically underserved areas and to medically underserved populations and Native Americans.

Read the full article.

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National Rural Oral Health Initiative

From the National Rural Health Association

The National Rural Oral Health Initiative is the combined effort of the National Rural Health Association and the DentaQuest Foundation to improve oral health disparities in rural America through policy, communications, education and research. As oral health issues have long impacted those living in rural communities, the activities included in this initiative are designed to enhance access to quality oral health care.
The specific purpose of the National Rural Oral Health Initiative is to provide leadership on rural oral health care with the intent to establish oral health care as part of primary care, thereby increasing health care access for all rural Americans.

NRHA will accept submissions related to rural oral health surrounding best practices and models for access to care, innovative collaborations, public-private partnerships, reimbursement methods, and workforce. The compendium’s purpose is to help highlight best practices and inform rural health stakeholders.

The submission deadline is January 19.  Click here to learn more.

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Mark Your Calendar

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

December 20: Addressing Opioid Overdose and Opioid Use Disorder in Hospitals - webinar
December 20: Comprehensive Care for Patients with HCV - webinar
December 22: Implementing Telehealth​ - webinar
January 5: Incorporating Key Finding from the Surgeon General's Report on Addiction into your Practice​ - webinar
February 5-8: Rural Healthcare Leadership Conference - Phoenix, AZ
February 7-9: 28th NHRA Rural Health Policy Institute​ - Washington, DC
April 2-4: MATRC Telehealth Summit - Leesburg

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Model Program: Felton Institute Prevention and Recovery in Early Psychosis
Need: A treatment model for those showing early signs of schizophrenia.
Intervention: The Felton Prevention and Recovery in Early Psychosis (PREP) program was started in rural and urban California counties. Felton PREP encourages schizophrenia remission in clients through medication and psychosocial initiatives.
Results: Clients’ hospitalization and psychiatric emergency room visits were reduced by 70% after 1 year of treatment. Schizophrenia symptoms also reduced significantly among Felton PREP clients.

Heartland OK
Need: Over 9,000 people in Oklahoma die from heart disease each year.
Intervention: Heartland OK, which began in 5 rural counties, is a care coordination model that works to reduce heart disease and stroke risks for patients.
Results: 25% of patients met their hypertension goals within 90 days.

Innovations in Rural Health System Development: Governance
A discussion about the need for collaboration between healthcare facilities and their communities, including ideas for new approaches to governance to help make these transitions happen. Provides examples of hospital/health system collaborations and population health programs.

Measuring Rural Wealth Creation: A Guide for Regional Development Organizations
Presents concepts and samples to create a development plan for measuring progress in rural wealth creation for rural development organizations (RDOs) involved in community and economic development. Specifically identifies 8 forms of capital measures useful to evaluate progress in rural wealth creation including the skills, understanding, physical health and mental wellness of the individuals within the community.

Rural America at a Glance 
USDA annual report on economic trends in rural areas. USDA’s Economic Research Service reports that, for the first time since the Great Recession began, population loss has leveled off, poverty rates are falling, and unemployment dropped below six percent.

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Funding Opportunities

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

Health Professions Extern Program
Provides externship opportunities for Indian Health Service Scholarship recipients, as well as other health professions students.
Application Deadline: Jan 31, 2017 

Pre-Doctoral Pediatric Dentistry Training
HRSA’s Bureau of Health Workforce is accepting applications for its Pre-Doctoral Pediatric Training in General Dentistry and Dental Hygiene program. The purpose of this program is to enhance clinical pediatric pre-doctoral dental or dental hygiene training focusing on children ages 0-5 to improve the oral health of vulnerable, underserved, and rural pediatric populations.
DEADLINE: January 30, 2017

Paralyzed Veterans of America Education Foundation
The Paralyzed Veterans of America is dedicated to veterans’ service, medical research, and civil rights for people with disabilities. The Paralyzed Veterans of America Education Foundation supports educational projects that serve individuals with spinal cord injury and disease (SCI/D), as well as their families and caregivers. The Foundation’s five grantmaking categories include the following: Consumer, Caregiver, and Community Education; Professional Development and Education; Research Utilization and Dissemination; Assistive Technology; and Conferences and Symposia. Members of academic institutions, healthcare providers and organizations, and consumer advocates and organizations throughout the United States and Canada are eligible to apply for grants of up to $50,000.
The application deadline is February 15, 2017. 

Virginia Health Care Foundation
The Virginia Health Care Foundation promotes public-private partnerships that increase access to primary health care services for medically underserved and uninsured Virginians. The Foundation’s Health Safety Net Grants support organizations that work to increase access to primary care for uninsured Virginians and those who live in areas with limited access to care. Funding focuses on projects that address one or more of these priorities: developing or expanding patient capacity, establishing a broader scope of services, creating local systems of care, and strengthening the infrastructure of health care providers. Nonprofit organizations and public agencies, including free clinics, community health centers, and other similar organizations are eligible to apply. The first concept paper deadline for 2017 is January 20th. 

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