VRHA Weekly Update
In this Issue  May 15, 2017

VRHA News Virginia News National News Mark your calendar
Funding Opportunities


May newsletter





By Carol Vaughn - DelMarVaNow

Riverside Health System has an annual impact of nearly $73 million on the Eastern Shore of Virginia economy, according to a recent study.  The Accomack County Board fo Supervisory reviewed findings from the study at its April meeting.

The healthcare system on the Eastern Shore operates [VRHA member] Riverside Shore Memoral Hospital near Onacock, as well as Shore Cancer Center, serveral medical centers and specialty physicians groups, home health and hospice services, and Riverside Shore Rehabilitation Cener in Parksley.

Read the full article.

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Members in the News

By Rachael Smith - News & Advance

A $4 million expansion project that will increase the size of [VRHA member] Bedford Memorial Hospital emergency department by more than 30 percent will begin in June. But before work gets underway, the hospital will open a temporary emergency department on the second floor starting May 18. 

Bedford Memorial Hospital CEO Patti Jurkus said the newly renovated and expanded emergency department is planned to open in March 2018.

“We are very excited about the opportunity to expand the emergency department,” Jurkus said. “We want the community to have easy access to the emergency department during this renovation.”

Read the full article and a related story in the Bedford Bulletin.

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More Members in the News

By Stephanie Porter-Nichols - SWVA Today

The local hospital’s CEO contends that the drug crisis impacting Smyth County is so serious that he implored the Smyth County Board of Supervisors to set up a task force to combat it. He called for the task force to be a public-private team made up of representatives of businesses, civic groups, churches, municipalities, health-care providers and other stakeholders.
[VRHA member] James Tyler, Smyth County Community Hospital’s CEO, told the supervisors that the drug-use situation is “highly significant” and creates a huge cost for the community. As just one example, he noted that two deputies frequently have to stay with a patient four to eight hours for a health check before they accompany the patient to a health-care facility for appropriate treatment. “It’s already affecting your budget,” the CEO said.
The cost isn’t just monetary. On the health front, Tyler said, the hospital is seeing an increase in HIV/AIDS and Hepatitis B and C cases as well as needle-site infections. He also pointed to the community’s overall economy, noting that a significant percentage of the county’s workforce is unemployable because of individuals’ drug use.
Read the full article.

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Virginia News

Aetna Leaving

By Zachary Tracer - Bloomberg

Aetna Inc. is quitting Virginia’s Obamacare market for 2018, the second state that Chief Executive Officer Mark Bertolini is exiting as he seeks to limit his insurer’s risks from the beleaguered health law.

“We will not offer on- or off-exchange individual plans in Virginia,” Aetna said in an emailed statement, citing $200 million or more in losses the company anticipates this year on individual products. The insurer also cited “growing uncertainty in the marketplace” for the plans.

UnitedHealth Group Inc., which has largely stopped selling ACA health plans, said last month it was pulling out of Virginia. Also in April, Aetna said it wouldn’t sell Obamacare plans on Iowa’s market next year.

Read the full article.

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By Laura Vozzella - Washington Post

Gov. Terry McAuliffe and the Republican legislature have escalated a long-running fight over whether a handful of his vetoes are valid — a battle that could determine whether the Democrat is able to pull off his marquee campaign pledge to expand Medicaid before leaving office in January.

McAuliffe on Friday issued an executive order directing state agencies to recognize the state budget as he sees it — including five vetoes he made to various parts of the two-year spending plan. One of those vetoes, issued a year ago, rejects language that the General Assembly had inserted to prevent him from expanding Medicaid under the Affordable Care Act without its permission.

Read the full article.

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$9.7 Million for Opioid Crisis

From the Office of the Governor

Governor Terry McAuliffe today announced that Virginia has received a $9.76 million federal grant to help fight the opioid epidemic. The one-year grant comes from the Substance Abuse and Mental Health Services Administration, an agency of the U.S. Department of Health and Human Services. It will support prevention, treatment and recovery efforts in 18 Virginia communities. The grant will be administered by the Department of Behavioral Health and Developmental Services (DBHDS). 

The grant money will be used to purchase medication, support medical staff necessary to prescribe and oversee clinical treatment, and remove barriers to access, such as transportation. These funds will also help provide the counseling and case management necessary to help individuals with opioid addiction stabilize their lives and begin the process of recovery. The project will strengthen and utilize existing local community coalitions that have formed across the Commonwealth to address this issue, building upon activities underway with Governor McAuliffe’s Executive Leadership Team on Opioid Abuse and Addiction.

Read the full press release.

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National News

Distributed Medicine

By Joshua Landy - The Hill

To say there aren’t enough doctors in the United States isn’t quite accurate: If you’re a patient at Mount Sinai Health System in New York City, there are plenty of brilliant specialists. It’s when you’re a patient at Haywood Park Community Hospital in Brownsville, Tenn., that there aren’t enough — that hospital closed its doors in 2014. Haywood County is what The Washington Post recently called a “dead-hospital zone,” a part of the country where the local ER is the back of an ambulance and the old operating room is used for movie shoots.
It is areas like this, in rural America and around the world, that telemedicine can most immediately help save lives. That melanoma can be caught earlier when diagnosing it is as easy as taking a photo. Chronic cough can be assessed without missing a day of work to make a pilgrimage to the clinic. And the availability of those remote services frees up healthcare professionals on the ground to devote themselves to the most urgent cases.
But as helpful as that will be to the citizens of Haywood County, it’s a solution that aspires only to bring us back to where we were. Telemedicine is a symphony on television. For a few, it’s exactly what they want. But the model can’t scale because it doesn’t let doctors see that many more patients. Yes, there is an immediate time savings in skipping the trip to the hospital and the time spent in the waiting room. And yes, a doctor might be able to squeeze a few more patients into each workday. But that’s not fixing healthcare. That’s trimming around the edges.  

Read the full editorial.

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Ride Hailing for Rural

By ML Schultze - NPR

It's easy enough for people who live in cities to hail a ride, either from a taxi or a service like Uber or Lyft. There's plenty of demand, and plenty of drivers. A startup is trying to bring a similar service to rural America, but it has required some creative thinking.
The town of Van Wert sits on the western edge of Ohio. It's a stretch of flat farm country punctuated with grain silos and a stone castle that's listed as the nation's first county public library.  It doesn't seem like the first place a ride-hailing service would likely come. But Erica Petrie says maybe that's a mistake.
Petrie is the mobility manager of the seven-county Area Agency on Aging. Her job is to find transportation options in Van Wert, which has no buses, one cab and a lot of needs.

Read the full article.

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Addicted and Expecting

By Jeremy Olson - StarTribune

Few things have been as heart-wrenching for obstetrics doctors and nurses at Sanford Bemidji Medical Center in recent years as helpless newborns hooked on the opioid drugs their mothers abused during or before pregnancy.

The tragedy has grown in lockstep with Minnesota’s rising number of overdoses and deaths from prescription opioid painkillers or illicit versions such as heroin — particularly in rural counties near American Indian reservations, where the opioid epidemic has been harshest. The number of babies born at Sanford Bemidji and placed on 72-hour protective holds due to positive drug tests has tripled since 2008, from 25 to 75 last year.

But now, for the first time, a concentrated effort at Sanford Bemidji to support addicted mothers before their deliveries has started to make a difference. And hospital leaders across Minnesota are hoping to expand on the success of Sanford Bemidji’s First Steps to Healthy Babies program to combat a worsening opioid epidemic.

Read the full article.

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Connecting Rural America

By Shirley Bloomfield - Daily Yonder

Recent events have put rural America and our country’s ability to bring broadband to rural locations in the spotlight. As part of this broader conversation about rebuilding rural America, one question keeps rising to the top: how best can those in charge of telecom policy address connectivity needs that will only grow in the coming years?

Ask those most familiar with rural infrastructure projects—not just rural telecom companies, but rural electric cooperatives or rural water operators—if they could justify building a significant, multi-million dollar system on the prospect of individual consumer vouchers, and they would tell you that’s impossible in most, if not all, deeply rural areas where densities are a handful of subscribers per square mile (or less). This is why we have electric rate bases that provide specified returns for electric cooperatives from rural consumer rates. And that’s why in the more deregulated telecom industry, policymakers support networks through universal service support in rural areas. If you did something drastic like eliminating the ability to recover costs from customers through a regulated electric rate base, or if you moved to a voucher system in the telecom space, the rural infrastructure system quickly falls apart.

As policymakers seem to recognize as they talk about infrastructure policy, such a change isn’t just about rural America. This isn’t about strengthening only certain regions of the United States. It’s about strengthening the entire country. That’s because investments in rural broadband don’t just help to make rural America strong; they boost the rest of the country as well. A recent Hudson Institute report showed that the impact of rural telecom investment extends to all of America, contributing $24.1 billion to the U.S. economy in 2015 and supporting nearly 70,000 jobs.

Read the full editorial.

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Mark Your Calendar

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

May 17: Providing Culturally and LinguisticallyCompetent Behavioral Health Services to
Diverse Populations in Rural Communities
 - webinar
May 18: Addressing Social Determinants to Improve Health Outcomes  - webinar
May 19: Aging in Appalachia Conference - Marion
May 23: Synthetic Narcotic & Opioid Abuse Prevention Seminar - Big Stone Gap
May 23: Magellan Complete Care of Virginia - webinar
June 8: Virginia Health Care Conference - Richmond
June 21: Responding to Natural Disasters in Rural Communities  - webinar
August 16: A Focus on Suicide Prevention in Rural Communities  - webinar

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A one-stop resource for information relating to private water well systems and groundwater. Learn how to protect this precious resource and safeguard health through properly constructed and maintained water well systems.

Report on State Telehealth Policies
The Center for Connected Health Policy recently released its 5th annual report on telehealth laws and reimbursement policies of the 50 states and Washington, DC.  These regulations, unique to each state, affect the potential to increase telehealth capacity in rural areas lacking adequate access to health care.

Mapping the Opioid Crisis
Rural communities, families, health providers and law enforcement can see the impact of substance abuse, but various factors make it difficult to find real time data about its impact. The Center for Health Journalism has created a guide to a series of resources and data tools that can help communities develop an accurate picture of the opioid epidemic at the local level.

Merit-based Incentive Payment System (MIPS) Lookup Tool
CMS is releasing a provider look-up tool, a web-based system that allows providers to verify their status.  For a clinician to determine his or her status, all they need to do is to enter their national provider identifier (NPI) into the entry field on the tool which can be found on the Quality Payment Program website. Information will then be provided on whether or not the clinician should participate in MIPS this year and where to find resources. 

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Funding Opportunities

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

SBA 7a Loans
Provides loans to small businesses (including small healthcare practices) for working capital; equipment purchase; real estate purchase; building construction or renovation; business acquisition; and debt refinancing.
Applications accepted on an ongoing basis 

Research in Transforming Health and Health Care Systems 
Robert Wood Johnson Foundation seeks to fund rigorous, empirical studies that evaluate or predict the potential effects of policies or policy changes intended to transform health and health care systems. The 2017 RTHS CFP will focus on empirical and policy–relevant analyses that can inform strategies to ensure access to high-quality, affordable health care and insurance coverage.
Deadline: June 23

American Legion Child Welfare Foundation
The mission of the American Legion Child Welfare Foundation is to provide nonprofit organizations with a means to educate the public about the needs of children across the United States. The Foundation supports organizations that contribute to the physical, mental, emotional, and spiritual welfare of children through the dissemination of information about new and innovative programs designed to benefit youth, or through the dissemination of information already possessed by well-established organizations. Grant requests should have the potential to help American children in a broad geographic area (more than one state).
The application deadline is July 15, 2017. 

Department of Health and Human Services
The Behavioral Health Workforce Education and Training Program aims to develop and expand the behavioral health workforce serving populations across the lifespan, including rural and medically underserved areas.
The application deadline is June 12, 2017. 

Food and Nutrition Service
The SNAP Process and Technology Improvement Grants program provides support to develop and implement simple SNAP application and eligibility determination systems, and to improve access to SNAP benefits by eligible applicants.
The application deadline is June 19, 2017.

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