Virginia Rural Health Association - Weekly Update
VRHA Weekly Update
In this Issue  October 27, 2014

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VRHA News

From Soup to Nuts: Getting a Telehealth Program Off the Ground     

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There are many forms of telehealth, including live-interactive videoconferencing, remote patient monitoring, store-and-forward imaging, and mobile health.  Telehealth is a great idea and has significant benefits for rural health care.  So now what?  What does it take to establish a successful telehealth program?  How do I decide on which technology solutions to use?   What are the legal ramifications?   If I build it, will anyone come?   And if they come, how do I make it financially sustainable?  This session will provide an overview of the guiding principles and core elements needed for building a successful telehealth program, with an emphasis on best practices for rural providers and in rural health care settings.

Come hear from Kathy Wibberly, Director of the Mid-Atlantic Telehealth Resource Center about the telehealth basics you need to consider during this session at the VRHA Annual Conference.  Click the conference logo above for more information about the event.

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Members in the News

By Laurence Hammack - Roanoke Times

Two members of Congress brainstormed Wednesday with a dozen medical minds on finding cures — both for sick patients and the sometimes broken health care system that treats them. U.S. Rep. Morgan Griffith was joined Wednesday by Rep. Phil Roe, R-Tenn., at [VRHA member] Edward Via College of Osteopathic Medicine for one in a series of roundtable discussions being held by committee members across the country.

The goal is to hear from doctors, health care administrators, researchers, biomedical experts and other specialists and then take their ideas back to Washington to craft new laws.

Read the full article, and related report from WSLS10.

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More Members in the News

From the US Department of Health and Human Services

HRSA Administrator Mary K. Wakefield, PhD, RN, announced $1.4 million to support  rural health organizations in their efforts  to inform Americans living in rural areas  about benefits available to them under the Affordable Care Act and to help them sign up for health insurance coverage. Non-profit and public entities, including hospitals, health departments, community health centers, and rural health centers in 57 rural communities, will receive up to $25,000 each from the Office of Rural Health Policy, housed within HRSA.

VRHA member Giles Free Clinic has been selected as a recipient.  View the full press release.

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Virginia News

Doctor Departure

By Bonnie Ralston - Allegheny Mountain Radio

Four doctors have submitted their resignations to [VRHA member] Bath Community Hospital.  The resignations came about as a result of concerns with administration following the hospital board’s decision to not renew the contract of Dr. James Redington.

According to reports in The Recorder newspaper and on WDBJ 7 in Roanoke, Bath Community Hospital’s Board of Directors did not renew Dr. Redington’s contract.  Dr. Redington immediately left work at the hospital when he was given ninety days notice that his contract would not be renewed.

Dr. Michael Bost and Dr. Jeff McCray, who are full time doctors at the hospital, and Dr. Asher Brand and Dr. John Stout, part time doctors, have also submitted resignations.  All have given ninety days notice.

Read the full article and learn about the community forum.

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No Medicaid? Blame Gerrymandering

By Sam Rasoul - Roanoke Times

The Affordable Care Act expanded health care coverage two ways: 1. For those above the federal poverty line, one can go to the federal exchange, and 2. those below the federal poverty line would be covered through an expansion of the state-run Medicaid program with mostly federal funding. The Supreme Court ruled that ACA is constitutional except for the clause that forces a state to expand its Medicaid program. While more than half of the states have already expanded their Medicaid programs, Virginia has not yet chosen to do so largely for political reasons, many of which stem from gerrymandering.

Given our fiscal reality in Virginia with recent budget cuts, we should have a clear path to finding a consensus on Medicaid expansion with so many federal dollars available. Set aside the humanitarian case for covering hundreds of thousands of Virginians; the commonwealth stands to save $1.1 billion over the next eight years by expanding Medicaid as federal dollars supplant current state dollars spent on indigent care. This does not include the billions that will be paid to hospitals for patients, the jobs saved/added, and the economic impact of such a sizeable infusion into our economy. As for those worried that Virginia cannot afford its share of costs in later years, a study completed by The Commonwealth Institute found that if Virginia put the savings over the next several years in a trust fund gaining zero percent interest, all additional costs to Virginia would be covered through the year 2040. Even considering these facts, legislators involved in any Medicaid compromise in Virginia run the risk of a primary challenger. We have created hyper-partisan districts, forcing our legislators to be the same. Virginia deserves better.

Read the full editorial.

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Close to Home

By Katie Bo Williams - Healthcare Dive

To get to Johnson County Community Hospital, 30 miles southeast of Bristol, TN, you must drive straight through the mountains. From Blacksburg, VA, you drive the switchbacks of Route 91 where it snakes alongside Laurel Creek and crosses the Virginia-Tennessee state line. Logging truck drivers ride their "jake brakes." Towering among the dark pine trees is a billboard reading, “Meth Kills.” 

Mountain City, where Johnson County is located, is one of many isolated enclaves across the country where health care is limited to a single critical access hospital. Budgets are tight and services are limited —​ most lack any complex care, like obstetrics. Yet despite the paucity of resources, most rural hospitals are a paean to efficiency and quality of care. Behind the tight, two-bed facility, a helicopter pad acts as a kind of contingency plan, but it’s one that Chief Medical Officer Mark Wilkinson says is used only once a week at most. The hospital has both processes and infrastructure in place to deal with whatever arises.

Read the full article.

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National News

Is Rural Ebola Ready?

By Raymond Christensen - National Rural Health Association

The National Rural Health Association has long advocated that we are either all prepared to deal with emerging public health crisis, or as a nation, we are simply not prepared at all. Such is the case for the emergence of the Ebola virus. Decades of rural public health underinvestment raise serious concern as to the ability of a rural community to handle an Ebola-positive patient.

Each rural community needs to assess and determine inherent risks and capacities that can be brought to bear in responding to any public health threat. Ebola is no exception. From a rural perspective, the ability to identify and diagnose, and then the contact tracing role of local public health officials are the great unknown at this point.

Read the full article.

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Cost-Per-Patient 

By Frank Lang - Time

Over the past few years, Downieville, CA has been caught up in changes for funding health clinics. Federal and state priorities have shifted from rural and frontier areas to underserved, urban population areas. When you do the math, the cost-per-patient equation will always come out in favor of a clinic in an urban area. As a result, a rural clinic must rely on the support of a larger, population-focused clinic.

Now, under the Affordable Care Act, everybody has insurance. Theoretically, this means people should have more access to healthcare. But that’s not true in Downieville. More insurance won’t help people if healthcare treatments are inconsistent or unavailable.

One of the changes expected to take place in this new healthcare landscape is more reimbursement for clinics. But such reimbursement is based on the number of people served. There are not enough patient encounters in frontier areas like ours to be sustainable without grant or government funding.

Read the full article.

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More CAHs Likely to Close

By Michael Sandler - Modern Healthcare

Amid ongoing federal scrutiny of the extra funding paid small hospitals to serve remote areas, the number of critical-access hospitals in the U.S. continued to fall over the past year. Georgia's four closings last year were nothing new, said Jimmy Lewis, CEO of HomeTown Health, an organization of rural hospitals in Georgia. “We have no clue how to stop it, it's so far gone,” he said.

The problem, Lewis said, is a lack of funding. He said that there are 62 hospitals in rural Georgia, and that it takes a population of 40,000 to support a rural hospital in the state. With about 1.8 million rural Georgians, that leaves only 45 hospitals that can be supported, Lewis said. 

Read the full article.

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When a Hospital Closes

By Lisa Gillespie - Kaiser Health News

People in this one-stoplight farming town really want their hospital back. In a scenario playing out in rural areas across the country, the closing [of Vidant Pungo Hospital] has left local doctors wondering how they will make sure patients get timely care, given the long distances to other hospitals, and residents worrying about what to do in an emergency and where to get lab tests and physical therapy. 

People in the community also wonder about the closure’s long-term impact. After all, the hospital was the largest employer and health care provider in the area.  Residents know that with the loss of the hospital, which will have an estimated economic impact of between $14 million and $16 million a year, Belhaven won’t be the hub it was. Arthur Bonner, who lives outside of Belhaven, still makes the trip to town to get prescriptions filled, shop at the Food Lion and visit friends. 

Read the full article.

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Mark Your Calendar

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

October 29: Strategic Planning That Leaves You Smiling - webinar
October 29-30: Strengthening Local Food Systems in Appalachia - Abingdon
October 31: A Small Physician Practice’s Route to ICD-10 - Chesapeake
November 5: Transitioning to ICD-10 - webinar
November 14: Virginia Oral Health Summit - Richmond
December 11 & 12: Virginia Rural Health Association Annual Conference - Staunton

NRHD2014

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Resources

Future of Nursing: Leading Change, Advancing Health
Institute of Medicine examination of how nurses’ roles, responsibilities and education should change to meet the needs of an aging, increasingly diverse population and to respond to a complex, evolving health care system. The recommendations in the report focus on the critical intersection between the health needs of patients across the lifespan and the readiness of the nursing workforce. These recommendations are intended to support efforts to improve health care for all Americans by enhancing nurses’ contributions to the delivery of care.

Heart-Healthy Lenoir Project
A community-based model in rural North Carolina to develop and test better ways to tackle cardiovascular disease from prevention to treatment.

Accountable Care Organization (ACO) Investment Model Fact Sheet
Outlines new CMS model for Accountable Care Organizations participating in the Medicare Shared Savings Program. This ACO Investment Model is a new model of pre-paid shared savings that builds on the experience with the Advance Payment Model to encourage new ACOs to form in rural and underserved areas and current Medicare Shared Savings Program ACOs to transition to arrangements with greater financial risk.

National Equity Atlas
A comprehensive online resource that puts data on demographic change, racial inclusion, and the economic benefits of equity into your hands. With a click of the button, you can access key indicators on the largest 150 regions, all 50 states, the District of Columbia, and the nation as a whole.

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Funding Opportunities


Walmart State Giving Program
Applications accepted starting 01/19/15
Funding to organizations with programs focused on hunger relief and healthy eating, career opportunities, or the unmet needs of low-income populations. 

Toyota Foundation
Deadline: Ongoing
Funding to organizations that focus on the three main areas of education, the environment, and vehicle safety.

American Association of University Women: Community Action Grants
The American Association of University Women (AAUW) Community Action Grants program provides funds to individuals, AAUW organizations, and local community-based nonprofit organizations throughout the country that address issues related to the needs of women and girls or that provide information to educate and benefit the public on those issues. Special consideration is given to projects focused on K-12 and community college girls' and women's achievements in science, technology, engineering, or math. One-year grants of $2,000 to $7,000 provide funds for community-based projects that include a clearly defined activity that promotes education and equality for women and girls. Two-year grants of $5,000 to $10,000 provide start-up funds for new projects that address the particular needs of the community and develop girls' sense of efficacy through leadership, advocacy, or training opportunities. The application deadline for both types of grants is January 15, 2015.

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Virginia Rural Health Association
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