VRHA Weekly Update
In this Issue  April 10, 2017

VRHA News Virginia News National News Mark your calendar
Funding Opportunities


April Newsletter





You're Invited!

United Health Care is running a series of listening sessions on how they can better address rural health issues in the communities they serve.  VRHA is assisting them with identifying participants and assuring that the meeting has representation from a broad variety of sectors (hospitals, RHCs, etc.).

The meeting will be held from 10am-noon on April 17th in Blacksburg.  Meeting information can be viewed here. The NRHA policy paper referenced within the invitation can be found here.
If you want to attend, or if you want someone else within your entity to be your designated representative, please contact Beth O'Connor (540-231-7923)

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New Officers

The VRHA student club at the Edward Via College of Osteopathic Medicine recently elected new officers.  Congratulations to:

  • President - Rachel Horn
  • Vice President - Lynsay Bush 
  • Secretary - Christina Lee  
  • Treasurer - Peyton Kremer

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Members in the News

By Scott Wise - CBS 6

A powerful storm damaged [VRHA member] Rappahannock General Hospital, according to witnesses at the Kilmarnock hospital. Photos shared with WTVR CBS 6 from the hospital showed broken windows and a damaged facade. There were no reported injuries at the hospital due to the storm.

"It was very scary, especially since we had patients, we had to quickly move to a safe location in the center of the building," nurse Becca Paige Gillie said. "About 10 of us, patients, and the wonderful oncology staff crammed into a storage room until we were told we could come out."

Read the full article.

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Virginia News

No Expansion

From the Office of the Governor

Governor McAuliffe released the following statement today after Republican legislators blocked his budget amendment empowering him to pursue planning for Medicaid expansion on October 1st, 2017:

“I am disappointed that Republicans in the General Assembly continue to put politics before the health of the people of Virginia. In light of President Trump’s failed attempt to repeal the Affordable Care Act, the Commonwealth has no excuses left to hold out on Medicaid expansion. By refusing to expand the program, we’ve forfeited $10.4 billion and we will continue to forego $6.6 million every day we do not take action.

“Expanding Medicaid will not just make Virginians healthier by extending coverage to nearly 400,000 people, it will also strengthen our economy. We would create up to 30,000 jobs, save our budget $73 million annually, build a healthier workforce, and help struggling rural community hospitals.

“While Republicans continue to play politics with the health of our residents, we will continue to investigate every available option to expand Medicaid in Virginia. I will continue to fight to bring our taxpayer dollars home to save lives, create jobs, and make our Commonwealth stronger.”

See related news articles at WVTF, Virginia FirstRichmond-Times Dispatch, Modern Healthcare, Winston-Salem Journal, Miami Herald, and the Washington Post.

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Fighting Fear

By Josh Barney - UVA Today

Researchers at the University of Virginia School of Medicine are hoping that the power of the Internet – and compelling personal experiences – will help reach people with HIV who are neglecting their health because of fear, stigma or substance abuse.

The researchers are testing an online program they have developed to address the most common problems they see among people who are failing to take their HIV medications. In some cases, they say, people won’t even fill their prescriptions because they don’t want anyone to know about their diagnosis – even their pharmacist.

“A lot of our patients are from rural areas, and they fear people finding out they have HIV, because they fear being rejected,” explained Karen S. Ingersoll, an associate professor in the Department of Psychiatry and Neurobehavioral Sciences. “It’s a realistic fear, so we address the need for social support when living with HIV.”

Read the full article.

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Close to Home

Lisa Philip - WUNC

On a recent morning, two third-graders from New Hanover County get their teeth cleaned and examined in the dentist's office that's parked next to a dumpster, under a stand of pine trees behind their school. The mobile clinic was at another school the day before.

Both students’ eyes are glued to Netflix movies of their choosing. Neither seem to notice the x-ray machines or dental implements crowding the 50-foot trailer. The unit, one of a handful around the state, has served nearly 5,000 children since it opened in 2006. For many, climbing aboard means their first visit to a dentist.

This is the Miles of Smiles mobile dental clinic. Operated by the New Hanover and Brunswick county health departments, it stops at 19 schools a year to screen and treat low-income children. With proof of Medicaid enrollment, students are seen for free.

Read the full article.

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National News

Population Health Doc Shortages

From Health IT Analytics

As the financial and professional environment for clinicians keeps getting tougher and tougher, the healthcare system is likely to continue experiencing a significant physician shortage, with up to 105,000 vacant positions expected by 2030, says the Association of American Medical Colleges (AAMC).

Surgeons are likely to be a much rarer breed by 2030, a new report predicts, with predicted shortfalls of between 20,000 and 29,000 physicians, while organizations seeking specialists are likely to post up to 61,000 unanswered job ads.

The majority of patients may be hit hardest by declining access to primary care providers, however.  Projected primary care shortfalls range between 7300 and 41,300 physicians, but that number could increase if underserved populations continue to make gains in access to care. 

And, counterintuitively, the shortage could become significantly more dire if the nation manages to achieve its population health management goals.

Read the full article.

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Telemedicine for Rural Vets

From mHealth Intelligence

The Veterans Administration is testing a telemedicine-based collaborative care model on rural veterans in two states who are diagnosed with HIV. It builds on an earlier attempt to use the Project ECHO telemedicine model to improve access to care for rural veterans with HIV – which officials admit didn’t fare too well.
This new program, launched by Michael Ohi, MD, of the VA’s Iowa City, Iowa, healthcare system, targets some 800 veterans with HIV in rural areas of Georgia and Texas. Those veterans who have to drive more than 90 miles to the nearest VA clinic with an HIV specialty clinic are given the chance to connect with that clinic via a telemedicine platform at a closer community-based outpatient clinic (CBOC) run by the VA.
“Veterans should have easy access to HIV testing and state-of-the-art HIV care regardless of where they live,” Ohi, an infectious disease specialist, said in a press release issued in January. “We know that compared to their urban counterparts, rural veterans with HIV enter care with more advanced illness, are less likely to receive the latest advances in HIV treatment, and have lower survival rates. We want to change that.”

Read the full article.

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Reducing Isolation

By Bryan Thompson - KCUR

The social and health effects of isolation on some rural Kansas residents spurred three Catholic nuns to convert a storefront in Concordia into a drop-in center where women can find support and resources.
Seven years after the center opened, two dozen women on average come through each day in the town of about 5,000 to socialize, do laundry, get a cooking lesson, or simply connect with others.
Sister Pat McLennon, who helped launch Neighbor to Neighbor in Concordia and still serves as its co-director, says the center started as a place for women in the community to teach skills to young mothers in poverty while providing enrichment activities like reading and music to their kids. But it quickly drew women of all ages, including some helping as volunteers and others fulfilling mandated community service.

Read the full article.

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The Rural/Urban Divide

By Stephan Weiler, Tessa Conroy, and Steve Deller - the Conversation

We’ve all heard of the great divide between life in rural and urban America. But what are the factors that contribute to these differences? We asked sociologists, economists, geographers and historians to describe the divide from different angles. The data paint a richer and sometimes surprising picture of the U.S. today.

  1. Poverty is higher in rural areas
  2. Most new jobs aren't in rural areas
  3. Disabilities are more common in rural areas
  4. Rural areas are surprisingly entrepreneurial
Read the full article.

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Mark Your Calendar

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

May 9: Rural Medical Education Conference - San Diego, CA
May 9-12: 40th Annual Rural Health Conference - San Diego, CA
May 9-12: Rural Hospital Innovation Summit - San Diego, CA

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2017 Virginia Population Health Summit
Slides from last week's event.

2017 County Health Rankings
The annual Rankings provide a revealing snapshot of how health is influenced by where we live, learn, work and play. They provide a starting point for change in communities. 

VA and Community Provider Training 
The U.S. Department of Veterans Affairs (VA) strives to share its research and medical approaches to Veteran care. A variety of free trainings that include continuing medical education credits are available on MyVeHu and VHA TRAIN VA training platforms. The Office of Rural Health identified the courses listed as beneficial for rural Veteran care.

Webinar Recording: NACRHHS Policy Brief on Social Determinants of Health
Watch the recording of our March 14th webinar that discussed the National Advisory Committee on Rural Health and Human Services' recommendations for addressing social determinants of health in rural communities.

CDC MMWR Rural Health Series
A collection of resources and information on the 2017 Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report Rural Health Series, as featured on the Rural Health Information Hub. 

Model Program: Hope Squad
Hope Squad helps students in Utah and six other states identify classmates struggling with suicide and other mental health concerns and refer them to adult advisors who can help. 

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Funding Opportunities

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

Targeted Capacity Expansion: Substance Use Disorder Treatment for Racial/Ethnic Minority Populations at High-Risk for HIV/AIDS
Awards funding to increase engagement in care for racial and ethnic minority individuals with substance use disorders and/or co-occurring substance use and mental disorders Grantees will work to reduce the negative impact of behavioral health problems, while increasing access to behavioral healthcare, creating healthcare linkages, and improving treatment retention.
Application Deadline: May 3, 2017 

Community Based Model of Public Health Nursing Case Management Services
Funding to establish a community-based model of public health nursing case management service in order to improve specific behavioral health outcomes of an identified high risk group of patients.
Application Deadline: May 15, 2017 

Strategies to Increase Delivery of Guideline-Based Care to Populations with Health Disparities (R01)
Awards funding for innovative, multi-level studies to test systems, infrastructures, and strategies that will accelerate the adoption of guideline-based recommendations into clinical care relevant to heart, lung, blood diseases, and sleep disorders. Vulnerable populations include medically underserved individuals, racial and ethnic minorities, low income groups, and rural-dwelling patients.
Letter of Intent (Optional): May 21, 2017
Application Deadline: Jun 21, 2017 

Promoting Integration of Primary and Behavioral Health Care
The Substance Abuse and Mental Health Services Administration (SAMHSA) is accepting applications for Promoting Integration of Primary and Behavioral Health Care Grants totaling up to $110 million over the course of five years. The purpose of this program is to promote full integration and collaboration in clinical practice between primary and behavioral healthcare. The grants will also help promote services related to screening, diagnosis, prevention and treatment of mental and substance use disorders as well as related physical conditions and chronic diseases.
Deadline: May 17

Relatives As Parents Program
As the nation continues to grapple with the toll of the opioid abuse epidemic, particularly in rural areas, more grandparents are raising their children.  The Brookdale Foundation group has issued a request for proposals (RFP) for its Relatives as Parents Program (RAPP).  Brookdale will select up to 15 programs to receive a seed grant of $15,000 and ongoing technical assistance to create or expand support services to grandparents and other relatives raising children.  Any not-for-profit organization can apply for the program, including aging service providers, county agencies, and health care providers.  
Deadline: June 15

MultiPlan Rural Health Outreach Grant
Grants to hospitals serving rural areas to introduce or expand services, education, screenings, and other programs aimed at improving the health of people in their communities.
Application Deadline: May 19, 2017 

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