VRHA Weekly Update
In this Issue  July 17, 2017

VRHA News Virginia News National News Mark your calendar
Funding Opportunities


Summer Newsletter





View from the Hill

Trying to make sense of what is going on in Washington, D.C.? The Thursday plenary session of the 2017 Virginia Rural Providers Conference will feature Maggie Elehwany, JD - Government affairs and policy vice president of the National Rural Health Association.  

Ms. Elehwany will provide an overview of the rural health policy landscape in Washington, DC. Learn firsthand about the development and implementation of healthcare policy at the federal level. 

Click the event logo to the right for additional details, including links to registration and lodging.
South Boston, VA
October 25 & 26

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Thank You Dr. McFadden

From the VDH Office of Health Equity

Thank You, Dr. McFadden for all that was accomplished under your leadership at the Office of Health Equity. As an office, we are all sad to see an energetic and determined leader leave our department, yet are ALL extremely appreciative of what was accomplished.  We wanted to highlight some of the great accomplishments that occurred under your leadership and guidance.

Click here to review the list.

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Members in the News

By Emily Brown - Nelson County Times

Randy Pirtle, a health administration executive with more than 30 years of experience in the health services field, has been named Blue Ridge Medical Center’s new CEO. He will take the helm this fall.

The news comes just about five months after former Blue Ridge Medical Center CEO Peggy Whitehead announced her retirement.

Read the full article.

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Virginia News

Merger Application

By Hank Hayes - TimesNews

Tennessee Department of Health Commissioner John Dreyzehner in consultation with Tennessee Attorney General Herbert H. Slatery III announced the Certificate of Public Advantage (COPA) application from Mountain States Health Alliance and Wellmont Health System has again been deemed complete and the COPA process will move forward.
The COPA, if given final approval, would allow both hospital systems to merge in Tennessee and be called Ballad Health. A similar cooperative agreement awaits action by the Virginia Department of Health.
"As we move into this next phase of the COPA process, TDH will work with the attorney general’s office to determine whether granting a COPA would provide an undisputable public benefit to the people of Northeast Tennessee,” Dreyzehner said.
The Federal Trade Commission believes the merger will eliminate health care competition in the region. Back in January, Dreyzehner said in an email that the merger “would result in less competition for health care services in Northeast Tennessee and Southwest Virginia.”

As outlined in state statute, the deadline for a decision on the COPA application is Sept. 19.

Read the full article, and related story from Johnson City Press.

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Highest Opioids in Nation

By Hannah Story - WDBJ7

A new report from the Centers for Disease Control reveals the city of Martinsville was number one in the nation for opioids being prescribed per-capita in 2015.

Martinsville Police recently noticed a rise in opioid abuse and started an "Opioid Task Force" with help from other community groups. Since May, members of the task force have been going door to door every Saturday delivering educational pamphlets.

Read the full article.

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What They Want

From PBS Newshour 

As Republicans on Capitol Hill try to repeal and replace the Affordable Care Act, we visit patients and health care providers at a free clinic in rural southwest Virginia -- a region that strongly supported President Trump, in a state that did not expand Medicaid under the Affordable Care Act -- to listen to the extreme health care challenges they face and what they think should be done. 

Watch the video.

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National News

BCRA Update

By Diane Calmus - National Rural Health Association

The Senate released their revised version of the Better Care Reconciliation Act of 2017 (BCRA). The text of the bill can be found here. 

While the National Rural Health Association is pleased the bill includes an additional $100 billion to help low-income Americans buy coverage and to combat the opioid epidemic, we are disappointed that the BCRA still falls woefully short in making health care affordable and accessible to rural Americans. The bill maintains some of the provisions that led to NRHA's opposition of the original language. 

NRHA is disappointed that the bill continues to include deep Medicaid cuts that change the program from an open-ended federal commitment to a capped federal payment that limits federal spending, leaving either states, patients, or providers to struggle with the loss of funds.

The Medicaid expansion is also eliminated, being phased out over a four-year period from 2020 to 2024. Tax credits to assist individuals in purchasing insurance remain in the bill, even with the increased levels to assist some low-income individuals, the premium assistance is still likely to fall short of making health insurance affordable for many rural Americans. While the bill does keep in place some of the taxes included in the Affordable Care Act (ACA) to pay for the coverage expansion, many are rolled back or eliminated. Furthermore, this bill continues to eliminate the individual and employer mandates.

​The bill tentatively includes a controversial amendment to allow for the sale of health insurance plans that do not meet the coverage requirements of the Affordable Care Act. While these deregulated plans are likely to have lower premiums, they will offer substantially diminished coverage that will leave many without meaningful insurance. While we support the goal of lowering premiums and the overall cost of receiving health care, simply providing lesser coverage will leave many rural Americans without the care they needAnd at the same time, raise premiums for full coverage marketplace plans even further out of reach of most rural Americans. Furthermore, plans without meaningful coverage will result in greater charity care and bad debt at rural hospitals, further exacerbating the rural hospital closure crisis. 

Read the full article and additional commentary on BCRA from the Commonwealth Institute, the American Hospital Association and Politico.

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Price Commitment to Rural

By Diane Calmus - National Rural Health Association

NRHA CEO Alan Morgan spoke with HHS Secretary Price on Thursday regarding proposed regulations just released by HHS for the Hospital Outpatient, Ambulatory Surgical Center Payment System. In this conversation, Secretary Price made a commitment to prioritize rural hospitals and health care.

Additionally, Secretary Price discussed a proposed change to the 340B drug discount program. This program currently provides discounted outpatient drugs to certain hospitals and covered entities, including rural hospitals. These savings are then passed along to patients that struggle to afford medications or can be utilized by the hospital to provide charity care. The proposed change would require the savings from the 340B program be instead passed along to the Medicare program and Medicare beneficiaries and will result in substantial savings to the Medicare program.

Secretary Price solicited NRHA input in how best to utilize these savings to help rural hospitals. NRHA is committed to ensuring these savings are directed to rural hospitals in order to ensure rural hospitals remain open and able to provide care to rural Americans, including rural Medicare beneficiaries. Since the change will result in a loss of funds to rural hospitals participating in the 340B program it is imperative that any funding directed as a result of this change is a net positive for rural hospitals.

Read the full article.

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Contraception Funding

Kim Soffen - Washington Post

Planned Parenthood would be cut off from Medicaid funding for one year under the Senate’s health-care bill. That would leave other clinics scrambling to pick up the organization’s Medicaid clients, in some cases needing to more than triple their contraception caseloads. And in the likely event that clinics can’t expand that much that quickly, the bill would leave many of Planned Parenthood’s 2.4 million annual patients without care, at least temporarily.

Rural health centers could see a spike in caseloads. The burden on FQHCs — and on the women who could no longer access birth control — would be most acutely felt in rural areas, where clinics are more sparse. This shows clearly in the data for New York, where Planned Parenthood locations in rural areas upstate serve a far greater proportion of contraception patients than they do in New York City. If patients were turned away from Planned Parenthood en masse, rural clinics would face much greater growing pains, potentially leaving many more women without care.

Read the full article.

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The Image Problem

By Jerry Hagstrom - National Journal Daily

Rural America has a problem with its image, one that may come to haunt both the Trump administration and the Democrats as they try to address the region’s problems and promote economic development.
Over the past several weeks, The Wall Street Journal, The New Yorker, The New York Times, and The Washington Post have all published articles that collectively portray rural Americans as culturally alienated from urban America— either unemployed or working in such dangerous jobs that they are in pain and turn to drugs, or at least cigarettes, for relief. Many articles have also pointed out that rural Americans expressed their frustration by voting for President Trump in the highest percentages in the country.
That image may help members of Congress seek more government assistance for their constituents in everything from health care to high-speed internet service, but it’s terrible for attracting private investment and encouraging young people to stay where they grew up. It will be hard for any government interventions to counter the idea that rural America is loser territory.

Read the full article.

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Mark Your Calendar

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

July 27: Community Conversation: Oral Health Care Access for Individuals with Special Health Care Needs - Weyers Cave
July 28: Practical Guide to Treating Dental Patients with Special Health Care Needs - Weyers Cave
August 10:Driving Individual and Population Health Improvements Using Data Analytics - webinar
August 16: A Focus on Suicide Prevention in Rural Communities  - webinar
September 7: Empowering a Rural Community to Create a Culture of Health - webinar
October 25 & 26: Virginia Rural Providers Conference - South Boston, VA

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2017 KIDS COUNT Data Book & Profile
Virginia is ranked 10th in the nation for overall child well-being, an improvement from last year's ranking of 11th place. This improvement marks the success of past investments in child well-being, but a closer look at the data reveals we still have work to do. To learn more about the 2017 Data Book and see Virginia's 2017 KIDS COUNT Profile, check out the Voices for Virginia's Children blog. Find out more about how kids in Virginia are faring by visiting the Virginia Data page and Virginia's KIDS COUNT Data Center.

Telemedicine and Rural Healthcare
Download to learn more about: Cost savings and improved patient outcomes possible through telemedicine capabilities. Engaging with the community and connecting with patients over their lifetimes. Implementing telemedicine in providers and what they need to have to ensure connections. 

2017-2018 Virginia Healthcare Guide
Hospitals listed by location, hospital facilities, hospital administrators, nursing home facilities, assisted living facilities, local health departments, medical societies, and more.

VDH Comprehensive Harm Reduction Guide
Comprehensive Harm Reduction (CHR) is a set of public health strategies intended to reduce the negative impact of drug use including HIV, Hepatitis C, other infections, overdose and death among people who are unable or not ready to stop using drugs.

Continuing Population Loss for Rural Areas
USDA’s Economic Research Service (ERS) tracks demographic change in non-metro areas and conducts research to help explain the relationship between population change and socio-economic well-being of rural residents. 

Healthcare Access in Rural Communities
This guide has been updated with new information and statistics related to healthcare access in rural communities. Visit the guide to learn about barriers to access and how rural communities can help improve access to healthcare for rural residents. 

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Funding Opportunities

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

Empowered Communities for a Healthier Nation Initiative
The Empowered Communities for a Healthier Nation Initiative will seek to reduce significant health disparities impacting minorities and disadvantaged populations through the implementation of evidence-based strategies with the greatest potential for impact. The program will serve residents in counties disproportionately impacted by the opioid epidemic; reduce the impact of serious mental illness at the primary care level for children, adolescents and/or adults; and reduce obesity prevalence and disparities in weight status among disadvantaged children and adolescents. 
Applications due August 1, 2017

Future of Nursing Scholars 
The goal of the Robert Wood Johnson Foundation Future of Nursing Scholars program is to develop the next generation of PhD-prepared nurse leaders who are committed to long-term careers that advance science and discovery, strengthen nursing education, and bring transformational change to nursing and health care.  75 will be selected for support of the Scholars. Each Scholar will receive $75,000 to be used over the three years of the program. This award must be matched by $50,000 in support from the school (which may be in-kind).
Deadline: September 14

Country Doctor of the Year 
The award is presented each year to a physician who best exemplifies the spirit, skill and dedication of America’s rural medical practitioners. We encourage anyone with knowledge of an extraordinary physician to submit an electronic nomination.
Deadline: October 31, 2017  (Note: this is not a financial award)

Kent Richard Hofmann Foundation Grants
Grants to support community-based organizations providing direct services, education, or research in the areas of HIV and AIDS.
Letter of Intent (Required): Sep 1, 2017
Application Deadline: Sep 22, 2017 

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