Virginia Rural Health Association - Weekly Update
VRHA Weekly Update
In this Issue  December 21, 2015

VRHA News Virginia News National News Mark your calendar
Resources
Funding Opportunities
VRHA Site



TCI


What are the important considerations in the Governor's budget?  See what TCI thinks.

 

 

 

VRHA News

Rural ACOs

Rural Health Clinics, Federally Qualified Health Clinics and Critical Access Hospitals  play a key role in the sustainability of Virginia’s rural health systems and are eligible to receive services through the Transforming Clinical Practice Initiative (TCPI) funding.  The support, training and programs provided will allow RHC’s, FQHC’s and CAH’s  to establish a value-based infrastructure at no cost. 

VRHA is teaming up with the National Rural Accountable Care Consortium to present:
Transforming Clinical Practice Initiative 
This free webinar will outline the tools and resources provided through the program and demonstrate the value they bring to RHC’s, FQHC’s and CAH’s.

So save the date for noon on January 27th and learn all about it!

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Members in the News

VRHA members LewisGale Hospital Montgomery, LewisGale Hospital Pulaski and Smyth County Community Hospital have all been recognized as "Top Performers" on Key Quality Measures by The Joint Commission. The Top Performer program recognizes hospitals for improving performance on evidence-based interventions that increase the chances of healthy outcomes for patients with certain conditions. 

More information about the LewisGale honor is here and the Smyth County honor is here.

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VRHA Office Schedule

The VRHA Office will be closed from December 23 to January 3, re-opening on the 4th.  VRHA wishes all of our rural health advocates a Happy Holidays!

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Virginia News

Medicaid Expansion - Round 2

By Karen Cameron - Virginia Consumer Voices for Healthcare

Virginia Governor Terry McAuliffe presented his 2016 budget to the Virginia Legislature’s Joint Money Committees this week, and made some very specific comments about healthcare, hospitals, and Medicaid expansion in the state.
Here are some direct quotes:

  • “The Virginia Chamber of Commerce and I have made the economic case that we are forfeiting $2.4 billion dollars in federal funds every year.”
  • “I recently met with the CEOs of Wellmont Health System and Mountain States Health Alliance, who are being forced to merge their hospital systems in order to survive. Let me underscore the severity of the situation: Those seven hospitals in Southwest Virginia are being subsidized by Tennessee to the tune of $11 million dollars per year.”
  • “Here in Virginia, we have a unique opportunity to craft a plan with no short- or long-term obligations to the Commonwealth. This opportunity is within our reach thanks to our hospitals. They have put a new plan on the table, one in which they will provide the matching contributions needed to draw down federal funds. This is a good deal for them and it’s a good deal for the Commonwealth. We can save $157 million dollars in state funds over the next two years and use those savings to provide Virginia businesses and families with $105.7 million dollars in personal and corporate income tax relief and boost the Commonwealth’s economy.”

Action Alert: It’s time for Virginia - our legislators, our citizens, all of our communities - to come to a decision, and take action, to ensure that all Virginia citizens have access to quality, affordable healthcare. Let your legislators know what you think - visit Who’s My Legislator, and contact your representatives today.

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Drug Abuse and Addiction 

By Marissa J. Levine, MD, MPH, FAAFP - State Health Commissioner

This holiday season for so many Virginians will be anything but happy and healthy as a result of the significant impact of drug abuse and addiction in the Commonwealth.  Preliminary data for the first nine months of 2015 show a 36% increase in the number of fatal heroin overdoses compared to the first nine months of 2014 (n=173).  Fatal prescription opioid overdoses, however, remain the number one drug category causing or contributing to death in Virginia.  Benzodiazepines and cocaine also remain significant causes of overdose deaths.  Finally, there has been a 45% increase in overdose deaths involving fentanyl in 2015 compared to 2014 year-to-date.  More details, including information on overdose deaths by city/county, are available.

We are issuing this urgent communication today to continue to highlight key approaches related to our collective efforts to address the epidemic of opioid abuse and overdose, and to reduce the broad health impacts of drug abuse and addiction on the communities of Virginia.  Specifically this correspondence focuses on:

Read the full announcement.

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Close to Home

From University of Pikeville

The University of Pikeville-Kentucky College of Optometry – the 22nd such school in the nation and the first in Kentucky – has entered a new phase and will begin recruiting its inaugural class for the fall of 2016. Sixty students will be admitted per class for a total of 240. With no other colleges of optometry in Kentucky, West Virginia, Virginia, North Carolina, South Carolina or Georgia, KYCO will be the most accessible college of optometry in the Southeastern portion of the country.

Central Appalachia is a region that has the highest incidences of severe vision loss from other factors such as diabetes and hypertension. Earlier this year, the Centers for Disease Control and Prevention reported on the U.S. counties with the highest prevalence of severe vision loss, the majority of which were located in the south. Overall, about three percent of people had severe vision loss. The highest rate amongst all American regions was Owsley County, located in the coalfields of Eastern Kentucky, at more than 18 percent.

“Our Kentucky College of Osteopathic Medicine has provided a successful blueprint and the experience to build a sustainable model for rural health care education,” said Paul Patton, the university’s chancellor and interim president. “National statistics demonstrate the need for quality, affordable vision care in rural areas. Our objective is to provide access and education to the people of the mountains and to address a critical health care need in our region and throughout the nation. We expect that the college of optometry will be nationally renowned as a premier college for teaching and research.”

Read the full article.

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National News

Hurting the Rural Poor

By Charles P. Pierce - Esquire

the decision of the Supreme Court to allow the Affordable Care Act's individual mandate—and, thus, the law itself—to stand contained a very effective land mine, courtesy of Chief Justice John Roberts. He allowed governors to opt out of the expansion of Medicaid that also was part of the law. And because many states are governed by rightwing hardbars who don't give a damn about anyone who can't cut them a check, we had the remarkable—and, well nigh unprecedented—spectacle of watching politicians turn down FREE MONEY! This occurred in many places. Georgia was one of them.

Hospital industry officials say Georgia's decision not to expand Medicaid under the Affordable Care Act has hurt rural health care. Hospitals in rural areas tend to treat many uninsured people, incurring heavy losses. If more low-income residents were covered by Medicaid, these hospitals would be guaranteed more revenue. Gov. Nathan Deal and legislative leaders have so far stood resolutely against Medicaid expansion, saying it would be too costly for the state. 

It's not just Georgia. It's happening all over the place, mainly in states where the governor has declined to accept FREE MONEY! Governor Nathan Deal could have kept this hospital open. He chose not to do so for reasons that had nothing whatsoever with the health of his constituents. Five will get you 10 that Obamacare gets blamed. Guaranteed.

Read the full article.

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Rural Quality

By Shannon Muchmore - Modern Healthcare

Rural providers should be required to participate in federal pay-for-performance programs, but the measurements should reflect rural patient volume and demographics and practice size, according to an analysis requested by HHS.  A 20-member committee convened by the National Quality Forum was tasked by HHS to determine how to deal with the difficulties in using performance measures to judge rural practitioners for CMS pay-for-performance programs.
 
The report recommends developing quality measures with rural providers in mind. These measures would need to consider the small patient populations as well as the challenges posed by heterogeneous rural populations. The data would have to be easily gathered and reported by small staffs. The document also suggests that the CMS should use performance-based payment incentives but not institute penalties. Rural providers are encouraged to group together to obtain the incentive payments.
 
In a statement regarding the report, the committee noted that ​since rural hospitals don't report quality data, patients may interpret the lack of data as meaning their hospitals are of lower quality​.

Read the full article.

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Medicare Prescription Monitoring

By Dan Heyman - Public News Service 

Congress is considering giving Medicare the power to monitor for excess use of pain medicines. Currently Medicare part D administrators don't have the authority to watch for signs that a patient might be intentionally or accidentally abusing opiods. 

"A large number of prescribers, or a large number of pharmacies, large quantities. They then designate a given prescriber and pharmacy for these patients," says Cynthia Reilly, director of the Prescription Drug Abuse Project with The Pew Charitable Trusts.

Reilly says more than anything, prescription monitoring is aimed at reducing accidental overdose deaths. She says there is some evidence of doctor shopping and patients seeking more of the pills than they need. But Reilly stresses that the patients and the doctors may not even know they are doing anything wrong.

Read the full article.

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Re-Opening Labor & Delivery

By Anna Claire Vollers 

Rural Bibb County, Ala. hasn't had local labor and delivery services at its hospital in nearly 20 years. Women in the area have to drive 30-45 minutes to Tuscaloosa or Birmingham to reach a hospital where they can safely deliver a baby.

Dr. John Waits, an obstetrician at Bibb Medical and CEO of Cahaba Medical Care Foundation has worked as a family doctor and obstetrician for the past 12 years at Cahaba Medical Care, less than a five minute walk to Bibb Medical in Bibb's county seat of Centreville. He dreamed of bringing L&D services back to the area.  After years of work and collaboration between his practice and hospital leadership, plus a federal grant, a capital investment and more than a few crossed fingers, the dream came true two weeks ago when a brand-new, four-room L&D unit opened its doors.

"The concept of focusing on maternal-child medicine in rural areas is not outdated," said Waits. "It's not an antiquated idea just because we've had a 20- or 30-year track record of labor & deliveries closing. Things have a way of having a pendulum shift. We want to be at the beginning of the backswing."

Read the full article.

AL.com

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Mark Your Calendar

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

January 27: Transforming Clinical Practice Initiative - webinar
February 2-4: Rural Health Policy Institute - Washington, DC
April 6-8: National Health Outreach Conference - Roanoke
April 10-12: Mid Atlantic Telehealth Resource Center Annual Summit - Cambridge, MD

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Resources

Virginia Lifespan Respite Voucher Program
Created to provide reimbursement vouchers to home-based family caregivers for the cost of temporary, short-term respite care provided to their family members with disabilities (children and adults, including elderly persons).  Respite is planned or emergency care provided to a child or adult with a special need in order to provide temporary relief to the family caregiver of that child or adult. Respite services may be provided by an individual or organization on a temporary basis, in a variety of settings, including the family home, adult day centers, respite centers, or residential care facilities.

Finding Rural Data
This step-by-step guide from the Rural Health Information Hub shows 2 methods for selecting rural data from the U.S. Census Bureau’s American Factfinder tool, which provides access to a wide range of statistics describing the U.S. population. Learn how to use the Geographic Comparison Tables and direct selection of locations to easily identify data for use in rural health grant applications, community health needs assessments, and more. 

Chronic Care Management Guide
The Centers for Medicare and Medicaid Services (CMS) has released a MedLearn Network Matters (MLN) article on the newly approved Rural Health Clinic, Chronic Care Management (CCM) benefit.  The article outlines the specific requirements and services the RHC must provide in order to qualify for the monthly CCM payment.  

20 Years of Rural Voices
Highlights and revisits articles from the last two decades of the Rural Voices journal. Covers topics including self-help housing, low-income housing, tax credits, housing trust funds, the Fair Housing Act, and the National Low Income Housing Coalition.

Promising Practices: A Year in Review
Each month, NOSORH identifies and shares a Promising Practice showcasing the innovative and collaborative work being done at the SORHs.

Medicare Learning Network e-newsletters:

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Funding Opportunities

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

Helping Children Get Health Insurance
CMS has announced $32 million support activities aimed at alerting families to the availability of free or low-cost health coverage under Medicaid and the Children’s Health Insurance Program (CHIP), identifying children likely to be eligible, and assisting families with the application and renewal process.  Target populations are those likely eligible for Medicaid and CHIP, but less likely to be enrolled, including teens, Latino children and children in rural areas. Eligible organizations such as state and local governments, Indian tribes and tribal organizations, and nonprofits including community and faith-based groups are encouraged to apply by Wednesday, January 20th. 

Treating Opioid Use Disorder in Rural Areas
The Agency for Healthcare Research and Quality (AHRQ) is funding demonstration projects to improve the use of Medication-Assistant Treatment (MAT) of opioid use disorder.  According to the funding opportunity announcement (FOA), “half of U.S. counties, mainly rural, lack a physician certified to prescribe the medications used in MAT. For these reasons, this FOA specifically targets rural primary care practices.” Up to $12 million over three years will go to as many as four public and/or non-profit private institutions who will demonstrate strategies for effectively overcoming the barriers of implementing MAT in rural primary care practices.  The deadline to apply is Friday, March 4th, 2016.

STEM Essay Contest 
The Council will award five scholarships (one in each of five regions) to a female junior or senior who will be pursuing a STEM education at an institution of higher education. Essays will be judged by a panel of Council members and women who hold a degree in or work in STEM fields. Deadline: Entries must be received by 11:59 p.m. on February 8, 2016.

Fiskars Project Orange Thumb
Project Orange Thumb, sponsored by Fiskars, is dedicated to supporting the community garden movement throughout the U.S. and Canada. Fiskars’ Project Orange Thumb garden grants provide tools and resources to help communities reach their goals for neighborhood beautification, community collaboration, and healthy, sustainable food sources. Project Orange Thumb is intended to promote new garden spaces and garden expansions. Nonprofit organizations, public schools, and municipalities in the U.S. and Canada are eligible to apply. The application deadline is February 1, 2016. 

Bank of America Charitable Foundation
The Bank of America Charitable Foundation works to create economically vibrant communities that are better places in which to live and do business. Grants are provided to nonprofit organizations that serve specific states and regions (in Virginia: Charlottesville, Hampton Roads, Richmond). In 2016, the Foundation will issue three requests for proposals that address the following focus areas: Workforce Development and Education applications will be accepted from January 19 through February 12, 2016. Community Development applications will be accepted from April 19 through May 6, 2016. Basic Needs applications will be accepted from July 18 through August 5, 2016.

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