Virginia Rural Health Association - Weekly Update
VRHA Weekly Update
In this Issue  November 16, 2015

VRHA News Virginia News National News Mark your calendar
Funding Opportunities


November 19th is National Rural Health Day!NRHD
Celebrate the Power of Rural!




Members in the News

CONGRATULATIONS to VRHA member Robert Alpino for being selected as a National Rural Health Association Fellow! The program is a year-long, intensive experience that will develop leaders who can articulate a clear and compelling vision for rural America.

Each year, NRHA selects 10-15 Fellows Rural Health Fellows to undergo an intensive yearlong skillbuilding program, including three advanced leadership training seminars, attendance at several of NRHA's educational conferences, monthly conference calls on rural health leadership, policy and strategic planning and a guided group project that will involve Fellows in the process of rural health policy analysis on a national level. 

Mr. Alpino is the Center Director of the Eastern Virginia Area Health Education Center and is the fourth VRHA member to be accepted as a NRHA Fellow since the program's inception in 2006.

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More Members in the News

By Ananda Rochita - WSLS10

A new program for mental health patients started at [VRHA member] Carilion Franklin Memorial Hospital. To understand how the program works, it is important to know the previous protocol.

Before, if someone in law enforcement custody needed mental health treatment, an officer would be taken off his or her regularly-scheduled shift to transport that person to Carilion Franklin Memorial Hospital, where there is no psychiatric facility. The patient may then have to wait – sometimes up to 10 hours – to be taken to another facility where they can get treatment.

Now, four days a week, 10 hours a day, there will be a law enforcement officer and a mental health professional waiting for a patient at the hospital, before being taken to a psychiatric facility. 

“We are not a psych facility, so we want to make sure we are moving people as rapidly as possible, and it’s something we’ve always done but we have funding from the state,” says Bill Jacobson, Carilion Franklin Memorial Hospital.

Read the full article.

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Virginia News

No Cost Expansion?

By Laura Vozella - Washington Post

Gov. Terry McAuliffe intends to make another push for Medicaid expansion despite intense opposition from Republicans, who retained full control of the General Assembly in elections last week.

McAuliffe (D) said he will pursue a new strategy that he thinks will be more palatable to conservatives — one that he said would allow Virginia to extend health-care benefits to 400,000 uninsured citizens at no cost to the state. Previous plans have called for Virginia to eventually pay 10 percent of the annual $2.4 billion cost, which amounts to $240 million.

Read the full article.

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Virginia is Falling Behind

By Dan Heyman - Public News Service

More children are getting health care coverage nationally, according to a new study from the Georgetown University Center for Children and Families. But Virginia is falling behind. Georgetown and the advocacy group Voices for Virginia's Children say the rate of uninsured children in the state changed little from 2013 to 2014.

Joan Alker, executive director of the Georgetown University Center for Children and Families, says the children most likely to go without insurance are not from the very poorest families, but from the working poor. The Affordable Care Act was intended in part to reach that population. But Alker points out that even states that don't want to have anything to do with Obamacare can bring many of their children into coverage with effective outreach for state programs.

Read the full article.

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Public Health Training Center 


The Institute for Public Health Innovation (IPHI) has become the Virginia performance site of the Mid-Atlantic Regional Public Health Training Center. The Public Health Training Center Program is funded by the federal Health Resources and Services Administration (HRSA) in order "to improve the nation's public health system by strengthening the technical, scientific, managerial, and leadership competence of the current and future public health workforce.  Emphasis is placed on developing the existing public health workforce as a foundation for improving the infrastructure of the public health system."

As the Virginia Public Health Training Center (VPHTC), IPHI is responsible for facilitating the identification of training needs of the governmental health workforce and other public health professionals, linking those needs with existing training resources, coordinating the development of new training resources to address gaps, and supporting the establishment of student field placements and student-faculty projects. We will expand training offerings to take advantage IPHI's health equity and social determinants of health workshop curriculum and community health worker curriculum and continuing education modules. VPHTC will have the infrastructure to provide continuing education credits and to create web-based course content for distance learning. IPHI plans to utilize a collaborative approach to achieve the HRSA-required goals and to ensure the training center is responsive to the needs of the public health workforce in Virginia.

Click here to l
earn more about the VPHTC, public health training centers and potential workshops/courses. 

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National News

Expansion = Life Support

By Wendy Wolf - Portland Press Herald

Since 2010, 57 rural hospitals have closed across the nation. According to a report from iVantage Health Analytics, one of the most important predictors of closure nationally was whether the hospital operated in a state that expanded Medicaid as part of the Affordable Care Act. Rural hospitals in states that did not expand Medicaid were twice as likely to close.

A recent study published in the October edition of the journal Health Affairs fleshes out the story a bit more. Researchers compared the amount of uncompensated (charity) care, profitability and market characteristics of rural hospitals in states that expanded Medicaid eligibility vs. those in states that did not. Hospitals in states that did not expand Medicaid provided greater amounts of uncompensated care as a percentage of revenues and appeared to be more financially vulnerable.

The closure of rural hospitals affects far more than access to health care services. In rural Maine communities, the hospital is an important large employer. Closure means lost wages and less money to support the local economy. It also has secondary effects on the need for enhanced local ambulance services, as patients require longer and more costly transports.

Read the full article and related stories from TPM, Washington Examiner, and Becker's Hospital Review.  Also available is a listing of all 57 closed hospitals.

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EMS Pipeline

By Sandra Knisely - University of Wisconsin-Madison

Helicopters, hazmat suits, fire extinguishers, search-and-rescue dogs — in many places, a summer camp boasting these kinds of things would likely be targeted at boys.
But in Ashland, Wis., Rescue Divas is a camp for middle-school girls that aims to attract new recruits to the field of emergency medical services. And it wouldn't have been possible without the support of the Wisconsin Office of Rural Health (ORH), housed at the UW-Madison School of Medicine and Public Health.

"In the past, you would have three or four new EMTs a year," says Carrie Okey, an EMT in Washburn, Wis., and manager at the Northwest Wisconsin Concentrated Employment Program. "Now you're lucky to get one every couple of years."

This trend worries experts, as dispatchers in some areas are contacting multiple communities before finding an EMS crew that can respond to a call. "We want people to know that the only way we can preserve the response time is for people to volunteer," says Okey. "If not you, who? If not now, when?"

Read the full article.

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Health IT Financing

By Frank Irving - Health IT Interoperability

Rural healthcare providers support approximately 40 to 45 percent of the U.S. population, which extrapolates to 150 million people across America. These organizations operate on the slimmest of financial margins, severely hampering their move to emerging care models in the areas of health IT integration and implementation.

“If you want to use data analytics to transition to a wellness delivery model, you’re going to need the technology to do that. But if you only have four or five days’ cash on hand, you don’t have the resources to make capital investments to actually position yourself strategically. You’ve got to worry about making payroll and keeping the lights on for the next 30 days,” according to Sean McPhillips, health IT program/project manager at CTG, an IT solutions and services company.

Read the full article.

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OB Emergencies

Medical professionals from six small hospitals across South Dakota are learning how to handle complications during childbirth. Avera Health teams of doctors, anesthesiologists, nurses, and other care providers are working in teams in critical simulations.

Avera’s Doctor Kimberlee McKay says health care providers in smaller hospitals don’t deliver that many babies, so they encounter few complicated births. She says that means they must rehearse for situations that go wrong. McKay says shoulder dystocia is a good example.

Read the full article.

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Mark Your Calendar

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

November 30: Veterans' Choice Program - webinar
December 3: TCI Policy Summit - Richmond
February 2-4: Rural Health Policy Institute - Washington, DC
April 10-12: Mid Atlantic Telehealth Resource Center Annual Summit - Cambridge, MD

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The Health and Well-Being of Children in Rural Areas
This chartbook presents indicators of the health and well-being of children, the supportive and risk factors in the family environment, and aspects of the neighborhood that may support or threaten families and children on the national level. 

A microsite of resources and tools to help you measure and describe your programs’ impact on families and communities and on factors related to health. MeasureUp provides examples, tools, and resources to help you make your case, without having to become an economist.

National Diabetes Month Social Media Toolkit 
The toolkit provides everything you need to share important diabetic eye disease messages across your social media channels, and to motivate and engage key audiences.

Rural Care Coordination
Care coordination has great potential to improve rural health access and quality, as well as health outcomes. This new guide looks at opportunities, barriers, and models related to coordinating care in rural settings. Topics covered include Accountable Care Organizations, patient-centered medical homes, the role of HIT in care coordination, and more. 

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Funding Opportunities

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

Graduate Psychology Education Program (GPE)
Offers grants to psychology schools and government, nonprofit, or private entities to support doctoral-level psychology education and training programs to prepare psychologists to address the behavioral health needs of vulnerable/underserved populations.

Economic Development Assistance Programs
Grants support the implementation of regional economic development, including public works projects and job creation projects. Past projects have included funding for water and wastewater projects in hospitals and healthcare facilities, and road infrastructure projects that would support the expansion of healthcare facilities.

Rural Health Network Development Planning Program
The purpose of the Network Planning program is to assist in the development of an integrated healthcare network, if the network participants do not have a history of formal collaborative efforts.  Health care networks can be an effective strategy to help smaller rural health care providers and health care service organizations align resources and strategies, achieve economies of scale and efficiency, and address challenges more effectively as a group than as single providers.  The Network Planning program promotes the planning and development of healthcare networks.

Rural Communities Facing Design Challenges
The RFP is intended to help small towns and rural communities, with populations of 50,000 or less, build their capacity and acquire technical expertise to solve their design challenges.

Department of Agriculture
The Community Food Projects Competitive Grants Program seeks to meet the food needs of low-income individuals; increase the self-reliance of communities in providing for their food needs; promote comprehensive responses to local food access, farm, and nutrition issues; and meet specific state, local, or neighborhood food and agricultural needs. The application deadline is November 30, 2015.

Evaluating High-Value Innovations from Low-Resource Communities
The Robert Wood Johnson Foundation (RWJF) is committed to seeking value from all levels of investment in health care, public health, and population health. Through this call for proposals the Foundation intends to pursue several objectives: (1) to identify promising innovations to improve health being implemented in low-resource communities, (2) to evaluate whether the innovations improve health care quality and health without increasing costs; and (3) to disseminate these  innovations as examples for other communities to implement. The evaluation of innovations from low-resource communities is the primary objective of this call for proposals.

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