Virginia Rural Health Association - Weekly Update
VRHA Weekly Update
In this Issue February 9, 2015

VRHA News Virginia News National News Mark your calendar
Funding Opportunities


An important budget update from VOHC






Virginia had a delegation of six people for the NRHA Policy Institute last week.  The delegation had the opportunity to have discussions with staff from the offices of Representatives Forbes, Wittman, Connolly, Goodlatte, Comstock, Hurt, Griffith and Beyer as well as Senator Kaine and Senator Warner.  Please review the NRHA Congressional Action Kit to see what issues were brought to your elected officials.

The Virginia delegation with Congressman Morgan Griffith

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Action Alert Update

Del. O'Bannon announced a health care budget proposal from the House that will provide a $124 million health care package for low-income Virginians, including those with serious mental illness. While we are glad the House is recognizing the need to do something, the proposal is only a very small step. The House has the power to address uninsured, low-income Virginians in a very comprehensive way. If they really want to help, the House would Close the Coverage Gap for 400,000 very low income Virginians by using available federal dollars to expand coverage. On Sunday, we will learn more about the details of the House plan, and we will also see what the Senate proposes.
VRHA would like to thank everyone who contacted the members of the Senate Finance HHR Subcommittee last week. The subcommittee members have heard from many of you in support of Senator Howell's "Healthy Transitions Program" budget amendment Item 301 #17s. We will see what happens on "Budget Sunday", and we will continue to strategize for the floor votes on the budget that will take place the following Thursday, February 12.

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Members in the News

By Carol Vaughn - DelmarvaNow

Veterans on the Eastern Shore of Virginia traveling long distances for medical attention now could have a closer alternative. Lt. Gov. Ralph Northam helped kick off the new Veterans Choice Program at [VRHA member] Eastern Shore Rural Health System Inc.'s Onley Community Health Center.

The program allows veterans who meet certain requirements to receive health care at participating local doctors' offices rather than a Veterans Affairs health care facility.  Eastern Shore Rural Health began serving its first patients under the new program this week.

Read the full article, related article in the Shore Daily News and Governor McAuliffe's press release on the program.

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Virginia News

The Sickest Town in America

By Olga Khazanadline - the Atlantic

Remote Area Medical was founded in 1985 by Stan Brock, a 79-year-old Brit who wears a tan Air-Force-style uniform and formerly hosted a nature TV show called Wild Kingdom. Even after he spent time in the wilds of Guyana, Brock came to the conclusion that poor Americans needed access to medical care about as badly as the Guyanese did. Now Remote Area Medical holds 20 or so packed clinics all over the country each year, providing free checkups and services to low-income families who pour in from around the region.

Just about everyone I spoke with at the Grundy clinic was a former manual worker, or married to one, and most had a story of a bone-crushing accident that had left them (or their spouse) out of work forever. For Rose, who came from the nearby town of Council, that day came in 1996, when he was pinned between two pillars in his job at a sawmill. He suffered through work until 2001, he told me, when he finally started collecting “his check,” as it’s often called. He had to go to a doctor to prove that he was truly hurting—he has deteriorating discs, he says, and chronic back pain. He was turned down twice, he thinks because he was just 30 years old at the time. Now the government sends him a monthly check for $956.

Read the full article and a rebuttal from the Huffington Post.

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Scholarship Bill


Students at colleges of osteopathic medicine could qualify for state scholarships in exchange for committing to work in rural Virginia under the terms of a new bill working its way through the General Assembly. Sen. Bill Stanley, R-Franklin, is angling to revive a program created to attract doctors to underserved and underprivileged parts of the state.

“Right now in our rural areas, we have a drastic shortage of primary care physicians and the physicians we do have are getting older,” he said, adding in his region the average age of a primary care doctor is over 57. "We need to not only replace retiring physicians, but grow and expand practices in rural areas — Southside, Southwest Virginia and even the coalfields — so we can ensure citizens have access to quality primary care,” he said. “This is a real issue for our area that needs to be solved.”

Stanley said he’s working on a budget amendment to replenish a long-dormant scholarship program. He’s also sponsoring a measure, Senate Bill 717, to make the money available to a wider range of students, including students at colleges of osteopathic medicine such as the one just opened by Liberty University. In the past, the scholarship only was available to medical students at the Virginia Commonwealth University, University of Virginia and Eastern Virginia Medical School.

Read the full article and track SB717.

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You’re the Cure

The American Heart Association/American Stroke Association, Mid-Atlantic Affiliate is looking to improve their outreach to elected officials from Virginia's rural health stakeholders and sends VRHA members this message:

Your voice can make a difference.  The American Heart Association’s advocacy arm, You’re the Cure, is working actively to educate about and advance policy impacting CVD and stroke. This grassroots network is designed to make communicating with your legislators fast and easy. 
If you’d like to help, simply sign up at, using your home address for proper legislator-matching.  Most communications are by email, and carefully controlled so as to not inundate your inbox.  Issues under discussion so far this session include tobacco cessation funding, tobacco tax, access to health coverage, and access to healthy foods in underserved communities, among others.  
Join now at www.yourethecure.orgYou’re the Cure will provide pre-written but customizable communications and connect you with the legislators working for you.  

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National News

Budget Disappointment

By Alex Olson - National Rural Health Association

The National Rural Health Association is disappointed with the president’s budget that again calls for cuts to critical access hospitals (CAH).  Obama’s 2016 budget proposal announced yesterday includes both a cut in cost-based reimbursement and the elimination of federally designated CAH status if another facility is less than 10 miles away.
“This budget policy is short-sighted and will cause further access to care concerns for rural patients,” says NRHA’s Maggie Elehwany. “Rural hospitals already operate at the narrowest of financial margins, and 41% already operate at a loss.”
Sequestration, DSH, bed-debt and other types of cuts have already hit rural hospitals hard.  
Forty-seven rural hospitals have closed since 2010. And 283 more are on the verge of closure. If this occurs, 700,000 rural patients will be without access to their closest point of emergency care.

NRHA is also disappointed that the president again has zeroed out funding for Area Health Education Centers, which provide valuable recruitment and training for quality medical staff to stay in or transfer to rural areas.  More than 90 percent of the rural counties in this nation are designated health professional shortage areas.

Read the full article.

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Endangered Species

By Don Wade - Daily News

The state of Mississippi has 110 hospitals and three-fourths of them are, as you might expect, in rural areas. “And 56 of them have fewer than 50 beds,” said Mendal Kemp, director of the Center for Rural Health at the Mississippi Hospital Association.

But in recent years, those community hospitals – whether they’re in Mississippi, Tennessee, North Carolina or New York – are becoming somewhat of an endangered species.

Over the last few years, two different community hospitals closed in Gibson County in West Tennessee and another closed in Brownsville, said Bill Jolley, executive director for the Tennessee Rural Partnership and a vice president of the Tennessee Hospital Association. 

Read the full article.

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Opportunities to Transform 

By Kavita Patel, Kate Samuels, Margaret Darling and Mark B. McClellan - Brookings

Rural communities face significant challenges to health care delivery: long distances to many medical services; shortages of health professionals (65 percent of all Health Professional Shortage Areas are in rural areas); and populations that are older, have lower incomes, and tend to be in poorer health.

Many payment initiatives have sought to address these challenges, including additional payments to support local hospitals and bonuses for physicians practicing in rural shortage areas, yet despite these initiatives, rural populations continue to experience substantial problems of access to high-quality care.

Many clinical leaders are pioneering innovations to enhance rural health care delivery through new technologies that provide the means to enhance communication and dissemination of knowledge.  The Merkin Initiative on Payment Reform and Clinical Leadership recently hosted: MEDTalk: Transforming Rural Health through Telehealth and Education, where clinical leaders and payers discussed these emerging opportunities to improve health care for rural Americans, the payment reforms that would support these changes, as well as means of overcoming barriers to meaningful payment reform.

Read the full article.

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Aging Tsunami

Patti Wittkopp has been to more this year than she could count on two hands. As she prepared that morning to bury 85-year-old Gene Huseby, one of her first patients as a nurse in this small town in Eastern Montana, she was again reminded that this community she poured her heart into is growing old.

Now a physician assistant, Wittkopp has for 14 years been the closest thing to a doctor in McCone County, one of twelve counties in Montana that has no doctor at all. From inside her little health center, she has watched a demographic shift that is sweeping across Montana--what officials here have dubbed an "aging tsunami."

Almost 25 percent of McCone County residents are over 65. Years are now conspiring to include Wittkopp among the aging. At 60, she is concerned less that she is slowing down — she hasn't, much — and more with the fact that she cannot be sure that when she hangs up her stethoscope, the system she poured her heart into will remain.

Read the full article.

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Mark Your Calendar

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

February 26: Impact of a Small Rural Hospital or Critical Access Hospital - webinar
March 26: Impact of a Rural Health Network - webinar
March 29-31: Shaping the Future of Healthcare through Innovation and Technology - White Sulphur Springs
April 8-9: Virginia Forum on Youth Tobacco Use - Richmond
April 30: Impact of a Community Health Center (FQHC) or Rural Health Clinic - webinar

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Slowing HIV Epidemic
Information regarding a model program featuring a role-playing video game which educates young people in rural Alabama about the risk of HIV.

Aim for Impact and Sustainability Resources
A compilation of tools, resources and educational materials based on the Baldrige Performance Excellence framework developed for rural health network grantees.

Care Coordination: A Self-Assessment for Rural Health Providers and Organizations Developed to provide a preliminary review of important factors for rural organizations interested in developing, expanding, or enhancing care coordination activities.

Population Health: A Self-Assessment Tool for Rural Health Providers and Organizations Developed to provide a preliminary review of important factors for rural organizations interested in developing, expanding, or enhancing a population health focused methodology.

CMS MLN Connects™ Weekly Provider eNews 

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Funding Opportunities

Hearst Foundation Grants
Applications accepted on an ongoing basis.
The Hearst Foundations provides funding to support large-scale health initiatives.

Sidney Stern Memorial Trust
Deadline: Rolling
Funding to provide support for nonprofit organizations, including for medical purposes.
Walmart Foundation State Giving Program 
Deadline: varies by state, Virginia Cycle 3 deadline - July 17
The Walmart Foundation State Giving Program awards grants to nonprofit organizations at the state and regional level throughout the U.S. and Puerto Rico for programs that give individuals access to a better life. There are four funding cycles per year; nonprofit organizations in each state have two opportunities per year to apply. Applications will be accepted in all four funding cycles for programs within the scope of one of the following Focused Giving areas: Career Opportunity or Hunger Relief and Healthy Eating. Organizations seeking funding for programs outside of the Focused Giving areas, and whose programs address the unmet needs of underserved low-income populations, can apply in cycles three and four only. Grants range from $25,000 to $250,000, with an average size of $40,000.

Geriatrics Workforce Enhancement Program
Deadline: March 5

The purpose of the grant is to establish and operate geriatric education centers that will implement the Geriatrics Workforce Enhancement Program (GWEP).  The goal of GWEP is to develop a health care workforce that maximizes patient and family engagement and improves health outcomes for older adults by integrating geriatrics with primary care.

Tooth Fairy Scholarship
America’s ToothFairy and the USHCC Foundation is seeking one youth from your community to lead a community project related to oral health. Youth will be provided a Community Education Kit, America’s ToothFairy staff support, and access to an online portal with downloadable materials and project ideas. Accepted participants will also receive a $1,000 scholarship at the conclusion of their project. Applications are due February 23, 2015. Upon notification of your acceptance, projects should then be completed by May 31, 2015.


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