Virginia Rural Health Association - Weekly Update
VRHA Weekly Update
In this Issue  April 4, 2016

VRHA News Virginia News National News Mark your calendar
Funding Opportunities


Spring newsletter now available





RHC Coalition

On March 23 & 24, VRHA hosted the first ever state-wide Rural Health Clinic meeting.  This was the capstone event for a year-long HRSA Network Development Planning grant.  The clinics in attendance voted unanimously to create coalition with the following purpose statement:

“The Virginia Rural Health Clinic Coalition (VRHCC) unifies Virginia’s Rural Health Clinics by providing advocacy, education, and networking opportunities”

VRHA will be working with the clinics to further support these efforts.  More information on the Virginia Rural Health Clinic Coalition can be found here.

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QIO Webinar

VRHA and KEPRO are teaming up to offer you the Beneficiary and Family Centered Care
Quality Improvement Organization (BFCC-QIO) Program Webinar.

KEPRO is the BFCC-QIO for over 30 states. KEPRO offers information and assistance to providers, patients, and families regarding beneficiary complaints, discharge appeals, and Immediate Advocacy. During the webinar, KEPRO representatives will present an overview of the role of the BFCC-QIO and the services provided.

Webinar is FREE and will be held April 6, 2016, 12 p.m. - 1 p.m. Click the logo to register.


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Members in the News

From Newsroom America
As part of the National Rx Drug Abuse and Heroin Summit, the President is announcing additional public and private sector actions to escalate the fight against the prescription opioid abuse and heroin epidemic, which is claiming the lives of tens of thousands of Americans each year.
The President has made clear that addressing this epidemic is a priority for his Administration, and today’s actions represent further steps to expand access to treatment, prevent overdose deaths and increase community prevention strategies.  These actions build on the President’s proposal for $1.1 billion in new funding to help every American with an opioid use disorder who wants treatment get the help they need.

In connection with the Federal announcements, more than 60 medical schools are announcing that, beginning in fall 2016, they will require their students to take some form of prescriber education, in line with the newly released Centers for Disease Control and Prevention Guideline for Prescribing Opioids for Chronic Pain, in order to graduate. Schools include VRHA member Edward Via College of Osteopathic Medicine.

Read the full article.

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Virginia News

Improving Access


A new report by the Department of Health and Human Services shows Medicaid expansion in Virginia could improve behavioral health care access. The report shows more than 100,000 uninsured people in Virginia with mental illness or substance abuse disorders had incomes that could qualify them for expanded medicaid under the Affordable Care Act. 

It also finds people with behavior health needs make up nearly 35 percent of low-income uninsured people. The report estimates that if Virginia expanded Medicaid, 16,000 fewer individuals would experience symptoms of depression and 24,000 additional individuals would report being in good or excellent health.

Read the full article.

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Mobile Health

In Appalachia, barriers to healthcare include distance from a provider, lack of transportation, lack of health insurance, and the inability to take the time off of work to drive, wait and be seen. So throughout the region, mobile health units are attempting to bridge that gap and bring services to some of the populations that need them the most. Outside of an old train station in southwestern Virginia, Teresa Gardner and Paula Hill-Meade are seeing patients.

In 2013, the latest year for which data are available, the Health Wagon assisted more than 11,000 patients at 11 southwest Virginia sites. These are often really sick people who either don’t have insurance at all or can’t afford the insurance they have.

“Not a day goes by that patients’ lives are not saved here,” says Gardner. “They come in with various co-morbid conditions, like diabetes, obesity, heart disease or lung disease.” 

Read the full article.

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Stopping the Bleeding

By Robert Burke - Virginia Business

Leaders of Virginia’s hospitals are frustrated, and they have some good reasons for feeling that way. After all, they were left hanging when the 2010 Affordable Care Act cut Medicare reimbursements to hospitals in anticipation of Medicaid expansion, but then Virginia refused to expand its program.

Then there were more Medicare cuts in the 2013 sequestration budget deal. According to the Virginia Hospital and Healthcare Association (VHHA), overall funding cuts will cost Virginia hospitals close to $1 billion annually by 2021. “This is not a sustainable business model,” says Sean Connaughton, VHHA’s president and CEO.

Hospitals are required by federal law to treat patients even if those patients are uninsured or can’t pay the bill. “I say let’s talk about this,” says Mark Merrill, president and CEO of Winchester-based Valley Health System. “I can’t walk into Starbucks or a Martin’s or a Food Lion and say, ‘I need a basket of food because I’m hungry.’ But if I need medical care, I can show up at the emergency department and get treated.”

Read the full article.

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National News

Broadband Gap Widens

By Brian Whitacre; Denna Wheeler: and Chad Landgraf - Dailly Yonder

A new study suggests that healthcare facilities in non-metropolitan counties connect with relatively slow speeds when compared to their metro counterparts.  More importantly, it also indicates that this connectivity gap is growing.
The finding comes at a time when healthcare field has changed dramatically, with technologies such as Electronic Health Records (EHRs) and Health Information Exchanges (HIEs) becoming commonplace.  These technologies require Internet connections – and, as more and more data is being transferred, those connections need to be fast.

This increasing connectivity gap happened despite the existence of a pilot (and resulting full-time) program called the Healthcare Connect Fund.  This program had funds available to support broadband connectivity for public or not-for-profit health care providers including hospitals, rural health clinics, and local health departments.  However, the fund is dramatically underused – perhaps due to overly stringent requirements.  This research suggests that changes to this program should be considered to encourage participation by nonhospital facilities.

Read the full article.

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Doc Burnout

By Jenn Lukens - Rural Monitor

It was 2008 when Dr. Jill Kruse, fresh out of residency, took a job at St. Michael’s Hospital Avera in Tyndall, South Dakota. As a young primary care doctor, she was eager to put her years of school to use and took on anything that was asked of her. Within a few years, she became the medical director for the nursing home, the overseer of the town’s emergency medical service, the football team’s sideline doctor, the clinic’s medical director, and the hospital’s trauma director and chief of staff. Kruse also shared rotations and call with only one other physician and two physician assistants to serve a town of 1,200 people.
Four years later, the demands of rural practice, coupled with trying to raise a young family, had started to take its toll. Her husband was the first to notice that she was becoming burned out. “He urged me to get a different job, saying ‘you are killing yourself slowly in front of my eyes, and I’m not going to watch it happen,’” recalls Kruse.
She admits trying to hide the burnout behind a brave face while working even harder, but that strategy only made it worse. Kruse was at her limit and didn’t know where to turn.

Read the full article.

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Premature Death Rates

From the Robert Wood Johnson Foundation

The 2016 County Health Rankings compare health differences on a broad range of measures among almost every county throughout the country. The report shows dramatic differences between rural and urban counties on a number of measures, most notably premature deaths rates. Rural counties not only have higher rates of premature death, but also nearly 1 in 5 rural counties saw rises in premature death rates over the past decade while most large urban counties experienced consistent improvement.

Rural counties have higher rates of smoking, obesity, child poverty, and teen births, and higher numbers of uninsured adults than their urban counterparts. Large urban counties have lower smoking and obesity rates, fewer injury deaths, and more residents who attended some college.

Read the full press release.

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Heroin is Everywhere

From NPR

There were more than 47,000 drug overdose deaths in the U.S. in 2014, according to the Centers for Disease Control and Prevention. That includes unintentional overdoses and suicides. More than half of those were from opioids, including painkillers and heroin.
I went to rural Berks County in southeast Pennsylvania to hear what the opioid epidemic means in a small town, a place where everyone knows everyone and the ripples of addiction spread wide.  Really, I could have gone just about anywhere. No community is immune.
The landscape in Berks County is bucolic: rolling farmland studded with silos and 19th-century stone barns. But that peaceful landscape belies a serious problem. Opioid addiction is deeply embedded in these small towns.

Read the full article.

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Mark Your Calendar

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

April 6: BFCC-QIO Program webinar
April 6-8: National Health Outreach Conference - Roanoke
April 10-12: Mid Atlantic Telehealth Resource Center Annual Summit - Cambridge, MD
April 25-26: National Reduce Tobacco Use Conference - Washington, DC
April 26: Virginia Colorectal Cancer Roundtable - Roanoke

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Model Program: Kid One Transport
Kid One Transport provides rides to specialty medical services in 43 Alabama counties to clients who otherwise have no other means of transportation. 

CMS: Medicare Program; Part B Drug Payment Model
The Centers for Medicare & Medicaid Services has released a proposed rule discussing the implementation and impact of a new, value-oriented Medicare payment model, a two-phase Part B Drug Payment Model. Includes impact analysis on effects of the proposed rural on small and rural hospitals.

Rural Services Integration Toolkit
This new toolkit offers strategies for rural communities seeking to integrate health and human services to increase care coordination, improve health outcomes, and reduce healthcare costs.

America After 3PM Special Report: The Growing Importance of Afterschool in Rural Communities
Provides an overview of afterschool and summer learning programming in rural America. Discusses health and wellness impacts of afterschool programs for rural children. Describes strengths of rural programs and identifies barriers to participation in rural communities.

Mapping Medicare Disparities
County-by-county interactive map providing information on geographic disparities in chronic disease among Medicare beneficiaries. Indicates disparities in health outcome, utilization, and spending among racial and ethnic minorities and geographic location.  

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Funding Opportunities

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

TIGER Discretionary Grants
Awards grants for transportation projects that better connect communities to centers of employment, education, and services and that hold promise to stimulate long-term job growth, especially in economically distressed areas. Applications may included linkages between transportation improvements, including walking and bike trails, and overall community wellness, health, and livability.
May 11, 2016Application Deadline: Apr 29, 2016 

Agricultural Medicine Occupational and Environmental Health for Rural Health Professionals Scholarship
Awards scholarships to attend the the Core Courses for Agricultural Medicine: Occupational and Environmental Health for Rural Health Professionals to be held in Iowa.
Application Deadline: May 1, 2016 

Innovation in Care Integration for Children and Youth with Autism Spectrum Disorders and Other Developmental Disabilities Program
This program supports the implementation of innovative, evidence-informed strategies to integrate care at a system-level within a state for children and youth with autism spectrum disorders (ASD) and other developmental disabilities (DD), with a special emphasis on medically underserved populations (based on poverty, rural geographic location, and/or populations that experience health disparities).
Application Deadline: May 10, 2016 

Healthy Eating Research: Building Evidence to Prevent Childhood Obesity
The RWJF program supports research on environmental and policy strategies with strong potential to promote healthy eating among children to prevent childhood obesity, especially among groups at highest risk for obesity.

Approximately $2.4 million will be awarded through Round 10. Each grant will award up to $190,000 for a maximum funding period of 18 months. Approximately one-third of the funds available under Round 10 will be earmarked for studies focused on any of the following underserved geographic locations or populations: 1) rural areas of the United States, including the Appalachian region as defined by the Appalachian Regional Commission (; 2) Asian/Pacific Islanders; and 3) American Indians.
Deadline: Concept paper due May 10.  Approved concept papers will be asked to submit a full proposal by July 20.  A second round of concept papers will be accepted through August 3.

Anthem Foundation Grants
Funding supports ongoing community health programs with proven and measurable outcomes. We invest in traditional and nontraditional problem-solving approaches. These include programs that provide services directly to people and those that change systems that transform health care. 
Deadline: August 19

Aetna Foundation: Cultivating Healthy Communities
The Aetna Foundation is dedicated to promoting healthy eating and active living, strengthening health equity, and advancing innovations that make it possible for people to have more healthy days. The Foundation's Cultivating Healthy Communities grant program is intended to help local communities in the continental U. S. to become healthier places to live, with emphasis on projects that benefit underserved, low-income, and minority communities. Grants are provided to nonprofit organizations and government agencies committed to improving results in up to two of the following five domains: Healthy Behaviors, Community Safety, Built Environment, Social/Economic Factors, and Environmental Exposures. Applicants can request either $50,000 or $100,000 for projects lasting between 18 and 24 months. Organizations with annual operating budgets below $250,000 are not eligible to apply.
The Stage 1 application deadline is April 15, 2016

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Virginia Rural Health Association
2265 Kraft Drive
Blacksburg, VA 24060

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