VRHA Weekly Update
In this Issue  November 20, 2017

VRHA News Virginia News National News Mark your calendar
Funding Opportunities


November Newsletter




Save the Date!

VRHA received a mini grant from the National Rural Health Association to host a Symposium on Oral Health in Rural Virginia.  Mark May 3rd on your calendar and plan on being in Abingdon that day.  We've teamed up with the Virginia Oral Health Coalition to make it a top-quality event!

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VRHA is proud to announce that board member Portia Brown has been accepted into NRHA's Rural Health Fellows Program!

Fellows participate in a year-long, intensive program to develop leaders who can articulate a clear and compelling vision for rural America.  Previous VRHA members in the program have been Carole Pratt, James Tyler, Janice Wilkins, and Bob Alpino.

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​Members in the News

From the DO

Nearly every fourth-year medical student dreams of matching into their first-choice residency program and specialty. This may be more likely to happen at certain medical schools, according to U.S. News & World Report, which recently published a list of the top 10 U.S. medical schools with the highest first-choice residency placements. The list includes three osteopathic medical schools.
The highest reported first-choice residency placement rate for an osteopathic school was [VRHA member] Edward Via College of Osteopathic Medicine, which has campuses in Virginia, South Carolina and Alabama, and reported a first-choice residency placement rate of 87.4% of students. West Virginia School of Osteopathic Medicine and University of New England College of Osteopathic Medicine in Maine both had more than 60% of their students match into their first-choice programs as well.

Read the full article.

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Virginia News

Ballad Transition Plans

By Nick Shepherd - Greenville Sun

Now that the merger between Mountain States Health Alliance and Wellmont Health Systems has been approved by Tennessee and Virginia, the two organizations are beginning the transition process into Ballad Health.

Two memos addressed to employees from MSHA CEO Alan Levine and Wellmont CEO Bart Hove dated Nov. 6 explain how the transition process will work and lays out ground rules for the senior management team. A new policy also laid out how the exchange of sensitive information would work. 

According to the first memo, the two health leaders said they expect the merger to be fully completed by early next year. The transition will not affect operations of either system.
Two major steps would be the assembly of a Board of Directors for Ballad Health and naming a transition team to prioritize closing the merger and establishing a process for the integration of the two systems once the merger is complete. 

Read the full article, and similar stories from the Herald Courier, Johnson City Press, WCBY, Coalfield Progress

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Expansion Odds

From Washington's Top News

The prospects of expanding Medicaid in Virginia are looking a lot brighter since Tuesday’s wave election that nearly wiped out Republicans’ overwhelming majority in the House of Delegates.

The long-held Democratic priority repeatedly failed when Republicans controlled two-thirds of the chamber. Control of the chamber is still up in the air as a couple of close races have yet to be called. Democrats say they believe they can get Medicaid expansion passed even if Republicans retain a slim majority. Gov.-elect Ralph Northam said he’s going to make it a top priority.

Republican leaders say they still oppose expanding the healthcare program for the poor, saying its long-term costs are too high.

See also related stories from ABC News, Modern Healthcare, Vox, News & Observer, WasteWatcher

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Drug Court Second Chance

By Fred R. Conrad - Guardian

“Opioid and methamphetamine abuse tore through this area like a wildfire.” This is the view of Rebecca Holmes, who is responsible for mental health and drug use outpatient treatment in Abingdon, Washington County, Virginia, as she looks back at the decision to set up a drug court.

Holmes, the medical director of Highlands Community Services, had seen how the growing crisis around opioids had taken such a heavy toll on families in the town, which is home to just over 8,000 people.

There was a growing need for a small group of addicts that did not respond to treatment or programs offered by the existing court or probation, she said, so five years ago she applied for a grant to use a federal model for a drug court that had first emerged in 1989. 

Read the full article.

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National News

Action Alert

By Jessica Seigel  - National Rural Health Association

House Ways and Means Committee is advancing legislation that will result in the closure of even more rural hospitals, further decimating access to health care and further escalating economic decline in rural communities across the country. Instead of advancing policies to improve the plight of rural America (where health disparity and mortality gaps between urban and rural populations escalate, and unemployment rates continue at levels of the Great Recession), the Ways and Means Committee calls for payment reductions to rural safety net hospitals known as Critical Access Hospitals.  And, perhaps the most hypocritical factor, is that the Committee plans to use this devastating payment cut to Critical Access Hospitals to partially pay for other important rural health programs that Congress has irresponsibly let expire.

Maybe the Ways and Means Committee is unaware that one in three rural hospitals are in financial risk of closure, and 41% of rural hospitals operate at a negative financial margin. Maybe the Ways and Means Committee doesn't realize that when a rural hospital closes, 20% of the rural economy vanishes and other health providers in the community, who are almost always hospital based, leave the rural area. Maybe the  Ways and Means Committee doesn't understand the depth of health workforce shortages, chronic poverty and chronic disease in rural America. If they did, perhaps the Committee would advance a robust health and economic development plan for rural America, instead of a plan to decimate rural health care delivery.

We urge you to Call Your Member of Congress and oppose cuts to Critical Access Hospitals. 
 Not sure who your member of Congress is?  Look it up here.

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Growing Rural Hospitals

By Meg Bryant - Healthcare DIVE

Rural hospitals are in crisis, facing demographic changes, declining inpatient volumes and reduced federal support. Since 2010, 80 rural hospitals have closed and 673 are at risk of closing — 210 at “extreme risk,” according to iVantage Health Analytics.  Economic pressures have caused populations to decline, leaving a smaller patient base and less revenue. Those who remain are often elderly and uninsured.

Despite these challenges, however, some hospitals are surviving and even prospering by acknowledging the shift to value-based care and aligning themselves with quality-driven, cost-conscious trends in healthcare.

Read the full article.

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Retaining Residents

By Rebecca Robbins - STAT

Desperate to persuade young doctors to settle in rural areas — or just keep them from leaving the state — medical schools, hospitals, and state legislators are getting creative. They’re forgiving tens of thousands of dollars in loans, setting up mentorships, and recruiting med school grads with local ties in an effort to hold on to providers.
Convince a 30-year-old doctor fresh out of her residency to stay put, after all, and she could easily wind up delivering four decades of care in a needy community.
But on this crucial metric, some states are faring far worse than others. California, with an abundance of space and jobs for doctors, retains 70 percent of residents and fellows trained in-state — compared to just 28 percent in tiny New Hampshire, where full-time physician jobs are few and leaving the state may only mean moving a short distance.

Read the full article.

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EHRs in CAHs

By Kate Monica - EHR Intelligence

A recent study by Julia Adler-Milstein, PhD, and Jay Holmgren at the University of Michigan found critical access hospitals (CAHs) are less likely than other hospitals to use EHR data for performance measurement and patient engagement.

According to the pair, this disparity in EHR use signals the emergence of a digital divide between CAHs and other hospitals. This digital divide could negatively affect the quality of patient care in CAHs.  

“Hospital EHR adoption is widespread and many hospitals are using EHRs to support QI and patient engagement,” they wrote in a discussion of study findings. “However, this is not happening across all hospitals.”

Read the full article.

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Mark Your Calendar

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

November 29: Managing Major Depressive Disorder in Rural Primary Care Settings - webinar
November 30: Oral Health in Pregnancy and Early Childhood - webinar
February 6-8: Rural Health Policy Institute - Washington, DC
May 8: Health Equity Conference - New Orleans, LA
May 8: Rural Medical Education Conference - New Orleans, LA
May 8-11: Annual Rural Health Conference - New Orleans, LA
May 8-11: Rural Hospital Innovation Summit - New Orleans, LA

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Provides real-time overdose surveillance data across jurisdictions to support public safety and health efforts to mobilize an immediate response to an overdose spike.  It links first responders on scene to a mapping tool to track overdoses to stimulate real-time response and strategic analysis across jurisdictions.  It is a mobile tool, capable of being used in the field on any mobile device or data terminal connected to an agency CAD system.  Agencies sign a teaming agreement and have the ability to upload data and view the map in real time.

NOSORH Rural Health Grant Writing Institute
A 5-month, 9-part webinar-based training series designed to help rural health professionals build grantseeking and grant writing skills.
Application Deadline: Jan 3, 2018 

Model Program: Mitchell Area Safehouse and Family Visitation Center
Serves victims of domestic violence in an 8-county region of rural South Dakota through temporary housing, advocacy, and community education. 

Recent Trends in Children's Healthcare - Coverage and Oral Health Outcomes
Kevin Bennett, PhD, from the South Carolina Rural Health Research Center discussed the latest information on healthcare coverage for children and adolescents. He also discussed recent findings from the South Carolina Rural Health Research Center regarding access to care, Medicaid coverage, and utilization among children. There was also discussion on recent research regarding oral healthcare among children and adolescents, including dental insurance and benefits, oral health status, and utilization of dental services.

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Funding Opportunities

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

Virginia Health Care Foundation
The Virginia Health Care Foundation promotes public-private partnerships that increase access to primary health care services for medically underserved and uninsured Virginians. The Foundation’s Health Safety Net Grants support organizations that work to increase access to primary care for uninsured Virginians and those who live in areas with limited access to care. Funding focuses on projects that address one or more of these priorities: developing or expanding patient capacity, establishing a broader scope of services, creating local systems of care, and strengthening the infrastructure of health care providers. Nonprofit organizations and public agencies, including free clinics, community health centers, and other similar organizations are eligible to apply.
The first concept paper deadline for 2018 is January 19.  

Craig H. Neilsen Foundation: Creating Opportunity & Independence
The Craig H. Neilsen Foundation’s funding is dedicated to supporting both programs and scientific research to improve the quality of life for those affected by and living with spinal cord injury. The Foundation’s Creating Opportunity & Independence portfolio supports nonprofit organizations that enhance services and develop innovative projects to improve participation and independence for people living with spinal cord injury throughout the United States and Canada. Areas of interest include Assistive Technology, Education, Employment, Independent Living, Rehabilitation, and Arts, Sports, and Recreation.
Letters of intent for Project Grants are due January 12, 2018; invited full grant applications must be submitted by April 27, 2018.

The Mary Byron Project: Celebrating Solutions Awards
The Mary Byron Project cultivates and supports efforts that extend beyond crisis management to attack the root causes of the domestic violence epidemic. The Project’s Celebrating Solutions Awards recognize innovative programs that demonstrate promise in ending the generational cycle of domestic violence. The focus is on pioneering programs that can serve as models for the nation. Four awards of $10,000 are presented each year. (An additional Roth Award of $10,000 recognizes one program that specifically addresses the needs of underserved and vulnerable populations.) Programs that have been in operation for a minimum of three years are eligible for the awards. Nominations must be postmarked by January 31, 2018.

500 Cities Data Challenge
A Robert Wood Johnson Foundation grant competition to fund projects that will connect work across sectors to improve health outcomes using the 500 Cities dataset. The Challenge will provide grants for up to 10 projects, with a total of up to $1 million in available funding.
The goal of this competition is to encourage communities to dig into the 500 cities data and design innovative solutions (or additional data analyses) which address social factors that influence health, such as housing, education, and transportation. The ideas generated can help build the foundation for more comprehensive cross-collaboration to foster a broad Culture of Health and guide communities in how to use data more effectively.
This grant competition will remain open until December 1st, 2017 at 5 PM EST. An introductory webinar will be held on November 20th for interested applicants and the full announcement for the challenge can be found here. Please contact 500citieschallenge@urban.org with any questions.”

Ryan White HIV/AIDS Program Part F Community Based Dental Partnership Program
Offers funding to organizations to work with community-based dental providers to increase service delivery to people living with HIV/AIDS in underserved populations or geographic areas, and to train dental and hygiene students and dental residents to deliver HIV/AIDS dental care.
Application Deadline: Jan 19, 2018 

Preventive Medicine Residency Program
Grants to provide graduate medical education training to preventive medicine residents for the purpose of increasing the number and quality of preventive medicine residents and physicians to support access to preventive medicine and to improve the health of communities.
Application Deadline: Jan 26, 2018 

Primary Care Training and Enhancement: Training Primary Care Champions
Grants to strengthen primary care and the workforce by establishing fellowship programs to train community-based practicing primary care physician and/or physician assistant champions to lead healthcare transformation and enhance teaching in community-based settings.
Application Deadline: Jan 30, 2018 

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