Virginia Rural Health Association - Weekly Update
VRHA Weekly Update
In this Issue October 5, 2015

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

ORH


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VRHA News

Bonus Session

Do you want to get the most out of your VRHA Conference experience?  Stick around for the REVIVE Training of Trainers which will be held once the VRHA event is over at the same location.

REVIVE! is Virginia’s Opioid Overdose and Naloxone Education (ONE) program, helping people learn how to recognize and respond to opioid overdose emergencies by administering naloxone, a medication that can reverse the effects of an opioid overdose. Medical experience is helpful but not necessary!

Come to a REVIVE! Training of Trainers event to learn:

  • How opioid overdoses happen and how naloxone works
  • How to recognize overdoses, risk factors for overdoses, and myths about overdose reversal
  • How to administer naloxone
  • How to teach others to do all of these things!
  • How to plan, prepare for, and lead your own REVIVE! Lay Rescuer Training event


Click here for additional information.

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Members in the News

VRHA member Giles County Health Network has been selected to appear on the Rural Assistance Center (RAC)'s Rural Health Models & Innovations Hub.   

RAC collects and shares stories about rural health programs and interventions. This collection includes approaches that have demonstrated success in research studies and program evaluations, as well as anecdotal accounts. 

Click here for for a list of Virginia programs or here for all programs, sorted by Level of Evidence, Topic, State, and Source. 

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More Members in the News

Congratulations to VRHA Student member Chirag Patel (VCOM Class of 2018) for winning first AND second place in the VCOM Focus Photo Initiative – Segment 1: “Building on Excellence”.

Click here to see the amazing pictures.

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Virginia News

Our Lifeline

VHHA Press release 

The Virginia Hospital & Healthcare Association is embarking on a statewide public awareness campaign to alert Virginians to the financial challenges confronting Virginia hospitals, and to explain how those pressures pose consequences for our economy and access to high-quality health care. Virginians are fortunate to have a network of more than 100 hospitals around the state open night and day, year-round to care for anyone in need of medical attention – including those who can’t afford to pay. That commitment to care is part of hospitals’ mission.

The cumulative effect of uncompensated care on hospitals is costly. So is the impact of declining Medicare and Medicaid reimbursement payments, which pay providers pennies on the dollar for treatment delivered. Additional stress on hospitals takes the form of provider cuts from the Affordable Care Act and sequestration. In 2013, Virginia hospitals provided $1.5 billion in community benefit reflecting charity care, financial assistance, Medicaid shortfall, and other factors. Combined with funding cuts and mandates, this is an unsustainable model.

Read the full press release and related stories from WCVE, the Washington Post, Daily Press, Alexandria News, and Healthcare DIVE

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Virginia Grants Website

From the Office of the Governor

GovernoMcAuliffe launched the first ever Virginia Grants website, a new public resource for anyone interested in state, federal, and private funding opportunities. The website will serve as a hub for taxpayers to search for grant opportunities, and have a better idea of how federal tax dollars are being spent, and which grants present opportunities for state and local governments as well as private businesses and organizations.  
 
“The new Virginia Grants website will help my administration serve taxpayers better by increasing transparency and accountability and offering residents a single hub for grant funding opportunities that may help them grow their businesses, improve their communities or make life better for their families,” said Governor McAuliffe. “Using technology to improve government customer service and seize more opportunities to fund important priorities is a great step forward in our efforts to build a new Virginia economy.”
 
In a communication to state agencies, Governor McAuliffe urged state agencies to utilize this website when applying for grants in order to foster collaboration amongst agencies. He also directed agencies to publish grants they offer on the Virginia Grants site so that Virginians can browse and apply for state grants more easily. 

To visit the new Virginia Grants site, click here

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Merger Paperwork

By News Channel 11

The approval process for merging the region’s two health systems has been begun, as the first paperwork in the proposed deal has been filed. Mountain States Health Alliance and Wellmont Health System announced earlier this year that the two entities intended to merge operations to create one single health provider to reduce health care costs.

The two systems announced the filing of what were described as letters of intent addressed to the Tennessee Department of Health and the Southwest Virginia Health Authority declaring that applications for a certificate of public advantage (COPA) would be submitted Nov. 1. This is also the projected effective date of the proposed cooperative agreement, according to the letter.

Read the full article.

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National News

Rural IMPACT 

By Erin Mahn Zumbrun - National Rural Health Association

The White House announced the 10 sites participating in the Rural IMPACT demonstration, an initiative to help address rural child poverty. More than six million rural Americans live in poverty, including about 1.5 million children.

Recognizing that every child, no matter where she is born, should have an opportunity to succeed, the White House Rural Council launched “Rural Impact,” a cross-agency effort to combat poverty and improve upward mobility in rural and tribal places. And in August, HHS announced a new demonstration project, Rural Integration Models for Parents and Children to Thrive (IMPACT), to help communities adopt a two-generation approach to addressing the needs of both vulnerable children and their parents, with the goal of increasing parents’ employment and education and improving the health and well-being of their children and families.

The Rural IMPACT Demonstration will help communities adopt a comprehensive, whole-family framework for addressing child poverty, such as through facilitating physical co-location of services, universal “no wrong door” intake, referral networks, shared measurement systems, and use of technology to deliver services.

Read the full blog and related press release.

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Surviving the Challenge

By Nina Flanagan - Healthcare DIVE

Rural hospitals have been struggling for decades, but the past few years have seen a cascade of closings. According to the National Rural Health Association (NRHA), 58 rural hospitals out of 2,322 have shut their doors since 2010, the latest one Mercy Hospital in Independence Kansas. Diane Calmus, government affairs and policy manager at NRHA, said there’s not one specific reason for the closings, but rather, a culmination of events. 

The financial hurdles for rural hospitals started back in 1983, according to Kaiser Health News. With the decision to implement a set fee for services versus reimbursement for actual costs, 440 rural hospitals closed from 1983 to 1988, according to NRHA. After the 2008-2009 recession, hospitals were hit with 2% Medicare payment cuts in 2011. Then in 2012, CMS reduced reimbursements by 30% to 35% to hospitals for Medicare patients who can’t cover their out-of-pocket expenses.

When a rural hospital closes, the impact is far-reaching. Calmus said rural hospitals represent as much as 20% of local salaries and wages. “The impact on these communities when hospitals close is huge. The average rural critical access hospital alone creates around 195 jobs and generates about $8.4 million in payroll annually.” She said when a hospital closes, physicians leave the area and don’t return. "Young families won’t move into an area without access to a local emergency room. It can really close down that town.”

Read the full article.

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New Doc Mentoring

By Jane Warstler and Tina M. Owen - Daily Yonder

Brittany Papworth, a UNC School of Medicine student finishing her third year at the school’s Asheville campus, never considered rural medicine as a career path. But a medical training program in western North Carolina helped Papworth see rural healthcare in a new light. Now she’s focusing on rural medicine and finds it’s a good fit with her desire to “do “grassroots work with a strong focus in public health and community advocacy.”
 
For 41 years, the Mountain Area Health Education Center (MAHEC) in western North Carolina has encouraged aspiring physicians to pursue primary care specialties and dedicate their careers to serving rural communities. MAHEC and its state network are part of a congressionally established medical training program designed to improve healthcare for underserved communities.
 
MAHEC residency training programs have graduated 466 physicians and dentists, many of whom stay in western North Carolina to become family doctors and community leaders.  Since its inception, MAHEC has successfully retained 65% of its family medicine graduates in the state of North Carolina and 60% have chosen to practice in the western part of the state.

Read the full article.

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Broadband: What's Going Where?

By Tim Marema - Daily Yonder

Could any of the recently announced $9 billion in broadband subsidies be used to help improve high-speed Internet connections in your community? It’s hard to say for sure. But new data from the Federal Communications Commission can give us a pretty good idea of where new federal subsidies could help deliver Internet service to hard-to-reach locations. This subsidy, part of the Connect America Fund, supports the nation’s largest telecommunications businesses like AT&T, Verizon, and Centurylink.

The FCC warns that there will be some variability in these potential service areas. Borders could change based on how the broadband work proceeds over the six-year subsidy program. But, as a rule, carriers that accepted this subsidy must provide broadband to these areas at a minimum speed of 10 megabytes for downloads and 1 megabyte for uploads.

So, take a look at the FCC map, find a part of America you know, and see what happens with broadband access there.

Read the full article.

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Mark Your Calendar

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

October 13-14: VRHA Annual Conference - Staunton
October 15: REVIVE! Training of Trainers - Staunton
October 29: Safe Prescribing of Opioids Seminar - Salem
November 13: VOHC Conference, 
Achievable Wellness: Engaging Communities and Clinicians for Better Health - Richmond
December 3: TCI Policy Summit - Richmond
February 2-4: Rural Health Policy Institute - Washington, DC

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Resources

2014 Behavioral Risk Factor Surveillance System (BRFSS) data    
The BRFSS is the largest ongoing telephone-based surveillance system in the world, with more than 460,000 interviews conducted in 2014. Using both landline and cellular telephones, the survey collects information on health risk behaviors, clinical preventive health practices, and health care access (primarily related to chronic disease and injury) from a representative sample of non-institutionalized adults aged 18 years and older in each state.

State Strategies to Improve Health and Control Cost
CDC is partnering with NGA and the Center for Medicaid and CHIP Services to provide governors' offices, Medicaid directors, and public health stakeholders with specific population health strategies that can be integrated into the healthcare delivery system to improve health and lower costs within five years. 

APHA State Innovation Model Guides
APHA has developed two new resources to help public health play a role in ACA implementation. "Integrating Public Health Into State Innovation Models" describes how state officials can team up with public health professionals to create better health outcomes, while "Taking Part in State Innovation Model Development" recommends ways that public health can take an active role in making the innovation models work and gives examples of what engagement can look like. 

State Factsheets: Prevention and Public Health Fund
Trust for America's Health released state-by-state factsheets that describe how each state has used dollars from the Prevention and Public Health Fund (PPHF) to address public health concerns. HHS also provides a PPHF Reporting Database that describes PPHF, funding distributions, and funding opportunity announcements that states can pursue.
 

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Funding Opportunities

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

American Academy of Dermatology: Shade Structure Grant Program
The American Academy of Dermatology's Shade Structure Grant Program provides support to public schools and nonprofit organizations for the installation of permanent shade structures for outdoor locations that are not protected from the sun, such as playgrounds, pools, or recreation spaces.

Toyota U.S.A. Foundation
The Toyota U.S.A. Foundation supports nonprofit organizations throughout the country that are dedicated to improving the teaching and learning of science, technology, engineering, and mathematics (STEM). Grants of $50,000 or more are available to support the development and implementation of programs in the STEM fields. Funded organizations must be classified as 501(c)(3) nonprofit organizations, be located within the United States, and have a national scope.  

Robert Wood Johnson Foundation Health Policy Fellows
Due date: Nov 12, 2015
Award: Up to $165,000
The Robert Wood Johnson Foundation Health Policy Fellows program provides the nation’s most comprehensive learning experience at the nexus of health, science, and policy in Washington, D.C. It is an outstanding opportunity for exceptional midcareer health professionals and behavioral and social scientists with an interest in health and health care policy. Fellows participate in the policy process at the federal level and use that leadership experience to improve health, health care, and health policy.

Benefits Enrollment Centers (BECs) Request for Proposals
Due date: Nov 13, 2015
Award: $100,000
The National Council on Aging is accepting applications for qualified organizations and agencies to become BECs. BECs help low-income seniors and persons with disabilities find and enroll in all the benefits programs for which they are eligible, and create coordinated, community-wide systems of benefits access. 

AIDS United: Sector Transformation
AIDS United is dedicated to ending the AIDS epidemic in the United States. Sector Transformation, an initiative of AIDS United, supports HIV/AIDS service organizations nationwide that are navigating the challenges to service sustainability posed by shifts in funding, implementation of healthcare reform, and scientific advances in HIV treatment and prevention. Grants of up to $50,000 are available for costs of restructuring activities, including staff, program, consultant, and legal expenses. Sector Transformation also offers technical assistance for specific restructuring-related activities, as well as funding for “reverse site visits” to help organizations learn from others that have successfully restructured. Applicants must be nonprofit, tax-exempt 501(c)(3) organizations or have a fiscal agent. Letters of inquiry are accepted throughout the year; invited proposals are reviewed quarterly.

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