VRHA Weekly Update
In this Issue October 2, 2017

VRHA News Virginia News National News Mark your calendar
Funding Opportunities


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Deadline #1

Deadline: October 7

VRHA is accepting applications for Poster Presentations from health and public policy students at the conference. 

The Poster Presentations provide participants with the ideal opportunity to disseminate information to other rural health stakeholders.

Poster Presentations may include research projects, case studies, clinical evaluations, case presentations, observations, unusual or uncommon situations and other topics as they relate to rural health.  

Click the event logo to visit the conference website, then visit the "Poster Presentations" tab for details.

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Deadline #2

Registration fees for the October 24 & 25 Rural Health Documentation & Coding Bootcamp will increase on October 5th.

With the changes from CMS, it has never been more important to make sure you are documenting and coding for 100% of what is done. Billing is not supposed to change – but if you aren’t documenting and coding correctly, revenue may be left on the table! 

Increase revenue and reduce compliance risks - Become a Rural Health Coding & Billing Specialist.

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Welcome, Mindy!

VRHA is proud to announce that Mindy Thorpe is now an official part of the VRHA team!  After receiveing her Master of Public Health from Virginia Tech, Ms. Thorpe started with VRHA in 2016 as a volunteer through the Conservation Legacy's VISTA program.

With her assistance, VRHA was able to successfully apply for the Federal Office of Rural Health Policy's Rural Health Opioid Program.  VRHA will use these funds to develop a High-Risk Patient Education Program for Virginia's hospitals and clinics.

Click here to learn more about the program and how your facility can be involved.  Mindy Thorpe will be the Program Coordinator and can be reached at mindy@vrha.org or 540-231-3899. 

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Virginia News

Talking About Opioids

By Paul Collins - Martinsville Bulletin

The need for in-patient rehabilitation facilities, drug courts and funding for programs to help drug addicts were mentioned by some audience members during a “community conversation” about the opioid epidemic at event titled “Legal Prescriptions and Heroin Addictions: A Community Conversation” in Martinsville.

According to figures provided by [VRHA member] Dr. Jody Hershey, director of the West Piedmont Health District, from 2007 to 2015, the city of Martinsville had a 330 percent increase in the opioid overdose death rate (from 6.9 to 29.7 per 100,000 population).

The city of Martinsville also had the highest three-year average opioid death rate (from 2013 to 2015) of any locality in the district and more than twice Virginia’s rate. The West Piedmont Health District is comprised of Henry, Patrick and Franklin counties, and the city of Martinsville.

Read the full article.

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Care without a Hospital

By Amie Knowles - Martinsville Bulletin

How do you provide medical care for a community without a hospital? That’s the challenge facing medical units in Patrick County. Earlier this month, Pioneer Community Hospital closed its doors to new patients. Now one fire department is looking at some new options, to help handle the calls.

Sept. 15 was the final day when new patients would be accepted at Pioneer, either in the emergency room or otherwise. That doesn’t stop the calls from coming in to local departments, however. The JEB Stuart Rescue Squad currently handles an estimated 54 percent of Patrick County’s emergency calls, but it’s become harder not just due to the volume, but also because of a shrinking number of volunteers. In years past, there have been as many as 40 volunteers on the rescue squad. Now, there are 15 active members.

Read the full article.

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Healthcare and the Governor's Race

By Alex Koma - InsideNOVA

Republican efforts to roll back former President Barack Obama’s signature healthcare law have repeatedly taken center stage in the Virginia governor’s race, and the first televised debate of the general election campaign was no exception.

Lt. Gov. Ralph Northam, a Democrat running to replace term-limited Gov. Terry McAuliffe, insistently invoked the latest efforts in Washington, D.C., to repeal the Affordable Care Act as he sparred with Republican Ed Gillespie in a debate co-sponsored by the Northern Virginia Chamber of Commerce and George Mason University's Schar School of Policy and Government Sept. 19.

Even as Gillespie, a former lobbyist and head of the Republican National Committee, repeatedly took shots at the health of the state’s economy (and his plans to use a hefty income tax cut to stimulate growth), Northam frequently shifted the conversation back to healthcare.

Read the full article.

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National News

No Reform Bill

By Diane Calmus - National Rural Health Association

The latest push to repeal the Affordable Care Act (ACA) from Republican Sens. Lindsey Graham (SC) and Bill Cassidy (LA) will not receive a vote in the Senate, ending the current effort to repeal the Affordable Care Act using the budget reconciliation process that would have allowed a bill to pass with 50 votes.

While NRHA does support empowering states to make their own decisions on the health care needs of their population, NRHA opposed the Graham-Cassidy bill because of the potential to harm rural patients and providers.

Senator Susan Collins (R-ME) cited the great danger of rural hospital closures as one of her major reasons for not supporting the Graham-Cassidy Bill. “If Medicaid is cut [Charles A Dean Hospital in Greenville Maine] will not survive,” Collins said. “It’s the biggest employer in town. It has 180 good-paying jobs. So not only would people lose access to health care that they need, it would be a devastating blow to the community. You could go all over the state and find that would be true.”

Read the full article.

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Wellness Coordinators

By Sara Heath - Patient Engagement HIT

Employing wellness coordinators is an effective strategy for increasing patient outreach and supporting widespread preventive care in rural areas. Increasing access to and utilization of preventive services can result in improved health outcomes for patients, the research team said.

However, delivery of preventive care in primary care settings often falls short due to clinician time restrictions, limited data interoperability, and complications in coordinating care across different community providers.

The County Health Improvement Organization conducted a 2-month outreach program included over 5,000 patients, 78 percent of whom had gaps in preventive care service access. As a result, nearly 8,000 priority patient outreaches were made, meaning some patients received more than one outreach. The extensive patient outreach resulted in a 35 percent increase in preventive care delivery, the researchers reported.

Read the full article.

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Opioid Crisis Budget

By Paula Seligson & Tim Reid - Reuters

As deaths mount in America’s opioid crisis, communities on the front lines face a hidden toll: the financial cost. Ross County, a largely rural region of 77,000 people an hour south of Columbus, Ohio, is wrestling with an explosion in opioid-related deaths - 44 last year compared to 19 in 2009. The drug addiction epidemic is shattering not just lives but also stressing the county budget.
About 75 percent of the 200 children placed into state care in the county have parents with opioid addictions, up from about 40 percent five years ago, local officials say. Their care is more expensive because they need specialist counseling, longer stays and therapy.

Read the full article.

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Price Resigns from HHS

By Dan Diamond, Rachana Pradham, and Adriel Bettelheim

HHS Secretary Tom Price resigned Friday in the face of multiple federal inquiries and growing criticism of his use of private and government planes for travel, at a cost to taxpayers of more than $1 million since May.

The White House said Trump asked Deputy Assistant Health Secretary Don Wright to serve as acting secretary of the agency, which has an annual budget $1.15 trillion and includes the Medicare and Medicaid programs, as well as the FDA, NIH and CDC.

Read the full article.

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Mark Your Calendar

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

October 24 & 25: Rural Health Documentation & Coding Bootcamp  - South Boston, VA
October 25 & 26: Virginia Rural Providers Conference - South Boston, VA
October 28: Rx Abuse Forum - Fishersville
October 29: Rx Abuse Forum - Lynchburg
November 2: 2017 Virginia Oral Health Summit - Richmond
November 12 & 13: Virginia Telehealth Network Summit - Richmond
November 15: Synthetic Narcotic & Opioid Abuse Prevention Summit - Abingdon

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Aging in Place in Small Urban and Rural Communities
Examines the current state of aging in place, including cost benefits of rural residents living independently and using home health services and public transportation, rather than relocating to assisted living facilities. Includes statistics on costs of various types of senior living situations in North Carolina, Pennsylvania, Missouri, Wisconsin, Mississippi, Maine, New Mexico, and Montana, and aging in place cost savings forecasts for these states.
Additional links: Executive Summary

An Assessment of Mobile and Portable Dentistry Programs to Improve Population Oral Health
Describes configurations of portable and mobile dental programs including models and applications, discusses targeted populations, details variations in regulations by state, and examines outcomes of preventive interventions in underserved areas. Includes case studies of 7 programs initiated to improve access in underserved populations or in rural areas.
Additional links: Policy Brief

The Appalachia Initiative: A Bipartisan Approach for the 21st Century
Reports on the current challenges facing Appalachia. Breaks down data by education and workforce, entrepreneurism and job creation, energy and infrastructure, and rural health. Looks specifically at mortality rates, obesity and diabetes prevalence, and drug overdose death rates.

Despair as a Cause of Death: More Complex Than It First Appears
Describes studies showing urban-rural and racial/ethnic comparisons of premature deaths due to self-destructive behaviors and possible underlying social and economic factors in the communities.

Roadmap to Behavioral Health
A consumer guide that connects individuals to resources for disaster distress, suicide prevention, veterans crisis and recovery from substance use disorder was created by the Centers for Medicare & Medicaid Services (CMS) and the Substance Abuse and Mental Health Services Administration (SAMHSA).  The guide provides simple explanations of feelings and behaviors that may need attention, a check list for getting help and treatment, and tips for managing long-term behavioral health care.  

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Funding Opportunities

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

RN Tuition Assistance
Mountain States is offering tuition assistance – $2,500 for four years and $1,500 for two years of school – to help hire and keep more registered nurses. Students applying for this must agree to accept full-time employment at Mountain States within the first month following graduation and stay with Mountain States for at least three years. The tuition assistance is available to Mountain States team members and the public.  To learn more about the tuition assistance and how to apply, contact Donna Ricker (423-302-3258).

Brownfields Assessment Grants
Funding to inventory, characterize, assess, and conduct planning (including cleanup planning) and community involvement related to brownfield sites.
Application Deadline: Nov 16, 2017 

Brownfields Cleanup Grants
Provides funds to carry out cleanup activities at a specific Brownfields site, resulting in better community environmental health.
Application Deadline: Nov 16, 2017 

For CAHs: Pediatric Readiness Quality Improvement
The Emergency Medical Services for Children Program at HRSA requests applications from Critical Access Hospitals (CAHs) to participate in this initiative.  Participating hospitals will receive mentoring from the Pediatric Readiness Quality Collaborative (PRQC); physicians can earn Maintenance of Certification Part IV credit and nurses can receive Continuing Nursing Education credit. The PRQC will focus on pediatric patient safety, patient assessments, inter-facility transfer guidelines, and disaster preparedness. Using a train-the-trainer model, teams will be supported through targeted quality improvement education, the provision of tools and resources to support local efforts, and sharing of best practices.  The deadline to submit a letter of interest has been extended to October 13, 2017. More information about the Pediatric Readiness Quality Improvement Collaborative is at https://emscimprovement.center/collaboratives/PRQuality-collaborative/  Additional questions can be directed to qeca@texaschildrens.org.

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