VRHA Weekly Update
In this Issue January 9, 2017

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

AgrAbility

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VRHA News

Welcome New Board Members!

VRHA elected six new members during the October Annual Meeting.  The following people started their term on the board January 1st:

  • Portia Brown, Valley Health-Page Memorial Hospital
  • Rebecca Frango, Virginia Premier Health
  • Jeffrey Hundman, The Clifton Companies
  • Julia Gohlke, Virginia Tech
  • Bill Jacobsen, Carilion Franklin Memorial Hospital
  • Kathy Landreth, Bath Community Hospital
VRHA also extends thanks to outgoing board members Chuck Carr, Melody Counts, Kate Lim, Ashley Kenneth, Emma Mitchell, and Gay Plungas.

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Members in the News

From Alexandria News

Serving the needs of patients and families dealing with a mental health diagnosis is an ongoing challenge that cuts across many segments of society including health care providers and behavioral health professionals, law enforcement personnel, the judicial system, elected officials and public health infrastructure, and much more. Mental health diagnoses have directly and indirectly affected millions of Virginians. The Commonwealth has experienced its share of high-profile mental health tragedies, and many families have also struggled to deal with personal behavioral health situations. In recognition of the ongoing community need for access to behavioral health services, [VRHA member] Virginia Hospital & Healthcare Association has developed a package of legislative proposals addressing the preadmission screening evaluation process, inpatient bed identification, commitment hearings, and funding.

The bi-partisan group of Virginia legislators sponsoring aspects of the VHHA 2017 Behavioral Health Legislative Agenda include Senator George L. Barker (D-Fairfax County), Senator A. Benton “Ben” Chafin Jr. (R-Russell County), Senator Janet D. Howell (D-Fairfax County), Delegate Roxann L. Robinson (R-Chesterfield County), and Delegate Joseph R. Yost (R-Giles County).

Read the full article.

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More Members in the News

From the Department of Health and Human Services

Health and Human Services (HHS) Secretary Sylvia M. Burwell announced over $50 million in funding for 75 health centers in 23 states, Puerto Rico and the Federated State of Micronesia.

“We expect this competitive New Access Point funding to provide health care to more than 240,000 additional patients, ” said Dr. Mary Wakefield,  Acting Deputy Secretary at HHS. “These new health center sites will contribute significantly to the health of families and communities across the nation.”  Read the full press release.

Both Virginia awardees are VRHA members: Community Health Center of the New River Valley
 and Piedmont Access to Health Services.

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Virginia News

Legislative Update

Bills recently proposed by the Virginia General Assembly which could have an impact on health and healthcare in rural Virginia:

  • HB 1467: Board of Health to adopt regulations to include neonatal abstinence syndrome on the list of reportable diseases. 
  • HB 1474: Dental hygiene; remote supervision. 
  • HB 1480: Mental health awareness training; law-enforcement officers, firefighters, and emergency medical services personnel.
  • HB 1483: Board of Behavioral Health and Developmental Services to amend regulations governing licensure of providers to include certain definitions.
  • HB 1533: Required immunizations; meningococcal conjugate.
  • HB 1544: Certificates of public need; alternative plans of compliance.
  • HB 1549: Community services boards and behavioral health authorities; services to be provided.
  • HB 1550: Study; Departments of Behavioral Health and Developmental Services and Medical Assistance Services to study use of the Involuntary Mental Commitment Fund; report.
  • HB 1610: Drug Control Act; Schedule I.
  • HB 1642 & SB 1031: Possession and administration of naloxone.
  • HJ 568: Study; Joint Commission on Health Care to study options for increasing the use of telemental health services in the Commonwealth; report.
  • HJ 597: Study; Joint Commission on Health Care; study of heroin use in the Commonwealth; report.
  • SB 922: Department of Professional and Occupational Regulation and Department of Health Professions; licensure, certification, registration, and permitting.
  • SB 933: DCJS training; jail officers; mental health first aid.
  • SB 940: Mental health screening of prisoners at local correctional facilities.
  • SB 974 & HB 1675: Palliative care information and resources.
  • SB 975: Community services boards; preadmission screening; regional jail inmates.
  • SB 1009: Practice of telemedicine; prescribing.
  • SB 1043: Joint Commission on Health Care; sunset.

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Budget Amendments

From the Office of the Governor

Governor Terry McAuliffe announced that his amendments to the FY-2016-18 budget will include significant investment in mental health and substance abuse treatment. The Governor also announced that he will submit legislation in the upcoming General Assembly session to further enhance Virginia’s approach to behavioral health and combatting opioids. 

“It is time to bring our behavioral health system into the 21st century,” Governor McAuliffe said. “For too long we have made reforms only in response to crises, but we need a better plan to improve the things that are working and change the things that are not. The budget I will propose will make investments to modernize our behavioral health system and align our approach with best practices.

The new funds will pay for increased same-day access to assessment at community services boards; increased medication-assisted treatment access for people with opioid addictions; reduction of the bed census at state mental health hospitals; an evaluation of the structure of the behavioral system through the Department of Behavioral Health and Developmental Services and Virginia’s 40 CSBs; and  an expansion of this year’s pilot project to improve mental health treatment in jails by funding grants to help jails identify a mental health assessment program. 

Read the full press release and related story by the Roanoke Times.

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Syringe Services Programs

By Katie Demeria - Richmond Times-Dispatch

In the shadow of a public health emergency declaration, state health officials are trying to legalize a program that could stifle the potential outbreak of two deadly infections. The Virginia Department of Health has drafted a bill that would legalize syringe services programs in the state as part of the department’s effort to prevent the opioid epidemic from creating an outbreak of HIV or hepatitis C.

Syringe services programs — otherwise known as needle exchange programs — provide clean equipment such as needles, hypodermic syringes and other injection supplies to drug users who meet certain criteria.

Read the full article.

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National News

Expanding MAT

From the U.S. Department of Health and Human Services 

The U.S. Department of Health and Human Services (HHS) is taking additional steps to address the U.S. opioid epidemic by further expanding access to medication-assisted treatment (MAT) for opioid use disorders.

Administered by the Substance Abuse and Mental Health Services Administration (SAMHSA), the announcement enables nurse practitioners (NPs) and physician assistants (PAs) to immediately begin taking the 24 hours of required training to prescribe the opioid use disorder treatment, buprenorphine.

NPs and PAs who complete the required training and seek to prescribe buprenorphine for up to 30 patients will be able to apply to do so beginning in early 2017. Previously, only physicians could prescribe buprenorphine. Once NPs and PAs receive their waiver they can begin prescribing buprenorphine immediately.

Read the full press release.

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Some Rural Hospitals Thrive

By Taylor Sisk - Daily Yonder

Dawn Langley moved to eastern North Carolina’s rural Robeson County 27 years ago to teach and coach at the University of North Carolina-Pembroke. She fell in love with the community and determined to help make it a healthier one. So she applied for and received a National Health Service Corps scholarship, attended Wake Forest University’s Bowman Gray School of Medicine and is now a physician assistant at Southeastern Health’s primary care clinic in the 2-square-mile town of Maxton.

“Here I am,” she said on a busily relaxed Thursday afternoon before sitting down with Louise Cummings, 75, a longtime patient, “and I wouldn’t be anywhere else.”

Not every would-be rural practitioner has that choice. Scores of rural hospitals around the country have closed in the last six years, but Southeastern Health’s 452-bed main facility and 30 primary care and specialty clinics remain open. That gives Langley the ability to focus on local care.

Read the full article.

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Neonatal Abstinence Syndrome

By Catherine Saint Louis - New York Times

As the opioid epidemic sweeps through rural America, an ever-greater number of drug-dependent newborns are straining hospital neonatal units and draining precious medical resources. The problem has grown more quickly than realized and shows no signs of abating, researchers reported. Their study, published in JAMA Pediatrics, concludes for the first time that the increase in drug-dependent newborns has been disproportionately larger in rural areas.

The rising rates are due largely to widening use of opioids among pregnant women, the researchers found. From 2004 to 2013, the proportion of newborns born dependent on drugs increased nearly sevenfold in hospitals in rural counties, to 7.5 per 1,000 from 1.2 per 1,000. By contrast, the uptick among urban infants was nearly fourfold, to 4.8 per 1,000 from 1.4 per 1,000.

Read the full article and legislation proposed in the Virginia General Assembly.

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Nursing Home IT

By Sheena Rice - University of Missouri

According to the Centers for Disease Control and Prevention, more than 1 million older Americans depend on nursing homes for their health care. The 16,000 nursing homes in the United States serve populations of all sizes; yet, according to new research from the University of Missouri, rural communities are lagging in health information technology (IT) needed to improve quality, safety and efficiency in health care. This gap could have implications for patient care as nursing homes in rural areas may have less capacity to exchange information with hospitals to ensure high-quality transitions in care.

“Previous studies demonstrate that IT sophistication can improve health outcomes for patients, such as reducing hospitalizations,” said Greg Alexander, professor in the Sinclair School of Nursing.  “The benefits of IT sophistication do not differ based on geography; however, in this national assessment, we found a significant gap in IT sophistication between rural and urban areas.”

Read the full article.

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Mark Your Calendar

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

January 18: Utilizing Virginia Medicaid's Addiction and Recovery Treatment Services (ARTS)  - Virginia Beach
January 20: Utilizing Virginia Medicaid's Addiction and Recovery Treatment Services (ARTS)  - Williamsburg
January 21: REVIVE! Opioid Overdose Education - Wytheville
January 24: Utilizing Virginia Medicaid's Addiction and Recovery Treatment Services (ARTS)  - Richmond
January 30: Utilizing Virginia Medicaid's Addiction and Recovery Treatment Services (ARTS)  - Fairfax
February 1: Utilizing Virginia Medicaid's Addiction and Recovery Treatment Services (ARTS)  - Winchester
February 3: Utilizing Virginia Medicaid's Addiction and Recovery Treatment Services (ARTS)  - Harrisonburg
February 5-8: Rural Healthcare Leadership Conference - Phoenix, AZ
February 7: Utilizing Virginia Medicaid's Addiction and Recovery Treatment Services (ARTS)  - Salem
February 7-9: 28th NHRA Rural Health Policy Institute​ - Washington, DC
February 9: Utilizing Virginia Medicaid's Addiction and Recovery Treatment Services (ARTS)  - Radford
February 13: Utilizing Virginia Medicaid's Addiction and Recovery Treatment Services (ARTS)  - Wise
February 15: Utilizing Virginia Medicaid's Addiction and Recovery Treatment Services (ARTS)  - Abingdon
February 17: Utilizing Virginia Medicaid's Addiction and Recovery Treatment Services (ARTS)  - Danville
February 21: Utilizing Virginia Medicaid's Addiction and Recovery Treatment Services (ARTS)  - Lynchburg
February 23: Utilizing Virginia Medicaid's Addiction and Recovery Treatment Services (ARTS)  - Charlottesville
April 2-4: MATRC Telehealth Summit - Leesburg

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Resources

DATA-waiver Practitioners
Nurse practitioners (NPs) and physician assistants (PAs) can now train and apply to become DATA-Waiver practitioners.

Opioid Treatment Program (OTP) Certification
Apply to have your opioid treatment program (OTP) certified by SAMHSA to dispense medications for the treatment of substance use disorders.

Surgeon General’s Report on Alcohol, Drugs, and Health
Reviews what we know about substance misuse and how you can use that knowledge to address substance misuse and related consequences.

Planning and Implementation of the Rural IMPACT Demonstration
This report summarizes findings from an ASPE study of the first year of the White House Rural Council/HHS Rural IMPACT demonstration, which aims to reduce poverty through coordinated services for both children and parents. Key findings include: greater tailoring of technical assistance to individual site circumstances may increase its effectiveness; additional site resources could better support Rural IMPACT; a range of partners must be involved, particularly families themselves; leadership is critical; the federal role in Rural IMPACT facilitated planning and implementation, with limitations; and sites are eager to encourage two-generation efforts more widely
 

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Funding Opportunities

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

Rural & Tribal Passenger Transportation Technical Assistance
Technical assistance for tribes and rural communities of less than 50,000 people to plan system start-up, transit service improvements, facility development, marketing, transportation coordination, and staff training.
Application Deadline: Jan 31, 2017 

Primary Care Medicine and Dentistry Clinician Educator Career Development Award
Grants to strengthen the primary care workforce by training and supporting physicians, physician assistants, dentists, and dental hygienists who plan to teach in the primary care fields.
Application Deadline: Feb 13, 2017 

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