Virginia Rural Health Association - Weekly Update
VRHA Weekly Update
In this Issue  October 19, 2015

VRHA News Virginia News National News Mark your calendar
Funding Opportunities


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And the Winners Are...

VRHA recognized the efforts of some fantastic individuals and groups last week at the annual awards ceremony.  The winners are:

  • Charles Crowder, Jr. Award - Luanne Rife for the article, Lee County prepares for hospital rebirth
  • Best Practices in Rural Health Award - Stone Mountain Health Services, for Behavioral Health Program
  • Ken Studer Friend of the Association Award - Virginia Hospital & Healthcare Association, for the "Our Lifeline" campaign
  • Lawmaker of the Year Award - Robert "Bob" Goodlatte, United States House of Representatives & Staff, for their support of Virginia's Critical Access Hospitals

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Members in the News

By Virgil Dickson - Modern Healthcare

Some Virginia hospitals are eyeing consolidation as they struggle to stay afloat financially in the face of continued Republican opposition to Medicaid expansion and reduced Medicare rates.

[VRHA member] Chuck Carr, CEO of Carilion Stonewall Jackson Hospital in Lexington, said other rural providers may consider similar consolidation moves. His facility was purchased by Carilion Clinic, a Roanoke, Virginia-based not-for-profit health care organization, more than a decade ago. That partnership has been a lifeline, he said. “We needed to partner with a system to stay afloat.”

Read the full article.

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Virginia News

In the Red

By Sean Gorman - PoltiFact Virginia

Hospital officials from across Virginia flocked to Richmond  to air concerns about tightening revenues at their facilities. Among them was Mary Mannix, president and CEO of Augusta Health, a rural hospital in Fishersville about 90 miles west of Richmond. Mannix said her facility is on solid financial footing but that many other rural hospitals are not.

"Just about half of rural hospitals operate in the red in Virginia," Mannix said at a news conference organized by the Virginia Hospital and Healthcare Association, a lobbying group. "They operate at a loss."

Many hospital officials hoped the General Assembly would ease the stress by expanding the state’s Medicaid program to reduce the medically uninsured. Under provisions of the Affordable Care Act, or Obamacare, the federal government would pay all of the costs of expanding the program through 2017 and at least 90 percent in the future. Republican lawmakers have blocked the expansion and say Uncle Sam can’t be trusted to pay his promised share.  

Read the full article and related articles by HealthcareDive, and Pilot Online.

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Rural Health Champion

The Virginia State Office of Rural Health wants to hear from you!

  • Is someone you know a rural health champion?
  • Do you know someone doing exceptional work in rural Virginia and advancing rural health?
  • Do you have a friend/family member/colleague who you feel should be recognized for contributions to rural health?

We are looking for nominations for rural health champions in Virginia! Follow the links below to find out what a rural champion is, and to submit your own nomination. Let's take a moment to acknowledge those who are making rural Virginia a healthy and prosperous place to live and work!
Definition of a Rural Health Champion
Nominate a Rural Health Champion
Send your nominations to Joanne Winburne, Health Equity Communications Specialist
Nominations are due November 10, 2015

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Close to Home

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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National News

Help Make 340B Work for Rural

By Diane Calmus - National Rural Health Association

The Health Resources and Services Administration (HRSA) recently released a proposed guidance about the 340B program, the long-anticipated so-called “mega guidance.” It’s comprehensive and discusses virtually all aspects of the 340B program. It includes restatements, clarifications, and proposed changes to current 340B policy. 

The “mega guidance” is only a proposal at this point, meaning HRSA is asking for your input about its enforcement policy. This is your opportunity to make your voice heard about what is and is not working in the current system and on your perception of the proposed changes. 

While not every change impacts rural, it’s important that there are many voices from rural America commenting to HRSA about the importance of 340B in rural America and the barriers and burdens to rural covered entities participating and receiving the greatest benefit.

Read the full blog.

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Considering Expansion

By Chris Reeves - Kansas & Missouri Kossacks

The closure of Independence, Kansas Mercy Hospital may mark the moment where discussion of Medicaid Expansion took a sudden and significant turn.  The Brownback administration had promised significant growth for Kansas communities, proclaiming that "The Sun Is Shining in Kansas" but for Montgomery County, Kansas, the last two years seem far more like a nightmare that they cannot escape.

Now, in a town of less than ten thousand, they face the loss of significant jobs - 190 directly impacted by the hospital. Hospitals, though, bring outside jobs and revenue. For maintenance crews who help upkeep the HVAC to a vending machine owner who collects the coins twice a month. For the town of Independence, the exit of a hospital represents a serious impact on their way of life.

It may be this moment, however, that forces some serious discussion. Jeff King hails from the small community. While he has been a stalwart of opposition to Medicaid Expansion, along with Republicans in the Kansas House, he is now starting to see some light.

Read the full article and a related story from South Dakota.

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Community Paramedics 

By Tinker Ready - HealthLeaders Media

The expanding field of community paramedicine faces challenges in all settings, but the programs "that seem to be making significant progress are those that are affiliated with a hospital system," says one researcher. A spring survey of state EMS directors found that 43 of 48 states reported that agencies are actively planning or providing some form of community paramedic (CP) service. Twenty nine reported that EMS programs in their states already offer CP-type services, according to the study by the National Association of State EMS Officers.

The push to reduce hospital readmissions is fueling growth in community paramedic programs despite challenges that come with the introduction of a new type of health provider. But, it's unclear whether EMT squads that double as non-emergency primary care extenders will offer a solution to gaps in care opened by rural hospitals closures.

And while the approach is growing in rural as well as urban areas, it is unclear whether the programs will allow hospitals to reach beyond their service areas into medically underserved rural communities.

Read the full article.

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Luring Mental Health Providers 

By Lauren Silverman - NPR

Of the 254 counties in Texas, 185 have no psychiatrist, according to Travis Singleton, who tracks physician shortages for Merritt Hawkins, a Texas-based consulting firm. "That's almost 3.2 million [people]," he says. The shortage goes beyond Texas. In the past year, Singleton's firm has been asked to recruit more psychiatrists nationwide than ever before.
Supply issues have crept up on psychiatry, Travis says. "You have less and less residents wanting to go in this specialty in general, and then you have those that actually do practice medicine not necessarily in the most optimal settings for us."

So how do you persuade students to become psychiatrists, social workers and psychologists and then be willing to work in rural areas? Republican state Sen. Charles Schwertner is trying cash. He sponsored a law that, starting in 2016, will help around 100 medical health professionals repay loans if they go to work in underserved areas. Schwertner says the investment will pay off.

Read the full article.

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Mark Your Calendar

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

October 8: Healthcare Access as a Moral Imperative - Norfolk
October 26: Healthcare Access as a Moral Imperative - Blacksburg
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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The State of Obesity: Better Policies for a Healthier America
Provides an in depth overview of obesity rates across the country over the past year. Findings underscore the need to continue promoting good nutrition and physical activity for all, especially starting in early childhood.

Office of Rural Health: Caring for Rural Veterans 
This three-minute video tells the story behind the Office of Rural Health and its mission to support the health and well-being of Veterans who live in rural communities – by removing barriers to care.

Appalachia Data Portal and Readmissions Explorer 
The Appalachia Data Portal was created as an online tool for exploring demographic, education, income, and health disparities for the 420 counties in the Appalachian region. The data included in the Appalachia Data Portal come from a variety of sources, including the American Community Survey, the Appalachian Regional Commission, the Robert Wood Johnson County Health Rankings, and the Centers for Medicare & Medicaid.

ICD-10 Resource Guide and Contact List
For providers having problems with the conversion to ICD-10 or issues getting claims submitted and processed correctly.

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Funding Opportunities

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

Scholarships, Loans, and Loan Repayment for Rural Health Professions
Provides an overview of scholarship, loan, and loan repayment programs available for healthcare students who intend to practice in rural areas. Visit the guide to find information and successful models for the development of programs designed to attract health professionals to rural areas. 

Fuel Up to Play 60 Grants
Offers funding to schools to start or maintain a healthy nutrition and physical activity program.
Geographic coverage: Nationwide
Application Deadline: Nov 4, 2015

Nursing Workforce Diversity (NWD) Program
Grants to establish and/or operate scholarship or stipend programs aimed at increasing nursing education opportunities for students from disadvantaged backgrounds.
Geographic coverage: Nationwide
Application Deadline: Nov 16, 2015

Continuum of Care Program
Provides grants for programs that assist individuals and families who are homeless by providing supportive care services as they move into transitional and permanent housing.
Geographic coverage: Nationwide
Application Deadline: Nov 20, 2015

E3 — Effectiveness, Efficiency and Excellence in Healthcare
Supports projects that focus on medication safety across the continuum of care from the hospital to home/ambulatory settings, scaling up successful past projects and engaging patient and their families in their care.
Geographic coverage: Nationwide
Application Deadline: Dec 4, 2015

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