VRHA Weekly Update
In this Issue  April 17, 2017

VRHA News Virginia News National News Mark your calendar
Funding Opportunities


Spring Newsletter




Members in the News

From Beth Blevins - National Organization of State Offices of Rural Health

Through lay rescuer training and the distribution of lifesaving kits, Virginia is taking aim at opioid overdoses in the state. Now it is increasing its outreach into rural parts of the state through [VRHA member] Virginia State Office of Rural Health (VA SORH).

Between 1999 and 2013, the number of deaths from opioid overdoses in Virginia increased by 1,578 percent. “When we looked at the data we found that the opioid epidemic was hitting our bigger cities and our rural areas—especially in Appalachia (the southwestern part of the state) and the Shenandoah Valley,” said Michael Mallon, Assistant SORH Director at the VA SORH. In the Shenandoah Valley, the opioid epidemic is defined primarily by heroin and other illicit drugs, while in the Appalachia region, it’s prescription opioids, Mallon said.

The state’s REVIVE! project trains professionals and others (including family members of addicts) to recognize and respond to an opioid overdose with the administration of naloxone, a drug that can save lives if given in the first few minutes after an overdose. The lay rescuers who take the training also receive a kit that contains gloves and directions—but, until recently, no naloxone.

Read the full article.

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More Members in the News

By Carol Vaughn - DelMarVaNow

Scores of community leaders volunteering on a dozen committees are working to raise $2 million in a capital campaign for [VRHA member Eastern Shore Rural Health's] new Eastville Community Health Center in Northampton County.

The $9 million center on Route 13 in Eastville will replace the aging Bayview and Franktown community health centers. It will be financed through a combination of funds raised through the capital campaign, grants, foundation funds and a loan.

Read the full article.

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Even More Members in the News

From Augusta Free Press

[VRHA member] Augusta Health has been accredited by the American College of Radiology as an ACR Designated Lung Cancer Screening Center. This accreditation signifies that Augusta Health provides valuable lung cancer screening services to the community “at the highest standards of the radiology profession”.

Read the full article.

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Virginia News

Hospitals and the Budget

By Michael Martz - Richmond Times-Dispatch

A long-pending plan to bring more federal Medicaid dollars to more than two dozen private Virginia hospitals has run into opposition from Gov. Terry McAuliffe and General Assembly budget leaders who now fear the plan could cost the state big money in the long run.

The proposal, first made to federal Medicaid officials in 2011 and approved a year ago, would allow private hospital systems to contract to provide services now performed by state human resources agencies to free up state money to match federal dollars on a 50-50 basis. Hospitals would pay for services the state provides so the state money would be freed to bring more federal funds to pay for uncompensated medical care.

But McAuliffe has proposed to strip language included in the pending state budget that would allow the plan to proceed — and the leaders of the General Assembly money committees are beginning to have second thoughts of their own.

Read the full article.

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Reaction to No Expansion

By Creigh Deeds - Augusta Free Press

One policy decision that could significantly help in our work to improve our mental health system, ties back to our work during the reconvened session. Since 2013, we have talked about and worked to expand Medicaid in Virginia. About 400,000 uninsured Virginians, more than 70 percent of whom work full-time or live in a household with someone who does, would be eligible for Medicaid if we expanded it under the provisions of the Affordable Care Act. Virginians who make more $200,000 a year, currently pay more than $1 billion a year in the surtax that was adopted back in 2010 to pay for Medicaid expansion. Ninety percent of the funding for the expansion costs would be paid by the federal government, so it only requires a 10% match from Virginia. The Governor again offered budget language for him to take the necessary steps to expand Medicaid. The language failed to pass on Wednesday. We have failed once again to thoughtfully consider expansion in Virginia.

Those who argue against Medicaid expansion point out correctly that the cost of the program has exploded. What they do not always point out however is that we have caused that explosion. By expanding the eligibility pool over the years to more than just the desperately poor, to the disabled and to low income elderly, we have already expanded Medicaid. Seventy percent of Medicaid dollars in Virginia are spent on those in nursing home care and those with disabilities. Those populations comprise roughly 23 percent of the Medicaid population. The remaining 77 percent of the population, which accounts for only 30 percent of the spending, are primarily pregnant women and children in very poor families.

Read the full editorial, and other commentary from the Richmond Times-Dispatch, Forbes, Augusta Free Press, Blue Virginia, and ARL Now.

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Healthy Eating in Reach

By Richard P. Wyeth - Roanoke Times

Here in Southwest Virginia, we take pride in a lot of things — from our outstanding institutions of higher learning to the Appalachian Mountains to our bountiful farmlands. In fact, Virginia was recently ranked ninth in the country in food quality, but for many of the commonwealth’s children, the richness of our state remains unfulfilled.

It’s a well-worn adage that “you are what you eat.” But instead of being sent to schools and corner stores, the fresh vegetables and fruits grown on our farms are most often sent to markets outside of town, where they’re too expensive and too far away for the families that need them. This is just one of the myriad factors that can make it difficult for many children here in Virginia to have good nutrition with fresh produce, fresh fruits, and vegetables. And as a result, many kids in less fortunate households are staring down futures that include increased risks for obesity, heart and vascular disease and diabetes, to name just a few. This does not need to be the case.

Read the full editorial.

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National News

Rural Hospital Access Act

By Erin Mahn Zumbrun - National Rural Health Association

The National Rural Health Association (NRHA) applauds Sens. Chuck Grassley (R-IA) and Chuck Schumer (D-NY) and Reps.Tom Reed (R-NY) and Peter Welch (D-VT) for introducing the Rural Hospital Access Act of 2017 (S. 872, H.R. 1955). This important bipartisan bill will improve access to care in rural areas by permanently addressing the Medicare Dependent Hospital and Low Volume Adjustment rural Medicare programs that expire October 1, 2017.

This legislation is essential to preserving continued access and keeping rural hospital doors open in rural America. The MDH and LVH programs for hospitals and providers are not ‘bonus’ or ‘special’ payments, but rather alternative, cost-effective and targeted payment formulas that maintain access to care for millions of rural patients and financial stability for thousands of rural providers across the country.

MDHs and LVHs play a critical role in rural communities, providing not only vital medical care but also as one of the largest employers within their community. Without these programs, rural patients would be forced to travel farther for more expensive care. Or worse, these rural Americans would forego essential care because they could not reach the necessary medical providers, resulting in poorer health, a lower quality of life, and more expensive care later.

NRHA encourages members of Congress to cosponsor the Rural Hospital Access Act.

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What's Happening to Rural America

By Stephen Heuser - Political

If you want to watch the health care version of a perfect storm, look at what’s happening to rural America. Forget the myth of healthy country living. People who live in rural counties are, on average, older and sicker than the population as a whole—and the problem is just getting worse.

As the U.S. has grown, the rural population has flatlined and even started to shrink, meaning hospitals and doctors’ offices struggle to stay in business. Country residents face high social isolation and a shortage of mental health care to deal with it. And the messy Washington politics of health care complicates matters enormously: Many Republican-leaning governors of rural states didn’t take the Medicaid expansion they were offered under Obamacare, which means fewer people in their states can afford insurance.

Welcome to the rural health issue of Agenda 2020.  

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J-1 Visa Waivers

From the American Hospital Association

Sens. Amy Klobuchar (D-MN), Susan Collins (R-ME), and Heidi Heitkamp (D-ND)  introduced legislation (S. 898) to improve and extend the Conrad State 30 program until 2021. First enacted in 1994, the program allows state health departments to request J-1 visa waivers for up to 30 foreign physicians per year to work in federally designated Health Professions Shortage Areas or Medically Underserved Areas.

The Conrad State 30 and Physician Access Act would increase the state allocations to 35 physicians per year and provide flexibility to further expand the number of waivers in states where the demand exceeds the limit, among other improvements. “The latest extension of the Conrad State 30 Program will expire on April 28,” noted AHA Executive Vice President Tom Nickels in a recent letter of support for the bill. “Without timely reauthorization, many communities that have benefited from these physicians may find themselves without access to such services.” More than 20 million Americans live in areas with a shortage of physicians, the letter notes.

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Fraying the Safety Net

By Taylor Sisk - Daily Yonder

Although the House of Representative Republicans’ effort to repeal and replace the Affordable Care Act failed to make it to a vote, the ACA’s future remains uncertain. President Donald Trump reacted to the defeat by saying that “the best thing we can do, politically speaking, is let Obamacare explode.” There are any number of ways the program could be inflicted a slow death.

A recent report from George Washington University’s Geiger Gibson Program in Community Health Policy and the RCHN Community Health Foundation Research Collaborative focuses on what Medicaid expansion, for which the federal government has been paying 90 percent of the cost, has meant to one particular traditionally underserved population: people who receive care at migrant health centers.

Read the full article.

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Mark Your Calendar

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

April 20: Oral Health Care for Individuals with Special Health Care Needs - Farmville
April 20: Rural HCAHPS Breakthrough 2017 - webinar
April 21-22: Dental Patients with Special Health Care Needs  - Farmville
May 9: Rural Medical Education Conference - San Diego, CA
May 9-12: 40th Annual Rural Health Conference - San Diego, CA
May 9-12: Rural Hospital Innovation Summit - San Diego, CA
May 19: Aging in Appalachia Conference - Marion
May 23: Synthetic Narcotic & Opioid Abuse Prevention Seminar - Big Stone Gap
June 8: Virginia Health Care Conference - Richmond
June 21: Responding to Natural Disasters in Rural Communities  - webinar
August 16: A Focus on Suicide Prevention in Rural Communities  - webinar

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Virginia Social Indicator Dashboard
A compilation of behavioral health data from various agencies and organizations across the state. The goal of the dashboard is to centralize key indicators of behavioral health and wellness to use as a resource for needs assessment, epidemiological monitoring and planning.

Model Program: Closing Preventive Care Gaps in Underserved Areas
In rural Appalachian Kentucky, a region with noted health disparities, FQHCs were able to increase cancer screening rates and decrease preventive care gaps. 

American Community Survey: Appalachian Data
This study examines state- and county-level data on population, age, race and ethnicity, housing occupancy and housing tenure, education, labor force, employment and unemployment, income and poverty, health insurance coverage, disability status, migration patterns, and veteran status from the 2011-2015 American Community Survey (ACS) for the 13 Appalachian states. Information is summarized for five Appalachian subregions and five metro designations.

CDC and Rural Health
To promote their ongoing work around rural health issues, the Centers for Disease Control and Prevention recently launched a website that provides an overview of the significant gap in health between rural and urban Americans, links to the Morbidity and Mortality Weekly Report rural health series, and resources on key health topics impacting rural Americans.  

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Funding Opportunities

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

Chronic Disease Management for Older Adults  
State and local governments, higher education institutions and Native American tribal governments are among those eligible to apply for up to $900,000 each for evidence-based programs that empower older adults and adults with disabilities to better manage their chronic conditions.
Deadline: May 12

General Motors: STEM Education RFP
General Motors is committed to fostering smart, safe, and sustainable communities around the world. GM has issued a Request for Proposals (RFP) that will address STEM education challenges facing students (third-12th grade and college), with a special emphasis on women and minorities. Funded projects should help to achieve the following social outcomes: increase the number of students who earn a degree in STEM that matches market needs; increase the presence, achievement, and persistence levels for underrepresented minorities in the STEM field; and increase the supply of qualified teachers for teacher training in STEM-related subjects. Grants of $25,000 and above will be provided. Nonprofit organizations and educational institutions nationwide are eligible to apply.
The deadline for letters of inquiry is May 12, 2017.

American Psychiatric Association Foundation: Helping Hands Grant Program
The American Psychiatric Association Foundation is dedicated to advancing public understanding of mental illnesses. The Foundation’s Helping Hands Grant Program was established to encourage medical students to participate in community service activities, to raise awareness of mental illness and the importance of early recognition of illness, and to build medical students’ interest in psychiatry and working in underserved communities. The program provides grants of up to $5,000 to medical schools for mental health and substance use disorder projects that are created and managed by medical students, particularly in underserved minority communities. Funded projects can be conducted in partnership with community agencies or in conjunction with ongoing medical school outreach activities.
The application deadline is May 31, 2017.

Consumer Advocacy for Transformation
This program will fund state-based or local consumer health advocacy projects that aim to develop and insert an organized, influential and permanent consumer voice in state and local health system changes. These health system changes should increase health care value by preserving efforts to increase access to care, improving health outcomes, and lowering costs, especially for populations with disproportionately poor health outcomes. Each of the selected projects should focus on building the capacity of consumer advocates to participate in public and/or private policy or health system change and ensure an ongoing infrastructure for consumer advocacy
Deadline: May 6

Primary/Behavioral Health Care Integration 
State health agencies are eligible to apply for 11 awards of up to $2 million each from the Substance Abuse and Mental Health Services Administration (SAMHSA) to support integrated care models for primary and behavioral health.  Successful applicants will select qualified community programs or community health centers to offer services to adults with serious mental illness and/or children with a serious emotional disturbance and co-occurring physical health conditions or chronic diseases.
Deadline: May 17

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