VRHA Weekly Update
In this Issue  September 29, 2014

VRHA News Virginia News National News Mark your calendar
Funding Opportunities


September newsletter available





Featured Speaker


Our featured speaker for the 2014 VRHA Annual conference is Senator Emmett W. Hanger, Jr. 
24th District Virginia State Senator Emmett Hanger has a strong voting record of limited government and fiscal conservatism. He values the protection of individual rights, coupled with a keen sense of individual responsibility. More importantly, Emmett believes common-sense solutions in government should win-out over party politics.

As a life-long Republican and resident of Augusta County, Emmett first served as Commissioner of the Revenue and then in the House of Delegates. Now as Senator, Emmett has earned a multitude of leadership positions, including being named a budget conferree and Chair of the Health and Human Services subcommittee on Senate Finance and Chairman of the Senate Agriculture, Conservation and Natural Resources Committee.

He is very involved in all aspects of the legislature but has become an ardent supporter of all matters dealing with education, mental health, and the environment. He holds several positions on national organizations such as the Southern Legislative Conference and the National Conference of State Legislators.

For more conference information - click the logo above.

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Poster Presentations 

VRHA is now accepting applications for Poster Presentations at the conference. A maximum of 14 applications will be approved for display and presentation.

Posters will be on display December 11 with presentations made from 3:30-5:00 that day.  

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.  Both students and professionals are encouraged to submit applications for consideration.

Visit the "Poster Presentations" tab of the conference webpage for additional information and application details.

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Many Members in the News

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

Health and Human Services Secretary Sylvia M. Burwell announced $295 million in Affordable Care Act funding to 1,195 health centers in every U.S. State, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, and the Pacific Basin to expand primary care services.

Today’s awards enable  health centers to increase access to comprehensive primary health care services by hiring an estimated 4,750 new staff including new health care providers, staying open for longer hours, and expanding the care they provide to include new services such as oral health, behavioral health, pharmacy, and vision services.  These investments will help health centers reach an estimated 1.5 million new patients nationwide, including over 137,000 oral health patients and more than 38,000 mental and substance abuse patients.

Read the full press release.

Virginia received 25 awards totaling $5,686,710, projected to support 91 new FTEs and 27,118 new patients.  VRHA members receiving funds will be:


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Virginia News

Enrolling Rural 

By Shefali Luthra - Kaiser Health News

Americans living in rural areas will be a key target as states and nonprofit groups strategize how to enroll more people in health law insurance plans this fall.

‚Äč An examination of experiences in Minnesota and Virginia shows how state decisions continue to shape these efforts. Both states have significant rural populations: about 13 percent of Virginians and 23 percent of Minnesotans, according to 2013 figures from the U.S. Department of Agriculture. In 2012, both had rural poverty rates in the teens: nearly 18 percent in Virginia versus 12 in Minnesota. And between 2011 and 2012, about 9 percent of Minnesotans were uninsured, compared to 13 percent in Virginia

“We're spread thin throughout the state, but that means in rural areas there are additional challenges in terms of finding the people and getting out to groups,” said Jill Hanken, health attorney at the Virginia Poverty Law Center, the state's principal navigator agency.

Read the full article.

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Black Lung is Back

By Dave Jamieson - Huffington Post

The proportion of coal miners who suffer from an advanced form of black lung disease has skyrocketed in central Appalachia in recent years, according to experts with the National Institute for Occupational Safety and Health.  In a letter in the American Journal of Respiratory and Critical Care Medicine, the NIOSH scientists wrote that the prevalence of progressive massive fibrosis, or PMF, a particularly lethal form of black lung, had reached its highest rate since the 1970s in Kentucky, Virginia and West Virginia. 

According to the letter, PMF was "virtually eradicated" just 15 years ago, but the sample of long-term underground miners from last year showed a nearly ten-fold increase, to 3.23 percent of workers, in the central Appalachian states. The officials attributed the alarming spike to two likely factors: workers' overexposure to coal dust, with many miners now working longer hours, or an "increased toxicity" in dust composition -- that is, even unhealthier air in today's mines.

As it grapples with a resurgence of black lung in many areas, the Labor Department recently announced it is updating and tightening its black lung regulations for the mining industry. Most notably, the reforms will lower a mine's allowable level of coal dust from 2.0 milligrams per cubic meter of air to 1.5, a move meant to force operators to better ventilate their mines.

Read the full article and related articles in WPFL, the Courier-Journal, the Charleston Gazette, and the Lexington Herald-Leader.

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Read the Plan!

By Sarahbeth Jones - VDH Office of Minority Health and Health Equity

The Virginia Department of Health (VDH) Office of Minority Health and Health Equity (OMHHE) is pleased to announce that Virginia’s Rural Stakeholder Communication Plan is now available.  As Virginia’s Office of Rural Health, VDH-OMHHE created the plan to guide effective and efficient communication with Virginia’s rural health stakeholders. The plan is available for public use and features the results of the Virginia Rural Stakeholder Preferred Communication Methods Survey, including information on preferred communication outlets, types of information, and frequency of communication of Virginia’s rural stakeholders.
An online version of the plan is located on the OMHHE’s webpage.  Thank you to all rural stakeholders for providing your valuable input to create this tool! For additional information, please contact Sarahbeth Jones (804-864-7422).

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National News

Uncertain Autumn

By Brock Slabach - National Rural Health Association

Autumn is here. The nights are cooler and football is back. Enough to brighten the mood of anyone worn down by a hot, muggy summer, unless your favorite football team lost, that is.

But the season isn’t looking bright for 26 rural hospitals that shuttered operations across the United States since 2013. That’s more closures in just the last 19 months than the total between 2003 and 2012. These communities are struggling to overcome the absence of vital health services and the economic loss of local jobs.

American Public Media’s Marketplace featured a look at this epidemic earlier this year. This poignant story, “When rural hospitals close, towns struggle to stay open,” tracks what happened to Sparta, Ga., when its rural hospital closed 14 years ago.

Read the full article.

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Telemedicine Services

By Michael Iorfino - Times-Tribune

Seconds after he appeared on a monitor set next to the emergency room bed, Edgar Kenton III, M.D., described how neurologists stationed 100 miles from Wayne Memorial Hospital will play a critical role in diagnosing and treating the hospital’s stroke patients. Using the same two-way videoconferencing software as Dr. Kenton, the director of Geisinger Health System’s neurology department, neurologists employed at Geisinger clinics in Danville will remotely examine the patients, analyze brain scans and recommend treatment.

“This has given us 24/7 access to a neurologist in a critical, life-threatening emergency that can coordinate care with our doctor, and visualize and interview the patient in real time,” said registered nurse James Pettinato, director of patient care services at Wayne Memorial Hospital, regarding the service contract with Geisinger.

Read the full article.

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Care for War Veterans

By Aaron Levin - Psychiatric News

Of the 2 million Americans who fought in Afghanistan and Iraq over the last dozen years, a disproportionate number came from—and are returning to—rural areas, according to Washington Post reporter David Finkel.

Given that veterans are more likely to live in rural areas than the average American, the Veterans Affairs rural health and mental health programs are working together to provide new outreach and access to services in ways that rural veterans and their families value, said [former VRHA member] Harold Kudler, M.D., chief consultant for mental health services at the Veterans Health Administration (VHA), who spoke after Finkel’s talk. “Initiatives range from offering telemental health services in veterans’ homes to educating rural clergy members about the issues facing veterans and their families and helping them know when and how to refer a veteran to the VA.”

Read the full article.

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RHC Provision not Enforced

From the Office of the Inspector General

The Rural Health Clinic (RHC) certification was created in 1977 to address the shortage of physicians in rural areas. RHCs had to meet two location requirements: (1) being located in rural areas and (2) being located in areas that have a shortage of health care providers. RHCs receive enhanced Medicare and Medicaid reimbursements for most services.

Approximately 12 percent of RHCs no longer met the location requirements in 2013. Pursuant to the BBA, these RHCs should continue to qualify as RHCs-and receive enhanced reimbursement-only if they are determined to be essential providers. However, CMS has yet to issue final regulations that would allow RHCs that do not meet the location requirements to qualify as essential-provider RHCs.

Read the full press release and related report.

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Mark Your Calendar

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

October 10: A Small Physician Practice’s Route to ICD-10 - Blacksburg
October 17 - 18: Dental Care Approaches for Adults with Disabilities - Chesapeake
October 17-18: VTAction Community/Grassroots Organizer Training - Blacksburg
November 14: Virginia Oral Health Summit - Richmond
December 11 & 12: Virginia Rural Health Association Annual Conference - Staunton

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Why Rural Matters 2013-14
The seventh in a series of biennial reports analyzing the contexts and conditions of rural education in each of the 50 states and calling attention to the need for policymakers to address rural education issues in their respective states.

Pharmacotherapy for Psychiatric Disorders in Primary Care
Archived webinar will help participants determine the appropriate selection, use and management of prescription medicines for mental health conditions. Participants will also learn to incorporate evidence-based therapeutic guidelines when treating patients with mental health conditions.
Diagnostic Considerations for Psychiatric Disorders in Primary Care
Archived webinar participants will learn standard screening, diagnostic, and clinical practice guidelines when treating patients with mental health conditions.

Community Paramedicine Topic Guide
his new guide focuses on the emerging profession of Community Paramedics and how rural communities can use paramedics and EMTs in expanded roles to provide healthcare services in the community. Visit the guide to learn how to start a community paramedicine program, find models and existing examples of programs, and challenges community paramedics’ face. 

Transportation to Support Rural Healthcare Topic Guide
RAC's Transportation topic guide has received a major update and is now focused on how rural communities can address transportation issues to improve access to care. 

Access to Rural Health Care – A Literature Review and New Synthesis
Reviews relevant literature to help clarify the meaning of access in the context of rural healthcare. Focuses on four dimensions of access, including people, place, provider and payment, and notes that changes in one dimension affect the others. Recommends that policymakers should address all dimensions of access throughout the policy making process to ensure best outcomes.

Improving Hospital Wound Care Billing and Coding Performance 
Nine tips that will help improve your wound center's billing and coding operations.

Rural Healthcare Workforce
RAC’s healthcare workforce guide has been updated with new FAQs examining rural health workforce supply, demand and distribution, as well as policies, programs, and strategies to address shortages. 

Recruitment and Retention for Rural Health Facilities
This new guide focuses on how rural communities and healthcare facilities can attract and keep healthcare providers. It offers resources, strategies, and incentives to help recruitment efforts succeed. 

Shortage Designations
This new guide provides an overview of health professional shortage designations, with information on the designation process and how to find lists of HPSAs and MUA/MUPs. 

Tools & Strategies for Managing Health Networks
A web-based searchable tool that provides templates, guides, and other resources to assist network leaders in the management and development of their network. Includes a variety of resources focused on rural health networks.

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Funding Opportunities

Wells Fargo Corporate Giving Programs
Geographic Coverage: Available in 40 States.
Application deadline: Applications accepted on an ongoing basis.
Funding for nonprofit organizations in the areas of community development, education, human services, arts and culture, civic responsibility, and environmental consciousness.

Healthy Tomorrows Partnership for Children Program
Application deadline: Oct 14, 2014
Grants to support community-based child health projects that improve the health status of mothers, infants, children, and adolescents by increasing their access to health services.

Whole Kids School Garden Grant Program
Application deadline: Oct 31, 2014
Offers grants to develop school gardens.

Rural Health Care Services Outreach Grant Program
Application deadline: Nov 14, 2014
Supports projects that will enhance and sustain the delivery of effective healthcare in rural communities.

Leona Gruber Trust Grants
Deadline: 1/31/15
Funding to organizations that provide the most benefit to humanity such as hospitals and educational institutions. Preference may be given to programs involving youth, health care, the community, or education. 

LG&E and LU Foundation Grant Program
Deadline: 11/15/14
Funding to organizations focused on education, diversity, environment, or health and human services. 

Funding Opportunity for Addressing Drug Abuse
The International Research Collaboration on Drug Abuse and Addiction Research program is offering funding for innovative ideas in all areas of science addressing drug addiction, including but not limited to, prevention, basic science, epidemiology, treatment, and health services. 

Dental Resource Centers
The Planning Grants for Dental, Oral, and Craniofacial Tissue Regeneration Consortium Resource Centers program invites applications to establish resource centers to develop partnerships and infrastructure. The resource centers will provide technical support and research capacity for a future Dental Oral and Craniofacial Tissue Regeneration Consortium. Letters of intent are due December 29, 2014. The application deadline is January 29, 2015. 

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