Virginia Rural Health Association - Weekly Update
VRHA Weekly Update
In this Issue  March 14, 2016

VRHA News Virginia News National News Mark your calendar
Funding Opportunities


March Newsletter now available





Members in the News

From WDBJ7

[VRHA member] Rockbridge Area Health Center served more than 3,000 thousand low-income, insured, and uninsured people in 2015. That number is growing and so is the health center.

Suzanne Sheridan is the CEO of the Rockbridge Area Health Center and said the center received a $1 million dollar government grant. The center plans to use the million dollars in grant money to renovate and add to the building.

Read the full article.

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More Members in the News

From the National Association of Community Health Centers

Baby’s first dental examinations are incorporated into each child’s well check visits at [VRHA member] Eastern Shore Rural Health System, Inc. (ESRHS) Since the effort began in September 2014, ESRHS has provided caries (tooth decay) risk assessments and preventive services, including anticipatory guidance and fluoride treatments, for more than 250 patient’s ages six months to 36 months at its busiest pediatric office in Franktown, Virginia.

The effort begins very early with new parents receiving a dental “welcome bag” at their baby’s two-month well child check. This welcome bag includes oral health information and an assortment of preventive home care tools for young children. At the child’s six-month well check, ESRHS pediatricians provide assessments to identify children at elevated risk for early childhood caries.  Finally at the child’s nine month check the dentist is introduced to the family. The dentist performs a dental examination and provides risk-based preventive interventions including a toothbrush prophylaxis and fluoride treatment at this visit. All the while, ESRHS outreach staff, baby care coordinators and health educators coach parents on the importance of oral health care during these critical first months of life.

Read the full article.

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Even More Members in the News

In its fourth year, Hands Together aims to provide one-stop access for various resources to homeless and precariously housed community members. Around 44 “providers” filled the Quarterpath gymnasium. Lackey Clinic and [VRHA member] Olde Towne Medical Center offered medical screenings. Nonprofit organizations, such as Literacy for Life, FISH, Avalon and Child Development, were there to connect with residents. There were social services representatives from Williamsburg, James City County and York-Poquoson.

People come through the doors with different needs, said Hands Together spokeswoman Natalie Miller Moore – needs ranging from finding housing to needing an identification card.

Read the full article.

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Virginia News

Successful Partnerships

By Ron Pollack - Virginian-Pilot

Over the past several years, arguments for Medicaid expansion in Virginia have been made using sound economic, budgetary and public health rationales. They have collapsed, however, under the reflexive antipathy toward the Affordable Care Act by conservatives in the state legislature.

The result: Tens of thousands of Virginia’s workers go without health insurance compared to states that expanded Medicaid, according to a study by Families USA. Expansion states, on average, saw a 25 percent decline in their rate of uninsured workers.

It shouldn’t be this way. State/federal partnerships, like Medicaid expansion, have a history of success and have been a hallmark of Republican governance for more than a century.

Read the full editorial and related story from the Commonwealth Institute.

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Deregulation Fails

From the Virginian-Pilot

An effort by doctors, tea party groups, conservative lawmakers and others to loosen government oversight of new or expanded health care facilities failed, marking a much-lobbied win for the state's hospitals.

The Virginia Senate used a procedural move Monday to effectively kill legislation aimed at reforming the state's decades-old certificate of public need law, which requires medical providers to prove to the State Board of Health that proposed new facilities, expansions or major equipment purchases are necessary in a geographic area.

Opponents of the current systems say it is uncompetitive and results in higher health care prices. Hospitals argue they don't operate in a free-market system and need the certificate of public need program to remain economically viable while providing charity care to the state's poor.

Read the full article.

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Close to Home

From the Rural Health Information Hub

Rural counties in North Carolina are suffering from a persistent shortage of healthcare providers. Studies have shown that medical students with rural backgrounds are more likely than their peers to return to rural areas, and yet schools of health professions continue to have low enrollments of students from these regions.
As a result, two UNC School of Medicine students started Project PROMISE (Providing Rural Opportunities in Medicine through Inspiring Service and Education). Based in Spruce Pine, North Carolina, the educational and experiential pipeline program was intended to pique the interest of high school students not only in pursuing a career in medicine, but also in returning to practice in rural North Carolina.
Through an application and interview process, Project PROMISE selects up to 3 high school seniors who have an authentic interest in healthcare. Participating students are from Mitchell High School and Mountain Heritage High School, both located in rural areas in the western part of the state. Each student completes a semester-long course that includes weekly sessions taught by medical students, rotations in healthcare facilities throughout Mitchell and Yancey Counties, and several health-related service projects. Through these elements, Project PROMISE provides their students with more than 135 credit hours and exposure to the following healthcare professions: dentistry, anesthesiology, obstetrics and gynecology, pediatrics, palliative care, family medicine, public health, geriatrics, pharmacotherapy, internal medicine, and radiology.

Read the full article.

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National News

Death by a Thousand Cuts


Rural hospitals continue to drop off the map, with an average of 11 hospitals closing each year since 2010. As the rural healthcare system slowly erodes, the aftermath leaves permanent gaps for local services in the small communities left behind.
Earlier this month, iVantage Health Analytics issued 2016 Rural Relevance: Vulnerability to Value Study, on rural hospitals. The study’s key finding is that 673 rural hospitals, two-thirds of which are Medicare-designated “critical access hospitals” (CAH), are vulnerable to closure. The CAHs identified as vulnerable comprise 35 percent of all critical access hospitals in the nation.

iVantage’s research concludes that almost two-thirds of the vulnerable hospitals are in states that did not expand Medicaid. This statistic appears significant, but the researchers did not screen for relative distribution of rural hospitals between states with Medicaid expansion and those without.

Medicare and Medicaid reimbursement rates are especially important to rural hospitals because they tend to have a higher percentage of patients eligible for either or both programs than many urban hospitals. Hospital reimbursement rates for Medicare and Medicaid tend to be lower than rates paid by private insurance (though CAHs get preferential treatment by Medicare in recognition of their special challenges).

Read the full article.

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Dealing with Pain

From WCBV5

President Barack Obama declined to endorse the boldest proposal from the nation's governors to tackle the heroin crisis: limiting the number of high-powered painkillers doctors can prescribe at a time.  A recommendation to limit the number opioid painkillers that doctors can hand out gained bipartisan support at the National Governors Association's winter meeting over the weekend.

But Obama was cool to the idea at a meeting with the governors he hosted at the White House on Monday, noting that painkillers are sometimes the only realistic treatment option for people in rural communities.

"If we go to doctors right now and say 'Don't overprescribe' without providing some mechanisms for people in these communities to deal with the pain that they have or the issues that they have, then we're not going to solve the problem, because the pain is real, the mental illness is real," Obama said. "In some cases, addiction is already there."

Read the full article.

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Too Few Geriatricians

By Sharon Sullivan - Colorado Trust

Basin Clinic serves the tiny Western Slope town of Naturita and the surrounding ranching communities with just one full-time staff member, physician assistant Ken Jenks. The part-time staff includes a part-time nurse practitioner and two physicians, who travel from Montrose and Ophir.
Some of Jenks’ older patients take more than a dozen medications and see several specialists, which makes their medical care complicated. Jenks says he would like to consult with a geriatric specialist from time to time, but there are none in the area.
“Thirty percent of our caseload is over age 70,” says Jenks. “I see about two patients a day that could use the services” of a physician specializing in geriatrics, he adds. As the national population ages, the shortfall in geriatricians has widened. Colorado is short about 176 geriatricians, according to the American Geriatrics Society.
The scarcity is much more pronounced in Colorado’s rural counties, some of which have seen their populations get older at a quicker rate than the rest of the state, as younger people seek jobs in cities. MedicalQuest, an online database of health care providers and their services, shows that out of the 148 geriatrician practices it lists in Colorado, only five are located outside the Front Range and Grand Junction.

Read the full article.

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Wanted:  Rural Health Expertise

The Health Resources Services Administration (HRSA) uses subject experts as peer reviewers to objectively evaluate grant applications against criteria in HRSA's Funding Opportunity Announcements. The Federal Office of Rural Health Policy wishes to identify qualified reviewers who have expertise in social, cultural, or health care issues of rural populations.

Each eligible application is read by at least 3 reviewers who then discuss their evaluation and initial scores with other reviewers on their panel. This process is completed for each application using the internet and telephone, a process that most often takes 3 days or less.  Non-federal participants receive an honorarium, but your knowledge about health in rural communities is invaluable.

Click here for additional information.

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Mark Your Calendar

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

March 23 & 24
: Rural Health Clinic Capstone Meeting - Blacksburg
March 28-31: National Rx Drug Abuse Summit - Atlanta, GA
April 6: BFCC-QIO Program webinar
April 6-8: National Health Outreach Conference - Roanoke
April 10-12: Mid Atlantic Telehealth Resource Center Annual Summit - Cambridge, MD
April 25-26: National Reduce Tobacco Use Conference - Washington, DC
April 26: Virginia Colorectal Cancer Roundtable - Roanoke

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Key Budget Policy Choices
House and Senate budget negotiators have submitted their conference budget for floor consideration by the General Assembly. It reflects their amendments to the Governor's 2016-2018 (FYs '17 and '18) budget. The analysis provides a summary-level assessment of key changes and other noteworthy information proposed by the House, Senate, and conference committee compared to the FY16 baseline.

Grant Writing Institute
Join NOSORH for a 9-part webinar series covering all aspects of grant writing.  This series is designed for beginning grant writers seeking to gain the skills to research and draft winning proposals from various agencies. Don't miss this unique opportunity to expand your rural health grant writing credentials. 

Model Program: Physician Recruitment 
Kearny County Hospital changed their recruitment model to include paid time off for doctors to serve as international medical missionaries, as well as medical school loan forgiveness.

Model Program: Sexual Assault Exams
The National TeleNursing Center (NTC) in Massachusetts uses telemedicine to connect Sexual Assault Nurse Examiners to clinicians in remote areas, offering them guidance through examinations. 

Sliding Fee Scale Discount Guide for Critical Access Hospitals 
This guide provides critical access hospital (CAH) executive and management teams with concepts and guidance in developing a Sliding Fee Scale Discount Program. It also assists in gaining an understanding of how sliding fee scale discount programs relate to Internal Revenue Code Section 501(r) compliance and participation in the National Health Service Corps (NHSC).

Attributes of a Successful Rural Ambulance Service 
A national group of State Office of Rural Health and State Emergency Medical Service (EMS) Directors worked on creating a "Rural EMS Survey Tool", a short survey that would both help states assess the capacity of rural (and urban) services, while also providing them a mini-roadmap to 'gold star' performance in each attribute.

Quality Improvement Implementation Guide and Toolkit for Critical Access Hospitals
This guide and toolkit offers strategies and resources to help critical access hospital (CAH) staff organize and support efforts to implement best practices for quality improvement. 

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Funding Opportunities

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

Virginia Breast Cancer Foundation
Mini-grants of up to $1,000 to non-profit organizations.  The purpose of this grant program is to provide funds for breast cancer health education for Virginians. Priority will be given to projects in areas of the state with breast cancer incidence or mortality rates higher than the state average and/or to projects serving low-income, uninsured or underinsured, medically underserved, or other marginalized populations in need of targeted, customized breast cancer educational approaches.
Deadline: April 6

Innovations in Rural Health Award
We’re looking for original, innovative solutions to drive health improvement in rural communities. These don't have to be finalized projects - we encourage submissions from around the country that highlight new ideas and emerging innovations. Individuals, for-profits, nonprofits and government agencies are welcome to apply. Finalists will receive a $7,500 award and one innovative and inspiring idea will win the New Rural Award and a total of $25,000. 
Deadline: April 29, 2016

National Health Service Corps Scholarship Program
You can apply to the Scholarship Program if you are committed to primary care and accepted to or enrolled in an accredited U.S. school in one of the following primary care disciplines:

  • Physicians (MD or DO)
  • Dentists
  • Nurse Practitioners (post graduate degree with clinical practice focus)
  • Certified Nurse-Midwives
  • Physician Assistants

The scholarship pays tuition, fees, other educational costs, and provides a living stipend in return for a commitment to work at least 2 years at an NHSC-approved site in a medically underserved community.

Brookdale National Group Respite Program
The Brookdale Foundation Group works to advance the fields of geriatrics and gerontology and to improve the lives of senior citizens. The Brookdale National Group Respite Program awards seed grants to service providers that plan to offer new, dementia-specific Group Respite or specialized Early Memory Loss (EML) programming to participants, along with support to caregivers, in order to help individuals remain in their communities. All funded programs must provide a day program for people affected by Alzheimer's disease or other dementia, which is limited to those who are cognitively impaired. Grants of $10,000 will be provided in year one, renewable for $5,000 for the second year, based on evaluation of first year’s activities and potential for future continuity of the program. The application deadline is July 7, 2016. 

Immunization Awards Program
The American Academy of Family Physicians (AAFP) Foundation's Immunization Awards Program recognizes Family Medicine residency programs for identifying and developing solutions to overcome barriers to immunizations, and promotes sharing of immunization best practices. 

NURSE Corps Scholarship Program – Students who are enrolled or accepted in a nursing program at diploma, associate, baccalaureate or graduate levels, may apply to receive funding for tuition, other fees and costs and a monthly stipend in exchange for a two-year commitment at an eligible NURSE Corps site upon graduation. Provides scholarships to nursing students in exchange for a two-year, full-time service commitment (or part-time equivalent), at an eligible health care facility with a critical shortage of nurses. 
Deadline to apply is Thursday, May 5th.  

Infinite Hero Foundation
The mission of the Infinite Hero Foundation is to combat the most difficult front line issues – mental and physical – facing returning military heroes and their families. The Foundation provides grants of $25,000 to $100,000 to nonprofit organizations offering effective programs or treatments at no cost to active duty service members or veterans for service-related mental and physical injuries. Grants must be applied directly to program costs and cannot be used for fundraising or administrative overhead. Letters of interest are due April 1, 2016; invited grant applications must be submitted by July 1, 2016. 

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Virginia Rural Health Association
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Blacksburg, VA 24060

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