VRHA Weekly Update
In this Issue June 16, 2014

VRHA News Virginia News National News Mark your calendar
Funding Opportunities


Newsletter available





Behavioral Health Policy

Arushi Kumar, a student at UVA's Frank Batten School of Leadership and Public Policy, recently completed Caring for the Commonwealth: Improving Access to Behavioral Healthcare Services in Rural Virginia.  Her thesis reviews the history of behavioral health care and the rationale for policy intervention before providing policy recommendations.

The VRHA Advocacy Committee will be using the paper as the basis for developing an official Behavioral Health Policy position.  If you would like to join the committee to work on this project, please contact VRHA Executive Director Beth O'Connor.

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Members in the News

By the National Health Service Corps

[VRHA member] Aileen Harris has been an NHSC Ambassador for nearly 10 years and coordinates and participates in several NHSC recruitment activities throughout Virginia. Aileen owns a consulting business and also helps develop primary care and workforce strategies for the Virginia Commonwealth University’s Office of Health Innovation. She says both roles help her promote NHSC programs to a wide range of people and organizations.  

As an NHSC Ambassador, Aileen attends scholarship fairs, gives NHSC presentations to medical students, and helps eligible sites become NHSC-approved. Aileen says being an NHSC Ambassador requires some committed time but that “you can be effective in just a few hours a week.” She encourages Ambassadors to partner with others when planning events and to remember to use the NHSC’s available resources and tools.

Read the full article.

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New Webinars

VRHA has some great new webinars coming up:

Funding Opportunities for Healthcare Reform in Rural America: Claiming a Seat at the Table   June 26, 2:00 p.m. - click here to register
The Affordable Care Act presents both challenges and opportunities for all healthcare providers, particularly those in rural America.  All too often, rural providers are left out of the conversation on healthcare reform.  Claiming a seat at the table requires being proactive in developing and participating in new models of care; but the question of how to pay for these initiatives leaves many providers scratching their heads.  This webinar will provide an overview of the ACA reforms and their implications for rural America, then focus on identifying federal, state, and federal funding opportunities, assessing grant readiness, and examining trends in funding.

On the radar after that are:

  • You Are the Key to HPV Cancer Prevention - July 2nd, noon
  • HIPAA Privacy and Security for Rural Providers: The Security Risk Analysis Tool and other free compliance resources - Thursday, July 10, 2:00 p.m.

 For more information on these webinars and to review slides and recordings from past events, visit the VRHA webinar page.

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Virginia News

Budget: No Expansion

By Jill Hanken - Healthcare for All Virginians

After a very long night of behind-the-scenes debates and political maneuvers, the General Assembly adopted a budget that does not include Marketplace Virginia or any plan to close the coverage gap.  More surprising and disappointing was the Senate's adoption of an amendment that requires a new, specific appropriation to pay for any expansion in the future.  Proponents argued the amendment was necessary to prevent the Governor from enacting new coverage on his own.  It was approved by all 20 Republican Senators.  The HAV Coalition has issued a response to the budget which you can view on our website - havcoalition.org .
However, even with this action, the debate on Medicaid is far from over.  The Governor has 7 days to review the budget.  He can sign, veto or amend it.  Senator Hanger also filed SB 5004, which provides for expansion (after Medicaid reforms are in place) unless rejected by a majority vote of the MIRC.  Consideration of the bill was postponed last night, but it could be taken up when the legislature reconvenes.  The legislature is still technically in special session.  
So our job remains the same - convincing our legislators to close the coverage gap for 400,000 uninsured Virginians.  Because of their failure to expand coverage, thousands of our fellow citizens are suffering and some are dying prematurely because they don't have access to the health care they desperately need.  Virginia continues to forfeit hundreds of millions of our tax dollars that could help people, support businesses, and bolster Virginia's economy.

See also related commentary from the Virginia Oral Health Coalition, and news reports:

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Decline in Doctor Shopping

By the Virginia Department of Health Professions

Behaviors associated with doctor shopping for the illegitimate use of prescription drugs is on the decline in Virginia, according to newly released data from the Department of Health Professions’ (DHP) Prescription Monitoring Program (PMP).  The PMP maintains a database of prescriptions written in Virginia, interoperable with 15 other states.
PMP data collected between 2012 and 2013 shows there has been a 73 percent decline in the number of patients identified as seeking simultaneous care from numerous physicians through multiple pharmacies to obtain Schedule II – IV medications.  Such controlled substances are often associated with pain management.  
“The Prescription Monitoring Program has helped to raise awareness about the problem of pain medication abuse and to amplify actions aimed at putting an end to illegitimate uses of these drugs,” said Bill Hazel, M.D., Secretary of Health and Human Resources. “I applaud the many health care providers who are taking action to keep their communities safe.”

Read the full press release.

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The Bottom Half 

By Kyle Benjamin - WCYB.com

A 2014 study by the University of Wisconsin Population Health Institute Breaks down health rankings by nearly every county in the country,and both Tennessee and Virginia are in the bottom half of the 50 states.

The study is designed to highlight community success, identify root causes of poor health, support policy change and engage communities in health improvement.

With that in mind, state health commissioners from Tennessee and Virginia say we can do better. Dr. Marissa Levine, Virginia State Health Commissioner, says a health coverage gap exists, and that's why Governor Terry McAuliffe wants to expand Medicare. "There are many people, many of whom are employed, who are working, but don't make enough money to buy insurance or be subsidized through the federal exchange," said Levine.

Read the full article.

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National News

Care for Veterans

By Erin Mahn - National Rural Health Association

The Senate passed a bill Wednesday allowing veterans to seek care from private providers if they experience long delays or live more than 40 miles from a VA hospital or clinic.

The bill also expands VA medical facilities across the country and calls for hiring more doctors and nurses to provide timely, quality care for veterans. Veterans experiencing long delays at the VA could access care at community health centers, Indian health centers, Department of Defense medical facilities or private doctors.

Rural veterans face significant challenges in accessing the health care services close to home. A disproportionate number of those serving in the military come from rural communities. Time, distance, and economic challenges prevent many rural veterans from receiving health care benefits through a VA facility. Preventative care and follow-up procedures are often impossible. Removing these barriers and allowing rural veterans to choose care close to home in their rural communities will expand veterans’ access to primary, emergency, and inpatient care for rural veterans throughout the nation.

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No Cure-all for Georgia

By Misty Williams - The Atlanta Journal-Constitution

A plan by Gov. Nathan Deal to help Georgia’s ailing rural hospitals could be too little too late for some hospitals on life-support and may not do much good for others.

The plan, sparked by a recent spate of rural hospital closures, enables hospitals in danger of shutting down, or that have closed in the past year, to downsize into freestanding emergency departments to cut costs. The departments would stabilize patients, then send them to nearby full-service hospitals.

Read the full article and related articles from NPR and the Saporta Report.

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Convincing Farmers

By Jack Westfall - Everyday Health

“I don’t think so Doc, seems like a lot of work for nothing.” Bill gave a rather candid opinion of my recommendation that he have a screening test for colon cancer. “Besides,” he added, “If I have cancer, I don’t want to know about it.” That last comment gave me my opportunity. Screening for colon cancer can actually be a test to prevent colon cancer.

Bill Stevens is a fourth generation farmer/rancher in eastern Colorado, farming dry land wheat, and 60 cow and calf pairs. He and his wife and kids live about eight miles from town on his great-grandparents’ homestead.  Uninsured for years, he accessed care only when absolutely necessary, like the time he lost a finger in the tractor belt.  When he came in, he had the 1-inch tip of his fourth left finger in an old jelly jar with some ice. There was no way to reattach the small and crushed tip, so we sewed up the wound and Bill went back to work. In a way, this was a badge of honor — so many old farmers have lost a bit of a finger, it’s hardly considered a serious wound. Bill’s response was that of the stereotypical old stoic farmer. And when Bill says he does not want to know if he has cancer, that too is a typical old stoic response.

Read the full article.

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In Critical Condition

By Kelly Baumgarten -  KHAS-TV 

Rural medicine in Nebraska is in critical condition. The number of doctors in rural areas is shrinking. But it's not just a problem here, the issue spans across the country. Over 20 percent of the U.S. population lives in rural areas, but, only 9 percent of the nation's physicians practice there. Experts predict that the shortage is only going to get worse. Health care in rural Nebraska isn't terminal, but it's on life support.

"You've got declining populations of young people in rural areas, the only growth is there are more people who need more care," said Dr. Jeff Harrison, the assistant dean of admissions at UNMC.

According to the American journal of preventative medicine, people who lived in metropolitan areas between 2005 and 2009 lived about 3 years longer than those living in rural areas,

Read the full article.

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Mark Your Calendar

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

June 16: Health on the Homefront: Addressing the Health Needs of Members of the U.S. Armed Forces, Veterans and Their Families - Hampton Roads
June 19: REVIVE! Training of Trainer (TOT) - Clintwood & Big Stone Gap
June 20: REVIVE! Training of Trainer (TOT) - Cedar Bluff & Abingdon
June 20-21: Dental Care Approaches for Adults with Disabilities - Lynchburg
June 26: Addressing Disaster Preparedness in Rural Communities - Richmond & videoconference
July 16-18: Rural Quality & Clinical Confernce - Atlanta, GA
September 30-October 1: Rural Health Clinic Conference - Kansas City, MO
October 1-3: Critical Access Hospital Conference - Kansas City, MO

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Bless Your Heart Toolkit  
The Bless Your Heart toolkit helps faith-based organizations create or strengthen their health ministries, as well as understand the vital role they play in improving the heart health of their members and  communities. This resource was developed specifically for the Crater Health District through VHQC's Step Up project. Click here to view it now. Contact VHQC if you would like a copy.  

NACHC Health Center Advocacy Toolkit 
"The Health Center Advocacy 101 Toolkit  was developed to help both new and seasoned health center advocates learn more about Community Health Centers and how to organize grassroots advocacy at the health center level.  Some of the toolkit materials are brand new, others are revised classics, but they are now all located in one convenient place.” 

How to Acquire Surplus Federal Personal Property
Eligible state and local government agencies and nonprofit organizations can obtain personal property that the federal government no longer needs through the Federal Surplus Personal Property Donation Program. 

CMS MLN Connects™ Weekly Provider eNews 

Centers for Medicare & Medicaid Webinar Video Presentations
The Centers for Medicare & Medicaid Services is pleased to announce that three new video recordings of the webinars hosted by the Philadelphia Regional Office earlier this year are now available for viewing.  The presentations include the Physician Quality Reporting System (PQRS), the Value-based Payment Modifier, and the Medicare and Medicaid EHR Incentive programs.  The links to the videos are listed below and can be found on the CMS MLNConnects YouTube page.  Additionally, CMS is evaluating this activity for continuing education (CE) credit.   Final CE information on the amount of credit, as well as post activity assessment and evaluation instructions, will be available soon.  

New Beginnings
A discussion guide that helps teach adults with diabetes skills for managing the emotional side of the disease and building helpful relationships with the people who support them. It was developed for diabetes educators, health educators, community health workers and others who provide diabetes education and support to address important skills.

Road to 10
With the passage of the Protecting Access to Medicare Act of 2014 (PAMA) (Pub. L. No. 113-93), the ICD-10 compliance date has been extended. To help small physician practices make the most of this extension, the Centers for Medicare and Medicaid Services (CMS) is excited to offer the Road to 10 Program at http://www.roadto10.org. Developed in collaboration with physicians from a variety of specialties, Road to 10 provides free and actionable resources to support the ICD-10 transition.


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Funding Opportunities

VHCF's Fall Funding Cycle
The Virginia Health Care Foundation (VHCF) funds public-private initiatives that grow and strengthen Virginia's health safety net. Our goal is to increase access to primary health care, including behavioral health and dental services, to Virginia's uninsured and medically underserved.
VHCF has four priority funding areas. Concept papers should address at least one of the following: 

  • Develop or expand patient capacity
  • Broaden the scope of services
  • Create local coordinated systems of care
  • Strengthen the infrastructure of the health safety net 

Key Dates for VHCF's Fall Funding Cycle

  • July 25, 2014: Concept Papers due to VHCF by 5:00 pm.
  • August 6, 2014: VHCF invites submission of full proposals based on concept paper submissions.
  • September 12, 2014: Formal proposals due to the VHCF office by 5:00 pm.
  • December 31, 2014: Grant awards announced by the Foundation Board.

For complete guidelines and more information, click here.
Questions? Please contact (804) 828-5804 or info@vhcf.org

Project Learning Tree: GreenWorks!
Project Learning Tree (PLT) is a national environmental education program for educators and their students in grades Pre-K-12. GreenWorks! is the service-learning component of PLT that provides grants to PLT trained educators for students to implement environmental improvement projects.

Robert Wood Johnson Foundation Unsolicited Proposals
Deadline:  Applications accepted on an ongoing basis.
The Robert Wood Johnson Foundation Pioneer Portfolio accepts unsolicited proposals for projects that pursue innovative approaches to solving problems in health and health care.

Navigator Grants 
The Centers for Medicare & Medicaid Services (CMS) today announced the availability of funding, totaling $60 million, to support Navigators in Federally-facilitated and State Partnership Marketplaces in 2014-2015. Navigators provide unbiased information to consumers about health insurance, the Health Insurance Marketplace, qualified health plans, and public programs including Medicaid and the Children's Health Insurance Program.
"Navigators have been an important resource for the millions of Americans who enrolled in coverage in 2014.  This funding ensures this work will continue next year, including during the open enrollment period for the Marketplaces," said CMS Administrator Marilyn Tavenner.

The funding opportunity announcement is open to eligible individuals, as well as private and public entities, applying to serve as Navigators in states with a Federally-facilitated or State Partnership Marketplace.  It is open to new and returning Navigator applicants, and applications are due by July 10, 2014.

Last month, CMS finalized regulations that update the requirements applicable to Navigators. 
Navigators will now be required to maintain a physical presence in the Marketplace service area, so that face-to-face assistance can be provided to consumers. Navigator grant applicants will also be encouraged to perform background checks for all Navigator staff that will be handling sensitive or personally identifiable information (PII).  In addition to quarterly and annual reporting, Navigators will be required to submit to CMS weekly and monthly progress reports detailing their progress and activities in their target communities.
To access the funding opportunity announcement, visit: http://www.grants.gov, and search for CFDA # 93.332. Click here for more information about Navigators.

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