It's Not Too Late!

The VRHA Grant Writing Webinar Series begins September 13, which means that YOU still have time to register!

Sessions will be:
• September 13 - Organizing Yourself to Write a Grant
• September 16 - Finding Funding to Support Your Proposal
• September 20 - Goals and Objectives
• September 27 - Using Data
• October 4 - Creating Better Budgets

All webinars will be held from 12:00 – 1:30.  Participants will also have access to the VRHA grant writing on-line community.

Pricing:
• VRHA members: $15/session or $50 for all 5
• Non-members: $25/session or $100 for all 5
• VRHA student members:  FREE!

For more information, visit the VRHA website.

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Members in the News

By [VRHA member] Glen Sink - Richmond Times-Dispatch

Virginia is a state of stark contrasts. The commonwealth boasts some of the fastest-growing metropolitan areas in the United States. The long predicted megacorridor stretching from Baltimore and Washington to Richmond and on to Hampton Roads is becoming more of a reality each year — even in these times of economic slowdown.

Virginia is also home to some of the nation's most rural and least populated regions.  The 2010 census revealed that the population of most Virginia rural regions has either declined or remained static over the past decade, and residents who remain in these areas are usually older, less educated and less affluent than the state average. These census findings resulted in the redistricting of the commonwealth's General Assembly districts, shifting more representation from these rural areas to suburban regions.

Education and workforce training and development are among the keys to revitalizing the economic sustainability of rural Virginia, as are the availability of health care, the responsible use of natural resources, and cooperation and partnerships among businesses, governments, educational institutions and the citizens of these areas.

Read the full editorial.

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More Members in the News

By Chattanoogan.com 

Governor Bill Haslam announced on Friday that [VRHA member] Dr. John Dreyzehner will join the administration to lead the Tennessee Department of Health. He will replace Susan Cooper, who after fulfilling her commitment to assist with the transition and the first legislative session, has decided to pursue other opportunities.

Dr. Dreyzehner, 48, currently serves as director of the Cumberland Plateau Health District in Southwest Virginia. During his nine years in that role, he also spent two years serving as acting director of the Lenowisco Health District.

Read the full article.

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4th Circuit Court of Appeals Decision

Governor Bob McDonnell issued the following statement regarding the decision by a three judge panel of the 4th Circuit Court of Appeals on Virginia's health care lawsuit.

"Today, a three judge panel, consisting of two judges appointed by President Barack Obama and one by former President Bill Clinton, found that Virginia lacks standing to challenge the individual mandate provision of the federal health care law.  We respectfully disagree with the panel's reasoning.  To conclude that a state has no standing to challenge an expensive and burdensome federal mandate on its citizens that the state has banned in its law, might cause James Madison and George Mason, Virginia's principal drafters of our nation's founding documents, to promptly roll in their graves.  To dismiss a Virginia statute as a basis for standing, declaring it to be 'quintessentially political,' and asserting that a state cannot be a 'constitutional watchdog' undermines our precious principles of federalism.  This decision must be promptly appealed.

Read the full press release.

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Medicare Cuts Tax Rural Communities

By Tim Size, Rural Wisconsin Health Cooperative 

There is no question that Washington must get its house in order. We owe that to our children and our grandchildren. But the recent “debt ceiling deal” breaks the oldest rule in medicine. “First, do no harm.” We all are at risk from too many politicians more concerned about looking tough than solving our county’s problems. Medicare and Medicaid are on the chopping block, but it is not just the elderly
and poor who may be harmed.

The law created a new “super Congress” to find more cuts. Most economists say Washington needs to find more revenue but politics seems to have taken that off the table.  Most people believe the super Congress will deadlock.  If Congress fails to act, cuts will be implemented across  the board. Most federal programs will be cut. Across the board cuts efficient programs along with the inefficient.
Across the board cuts necessary along with the less necessary. The country deserves better than bulldozers driven by blindfolded drivers.

Most rural hospitals are financially just holding their heads above water. Previous under-payment by government programs for care provided, a sluggish economy and an increasingly competitive health care market place are taking their toll. Additional Medicare and Medicaid cuts, rural hospitals’ largest payers, are likely to tip many rural hospitals into the red and eventual closure.

Bottom line: forcing a rural hospital to close has the economic impact of a 4% tax increase on the rural community.

Read the full editorial.

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VA Assists Rural Vets with Telehealth

By U.S. Department of Veterans Affairs

Kenneth Winn, 48, suffered a head injury while deployed in Operation Desert Storm. Since then, he has experienced many challenges in life. He has been looking for a job now for two years.

Winn said he finds it comforting to share his thoughts and feelings with his mental health provider at the Roseburg VA Health Care System. Fortunately, in order to see her, he doesn't have to drive the more than 150 miles (three hours) from his home in Crescent City along the northern California coast to Roseburg, Ore. Because of a technological tool known as Telehealth, all he needs to do is drive to his VA clinic in town, where he is quickly connected with his counselor at VA Roseburg.

Read the full article.

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Rural Publications

Idaho Rural Family Physician Workforce Study: the Community Apgar Questionnaire
Babies with good Apgar scores are not in need of resuscitation. The Community Apgar may also indicate small communities that are likely to do well with viable workforce.

The BRIDGE Community Consultation Project: building rural interprofessional discussions and group experiences
Interprofesional education is a key strategy for addressing workforce issues in rural and remote areas of Canada. This article discusses the BRIDGE project which has been implememented in the interior of British Columbia to explore IPE opportunities for students and communities.

White Infant Mortality in Appalachian States, 1976–1980 and 1996–2000: Changing Patterns and Persistent Disparities
Conclusion: Appalachian counties continue to experience relatively elevated infant mortality rates. Poverty and rurality remain important dimensions of health service need in Appalachia.

Opportunities to pursue bachelor's degrees may be limited for nurses in rural hospitals
When quality professionals look at hospitals across the Nation, they tend to lump all rural hospitals into one category. A new study finds that nursing characteristics vary among large and small rural hospitals. Most nurses in both types of rural hospitals graduate from associate degree programs.

A cardiovascular disease risk factor screening program designed to reach rural residents of Maine, USA
The message for those interested in improved rural health outcomes is "Ask not for your target population to come to you. Go out to meet them." While the object of this outreach was cardiovascular risk factors in a US rural population, the same strategy could be applied to health screening programs for any other specific population.

Advancing Health in Rural America: Maximizing Nursing’s Impact
Provides a link between the evidence-based nursing solutions in the IOM Future of Nursing: Leading Change, Advancing Health report and the health care challenges facing rural America. Outlines the challenges of providing access to quality, affordable care in rural areas, followed by examples of initial progress in additional support to key programs.

Improving Access to Oral Health Care for Vulnerable and Underserved Populations
Presents a vision for how to improve oral health care for vulnerable and underserved populations, and recommends ways to achieve this vision. Chapters include oral health status, workforce, expenditures, health care delivery, and oral health settings.

Jobs and Economic Security for Rural America
This report lays out the economic landscape rural America faces today and presents some of the
Administration’s many efforts to promote economic growth and job creation in rural communities.

Patterns of Food Insecurity, Food Availability, and Health Outcomes Among Rural and Urban Counties
Policy Brief & Final Report
Rural counties are disproportionately associated with high food insecurity risk relative to urban counties.  Programs and policies may
focus on improving food availability and access for rural populations.  More research, with multivariate analysis across regions, can shed
additional light on the impact of food insecurity on the health of the population, especially for those living in rural areas.

Rural Hospital Charges Due to Ambulatory Care Sensitive Conditions in the United States, by Insurance Type, 2000 to 2004
In this policy brief, we report findings from a study that used nationwide hospital inpatient discharge data to examine the trends and regional variations of rural hospital charges due to ambulatory care sensitive conditions (ACSCs) in the United States, by insurance type, from 2000 to 2004. Hospital charges due to ACSCs are reported by region and payment source. Changes in the percentage of hospital charges generated by ACSCs may indicate opportunities for cost savings through use of care management. The data presented in this policy brief indicate potential benefit from targeting resources designed to support ambulatory primary care. 

Partnering With Communities to Address the Mental Health Needs of Rural Veterans
Many veterans who face mental illness and live in rural areas never obtain the mental health care they need. To address these needs, it is important to reach out to community stakeholders who are likely to have frequent interactions with veterans, particularly those returning from Operations Enduring and Iraqi Freedom (OEF/OIF).  Three community stakeholder groups—clergy, postsecondary educators, and criminal justice personnel—are of particular importance for OEF/OIF veterans living in rural areas and may be more likely to come into contact with rural veterans struggling with mental illness or substance abuse than the formal health care system.

Government bodies and their influence on the 2009 H1N1 heath sector pandemic response in remote and isolated First Nation communities of sub-Arctic Ontario, Canada
The recent H1N1 influenza pandemic presented a challenge to health care providers and public health decision makers alike. This article documents the results of a community-based participatory approach with First Nations communities in isolated areas of Canada and highlights the barriers and recommendations to address future pandemics.

Modernizing Rural Health Care: Coverage, quality and innovation
Provides an in-depth overview of the challenges facing rural health care and possible solutions. Addresses the role of primary care, the impact of health reform, teamwork, telemedicine, health information technology, and more. Appendix 4 includes state by state rural primary care capacity estimates. 

A Rural Socioeconomic Vulnerability and Resiliency Index and Associated Health Outcomes: Policy Brief & Final Report
Rural areas, especially in the Southeast, Appalachia and parts of the West, have worse VRI (Vulnerability and Resiliency Index) scores whichare a measure of six socioeconomic indicators across counties in the United States. Better VRI scores were associated with better healthoutcomes (lower heart disease, cancer, and stroke death rates) across the rural-urban continuum. These analyses provide evidence to support the development of programs and policies that foster educational development, and economic diversity and vitality, as means of public health improvement, especially in rural areas in selected regions of the country. 

Trends in Skilled Nursing Facility and Swing Bed Use in Rural Areas Following the Medicare Modernization Act of 2003
This findings brief examines the availability and use of swing bed and other post-acute skilled care following changes in reimbursement policy in recent years.

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