

Also online at http://www.vrha.org/weeklies.html	February 4-10, 2008

In this Issue...

VRHA News
>>VRHA at the Policy Institute

Virginia Rural Health News
>>Serving a Full Set of Patients, and More
>>Busy School Nurses Ask for More Hours
>>The Health Care Market is Killing Us

National Rural Health News
>>Data Communications Standard & Rural Networks
>>Medicaid Provisions in Stimulus Package
>>Resources on Health Care and Economic Downturns

Mark your calendar...
Job Announcements...
Funding Opportunities...

VRHA Executive Director Beth O'Connor (left) and President Ken Cook (right) after a lively discussion
with Congressman Virgil Goode.

VRHA News

VRHA at the Policy Institute

Six delegates from Virginia visited Washington, D.C last week as part of the National Rural Health Association's Rural Health Policy Institute. Educational sessions included presentations by Dr. Marcia Brand, Office of Rural Health Policy Director, and Kara Hawthorne, Director of the newly created Veterans Administration Office of Rural Affairs.

In addition to meeting with staffers from the offices of Senators Webb & Warner; as well as the offices of Representatives Wolf, Wittman, Drake, Scott, and Goodlatte; the delegates had the opportunity to meet with Congressmen Rick Boucher and Virgil Goode (above) in person.

To read the materials VRHA presented to our elected officials during the visits; please see our Legislation web page.

Virginia Rural Health News

Serving a Full Set of Patients, and More

By Janet Caggiano - Richmond Times-Dispatch

Crystal Clements grabbed hold of her grandmother's hand as the dentist started the drill. "Ow! That hurts!" Crystal cried.

The tears fell, and the dentist, Dr. Frederick Meyer, stopped his work. The Novocain had taken hold - as evidenced by Crystal's swollen lips - but she still felt pain as Meyer attempted to fill several cavities. With no nitrous oxide available at the small dental clinic in Louisa County, Meyer had to refer his 11-year-old patient to Charlottesville.

"It's frustrating," Meyer said. "There are some people we can't do anything for. We are just fixing what we can." Many rural dental clinics face similar challenges. Their limited resources can't keep up with the relentless demand. "They do the best they can, and a lot of people go without care," said Debbie Oswalt, executive director of the Virginia Health Care Foundation. "That's just the way it is."

Free clinics, community health centers and local health departments - often run by volunteers - offer free and reduced-rate dental services to low-income families across the state. Sixty-five of the state's 135 localities have these safety-net clinics, but that's not nearly enough, Oswalt said, because more than 3 million people in the state lack dental insurance. "Free clinics are wonderful," she said. "They pull in superhuman volunteer efforts. But the demand is much more than the supply can handle."

The Louisa clinic, for example, is open one day a month for about six hours. Meyer volunteers each month along with two other dentists, but they are limited in the number of hours they can contribute because they all work in private practice. That means patience is a virtue. More than 30 people are on the waiting list.

That pales next to King William County, where the waiting list stands at 154 at the St. David's Free Medical Clinic in Aylett. That translates to a two-year wait for some. The free clinic also serves residents of King and Queen County and the Northern Neck.

Read the full article.

Busy School Nurses Ask for More Hours

By Anna L. Mallory - The Roanoke Times

Every 10 minutes after lunch Monday, a new child sheepishly stepped into Trisha Irby's office at Critzer Elementary School. One boy cut his finger while working with scissors in class. Irby washed his hand and applied a fresh Band-aid to the wound. Irby, one of Pulaski County's full-time elementary school nurses, spends her day tending to wounds or health emergencies. But across the county - and the New River Valley - students in higher grades don't have clinicians poised with bandages all the time. Nor are the nurses always available for what the health-care professionals think is an often overlooked role: education.

"We may not teach in a formal classroom setting, but we do education every day," said Lynn Newberry, president of the Virginia Association of School Nurses. "It could be as simple as teaching an elementary student how to blow their nose or a middle school student about hygiene." Older students often need guidance on how to handle health issues in the 'real world,' such as birth control, she said.

School leaders in Pulaski and Montgomery counties are eyeing county funding sources to increase the number of hours that middle and high school nurses are present during the day. Meanwhile, the state association is pushing two bills in the House of Delegates, hoping lawmakers will note their importance and require at least one nurse per building.

"At 2 o'clock in the afternoon, you can't lock the door and turn away the children who are lined at the door," Newberry said. One bill asks that at least one nurse work at every school, and the other would require a registered nurse as a health coordinator. Montgomery County has 20 school nurses, including coordinator Joni Mitchell. Elementary school nurses work full time, but those at middle and high schools each work 20 hours a week and set their own schedules.

Read the full article.

Editorial: The Health Care Market is Killing Us

By Steve Huff - The Roanoke Times

The U.S. health care system - is it broken? Here's the shakedown:

Democrats blame Republicans for bowing to Big Medicine. Republicans accuse Democrats of promoting socialized medicine. Citizens blame legislators for playing politics with their health. Big Medicine blames Americans for craving expensive treatment. Doctors blame lawyers for whipping up lawsuits. Lawyers sue doctors for skimping on health care. Insurers penalize doctors for prescribing too much care. Patients complain they are pawns in this out-of-control health care game.

Meanwhile, the United States has fallen to dead last among 19 industrialized countries for quality of health care.

The study "Measuring the health of a nation: Updating an earlier analysis" was compiled by the prestigious, nonpartisan Commonwealth Fund and appears in the current issue of Health Affairs. It analyzes data from patients, doctors and national statistics to measure a broad array of outcomes. The U.S. falters in nearly every category, from access to equity to efficiency. The most glaring deficiency is lack of health coverage for all citizens. That sets us apart from every other country.

Read the full article.

Huff is a family physician from Patrick County and a columnist for the Roanoke Times.

National Rural Health News

Data Communications Standard & Rural Networks

The American Hospital Association urged a Federal Communications Commission advisory committee to recommend that Congress and federal agencies prioritize the establishment of a single standard for health information capture and exchange, and complete the deployment of broadband and wireless networks in rural areas.

In a statement to the Joint Advisory Committee on Communications Capabilities of Emergency Medical and Public Health Care Facilities, the AHA said, "It is crucial that the JAC recommend policies that will produce a roadmap for the creation of a single standard for the capture and exchange of health care information and completion of the deployment of broadband and wireless networks nationwide. It is also vital that federal policies ensure the interoperability of emergency and medical communications systems and provide for the ongoing maintenance and upgrading of mandated new technology."

Medicaid Provisions in Stimulus Package

As the Senate Finance Committee considers an economic stimulus package, the American Hospital Association urged the panel to include support for state Medicaid programs. The one-year moratorium on the cost-limit final rule and graduate medical education proposed rule is set to expire May 25. AHA also called for moratoria on CMS’ proposed outpatient and provider tax rules for Medicaid, departures from longstanding policy that would result in deep cuts in Medicaid spending.

"Medicaid is the public program designed to assist vulnerable populations in times of economic hardship," AHA wrote in a statement to the panel. "…A fiscal relief package for states is important before the economy worsens and should include two critical health care initiatives: an extension of the moratorium on several Centers for Medicare & Medicaid Services regulations that would drastically cut federal funds to state Medicaid programs; and a temporary increase in Medicaid’s federal medical assistance percentage."

Resources on Health Care and Economic Downturns

With growing economic anxiety, federal and state policymakers are urgently discussing how to soften the impact of an economic downturn. As unemployment rises, the uninsured population is likely to increase, straining the nation's health coverage programs for low-income families. Analysis of fiscal relief provided to state Medicaid programs in 2003 - an idea also under consideration now - suggests that federal assistance to the states via increased Medicaid funding helped forestall some coverage cutbacks by the states.

The Kaiser Family Foundation’s Commission on Medicaid and the Uninsured studied and tracked health coverage during past economic downturns and resulting in several publications that may be useful as policymakers decide how to deal with these issues once again:

A policy brief examining the impact of providing federal assistance to states via an increased federal match rate of Medicaid funds.
A brief examining the relationship between rising unemployment and the nation’s uninsured population.
A brief examining the relationship between unemployment and Medicaid.
A fact sheet reviewing the impact of the fiscal relief provisions for Medicaid.
A background piece looks at the role Medicaid plays in state budgets and the impact of declining state revenues on Medicaid.
A compilation of many studies examining Medicaid’s role and impact on state economies, including estimates of the economic stimulus derived from Medicaid spending, and analysis of the adverse effects on the state economy from reducing Medicaid spending.
A series of case studies examining how eight states (Alabama, California, Colorado, Massachusetts, Michigan, New York, Texas, and Washington) from around the nation responded to their budget crises from 2003 to 2005, with a focus on how Medicaid and State Children’s Health Insurance Programs were affected.

For further information on these issues, please contact the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured at kcmu@kff.org

Mark your calendar

For more information about these and other events, visit http://www.vrha.org/events.html

February 7: The Fundamentals - Caroline County
March 24-28: 24th Annual HPR III Training Institute - Roanoke
March 28-30: Women's Health 2008: The 16th Annual Congress - Williamsburg
April 27-29: 12th Annual Virginia Faith Community Health Ministry Retreat - Toano
May 7-10: NHRA's Annual Conference - New Orleans, LA

Job Announcements

For more information about these and other positions, visit http://www.vrha.org/index/jobs.html

Job Title: Executive Director

The Community Health Center of the Greater Prince William Area, a not-for-profit organization, has an immediate opening for an Executive Director. This position reports directly to the Board of Directors. The person will serve as the organization's primary administrative and operations officer. Experience in grant writing and fundraising preferred. Requirements include a Masters degree in Health Administration, Public Administration, Public Health, Hospital Administration or related field. The candidate must demonstrate minimum of five years of successful management experience in community/not-for-profit organizations. Experience with the operations of a Federally Qualified Community Health Center is preferred. Salary is commensurate with experience.

Please send resumes to sherry.dunphy@verizon.net

Job Title: NP

Licensure as a Nurse Practitioner in the state of Virginia in one of the following categories: Adult, Family, or Geriatric. Former work experience as a nurse in a clinical setting desirable. Demonstrated exceptional interpersonal skills and problem solving; clinical experience with adult and specifically geriatric populations with a minimum of one year’s experience working with the frail or elderly population.

Responsibilities include assessment and management of chronically ill geriatric participants in a day health center or participant home. Evaluates and treats episodic illness, emphasizing promotion of health, prevention, and early detection. Works closely with the interdisciplinary team doing assessments/re-assessments, developing and coordinating the plan of care. Acts as a liaison with community based physicians and other healthcare professionals within the program.   Requires home visits in Buchanan, Dickenson, Russell, and Tazewell counties. Full-time with benefits.
Submit an agency application, current resume, and three professional references to:
Rose Hurley, Program Director
Appalachian Agency for Senior Citizens, Inc.
P.O.B. 765
Cedar Bluff, VA 24609
(276) 964-7152


Job Title: NP

The Free Clinic of the New River Valley seeks nurse practitioner 15-20 hrs/wk to conduct patient assessments, perform exams and diagnose and treat patients according to professional standards and practice. Individual will be patient-focused with excellent customer service skills and will work in the new Pearisburg Satellite Clinic near Carilion Giles Memorial Hospital. Flexible hours and competitive pay. Send cover letter and resume to: Nurse Practitioner Search, Free Clinic of the New River Valley, 215 Roanoke Street, Christiansburg, VA 24073. www.nrvfreeclinic.org

Job Title: General Dentist

Job Description: Work in the beautiful Shenandoah Valley, and accessible to Washington, D.C. amenities. Recent grads may also qualify for student loan repayment. A great opportunity for a new grad or semi-retired dentist who wants to avoid the expense and hassle of running a business and still earn a competitive salary. Dentist will treat children and adults.

Please email your resume to Pam Murphy at scfc@shentel.net or call (540) 459-3790 for more information.

Funding Opportunities

2008 Aetna Foundation Regional Community Health Grants Program

Program web site http://www.aetna.com/foundation/grants_reg/

Sponsor Aetna Foundation

Deadline Applications accepted on an ongoing basis

Purpose Aetna and the Aetna Foundation will award up to $4 million for philanthropic initiatives focused on the following health care issues:

A. Community-based initiatives that increase access to quality health care and improve overall wellness in the following areas-

Depression, including early treatment and diagnosis to help minimize the incidence of disabilities due to mental health issues

Obesity, including diabetes and other disease management

Proposals must incorporate and/or demonstrate impact on one or more of the following: Expansion of primary caregiver role; Community care delivery (e.g., promotoras, visiting nurse, mobile clinics, etc.), with special emphasis on elder populations; School-based implementation; Integrated care delivery (e.g., medical with behavioral and/or oral); Enhancing access to health information; Delivery of culturally sensitive care; Increasing racial and ethnic health equality

B. Health professions training and support programs to address one or more of the following challenges within the U.S. health care delivery system:

Growing shortage of skilled nurses; Representation of racially and ethnically diverse health care professionals across the continuum (doctors, dentists, nurses, social workers, community health workers and allied health professionals); Health care professionals' cultural competency (e.g., ability to communicate effectively with diverse populations)

Eligibility Nonprofit organizations with evidence of IRS 501 [c] (3) designation or de facto tax-exempt status may apply for a grant, with the following exceptions:
Advertising; Capital investments, equipment purchases, depreciation; Fund-raising activities, including tables, tickets, dinners, walks, sporting events, etc.; Grants or scholarships to individuals; Political causes or events; or Religious organizations in support of their sacramental or theological functions.

Geographic coverage Nationwide

Amount of funding Grant requests ranging from $25,000 to $50,000 will be considered.

Application process Guidelines are available on the Program web site. Deadline dates vary, see Program web site for details.

For more information contact:
Program inquiries should be directed to the Community Grants program information line at (860) 273-6747 or the Aetna Foundation mailbox at AetnaFoundation@aetna.com

Do you have exciting rural health news that needs to be shared?
Do you know of an upcoming health-related event which should be on our calendar?
E-mail Beth O'Connor at: boconnor@vcom.vt.edu

Disclaimer: The VRHA circulates state and national news as an information service only. Inclusion of information is not intended as an endorsement. If you prefer to receive email in plain text or rtf format instead of html or if you receive this email more than once, email VRHA.

	Virginia Rural Health Association The leading voice for rural health in Virginia
2265 Kraft Drive Blacksburg Virginia 24060 Ph: 540-231-7923 Fax: 540-231-5338 www.vrha.org