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>>Telemedicine Improves Stroke Care

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Editorial - Roanoke Times

Pick of the day: Debt talks threaten rural hospitals

Rep. Eric Cantor, as part of debt ceiling negotiations, has proposed $16 billion in cuts to rural hospitals and frontier areas, including $14 billion from rural hospital programs.

Rural hospitals are critical access points for the rural people of Virginia. Such devastating cuts could result in more than $1 million in cuts to a rural hospital each year. Reducing rates for rural providers will force many facilities to offer reduced services or even to close their doors.

In Virginia, this means the hospitals located in the counties of Bath, Giles, Dickenson, Page, Patrick, Rockbridge and Shenandoah. A closed rural hospital could result in a 20 percent loss of revenue in the local economy.

Congress should not let debt ceiling reductions harm the people of rural Virginia.

VRHA Member Blue Ridge Medical Center was the only Virginia entity named in the School-based Health Centers grant awards. Health and Human Services (HHS) Secretary Kathleen Sebelius and Education Secretary Arne Duncan announced awards of $95 million to 278 school-based health center programs across the country. Provided by the Affordable Care Act, the awards will help clinics expand and provide more health care services at schools nationwide.

The awardees are currently serving approximately 790,000 patients. Today’s awards will enable them to increase their capacity by over 50-percent, serving an additional 440,000 patients. School-based health centers improve the overall health and wellness of all children through health screenings, health promotion and disease prevention activities and enable children with acute or chronic illnesses to attend school. The Blue Ridge Medical Center will receive $402,000 in HHS funds for the project.

Click here for additional information and a full list of grantees.

The Blue Ridge Medical Center will also receive $164,700 from the Virginia Health Care Foundation to help expand dental clinic services.

By John Wickline - Ogden Newspapers

West Virginia Wesleyan College leaders joined with those from Shenandoah University in Winchester, Va., on Friday to announce a partnership that will bring maternity and psychiatric nursing services to some of the most underserved communities in Appalachia.

The two colleges will collaborate to offer two new nursing degrees, giving students the ability to become certified in nurse-midwifery or as a psychiatric mental health nurse practitioner.

The announcement culminates a year of meetings and planning, and Shenandoah's coordinator of nurse-midwifery Juliana van Olphen Fehr [a VRHA member] said the program offers a chance for her to share her dreams. She added that maternity services are not unlike the mountain routes officials from her school had to drive to reach the Wesleyan campus for Friday's announcement.

Read the full article.

By Matt Dobias - Politico

An on-again, off-again proposal that forces pharmaceutical companies to essentially discount drugs for Medicare's poorest seniors is back on-again —despite fierce opposition from the drug lobby and one of their staunchest defenders, House Majority Leader Eric Cantor.

The pairing of Cantor and the powerful Pharmaceutical Manufacturers Association could prove more than enough to squelch the White House-endorsed proposal, which has emerged as one of many divisive concerns among President Barack Obama and congressional leaders who are trying to hammer out a deal to cut federal spending and extend the nation's debt limit.

Oral Health Initiative

South Boston Smiles

As debt ceiling negotiations continue in Washington, D.C., various plans have been presented that would cut spending and extend the statutorily allowed debt limit for the United States government.
While rumors continue about possible health care cuts, it is imperative that NRHA members continue to contact their representatives to tell them not to support a proposal that contains devastating cuts to rural hospitals and the rural health care safety net.
Please contact your members of Congress and tell them:

1. To oppose any debt ceiling proposal that contains devastating cuts to rural health care.
2. Billions in Medicare cuts to rural providers will decimate the delivery of health care in rural America, likely forcing many facilities to close.
3. Rural hospitals are critical to the 62 million patients they serve.
4. The rural economy is dependent on jobs in hospitals and the health care industry. As much as 20 percent of revenue generated in rural areas is attributable to the health care industry and local hospitals.

Contact information for your members of Congress is available on NRHA’s web site. NRHA will also continue to update the Rural Health Voices blog, Facebook page and Twitter feed as additional information becomes available.

By Alan Morgan - National Rural Health Association

The Health Resources Services Administration Negotiated Rulemaking Committee continued work in Washington DC. The Committee’s purpose is to reconsider how Health Professional Shortage Areas (HPSA) and Medically Underserved Areas (MUA) are designated for the purposes of Federal programs.

New models were identified for HPSAs and MUA/Ps but much, much work remains to be done.

These models can now be further tested and modified to capture underserved areas as the committee deems appropriate. Simply stated, the committee is attempting to move forward with simple, easy to understand models, and has rejected consideration of more complicated models with more extensive factors to consider.

It is unfortunate, that as presented for consideration by the committee, ALL of these models currently appear to disproportionately impact rural frontier areas in a negative manner. However, there is consensus that these models will be reviewed and modified to adequately represent underserved populations in rural America prior to final adoption by the committee.

Again, much work still to be done. In fact, the committee discussed the potential of a further extension of the committee’s work.

By Robert Bowman M.D. - Daily Yonder

Rural health care providers are paid less to provide treatment to a population that is more likely to be poor than those in the cities. Now medical researchers are saying rural hospitals don't provide the same quality of care as those city institutions that have more money and richer patients.

Which is it, JAMA? Where is your consistency in articles regarding quality of care?

One article, published in the Journal of the American Medical Association last year by Clemens Hong, notes the difficulty of separating the context of primary care of the underserved from the quality of care. This is a landmark article, painstakingly difficult to complete, and it concluded that "greater proportions of underinsured, minority, and non–English-speaking patients were associated with lower quality rankings for primary care physicians."

Now JAMA has an article this year claiming lower quality of care in certain types of rural hospitals that are completely different in location, population, funding, and workforce - different by design.The article was titled "Quality of Care and Patient Outcomes in Critical Access Rural Hospitals." Researchers at Harvard report that they found that smaller, rural hospitals had "fewer clinical capabilities, worse measured processes of care, and higher mortality rates" for patients with heart attacks, congestive heart failure and pneumonia.

So what happened between last year, when patients made the difference in quality, and this year when it was location of the hospital?

Read the full article.

By Getahn Ward - The Tennessean

When a patient comes into the emergency room with symptoms of a stroke, access to a neurologist within minutes can make a big difference between whether they live, die or end up permanently disabled.

Technology that hospital chain HCA’s local TriStar Health System subsidiary plans to roll out next week at five of its Nashville-area hospitals aims to ensure there’s a neurologist on hand instantly — albeit virtually — to make the right life-saving choices.

TriStar’s system can be used to determine whether the patient had a severe stroke and needs clot-dissolving drugs to prevent more damage.

Using his laptop from any location, neurologist Dr. Adrian A. Jarquin-Valdivia of the TriStar Stroke Network can interact with the patient and ER medical staff through a video monitor and listen to the patient’s heart rhythm through a stethoscope connected to the telemedicine robot.

Read the full article.

Mark your calendar

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

July 26: Pre-Existing Condition Insurance Plan - Henrico
August 1: Spirituality in the Addictions Counseling Process - webinar
August 10: Language and Literacy Barriers in Safety and Health Training of Agricultural Workers - webinar
August 16: Beyond Body Image - Roanoke
September 12-13: 2011 Virginia Rural Summit - Glen Allen
September 17: Educational Forum on Prescription Drug Abuse - Richlands
October 4-5: Weight of the State Conference - Richmond
October 5-7: International Rural Nursing & Rural Health Conference - Binghamton, NY

Resources

Exchange Monitor
Monitor where states are on creating their health insurance exchanges under the Affordable Care Act and what those exchanges may look like through the Kaiser Family Foundation’s Exchange Monitor, featuring new data on Statehealthfacts.org.

Toolkit for Community Action
The NPA Toolkit for Community Action is designed to support community efforts in the goal of ending health disparities and promoting health equity, the Office of Minority Health has released the new NPA Toolkit for Community Action. Through this toolkit, community members will have the information and resources they need to help engage fellow citizens and local media as they spread the word about health disparities and educate others about the impact disparities have in the lives of individuals and the greater impact on society.  

Bone Mass Measurement
The “Bone Mass Measurement” brochure is designed to provide education on the bone mass measurement benefit, and includes information on methods of bone measurement (bone density), coverage information, and risk factors.  This brochure has been updated and is now available in downloadable format, free of charge, from the Medicare Learning Network.

Funding Opportunities

WHO Foundation: Women Helping Others
The WHO Foundation: Women Helping Others supports grassroots organizations throughout the United States and Puerto Rico that serve the overlooked needs of women and children. The Foundation provides grants of $1,000 to $40,000 for critical health programs and social services projects that give women and children the knowledge and tools they need to improve their lives. Examples of funded programs include food and shelter for the homeless, healthcare for the poor, after-school programs, career training for under-employed women, positive programs for young girls, and domestic violence prevention programs. Eligible organizations must have been incorporated for a minimum of three years. (The Foundation will consider funding projects of an original or pioneering nature within an existing organization.) Applications are due on September 6, 2011.

Robert Wood Johnson Foundation Scholars in Health Policy Research
Application Deadline: October 12, 2011
The Robert Wood Johnson Foundation Scholars in Health Policy Research program develops and supports a new generation of creative health policy thinkers and researchers within the disciplines of economics, political science and sociology. Each year the program selects up to nine highly qualified individuals for two-year fellowships at one of three nationally prominent universities with the expectation that they will make important research contributions to future U.S. health policy.