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June newsletter

By Sarah Bruyn Jones - Roanoke Times

Which is healthiest: shredded wheat, Cheerios or Special K? What really is the nutritional difference between natural applesauce and its original counterpart? Are all yogurts created nutritionally equal?

With an average of 50,000 products filling the shelves of grocery stores, it can be an overwhelming process for some people to figure out just which cereal, applesauce or yogurt is the healthiest choice.

Enter NuVal, a food scoring system that is popping up at grocery stores across the country -- including Food City locations in Southwest Virginia -- with the aim of helping shoppers understand the nutritional value of a product at a glance. It's also being embraced by public health officials as they seek buy-in from businesses into community health and wellness.

(VRHA member) Dr. John Dreyzehner, director of the Cumberland Plateau Health District with the Virginia Department of Health, is excited about the potential the program has to help improve the health education of Virginians.

He said he recently shared information about NuVal with colleagues from around the state by inviting Food City's dietician to speak to other health directors. Many reacted with questions about how to get other grocery stores to adopt the program, he said.

Read the full article.

Governor Bob McDonnell announced appointments to 18 boards and commissions, including:

Advisory Board on Midwifery

• Christian A. Chisholm  of  Charlottesville, Associate Professor of Obstetrics and Gynecology and Residency Program Director for the University of Virginia Medical School-Department of Obstetrics and Gynecology
• Wendy A. Graefe, CNM, MS of Norfolk, Certified Nurse Midwife with Naval Medical Center Portsmouth
• Deb McPherson of Lynchburg, President of Home Works Lynchburg

Board of Directors of the Virginia Birth-Related Neurological Injury Compensation Program

• Francoise Mullen of Richmond, French Teacher at St. Catherine’s School
• Neal C. Schulwolf of Norfolk, Attorney with Kalfus & Nachman
• Arthur Lee Talley, Jr. of Portsmouth, Software Engineer for Mantech International, Advocacy Chairman for Autism Speaks and Legislative Director for the Virginia Autism Project
• J. Scott Walters* of Midlothian, Associate Vice President and Regional Counsel, Nationwide Insurance Company

View the full list of appointees.

Mining and Birth Defects

By CMIO

A South Carolina bill requiring the state’s Department of Health and Environmental Control (DHEC) to identify hospitals that use telemedicine in stroke treatment is slated to hit the governor’s desk after passing unanimously in both the state House and Senate.

The South Carolina General Assembly on June 1 unanimously passed the Stroke Prevention Act of 2011 (S 588) after the state Senate also unanimously voted in favor of the measure on May 25. Sponsored by Sen. Darrell Jackson (D), the bill is expected to increase the use of telemedicine in treating strokes.

If ratified, the bill will require the DHEC to identify hospitals that use telemedicine in treating acute or early strokes as “stroke enable centers through telemedicine." Additionally, it will create a Stroke System of Care Advisory Council to be appointed by the DHEC, one of whose members must be “a hospital administrator, or designee, from a hospital with a stroke telemedicine program that is not a primary stoke center upon the recommendation of the South Carolina Hospital Association.”

Read the full article.

By Bill Bishop - the Daily Yonder

Nearly one out of four rural Americans live in counties where women in the last decade can expect to live shorter lives.

Life expectancy for women declined in 737 U.S. counties from 1997 to 2007, according to a new study conducted by researchers at the Institute for Health Metrics Evaluation at the University of Washington.

Only 38 of those counties were urban; 138 were exurban counties; and 561 of the counties with declining female longevity were in rural America.

Nationally, the researchers found, longevity in the U.S. is falling behind most other industrialized countries. More than 8 out of ten U.S. counties have longevity rates that are falling further behind averages in other industrialized countries.

Read the full article.

By Mary Sheppard - CBC News

"It works. It's the next best thing to being there." Dr. Tony Pignatiello is talking about the telepsychiatry program at the Hospital for Sick Children (SickKids) in Toronto. The program has grown over the past 10 years, wants to grow some more, and may well be part of a renewed focus on children's mental health across Canada.

The very first remote consultation in Ontario took place by teleconference in 1994 in Parry Sound. Jeffrey Hawkins, executive director of the Hands Children's Mental Health Centres in North Bay and Parry Sound, was there for the first call. "We did it over a phone line and got the money through an innovation grant. But it was very exciting and was the beginning of keeping at-risk northern children in their communities. It grew from there."

Read the full article.

Developing rural palliative care: validating a conceptual model
Rural residents want to remain in their home communities for end-of-life care, however providing palliative care in rural areas is an exercise in managing limited infrastructure and resources. This article offers a solution by focusing on community capacity development as the basis for a rural palliative care model. The authors detail the process of model development.

Increasing the enrolment of rural applicants to the faculty of medicine and addressing diversity by using a priority matrix approach to assign values to rural attributes
If identifying 'rural-attribute applicants' for admission to medical school was as simple as asking for 'high school graduation location', the rural-urban medical workforce gap would be narrowing. In taking a matrix approach to distinguishing potential students' rural attributes, these authors from Manitoba, Canada, acknowledged that rural-student selection is a more complex exercise, where even some urban-background applicants are considered. The result has been a promising increase in the rural-origin mix of local admissions, and a methodology that promises the same for faculty selection committees in other world regions.

Community Strength and Economic Challenge: Civic Attitudes and Community Involvement in Rural America
Residents in rural areas that are rich in amenities report a positive outlook about their community strength and civic engagement, with nine out of ten saying they would work together to solve a community problem. However, residents in chronically poor rural communities are less likely to trust, get along with, and help their neighbors.

Trends in Skilled Nursing Facility and Swing Bed Use in Rural Areas Following the Medicare Modernization Act of 2003
Changes in Medicare reimbursement policy that began with the Balanced Budget Act of 1997 resulted in differential reimbursement for care in swing beds and skilled nursing facilities.  This final report looks at whether the availability of post-acute skilled care stabilized once these changes were implemented and how and where this care is being provided today.

Rural Adults' Use of Health-Related Information Online
Rural Americans are increasingly using the Internet to acquire information about chronic disease, mental health, doctors, and treatment options. Priorities should include further development and rigorous evaluation of online resources to ensure high-quality, more direct tailoring of resources to rural families and development of tools to assist consumers in assessing the credibility of online information.

Country Doctor
Journal issue focused on rural physicians. First half examines patient-physician relationship dilemmas encountered in rural medicine and second half discusses policy initiatives undertaken on national and state levels, and new strategies in medical education, to increase rural physician workforce.

Key Questions About Medicaid and Its Role in State/Federal Budgets and Health Reform
Presents several FAQs regarding Medicaid, what it does, its cost, state and federal budgets, and health reform. Discusses urban and rural communities.

Rural Behavioral Health Programs and Promising Practices
Examines rural behavioral health programs that were involved in a 2008 study. Reports information gathered from the study, the value of collecting and using the data to make program improvements, and finding funding for sustainability.

Rural HIV and STD Prevention in Challenging Economic Times
One of seven papers and four brief program reports in The Eighth Special Issue on AIDS/STD Education and Prevention in Rural Communities. Describes the report of 230 respondents from 44 states concerning rural HIV/STD prevention needs, barriers and programs.

Rural vs. Urban Ambulatory Health Care Review
Examines evidence regarding potential disparities between rural and urban areas in health care provision and delivery, and how differences in health care may contribute to disparities in health outcomes of veterans that seek care in VA and non-VA health systems.

A conceptual model of suicide in rural areas
Finding an approach to reducing rural suicide can seem an overwhelming task, with the large available literature just the first issue to tackle. If this is a professional concern of yours, look no further than this new literature review, which also offers a unique 'Conceptual model of rural suicide'. The model has the potential to help identify precise points for intervention that are unique to individual rural localities, making this article a 'must-read' for academic researchers, rural service-planners and healthcare staff in any rural location.

The use of Photovoice to document and characterize the food security of users of community food programs in Iqaluit, Nunavut
Little is known about "food insecurity" although it is an increasingly important issue among Canadian Arctic communities. This article reports on a unique "Photovoice" study in which images captured by participants assisted in determining factors that influenced the type, quantity and quality of food consumption. The study findings link social determinants of health to cultural values, adding valuable knowledge to our understanding of this significant issue.

Recent Changes in Health Insurance Coverage in Rural and Urban Areas
This findings brief compares changes in health insurance coverage for non-elderly Americans in rural areas to changes in urban areas during the recent economic recession.

Mark your calendar

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

July 14: Working with At Risk Youth - Roanoke
July 16: Educational Forum on Prescription Drug Abuse - Wythville
July 17: Educational Forum on Prescription Drug Abuse - Dublin
July 21: AccuDEXA Technician National Certification - Wise
July 20-22: NRHA Quality & Clinical Conference - Rapid City, SD
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

Resources

Toolkit of Public Health Emergency Text Messages
A new toolkit of prepared cell phone text messages advising people how to protect their health after a disaster is available now through the U.S. Department of Health and Human Services. These messages support state and local emergency managers in disaster response and are available online.

From the Medicare Learning Network

• Annual Wellness Visit
  This brochure is designed to provide education on the Annual Wellness Visit and providing Personalized Prevention Plan Services, at no cost to the beneficiary, so beneficiaries can work with their physicians to develop and update their personalized prevention plan.
• Correct Provider Billing of Admission Date and Statement Covers Period
  Reminds affected providers about the National Uniform Billing Committee’s (NUBC) definition for reporting the ‘admission date’ and ‘statement covers period’ elements on claims submitted on or after Sat Oct 1, 2011.
• Recovery Audit Program Diagnosis Related Group Coding Vulnerabilities for Inpatient Hospitals
  Provides information about DRG validation review findings related to an incorrect principal diagnosis, is now available.
• Provider-Supplier Enrollment Fact Sheets Revised
  The fact sheets below provide education to specific provider types on how to enroll in the Medicare Program and maintain their enrollment information using internet-based PECOS (Provider Enrollment, Chain, and Ownership System).  They have been recently updated and are available in downloadable format from the Medicare Learning Network®:
  • “Medicare Fee-For-Service (FFS) Physicians and Non-Physician Practitioners: Protecting Your Privacy – Protecting Your Medicare Enrollment Record” advises FFS physicians and non-physician practitioners on how to ensure their enrollment records are secure and up-to-date, and can be found at http://www.CMS.gov/MLNProducts/downloads/MedEnrollPrivcy_FactSheet_ICN903765.pdf.
  • “The Basics of Medicare Enrollment for Physicians and Other Part B Suppliers” explains general Medicare enrollment information relevant to physicians and other Part B suppliers and can be found at http://www.CMS.gov/MLNProducts/downloads/MedEnroll_PhysOther_FactSheet_ICN903768.pdf.
  • “The Basics of Internet-Based PECOS for DMEPOS Suppliers” describes general Medicare enrollment information relevant to DMEPOS (Durable Medical Equipment, Prosthetics, Orthotics, and Supplies) suppliers and can be found at http://www.CMS.gov/MLNProducts/downloads/MedEnroll_PECOS_DMEPOS_FactSheet_ICN904283.pdf.
  • “The Basics of Medicare Enrollment for Institutional Providers” explains general Medicare enrollment information relevant to institutional providers and can be found at http://www.CMS.gov/MLNProducts/downloads/MedEnroll_InstProv_FactSheet_ICN903783.pdf.
  • “The Basics of Medicare Enrollment for Physicians Who Infrequently Receive Medicare Reimbursement” describes general Medicare enrollment information relevant to those physicians required to enroll in Medicare for the sole purpose of certifying or ordering services for Medicare beneficiaries and can be found at http://www.CMS.gov/MLNProducts/downloads/MedEnroll_Phys_Infreq_Reimb_FactSheet_ICN006881.pdf.
  • “The Basics of Internet-Based PECOS for Physicians and Non-Physician Practitioners” provides an overview of how physician and non-physician practitioners can enroll in Medicare using internet-based PECOS and can be found at http://www.CMS.gov/MLNProducts/downloads/MedEnroll_PECOS_PhysNonPhys_FactSheet_ICN903764.pdf
  • “The Basics of Internet-Based PECOS for Provider and Supplier Organizations” describes how provider and supplier organizations can enroll in Medicare using internet-based PECOS and can be found at http://www.CMS.gov/MLNProducts/downloads/MedEnroll_PECOS_ProviderSup_FactSheet_ICN903767.pdf.
  • “Internet-Based PECOS Contact Information” provides contact information for technical assistance with internet-based PECOS and can be found at http://www.CMS.gov/MLNProducts/downloads/MedEnroll_PECOS_Contact_FactSheet_ICN903766.pdf.
• Medicare Billing for Speech-Language Pathologists in Private Practice
  This fact sheet is designed to provide education on enrollment and billing procedures specific to speech-language pathologists (SLPs) and includes general billing and enrollment information and what services can be billed directly by an SLP.
• Inpatient Psychiatric Facility Prospective Payment System
  This fact sheet is designed to provide education on the Inpatient Psychiatric Facility Prospective Payment System (IPF PPS), including background, coverage requirements, how payment rates are set, and the Rate Year 2012 update to the IPF PPS.
• Glaucoma Screening Brochure
  Designed to provide education on Medicare-covered glaucoma screening, has been updated
• Advance Beneficiary Notice of Noncoverage – Part A and Part B
  Designed to provide education on the ABN, has been updated
• Expanded Benefits
  This brochure is designed to provide education on three preventive services: the Initial Preventive Physical Examination (IPPE) (also known as the Welcome to "Medicare Physical" Exam or the "Welcome to Medicare" visit), Ultrasound Screening for Abdominal Aortic Aneurysms, and Cardiovascular Screening Blood Tests.

Funding Opportunities

Christopher and Dana Reeve Foundation: Quality of Life Grant Program
The Christopher and Dana Reeve Foundation is dedicated to curing spinal cord injury by funding innovative research, and to improving the quality of life for people living with paralysis. The Foundation’s Quality of Life Grant Program supports nonprofit organizations in the United States that provide services to individuals with paralysis, with some emphasis on paralysis caused by spinal cord injuries. Grants are awarded twice each year to programs in three broad categories: Actively Achieving, Bridging Barriers, and Caring and Coping. The Foundation gives special consideration to organizations that serve returning wounded military and their families, and to those that provide targeted services to diverse cultural communities. The next application cycle will open on July 1, 2011 with an application deadline of September 1, 2011.

Cooperative Development Foundation: Mutual Service Cooperative Fund
The Mutual Service Cooperative Fund, administered by the Cooperative Development Foundation, focuses on cooperative development programs that enhance the quality of life for seniors living in rural America. (For information about cooperatives, visit www.ncba.coop/.) Funded projects should contribute to the development of systemic approaches to replicate successful cooperative models that already serve seniors in rural areas, provide technical assistance to support the development of cooperative ventures that will serve rural seniors, and/or provide a better understanding of lessons learned from cooperatives that have served or are currently serving seniors living in rural areas. In 2011, the Fund is only reviewing proposals that relate to cooperative home care or cooperative housing. Cooperatives and cooperative-related organizations, as well as other nonprofit organizations that address the Fund’s priorities, may apply for a grant. The application deadline is August 1, 2011.

Robert Wood Johnson Foundation
The mission of the Robert Wood Johnson Foundation is to improve the health and healthcare of all Americans. The Foundation works with a diverse group of dedicated people and organizations to address problems at their roots and to help make a difference on the widest scale, particularly for the most vulnerable among us. Grants are awarded for projects in the United States and U.S. territories through Calls for Proposals that target specific health issues. In addition, support is provided in response to unsolicited proposals that address the Foundation's Pioneer program area, which supports innovative ideas that push beyond conventional thinking to explore solutions at the cutting edge of health and healthcare. Unsolicited proposals are reviewed throughout the year; Calls for Proposals have specific deadlines.