VRHA Weekly Update
In this Issue March 10-16, 2014

Virginia News National News Mark your calendar
Funding Opportunities


National Groundwater Awareness Week

March 9-15, 2014




Take Action!

Medicaid Expansion is still being hotly debated in Richmond. You can take action to assure that Virginia's rural citizens have the healthcare coverage they need and rural healthcare facilities can stay open.

Steps to take:

1) Review the February 24 and March 3 editions of the Weekly Update and make sure you have contacted all of the Budget Conference Committe members.

2) Contact House Majority Leader Cox and relay stories of people in your community who have suffered because they couldn't afford health insurance. Cox recently stated that people still receive service and no one dies because of lack of coverage. Demonstrate to Cox that his statement is not accurate.

3) Contact your member of the General Assembly and demand that the coverage gap be closed.

4) Join the Rally for Health Care. Several consumer advocacy groups have joined forces to host the Rally for Health Care on March 15 in Richmond from 11 am to 1 pm. Event organizers are hoping to have 1,000 participants from all areas of the Commonwealth. They are also organizing carpools and making plans for buses to bring advocates from Northern Virginia, Hampton Roads, and the New River Valley so don't let lack of transportation be a barrier.

Check out VRHA's Action Alert for talking points on Medicaid Expansion.

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Student Representatives

VRHA is now accepting applications from health professions students who wish to serve as representatives to the VRHA Board of Directors for the 2014-2015 academic year.

Applications must be submitted no later than April 25, 2014. Download the application form for additional details.

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Group Purchasing Opportunity

VRHA is pleased to offer a unique group purchasing opportunity for ICD-10 training.  The Association of Rural Health Professional Coders will allow us to purchase access to their full ICD-10 e-learning library for only $100/user.  Since the 7 training modules are typically $150-$200 each, this is a tremendous savings.  Five of them are approved by AAPC and AHIMA and users can earn up to 20 CEUs recognized by both companies.  Since ICD-10 begins October 1, the timing is perfect.

Click here to review the training modules available.

In order to receive the discount, VRHA will need to guarantee that we will purchase at least 100 user keys to the library.  This offer is not exclusive to VRHA members, or even people in Virginia, so feel free to share with your colleagues.

To order user keys your organization needs, please complete this form. VRHA will take potential orders until April 1st, but will purchase them sooner if we reach 100 before then.

Contact Beth O'Connor (540-231-7923) with any questions you may have.

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Virginia News

Virginia’s Brave New World

By Michael Cassidy - Commonwealth Institute

Apparently, we’re about to enter a brave new world here in Virginia. House Speaker Howell and Majority Leader Cox say they are hesitant to accept federal money to allow more Virginians to get health care through Medicaid, arguing that the federal government can’t be counted on to hold up its part of a very good bargain for Virginia – full federal funding of the costs for the next three years and no less than 90 percent after that.

But if these lawmakers and their colleagues are serious about going cold turkey on Virginia’s use of federal funding because someday maybe Congress will reduce that funding, then we should expect a radically new budget from the House of Delegates on February 16, when it releases a state spending plan for the next two years.

That’s because more than 21 percent of Virginia’s revenue comes from the federal government.

Read the full article.

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Focus on Mental Health

By Saria Saccocio - GoDanRiver.com

It all matters. It all makes a difference.

According to the National Institute of Mental Health, nearly one in four adults — and one in five adolescents — suffer from a diagnosable mental disorder such as depression, bipolar disorder or schizophrenia. That equates to tens of millions of people. Given so, it comes as no surprise that in the United States, mental disorders are the leading cause of disability among those ages 15-44.

In December 2013, the federal government announced it would invest $100 million in our country’s mental health system, with funds to be used in expanding mental health services at community health centers and in rural locations across the nation.

Utilizing the entire mental health care team — legislators, city and county officials, mental health and other healthcare leaders, patients, family members and concerned citizens — we can ensure a safe and healthy environment for all members of our community.

Read the full article.

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Progress on Telehealth

From the Office of the Governor

Governor Terry McAuliffe announced the results of the Virginia Center for Innovative Technology’s 2013 Health Information Technology (IT) Assessment, which once again demonstrates Virginia's national leadership in telehealth initiatives.  It also documents faster broadband speeds across the Commonwealth and an increase in adoption rates of electronic health records by Virginia physicians. 

The annual assessment identifies gaps in broadband access, trend data related to how gaps are closing and the development of health IT initiatives in Virginia.  It also identifies changes in broadband connectivity across health care provider segments, generates new data used to populate the Commonwealth’s Broadband Map for healthcare facilities and providers, and classifies progress in adoption of key health IT capabilities across the Commonwealth, such as electronic health records (EHR), health information exchange (HIE) and telehealth services. 

Read the full press release.

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National News

Life and Death in a Small Town

By Alan Morgan - National Rural Health Association

John Cougar Mellencamp sang in his 1985 hit song Small Town, “I was born in a small town… probably die in a small town.” Unfortunately for John, it also appears that he will probably die sooner in a small town.

A study published last month in the American Journal of Preventative Medicine by Dr. Gopal Singh examines the trends in life expectancy disparities between rural and urban areas in the United States between 1969 and 2009. The article finds that the disparity has increased since 1990, because life expectancy has grown more rapidly in urban than in rural areas.

According to the research findings, the life expectancy disparity of urban over rural areas stood at 2.4 years in 2005-2009. Furthermore, the findings indicate that mortality from cardiovascular diseases, injuries, lung cancer and COPD is much higher in rural than in urban areas. For more data on this, visit NRHA’s What’s Different About Rural Health.

“The rural poor and rural blacks currently experience survival probabilities that urban rich and urban whites enjoyed four decades earlier,” according to the report’s conclusion. Four decades. Another way of saying this is that advances in public health and preventative care are not reaching rural communities.

Read the full article.

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“Most Wired”

By Candi Helseth - Rural Assistance Center

Wheat fields and open prairie dominate the majority of Syringa Hospital’s 7,500-mile service area in Idaho’s frontier region, where only 16,000 residents reside. Yet, Hospitals and Health Networks has twice recognized this Critical Access Hospital (CAH), which has only 16 beds, as one of the nation’s Most Wired Hospitals.

“This whole project was like a big puzzle where you analyze your operation and look at everything like workloads, procedures, etc. With every step, you ask why you have been doing it the way you do,” Anglen-Whitley said. “It’s been a challenge all over the country for physicians to deal with Meaningful Use mandates for things they were never responsible for in the past. Our staff did struggle with that at first. But now they are quite satisfied with how well it all works.”

Read the full article.

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Georgia’s Deal

By Steve Benen - MSNBC

Georgia Gov. Nathan Deal (R) has a problem: rural hospitals keep closing, overwhelmed by financial troubles they can’t solve on their own. The obvious solution – accepting Medicaid expansion under the Affordable Care Act – is the one thing Deal refuses to even consider.

There is no great mystery here as to why the rural hospitals can’t keep their doors open. These facilities have routinely covered low-income Georgians who don’t have insurance, leading to facilities that can’t pay their bills. Medicaid expansion would “help rural hospitals by turning many of their uninsured patients into paying patients,” but the governor and GOP state policymakers won’t budge.

But don’t worry, Deal is ready to think outside the box. The Emergency Medical Treatment and Labor Act is a 1986 law that requires hospitals to provide emergency health care treatment to anyone who needs it, regardless of citizenship or their ability to pay. It’s provided life-saving care to countless people, but it’s also strained hospital resources and turned emergency rooms into the first stop, instead of a last resort, for some.

“If they really want to get serious about lowering the cost of health care in this country, [federal policymakers] would revisit another federal statute that has been there for a long time,” Deal told a crowd of dozens at a University of Georgia political science alumni gathering.

Uninsured Georgians in rural parts of the state have shown up for medical care at emergency rooms that can’t turn them away. The hospitals provide care, as required by law, but the financial strain ultimately proves to be too great a burden for some facilities.

Deal’s solution isn’t to extend coverage to struggling families, thereby creating paying health care consumers for the hospitals; Deal’s solution is to make it easier for the hospitals to deny care to the struggling families.

Read the full article.

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Fighting Childhood Obesity

By Kentucky Health News

Many people are surprised to hear that childhood obesity is a rural phenomenon because they assume that rural kids have more access to the outdoors and physical activity. However, studies have found that there is little open public space in rural areas, often because of a lack of a strong government to provide and maintain such public spaces. They also cite research showing that fear of crime in public spaces is a reason rural families don’t use public activity areas, even though crime is least likely to occur in rural areas.

Rural children are also at increased risk of poverty compared to children in cities or suburbs, and face lower access to health care, lower levels of physical activity, lower-quality food, and limited options for transportation

Rural communities are using several school-based strategies to fight obesity. They include making sure school-bus schedules and family transportation schedules coordinate to encourage after-school activities; ensuring that schools provide gym class and recess; allowing recreational areas of school grounds to be available to the community after hours; providing alternative transportation options to students who need rides home in order to participate in after school activities; improving school meals to include more whole grains, fruits and vegetables; and improving the choices available in soda and vending machines.

Engaging programs and groups that are already in existence, such as 4-H Youth Development and telemedicine programs that focus on childhood obesity intervention, are great places to start when initiating childhood obesity programs, the authors write. Having local farmers teach gardening skills can also improve access to healthy food.

Read the full article.

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Mark Your Calendar

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

March 12: Keep Kids Away from Tractors - webinar
March 19: Neonatal Abstinence Syndrome - webinar
March 30-April 1: Adding Value through Sustainable Telehealth - Fredericksburg
April 10-11: Reduce Tobacco Use Conference - Arlington
April 22: NRHA's Rural Medical Educator's conference - Las Vegas, NV
April 22-25: NRHA's Annual Conference - Las Vegas, NV
April 22-24: National Rx Drug Abuse Summit - Atlanta, GA
May 12-16: Behavioral Health and Integration Training Institute - Radford
May 21: Project REVIVE! - webinar

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Oral health and overall health 
Current information on how oral health is connected to overall health and well-being. 
Early Detection of Diabetes in Dental Setting 
Effective Communication with Seniors 
Omega-3 and Oral Health 

MLN Connects ™ Provider e-News
- February 13
- February 20
- February 27
- March 6

Low Vision Education Program
Resources that provide people living with low vision and their loved ones information about the benefits of vision rehabilitation and services and devices can help them live independently and maintain their quality of life

National Eye Institute Website
NEI has launched new options as part of its online knowledge base. In addition to being able to search for answers to your eye health questions, you can submit an inquiry or provide feedback. You also can choose to share an answer via social media, print it, or e-mail it to someone else. NEI added these self-service options to help visitors easily interact with NEI and improve their online experience. The knowledge base includes more than 300 answers to the most frequently asked questions (FAQ) NEI receives from the public.

Health Insurance and Your Eyes
Free fact sheets and information about health insurance, Medicare benefits, the Affordable Care Act, and eye care.

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Funding Opportunities

Game-Changer Award
Do you have a winning strategy for employee health? The Game-Changer Award in Employee Health will recognize one Virginia organization that has implemented an employee health strategy that demonstrates excellence in: employee engagement, organizational culture, community connections. After selection by a panel of judges, the winning organization will be announced during a special reception at the 2014 Virginia Health Care Conference & Health Innovation Showcase, on Wednesday, June 4, 2014 at the Greater Richmond Convention Center.
The winning organization will: 1) Be featured on the Virginia Health Innovation Network, an online community with over 700 members representing business, health care, higher education, government, consumers and philanthropic organizations; 2) Have the opportunity to provide a $5,000 cash gift to a community non-profit partner mutually agreed upon by the winning organization and Game-Changer sponsor.

Rural Health Outreach Grant
MultiPlan, Inc., the nation’s oldest and largest independent PPO network, is accepting applications for its 2014 Rural Health Outreach Grant. The program, now in its 19th year, awards hospitals serving rural areas financial grants to help them introduce or expand services, education, screenings and other endeavors aimed at improving the health of people in their communities. This year, MultiPlan will award four grants of $7,500 each through the Rural Health Outreach Grant.

ING Run For Something Better School Awards Program
The ING Run For Something Better School Awards Program, in partnership with the American Alliance for Health, Physical Education, Recreation and Dance (AAHPERD), seeks to increase physical activity in students and help fight childhood obesity nationwide through the creation of school-based running programs. The awards program will provide at least sixty grants of $3,500 to elementary or middle schools that want to establish a school-based running program, or expand an existing program. Funded programs must have a commitment of at least 25 students in order to apply and be offered for at least eight weeks. The application deadline is May 15, 2014.

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