VRHA Weekly Update
In this Issue March 17-23, 2014

Virginia News National News Mark your calendar
Funding Opportunities



March newsletter




Work at Home!

The Virginia General Assembly adjourned for the session without passing a budget or dealing with the question of Medicaid expansion.  They will reconvene on Monday, March 24, for a Special Session on the budget and Medicaid expansion.  The Senate is holding to their plan to expand coverage to hundreds of thousands of Virginians through Marketplace Virginia, while the House is continuing to refuse to budge on their opposition to Medicaid expansion.


All of this means that for the next week we have a great opportunity to voice support and the need for expansion in our home cities, towns, and counties!  Our state Delegates and Senators will be home from Richmond and NEED to hear from local constituents who want Medicaid expanded to cover hundreds of thousands of Virginians who currently lack health insurance coverage. 

There are MANY ways to do this:

  • Write Letters to the Editors: in your local newspapers; your state Delegate and Senator will be in the area and paying attention to local media!
  • Make a call: contact your local GA offices and tell them about the importance of Medicaid Expansion.  And ask your friends and neighbors to call too.
  • Organize a Media Conference or Event:  Invite local media to your facility and tell them how Medicaid Expansion would help the people you serve.
  • Attend a Town hall or Tele-town hall:  There may be some town hall meetings in local districts in the next two weeks, or “meetings” where you get a call from a member connecting you to their tele-town hall.    Raise questions about expanding Medicaid expansion at every opportunity you get!
  • Ask your local government officials to sign on in support:  Just last week, seven cities in South Hampton Roads and the Peninsula had mayors send a letter to the General Assembly asking them to pass Medicaid expansion!
  • Get representatives of your local hospital, your local Chamber of Commerce, and your health care providers to add their voices to the growing chorus for Medicaid expansion.  Most hospitals and business people are saying they are for it!
  • Pass out flyers to everyone you know, asking them to call your state Delegate and Senator. 

Please contact VRHA if you would like any assistance with the above activities.

Check out VRHA's Action Alert for talking points on Medicaid Expansion. Additional information can be found from Healthcare for All Virginians and Virginia Organizing.

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Members in the News

By [VRHA member] Roderick V. Manifold - Daily Progress

For the past 28 years, I have had the great honor of serving the patients of Central Virginia Health Services. Over the years, Virginia’s health care environment has changed significantly. We are now at the crossroads of another significant change with possible Medicaid expansion.

I have spent a great deal of my professional life advocating for our patients, particularly our uninsured patients: those who are often overlooked and feel as though they don’t have a voice. A vast majority of these patients could benefit from the Medicaid expansion. These are folks who are in working families, but in low-income jobs that do not provide insurance, or who can’t afford insurance through the federal health-care exchange or their employer.

Read the full editorial.

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Webinar Series

VRHA's Spring webinar series will begin this week:

Neonatal Abstinence Syndrome (NAS) - 2pm March 19  Click here to register
This webcast will increase awareness of prescription drug abuse and its relationship to Neonatal Abstinence Syndrome (NAS) within the healthcare community. We will present data characterizing the prescription drug abuse problem in Virginia, including the rate of death by poisoning, rate of hospitalization due to drugs of abuse, and NAS rate, based on Virginia death certificate and hospital discharge data. We will also discuss effective prevention strategies that can be used to address NAS. Participants will have the opportunity to ask questions and participate in discussion.

Improving Health Care for Veterans Begins With You - 10am May 7 Click here to register
Veterans live in every community in our country, with many of them returning home to rural areas after their military service. Veterans in rural areas access health care through a variety of providers and agencies. It is important as a health care provider to be knowledgeable about Veterans issues and resources available. Veterans face different health care concerns, such as Agent Orange exposure, Traumatic Brain Injury, Post Traumatic Stress Disorder and many times have a propensity for other illnesses. This webinar will review common concerns that Veterans have and will provide you with screening tools to use when providing care to Veterans. It will also provide basic information about Veterans benefits and review existing resources.

Project REVIVE!  - 2pm May 21  Click here to register
Virginia has been severely impacted by opiate abuse, particularly the abuse of the prescription drugs. In 2011, 394 citizens died as the result of misuse of fentanyl, methadone, hydrocodone, and/or oxycodone, an increase of more than 20% (20.85%) since these data were first tracked by the Office of the Chief Medical Examiner in 2006. The deaths related to all opioids, including heroin, are even higher. In 2011, for the first time ever, drug-related deaths happened at a higher per capital level than motor vehicle crashes (9.6 deaths per 100,000 for drug-related deaths versus 9.4 deaths per 100,000 for motor vehicle crashes).

Lay rescuers who are participating in REVIVE! will receive comprehensive training on recognizing overdose, administering naloxone, and encouraging the individual to seek treatment for their drug use. Individuals will be prepared for the possibility of withdrawal symptoms, and will understand the need to stay with the victim until First Responders arrive. Most importantly, lay rescuers will understand that calling 911 is a vital and necessary part of responding to an individual who is experiencing an opioid overdose.

Visit the webinar page for additional information about these and other webinars presented by VRHA

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Virginia News

Un-Risky Business

By the Commonwealth Institute

Virginia has little to fear – and much to gain – by accepting federal money to provide health coverage to as many as 400,000 residents without insurance, given the safeguards state lawmakers have already built in and historically stable federal health care funding for states.

Despite the unfounded fears being stoked by some opponents, closing the coverage gap will actually save the commonwealth more than $600 million over the next eight years. That’s because the new federal funding will allow Virginia to pay for a large number of health care services currently paid for with state funds.

Read the full article and related reports. A variety of articles and editorials have been published on this topic recently in the Washington Post, Roanoke Times, and Richmond Times-Dispatch.

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Inspector General Quits

By Julian Walker - Virginian-Pilot

State Sen. Creigh Deeds reacted with dismay Tuesday to news that the state investigator probing the circumstances preceding his son's death has resigned. In his resignation letter, G. Douglas Bevelacqua said he was quitting because of officials meddling with his work.

"It would be a grave disappointment to me if the investigation were sanitized," Deeds told reporters during a brief interview, in which he complimented Bevelacqua.

Since 2010, Bevelacqua had served as inspector general for behavioral health and developmental services, a unit of state government now under the Office of the State Inspector General.

Read the full article, a related article Richmond Times-Dispatch and the full letter of resignation.

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EMS Demand

By Katrina Koerting - News & Advance

Tones rang out on a recent morning announcing three simultaneous emergency medical services calls in Campbell County.

A mixture of paid and volunteer EMS crews responded, illustrating the current emergency services environment throughout Virginia — and the reason Campbell County is adding another career EMS crew, or a crew that is paid to offer emergency medical care.

Mandy Lundy, a career Advanced Life Support firefighter for Campbell, said EMS crews will often respond to calls back to back without returning to the station. The number of daily calls varies, but Lundy said it’s rare for the county’s three career crews to not all be on the road during the day, when it is more difficult for volunteers to answer calls.

Read the full article.

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National News

Rural March Madness

By Erin Mahn - National Rural Health Association

The end of March brings the expiration of the Sustainable Growth Rate (SGR) moratorium, as well as expiration of important Medicare payments (including Medicare Dependent Hospitals and the Low Volume Hospital adjustment). This means only two weeks remain until rural providers lose hundreds of millions of dollars.

Members of Congress will be back in their states next week and they need to hear from you. Contact your member of Congress, attend a town hall meeting and invite them to your facility.

NRHA is working hard to ensure Congress passes a permanent repeal of the SGR and the permanent extension of critical Medicare programs without any “pay-fors” that harm rural providers. Cuts to Critical Access Hospitals and other rural providers would be devastating for the rural health safety net.

Read the full article.

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The President's Budget

By David Lee - National Rural Health Association

President Obama's budget proposal, released March 4th, continues to be a source of concern for many rural health providers.  While the non-binding budget proposal is unlikely to be adopted by Congress, the President again proposes cuts to the Critical Access Hospital (CAH) system and other members of the rural health safety net.  As in years past, the President's proposal suggests cutting all CAH reimbursement from 101% of cost to 100% while completely excluding current CAHs that are within 10 miles of another health care facility, regardless of the care that other facility offers or who it is intended to serve.  Additionally, the budget proposal calls for additional cuts to bad debt reimbursement for all providers.  Even discretionary programs designed to help CAHs are being cut; the Rural Health Flexibility Grant line is cut by 15 million dollars.

The President's proposal is not all bad, though.  As part of an effort to expand access to primary care providers, the President has proposed a significant investment in the National Health Service Corps (NHSC). In addition to nearly 310 million dollars in mandatory funding for the NHSC enacted as part of the Affordable Care Act (ACA), the budget asks for an additional 100 million dollars in FY 2015 to train more primary care providers to serve newly insured populations throughout rural America. Similarly, the Teaching Health Center program would continue to receive significant funding, as mandated by the ACA.

While NRHA is appreciative of this funding, a number of other programs are targeted for cuts in the President's budget.  Area Health Education Centers would see their federal funding completely eliminated. A grant program designed to help rural communities acquire emergency medical devices would also be left without funds.  Taken in concert with the cuts proposed to CAHs, these sections of the President' budget would severely damage the rural health safety net.  NRHA will continue our efforts to ensure that these cuts are not enacted while working with the Administration and Congress to adequately train and retain a quality workforce in rural America.  

National Rural Health Association

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CAH Designations

By Kelsey Ryan - The Wichita Eagle

In rural areas, small town hospitals can be a lifeline. But leaders at rural hospitals across the state are concerned about a report released by the Department of Health and Human Services last fall that suggests the federal government re-evaluate how those hospitals are designated for purposes of Medicare reimbursements.

“I don’t think there’s any question that it would send some of those hospitals over the edge,” said Tom Bell, president and CEO of the Topeka-based Kansas Hospital Association.

“They’re fragile right now, and in addition to this issue kind of looking over their shoulder there are so many regulatory burdens. ... They’re trying to deal with the very specific day-to-day concerns that are created by these regulations and at the same time in the background is this looming report that threatens their entire existence.”

A change in designations could affect how much the 1,300 critical access hospitals nationwide receive in reimbursements – part of the federal government’s effort to contain the growth of Medicare.

Read the full article.

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Small Hospital Decisions

By Philip Betbeze - HealthLeaders Media

Seeking a strategic path for a healthcare organization amid historic levels of disruption can be exhilarating, but small systems and standalone hospitals are essentially betting their institutional lives on the changes they're making.

Mike Phelps is not shy about adapting to a rapidly changing healthcare business model under which healthcare organizations' success—or lack thereof—is less a function of their ability to attract referrals and patients and more a function of their ability to deliver better outcomes and, critically, better value.

Despite his willingness to change, he knows that as the chief operating officer for Ridgeview Medical Center and Ridgeview Clinics in Waconia, Minn.—a relatively small organization with an 85-staffed-bed hospital, several clinics, and about 1,700 employees—the strategic shifting required to adapt to a new measurement regime in healthcare is inherently more risky for him and for leaders of other small or standalone systems than for those with bigger war chests. By changing too fast or too much, are organizations like his essentially making life-or-death decisions?

They are, he says, but what's the alternative?

Read the full article.

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Mark Your Calendar

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

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 7: Improving Health Care for Veterans Begins With You - webinar
May 12-16: Behavioral Health and Integration Training Institute - Radford
May 21: Project REVIVE! - webinar

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Virginia Cancer Plan
The five-year Virginia Cancer Plan, 2013-2017 by nonprofit Cancer Action Coalition of Virginia, sets goals and strategies for the early detection and treatment of the disease, along with reducing preventable cancers throughout the state.

VFHY Report
The Virginia Foundation for Healthy Youth (VFHY) has released its FY 2013 annual report, outlining VFHY's latest initiatives to reduce and prevent youth tobacco use and childhood obesity across Virginia.

Merck Connect
A library of free webinars on a wide variety of topics, including: Transitioning Your Practice to the Patient-Centered Medical Home, Building Partnerships to Improve Health Care Quality, Improving Transitions of Care, Office-Based Diabetes Education and many more.

Mental Illness Levels
A new report by the Substance Abuse and Mental Health Services Administration (SAMHSA) provides an overview of the nature and scope of mental illness within each state and the District of Columbia.


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Funding Opportunities

2014 STEM Essay Contest
The Virginia Council on Women in collaboration with the Science Museum of Virginia is pleased to present the 2014 STEM Essay Contest.  The purpose of the Council on Women (Council) is to help women reach their potential and maximize their contribution to society and the Commonwealth as wage earners and citizens. The Council has initiated several projects to meet this goal, one being the annual essay contest for young women in high school. We believe opportunities offered to women early in life will help lead to their success as productive and resourceful citizens.

The awardee will receive a $5,000 scholarship to an institution of higher education provided through the fundraising efforts of the Council.  Other smaller scholarships may be awarded at the discretion of the Council. The winning essay will be selected by a panel of judges who have degrees in or background in STEM fields; along with members of the Council.

Farm To School
he purpose of the USDA Farm to School Grant Program is to assist eligible entities in implementing farm to school programs that improve access to local foods in eligible schools. On an annual basis, USDA awards up to $5 million in competitive grants for training, supporting operations, planning, purchasing equipment, developing school gardens, developing partnerships, and implementing farm to school programs.

Proposals for planning, implementation, and support service grants are due at 11:59 p.m. Eastern Time, April 30, 2014. A 25% cash or in-kind match of the total project cost is required. Letters of Intent for Conference/Event grants are due at 11:59 p.m. Eastern Time, April 2, 2014.

National Health Service Corps
The deadline for the 2014 NHSC Loan Repayment Program has been extended to Monday, March 24, 2014 at 7:30 pm ET.  Applicants may log into the Customer Service Portal and follow the steps to submit their completed application.  Please refer applicants to the 2014 Application and Program Guidance to review program requirements and encourage them to visit the application checklist on the NHSC website.  Additional questions can be addressed to the Customer Care Center at 1-800-221-9393.

Citizens' Institute on Rural Design
The Citizens' Institute on Rural Design (CIRD) provides rural communities throughout the United States access to the resources they need to convert their own good ideas into reality. CIRD offers annual competitive funding to as many as four small towns or rural communities to host an intensive, two-and-a-half day community workshop. CIRD’s contribution includes a $7,000 stipend and in-kind technical assistance and design expertise valued at $35,000. Support is provided for rural communities with a population of 50,000 or less. The application deadline is May 6, 2014.

State Farm Youth Advisory Board National Grant Program
The State Farm Youth Advisory Board is composed of young adults who demonstrate exemplary work in service-learning, volunteering, and philanthropy in their communities. The Youth Advisory Board National Grant Program funds student-led service-learning projects throughout the United States and in the provinces of Alberta, New Brunswick, and Ontario in Canada. Grant requests must fall under one of the following issue areas: community safety and natural disaster preparedness, environmental responsibility, accessing higher education/closing the achievement gap, social health and wellness issues, financial literacy and economic inclusion, or arts and culture. Public K-12, charter, and higher education institutions are eligible to apply. Nonprofit organizations are also eligible if they are able to demonstrate how they plan to interact with students in public K-12 schools. Grants range from $25,000 to $100,000. Applications must be submitted online by May 2, 2014.

WellPoint Foundation
The WellPoint Foundation promotes the company's commitment to enhance the health and well-being of individuals and families in communities that WellPoint serves in 25 states. The Foundation seeks to promote healthy behaviors, health-risk prevention, and healthy environments by supporting public health-related issues that impact key health conditions and systems. The focus is on organizations that commit to increase access to healthcare, keep healthcare quality high, and reduce costs associated with quality care. Nonprofit organizations that serve company communities are eligible to apply. The application deadlines for 2014 are May 9 and September 12.

Department of Agriculture 
The Agriculture and Food Research Initiative’s Childhood Obesity Prevention program supports efforts to reduce the prevalence of overweight and obesity among children and adolescents, ages 2-19. Letters of intent are due April 17, 2014. The application deadline is June 19, 2014.

Department of Labor 
The YouthBuild program offers support to provide education, occupational skills training, and employment services to disadvantaged youth as they perform meaningful work and service to their communities. The application deadline is April 22, 2014.

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