VRHA Weekly Update
In this Issue March 24-30, 2014

Virginia News National News Mark your calendar
Funding Opportunities


National Health Service Corps

March Newsletter




Keep It Up!

The Governor has called a special session for this week.  The legislators will return to Richmond to try to complete work on the budget and make a decision about closing the coverage gap. The Senate Finance committee has proposed "Marketplace Virginia" as a viable option for closing the gap.
We have all been working hard to keep pressure on legislators (especially Delegates) to find a solution to the current impasse. All VRHA members should be working to distribute information and inform legislators about the importance and urgency of closing the coverage gap for hundreds of thousands of uninsured Virginians - and the importance/urgency of bringing Virginia's tax dollars back to the Commonwealth to support health coverage and Virginia's economy.

VRHA contacted the office of Del. Cox regarding his statement that people do not die from lack of health insurance and received this reply.

Keep up the pressure! Even if you have done so before - contact your GA member today!

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Members in the News

By Michael Sluss - The Roanoke Times

Gov. Terry McAuliffe brought his campaign for Medicaid expansion to the New River Valley on Tuesday, arguing that the state has a moral and social obligation to accept federal funds to extend health coverage to hundreds of thousands of low-income, uninsured Virginians.

[VRHA member] New River health center recently transitioned from a free clinic model to a center that serves people with Medicaid and Medicare coverage and uninsured patients who pay for services on a sliding scale. “I think if you talk to our staff, who talk to that 75 percent of our patients who cannot get Medicaid, that that is what they would like to do — they want to be insured,” said Michelle Brauns, the center’s CEO. “Our patients want to have some skin in this game. They don’t like to get free care.”

Read the full article and related video from WBDJ7.

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Deadline Approaching

REMINDER - deadline is April 1

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

Why Healthcare?

By Senator Walter A. Stosch, 12th Senate District, Co-Chairman, Senate Finance Committee

There are calls to de-couple the budget and the issues surrounding healthcare in the budget debate. Let me share my perspective.

The Affordable Care Act (ACA), otherwise known as Obamacare, is tearing our country apart. 56% of the public is now opposed to the ill-conceived and equally ineptly implemented ACA. The Republicans are especially divided on how to best respond nationally and in the states.

But, despite my personal opposition to the entire plan, it is the law of the land. That decision was made when my preferred presidential candidate failed to be elected. So, if we now do not have the votes in Washington to repeal it or defund it, at least during the remainder of President Obama's term, how can we make the best of a bad situation?

Read the full editorial and related articles in the Roanoke Times, Washington Post, Richmond Times-Dispatch, News Virginian, GoDanRiver.com, and ABC7.

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Mental Health Compromise

By Julian Walker - The Virginian-Pilot

Virginia lawmakers have reached compromise on reforming mental health policies that satisfies the state senator whose personal tragedy inspired this round of revision to state psychiatric protocols.

The negotiated deal extends emergency custody orders to 12 hours -- the current maximum is six-hours -- and requires state hospitals to take patients after eight hours if another bed isn't found. Sen. Creigh Deeds hopes that means people in psychiatric crisis will no longer be discharged, or streeted, when they need treatment.

Read the full article and related articles in the Washington Post.

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Healthy Air

By Laura Kate Anderson Bender - American Lung Association

Last month, Healthy Air Campaign staff traveled to Southwest Virginia to capture on camera the stories of people whose lives have been impacted by air pollution.

It’s ready! Check out our brand new video, “Southwest Virginians Support Healthy Air”: http://bit.ly/OvSCen

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National News

Support the Extenders

By Erin Mahn - National Rural Health Association

S. 2110, the Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 will likely come to the Senate Floor next week.  This bill, introduced by Senate Finance chairman Ron Wyden late last week, is modified from previous Senate legislation but is similar to a strong rural bill that was reported out of the Senate Finance committee last December.  S. 2110 contains a permanent fix to the SGR and includes all rural Medicare extenders (the Work geographic adjustment, Medicare payment for therapy services, Medicare ambulance services, the Medicare Dependent Hospital program and the Low Volume Hospital adjustment) and make all but the ambulance provisions permanent.

NRHA requests you contact your Senators and urge them to support legislation that contains permanent extension of critical rural health Medicare funding; and not “pay-for” the SGR fix out of the pocket of rural providers.  For more information visit our Congressional Action Kit.

Read the full article.

National Rural Health Association

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Rural vs. DC

By Tim Size - Tomah Journal

The threats we face fall into two buckets, one from Congress and one from the administration.

All rural and urban hospitals are at risk for ongoing Congressional cuts related to health reform and the federal budget deficit. Our message is the same as the Wisconsin Hospitals Issue Advocacy Council: “Enough is Enough.” We, along with the council, know that “we have some of the best hospitals in America. Study after study shows our hospitals are tops in quality of care and creating value … but in Washington, they keep cutting Medicare payments to hospitals —across-the-board cuts that hurt leaders like Wisconsin the most.”

The second bucket is unique to rural and effects rural hospitals nation-wide. And it feels a lot more personal. It comes not from Congress but from the Federal Department of Health & Human Services and in particular the Centers for Medicare and Medicaid Services. Rural hospitals feel under siege, and unlike most urban hospitals, believe that there is a deliberate campaign by the federal government to drive them out of business.

Read the full article.

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No ICD-10 Delay

By Lena J. Weiner - HealthLeaders Media

CMS Administrator Marilyn Tavenner has announced that the ICD-10 deadline will not be delayed, but she is offering relief to providers, payers, and health information technology vendors struggling to meet Meaningful Use Stage 2 requirements. Two announcements from Centers for Medicare & Medicaid Services Administrator Marilyn Tavenner will have wide-ranging implications for healthcare providers, insurers, and vendors.

The deadline for implementing the ICD-10 diagnostic coding set, which had already been delayed one year to October 1, 2014, will not be delayed again, Tavenner said. And while the Stage 2 Meaningful Use deadline will also not be delayed, Tavenner said that providers and vendors struggling to meet the incentive program's requirements will see some flexibility.

Read the full article.

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Transforming Rural Care

By Mike Miliard - Healthcare IT News

In sparsely populated areas, where 46.2 million Americans live, things are very different from the cities where most health policy is developed. The provider base is different, with a bigger focus on primary care. The payer mix is different, with a heavier reliance on Medicare and Medicaid. Technology infrastructure is more limited. Small hospitals struggle with regulatory burdens, even as they're stretched thin dealing with more prevalent chronic disease. And, of course, geography – with vast open spaces between care facilities – poses huge challenges for patients and providers alike.

"Meaningful use is a means to an end," said said Judy Murphy, RN, deputy national coordinator for programs and policy at the Office of the National Coordinator for Health IT. And with $21 billion in incentives doled out so far, that goal of improved outcomes gets closer each day.

Rural physicians are participating in MU at roughly the same rate as the national average, and while hospitals are lagging a bit behind the overall trend, more than 60 percent of critical access facilities – more than 1,000 of them – have achieved meaningful use, fast exceeding an "all-hands-on-deck" challenge issued by ONC in 2012. Even better, there's been an improvement in rural technical infrastructure and, crucially, an increase in the knowledge base of the people putting it to work toward better care.

Read the full article.

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Mark Your Calendar

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

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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Evidence-Based Resources from AHRQ
The Agency for Healthcare Research and Quality (AHRQ) offers free evidence-based research summaries that help health care professionals, patients, and caregivers learn about treatment options for a wide variety of health conditions. Brief, plain-language summaries developed by AHRQ’s Effective Health Care (EHC) Program highlight findings of research reviews that compare the effectiveness, benefits, and risks of treatment options for many common conditions. Summaries for patients help them and their caregivers learn about their condition and treatment options; while summaries for health care professionals provide key findings in a “Clinical Bottom Line” chart. Visit www.ahrq.gov/clinicalbottomline for clinician resources and www.ahrq.gov/treatmentoptions for patient and caregiver resources. To order free printed copies, call the AHRQ Publications Clearinghouse at 800–358–9295 and use code C-02.

New Rural Mental Health and Substance Abuse Toolkit Launched
The Rural Assistance Center (RAC), the University of Minnesota Rural Health Research Center, and the NORC Walsh Center for Rural Health Analysis, today launched the new Rural Mental Health and Substance Abuse Toolkit. This toolkit is designed to help rural communities and organizations develop and implement programs that meet the targeted mental health needs of communities based on proven approaches and strategies. The toolkit is available for free on the RAC website.

The Rural Mental Health and Substance Abuse Toolkit contains eight modules with information and links to resources, websites, publications, and tools. The toolkit includes:an overview on mental health issues in rural areas; program model examples; guidance on implementation, evaluation methods, and more.

Development of the Nursing Community Apgar Questionnaire (NCAQ): A Rural Nurse Recruitment and Retention Tool
Offers a guide to assess strengths and weaknesses of critical access hospitals (CAHs) in rural communities to address nurse recruitment and retention.

Discharge to Swing Bed or Skilled Nursing Facility: Who Goes Where?
Examines health conditions of patients discharged from rural Prospective Payment System (PPS) hospitals and Critical Access Hospitals (CAHs) to swing beds and skilled nursing facilities (SNFs).

Map Facts: Disability in Rural America
Demonstrates with 2008 - 2012 U.S. Census data the prevalence of impairments leading to disability is significantly higher in non-metropolitan (rural) counties than in metropolitan counties.

Supporting Iowa Rural Provider Capacity Through Community Care Coordination Teams
Provides an overview of a collaborative effort between Medicaid and safety net providers in establishing a community care coordination team pilot in Iowa to demonstrate success for implementation in other states. These types of collaborations are growing in popularity to build provider capacity, especially in small and rural communities.

Uninsured: An Analysis by Age, Income, and Geography
Analyzes 2010 health insurance data showing the proportion of the rural population that is uninsured and living below 138% of federal poverty level in comparison with that of the urban population.

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Funding Opportunities

Black Lung Clinics Grant Program (BLCGP)
Application deadline: Mar 28, 2014
Awards grants to state, public or private entities for screenings, diagnosis and treatment services to active, inactive, disabled, and retired coal miners. Programs must also seek to increase care coordination.

National Center of Excellence for the Prevention of Childhood Agricultural Injury (U54)
Application deadline: May 2, 2014
Awards funding to operate a National Center of Excellence that would work to prevent childhood agricultural injury through outreach, education, networking, training, prevention, intervention, and research.

Oral Health 2020 Initiative
Application deadline: Applications accepted on an ongoing basis.
Awards funding to organizations to create networks, establish partnerships, and analyze policy with the goal of eliminating oral disease in children and increasing oral health across the lifespan. Proposal that address one or more of the multiple factors affecting health equity (race, ethnicity, geography, etc.) are encouraged.

National Health Service Corps (NHSC) Scholarship Program
Application cycle is now open. All completed applications must be submitted by May 15, 2014, at 7:30 p.m. ET to be considered for an award. Please refer to the Application and Program Guidance for all of the program requirements.

NURSE Corps Scholarship Program
Application cycle is now open.  All completed applications must be submitted by May 22, 2014, at 7:30 pm, ET to be considered for an award.  Please refer to the Application and Program Guidance for all of the program requirements.

CPF Eco Tech Grants
Deadline: May 31st, 2014
Funding to support schools or non-profits for engaging children in STEM (science, technology, engineering and math) projects that use innovation, nature-based design, or technology to address environmental problems in their communities.

Gene Conley Foundation Grants
Deadline: Ongoing
Funding to support organizations and programs with religious, charitable, scientific, literary or educational purposes, or for the prevention of cruelty to children or animals.

Robert Wood Johnson Foundation: Reducing Health Care Disparities through Payment and Delivery System Reform
Reducing Health Care Disparities through Payment and Delivery System Reform, an initiative of the Robert Wood Johnson Foundation, will fund up to three implementations of paired healthcare payment and delivery system changes that incorporate a focus on reducing disparities in care and/or outcomes.

ADA Foundation: Samuel D. Harris Fund for Children’s Dental Health
The American Dental Association (ADA) Foundation provides grants for sustainable programs in dental research, education, and access to care, and also provides assistance for dentists and their families in need. The Foundation’s Samuel D. Harris Fund for Children’s Dental Health provides grants of up to $5,000 to nonprofit organizations nationwide whose oral health promotion initiatives are designed to improve and maintain children’s oral health through primary prevention and education. For 2014, grant funding will be considered for community-based nonprofit organizations that offer parent/caregiver education programs to prevent early childhood caries in babies and toddlers by circumventing primary oral bacterial infection before it can take hold in the baby’s mouth. Approximately 23 grants will be provided. Applications must be received by April 11, 2014.

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