VRHA Weekly Update
In this Issue March 3-9, 2014

Virginia News National News Mark your calendar
Funding Opportunities


National Rural Health Association

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Action Alert- Part 2

Last week, VRHA asked you to contact the House members of the Budget Conference Committee. This week we encourage you to contact their Senate counterparts:

Walter A. Stosch (R-District 12)
Charles J. Colgan (D-District 29)
Janet D. Howell (D-District 32)
Thomas K. Norment, Jr. (R-District 3)
Emmett W. Hanger, Jr. (R-District 24)
John C. Watkins (R-District 10)
Richard L. Saslaw (D-District 35)        

Even though the Conference Committee will meet behind closed doors and hammer out a deal, it is more important than ever that you contact the Conferees and also your own Senator to urge them to expand Medicaid this year! 

Also, please contact your state Delegate and state Senator and let them know that Virginians CANNOT wait any longer for Medicaid to be expanded! You may wish to review Governor McAuliffe's statement on the budget proposals and the Marketplace Virginia amendment.

VRHA also encourages you to write a letter to the editor of your local paper to encourage more people to contact our legislators. 

Click here for talking points for your contacts and letters. Contact VRHA if you would like assistance in composing and submitting your letters.

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Members in the News

By Tom Sullivan - Government Health IT

Even though they are often working toward similar ends, rural health organizations face unique challenges, perhaps chief among those a lack of understanding the funding and technology options federal and state governments offer.  

“We don't rub two nickels together and find a dime very often,” said [VRHA member] Nancy Stern, CEO of Eastern Shore Rural Health System. “Sometimes we find 9 cents.”

Except when Stern found some funding to jump on, that is. “We are positioned for telemedicine,” she said because of the money, “and moving toward that.”

With a patient population divided by water and the Chesapeake Bay Bridge-Tunnel, telehealth opens a new world of care to eastern shore patients.

Read the full article.

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Virginia News

Plan for Mental Health

By Michael Sluss - Roanoke Times

Virginia could strengthen mental health services for the uninsured by enacting a plan to accept federal funds designated for Medicaid expansion, advocates said Wednesday.

As a political war of words over Medicaid expansion escalated in the state Capitol, mental health advocates held a news conference to embrace a Senate plan that would use Medicaid expansion funds to help low-income Virginians purchase private health insurance.

The so-called “Marketplace Virginia” plan would pump $1.2 billion into community mental health services over eight years and $426 million into traditional psychiatric services, advocates said.

But the Republican-dominated House of Delegates remains adamantly opposed to any form of Medicaid expansion under the Affordable Care Act, a position that GOP caucus leaders reinforced on Wednesday. Republican delegates want the issue severed from negotiations on a new state budget, and warned that Democrats and Gov. Terry McAuliffe could jeopardize other spending priorities by holding out for Medicaid expansion.

Read the full article.

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Left Behind

By The Commonwealth Institute

Military veterans and their families in Virginia are among the people who would benefit from expanding Medicaid eligibility under the Affordable Care Act, a move currently being considered by state lawmakers. More than 25,000 veterans, along with their spouses, could gain access to quality, affordable health care coverage – at little cost to the state – if lawmakers do the right thing and approve the expansion.

Contrary to what many people assume, veterans and their families often do not have automatic and easy access to Veterans Affairs (VA) health care despite their service to our country. As a result, over 1.3 million veterans lack health insurance nationally, while hundreds of thousands more only have access to VA health care and, in many cases, may live too far from a VA center to be able to conveniently and routinely get care.

Read the full article and related report.

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Telehealth Certification

By Laurie Wardle - StarTelehealth

The New College Institute (NCI) and the University of Virginia (UVA) Center for Telehealth have launched the first telehealth certification program in the state of Virginia. The new Southside Telehealth Training Academy and Resource Center (STAR) offers training for health care providers to become certified as telehealth presenters or coordinators. 

Two education tracks are offered:  one for clinicians, to help them conduct virtual encounters between patients and doctors; and one for non-clinicians, to help them manage and operate telehealth programs and equipment.

Read the full press release and download the training flyer.

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National News

Socioeconomic Policy Is Health Policy

By Wayne Myers - Rural Assistance Center

Last quarter I made the point that medical care isn’t uniquely important in improving people’s health.  More important than medical care are the conditions under which people live and the choices they make.  Unemployment remains high, particularly in rural America.  Now there’s a lot of controversy about the Supplemental Nutritional Assistance Program (“SNAP,” formerly known as food stamps) and unemployment assistance.  When wondering about policy questions, I tend to see what’s going on in the rest of the world.

One succinct report, published in 2003, has had great impact across Europe.  The report covers what its title promises, Social Determinants of Health: The Solid Facts.   It has several references to the original research for each of its points.  The review was written by Richard Wilkinson and Michael Marmot and published by the European Office of the World Health Organization.  It’s often referred to as the “Marmot Report.” 

The bottom line:  social services for low-income people and the unemployed are just as important to health as health care.  Claims that our social support programs are excessive are not justified by comparison with other developed countries.

Read the full article.

Rural Assistance Center

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Rural Dental Therapists

By Larry Dreiling - High Plains Journal

The first U.S. private practice dentist to add a dental therapist to his team was able to see a significant number of new patients, increase treatment of Medicaid patients, as well as increase profits. These findings track with similar findings of public practices in Minnesota that have added midlevel dental providers to their teams.

Specifically, Main Street Dental Care in Montevideo, Minn., increased profits by more than $16,000, handled 27 percent more patient visits, and increased new patients by 38 percent; the analysis also found that the practice increased its Medicaid patient load from 26 percent in 2011 to 39 percent in 2012.

In addition to increases in patient visits and profits, the report found that having a dental therapist on staff allowed the dentists in both practices to perform more complex procedures like crowns and bridges. In the Minnesota practice, billings for complex procedures increased 33 percent.

Read the full article.

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Rural ICU Care

By Rita Rubin - Kaiser Health News

An intensive care unit nurse in a small-town hospital on Maryland’s scenic Eastern Shore suspected that a patient had necrotizing fasciitis, the so-called “flesh-eating” disease.

The condition is rare. Even experienced intensive care doctors seldom see it, and, since it was nighttime, no such physician was in the ICU. Pinning down the diagnosis was critical—and in this case Berlin, Md.’s Atlantic General Hospital had back-up.

Atlantic General is one of Maryland eCare’s six original community hospital clients, which have a total of 72 ICU beds. By the end of the year, the program will go live in three more Eastern Shore hospitals, adding 18 more ICU beds.

Read the full article.

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Rural Lawmakers Struggle

By Steve Karnowski - Associated Press

They're an endangered species in many state legislatures as more Americans move to urban centers or suburban cities: the rural lawmaker who knows what it's like to care for a herd, plant a crop or drive on gravel roads.

Lawmakers and political experts say the dwindling numbers of farmers, ranchers and others who make their living off the land affects not just agricultural policy but other rural concerns — highways, health care, schools and high-speed Internet access. Urban and suburban lawmakers might be sympathetic, but they're often unfamiliar with particular concerns.

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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Programs for Loan Repayment and Forgiveness
A List for Rural Providers. Loan repayment/forgiveness programs can be an optimal way to attract needed healthcare professionals.  In exchange for varying levels of loan repayment/forgiveness from the federal and/or state government, providers work at an approved site in an underserved area for a certain amount of time (often subject to increase, if desired). Rural areas that are underserved are often host to sites that are approved or are able to become approved.

Virginia Navigator/Assister Dental Training Resources
The Virginia Oral Health Coalition hosted a webinar for northern Virginia navigators, assisters and others helping individuals to enroll in the Health Insurance Marketplace (or Exchange) that answers these questions and more. The webinar includes Virginia-specific information about dental benefits offered within the Exchange as well as information about why dental benefits matter in the first place. An archive of the hour-long webinar and the companion materials are now available.
Dental Coverage Fact Sheet for Exchange Enrollment (PDF)
Buying Children's Dental Coverage through the Marketplace (PDF)

Kids a Smile Toolbox 
A resource for dentists and other team members interesting in implementing the program in their community. The guide includes a step-by-step timetable on how to plan an educational, screening, or treatment event; how to promote the event to the media; and what legal issues may arise.

Barriers to Healthy Country Living: Child Obesity in Rural America, Part 1
Barriers to Healthy Country Living: Child Obesity in Rural America, Part 2
2 part article from Altarum Institute discusses how rural communities face unique challenges when it comes to childhood obesity prevention; highlights promising practices that rural communities can use to help fight childhood obesity, including working with schools, community groups, and employers on physical activity and health meal programs.

HRSA Data Warehouse
The redesigned website includes visual enhancements and improved content structure, making it easier to find data through charts, maps, and tools. The site also includes enhanced support for both desktop and mobile devices.

CMS Provider Modules
CME/CE credits on the Medscape website:
Talking with Patients about the Affordable Care Act -- Part 1: Why Insurance Matters”
Implementing the National Quality Strategy: 6 Priorities for Better Healthcare”
Helping Your Patients Navigate the Health Insurance Marketplace
Meaningful Use and Patient Encounters
ACA and CHIP: What Providers and Patients Need to Know”
Is Your Practice Ready for 2015? Assess Your EHR Preparedness”

Road to 10
Intended to help small medical practices, such as RHCs, jumpstart their ICD-10 transition.

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Funding Opportunities

2014 Migrant Health Scholarship
The purpose of the scholarships is to assist health center staff to pursue their educational goals in health care and to contribute to the development of the Community/Migrant Health Center workforce. Selection of recipients is based on demonstrated commitment to working in migrant health, choice of career path, and personal experience, with special recognition of those who have a family history as farmworkers. Application deadline: March 21

Farmworker Health Training Programs
The National Center for Farmworker Health is currently offering a limited number of complimentary or discounted trainings for your health center/organization. Take advantage of this offer and provide your staff with practical tools and strategies to implement in the workplace.

Future of Nursing Scholars Releases Call for Proposals
Proposal Deadline: April 15, 2014 (3 p.m. ET)—The goal of the Robert Wood Johnson Foundation Future of Nursing Scholars program is to develop the next generation of PhD-prepared nurse leaders who are committed to long-term leadership careers that advance science and discovery, strengthen nursing education, and bring transformational change to nursing and health care.

Build-A-Bear Workshop Bear Hugs Foundation
The Build-A-Bear Workshop Bear Hugs Foundation supports nonprofit organizations in the United States and Canada that enhance the quality of life for children, families, and pets. The Foundation’s grant categories include children's health and wellness, literacy and education, and domestic pets. The Foundation prefers to support specific programs rather than general operational requests or requests for unrestricted funding. Priority is given to nonprofit organizations located near Build-A-Bear Workshop stores. Applications will be accepted through March 31, 2014.

BJ's Charitable Foundation
BJ's Charitable Foundation is dedicated to enhancing local programs that benefit children and families in the communities served by BJ's Clubs throughout the eastern U.S. The Foundation’s grant categories include the fol1lowing: The Hunger category supports organizations that aim to alleviate hunger and feed those in need. The Self Sufficiency category targets organizations that work to prevent clients from becoming homeless, stabilizing them while they are homeless, and supporting them as they come out of homelessness, such as shelter programs and family safety programs. The Healthcare category focuses on organizations that provide healthcare to those who would not normally have access. The Education category promotes organizations that provide academic and vocational opportunities for the disadvantaged. The upcoming application deadlines are April 11 and July 11.


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