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Winter 2008 Edition now available

Governor Timothy Kaine will begin a series of statewide town hall meetings on Monday, March 10 through the reconvened session, to discuss the budget and legislation passed during the 2008 General Assembly Session and take questions from the public. No sign-in is required to attend or ask questions. All town hall meetings are open to the public and media.

VRHA would like to encourage its members to use this opportunity to discuss any issue with the Governor, including rural health. The meeting schedule is:

VTN Updates

By Jim Hall - Fredericksburg Free Lance-Star

Edna Manning's feet were swollen and discolored, and Isabelle Amann, a nurse practitioner, was having trouble finding a pulse.Amann spread gel on the top of Manning's feet and used a hand-held device, a Doppler, to listen for a pulse. Soon, the machine was beeping rhythmically.

"There you are," Amann said. "Hear it?" Manning, 72, is a patient at Fredericksburg Primary Care, the office of Dr. Joseph Ferguson. She has been receiving care there for a variety of problems, including heart disease and diabetes.This visit was a follow-up to an earlier one when her blood pressure was below normal.

Her son, Greg Manning, was with her. This time Manning's blood pressure was fine, and Amann pronounced her blood sugar "perfect" after a finger stick.

Manning's visit illustrates the care offered by advanced-practice nurses like Amann: They diagnose, treat, prescribe medications, and provide counseling and education.

The visit also symbolizes what has become a daily occurrence in the Fredericksburg area. Today there are at least 93 nurse practitioners in the region, working in family practice and internal medicine offices, but also in specialty areas such as pediatrics, oncology, surgery, geriatrics, women's health and hospice care. Chances are that if a patient has been treated at a local clinic, hospital or doctor's office, a nurse practitioner provided some of the care.

Read the full article.

By Karen Bolipata - Fredericksburg Free Lance-Star

In past years, Germanna Community College admitted 100 students into its nursing program. Now, it will be accepting 80 at the most. Jane Ingalls, the college's director of nursing and allied health programs, said there simply isn't enough qualified faculty to teach more students.

To keep its accreditation from the National League for Nursing Accrediting Commission, at least 75 percent of Germanna's faculty must hold master's degrees in the science of nursing, Ingalls said. Currently, the program's 12 full-time faculty members have master's degrees. In total, 25 to 30 full-time and part-time members make up the staff. The 500 pre-nursing students will have to endure a competitive selection process to be admitted.

"We've got all these people in the pipeline but we don't have the faculty to teach them," Ingalls said. "They have potential to do it, but we can't."

What's happening is not unique to Germanna. Across the country, nursing schools are struggling to serve potential students because of the difficulty of finding nursing faculty.

Read the full article.

By Candi Helseth - Rural Assistance Center

Disparities in health care insurance coverage contribute to increased financial vulnerability for people living in rural areas. Rural people are more likely to be insured through the non-group market and consequently pay higher premiums on policies with higher deductibles. They are also more likely to have fewer benefits and spend higher percentages of their income on health care than those with employer-sponsored coverage, according to Dr. Alana Knudson, the associate director for research at the Center for Rural Health at the University of North Dakota, School of Medicine and Health Sciences.

Knudson recently co-authored the 2007 Health Insurance Survey of Farm and Ranch Operators, which looked at health coverage issues for farm families in seven Great Plains states. Data from the survey, which was conducted by the Center for Rural Health in collaboration with Brandeis University and The Access Project, will be shared with state and federal policymakers to help inform them on how to improve farmers’ access to insurance.

Important Information for Medicare FFS Providers

Effective March 1, 2008, all 837P and CMS-1500 claims must have an NPI or NPI/legacy pair in the required primary provider fields.  Failure to include an NPI will cause the claim to reject!

Background
One of the Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA, Title II) required the Department of Health and Human Services (HHS) to establish unique national identifiers for providers. The purpose of these provisions is to improve the efficiency and effectiveness of the electronic transmission of health information. 

Providers must use this information when they submit their claims to Medicare carriers, A/B Medicare Administrative Carriers (MACs), and DME MACs when they use certain electronic and paper Medicare claims (specifically the X12N 837P electronic claim and the CMS-1500 paper claims). 

CMS is anticipating that some providers will experience some problems with claims submitted after March 1 – problems could arise in the following situations:

• The provider does not have an NPI
• The provider does not submit their NPI on their claim
• The provider has already received an NPI, but the NPI is not consistent with the provider’s enrollment information received by the contractor. 

Providers whose claims are rejected and returned to them should immediately contact their contractor before resubmitting that claim or submitting new claims for services provided to Medicare beneficiaries.  Contact information for the Medicare contractors can be found at www.cms.hhs.gov/MLNGenInfo/ - scroll to 'Downloads.'  The file is named, 'Provider Call Center Toll-Free Numbers Directory.'

Click here to read the full article.

NRHA testifies on the future of a rural health workforce before the Senate HELP Committee

On Feb. 12, Beth Landon testified on behalf of the NRHA before the Senate Health, Education, Labor and Pensions Committee in a hearing regarding the health care workforce. Landon, NRHA president-elect and director of the Alaska Center for Rural Health, focused her testimony on her experience in Area Health Education Centers. Alaska’s workforce challenge is similar to that of other rural areas but is exacerbated by the sheer size and geography of the state and smaller population. Despite an area larger than the combined sizes of California, Texas and Montana, Alaska has fewer miles of road than any other state, which means residents simply do not have the option of traveling to another community for care if their own does not have the needed health care providers.

Landon emphasized the importance of the Title VII and VIII programs of the Public Health Service Act and the National Health Service Corps, as these programs can help rural areas to "grow their own workforce." The testimony also included a suggestion for Congress on how to avert a nationwide health care workforce crisis. 

To read the full testimony click here.

Mark your calendar

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

March 18: The Difference Between Urban and Rural Shortage Issues - Webinar
March 19: Supporting Rural Family Caregivers - Satellite & Phone
March 24-28: 24th Annual HPR III Training Institute - Roanoke
March 28-30: Women's Health 2008: The 16th Annual Congress - Williamsburg
April 3-4: 2nd Annual Palliative Care Conference - Wythville
April 27-29: 12th Annual Virginia Faith Community Health Ministry Retreat - Toano
May 7-10: NHRA's Annual Conference - New Orleans, LA
June 25: Retention in Times of Exponential Change - Web conference

Job Announcements

For more information other positions, visit http://www.vrha.org/index/jobs.html

Position Vacancy - Site Director, Virginia Local Performance Site of the PA/MAAETC

Description:  To provide leadership in the coordination, planning, and implementation of HIV Education and Prevention training programs in accordance with the goals and objectives specified in the PA/MAAETC grant. To ensure that education programs, technical assistance, capacity building activities, and consultation are provided for the appropriate target audiences identifies by the PA/MAAETC grant located throughout the Commonwealth of Virginia. To serve as a liaison and foster collaboration among health care educators, clinicians at infectious disease clinics throughout the state, the Virginia Department of Health Resource and Consultation Centers, community based minority organizations, Historical Black Colleges and Universities, the VCU HIV/AIDS Center and the Virginia Local Performance Site of the Mid-Atlantic AIDS Education and Training Center. To provide key input in the strategic planning and oversight of the educational mission of the VCU HIV/AIDS Center. To coordinate PA/MAAETC grant activities at VCU, in addition to monitoring the quality assurance and fiscal contracts of the central office of PA/MAAETC and federal agencies.  

Qualifications:  Special licenses, registration or certification: Licensed as Registered Nurse in Virginia required. Certification as AIDS Certified Registered Nurse (ACRN) preferred. Valid VA Drivers License required.

Education or training:  Prefer Bachelors or graduate degree in Nursing (B.S.N., M.S.N., Ph.D.) or Masters of Public Health (M.P.H.).

Level and type of experience: Some years of experience in adult education and/or program development. Experience working with federal and state funded grants and contracts. Some years of clinical nursing experience or minimum of some years of experience working in the field of HIV/AIDS required.

Open immediately, Pay Rage $55,000-$70,000
Click here for more information or contact Donna Cantrell

Funding Opportunities

Seed Money for Health Care Projects

Robert Wood Johnson Foundation: Local Funding Partnerships
Local Funding Partnerships (LFP), a collaborative program of the Robert Wood Johnson Foundation and local grantmakers, supports innovative, community-based projects throughout the United States that aim to improve health care for vulnerable populations.

Through LFP, a local grantmaker proposes a funding partnership with the Foundation to provide seed money for a new project that addresses the health or health care problems of people who are not reached by traditional health and social services or for whom existing services are insufficient.

LFP provides grants of $200,000 to $500,000 per project, which must be matched dollar for dollar by local grantmakers such as community foundations, family foundations, corporate grantmakers, etc. Brief proposals are due July 8, 2008.

Visit the website for program details and online application information.