VRHA

2011 Conference

Models & Money:
Finding Solutions with Limited Resources
Dec 7 – 9, 2011
Stonewall Jackson Hotel and Conference Center
Staunton, VA

Welcome to the 2011 VRHA Annual Conference website!

The clichés are everywhere. Doing more with less, operating on a shoestring, stretching dollars, making the most of what we have, feeling the squeeze, wearing multiple hats. Whichever phrase you want to use, everyone is dealing with the results. More competition for grant funding, cuts in government funds, hiring freezes and other financial restrictions are limiting what services can be provided to those in need.

And in the current economy, the need is great. Healthcare safety net providers may have smaller budgets, but more people than ever are requesting their services. What can be done?

Models & Money: Finding Solutions with Limited Resources is the theme for the 2011 VRHA Annual Conference. Again this year, the event will focus on providing a forum for interactive discussions between participants to encourage the development of creative ideas.

The six key focus areas from the 2010 conference will return in 2011:

Aging in Place, Behavioral Health, Care Coordination, Maternal Health, Oral Health, Veterans Health.

Breakout sessions will feature a model program for each of the six areas. Speakers will provide an overview of the program then contribute to a facilitated discussion on how the program could be adapted in Virginia's rural communities.


Agenda

Wednesday December 7

4:00pm-6:00pm Reception & Exhibit expo

Thursday December 8

8:00am-8:30am Welcome

8:30am-10:00am Breakout Sessions

  • Aging in Place
  • Behavioral Health

10:00am-11:00am Keynote Speaker
 

Delegate T. Scott Garrett, MD
23rd District
Rural Health and the General Assembly

11:00am-11:30am Break/visit exhibits

11:30am-1:00pm Breakout Sessions

  • Care Coordination
  • Maternal Health

1:00pm-2:00pm Networking Lunch

2:00pm-3:30 Breakout Sessions

  • Oral Health
  • Veterans Health

4:00pm-6:00pm Reception – Please join us at the R.R. Smith Center/Staunton Augusta Art Center!

Friday December 9

9:00am-10:00am Academic program reports

10:00am-11:00am Brainstorming sessions

  • Solutions on a Shoestring
  • Health Reform in Rural
  • Creating a Community Network

11:00am-12:30pm Foundation Roundtables

12:30pm-2:00pm Awards Luncheon & Annual Meeting

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About Our Sessions

Thursday December 8
Breakout Sessions

Each of the six key focus areas will have a breakout session.  For each session, a short presentation will be provided about a model program providing service in that area.  After the presentation, a facilitator will lead the group in a discussion about how elements of the model (or the whole program) could be incorporated into our rural communities.  Focus areas are:
 

Friday December 9
Brainstorming sessions

Conference attendees will have the chance to put their heads together and share ideas for addressing common issues.  Brainstorming sessions are:

Foundation Roundtable

Thursday December 8
Breakout Sessions

8:30am-10:00am
Aging in Place – Over the last two years the Cabin Creek Health Systems (CCHS) providers, staff, and outside consultants have been involved with developing, implementing, and evaluating a Senior Medical Home (SMH) project for patients 65 and over. This medical home model of care focuses on patients who have been identified as “frail” and patients with multiple chronic conditions. The intervention developed followed the basic elements of the medical home enhanced by custom elements that were adapted to meet the needs of the elderly. The elements of this model include easy access to primary care, senior care teams, structured risk assessments and care plans, computer tracking of preventive and chronic care measures, timely follow up after hospitalizations and emergency room visits and linkage to social services.

Craig Robinson is currently the Executive Director of the Cabin Creek Health Systems which is a federally qualified health center with 4 health centers and 3 school based health centers in Kanawha County, West Virginia. He received his BA from Oberlin College in Oberlin, Ohio and his MPH from UNC-Chapel Hill. Mr. Robinson has served as the executive director of Cabin Creek for five years and has over 30 years of experience working in rural areas in West Virginia. First as a VISTA volunteer, a clinic organization and occupational health advocate with the United Mine Workers of America, and then as the organizer and director New River Health Association.

Amber Crist is the Education and Program Development Director of the Cabin Creek Health Systems and serves as the executive director of the Central Counties Area Health Education Center. She received her BA in Psychology and MS in Community Health from West Virginia University and her Public Health Leadership Certificate from the University of North Carolina at Chapel Hill. Ms. Crist has worked at the Cabin Creek Health Systems since finishing her undergraduate degree in 2002.

Some of Mr. Robinson’s and Ms. Crist’s professional interests include engaging staff in healthcare improvement and engaging patients in health improvement, designing and implementing medical homes for complex patients and underserved groups, and applying lessons from complexity science and complex adaptive systems to healthcare.

Behavioral Health – Research has shown that the majority of people seeking relief of mild to complex mental and behavioral health distress show up in primary care. The prevalence of atypical antipsychotic and antidepressant medication prescriptions written in primary care far exceeds those written in specialty care. In fact, recent data indicates that fewer than a quarter of patients who come to their primary care provider are found to have a biological basis for their complaint; stress, anxiety, substance use, depression and other disorders are known to have a profound impact on a person’s biopsychosocial and overall physical status. Additionally, chronic diseases such as diabetes, obesity, heart disease and respiratory diseases often have a prominent anchor in behavioral health. At Cherokee Health Systems we believe that every health encounter has a behavioral component.

Our behaviorist-embedded primary care practice model appreciates the profound impact of behaviors on one’s health. Cherokee Health Systems employs well-trained, highly-skilled behaviorists who are a part of our primary care provider team and assist with emerging mental health issues and chronic disease management of our primary care panel. As both a Community Mental Health Center (CMHC) and Federally Qualified Health Center (FQHC), Cherokee Health has practiced an integrated model for over 30 years in East Tennessee and subscribes to the “no wrong door” belief to healthcare.

Bob Franko has worked in community mental health and healthcare for over 20 years. He has served as an administrator in a community mental health center for nearly 15 years working with chronically mentally ill adults, and was the project manager for a successful collaboration with a local health center. Bob received both his undergraduate and graduate degrees from Purdue University and still lives in northwest Indiana with his wife and two children, while commuting to Knoxville, TN through his employment with Cherokee Health Systems.

11:30am-1:00pm
Care Coordination – Carolina Access / Community Care of North Carolina (CCNC) is North Carolina’s Medicaid managed care program. Center for Medicaid and Medicare Services (CMS) recognizes this provider driven model of managed care as a Primary Care Case Management (PCCM) model. Over 1 million Medicaid recipients are assigned to a participating primary care provider that serves as their medical home. Currently 1,470 primary care practices, with over 4,500 providers have joined one of fourteen regional CCNC Networks.

Community Care utilizes a population management model that stratifies and identifies recipients with the highest cost and risk. Population management includes implementing evidence-based best practices in the medical homes, disease and care management, transitional support, pharmacy management, integrated care and other evidenced based initiatives. The Networks jointly fund a robust informatics center that includes statewide web based: case management information system, claims data and high risk reporting features. DHHS is expanding the use of CCNC’s infrastructure to support care management activities for uninsured, public health and in support of CMS’s multi-payer demonstration.

Chris Collins serves as the Deputy Director for the North Carolina Office of Rural Health and Community Care (ORHCC).  Ms. Colins oversees programs that support: critical access hospitals, migrant health, prescription assistance, integrated care, and community care network development for both Medicaid and uninsured populations. She is the DHHS project lead for AHRQ near miss events in primary care, CMSs’ CHIPRA quality improvement and Multi-payer Primary Care Provider (MAPCP) Medical Home demonstrations.

Maternal Health – CenteringPregnancy® is a multifaceted group model of care that integrates health assessment, education, and support, into a group setting throughout the pregnancy and for postpartum.  Through this unique model of care, women are empowered to choose health-promoting behaviors.  Health outcomes for pregnancies, specifically increased birth weight and gestational age of  mothers who deliver preterm, and the satisfaction expressed by mothers and the providers, support the effectiveness of this model for the delivery of care.  The session will include an overview of how the model has been implemented in Virginia, lessons learned, and what support the March of Dimes provides.  Practical details on grant funding available for 2012 will be explained.

Sara Long is a VCU graduate with a multifaceted career in maternal; and child health.  In 1996, she joined the Virginia chapter of the March of Dimes to manage programs and lead advocacy efforts that improved the lives of women and babies in the Commonwealth.

2:00pm-3:30
Veterans’ Healththe Department of Veterans Affairs Office of Rural Health will provide information about the Rural Health Initiative program.  The presentation will emphasize the value of rural health to Veterans, the development of community partnerships, utilization of nursing staff in health promotion and program sustainability.  The attendees will then participate in a discussion to assist the Office of Rural health in action plan development and finding ways to integrate the Rural Health program into Virginia’s rural communities.

Leading the session will be Gary Pond and Jenni Cook.  Gary Pond is a Veteran of the US AF and Lead Health Educator for the Rural Health Initiative Program at the McGuire VA Medical Center.  Chaplain (Dr.) Jeni Cook has served our nation’s Veterans as a VA chaplain since 1984.  Currently, she is Associate Director at VA’s National Chaplain Center which is a national office, but located on the grounds of the Hampton, Virginia VA medical center property.

Oral Health – Eastern Shore Rural Health maintains a school based Oral Health program with two sites.  Each site is located in a fixed facility located next to an elementary school in Accomack County on the Eastern Shore of Virginia.  The collaboration with this county’s school district is a large reason for the success of the program.  The last 7 years have seen a substantial increase in the participation of students within these schools as well as the school-age population in the surrounding community.

The Program has been extended to full-time, year round, through MOA’s with Migrant Head Start and traditional Head Start Programs as well as increased exposure to the community at large. Through limited outreach we are finding that there are many more young people needing Oral Health services and education on Virginia’s eastern shore than originally estimated. In light of this we are searching for ways to connect with the rest of the community and overcome the hurdles in access to care as well as identifying the children at risk for developing dental disease.

Nancy J. Stern, Chief Executive Officer of Eastern Shore Rural Health System, Inc. has worked in healthcare for 25 years. Nancy has served on Governor Tim Kaine’s Commission for Healthcare Reform, Congressman Nye’s Health Advisory Committee and is currently serving on Governor Bob McDonnell’s Health Care Work Force Authority Board and the Health Benefit Exchange Task Force.

Dr. Noel Root has served as the Dental Director for Eastern Shore Rural Health for seven years. Prior to this he was in private practice for 23 years. Currently he is also a clinical professor for the A.E.G.D. residency at V.C.U. School of Dentistry.

Friday December 9
Brainstorming sessions

Solutions on a Shoestring – Dr. Janet McDaniel will moderate this brainstorming session for participants to share their successes and challenges in developing healthcare services for rural populations, such as seeking federal and foundation grants, soliciting donations from individuals and organizations, collaborating with community partners for shared space and positions, integrating education of health professions students with service delivery, involving faculty and students in projects to address client/agency problems/needs, utilizing volunteers, and more. Come learn from colleagues about ways to address the challenges you and your agency are facing.

Dr. Janet McDaniel has over 30 years experience in teaching nursing and developing community programs for serving low-income, medically underserved populations in rural Virginia.  While at Radford University, she obtained over three million dollars in grant funds for outreach programs.  Currently, she is  utilizing her grant writing and program development skills to assist rural agencies and mentor rural community leaders in grant development and outcomes evaluation, developing health education programs to increase the rural workforce, and program evaluation.

Health Reform in Rural – Most of us have questions about the Affordable Care Act. (And we should. Because it impacts us all!) Whether you are wondering about what the health care law means for your family's insurance, for the insurance you provide to your employees, if you can stay on your parents' insurance plan, or about the timeline of when different parts of the law will go into effect, this session will have answers for you.  We are all impacted by the Affordable Care Act. 

The National Rural Health Association will provide an overview of the ACA and which parts are specific to rural America.  The session moderator will then lead participants in a discussion on how they can help people in our rural communities understand health reform and how it can benefit them.

Alan Morgan, MPA – the Chief Executive Officer at the National Rural Health Association (NRHA), where he serves as a policy resource for the national media, as well as a presenter at both national and state health conferences. Morgan, who joined the NRHA staff in 2001, has more than 17 years experience in health policy development at the state and federal levels, including working for former U.S. Congressman Dick Nichols and former Kansas Governor Mike Hayden. His health policy articles have been published in multiple health journals.

Creating a Community Network – How does community participation work, and how does it work best? Are communities targets, partners, the best source to find out what they need, or the best beneficiary of impartial eyes?  Funders, legislators and academics are increasingly turning to community networks to get things done—with good reason. But how can public health officials best work within this milieu?  Bring your questions and your own personal experiences to share. 

Wendy Welch, PhD, specializes in cultural competency issues in rural public health. She is the author of a forthcoming memoir from St. Martin’s Press and is working with McFarland Publishers to edit a volume of clinic, culture and community pieces on health in Central Appalachia.

Foundation Roundtable
Representatives from a variety of Virginia foundations will participate in a Q&A session, followed by time for participants to talk one-on-one with the foundation staff.
Twenty predictors of a successful project handout
Session notes

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Registration

2011 Annual Conference Rates
In keeping with our "Models & Money" theme, VRHA has kept the registration rates at the 2010 level for 2011.

Registrations received after November 18th:

  • $250 for both members and non-members.

Click here to register for the event.

*Group rate (5 or more participants from the same organization) = $150/person – contact VRHA prior to registration to receive discount

**Group rate (5 or more participants from the same organization) = $180/person – contact VRHA prior to registration to receive discount

All registration fees include 2012 VRHA membership dues.

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Sponsor/Exhibitor Information

In order to serve our members, we are seeking sponsors and exhibitors for our 2011 Annual Conference. This event will be held December 7-9 at the Stonewall Jackson Hotel & Conference Center in Staunton, VA.

The goal of the 2011 conference is to provide participants the opportunity to discuss how to make the most of shrinking budgets in a time of increased need. We will also recognize individuals and organizations who have worked hard to improve rural health in Virginia.

If you have partnered with us in the past, we invite you to join us again this year. If you are new to VRHA – welcome! We look forward to sharing information about your services with our members.

Exhibit Schedule will be:

Exhibit Hall Set-up:
December 7, 2-4pm

Exhibit Hours:
December 7, 4-6pm
December 8, 8am – 4pm

Exhibit Tear Down:
December 8, 4pm (exhibitors may not tear down prior to 6pm)
December 9, 8-11am (all exhibits must be removed prior to noon)

Click here to register for one of the many opportunities we have for organizations to take a supportive role in our conference as we continue in our mission to improve the health status of people in Virginia. Note that basic exhibit fees do not include meals at the conference.

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Lodging and Area Information

The 2011 VRHA Annual Conference will be held at the Stonewall Jackson Hotel and Conference Center in Staunton, VA.

The Stonewall Jackson Hotel & Conference Center, named for General Stonewall Jackson, originally opened in 1924, and quickly became the gathering place for Shenandoah Valley society. The architecturally significant hotel was designed by H.L. Stevens and includes a one of a kind circa 1924 Wurlitzer Organ in the hotel's famous Colonnade Ballroom. A renovation was completed in 2005 to historically preserve its charm while offering guests the most modern amenities, accommodations and services.

VRHA has rooms set aside at the discounted rate of $77/night (+ tax, fees & parking) for the conference. You must reserve by November 8th to ensure a room at this rate.

To register, call the hotel (866-880-0024) and ask for the Virginia Rural Health Association rate or register online.

The Stonewall Jackson Hotel & Conference Center is located at:
24 S. Market Street · Staunton, VA 24401
phone: (540) 885-4848

The hotel is easy to access from I-81 & I-64
Click here for directions

You can also visit the hotel's website for additional information.

Area information:

Where to dine?
What to see and do?
What's at the American Shakespeare Center?

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Student Scholarships

VRHA has funds available to assist students who wish to attend the VRHA 2011 Annual Conference. Any full-time student studying a health related profession may apply. Funds will only cover conference registration fees, not travel or lodging expenses.

Click here to download the scholarship request form. Completed forms must be submitted on or before October 21st. Winners will be announced on October 28th.

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VRHA Awards

The Charles Crowder, Jr. Award:  Eleanor Sue Cantrell
This award is given annually by the Virginia Rural Health Association to recognize outstanding individual commitment and service to the advancement of rural health in Virginia.


Eleanor Sue Cantrell completed pharmacy school, medical school and training for a career in internal medicine. After several years in the practice of internal medicine in southwest Virginia caring for many people suffering from a host of chronic diseases, she was led ultimately to a career with a somewhat different focus, that is public health. She has worked with communities and people in rural Virginia, underserved and uninsured populations that are among the neediest in the state, with evidence of numerous health disparities.

Since 1991, as District Director of the LENOWISCO Health District, located in a mountainous rural region of Appalachia, Dr. Cantrell has led a series of public health initiatives that have increased access to basic health care, and used telemedicine technologies to support screening, diagnostic and treatment programs to enhance the region's health care.

She has been a primary medical contact and medical services coordinator of the Remote Area Medical Clinic, providing medical care along with dental and vision services to the uninsured and which, on one weekend in 2010, delivered more than 4000 services in the first two days. Additionally, with grant funding from the Virginia Healthcare Foundation she developed the original software for a pharmacy access program that assists eligible patients in acquiring prescription medications directly from pharmaceutical manufacturers at no or reduced cost, and developed a model plan for small community wastewater disposal.

Dr. Cantrell currently works with many health initiatives, among them: One Care of Southwest Virginia, Healthy Appalachia Institute, Southwest Virginia Health Authority, GMEC-AHEC and the Virginia Health Workforce Development Authority. She often has been cited for the creativity and perseverance she brings to the challenges of public health. Wrote a colleague "Not only are her heart and soul in her work, Sue brings ingenuity to the problems that confront rural and underserved populations."

The Best Practices in Rural Health Award:  Augusta Dental Health
This award is given annually by the Virginia Rural Health Association to recognize a program or institution that exemplifies commitment and service to the advancement of rural health in Virginia.

Many children with Medicaid coverage were unable to get care as there weren’t enough dentists who would take Medicaid. Because dentistry is such an expensive service to provide, many uninsured adults were also unable to get needed care. The staff at Augusta Dental Clinic developed and piloted a new model, now known as the 70-30 plan (70 percent Medicaid and 30 percent uninsured). This served the Medicaid children, and used that reimbursement to heavily subsidize the care of uninsured adults who also had nowhere else to go. Their own clinic continues to grow and serve more people from throughout the region, and they have recently built a new facility that will help them more than double their capacity.

While they have helped thousands of patients from their region, they have excelled in generosity by helping many other clinics through sharing their experience and technical knowledge. Three more dental clinics along Interstate 81 (Winchester, Harrisonburg and Woodstock) leaned on them for information and support while they started their own clinics. More Free Clinics are planning dental clinics of their own upon seeing the success generated by Augusta. Their dental director, Chris Harman, has presented to many other clinical groups to show them that they can help indigent people get access to care without losing their shirts (or scrubs as the case may be!).

The Shenandoah Dental Clinic reports: "My clinic went from two days of care per month to five days of care each week. We help many Medicaid children who weren’t getting care at all, or who drove two hours to see a Medicaid dentist. We are helping four times as many uninsured patients as we could in our former time-limited services, which were mostly tooth extractions. We are helping nearly 1,000 people with oral health each year and we are only one small clinic. Many others have learned tips from this clinic potentially helping tens of thousands of people each year."

Friend of the Association:  National Rural Health Association
This award is given to recognize a program, institution or individual that has advocated for or aided the Association in support of the Association's mission.

The National Rural Health Association and its staff, has consistently provided the financial, organizational, and even emotional support needed to build its Virginia affiliate into the strong and fiscally sound organization it is today.

NRHA provides funding to allow the VRHA Executive Director and staff to attend the national annual conference and policy institute. These events deliver invaluable opportunities to develop resources, connections and ideas.

NRHA also holds an annual workshop specifically for state rural health association staff. The workshop teaches important lessons on fiscal management, board development, marketing, member recruitment and other aspects of organization management that can be difficult for small non-profit entities to develop on their own.

Additionally, NRHA hosts the State Association Council. Made up of state association staff and board members, the council supplies the opportunity to share ideas, concerns, and the general joys and woes of organizing a State Rural Health Association.

Most recently, NRHA provided the Virginia Rural Health Association with a mini-grant. These funds allowed VRHA to conduct a complete re-design of the association website. If you have not looked over the site since mid-July, I highly recommend that you review the beautiful new pages.

Previous Winners:

Friend of the Association
2010 – Va Rural Center
2009 – State Office of Rural Health
2008 – South Atlantic Division of the American Cancer Society
2007 – Rebecca J. Davis, PhD
2006 – Herman Marshall
2005 – Edward Via Virginia College of Osteopathic Medicine

Best Practices Award
2010 – Carilion Giles Community Hospital
2009 – Lackey Free Clinic
2008 – Eastern Shore Rural Health System
2007 – Virginia Community Healthcare Association
2006 – Rappahannock Area Health Education Center
2005 – Virginia Dental Health Association
2004 – Bon Secours St. Mary's Hospital Health Wagon

Charles D. Crowder, Jr. Award
2010 – Dr. David B. Nichols
2009 – Janice Wilkins
2008 – James E. Tyler
2007 – Dr. Gregory Byrd, Jr.
2006 – Dixie Tooke-Rawlins
2005 – Dr. Charles Miller
2004 – Delegate Albert D. Pollard

Lawmaker of the Year
2010 – Delegate Clarence “Bud” Phillips
2009 – Delegate Dave Nutter

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Thanks to our Sponsors!

The conference would not be possible without the generosity of our sponsors. The 2011 Conference Sponsors are:

Platinum

Office of Minority Health and Health Equity

Virginia Area Health Education Centers

Diamond


Gold

Silver

Bronze

 

Exhibitor

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