Rural Health Story Archives - West Virginia Public Broadcasting

Martinsburg Physicians Develop New Approaches To Rural Veteran Health Needs

A program at the Martinsburg VA Medical Center trains medical providers to better serve rural veterans, who often face a number of barriers to accessing health resources.

The Martinsburg VA Medical Center (VAMC) serves veterans across county and even state lines.

With such an expansive patient base, the medical center’s health care providers not only have to consider veteran needs, but also disparities in rural health care access — and the ways these experiences overlap.

That is where the VAMC’s local chapter of the national VA Rural Interprofessional Faculty Development Initiative (RIFDI) comes in. The voluntary program trains medical professionals to better serve rural communities, and the veterans who call them home.

Over a two-year period, the program provides physicians lectures, group discussions and project-based learning on rural health care.

So far, three cohorts have completed the program, and RIFDI is still admitting new cohorts of health care providers.

VAMC Deputy Chief of Staff Michael Zapor began the Martinsburg RIFDI program, and said that it helps fill gaps where disparities in veteran and rural health care access overlap.

Veterans living in the rural United States often have less access to stores, transit options and the internet, which limits the health care resources at their disposal, he said.

“When you’re talking about … ‘We’re going to leverage telehealth.’ Even that is not a silver bullet for everybody, because we’ve got some veterans who don’t have computers,” he said.

This requires health care providers to consider the needs of rural veterans across the region and develop strategies to better provide them with health services.

In response, RIFDI considers “innovative ways” to serve the local veteran community, Zapor said. This includes educating veterans on proper nutrition, and offering a mix of in-person and telephone-based services so veterans can choose the resources best suited to their lifestyles.

In developing these strategies, physicians also learn about the health care experiences of the patients they serve.

“We leverage all kinds of ways to be able to project that care out to the more rural remote veterans who may have more difficulty accessing it,” he said.

For more information about RIFDI, visit www.ruralhealth.va.gov.

**Editor’s note: A previous version of this story incorrectly stated that Michael Zapor founded the VA Rural Interprofessional Faculty Development Initiative (RIFDI). Instead, he launched Martinsburg’s local RIFDI program. The story has been updated with the correction.

Rural Health Care Advocates Stress Needs At Capitol

Health care providers and health advocacy organizations were at the Capitol Thursday to discuss challenges and advocate for possible solutions in rural health care.

Transportation is one major challenge, especially for elderly residents. Karyn O’Dell, communication and leadership strategist for Southern West Virginia Health System, said lack of access to public transportation and preventative care contribute to worse health outcomes in rural areas.

“If you are an individual who is single, living by themselves, and does not have a family member or maybe a neighbor who can assist,” O’Dell said. “Then when you go to have a specialist procedure that requires somebody to drive you, you may not seek that specialist care.”

She said this is especially important for life saving screenings like colonoscopies or cancer screenings.

O’Dell said she believes that it’s important for rural communities to have access to primary and specialty care from health care providers in the community.

“It’s super important to have people in local and rural communities, where patients feel that they can trust that individual,” O’Dell said.

Rhiannon Wiseman, customer service representative for the West Virginia Drug Intervention Institute, said rural health care is key to combating the opioid epidemic in the state.

“They deal with the smaller things, and that’s the most important thing — is the smaller things. Those are the things that lead to big things,” Wiseman said. “So when in recovery, anything, anything that anybody can provide, I mean, from just support to, you know, like dental plans or drug prevention or recovery.”

She said having access to opioid reversal agents, like naloxone, is especially needed for rural communities where wait times for ambulances are longer.

CDC Begins Appalachian Fact Finding Mission In West Virginia

Public and private health care leaders and community stakeholders gathered at the Cabell Huntington Health Department on Tuesday to meet with leaders from the U.S. Centers for Disease Control and Prevention (CDC). The session was intended to showcase what’s working locally and address the challenges of rural health care delivery.

Public and private health care leaders and community stakeholders gathered at the Cabell Huntington Health Department on Tuesday to meet with leaders from the U.S. Centers for Disease Control and Prevention (CDC). The session was intended to showcase what’s working locally and to address the challenges of rural health care delivery.

CDC Health Care visit the Cabell-Huntington Health Department.

***Randy Yohe/ West Virginia Public Broadcasting***

Dr. Leslie Dauphin, CDC Director of Public Health Infrastructure, said this mission started here after learning about the successes of local community based partnerships.

“This was recommended as a place to start because of their accredited health departments,” Dauphin said. “That, and the way that the public-private partnerships work together with the health system to protect people.”

Dauphin said that due to a federal flexible funding program, the Cabell-Huntington Health Department has been able to hire staff. She said her concern was what will they do when that funding runs out.

“In order to get the work done to protect the health of communities, we must have a sustained growth,” Dauphin said. “We know that with their workforce, we’re here to learn what’s working, how they’re using the funding that they’ve received, to hire, recruit, retain a workforce, and what we can do to help them sustain.”

Cabell-Huntington Health Department CEO Dr. Michael Kilkenny said the CDC infrastructure director needed to know the state’s continuing broadband access challenges relate directly to health care.

“Telemedicine is showing a growing importance, Kilkenny said.” One of the ways to break down some of the transportation difficulties that we hear time and time again from the public is being able to come into your living room no matter where you’re at.”

Dauphin said the CDC is here to learn more about infrastructure, workforce issues, community partnerships and data modernization. She said the results must be federal health care policies made to bring the most benefits to those with the greatest need.

Medicaid Buy In, Other Health Legislation Advances During Saturday Session

Legislation focused on West Virginia health issues was a topic of debate and lawmaking during Saturday’s legislative session with many bills being passed through both chambers.

HB 3274 – Affordable Medicaid Buy-In Program Passed the House

Affordable Medicaid Buy-In Programs were a topic for debate in the House of Delegates.

House Bill 3274 would create the Affordable Medicaid Buy-in Program to help alleviate financial strain on recipients of Medicaid who start a job that disqualifies them from receiving their benefits.

Medicaid buy-in programs soften the “cliff effect” for recipients who lose their coverage when starting a new job that pays too much for Medicaid eligibility, until they can earn enough to afford other health insurance plans.

According to 2023 data from the U.S. Department of Health and Human Services, an individual would lose their Medicaid benefits in West Virginia when they earn more than $20,120 annually. The Affordable Medicaid Buy-in Program would allow that threshold to rise to 200 percent, or $29,160 annually.

Del. Evan Worrell, R-Cabell, explained the bill on the house floor.

“The idea behind this legislation is an attempt to mitigate the cliff effect for those individuals on Medicaid,” Worrell said. “The cliff effect occurs when wages from a new employment opportunity do not make up for a family’s loss of state benefits, putting the family in a worse financial situation.”

Del. Riley Keaton, R-Roane, asked Worrell questions and spoke in opposition to the bill on the House floor.

“So, we’re actually going to see is the public payer mix of patients grow pretty substantially for our health care providers,” Keaton said. “And then we’ll be faced with politically complicated decisions about how to make that program make sense.”

Jordan Maynor, R-Raleigh, spoke in support of the bill.

“I think my friend from the 15th (Keaton) brings up a great point. And it did get me thinking, but I think the intent of the bill is to move people off of Medicaid, keep a job, keep climbing that ladder of economic success, if they get off Medicaid completely eventually,” Maynor said. “And right now, it seems to be if we don’t do this, we’re incentivizing them to not keep their job, not take that pay raise and just be on Medicaid completely, which means no buy in from the patient.”

The bill passed the House with a vote of 73 yays, 19 nays and 8 absent, or not voting. The Senate will decide whether or not the bill makes it to the governor’s desk for his signature.

House Bill 2993 – Rural Emergency Hospital Legislation Passed Unanimously

House Bill 2993 would create a new hospital designation called “Rural Emergency Hospital.”

During discussion of the bill in the Senate Health and Human Resources Committee Feb. 21, it was stated that the new designation was intended to allow access to critical outpatient hospital services in communities that might not be able to support or sustain a traditional critical access hospital.

The bill passed the Senate unanimously on Feb. 25 and was sent to the House with a request to concur.

Senate Bill 613 – Certificate of Need was laid over

In recent years, “Certificate of Need” has been a topic of interest in the West Virginia legislature.

Since 1977, most West Virginia health care providers that want to open or expand facilities must obtain a Certificate of Need. The process is overseen by the state’s Health Care Authority. To acquire a Certificate of Need, facilities must prove that their community needs the proposed service.

The purpose is to regulate the healthcare market to discourage unnecessary duplication of services. However, some lawmakers and advocates have asserted in recent years that the process — which can cost providers tens of thousands of dollars — actually creates more barriers to care. They claim it protects existing providers from competition more than it protects patients.

Senate Bill 613 aims to amend state code relating to a certificate of need. Two sections relate to birthing centers which are healthcare facilities, staffed by nurse midwives, midwives and/or obstetricians, for mothers in labor, who may be assisted by doulas and coaches.

This discussion comes just weeks after the Senate passed House Bill 2789 removing the requirement that a birthing center obtain a certificate of need; and exempting birthing centers from obtaining a certificate of need, to the committee on Health and Human Resources on Feb. 8.

Senate Bill 613 would remove birthing centers from the list of reviewable services, providing that birthing centers are exempt from certificate of need review; and removing an exemption for hospital based birthing centers.Other code changes include, providing physician office practice meeting specified criteria may acquire and utilize one magnetic resonance imaging scanner and providing for data verification.

The bill was laid over on 3rd reading with the right to amend.

HB 3341 – Allowing for Cigar Bars

House Bill 3341 would permit cigar bars and cigar lounges to operate in West Virginia resorts. It passed through the House of Delegates.

The bill was discussed in the House of Delegates with lawmakers arguing for personal freedoms, while others argued the bill would be a step in the wrong direction for tobacco cessation in West Virginia.

Del. Moore Capito, R-Kanawha, explained the bill on the House floor.

“The purpose of this bill is to permit cigar bars or cigar lounges, meaning an indoor area designated specifically for the smoking of tobacco products at a resort,” Capito said. “The bill defines what a resort is and puts forth a framework under which these lounges or bars are to operate.”

Some legislators argued that the definition of resort was not clear while others stood to share personal stories of tobacco use hurting them and their loved ones, arguing against exposing employees of resorts to secondhand smoke.

Del. Adam Burkhammer, R-Lewis, said he felt the bill would push West Virginia in the wrong direction.

“I believe that in recent years, we’ve even created a Tobacco Prevention Task Force. And now I’m not real quick on the budget, but I believe we give that about $3 million a year. I’m sure someone can probably correct me in that, but we’re moving in the wrong direction for things that we have said we did not want in public places anymore,” Burkhammer said. “And I will agree, and I support freedom, but I will tell you that you can take your freedom and smoke outside.”

After a half hour of debate on the House floor, House Bill 3341 passed to the Senate for their consideration with a vote of 57 yays, 33 nays and 10 absent, or not voting.

Southern W.Va. Health Leaders Announce Collaboration To Enhance Region’s Health Care Services

On Friday afternoon, local health providers announced a collaboration aimed at enhancing health care services in southern West Virginia.

In a conference room brimming with excited chatter, Mountain Health Network, Marshall Health, and Logan Regional Medical Center announced they have partnered to improve access to specialty care in Logan and surrounding areas.

Kevin Yingling is the president and CEO of Mountain Health Network. He said the agreement is aimed at providing care to rural areas and lessening travel time for patients.

“Mountain Health and Logan Regional Medical Center have held a longstanding mutual respect and common purpose of providing high-quality medical care for patients, close to home,” Yingling said. “We are honored that the Logan and ScionHealth teams have chosen Mountain Health and our academic medical center partners, Marshall Health…so patients and families do not need to travel long distances for advanced medical care.”

Under this initiative, specialists will be trained at Logan Regional Medical Center to provide access to specialized heart, pediatric and cancer services.

“Regardless of where West Virginians live, they deserve to be able to reach the lifesaving medical services they need and rely on,” said Sen. Shelley Moore Capito, who was in attendance. “Today’s announcement means more West Virginians receiving care, more West Virginians providing care, and more teamwork between our medical organizations.”

While some specialty care has been available at Logan Regional Medical Center, this partnership aims to add to these services by implementing workgroups of experts from each hospital that will develop programs that advance cardiology, pediatric and oncology services for patients in the Logan area.

Omnibus Bill To Establish CDC Office Of Rural Health

The Federal 2023 Omnibus Appropriations Bill includes $5 million to establish an Office of Rural Health (ORH) at the Centers for Disease Control and Prevention (CDC).

A. Toni Young is the Executive Director of the Community Education Group (CEG) and a long-time advocate for vulnerable and at-risk communities, including advocacy for the establishment of the rural health office. .She works alongside lawmakers to combat public health crises, including HIV/AIDS, substance use disorder and opioid addiction and more.

“If we can get this office, then there’s a continuum of care for rural communities,” Young said. “So, from the prevention to thinking about it for prevention and planning at CDC, to the implementation and response that would happen at HRSA (Health Resources and Services Administration) in an office on Rural Health Policy, and if we can have that level of coordination, I think we can have a more robust response to the health needs of folks in rural communities, particularly in the Appalachian region.”

While the 2023 appropriations bill is still being deliberated by Congress, the establishment of the Office of Rural Health at the CDC is not being contested.

“Our focus is certainly to say, ‘We need you to see the folks of Appalachia and we need you to respond to the folks of Appalachia,” Young said. “So again, this is like a big picture saying, if we can put this piece of the puzzle together, then we can go back and say we now need you to develop a robust and coordinated plan for the health needs of the people of the Appalachian region.”

The ORH will enhance the implementation of CDC’s rural health portfolio, coordinate efforts across programs, and develop a strategic plan for rural health. The agreement also encourages ORH to accelerate innovation, make scientific and communication resources tailored to current rural public health needs, build and improve public health functions and service delivery and provide leadership in matters of public health infrastructure.

“Rural communities have been devastated by COVID-19 and other health disparities, and this new CDC office will be critical to increasing resources and raising awareness of rural Americans’ needs,” Young said. “One of the things that I think is really important for people to understand, is the role that Senators Manchin and Capito have played in this response. They too, they’ve asked the CDC, about West Virginia being included in ending the HIV epidemic. They’ve been supportive of this request for the CDC to get this Office of Rural Health.”