May 2 , 2019
  WVPCA Weekly Outlook Newsletter
    A Newsletter on Community Centered Healthcare
 

We offer this publication as a member service of the West Virginia Primary Care Association (WVPCA).

If you have questions regarding our organization, WVPCA membership, or if you have content to suggest for this newsletter, please contact Kelsey Clough, Education and Communications Coordinator, by email or by phone at (304) 346-0032.

Sincerely,

West Virginia Primary Care Association
1700 MacCorkle Avenue
Charleston, WV 25314-1518
304-346-0032
1-877-WVA-HLTH

News 
Flash!

New River Health to create medical mall in former Kmart building
Read the entire article from the  Register-Herald  here

Valley Health enters new partnership with NYU Langone Health to provide advanced training to dental residents while improving local access to dental care
Read the entire release from Valley Health Systems here.

WV hospitals sue opioid firms
Read the entire article from the Charleston Gazette-Mail here

Physicians get addicted too
Read the entire article from the Atlantic  here

Active HIV cluster in Cabell County now totals 44 cases
Read the entire article from the Charleston Gazette-Mail here

US measles outbreak is largest since disease was declared eliminated in 2000
Read the entire article from CNN here

Worries mount as VA races to launch private-care program in June
Read the entire article from Modern Healthcare  here
WVPCA NewsWVPCA
 
Tug River Health Association has developed a program equipped and ready to help Prenatal Patients with Opioid Use Disorder by providing a safe addiction treatment to give mom and your baby the best possible chance for a safe pregnancy and delivery.

Partnering with Dr. Brandon Lingenfelter as the Primary OB and Delivery services, the program refers prenatal patients to receive prenatal and Medication Assistance Treatment (Subutex) by Tug River Health's Medical Provider, Monique Rash, C-FNP. Ms. Rash provides monthly prenatal examinations, behavioral health and medication services.   Participants in the program must adhere to all program requirements including behavioral health services and drug screenings.   In addition, the Program provides Peer Recovery Coach services to assist with resources and adaption of behaviors.

"If you are pregnant and have been using drugs, you can still help your baby. Tug River has created a prenatal program to guide and support pregnant women through many physical and emotional challenges of addiction recovery for both themselves and their unborn child. Our goal is to help minimize the challenges and to promote the health and well being of both mother and child." Said Tim Crofton, CEO.
Join the WVPCA for a 2-Day CHC Billing, Coding & Documentation Strategies Workshop
The West Virginia Primary Care Association (WVPCA) invites Community Health Center (CHC) Billing and Coding staff and Providers to attend a two-day workshop in South Charleston, WV on May 20-21.  Shellie Sulzberger, LPN, CPC, ICDCT-CM is the Co-founder of Coding & Compliance Initiatives and will present this workshop. 

Topics to be discusses include:
  • FQHC billing responsibilities
  • Qualified Providers and covered services
  • Coding for preventive, chronic and traditional care

  • Medicare/West Virginia Medicaid
  • What medical documentation facilitates
  • Key components of E/M Services
  • Learning lab
In preparation for the workshop, we ask that you do the following:
  • Please submit your questions for an interactive Q/A Session at the end of both days to Debra Boyd at debra.boyd@wvpca.org
  • Please bring CPT and ICD-10 Coding Books.
For more information, or to register, click here
CMS Issues Final Rule for 2020
On Jan. 17, CMS released the 2020 Notice of Benefit and Payment Parameters Proposed Rule to finalize standards for issuers and Exchanges in the Health Insurance Marketplace. A version of these proposed rules was made final on April 18, 2019. In the past, these rules were finalized earlier, meaning this year the window of time allotted for insurers and department of insurances to approve rates for 2020 is reduced. Insurers still must submit their qualified health plans (QHPs) to the Centers for Medicare and Medicaid Services (CMS) by June 19, 2019. Here are some highlights from the final rule:
  • Automatic re-enrollment into QHPs will continue
  • CMS reminded insurers of essential health benefits (EHB) nondiscrimination requirements, which prohibit discrimination in benefit design or the implementation of benefit design based on age, expected length of life, present or predicted disability, degree of medical dependency, quality of life or other health conditions
  • CMS declined to adopt changes to its regulations on guaranteed renewability regarding mid-year formulary changes
  • CMS did not finalize a proposed change to change the drug formulary for brand-name prescription drugs and general equivalents so it could consider the brand name drug not to be EHB if the generic drug is available and medically appropriate
  • The CMS proposal to require insurers that cover non-Hyde abortion services to also offer at least one "mirror QHP" without the coverage of non-Hyde abortion services but otherwise identical benefit coverage is still under review and was not finalized
  • No changes will be made to Silver loading of QHPs
  • The Navigator training for 2020 will be streamlined to four broad categories instead of the existing 20 topics and certain types of assistance, including post-enrollment assistance, are permissible but not required
  • Individuals can claim hardship exemptions through the tax filing process without having to obtain an exemption certificate number from an Exchange
  • New special enrollment periods (SEPs) are available for consumers enrolled in off-exchange coverage that qualifies as minimal essential coverage (MEC) who experience a decrease in household income and are newly determined to be eligible for advance premium tax credits (APTC)
CMS also released a Fact Sheet of the Final Rules to provide a brief overview of the regulatory changes. See the official Final Rule.
Why Not Use Our State's Greatest Resource for Therapy?
Wild and wonderful is used to describe the state of West Virginia and is promoted as having some of the very best and most beautiful outdoors there is. There is growing research that our state's greatest asset could positively impact one's mental health. Recent research findings suggest that "Experiencing the awe in nature is a powerful way to impact people's psychology" according to Jill Suttie Psy.D. Have you taken advantage of this intervention to improve your mental health? Read the entire article, originally published by the Greater Good Science Center at UC Berkeley  here.
State NewsState
Employers Must Provide Pay Data to EEOC by September 30
According to a recent news alert by Jackson Kelly PLLC, a federal just ruled on April 25 that employers are required to provide 2018 pay data to the U.S. Equal Employment Opportunity Commission (EEOC) by September 30. This report should detail how much workers were paid as well as the number of hours worked and must be broken down by gender, race and ethnicity.  The judge also ordered the EEOC to collect a second year of pay data and is allowing the Commission to decide whether to collect employers' 2017 data or collect 2019 data in the future. 

Read the entire alert here
Mark Your Calendars - Events/Trainings Across WV
Mid-Atlantic AIDS Educational and Training Center Training Opportunities 

When:  May 16 in Parkersburg, WV; May 23 in Elkins, WV; and June 13 in Wheeling, WV
Important Information: This program has been approved by the WV Board of Medicine and the WV Board of Osteopathic Medicine.
RegistrationContact Donna M.
Steigleder, (304) 462-6292.


15th Annual HIV in WV Conference

When:  May 10 at Stonewall Resort in Roanoke, WV. 
Registration: This training from the MidAtlantic AIDS Education and Training Center, is targeted to physicians, physician assistants, nurse practitioners, advance practice nurses, social work and ancillary team members.  For more information, clic here

Alzheimer's and Dementia Care ECHO Program

When: Every other Thursday beginning May 9, 2019 12-1 PM CST
Whoclinician, (physician or NP)and other care team members (e.g., PA, social workers, care coordinators, medical assistants, etc.).
RegistrationThis ECHO Program is hosted by the Alzheimer's Association and is an innovative distance - learning model to build workforce capacity and improve access to specifically care in local communities. For more information, click here

Community Healthcare Planning and Response to Disasters

When: June 18-19 at Cedar Lakes Conference Center in Ripley, WV
WhoThe West Virginia Division of Homeland Security and Emergency Management and Jackson County Health Department are coordinating an educational training, Community Healthcare Planning and Response to Disasters. 
RegistrationFor more information, click here
Funding OpportunitiesFunding
Rural Communities Opioid Response Program - Implementation (RCORP - Implementation)
Application Deadline: May 6, 2019
The HRSA Federal Office of Rural Health Policy (FORHP) will be making approximately 75 awards of up to $1 million each to rural communities to enhance service delivery for substance use disorder, including opioid use disorder. All domestic public and private entities, nonprofit and for-profit, are eligible to apply and all services must be provided in HRSA-designated rural areas (as defined by the Rural Health Grants Eligibility Analyzer).  The applicant organization must be part of an established network or consortium that includes at least three other separately-owned entities, with at least two located in a HRSA-designated rural area.  FORHP will hold a 90-minute webinar for applicants on Wednesday, March 27, 2019 from 11:30-1:00 pm ET.  A recording will be made available for those who cannot attend.  For the webinar dial-in and playback information, please reference page (ii) in the Notice of Funding Opportunity on Grants.gov.  (Click "Preview" on the Package tab, and then "Download Instructions".)  Contact ruralopioidresponse@hrsa.gov with questions.
HRSA Graduate Psychology Education Program
Application Deadline: May 7, 2019
Grants to support doctoral-level psychology education and training programs to prepare psychologists to address the behavioral health needs, including opioid use and substance use, in high-need underserved and rural populations.

For more information, click here
USDA Community Food Projects Competitive Grants Program
Application Deadline: June 3, 2019
The U.S. Department of Agriculture (USDA) will make awards ranging from $35,000 to $125,000 for projects that meet the food needs of low-income individuals through food distribution and community outreach, and that promote local access to farm-produced food.  Eligible applicants are public food program service providers, tribal organizations, and private nonprofit entities, including those that collect or harvest surplus food. 

For more information, click here
Rural Communities Opioid Response Program-Medication-Assisted Treatment Expansion (RCORP-MAT Expansion)
Application Deadline: June 10, 2019
HRSA's 
Federal Office of Rural Health Policy (FORHP) will be making approximately 11 awards of up to $725,000 each to eligible rural health clinics, Critical Access Hospitals, health center look-alikes, other small rural hospitals with 49 available staffed beds or less, and tribal organizations to establish and/or expand medication-assisted treatment (MAT) in high-risk rural communities over a three-year period of performance.  All applicants must be located, and all services must be provided, in HRSA-designated rural areas (as defined by the  Rural Health Grants Eligibility Analyzer ).  For additional eligibility information, please reference pp. 4-5 of the notice of funding opportunity (NOFO).  Award recipients are strongly encouraged to leverage workforce recruitment and retention programs like the National Health Service Corps (NHSC) .    FORHP will hold a webinar for applicants on Thursday, May 16 from 12-1:30 p.m. ET .  A recording will be made available for those who cannot attend.  Please reference page ii in the NOFO for the dial-in and playback information for the webinar and contact ruralopioidresponse@hrsa.gov with questions.

For more information, click here
HRSA Graduate Psychology Education Program
Medline is pleased to announce the Community Impact Grant program for Community Health Centers. Through this grant program, we will award results focused grants addressing prevalent healthcare challenges to stimulate health equity and improve the well-being of patients receiving care at community health centers.

The 2019 Community Impact Grant cycle is now open and the application deadline to apply is May 31, 2019. Applications may be submitted at any time during this funding cycle. Applications must be completed in full and submitted online to be considered. Submitting an online application does not guarantee funding.
 
The 2019 grants will be announced on or before June 27, 2019.  Medline will offer a second grant cycle for community health centers beginning on August 4, 2019.

For more information, click  here  or  contact socialresponsibility@medline.com for more information. Apply today.  
Funding Opportunity Reminders
FY 2019 Integrated Behavioral Health  Services (IBHS)

T he fiscal year (FY) 2019 Integrated Behavioral Health Services (IBHS) funding opportunity is a non-competitive supplement for organizations currently receiving Health Center Program operational grant (H80) funding. IBHS funding will help health centers increase access to high quality, integrated behavioral health services, including the prevention or treatment of mental health conditions and/or substance use disorders (SUDs), including opioid use disorder. Applications are due by May 13, 2019.

For more information, click  here

Opioid Workforce Expansion Program - Professionals and Paraprofessionals

HRSA is accepting applications for the FY 2019 Opioid Workforce Expansion
Porgram (OWEP)
Professionals and
Paraprofessionals funding
opportunities until May 7, 2019.

Apply on Grants.gov by Tuesday, May  7. HRSA anticipates awarding $39.3 million for approximately 29 OWEP for Professionals awards and $29.8 million to fund about 33 OWEP for Prarprofessionals awards. 
National NewsNational
HHS Secretary Azar Statement on National Infant Immunization Week
HHS Secretary Alex Azar issued the following statement to mark National Infant Immunization Week:

"This week is National Infant Immunization Week, which is an opportunity to celebrate lifesaving vaccines that protect our children.

"Unfortunately, because we are seeing significant outbreaks of measles across the country, it is also a more important opportunity than ever to remind Americans: Vaccinations are safe and have been proven time and again to be effective. I can personally testify to how important they are: As a parent, I ensured that all my kids were vaccinated according to the childhood schedule, and I recently received a recommended vaccine to prepare for some international travel.

"We have come a long way in fighting infectious diseases in America, but we risk backsliding and seeing our families, neighbors, and communities needlessly suffer from preventable diseases. This National Infant Immunization Week, all Americans should check to make sure that they and their loves ones are up to date with the CDC's recommended vaccine schedule, which provides guidelines for Americans of all ages and with specific health conditions.. Especially if you have an infant, talk to your doctor about what vaccines are recommended. It's one of the easiest ways to keep you, your family, and your community healthy."
For more information on vaccines, go to Vaccines.gov.
Case Study: "How CHCs Are Addressing the Opioid Epidemic" Released
Recently, the Milbank Memorial Fund and United Hospital Fund released "The Ripple Effect: The Impact of the Opioid Epidemic on Children and Families." A companion case study, "How Community Health Centers Are Addressing the Opioid Epidemic," was released in mid-April. The study follows Community Healthcare Network, a federally qualified health center (FQHC) in New York City, as it treats Asia, a woman who developed an opioid addiction as a teenager. The case study demonstrates what policymakers and the public need to understand: medication-assisted treatment integrated with behavioral support services saves lives.
Check Out HRSA's New SUD Page
The Health Resources and Services Administration (HRSA) has compiled resources to assist health centers in integrating substance use disorder (SUD) treatment services into primary care delivery on its new Substance Use Disorders and Primary Care Integration web page.   Also see HRSA's opioid webpage outlining other strategies to combat the opioid crisis.
FTCA PAL for Volunteer Health Professional Program Now Available
HRSA has issued the Health Center Volunteer Health Professional (VHP) FTCA Program PAL 2019-03 detailing the requirements for Health Center Program grantees to submit applications to sponsor VHPs for FTCA initial, supplemental, and redeeming for calendar year 2020. Also see PAL 2019-02, Calendar Year 2020 Requirements for Federal Tort Claims Act (FTCA) Coverage for Health Centers and Their Covered Individuals. Health center and health center VHP FTCA program redeeming applications for CY 2020 coverage are due by 11:59 pm ET on Monday, July 1. The redeeming application period begins on Friday, May 17. Initial deeming applications are accepted year-round.
Service Area Considerations Request for Information Available for Preview
HRSA is pleased to announce the release of the Health Center Program Service Area Considerations Request for Information (RFI). HRSA seeks input from the public on service area considerations that may inform HRSA decisions regarding Health Center Program expansion through an existing health center's addition of new service delivery sites.

The Service Area RFI announcement will begin with a 30-day preview period. Instructions on how external stakeholders may submit feedback are forthcoming. Following the preview period, HRSA will accept public feedback for 60 days and plans to announce those details in a future Primary Health Care Digest newsletter. We look forward to receiving your feedback.
Capital Link to Host 'Developing a CHC Capital Project Plan and Budget' 2-Part Webinar Series
Join Capital Link for a two-part webinar series examining capital planning and financing activities. 

Developing a Community Health Center Capital Project Plan and Budget - Part 1
Tuesday, May 7, 2019 2:00-3:00 p.m. ET | Register
Presented by Adrienne Cooksey, Capital Link Associate Project Consultant 
This session will discuss how to estimate service area demand, workforce needs, and space requirements so you can build a realistic budget, calculate your debt capacity and measure financial feasibility.
 
Developing a Community Health Center Capital Project Plan and Budget - Part 2
Wednesday, May 22, 2019 2:00-3:00 p.m. ET | Register
Presented by Duncan McGillivray, Capital Link Project Consultant 
In addition to looking at how to determine sources and uses of funds for capital projects, including how to reduce financing costs through New Markets Tax Credits and the HRSA Loan Guarantee Program, this session will also discuss how health centers can use scenario modeling to strategically manage capital projects in a changing environment. Attending Part 1 is not required for Part 2.

If you are unable to attend these webinars, recordings will be available to FQHCs and PCAs here on Capital Link's website along with past webinars. Find a list of all Capital Link upcoming webinars here. Contact Chloe Tsetsos at 617-422-0350 or ctsetsos@caplink.org with any questions.
Webinar/Training Opportunity Reminders
Risk Management Manuals for CHCs: A Guided Tour Webinars

The ECRI institute, on behalf of HRSA will be offering two free live webinars discussing risk management. To attend the  May 7 webinar at 3:00 PM EST, click  here . To attend the May 8 webinar at 12:00 PM EST, click  here
 
2019 UDS Changes Webinar

This one-hour webinar is scheduled for May 9 at 1:00 PM EST and will provide an overview of the major changes for calendar year 2019.

For additional information and to access the webinar, click  here .

HRSA Telehealth Learning Series: Teledentistry 
HRSA will host a 60-minute webinar today, May 2 at 1:00 p.m. on the Use of Telehealth in Increase Access to Dental Care. Registration is available hereSpeakers from Children's Dental Services and the University of the Pacific will discuss best practices in reducing oral health disparities in rural communities through dental therapy and telehealth innovations as well as the methodology and results of the Virtual Dental Home system developed in California and now deployed in multiple states.  Contact Nancy Rios  for more information about the session.  Archived sessions of the HRSA Telehealth Learning Series can be found online here.

Registration Available for 2 HRSA  Grants Management Workshops

An Atlanta, Ga.,  Regional Grants Management Workshop is  May 15-16. Limited to 100 active HRSA grantees.


For more information, reach out to the workshop staff at  HRSAGrantsWorkshop@hrsa.gov .

Free Federal Grants TA Webinar

HRSA's Region III Office is hosting a free Federal Grants Technical Assistance Webinar on Thursday, May 23 from 10:00 a.m. - 11:15 a.m. to present key steps and resources for seeking federal grants. Topics will include: overview of HHS/HRSA national and regional offices; identifying federal grant opportunities; navigating the federal grant application process; accessing technical assistance resources; and overview of fiscal grant requirements.  In order to receive the link to the webinar, registration is required.  


Community Health Center ResourcesResources

CONTINUITY OF CARE FOR FEDERALLY QUALIFIED HEALTH CENTERS

Federally Qualified Health Centers (or "FQHCs") must be able to ensure a full continuum of care for their patients. To this end, every FQHC must provide required primary health services promptly, and in a manner which will assure continuity of service to patients within the FQHC's service area. FQHCs must also develop an ongoing referral relationship with one or more hospitals to ensure that patients are able to receive a full spectrum of care and are able to receive emerge ncy and other inpatient  health care services that the FQHC is not able to offer.

First, to demonstrate a proper continuum of care, FQHCs should maintain documentation of hosp ital admitting privileges. This  could be achieved through employment contracts or other files which explicitly indicate that FQHC providers have admitting privileges at one or more hospitals. FQHCs could also have formal arrangements with hospitals or other related entities (e.g., hospitalists and obstetrics hospitalist practices) for the purposes of hospital admission of FQHC patients.

Second, FQHCs should adopt internal operating procedures that address the care of patients who are hospitalized as inpatients or who visit a hospital's emergency department ("ED"). Agreements between FQHCs and external entities related to inpatient or ED care should set forth the FQHC's coordination of care internal operating procedures. Specifically, FQHCs should have internal operating procedures that ensure the FQHC's receipt and recording of medical information related to the hospital or ED visit, such as discharge follow-up instructions, and the transmission of laboratory, radiology, or other results. Procedures indicating the extent and type of follow-up care that will be implemented by FQHC staff ancillary to a patient's hospital or ED visit, when appropriate, are also necessary.

Finally, FQHCs must not only have these internal operating procedures and external arrangements in place but must document that they are following such procedures and arrangements. FQHCs can document compliance by saving and recording all transmitted medical information related to the patient's hospital or ED visit, and by thoroughly detailing any follow-up care that was received by the patient from FQHC staff.

By implementing, adopting, and following these procedures and arrangements, the FQHC, its patients, and the entire community will benefit from its ability to provide of a full continuum of care. Additionally, the FQHC will comply with the applicable continuity of care requirements.

Authority: Sections 330(k)(3)(A) and 330(k)(3)(L) of the PHS Act; 42 C.F.R. § 51.c.303(a); 42 C.F.R. §56.303(a). See also Chapter 8 of the HRSA Health Center Program Compliance Manual
***
Rachel Ludwig and Neil Brown are members of the healthcare group at Jackson Kelly PLLC.  They are available for consultation through a special retainer relationship with the WVPCA.  Rachel and Neil can be reached at (304) 340-1000.
Jackson Kelly PLLC
 
The WVPCA has retained the law firm of Jackson Kelly, PLLC to provide legal guidance to the WV Primary Care Association and its members.
 
Jackson Kelly attorneys provide limited consultation to all members of the WVPCA at no charge, as part of the WVPCA contract. There is no limit to the number of calls which any member may make. All inquiries within the scope of professional competence of firm attorneys will be addressed. Inquiries which require expertise not available through the firm will be promptly identified and, when requested, Jackson Kelly will assist in referring the matter to accounting firms, insurance agents, or others as circumstances warrant.
 
All inquiries, responses and consultation services provided by the firm lawyers will be provided without additional charge beyond the retainer amount, except for matters which require formal opinions, representation of record in litigation, transactional work, e.g. the purchase or sale of real property, or matters which require continued representation, research or consultation beyond a single inquiry or document review.

Justin M. Harrison is a labor & employment lawyer with Jackson Kelly PLLC. He is available for consultation through a special retainer relationship with the WVPCA.  Justin can be reached at 304.340.1358.  
ECRI Institute 
 
The  ECRI Institute  offers numerous policy templates that can be used as guidance consistent with the needs of community health centers. To take a look at their library of policy templates, click  here .

If you are not an ECRI member, creating a free account before accessing these materials is required. ECRI Institute resources are provided for free on behalf of HRSA.

To Access Policies: 
  • From the main page, click on the clinical risk management link on the left hand side of the page
  • Click sample policies and tools listed under tool-kits on left side of page
Click on the + sign to access individual templates.
WVPCA Staff

Chief Executive Officer

Chief Financial/Chief Operations Officer
Data Services & Integration  Speci alist

 Jennifer Boyd  PA-C, PCMH-CCE Clinical Consultant
Education & Communications
Coordinator
 Warne Dawkins, MBA
Health Data Analyst
J ohn Kennedy
School-Based/Behavioral Health Coordinator
Member Relations Coordinator
Shannon Parker, 
MBA, PCMH-CCE 
Director of Health Center Operations
Special Programs Coordinator
Staff Accountant
Clinical Quality Improvement Coordinator
To sign up to receive the WVPCA Weekly Newsletter, click HERE
West Virginia Primary Care Association
  1700 MacCorkle Ave. Charleston, WV 25314| (304) 346-0032 | WWW.WVPCA.ORG
STAY CONNECTED: