Organization Newsletter

November 2016

In this issue...

  1. Executive Directors' Message
  2. Statin Drugs Reduce Infection Risk in Stroke Patients
  3. Shriners Hospital aids transition into adulthood
  4. UW Doctors' "Infant Mortality" article featured in the Rural Monitor
  5. Colville Hospital Named "Top 20 CAH" by the NRHA!
  6. Rural Health Funding Opportunities
  7. Get Involved!!
  8. Upcoming Educational Events
  9. WA State Legislative News


Welcome to the
November 2016 issue of the Washington Rural Health Association e-Newsletter.
Inside this issue you will find news and information from the new Executive Director and board of directors, members, and community partners from across the state of Washington. 

If you would like to submit your own story, please click here.

The WRHA e-newsletter is a publication of Washington Rural Health Association, a not-for-profit association composed of individual and organization members who share a common interest in rural health. This e-newsletter seeks to disseminate news and information of interest to rural health professionals and stakeholders to help establish a state and national network of rural health care advocates.

WRHA Members

WRHA members include administrators, educators, students, researchers, government agencies and workers, physicians, hospitals, clinics, migrant and community clinics, public health departments, insurers, professional associations and educational institutions. If you are interested in joining or renewing your membership with WRHA click here.




Submitted by: Beionka Moore
[email protected]

Personal growth sometimes includes changing careers and getting older. Yet many let that stamp determine how worthwhile their lives are or will be. The thing that brings me pause with that way of thinking is few people focus on the wins; some typically look through life lens with deficits. Often we highlight dream jobs, businesses, marriages, kids, things we’d assumed we have by a specific age. I say all of this to convey: Don’t let age or your dream job be the marker you use to assess your life. We are never too old or too wise.  Fear sometimes gets in the way of our happiness. Go after your dreams-with the excitement of a child regardless of age. I’m ready to lead the Washington Rural Health Association and feel honored to have been chosen to do so.  I’m an optimist, don’t wait for something to happen you go after it, no matter the dream or the age.
People in rural America indeed, compared with their urban counterparts, have higher rates of preventable conditions such as obesity, diabetes, cancer, and injury, and higher rates of related high-risk health behaviors such as smoking, physical inactivity, poor diet, and limited use of seat belts.  Rural individuals are greatly influenced by geography, and so is their health.  Reducing risky individual behaviors is an important strategy for reducing the burden of chronic disease in rural communities. Complementary strategies to reduce the health disparities include increasing the availability of health insurance and health care professionals for rural residents.  Health insurance coverage tends to increase the likelihood of timely access to health care, including preventive care, diagnostic tests, and prescriptions, which can help prevent escalation of health problems and increase survival rates from life-threatening disease.

Washington Rural Health Association is unique. We are the vehicle for a broad array of interest related to rural health care and delivery. The association provides leadership on rural issues through advocacy, communications, promoting education and research.  We proudly represent your priorities, your organization, and your voice in Washington.  WRHA collaborates with statewide rural health associations and other public and private agencies to promote rural health services across Washington State.  Increasingly, we are interested in collaborating with our rural partners. This is particularly relevant, given the associations renewed strategic focus. In my role as Executive Director, I will have the privilege of traveling around the state to meet with leaders and change agents in rural communities which include: member associations, oral heath leaders, mental health leaders, aging and disabilities leaders, as well as rural health clinic leaders, lawmakers, WRHA board members, and community leaders.  The goal is to find out a common issues and work towards solutions.
Here at WRHA, we are operating with an abundance of energy and excitement to bring our members new and improved services and benefits as part of your annual membership.  We look forward to partnering with you as we plan and prepare for the future. We also look forward to hearing your stories and ideas for upcoming issues and welcome your thoughts and feedback.  Please continue to be a strong advocate for those that reside in rural communities. Each of us makes a difference and it takes all of us to WIN!

Please feel free to contact: Beionka Moore at [email protected] to find out more information.  

WRHA now on Facebook and Linked-In!!  Please search for us and like or connect! 

P.O. Box 882
Spokane, WA  99210

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Statin Drugs Reduce Infection Risk in Stroke Patients

Submitted by: Megan Pierliussi
[email protected]

A Washington State University researcher has found that statin drugs can dramatically lower the risk of infections in stroke patients. Doug Weeks, an adjunct professor in the Elson S. Floyd College of Medicine and director of research at St. Luke's Rehabilitation Institute, analyzed the records of more than 1,600 hospitalized patients who suffered an ischemic stroke and found statins reduced the risk of infection by 58 percent. Ischemic strokes are due to blockage of a vessel that supplies blood to the brain. His findings appear online this month in the Journal of Stroke and Cerebrovascular Diseases ( "If patients had statins before there was evidence of an infection, there was a reduced risk that they would actually develop an infection," said Weeks.

Statins are typically used to lower cholesterol levels to reduce the risk of cardiovascular disease. But in the past decade, said Weeks, researchers have noticed that they also have anti-inflammatory properties in humans that can benefit the body's response to infection. Weeks analyzed data of hospitalized stroke patients and saw that those on statins upon admission or early in their stay had significantly lower risk for developing infections than those put on statins later in their hospitalization or not at all. Weeks controlled for other possible influences like the severity of strokes, age and the presence of other conditions like diabetes. He and his colleagues also noticed that the timing of the drug was a major factor. "The administration of statins relative to infection is critically important," he said. "We've been able to establish that if statins are given early, before infection can occur, the risk of infection is substantially reduced. However, this relationship needs to be tested in more rigorous placebo-controlled studies to see if this benefit with statins is maintained." Estimates vary, but one-third to almost one-half of stroke patients develop infections, he said. The infections could be introduced through tubes or catheters. There are also indications that stroke subdues the body's immune system, making a patient more prone to infection. Weeks' coauthors are Christopher Greer, pharmacy manager at St. Luke's and adjunct faculty in WSU's Department of Pharmacotherapy, and Megan Willson, a pharmacist at Providence Sacred Heart Medical Center and a WSU clinical associate professor of pharmacotherapy.

Their work is in keeping with WSU's Grand Challenges, a suite of research initiatives aimed at large societal issues. It is particularly relevant to the challenge of Sustaining Health and its theme of changing the course of disease.

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Shriners Hospital Aids Transition into Adulthood

Submitted by:  Damon Pilgrim
[email protected]

The teenage years are known to be a time of uncertainty and change as we make the transition from childhood and adulthood. The care team at the Spokane Shriners Hospital recognizes this time can create unique challenges for its teenage patients. With that in mind they created a transitional training camp they call FutureFest. FutureFest is designed to provide the tools and resources to help our campers feel comfortable and confident as they take control over their everyday lives. They learn about finance, social skills, healthcare (both during the appointment and insurance), housing, studying and college among many other topics. Shriners staff create a safe environment in which these teens are able to experience adult life without parental supervision. They bond with their fellow campers and, should they need it, staff are there to offer their wisdom and assistance.

This year, campers got to know each other during an ice breaker session after an always-popular pizza party. The second day they visited Spokane Community College where they learned how to identify their learning style and how to adapt their study habits accordingly. That evening they got to see their peers' competitive side on a trip to Laser Quest for some laser tag. During the week, campers also learned to set up their own doctor appointments and what to expect out of insurance companies. Umpqua bank taught them about budgets, financial responsibility and even what to look for when evaluating credit card offers. Day three ended in a fun dance at the hospital auditorium. Exercise and physical education were present every day, but was particularly highlighted during a trip to nearby Comstock Pool, rented out on their behalf to teach them water exercises and self-confidence in the water. Campers then visited downtown to enjoy dinner and a movie before rising the next day for a trip to the grocery store to learn about meal planning, grocery shopping and budgeting. Campers are given a budget and are guided on how to shop within those limits. One parent was noted as saying his daughter was a completely different girl in a positive way. He expressed amazement in how much she had learned and grown as a young lady in just five days! 

Camp nurse Jen said "I think my favorite part of camp is observing a group of teens, each with their own personality, values, beliefs and life experiences grow as a group. They begin camp quiet and shy and really bloom and grow as individuals and as a group." She continued "We simply take the incredible foundation that the parents have provided their children and we help these campers build on that foundation and apply new skills and ideas. It really is inspirational to watch each camper transform."

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        UW Doctors' "Infant Mortality" article featured in the Rural Monitor

Submitted by: Jenn Lukens
[email protected]
Rural Health Information Hub

Exploring High Infant and Maternal Mortality Rates in the Rural U.S. with Dr. Ali Mokdad

Dr. Ali Mokdad has spent much of his career educating others about health. He is currently the Director of Middle Eastern Initiatives and Professor of Global Health at the Institute for Health Metrics and Evaluation (IHME) and Head Faculty Member of U.S. Studies at the University of Washington. Prior to joining IHME in 2009, Dr. Mokdad worked at the U.S. Centers for Disease Control and Prevention.

One of the major health issues IHME covers is maternal and infant mortality. Since the 1980s, infant mortality rates have decreased in the United States; however, the rates are still high in comparison to other developed countries. The U.S. is also among only eight other countries that experienced an increase in maternal death rates since 2003. In one of the most medically-advanced countries in the world, it leaves us wondering, “what’s the issue?” Dr. Mokdad took some time to speak with me about some reasons behind this reality from a rural perspective.

What are some factors that contribute to the high rates of infant and maternal mortality in the United States?

What we see are many health indicators related to infant and maternal mortality that contribute to us not performing at the same level of our competitors. Our rank of life expectancy at a global level is about 39 or 40. It’s a combination of things that also explains why we have a variation of these disparities between rural and urban, but there are four risk factors that lead to these disparities – infant and maternal, as well as overall mortality – within our country:

The first is socioeconomic factors. If you take somebody’s education and income, these are important factors in health achievements. To give you an example, if a woman is educated, she is more likely to know the health danger signs and seek medical care, she is more likely to adhere to the message of medical care, et cetera. If you look within the U.S. between rural and urban and compare education levels and income levels as a nation, we also fall short of some of our competitors.

The second factor is access to medical care, meaning health insurance, financial means, and distance. Now many people have insurance, but before many didn’t. Even with health insurance, you can still be underinsured. It may only allow coverage for an emergency or accident, but it may not allow coverage for preventive care.

The third factor contributing to mortality in the U.S. is quality of medical care. This is very important, especially when you put it in a rural compared to urban context. The timing of injury related to the timing of intervention is also important. For example, in Seattle, Washington, it would take 15 minutes to receive first line of defense treatment to prevent mortality. Whereas, in a rural area, it may take much longer.

The fourth one, which is the most important risk factor that makes us fall behind other countries and makes rural areas here perform at a lower level than urban areas, is preventable risk factors. These include smoking, obesity, physical inactivity, and drug and alcohol abuse. We know that rural areas have a higher profile of these risk factors. One thing in particular that is really impacting rural areas is the drug abuse epidemic. Many babies are born with a mom who is an addict, and there are complications with these babies. There is a rise in infant mortality because of drug use.



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Colville Hospital Named "Top 20 CAH" by the NRHA!

Submitted by:  Elizabeth DeRuyter, External Communications Director
Providence Health Care
(509) 474-3081

Providence Mount Carmel Hospital named "Top 20 Critical Access Hospital"

Spokane, Wash. — Providence Mount Carmel Hospital in Colville was recently named by the National Rural Health Association (NRHA) as one of the Top 20 Critical Access Hospitals (CAH) in America.

The Top 20 Critical Access Hospitals are those hospitals that have achieved success in overall performance based on a composite rating from nine indices of strength: inpatient market share, outpatient market share, population risk, cost, charge, quality, outcomes, patient perspectives, and financial stability.

Providence leadership and board members will honor caregivers for their work in achieving “Top 20” status during a celebration Nov. 9 at 2 p.m. in the hospital’s Courtyard Café.

“This recognition shines a spotlight on the amazing care that our medical staff and caregivers at Providence Mount Carmel deliver to patients every day of the year,” says Ron Rehn, chief executive of Mount Carmel Hospital.  “It is this dedication that distinguished Providence Mount Carmel among the best critical access hospitals in the country, and is one more indication that our community can count on us to deliver the services they need now and in the future,” Rehn adds.

Providence Mount Carmel Hospital is a 25-bed Critical Access Hospital serving a three county area in Northeast Washington. Located in Colville, the hospital provides advanced medical and surgical care as well as specialty support and outpatient services. It is a member of Providence Health Care – a not-for-profit Catholic health care network in Eastern Washington committed to providing for the needs of the communities it serves, especially for those who are poor and vulnerable. For more information, visit


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 Rural Health Funding Opportunities

Submitted by:  Beionka Moore
[email protected]

Rural Health Research Dissemination Cooperative Agreement
HRSA-17-002 | Office of Rural Health Policy
Application Accepted: 09/02/2016 to 12/14/2016 - Projected Award Date: 07/01/2017
Estimated Award Amount: N/A
This announcement solicits applications for the Rural Health Research Dissemination Cooperative Agreement.  The purpose of this program is to disseminate and market rural health services research funded by the Federal Office of Rural Health Policy (FORHP) to diverse audiences, such as decision makers and rural stakeholders at national, state, and community levels, with the goal of informing and raising awareness of key policy issues important to rural communities.  FORHP primarily funds health services research through our Rural Health Research Center (RHRC) cooperative agreement.  The successful applicant for this program will develop and maintain a website which includes the entire body of research funded by FORHP and allows that research to be easily and freely accessible to the public.  
Contact Information:
Sarah Bryce, [email protected]
Phone: 301-443-5982

Rural Health Network Development Program
HRSA-17-018 | Office of Rural Health Policy
Application Accepted: 09/21/2016 to 11/28/2016
Projected Award Date: 05/01/2017
Estimated Award Amount: N/A
This announcement solicits applications for the Rural Health Network Development (RHND) Program.  The purpose of this program is to support mature, integrated rural health care networks that have combined the functions of the entities participating in the network in order to address the health care needs of the targeted rural community.  Awardees will combine the functions of the entities participating in the network to address the following statutory charges:  (i) achieve efficiencies; (ii) expand access, coordinate, and improve the quality of essential health care services; and (iii) strengthen the rural health care system as a whole.
Contact Information:
Jayne Berube, [email protected]
Phone: 301-443-4281

Rural Policy Analysis Program
HRSA-17-003 | Office of Rural Health Policy
Application Accepted: 07/12/2016 to 11/14/2016  
Projected Award Date: 07/01/2017
Estimated Award Amount: N/A
This funding opportunity announcement solicits applications for the Rural Policy Analysis Program.  The purpose of this program is to support research and analysis of key policy issues affecting rural communities that informs policy makers.  The program is national in scope and looks at cross-cutting rural health and human services issues in order to identify trends and challenges. Funded projects should focus on the changing rural environment and products should achieve the following: facilitate public dialogue on key rural policy issues by tracking emerging rural health and human services policy issues and quickly synthesizing them in a manner that provides for easy consumption by rural community leaders, with particular emphasis on rural health care providers and systems; identify opportunities for integrating health and human services in rural policy, program, and evaluation in a local community context; identify opportunities to demonstrate broad community impact of policies and programs in rural health and human services, consistent with policy goals related to rural revitalization and sustainability of rural regions.
Contact Information:
Amy Chanlongbutra, [email protected]
Phone: 301-443-5843

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 Get Involved, Join A Committee!


Submitted by: Abigail Richardson, WRHA Membership Committee Chair
[email protected]

It takes you to make a difference!

Would you like to have a greater impact on the future of rural health and the direction of the Washington Rural Health Association?  If so, I invite you to review the following list of Standing Committees and their charges, and consider joining us.

The WRHA is seeking volunteers to join the following committees:

•    Awards Committee – selects WRHA award winners and presents awards at the 2017 NW Regional Rural Health Conference in February
•    Communications Committee – coordinates WRHA publications, enhance communication and publicity to members, contribute to the website and the newsletter. Work together with the WRHA Board, to inform, engage, and educate members and other interested parties regarding issues important to the rural community
•    Membership/Development Committee – this committee is charged with advancing new initiatives. I call it the “Idea Committee.”  This group has been brainstorming ideas and concepts to broaden our financial base, as well as pursue activities to enhance active membership
•    Legislative Committee – If you have questions or hear of legislation that we should know about, please let us know. There’s always something happening here. Mainly active during the legislative session, this committee reviews the Bill Tracking Report, compiles a list of bills to be tracked, and works for legislative event planning
•    Bylaws Committee – headed by the WRHA president, this committee meets every two years to review Association bylaws
•    Finance Committee – we are entering a time of change and current sources of funding are certainly changing. Assists the treasurer in developing an annual budget, review disbursements, makes recommendations to the Board, and manages additional revenue

To request to join or for more information about WRHA Committees, please click here!

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Upcoming Educational Events

Below is a short list of upcoming Rural Health conferences that you may find beneficial.  Happy Training & Education!

National Rural Health Day — November 17, 2016
The third Thursday in November has been set aside to highlight rural communities as wonderful places to live and work, increase awareness of rural health-related issues, and promote the efforts of State Offices of Rural Health and the National Organization of State Offices of Rural Health in addressing these issues.
Website to full article:

February 7-9, 2017
28th Rural Health Policy Institute
Washington, DC

Feb 22 - 24, 2017
2017 Annual Western Forum for Migrant and Community Health
San Francisco, CA

February 28-March 1, 2017   
NW Regional Rural Health Conference
Seattle, WA

Apr 3 - 5, 2017
2017 National Council for Behavioral Health NATCON Conference National
Seattle, WA

Apr 10 - 12, 2017
6th Annual Northwest Regional Telehealth Resource Center Telemedicine Conference
Seattle, WA

May 9, 2017 (4 separate topics)
22nd Health Equity Conference
Rural Medical Education Conference
40th Annual Rural Health Conference
Rural Hospital Innovation Summit
San Diego, CA

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 Washington State Legislative News

Submitted by:  Jeff Johnson, WRHA President


Governor Inslee recently shared budget decision packages that were submitted by the various state agencies to the Office of Financial Management (OFM). These budget requests will be considered by the governor in forming his proposed budget for the 2017-2018 biennium. Anticipate seeing the governor’s budget in mid-December.

The decision package highlights include a request from the Health Care Authority to spend $537 million in federal funds to improve Medicaid care, a request of $60 million from the Department of Health to cover gaps in public health, a request of $18.5 million from the Department of Social and Health Services for improvements in mental health treatment and a request from the Aging and Long Term Support Administration of $59 million in federal funds to increase nursing home reimbursement rates in rural areas where acuity levels are lower but the current rate structure does not sufficiently support the nursing homes. Click here to read more.  Courtesy of the Washington State Hospital Association

Gov. Jay Inslee and the Washington State Health Care Authority (HCA) announced today a new state-federal partnership that will bolster state efforts to improve the physical and mental health of Washington families and transform the state’s Apple Health (Medicaid) program to control costs.

After months of detailed negotiations, the HCA—in partnership with the Department of Social and Health Services (DSHS)—and the federal Centers for Medicare & Medicaid Services (CMS) reached an agreement in-principle, on a five-year Medicaid demonstration waiver to continue implementing the governor’s Healthier Washington plan.

“This project is the result of months of discussion with President Obama’s administration and is a significant boost to our state’s health care reform efforts,” Inslee said. “I commend the teams at HCA and DSHS for designing this community-led and broadly supported plan to improve health and reduce costs for families and our state.”

The project is part of Washington state’s effort to focus on prevention and proactive management for conditions like diabetes and mental illness. It funds supported employment and housing services and long term care services and supports for unpaid family caregivers so they are able to keep caring for their loved ones. The result will be less use of high-cost services and better health outcomes.

The five-year demonstration provides up to $1.1 billion of incentives for delivery system reform and $375 million to support critical services for Apple Health clients over five years.

Significant stakeholder and community input, including multiple public comment periods and public meetings around the state, led to this demonstration plan that has four goals:
•    Reduce avoidable use of high-cost services such as acute care hospitals, psychiatric hospitals, and nursing home facilities.
•    Improve population health, with a focus on prevention and proactive management of diabetes and cardiovascular disease, pediatric obesity, smoking, mental illness, and substance abuse for Apple Health clients.
•    Accelerate Medicaid payment reform to pay providers for better health outcomes.
•    Bend the Medicaid cost curve below national trend.

Key initiatives under the demonstration are funded through reinvestment of past and future federal savings from Washington’s Medicaid reform efforts. Locally-led efforts will engage and support clients, providers, and communities through:
•     Delivery system transformation strategies led by regional Accountable Communities of Health
•    A broader array of service options to enable older adults and individuals with disabilities to stay at home and delay or avoid need for more intensive care.
•    Supportive housing and supported employment services for Medicaid clients with the most critical needs.

“This decision will allow Washington state to build on a tradition of leadership in health care with important reforms to improve the quality and efficiency of care in Medicaid,” Senator Patty Murray said. “The Medicaid waiver has been a crucial tool for many states—and I’m confident that with the right changes and improvements under the leadership of Governor Inslee and others, we’ll be able to continue to make important strides toward providing quality, affordable health care for all Washingtonians.”

“This agreement is one of the most powerful tools we have as we continue the work of improving health, improving the quality of care, and lowering costs,” said HCA Director Dorothy Frost Teeter.

“We have anchored our approach to local communities where real health transformation can occur,” said State Medicaid Director MaryAnne Lindeblad. “Our new targeted services will help keep individuals stably housed and employed and get them the care they need.”  “Every medical group and provider who serves Medicaid patients faces the same difficult choice between wanting to help all people of all income levels and maintaining the ability to provide care for patients long-term through a financially stable organization. We have advocated for these changes to allow for better outcomes for patients and sustainable health care in our community,” said Rick Cooper, northwest regional market president for HealthCare Partners, a DaVita Medical Group (recently CEO of The Everett Clinic) and co-chair of the Health Innovation Leadership Network.

“The rapid growth in the aging population means we either find a new innovative way of delivering services or come up with significant new Medicaid resources for the long-term care system,” said DSHS Assistant Secretary for Aging and Long-Term Support Bill Moss. “Washington will lead the nation to demonstrate how we can support unpaid family caregivers and offer targeted services that will actually avoid much more expensive utilization down the road.”

The demonstration waiver is an option to states under Section 1115 of the Social Security Act. The specific terms of the demonstration are still being finalized.

The letter from CMS can be found here.  For more information about the demonstration, visit

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Submitted by: Dawn Bross, President of the RHCAW

2017 Northwest Regional Rural Health Conference preliminary information can be seen on the flyer below, click on link!  More coming soon!

assets/nwrhc 2017 save the date.pdf 



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