As legislators criss-crossed rural Virginia this year, they heard a common refrain: “Rural areas are struggling with health care staffing shortages and transportation issues.”
After months of meetings and field visits, the bipartisan House Select Committee on Rural and Small Town Health Care Advancement on Tuesday released a report outlining legislative and budgetary recommendations aimed at addressing these challenges. announced.
Some of the proposals include state grants to help local health care providers recruit specialists and increased investment in nursing education programs to build a stronger workforce. Included.
To improve transportation access, the report recommends a new program that would provide free transportation to clinics and federally qualified health centers. Lawmakers point to Virginia's existing non-emergency transportation program for Medicaid patients, run by the Department of Medical Support Services, as a potential model.
“There's something here that will help at least some people,” Henrico Democratic Party Chairman Rodney Willett said at a September meeting on the Eastern Shore. “Can we take advantage of that? Is there a way to extend it to non-Medicaid people who live at certain income levels or in certain areas?
The committee also recommends requiring insurance companies to cover audio-only telehealth services. Mr Willett previously told the Mercury that this would be a lifeline for people with limited broadband access, as well as older patients and those who don't have computers and rely on their phones for telemedicine. .
Support for people becoming parents in rural areas
Key sections of the report include the recently published “mama mani bus” A package of bills and budget proposals from Democratic lawmakers. Gov. Glenn Youngkin also outlined his plan to address maternal health, setting the stage for a bipartisan push in the 2025 Legislature.
Approximately 30% of Virginians live in areas with limited or no obstetric care services, and rural patients are often forced to travel long distances for care.
Midwives have become essential to filling these maternal care gaps, providing perinatal care in the home, birth center, and local hospitals. To strengthen this workforce, the report recommends increasing Medicaid reimbursement rates for midwives.
Midwives are often rooted in the communities they serve and remain local compared to some obstetrics and gynecology residents who may work in rural areas for a while before going to work elsewhere. Very likely.
Yonkin promised, Ongoing funding For obstetrician-gynecologist and family medicine residents (which is important as local hospitals close maternity wards), the report calls for broader investments in training for gynecologists and family medicine residents across the state.
Additionally, Youngkin on Tuesday voiced support for legislation that would streamline the number of out-of-state midwives who wish to work in Virginia and further strengthen the maternal health workforce.
The report also recognizes the important role doulas play in supporting and improving the health outcomes of parents-to-be and recommends increasing funding for community college doula training programs. There is. This support is especially impactful for patients of color, who face disproportionate risks during pregnancy.
Data from the Centers for Disease Control and Prevention shows: Black women are noticeably more likely to die They have fewer pregnancy complications than white women. Research points out that racial prejudice Doulas are key advocates for patient needs and care, contributing to poor health outcomes for women of color.
Earlier this year, Yonkin signed a bill supporting health insurance. Coverage for doulasrecognizes its role in maternal health. But he exercised the right of veto Separately, unconscious bias training was supposed to be required when renewing a nursing license.
Bias training remains a key recommendation of local health boards, but it faces resistance from some Republicans.
Committee member Rep. Otto Waksmann (R-Sussex) expressed hesitation.
“The problem isn't that Republicans are against cultural awareness training, which I think everyone is really in favor of, but that it's putting new burdens on providers,” he said. .
Earlier in the day, as Mr Youngkin outlined the maternal and child health policies he supports, the Mercury asked what changes might cause him to reconsider if the Unconscious Bias Bill were reintroduced. and acknowledged disparities in health outcomes for patients of color compared to white patients, but said this was not the case. He would not say whether he supports the bill.
“I think the right way to address this issue is to use the data that we collect and analyze to take really concrete steps,” he said.
What Yonkin said: administrative directive The state health department now includes pregnancy-related data in its Maternal and Child Health Data Dashboard.
I'm looking forward to it
As lawmakers debated the report's recommendations, many spoke of the bipartisan partnership that was built during their time on the committee, a spirit of cooperation they hope to continue into the 2025 session. I looked back on what happened.
“This was an overnight trip,” Waksman said. “I felt a lot of camaraderie just by breaking bread at the table and spending time together.”
Waksman, who represents rural communities, has first-hand experience with the challenges highlighted in the report.
“I've seen pharmacies disappear in our area,” Waxman said. “We've seen our grocery stores go out.”
He added that it was “refreshing” to see both rural and urban legislators come together to focus on the unique struggles facing rural areas.
Committee Chair Willett emphasized that while the proposal is not a complete solution, it is an important step toward improving access to health care.
Even if all of the commission's roughly 30 recommendations are ultimately adopted, Willett said rural health care issues won't “disappear” overnight.
“I can speak on behalf of all of us here to say that we are committed to continuing the case and moving forward,” he said.
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