Affordable Care Act provides incentives to encourage doctors to serve in rural America, funds health rural centers, helps rural Americans get access to care

USDA awarding more than $10 million in grants to support telemedicine and rural health research

Washington, D.C., Nov. 20, 2014 - Today, on National Rural Health Day, Agriculture Secretary Tom Vilsack announced more than $10 million in grants through two U.S. Department of Agriculture (USDA) programs to improve access to health care for rural Americans across the nation. The Secretary also highlighted initiatives created by the Affordable Care Act that specifically address critical health needs in rural communities.

"Delivering these programs to rural communities that often do not have access to quality, affordable medical and educational services has tremendous economic and social benefits," Vilsack said. "They also mean that people who live and work in rural areas will not have to travel long distances for specialized health care services. These investments mean that students in rural high schools will have educational opportunities often not available outside urban areas."

Through the Distance Learning and Telemedicine (DLT) program, USDA has helped hundreds of rural communities deliver care in remote areas since it began two decades ago. Today, USDA's Rural Development is awarding $20.4 million in grants that will provide rural Americans access to medical services, improve educational opportunities, and support Native American communities. Fiscal Year 2014 Distance Learning and Telemedicine Grant recipients

Rural residents are more likely to report a fair to poor health status and have higher rates of health complications, morbidity and mortality due to challenges associated with low levels of employment and education, geographic barriers and isolation, lack of quality nutrition and health education, and lack of access to health care.

USDA's National Institute of Food and Agriculture (NIFA) is awarding 12 grants totaling more than $1.4 million to universities aimed at enhancing the quality of life in rural areas through improved health and safety education efforts. NIFA funded the grants through the Rural Health and Safety Education program which addresses these challenges by developing programs that provide the necessary health information to rural residents. The program has three main focus areas: 1) individual and family nutrition and health education; 2) farm safety education; and 3) rural health leadership development education.

Projects funded in fiscal year 2014 focus on a diversity of rural health and safety issues, from diabetes education, obesity prevention, and physical activity and healthy nutrition education, to eco-healthy child care promotion, and rural expansion of 4-H Healthy Living program. Fiscal Year 2014 Rural Health and Safety Education Grant recipients

In addition to today's announcements, Secretary Vilsack encouraged rural Americans to take advantage of the Health Insurance Marketplace created by the Affordable Care Act and discussed the health care reform law's specific benefits for rural communities.

"Rural residents have higher rates of chronic conditions.  This can be exacerbated by a lack of doctors or clinics in rural communities," Secretary Vilsack continued. "The Affordable Care Act is improving the health of rural communities and giving all families the security they deserve. No one should go without healthcare because of where they live, or be forced to leave the communities they love to get the coverage they need."

Rural Americans suffer from higher rates of chronic conditions like diabetes, heart disease and high blood pressure.  The Affordable Care Act has taken steps to address the unique challenges rural communities face when it comes to getting the health care they need.

One in five uninsured Americans lives in a rural area, and yet on average only 10 percent of the nation's physicians practice in these communities. The Affordable Care Act has significantly increased the size of the National Health Service Corps, which offers scholarships and loan repayment to health practitioners in return for practicing in rural communities and other underserved areas. More than 3,500 Corps members now serve in rural areas, and an average of 86 percent of them will remain in their communities even after completing their service.

The Affordable Care Act also invests significantly in expanding services at community health centers, where 7.5 million rural Americans get access to primary and preventive care. That comes on top of the more than $3 billion USDA has invested since 2009 to strengthen health infrastructure in rural areas, building rural hospitals and health clinics and expanding access to health care in remote rural areas through telemedicine.

Not only can a lack of health insurance coverage help lead to high rates of chronic conditions, it threatens rural families economic health as well.  Before the Affordable Care Act passed, the average rural family paid nearly 50% of all health costs out of pocket. One in five farmers is in debt because of medical bills. Uninsured individuals living in rural areas are able to use the Marketplaces to compare qualified health plan insurance options based on price, benefits, quality, and other factors with a clear picture of premiums and cost-sharing amounts to help them choose the qualified health insurance plan that best fits their needs.

Open Enrollment for the Health Insurance Marketplace began Nov. 15, 2014, and runs through Feb. 15, 2015. Those who have plans can continue them without re-enrolling. However, consumers are encouraged to visit HealthCare.gov to review and compare health plan options and find out if they are eligible for financial assistance, which can help pay monthly premiums and reduce out-of-pocket costs when receiving services. In order to have coverage effective on Jan. 1, 2015, consumers must enroll or update their coverage by December 15.

Consumers can find local help at: Localhelp.healthcare.gov or call the Federally-facilitated Marketplace Call Center at 1-800-318-2596. TTY users should call 1-855-889-4325. Translation services are available. The call is free.

To preview plans in your area, visit: www.healthcare.gov/see-plans/

For more information about Health Insurance Marketplaces, visit: www.healthcare.gov/marketplace

Washington, D.C. - Congressman Dave Loebsack today announced that the University of Iowa has received a $498,973 grant from the USDA's Distance Learning and Telemedicine Grant Program. The funding will be used to provide adult, pediatric and geriatric healthcare for patients at 64 remote rural locations.

"Residents of rural communities deserve to have access to the same medical care as someone living in a larger community," said Loebsack. "I am pleased the University of Iowa is receiving this funding to help them continue to lead the way in providing quality health care to all Iowans, no matter their location."

These funds will be used to provide telemedicine videoconferencing services for Family Medicine at 40 rural sites, for Child Health Specialty Clinics at 9 rural sites and for Geriatric Outreach at 15 rural sites. The rural locations are in the following counties: Allamakee, Appanoose, Benton, Bremer, Buchanan, Buena Vista, Cass, Carroll, Cerro Gordo, Cherokee, Clay, Clayton, Decatur, Delaware, Des Moines, Dickinson, Emmett, Fayette, Fremont, Hardin, Henry, Iowa, Jackson, Jefferson, Johnson, Keokuk, Kossuth, Linn, Louisa, Mahaska, Marion, Montgomery, Page, Plymouth, Polk, Poweshiek, Scott, Shelby, Union, Van Buren, Washington, Wayne, Winneshiek, and Wright.

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'There is Always a Way Through' Emotional Trauma, Says One Who's on the Journey

Neglect. Abuse. Divorce. Addiction. These are just a few of the life experiences that can leave children emotionally bruised or worse, causing some to develop dysfunctional outlooks and behaviors that condemn them to perpetual self-victimization as adults.

"We not only perpetuate, but also protect the obstacles that stand in the way of our healing and happiness," says Marta Maranda. "But there is always a way through, no matter what your situation."

The author of "What It Looks Like," (http://martamaranda.com/), a new memoir detailing her own journey of healing, Maranda says she continued to use the defense mechanisms she developed in response to childhood trauma far into adulthood, which only served to block healthy emotional growth.

"As an adult decades after the initial abuse, I was still surrounding myself with similar trauma, and still reacting in the same ways to the trauma, even though those childhood survival tools no longer served me. Basically, the only one keeping me stuck in a dysfunctional and unfulfilling life was me."

Maranda says she didn't realize she played a part in her own dysfunction until the treatment of a family member for substance abuse caused her to think differently.

"I don't drink, use drugs, or have a sexual dysfunction. I've never even had a cup of coffee in my life," she says. "So it was easy to look at everyone else as the cause of my problems.

"But during family therapy sessions, I finally realized that there are two dysfunctional people in an unhealthy relationship, and there is an entire dysfunctional family in an unhealthy family system."

Maranda became a rarity: sober and voluntarily, she admitted herself into a five-week residential treatment center. That's where her healing began.

"But I'm not done," she says. "Healing involves tearing down all those dysfunctional coping mechanisms?fear, anger, denial, justification?and rebuilding your life piece by piece. I still have to do the work every day."

She offers these tips for others whose past trauma has resulted in self-destructive thought and behavior patterns, such as a willingness to remain in unhealthy relationships or an over-reliance on comforts like food, drugs, or alcohol to soothe painful emotions.

·  Look inward for reasons, not outward for blame.
It's easy to find other people or situations to blame for your problems. Even if the initial trauma was inflicted when you were at your most vulnerable, and by someone you should have been able to trust, at some point you have to take responsibility for your own life. "How are you contributing to the dysfunction in your life?" Maranda asks. "The decision to remain stuck in a dysfunctional life is yours. The responsibility to move forward toward healing and happiness is also yours."

·  If you've done it, admit it.
Look fearlessly at the wrong you've done, at the pain you've inflicted on yourself and others through your own dysfunctional behavior, and admit it. "Only by owning it can you change it," Maranda says. "And only through change can you heal." Likewise, look kindly and with humility at the good you've done. Own all that is valuable about you, and build upon it.

·  Information, not shame.
The lessons of healing always come with a choice: information or shame? If you are doing your healing work properly?meaning completely breaking down every defense mechanism you've built to keep yourself blind to your own dysfunctional behavior?the realizations that you've caused others harm, pain, or even extreme damage will come. But eventually you have to choose between continuing to feel shamed, which leads to feelings of worthlessness and hopelessness, or accepting the realizations as the information necessary to repair your life. "Much like a doctor needs to objectively understand what's broken to diagnose a problem, so do you need to look objectively at your dysfunction and its consequences to heal it," Maranda says. "Then use your healthy guilt feelings, not shame, as a reminder of what you can't do again."

·  Build a support system.
No one's said it better than Einstein: You can't fix a problem with the same broken mind that created it. Left to their own devices, many people who are convinced they need to change will still seek out environments that support their dysfunctions rather than strengthen their healing. "Change is hard, and healing isn't always comfortable," Maranda says. "That's why people often find their way back to what they know, even if what they know is destructive or deadly." Building a support system of people?whether family or friends, or from a therapeutic or spiritual community?whose perspectives get you out of your comfort zone and away from the dysfunction you know is essential for healing.

About Marta Maranda

Marta Maranda is a writer, businesswoman, and author of "What It Looks Like," (http://martamaranda.com/). She holds a bachelor's degree in communications and undertook a year of post-graduate study in psychology. She is currently working on her second book.

Changes in health insurance raise many questions for consumers. Iowa State University Extension and Outreach is offering a FREE online two-hour unbiased, research-based educational workshop for consumers on December 10 from 6 - 8 PM. The Smart Choice Health Insurance Education program will equip consumers with tools they need to make the best possible decision when choosing health insurance plans for themselves and their families. Register for this free online class at http://tinyurl.com/pvmceb7. For more information, contact Phyllis Zalenski, Human Science Family Finance Specialist, at 319-465-3224 or zalenski@iastate.edu

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PEORIA, Ill. (Nov. 19, 2014) - The first nationwide partnership and "Fuel Your Community" campaign between the American Red Cross and energy provider Suburban Propane in October helped collect thousands of lifesaving blood and platelet donations for patients at approximately 2,600 hospitals and transfusions centers served by the Red Cross.

Hundreds of Suburban Propane employees rolled up their sleeves to give blood and volunteer at 64 Red Cross blood drives across the country the October campaign, resulting in more than 1,500 blood donations at those drives, and nearly 600 first-time donors. With each blood donation potentially helping up to three people, as many as 4,500 lives could be impacted.

"Our employees are proud to support the American Red Cross and the hospitals and patients it serves," said Chief Operating Officer Mark Wienberg of Suburban Propane. "This is the sixth time Suburban Propane has partnered with the Red Cross to raise awareness about the constant need for blood and platelet donations, and is our largest and most successful effort to date. We look forward to continuing to support the Red Cross and its humanitarian mission with our national sponsorship."

Through the "Fuel Your Community" campaign, Suburban Propane also sponsored an advertising campaign to raise greater awareness for the constant need for blood and platelet donations, and donated a $5,000 Visa gift card for one lucky presenting blood donor to win.

"Partnering with civic-minded organizations, like Suburban Propane, is at the heart of our humanitarian and volunteer supported organization," said Donna M. Morrissey, director of national partnerships, Red Cross Blood Services. "With Suburban Propane's support, overall the Red Cross collected more than 460,000 blood donations at over 19,000 blood drives in October, helping to meet the need of about 15,000 blood donations every day for patients."

"It's the blood products already on the shelves that help to save lives in an emergency," said Shelly Heiden, community CEO, Red Cross Heart of America Blood Services Region. "Suburban Propane's support helps ensure that blood is available for cancer patients, those fighting blood diseases, trauma victims and others here in the Heart of America Region as well as patients throughout the country."

To learn more about blood donation or find a blood donation opportunity, download the Blood Donor App, visit redcrossblood.org or call 1-800-RED CROSS (1-800-733-2767). Eligible donors with all blood types - especially O negative, A negative and B negative - are needed to maintain an adequate supply for patients.

 

About the American Red Cross

The American Red Cross shelters, feeds and provides emotional support to victims of disasters; supplies about 40 percent of the nation's blood; teaches skills that save lives; provides international humanitarian aid; and supports military members and their families. The Red Cross is a not-for-profit organization that depends on volunteers and the generosity of the American public to perform its mission. For more information, please visit redcross.org or visit us on Twitter at @RedCross.

About Suburban Propane

Suburban Propane Partners, L.P. (NYSE:SPH) is a nationwide distributor of propane, fuel oil and related products and services, as well as a marketer of natural gas and electricity. Headquartered in Whippany, New Jersey, Suburban serves the energy needs of more than 1.2 million residential, commercial, industrial and agricultural customers through approximately 710 locations in 41 states.

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Over time, the presence of too much glucose in your cells can injure the walls of the tiny blood vessels called capillaries that deliver blood to your nerves, especially in the legs. This can cause tingling, numbness, burning, or pain.

Poorly controlled blood glucose can even cause you to lose all sense of feeling in the affected limbs - and a loss of feeling in your feet makes you more vulnerable to injury and infection. Let's say you get a blister or small cut on your foot that you don't feel: Because you don't know it's there, you may miss the symptoms of an infection in the wound. It's imperative for you to check your feet regularly to avoid this and be meticulous in your foot care, because untreated infections can result in gangrene (the death of tissue) and may lead to the amputation of the affected limb or toes.

Diabetes can also make it more difficult for your body to fight infections in general. Various skin conditions are linked to diabetes, and even the most minor cuts or sores can turn serious fast. Any bumps, cuts, or scrapes should be cleaned and treated with an antibiotic cream and monitored carefully.

Nerve Damage: What to Watch For

If you notice any of these symptoms associated with nerve damage or infection, see your doctor:

  • Inflammation and tenderness anywhere on your body
  • Red, itchy rash surrounded by small blisters or scales
  • Cuts, sores, or blisters on your feet that are slow to heal and are not as painful as you would expect (due to a loss of sensation)
  • Numbness, tingling, or burning sensations in your hands or feet, including your fingers and toes
  • Sharp pain that gets worse at night
  • Muscle weakness that makes walking difficult
  • Bladder infections and problems with bladder control
  • Bloating, stomach pain, constipation, nausea, vomiting, or diarrhea
  • Erectile dysfunction in men and vaginal dryness in women

Remember: If you keep your blood-glucose levels on target, you can help prevent or delay nerve damage. If you already have nerve damage, this will help prevent or delay further damage. You should also speak to your doctor about other treatments that can help.

Next step: Protecting Your Kidneys

November 2014 (Muscatine, IA) Gilda's Club, Susan G. Komen Quad Cities, Flickinger Learning Center, and the Diversity Service Center Muscatine are partnering to put on a free of charge breast cancer awareness luncheon in Spanish. A $50 gas card will be raffled off. It will take place Saturday November 22nd at 12:30 p.m. at Flickinger Learning Center 413 Mulberry Avenue, Muscatine, IA. Please call the Diversity Service Center Muscatine at 563-264-8883 to register.

Open enrollment for health coverage through the Iowa Health Insurance Marketplace has just begun and will run through February 15, 2015.  During these next three months, you will have the opportunity to renew your current coverage, enroll in a different plan, or purchase insurance for the first time.  I wanted to provide you with some information as you begin exploring your options.

Here are a few key things to remember:

  • If you are currently enrolled in coverage through the Marketplace, you do not have to sign up again and will be automatically re-enrolled.  However, I encourage you to take a look at the plans available to see if you can get a better deal or a plan that better fits your health care needs.

  • If you do not currently have coverage, you must apply by December 15 in order to get coverage beginning January 1.  If you apply past the 15th of the month, your coverage begins the first day of the second following month.

  • You may qualify for a special enrollment period outside of open enrollment in the following circumstances:

    • You change your job

    • Your income changes

    • You turn 26 and leave your parents plan

    • You move your residence

    • You have a baby or adopt a child

    • You get married or divorced.

  • There are several ways to apply for coverage on the exchange.  These include :

    • Over the phone by calling the Marketplace Call Center at 1-800-318-2596.
    • Online at HealthCare.gov or CuidadoDeSalud.gov

    • In-person. Find people in your community trained and certified to help you enroll at Localhelp.HealthCare.gov

    • Paper application. You can get a paper application by calling the Marketplace Call Center of downloading a copy from HealthCare.gov.

Updates to the HealthCare.gov website now allow you to shop for and compare plans before submitting an application and have streamlined the application process.  Further, the website has been improved to allow for many more users than are expected in order to avoid the frustrating wait times that some experienced during last year's enrollment process.  I will continue to monitor the operation of the site to ensure that all Iowans who want to purchase or change their insurance are able to do so.

As always, please feel free to contact my office if you need any assistance as you consider your options and apply for health care coverage.

Sincerely,

Dave Loebsack
Iowa's Second District

November 2014 (Davenport, IA) Gilda's Club invites women with breast cancer and their caregivers to a national patient education program. This thoughtful and comprehensive empowerment program streamlines information for women diagnosed with breast cancer to emphasize options and tools for decision-making around breast reconstruction.

This free workshop will have information on breast reconstruction after a breast cancer diagnosis. Come learn about:

  • Breast reconstruction and non-reconstruction options

  • How to make a decision that is right for you

  • Medical factors that can influence your decision

  • How to prepare for and what to expect after surgery

Our featured speaker is Dr. Stephen Bayne, Board Certified Plastic Surgeon. Dr. Bayne is a board certified plastic and reconstructive surgeon who was born and raised in the Midwest. Dr. Bayne has a Bachelor of Arts degree from Augustana College graduating in June 1984, he attended University of Illinois, College of Dentistry graduating in June 1986 with a Bachelor of Science degree in Dentistry. He atteneded Rush Medical College and completed his medical training in June 1990 with a doctorate in medicine. Dr. Bayne completed seven years of surgical residency: in 1990 to 1995 he attended Akron City Hospital for General surgery and in June 1995 to 1997 he completed his Plastic Surgery training from Summa Health Systems, Akron Ohio. He served as Chief Resident in General Surgery as well as in Plastic Surgery. Dr. Bayne is Board Certified by The American Society of Plastic Surgery.

This workshop is free of charge and dinner is provided.

November 20th at 6:00 pm at Gilda's Club 1234 East River Drive, Davenport, IA

Please call Gilda's Club to register at (563) 326-7504

Frankly Speaking About Cancer: Coping with the Cost of Care

Muscatine, Iowa (November 2014) - Gilda's Club and Susan G. Komen are partnering to offer Frankly Speaking About Cancer: Coping with the Cost of Care. This free educational workshop is designed for people living with cancer and their loved ones. Participants will gain practical advice on how to navigate the numerous and complex challenges of managing the cost of cancer care. Our featured speaker will be Ruth Laabs-Wilcox, LMSW This workshop will take place on Tuesday November 18th at 6:00 PM at 1st Presbyterian Church 401 Iowa Avenue
(Gathering Room 2nd Floor.)

Advanced registration is preferred as dinner is included. For more details and registration call Gilda's Club at (877) 926-7504

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