State Rural Hospital Flexibility Program

The Medicare Rural Hospital Flexibility Program (Flex) enables state designated entities to support critical access hospitals in quality improvement, quality reporting, performance improvement, and benchmarking; to assist facilities seeking designati

The Medicare Rural Hospital Flexibility Program (Flex) enables state designated entities to support critical access hospitals in quality improvement, quality reporting, performance improvement, and benchmarking; to assist facilities seeking designation as critical access hospitals; and to create a program to establish or expand the provision of rural emergency medical services. The Flex Program objectives include quality, operational, financial, and population health improvement with the goal of supporting access to necessary health care services in rural communities. State Flex programs will act as resources and focal points for these activities within their respective states. The Rural Veterans Health Access initiative provides funding to states to coordinate activities to provide rural veterans access to services for needed mental health care via the use of networks, electronic communication and telehealth networks. The program targets states with high percentages of veterans to the total population. The Medicare Rural Hospital Flexibility Program Evaluation Cooperative Agreement improves healthcare in rural areas by analyzing Critical Access Hospital (CAH) data, capturing best practices, and targeting limited CAH resources. The Information Services to Rural Hospital Flexibility Recipients Cooperative Agreement provides TA, capacity building and support to the Medicare Rural Hospital Flexibility Program and the Small Rural Hospital Improvement Program. The Rural Quality Improvement Technical Assistance Cooperative Agreement provides TA to FORHP recipients, Critical Access Hospitals (CAHs), and other rural providers, using data to demonstrate improvement in quality of care for rural patients

State (includes District of Columbia, public institutions of higher education and hospitals), Federally Recognized lndian Tribal Governments, State, Native American Organizations (includes lndian groups, cooperatives, corporations, partnerships, associations) Flex and Rural Veterans Recipients: Only states with certified Critical Access Hospitals are eligible for this Program. The Governor designates the eligible applicant from each state. All other states need to submit an application to the Regional Administrator of their CMS Regional Office that expresses the state's interest in developing a Medicare Rural Hospital Flexibility Program before they can apply for funds. Medicare Rural Hospital Flexibility Program Evaluation, Information Services to Rural Hospital Flexibility Recipients Cooperative Agreement, and Rural Quality Improvement Technical Assistance: domestic public, private, and nonprofit organizations, including federally recognized tribal government and tribal organizations.

States with at least one hospital located in a non-metropolitan statistical area or county that provide CMS with necessary assurances.

All funds awarded are to be expended solely for the purposes outlined in the approved projects. Administrative (indirect) expenses are limited to the lesser of 15 percent of the award or the state's federally negotiated indirect rate for administering the award.

All funds awarded are to be expended solely for the purposes outlined in the approved projects. Administrative (indirect) expenses are limited to the lesser of 15 percent of the award or the state's federally negotiated indirect rate for administering the award.

Awards are made annually.

Criteria are listed in the application guidance.

Based on the advice of the objective review committee, the HRSA program official with delegated authority is responsible for final selection and funding decisions. Notification is made in writing by a Notice of Award (NOA).

Up to six months.

Flex awards may be made for up to 5-year periods of performance. Subject to availability of funds, after initial awards, projects may be renewed non-competitively contingent upon submission and approval of an application, availability of appropriated funds, and recipient's satisfactory performance. The Rural Veterans Health Access Program awards are made for up to 3-year period of performance.