State Rural Health Flexibility Program Scope Account for Agricultural Economics

The Kentucky Rural Hospital Flexibility Program (KRHFP/Flex) is under the auspice of the Kentucky State Office of Rural Health (KSORH), which is housed within the University of Kentucky Center for Rural Health (UKCRH). The KRHFP partners include, Kentucky Hospital Association, Kentucky Department of Public Health, Kentucky Primary Care Association, and Kentucky Area Health Education Centers, Kentucky Board of Emergency Medical Service (EMS), University Medical Placement Service's, Eastern and Western Kentucky Universities, UK College of Agriculture and Cooperative Extension Service and Kentucky TeleCare. Through these partnerships, the strategy is to build rural systems of care by strengthening Critical Access Hospitals and eligible facilities which enable them to serve as the hub of a collaborative delivery system in their communities. Since the inception of the KRHFP in 1999, the KSORH and the Flex Program have partnered with the Kentucky Hospital Association and together they hold statewide stakeholders meetings to consult with rural hospital administrators on the most appropriate utilization of grant funds. The KRHFP has supported small rural hospitals and their communities throughout the state to improve access, improve the quality of rural health and to stabilize the rural health delivery system through a number of activities. The programs major accomplishments during the past years of federal funding include the following: Development of a State Rural Health Plan, a multi-disciplinary Advisory Committee created to assist in fostering community health planning at both the state and local level, thirty-eight financial feasibility analysis funded, development of an on-site conversion program to support hospitals as they consider, plan for and become a CAH, thirty-two hospitals converted to CAH designation, funded eighty two economic impact studies, assisted in formalizing thirty-two referral networks, three vertical networks and two horizontal networks. Three networks are currently in the formative stages of development and will require ongoing support. Technical assistance in grant development resulted in eleven grant opportunities being funded. The partnership with the Kentucky Hospital Association provided CAHs with comparative state data through the Rural Hospital Benchmarking program which allows hospitals to benchmark and determine best practices as well as; access to an on-line compliance program, access to COMPdata (a patient-level, all-payer database), accreditation education and training workshops and annual CAH seminars on cost-based reimbursement. Sixty-one rural counties received paramedic/EMS education and training through a partnership with Eastern and Western Kentucky Universities which has promoted, supported and strengthened the role of EMS in the local systems of care. Continuing educational programs for EMS professionals have been provided to assist rural communities with workforce shortages. The KRHFP staff will continue to provide a wide-range of technical, operational, and financial assistance to existing CAHs and rural hospitals to assure sustainability of the local health care infrastructure. The Kentucky Rural Health Works Program will provide economic and financial analysis which will enable hospitals to better identify their local market share and service area as well as a potential demand for an increase in scope of services. In the coming year the Flex program will offer educationltraining on the Balanced Scorecard, Quality Improvement, and assistance to provide date to the new statewide Patient Safety Organization and Pay for Performance Initiatives. The staff will continue to facilitate, inform, educate and assist communities, hospitals and providers on the importance and benefits of networking. Continued collaboration for the improvement of local EMS services and integration into the local system of care will continue to be a primary focus. The FLEX program will partner in a project "Kentucky Rural Community Health Center/Critical Access Hospital Collaborative Demonstration". This project will be aimed at developing successful collaborations with consequent improvements in rural health care access and delivery. The proposed project will target two CAHs and two Community Health Centers (FQHC) to develop collaborative activities that may benefit and improve the availability and coordination of services in their communities. The project will document the collaborative process and its outcomes to guide other CAH/FQHC collaborative efforts.