State Rural Hospital Flexibility Program

The Kentucky Rural Hospital Flexibility Program (KRHFP) is under the auspice of the Kentucky State Office of Rural Health, which is housed within the University of Kentucky Center for Rural Health (UKCRH). The KRHFP partners with the Kentucky State Office of Rural Health, Kentucky Hospital Association, Kentucky Department of Public Health, Kentucky Primary Care Association, Kentucky Area Health Education Centers, Kentucky Board of EMS, UK Medical Placement Service, Eastern and Western Kentucky Universities, UK College of Agriculture and Cooperative Extension Service, and Kentucky TeleCare. Through these partnerships, the KRHFP has developed and implemented numerous innovative program activities that directly assist rural providers and their communities in building financially viable and sustainable hospitals and rural health care networks. Through the KRHFP Conversion Program, rural hospitals have converted to critical access certification in a simplified and expedited manner. This program assists hospital administrators in developing community support and engagement, and has been copied as a "model" by other states. The Kentucky Rural Health Works provides the KRHFP with an evaluation process, surveys, financial and economic analysis, and other studies that provide information to rural providers, communities and KRHFP staff. These analyses support community awareness process and provide decision-making information. The KRHFP Evaluation Program found that Kentucky CAHs are developing a stronger financial position and are in the process of becoming financially stable. KRHFP will continue to allocate funds to CAH designation and to programs that sustain existing CAHs and their communities, and support network development. The KRHFP staff has the capacity to provide technical assistance to CAHs and other rural providers that promote activities that strengthen the rural health care infrastructure; and increase access and assist rural communities, providers and their leaders in sustaining a continuum of care systems. KRHFP staff have facilitated the development and implementation of vertical and horizontal rural health networks across Kentucky. These rural health care networks are in various stages of development and will require ongoing support for long-term sustainability. Participating KRHFP hospitals have progressed and formed rural health care networks that collaborate to increase access and improve quality of care. KRHFP staff has fostered health care network collaboration with the state partners to promote growth of rural collaborative health care system across the continuum of care at the community level. KRHFP staff continues to collaborate with the Kentucky Board of EMS and local EMS systems to foster integration of emergency medical services into the communities, and to strengthen EMS operations within the local rural health care networks. With the partnerships between Eastern and Western Universities, the KRHFP funds first responders, EMT, and paramedic training courses and provides continuing educational programs for EMS professionals. Through the partnership between the KRHFP and the Kentucky Hospital Association, the CAHs, other rural hospitals and rural health networks have access to a professional grant writer to identify funding sources and assists in grant preparation. The Kentucky Hospital Association's Rural Hospital Clinical Benchmarking Program provides comparative state data to CAHs and other rural hospitals, which was not previously available. Quality specific data allows CAHs and other small hospitals to benchmark and determine best practices. The Kentucky Hospital Association assists rural hospitals to prepare for and maintain JCAHO and AOA accreditation through the CAH Quality of Care Program. Kentucky Rural Hospital Flexibility programming activities will continue to provide technical assistance that supports, promotes and emphasizes rural health care access, quality of services and financial stability. Our state partnerships allows the KRHFP staff to assist in the development of a rural health care infrastructure that is sustained and strengthened, with the hospital operating as the hub of the local delivery system, if available. Therefore, network development will continue to be a primary focus of the KRHFP staff and partners. KRHFP staff will continue to foster the growth of rural collaborative health care systems across the continuum of care at the community level with appropriate external relationships for referral and support (i.e. RHCs / FQHCs).