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Hi Everyone,
It's that time of year again where we are closing out the program year and planning for the competitive Fiscal Year (FY) 2019 Notice of Funding Opportunity (NOFO). Please remember that TASC is here as a resource for you during the grant writing process. Also refer to the Managing the Flex Program
section of the Core Competencies Guide for State Flex Program Excellence.
Enjoy this month's edition of
Rural Route
which includes the following articles: Critical Access Hospital (CAH) Recognition, 2018 Summit Financial Findings and a call for participation in an opioid focus group. As always, thanks for reading!
Until next time,
Technical Assistance and Services Center (TASC)
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Welcome and Farewell
Welcome to:
- Robert Shaw, Flex Coordinator, Texas
- Jennifer Edwards, Flex Coordinator, Pennsylvania
- Nathan Morse, Flex Coordinator, Maine
- Mariah Quick, Flex Monitoring Team
Farewell to:
- Larry Baronner, Pennsylvania
- Judy Bergh, Minnesota
- Shawn Balleydier, Pennsylvania
- Bridget Ware, FORHP
- Alex Evenson, Flex Monitoring Team
Please keep your Flex staff contact information current by completing the
Flex Contact Information Form
w
henever you have staffing changes. Please review your contacts as listed in your State Flex Profile and complete the form as necessary for any additions or changes.
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 Notes from FORHP
Hello and happy summer,
I have several updates and reminders of upcoming events. The end of August marks the end of the Fiscal Year (FY) 2017 Flex budget year which ran from 9/1/2017 - 8/31/2018. As I announced last week on the mailing list, your Flex Notices of Award (NOA) for the upcoming FY18 budget year may be delayed. Even if the NOAs are issued later, the start date for the new funding will be 9/1/2018. This extension-with-funds year will be the fourth year of the current Flex performance period.
Performance Improvement and Measurement System (PIMS) reporting for the FY17 budget year will start on September 1, 2018. Please join me this Thursday, August 30 at 3 p.m. Eastern Time for a quick refresher
webinar on the FY 17 PIMS reporting process.
This year the 340B recertification period for hospitals (including critical access hospitals CAHs)) is August 15 through September 12, 2018. Please see
my post in the Flex Forum
for more
information about recertification. Add any 340B questions you have to the Forum thread and I'll get you answers.
Owmy Bouloute and I will be attending the National Rural Health Association (NRHA) CAH Conference in Kansas City beginning September 26. Please find us and say hi if you are there too.
Flex Program Coordinator
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CAH Regulatory Update
Read details about these CAH Regulatory Updates on the
TASC website
.
- Calendar Year (CY) 2019 Proposed Rule for Hospital Outpatient Prospective Payment System
- Proposed Rule on Medicare Shared Savings Program (MSSP) Accountable Care Organizations (ACOs)
- CY 2019 Proposed Rule for Medicare Physician Fee Schedule (PFS) and Quality Payment Program (QPP)
- Final Rule on Short-Term Limited Duration Insurance Policies
- FY 2019 Final Rule for Medicare Inpatient and Long-Term Care Hospital Prospective Payment Systems (PPS)
- FY 2019 Final Rule of the Inpatient Rehabilitation Facility PPS
- FY 2019 Final Rule for the Inpatient Psychiatric Facility (IPF) PPS
- FY 2019 Final Rule for Skilled Nursing Facility (SNF) PPS
- FY 2019 Medicare Final Rule for Hospice Prospective Payment System
FORHP's Policy Team is ready to answer any questions you may have about these updates at
[email protected]
.
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2018 Financial Summit Findings
2018 Rural Hospital and Clinic Financial Summit Report
With the support of the Federal Office of Rural Health Policy (FORHP
), the National Rural Health Resource Center (The Center) developed this report following a Summit of key rural hospital and clinic stakeholders to identify the most important financial indicators and strategies to transition to value-based payment. This report is designed to help rural hospital and clinic leaders meet this transition with financial success. View the report.
Small Rural Hospital and Clinic Finance 101 Manual
This manual was developed for use by state Medicare Rural Hospital Flexibility (Flex) Program personnel as well as staff and boards of small rural hospitals and clinics. The content is designed to be as non-technical as possible and provide answers to frequently asked questions regarding critical access hospital (CAH
), small rural hospital and rural health clinic (RHC
) finance and financial performance. View the manual.
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Participation Requested in Upcoming Opioid Focus Group
FORHP is interested in partnering with Flex Coordinators and state offices of rural health (SORH) to help determine the needs of Flex Programs, SORHs, and the CAHs you serve as it relates to the opioid crisis.
FORHP is looking for volunteers to participate in focus groups in the month of September to help inform potentially new funding opportunities within the Health Resources and Services Administration (HRSA)-funded Rural Communities Opioids Response Program. In these focus groups we are looking for both the state level and the CAH level perspective of needs, and they will run no more than one hour. If you'd like to volunteer, or if you have any questions, please email
[email protected]
.
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Critical Access Hospital (CAH) Recognition
Union General Hospital in Farmerville, Union Parish, Louisiana Recognized
TASC recently accepted nominations for national recognition of critical access hospitals (CAHs) across the country. Flex Programs were asked to submit information to support their nomination of CAHs demonstrating excellence and innovation in the areas of behavioral or mental health. Union General Hospital in Farmerville, Union Parish, Louisiana is one of the five hospitals that was recognized, pictured below.
Union General Hospital
was recognized for the development of its innovative programs geared toward adolescent behaviors,
It's a Girl Thing: Making Proud Choices
and
Together We Can Be Bully Free.
Since implementing these programs, Farmerville has seen an 18% decrease in teen pregnancies in the first three years of
It's a Girl Thing
, a decrease in bullying-related calls to the
Union Parish
Sheriff's Office from 24 calls per to week to three calls per week and the programs have served over 3,000 students in five years. There has also been a decrease in the number of adolescent suicide attempts reported through the Sheriff's Office. Please join us in congratulating Union Parish Hospital on the implementation of these successful programs.
Evalyn Orman, CEO said, "We have a goal in all our programs to teach our youth what is happening to their bodies and minds, recognizing the intimate relationship between development, health and behavior, encouraging self-responsibility and self-care, and providing a friendly environment and an innovative team approach in each of our sessions."
A one page summary of their initiatives can be found here. Watch future issues of Rural Route for the other four CAHs receiving recognition for excellence and innovation in behavioral or mental health. The next CAH recognition topic will also be released for nominations soon.
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| Union General Hospital in Farmerville, Louisiana receives their CAH Recognition Certificate. The picture includes: Tim Tettleton, Board President, Evalyn Ormond, CEO, Claudia Wade, Community Development Manager/Grant Writer, Allyson Rogers Crow, Board Member. |
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MBQIP Updates
As a reminder, please send your MBQIP questions to the Technical Assistance and Services Center (TASC) email address
. TASC will ensure your question reaches the appropriate person.
MBQIP Data Reporting Reminders
MBQIP Monthly
MBQIP Monthly is a monthly e-newsletter that provides CAHs with information and support for quality reporting and improvement and highlights current information about MBQIP. State Flex Programs are encouraged to distribute MBQIP Monthly to their CAHs as an additional resource to supplement state level MBQIP support. The most current version is always available on the
MBQIP Monthly webpage
.
Ask Robyn - Quarterly Open Office Hour Calls for MBQIP Data Abstractors
Sometimes it just helps to talk to someone! Quality Reporting Specialist Robyn Carlson will be offering open office hour calls to discuss MBQIP data abstraction questions. Sessions are free of charge, but registration is required - register now for October 10! For more information about the Ask Robyn calls, contact Robyn Carlson of Rural Quality Improvement Technical Assistance (RQITA).
Contact
TASC
with your inquiries, questions and comments related to MBQIP and/or resources.
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Assessment Request: Help to Improve MBQIP Support
The Rural Quality Improvement Technical Assistance Center (RQITA) is seeking your feedback as they plan for the upcoming years of providing MBQIP support. The information you provide will be used to evaluate and improve MBQIP-related products, resources and assistance provided by the RQITA team to most effectively and efficiently support you and the critical access hospitals (CAHs) in your state. For reference, lists of key MBQIP related resources supported by RQITA for state Flex programs and CAHs are available in Appendices D and E of the
MBQIP Fundamentals Guide for State Flex Programs
.
As a reminder, RQITA was launched in Fall of 2015 to support state Flex programs in quality data reporting and quality improvement in CAHs. In the three years since it began, the RQITA team has: developed 22 resources and products, published 31 issues of the
MBQIP Monthly newsletter, convened 16 Virtual Knowledge Groups, received and responded to over 1,380 technical assistance requests and given more than 55 presentations. The RQITA team values your feedback and input to be able to serve you in increasingly helpful ways.
This assessment has been distributed to Flex staff and MBQIP subcontractors and partners. However, we ask that Flex staff and MBQIP subcontractors, or other partners as appropriate, work together to complete ONE assessment for your state by
Tuesday, September 4, 2018:
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FORHP Flex Program Workshop
The goal of the W
orkshop is to provide new Flex Program staff an orientation to the Flex Program. We'll cover
multiple topics, including basic critical access hospital finance, quality and performance improvement concepts, information on emergency medical services (EMS
), population health and Flex Program core competencies and best practices.
By the completion of the Workshop, participants will have gained a better understanding of the Flex Program's goals and services available from TASC
, a program of The Center, to support Flex Program excellence.
There is no charge for the workshop; however, states are required to pay lodging and travel expenses which is allowable as part of the Flex grant. The October Flex Program Workshop is full but another Workshop will be offered for new and returning Flex personnel in April 2019.
If you have any questions on any of the above work under development, or an idea for TASC to consider, please let us know by emailing
Tracy Morton
.
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New Substance Use Resources
With the additional efforts and projects relating to substance use, TASC continues to identify resources that might be useful to
you and your hospitals as you work to meet the challenges of substance use/abuse.
Resources available in the TASC resource library focus on prevention, tools for providers and examples of other programs, among other topics. Please take a look at a sample of the resources below. Please share with those who can benefit from these resources and suggest any others to TASC that you have found helpful.
- Fentanyl Safety Recommendations for First Responders
- This resource provides unified, scientific, evidence-based recommendations to first responders so they can protect themselves when the presence of fentanyl is suspected during the course of their daily activities, such as responding to overdose calls and conducting traffic stops, arrests and searches
- Fentanyl: A Briefing Guide for First Responders
- This resource shares the history of Fentanyl, describes Fentanyl-related substances and lists common illicit forms of the drug. It also shares information on responder exposure risks and treatment as well as remediation and decontamination.
- Six Building Blocks
- Access a toolkit for primary care practices to improve care for patients taking opioids for chronic pain. It offers a structured team-based approach to improvement in leadership and consensus, policies, patient agreements and workflows, tracking and monitoring patient care, planned patient-centered visits, caring for complex patients and measuring success.
Many more resources can be found on the
TASC website by searching for "substance use" or other key words in the search field.
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Weekly Rural Health Leadership Radio Program
A weekly radio program,
Rural Health Leadership Radio
, was launched a year ago to support rural health leaders to share stories and information about what is working and what is not. To read the story of the program's development, please visit an
article
promoting the resource from the National Organization of State Offices of Rural Health. Here are a few recent speakers:
- Andrea Wendling, MD, Professor of Family Medicine and Director of Rural Medicine Curriculum, Michigan State University College of Human Medicine
- Nicole Thorell, MSN, CEN, Chief Nursing Officer, Lexington Regional Health Center
- Kelly McGrath, MD, MS, Chief Medical Officer, Clearwater Valley hospital and Clinics
- Jenna Bernson, Student, Michigan State University
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New & Updated Resources
The following resources on the TASC website are new or recently updated:
Author: Networking for Rural Health Project
This tool can be used to assess a network's organizational strengths and weaknesses and target technical assistance needs. It is intended to be used as a self-assessment instrument that network executives and members can use to identify areas needing attention.
Author: University of Minnesota Rural Health Research Center
This policy brief describes the availability of respiratory therapy and therapists in CAHs and in urban and rural prospective payment system (PPS) hospitals. It includes statistics with breakdowns by hospital type and rural or urban location.
This article describes a provider staffing model for rural hospitals that uses internal medicine physicians to provide inpatient care and to consult on outpatient care in Washington state. It describes the hospital setting, staffing needs and lessons learned.
Author: Rural Health Value (RHV)
This brief summarizes the health care value issues most frequently cited, and given the highest priority, by 26 rural health care leaders.
Author: Rural Policy Research Institute (RUPRI) Health Panel
This paper reviews the essential elements of a robust rural primary care system, including development and maintenance of a high performance rural primary care system and workforce, as well as policy considerations and opportunities that address the sustainability of rural primary care.
Author:
Medicare Payment Advisory Commission and the Medicaid and CHIP Payment and Access Commission (MACPAC)
This fact sheet describes the role of rural hospitals in serving Medicaid beneficiaries and how Medicaid programs pay rural hospitals.
Author:
Medicare Payment Advisory Commission and the Medicaid and CHIP Payment and Access Commission (MACPAC)
Learn how each state Medicaid program pays for inpatient hospital services under fee-for-service, including how each state sets its payment rates and the various adjustments and supplemental payments that states make.
Author:
National Institutes of Health (NIH),
All of Us Research Program
This document outlines several overarching principles of engagement with tribal communities, including respect for tribal sovereignty, acknowledgment of historical transgressions, the importance of engagement with Urban Indian leaders and the need for continued bi-directional engagement.
Author: The BUILD Health Challenge
This report features the five most common data challenges faced by cross-sector teams, as well as reflections and solutions from the practitioners involved. Topics include Health Information Portability and Accountability Act (HIPAA) concerns, logistics of data sharing across various systems, language differences and more.
Author: National Quality Forum (NQF), Measures Applications Partnership (MAP)
This document describes selection criteria and processes used to create a draft core set of measures and describes measurement gap areas identified by the Measures Applications Partnership (MAP) Rural Health Workgroup, a public-private partnership of healthcare stakeholders.
Author: Institute for Diversity and Health Equity
This tool helps health care organizations assess their progress to create high-quality, inclusive, equitable and safe care environments aimed at eliminating health and health care disparities to improve the health and well-being of our neighbors and communities.
Other new resources include:
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Connect Peer to Peer in Flex Program Forum
Do you have a question, idea, success or challenge to share with your Flex Program peers? Don't miss the ongoing discussions on the
Flex Program Forum
.
If you have questions about the Flex Program Forum, please contact
TASC
.
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Webinar Playbacks and Event Materials
Are you looking for resources? Check out these recent webinar playbacks and their supporting materials from TASC, the Small Rural Hospital Improvement Program (SHIP), the Small Rural Hospital Transitions (SRHT) program, Networks technical assistance (TA) or Allied Health TA? Look no further!
TASC
Learn how the transition to value affects EMS. Discuss the potential for EMS to adapt in a value-based health care system. Discover how Flex Programs are working with EMS in the transition to value.
This training is targeted specifically to state-level grantees to provide tips and advice for successfully managing your award and will be useful to ensure that you are effectively managing your Federal Award.
Understand updates to the CAH Finance 101 Manual.
Learn about the new strategies and indicators focused on the transition to value for CAHs, RHCs and small rural hospitals that the 2018 Financial Summit participants identified.
This quarterly webinar will also include updates from TASC, FMT and FORHP, to include both the Flex Program and policies impacting CAHs.
SHIP
This Learning Collaborative is a Two-Part Series on Networking - How to Assess the Needs of Your SHIP Hospitals and Choose Activities. Learn methods for identifying needs of SHIP hospitals. Empower participants to choose activities for SHIP hospitals that reflect the assessment of their needs. Obtain knowledge of equipment and training resources to address needs as a SHIP network or consortium. Promote SHIP activities to hospitals as a network or consortium.
This Learning Collaborative is a Two-Part Series on Networking - How to Assess the Needs of Your SHIP Hospitals and Choose Activities. Learn methods for identifying needs of SHIP hospitals. Empower participants to choose activities for SHIP hospitals that reflect the assessment of their needs. Obtain knowledge of equipment and training resources to address needs as a SHIP network or consortium. Promote SHIP activities to hospitals as a network or consortium.
Marketing is defined as discovering and meeting the needs of network partners to the mutual, continuous benefit of all parties. Your marketing plan outlines, in detail, the ways that the network will meet member needs and communicate with members. Learn about the toolkit designed to support your work of developing a marketing plan for your project.
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Grow your Career: Save the Dates
Below is a list of upcoming events relevant to rural health:
August 30, 2018
Join the Federal Office of Rural Health Policy (FOHRP) Hospital State Division (HSD) for a webinar that will provide an overview of the Fiscal Year (FY) 2017 Performance Improvement and Measurement System (PIMS
) reporting process.
September 10, 2018
Learn how to utilize your PIMS data to help inform activities and projects for your Flex program. Hear tracking and data collection suggestions from other Flex program.
September 25-26, 2018
Join NRHA in Kansas City for their RHC and CAH conferences.
Take advantage of the educational and networking opportunities designed for clinic and hospital professionals and board members serving rural America.
September 26-28, 2018
Join NRHA in Kansas City for their RHC and CAH conferences. Take advantage of the educational and networking opportunities designed for clinic and hospital professionals and board members serving rural America.
October 23-25, 2018
Join TASC in Duluth, Minnesota on October 23 for the FORHP Flex Program Workshop for new Flex personnel.
The FORHP
Flex Program Workshop covers multiple topics, including basic critical access hospital finance, quality and performance improvement concepts, information on emergency medical services (EMS
), population health and Flex Program core competencies and best practices. The October Flex Program Workshop is full but another Workshop will be offered for new and returning Flex personnel in April 2019.
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Are you interested in receiving quick, up-to-date information from the National Rural Health Resource Center? Like the National Rural Health Resource Center on
Facebook and follow us on
Twitter and
LinkedIn!
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