RURAL ROUTE

September 2021

It's all happening!

I do not know about you, but I am very excited about the fall weather. In a few weeks, many of us will be dreading winter weather so let's enjoy football, leaves, pumpkins, cool breezes, and bonfires while we can.

COVID-19 continues to factor into our daily lives here at The Center, and part of that is hoping you, your co-workers, and your families are staying healthy and safe. Additionally, we want to remind you of our extensive COVID-19 resource library. Let us know if there's anything we can help you with or any resource you may need help finding.

Since last month's Rural Route, we have completed the FY 2020 Wrap Up Webinar, kicked off the State Flex Program QI Project, and released the CAH Telehealth Guide. Thank you to everyone who participated in these online events. Click on the links to rewatch or download relevant materials.

As we get ready to submit reports, we want to be an encouragement and resource for you. Please let us know if you have any questions and let us know by Nov. 15 if your state would like TASC to review one part of your annual report.

You are all an essential part of providing quality health care to rural communities. Always remember that you are making a difference in many lives across the county. Here's to you and a prosperous fall!

Matt Bancroft

Program Specialist - TASC/SHIP

Oct 7: Webinar: New COVID Finance guide

Oct 12: NOSORH Annual Meeting

Oct 30: PIMS due

Nov 1: Fall Flex Workshop (Start)

Nov 11: Veterans Day (Federal)

Nov 18: Nat'l Rural Health Day

Nov 25: Thanksgiving (Federal)

Nov 30: End of Year Report Due

Dec 24: Christmas Eve (Federal)

Dec 25: Christmas Day (Federal)

Dec 31: New Years Eve (Federal)

Jan 30: Fed. Financial Report Due

Pssst... Here are a few resources from Center programs and other rural health partners:

Delta Program: Fall Communication Webinar Series

RHPTP: Application Deadline: October 1

Federal Office of Rural Health Policy Updates

Dear Flex Program Coordinators

Happy Fall! I hope you are all experiencing some cooler weather and colorful leaves. I want to take this opportunity to thank you for the fantastic work you are doing to support your rural hospitals during this critical time. As hospitals continue to experience high volumes, please keep us informed about what your rural communities are experiencing related to the public health emergency.

Earlier this month, FORHP hosted a webinar with TASC regarding the Flex Fiscal Year 2020 Wrap Up. We discussed the following reports and provided detailed instructions. Please reach out to your Flex Project Officer for any questions on these reports.

FY 2020 Performance Improvement Measurement System (PIMS) Report

Due: October 30, 2021 (Friday, October 29)

FY 2020 End of Year Report (EoYR)

Due: November 30, 2021

FY 2020 EMS Supplement End of Year Report (EMS-EoYR)

Due: November 30, 2021

FY 2020 Federal Financial Report (FFR)

Due: January 30, 2022 (Friday, January 28)

Prior approval Carryover Request due: 30 days after FFR submission

We are excited about the Flex Quality Innovation Lab kick-off meeting held earlier this month. Your topic-specific QIL meetings will begin in October. Please look out for the corresponding communication from RQITA. Your first task is to work with your state to make appropriate updates to your state project plan. These would include:

Reviewing the "Model for Improvement Three Questions" with the audience of the final poster presentation in mind.
Capturing any updates to high-level work plan and data tracking
Redacting any hospital names tied to performance data as necessary

States are being asked to post updated plans to the QIL library under Quality Innovation Labs (located on the top menu bar of the QIL Hub SharePoint site) by noon on Friday, October 1.

Thanks for all that you do,

Tori

CAH Regulatory Update

New COVID-19 Provider Relief Funding (PRF) Available

Grace period for PRF Reporting

HRSA Reorganization and Changes to FORHP

HHS: Overview of Barriers and Facilitators in COVID-19 Vaccine Outreach

Continue reading about multiple new resources, guidance, and regulations on the Flex Forum (login required).

Flex Welcomes and Farewells

It is always bittersweet to bid our partners farewell as they set out on new adventures. We wish everyone the best of luck and are thankful for your hard work.

This month we say goodbye to Bill Jolley at the Tennessee Hospital Association. Best of luck Bill!

Join me in welcoming new Flex Coordinators Alushus Cooper (MS), Tiffany Taylor (MO), and Gina Gulley (AR). We are excited to have you on the team!

Please keep your Flex contact information current by emailing Matt Bancroft and completing the State Flex Program Contact Information Form whenever there are staffing changes in your office.

Provider Relief Funds Tranche 4

Important Funding Opportunity for EMS Providers

The American Ambulance Association (AAA) hosted a webinar on September 24, 2021, to provide information for ambulance services about additional Phase 4 General Distribution for EMS agencies and American Rescue Plan (ARP) payments for qualified rural providers who furnish services to Medicaid/CHIP and Medicare beneficiaries. AAA feels that many EMS providers did not apply for the Tranche 3 funding opportunity because they did not believe that they would be eligible to receive funds under the announced funding formula. Due to the limited number of applicants in Tranche 3, the Health Resources and Services Administration (HRSA) modified the formula and AAA believes that many who failed to apply would have received funds. The deadline to apply is 11:59 p.m. on October 26, 2021. There is no penalty for applying.

What is Oregon up to?

Submitted by Sarah Anderson, Director of Field Services (Edited for space)

The Oregon Office of Rural Health (ORH) is off and running with its FY21 Flex activities!

ORH is pleased to share some highlights they are working on to begin the year. One major focus is the Flex QI Project. ORH is partnering with the University of Washington Tele-Antimicrobial Stewardship Program (UW TASP) to support Critical Access Hospitals (CAHs) to improve antibiotic use in asymptomatic bacteriuria (ASB). This year-long project supports a cohort of hospitals with the goal of improving ASB prescribing and ASP reporting.

The ORH Flex Program continues to grow its support for RHCs across Oregon and supports multiple projects for Provider-Based RHCs. Its provision of mock surveys to clinics to assist them in preparing for recertification remains one of the most needed and requested activities among clinics. To assist RHCs in building capacity for ongoing compliance, an exciting project that starts this year is the development of an RHC Compliance Team Cohort to help train and support clinics in building both internal and cross-clinic peer-to-peer compliance teams to maintain the ongoing regulatory requirements of being an RHC. ORH plans to continue growing this cohort model in the coming years and bring additional RHCs into the cohort to build strong peer-to-peer connections in the state. Additionally, in October, ORH will kick off a SigmaMed Solutions Quality Improvement Training Collaborative for RHCs to support them in building capacity to track and measure their quality efforts.

ORH continues to work on CAH and EMS Partnered Improvement Grant opportunities, is recruiting for a Program Manager, planning the Forum on Aging in Rural Oregon, and administering the Elder Service Innovation Grants. Click here for a PDF of their activities, including how they are managing COVID-19.

CAH Telehealth Guide

The CAH Telehealth Guide provides practical guidance on implementing and sustaining telehealth to optimize health care delivery, expand access, and enhance care coordination. Note that this is not an all-inclusive policy guide for telehealth. Just as health care organizations strive to take a person-centered approach to health care, this guide seeks to take a CAH-centered approach to telehealth that keeps the patient and community at the forefront. The target audience is any individual, team, or organization seeking to implement or expand telehealth services in the CAH setting. The guide primarily focuses on Medicare outpatient telehealth services but includes Medicaid coverage and remote services that may not strictly be considered telehealth.

Mid-Level Leaders and Transition to Value Series

We are pleased to announce a new video series on Mid-Level Leaders and the Transition to Value. This 6-part educational video series provides mid-level leaders with foundational knowledge and strategies for leading their teams and influencing others as they navigate the shift to value-based payment and population health.

Please share this resource with your state partners and utilize the one-page summary as a description of the series.

One-Page Summary

Revenue Cycle Management Best Practices Guide

This guide provides rural hospital executive and management teams with generally accepted best practice concepts in revenue cycle management so that they may consider opportunities for performance improvement within their hospitals and individual departments. It is also designed to assist State Offices of Rural Health directors and Flex Program coordinators in gaining a better understanding of the revenue cycle best practices to develop educational training to assist rural hospitals with performance improvement further.

You can find additional revenue cycle resources at the links below. Contact drchsd-program@ruralcenter.org with any questions.

MBQIP Updates

The MBQIP Monthly includes:

CAHs Can! Resilience: Factors to Help Your Organization Bounce Back
Data: CAHs Measure Up – Antibiotic Stewardship Action Implementation
Tips: Robyn Quips – Quality Reporting Notification from CMS
Tools and Resources – Helping CAHs Succeed in Quality Reporting & Improvement

Please send your MBQIP questions to tasc@ruralcenter.org. TASC will ensure your question reaches the appropriate person.

Webinars, Recordings, and Resources

Playbacks

FY 2020 Wrap Up Webinar

State Flex Program QI Project

CAH Telehealth Guide

August VKG: Best Practices in Flex Program Contract Management

RSV: Quality Improvement Project Group Discussion

Webinar: Rural Tele-Behavioral Health

Resources: Highlights for your Flex Program

Delta Program: 2021 Value-Based Care Webinar Series (5 Parts)

RHPTP: Resilience: Springing Back to Move Forward

FMT: Community Impact and Benefit Activities of CAHs...

NOSORH: RHCs Awarded Nearly $100M for Vaccine Confidence Grant

A full list of resources is available in the TASC Resource Library.

For any questions or concerns, please contact us:

tasc@ruralcenter.org - 877-321-9393 - www.ruralcenter.org

This project is/was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number UB1RH24206, Information Services to Rural Hospital Flexibility Program Grantees, $1,009,120 (0% financed with nongovernmental sources). This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS, or the U.S. Government.