November 2022

Hello Flex Coordinators,

I hope you all are staying warm and enjoyed a well-deserved Thanksgiving break! I certainly did and ate far too much, but I am very happy about it! First, thank you all for your hard work in November, and say you did it! I know we had many deadlines across all of the programs in November, with several reports to write, and we really appreciate the care you take in writing them for us. We are very excited to read your newly submitted FY21 End of Year Reports and see your incredible accomplishments this year, especially your Quality Innovation Lab projects!

A quick reminder for some upcoming deadlines:

• FY 2021 Federal Financial Report (FFR) Due: January 30, 2023
• NOTE: You must use the FFR Remarks Section to express your intent to carry over funds. If you intend to carry over funds and do not make a note in this section, you must resubmit your FFR.
• Questions related to issues with the FFR: PMS Self-Service Web Portal  
• Help Desk Number: Telephone #: 877-614-5533 E-Mail: PMSFFRSupport@psc.hhs.gov
• Prior approval Carryover Request  Due: 30 days after FFR submission
• If you have an Unobligated Balance (UOB) for your U2W award, you can carry over those funds to your current budget period, to be spent by August 31, 2023. Please discuss your plan to utilize your carryover with your Project Officer. You can then submit a Prior Approval – Carryover Request in EHB, which should include:
• Cover Letter – detailing the reason for the UOB and your plan to spend down the funds in the current budget period making direct connections to your work plan. 
• Budget Justification – for the carryover amount only
• SF424A – for the carryover amount only (Note: This form is now electronic and built into the EHB submission)
• Please see this helpful video about the carryover request process
• Please note: you can use carryover funds to complete an activity that was delayed in the previous budget year or expand upon an existing work plan activity. You cannot use carryover funds for NEW activities.

FORHP hosted a webinar in September with TASC regarding the Flex Fiscal Year 2021 Wrap-Up. There is a lot of great information in this recording about FFRs and carryover requests, so please take a look if you have any questions. Your project officer will be reaching out to you soon to discuss any unobligated balances and potential carryover projects, so start thinking of some ideas!

Thank you all for everything you do! And wishing you all a happy holiday season, however, you are celebrating 😊

Laura

National Rural Health Day (Recap)

Each year rural health organizations and partners take an opportunity to promote and draw attention to the work in our communities. This is known as National Rural Health Day (NRHD). This year, TASC and the National Rural Health Resource Center celebrated by highlighting health equity efforts in our communities. Below are quick links to the resources we shared.

This year's National Rural Health Day theme is "Driving Change." We feel that removing barriers to health and advancing health equity are great examples of the theme.

Rural Health Equity and Quality Summit Report

Board Leadership Series: Health Equity

Stepping Up: Health Equity in Rural Hospitals Podcast Series

FMT: Financial Characteristics of Critical Access Hospitals Participating in Accountable Care Organizations

The Flex Monitoring Team has released a new brief on the Financial Characteristics of Critical Access Hospitals Participating in Accountable Care Organizations. The abstract states:

This brief describes CAH participation in ACOs and the financial performance and organizational characteristics of participating and non-participating CAHs. An understanding of the financial and operational factors that may be important to ACO participation may benefit hospital leaders and State Flex Programs as they identify areas for improvement and benchmark performance. The brief finds that as compared to CAHs not participating in an ACO or not responding, CAHs that were leading or participating in an ACO had greater net patient revenue and were more likely to be in the Midwest region, not-for-profit, and affiliated with a health system. 

Rural Health Information Hub and Walsh Center for Rural Health Analysis Launch Rural Emergency Preparedness and Response Toolkit

The Rural Health Information Hub recently announced a new Emergency Preparedness and Response Toolkit that we would encourage all states to explore and distribute as needed. From their release email:

“This toolkit provides important insights for rural communities, no matter where they are in their emergency preparedness planning cycle. It combines evidence, expert advice, and the actual experiences of rural communities into an easy-to-use resource,” said Tom Morris, the Associate Administrator for Rural Health Policy in the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services.

Below are a few highlights from this month's Critical Access Hospital (CAH) Regulatory Update. You can find additional resources, guidance, and regulations on the Flex Forum (login required).

CMS Releases Framework for Advancing Health Care in Rural, Tribal, and Geographically Isolated Communities

CMS Publishes the Medicare Outpatient Prospective Payment System Final Rule

CMS Publishes Medicare Physician Fee Schedule Final Rule

Several state Flex programs have had staffing changes recently. It is always exciting to welcome new partners and see what unique talents they bring to rural health!

CAHs Can! National Rural Virtual Quality Improvement Mentor Profile Series: Katrina Strowbridge

Data: CAHs Measure Up – Antibiotic Stewardship Program Reporting Implementation Update

Tips: Robyn Quips – Influenza Vaccination Coverage Among Healthcare Personnel

Tools and Resources – Helping CAHs Succeed in Quality Reporting & Improvement



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, $1,100,000 (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.