State Offices of Rural Health Grant Program (SORH)

The goal of the State Offices of Rural Health (SORH) grant program is to assist States in strengthening rural health care delivery systems by creating a focal point for rural health within each State. The program provides an institutional framework that links small rural communities with State and Federal resources to help develop long term solutions to rural health problems. The SORH grant program features a single grantee from each of the 50 United States. The program is a Federal-State partnership that requires a State funding match of $3 for each $1 of Federal funding.
SORH Award Amount (FY06): $150,000

Major Accomplishments in FY 2005 (October 1, 2004 - September 30, 2005):

1. The rural towns support fifteen of the twenty-six acute care hospitals within the state, thirteen Critical Access Hospitals, four Federally Qualified Health Centers (FQHCs), two other community health centers, seventeen rural health clinics, and one private allopathic medical school.
2. The SORH assisted approximately 36 communities during this time period. The communities ranged from hospitals to local funders, and included health centers, universities, and advocacy groups.
3. The SORH contracted with the New Hampshire Recruitment Center (NHRC) to act as a single point of contact for primary care retention and recruitment of providers, and through this agreement, utilizes the 3RNET for rural recruitment.
4. Expanded cooperation and collaboration include a four state project to assist rural hospitals to determine quality improvement successes and challenges, and then to offer solutions; and a six state plan to identify rural health disparities throughout the region, as well as at the state level.
5. Contracted with Rural Scholars Program at Dartmouth Medical School.

SORH Contact Information:

Office: New Hampshire DHHS, Rural Health & Primary Care Section
Address: 29 Hazen Drive, Concord, NH 03301
Phone: 603-271-4741
Fax: 603-271-4506
Email: agbutler@dhhs.state.nh.us
Website: www.dhhs.state.nh.us/DHHS/RHPC/default.htm
Director: Alisa Butler


Other Grant Programs

1. Medicare Rural Hospital Flexibility Grant Program (Flex)

The Flex Program helps sustain access to high quality health care services in rural America. It facilitates the development and support of community-based collaborative rural delivery systems in all grantee states through conversion of hospitals to critical access status, development of rural healthcare networks and integration of EMS.
Flex Award (FY05): $370,000

Program Highlights:

• Number of Critical Access Hospitals (CAHs) supported: 13
• Number of Critical Access-eligible Hospitals supported: 0
• Number of Rural Health Networks developed: 19
• Number of Emergency Medical Services (EMS) assisted: 6
• Number of Rural Communities assisted: 6

Major Accomplishments:

1. Partnered with the Northeast Healthcare Quality Foundation, NH's QIO to launch a website (www.nhqualitycare.org) to report on CMS Core Measures. 100% of the CAHs are participating.
2. Regionally, the Flex Programs of New Hampshire, Vermont, Maine, and Massachusetts, formed the New England Performance Improvement (NEPI) network during the summer of 2004. The NEPI partnered with the New England Rural Health RoundTable (NERHRT) to create a website to serve as a single point of contact for regional benchmarking, quality and performance improvement processes, and peer communications. Utilization of the site has seen steady increases over the past year. Since its launch, the website has received over 250,000 hits from over 10,000 unique users. In April of 2006, NEPI held the second annual regional performance improvement summit for small rural hospitals. A pilot management training program, designed specifically for CAH department managers was initiated at the Mt. Ascutney Hospital in Windsor, Vermont. The management-training concept will be implemented at facilities in Maine, New Hampshire, and Massachusetts over the next few months.
3. Second stage of a Rural Ethics project: (1) develop, pilot, revise, if necessary, and implement an ethics conflicts survey instrument in NH; and (2) develop a study plan to implement the survey instrument to a broader US population. The survey will generate information regarding rural ethical issues in NH and foster the development of a reliability survey instrument. The results of the data will be presented in a paper and shared at appropriate NH healthcare conferences, meetings and health care facilities. The study is expected to provide an empirical understanding of the specific ethics challenges facing today's rural health care professionals.
4. Mini-grants of $13,000 have been awarded to the 12 CAHs who applied to improve outcomes and efficiency of local EMS. Project proposals submitted to the RHFP through the Foundation for Healthy Communities highlight projects in the areas of: critical care transport training, advanced training in pediatric care, AED distribution and CPR training in local community, support for basic EMT training, a joint EMS-CAH quality improvement project and the purchase of equipment to improve cardiac care outcomes.
5. The Flex Coordinator also began working with an inter-facility transport work group, which was created when both the CAHs and the EMS providers identified this as a priority issue. An Inter-facility Transport Summit was held in March 2006 to deploy tools that were created by the group.
6. Mini-grants have been distributed to the 12 CAHs and their communities to develop new rural health networks or advance existing ones to improve access to oral or behavioral health care services, especially for the low-income and uninsured. Proposed projects include a two CAH network to open a dental center, expand or improve quality in school-based programs, support FQHC efforts to provide oral health care, and a plan to integrate primary care and behavioral health.

2. Small Rural Hospital Performance Improvement Grant Program (SHIP)

The goal of SHIP is to assist small (less than 50 beds) rural hospitals pay for any or all of the following: 1) costs related to implementation of prospective payment systems, (2) compliance with provisions of HIPAA and 3) reduction of medical errors and quality improvement. State Offices of Rural Health (SORH) help eligible rural hospitals to participate in SHIP. Eligible hospitals submit an application to their SORH; the SORH prepares and submits a single grant application to HRSA on behalf of all hospital applicants in the State. There are approximately 1600 eligible hospitals nationwide and each usually receives between approximately $9,000.
SHIP Award (FY 05): $123,000

Program Highlights:

• Hospitals receiving funding: 12
• Hospitals in consortiums, networks or systems: 12
• Hospitals using funds for QI and /or reduction of medical errors: 12
• Hospitals using grant funds for Health Information Technology: 0

Major Accomplishments:

1. In collaboration with the Rural Health Coalition a Quality Improvement Network (QIN) was established, several quality initiatives (patient safety, HIPAA) are being developed 12 hospitals.

Total HRSA Funding (FY 05): $643,000