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):
- Partnered with Nevada Health Centers (CHC)
in the development of a four chair dental opertory in Elko Nevada
that is dedicated to care for the underserved. The project was
an expansion of the Miles for Smiles dental program for underserved
children which the Nevada State Office of Rural Health (NSORH)
facilitated coming to Rural Nevada in 2003. The new Clinic, which
opened January17, 2006, expanded its focus to include seniors
and other underserved populations. This expansion was made possible
due to NSORH's role in spearheading the networking and collaboration
of state, county, community business leaders. Each one of these
entities was instrumental in providing the funds necessary to
complete the project. The clinic has provided 5022 treatments
during the first six months of operation.
- Provided technical assistance to secure funding
for a pioneering telemedicine project. This program will provide
diagnosis and treatment of individuals suffering from the symptoms
of Alzheimer's in rural Nevada. Once available only in urban areas,
this project expands access to over 80% of Nevada.
- Increased access to medical care for four remote
American Indian tribes through the development of telemedicine
sites in their respective tribal clinics.
- Facilitated broader access to care for Rural
Nevadans through telemedicine treatment expansion. Telemedicine
consultations now include: Cardiology, Radiology, Sleep Medicine,
Alzheimer's, Neurology, Dermatology, Nutrition, Endocrinology,
Psychiatry, Pediatric and Behavioral Medicine. Also facilitated
rural telemetry services for remote patient monitoring in two
rural hospitals.
- Administered the Obstetrical Access Program
that encourages practitioners to provide prenatal and OB care
by offsetting some of the costs related to malpractice insurance,
offsetting uncompensated care costs, and providing education and
training opportunities. In return, the practitioner agrees to
accept Medicaid and accept those unable to pay. While limited
OB services is still a major problem in rural Nevada, the OB Access
program has been instrumental in keeping practitioners providing
care and provides an incentive to accept Medicaid and uninsured
patients.
- Enrolled 12 practitioners into the Nevada
Health Service Corps. This program provides payment towards student
loans in return for working in health professional shortage areas
and providing care for underserved individuals. The 12 contracted
health professionals consist of five dentists, two physician assistants,
two medical doctors, two mental health workers and one nurse practitioner.
SORH Contact Information:
Office: Office of Rural Health
Address: 701 Walnut St., Elko Nevada 89801
Phone: 775-738-3828
Fax: 775-738-0689
Email: cford@med.unr.edu
Website: www.unr.edu/med/dept/cehso/orh.html
Director: Caroline Ford
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.
The Nevada Flex Program helps sustain high
quality health care services in rural and frontier regions of Nevada
through the ongoing provision of technical assistance and support
to hospitals and other rural health care providers.
The Nevada Flex Program and its principal subcontractor, Nevada
Rural Hospital Partners, provide the following services and assistance
to rural and frontier hospitals across the state: comprehensive
on-site CAH and state licensure preparation for facilities; financial,
operations, and regulatory impact assessments and technical assistance;
assistance with the development of hospital policies and procedures,
network agreements, and contracts; and assistance with strategic
hospital planning, board education, and performance improvement.
With the support of the Nevada program and its partners, ten facilities
have been designated as Critical Access Hospitals in Nevada.
Flex Award (FY 05): $545,000
Program Highlights:
- Number of Critical Access Hospitals
(CAHs) supported: 10
- Number of Critical Access-eligible Hospitals
supported: 5
- Number of Rural Health Networks developed:
35
- Number of Emergency Medical Services (EMS)
assisted: 104
- Number of Rural Communities assisted: 35
Major Accomplishments:
- Facilitated the designation of 10 Critical
Access Hospitals and the ongoing assessment of CAH designation
for 5 CAH-eligible facilities in Nevada, which have improved the
economic viability of Nevada's rural and frontier hospitals.
- Provide technical assistance to 17 rural and
frontier hospitals and communities in Nevada, including revenue
cycle enhancement, strategic planning, and on-site Medicare survey
preparation.
- Prepared health sector economic impact reports
for 12 rural and frontier counties in Nevada that contain current
estimates of the employment and payroll impact of the hospital
industry on local economic development.
- Undertaken community health care needs assessments
and health services financial feasibility assessments in 7 communities.
- Supported improvements in 104 EMS services
across all14 rural and frontier counties of Nevada and the rural
regions of Nevada's urban counties.
- Improved the capacity of the Nevada Office
of Rural Health to undertake rural health care data collection,
analysis and dissemination, including the publication of a biannual
Nevada Rural and Frontier Health Data Book for rural health care
stakeholders and public policymakers in Nevada.
- Supported performance improvement activities
in 15 hospitals, including the capacity of facilities to monitor
and benchmark financial, operational, and quality performance.
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.
The Nevada SHIP Consortium is comprised of all
15 SHIP-eligible hospitals in Nevada - all of whom have agreed to
participate in the consortium. The Nevada SHIP Consortium activities
are currently focused on the following quality improvement needs
identified by consortium facilities: (1) Further assistance with
the implementation of efficient, electronic systems that support
internal performance improvement (PI) in both business and clinical
settings such as the ability to capture, track, trend, analyze and
report quality, patient safety, financial, and operational indicators;
(2) Assistance with the meaningful comparison and interpretation
of PI indicators with other similar facilities; and (3) Automation
of the collection, distribution, and retention of the myriad of
healthcare documents generated everyday in their facilities and
a migration to an electronic health record (EHR).
SHIP Award (FY 05): $140,100.
Program Highlights:
- Hospitals receiving funding: 15
- Hospitals in consortiums, networks or systems:
15
- Hospitals using funds for QI and /or reduction
of medical errors: 15
Major Accomplishments:
For the past four years, the quality and performance
activities undertaken by the Nevada SHIP Consortium represent the
successful coordination and use of both SHIP and Flex grant dollars
by the Nevada Office of Rural Health and Nevada Rural Hospital Partners
(NRHP). NRHP is a formal network of rural and frontier hospitals,
which also serves as the Critical Access Hospital network for Nevada.
The primary benefit of the consortium approach adopted by Nevada
has been the ability to coordinate and build programs over time
- particularly, the development of shared financial management expertise,
shared information technology management expertise, support for
access to the same quality data management system (DeskHDC), the
development of an Application Service Provider (ASP) EHR model,
and overall shared program coordination, consultation, and facilitation.
The goals and objectives developed by the Nevada Office of Rural
Health, NRHP and Nevada SHIP Consortium hospitals are explicitly
designed to complement the goals and objectives of the Nevada Flex
Program.
Total HRSA Funding (FY 05): $835,100
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