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Hello everyone,
Happy holidays! On behalf of the Technical Assistances and Services Center (TASC), I wish you all have a great holiday season and a great, healthy new year.
As always, thank you for reading the newsletter. If you have questions or need assistance, please do not hesitate to reach out to me or TASC.
Best, Andy Naslund Program Coordinator TASC
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Federal Office of Rural Health Policy (FORHP) Updates
Dear Flex Coordinators,
I don't know if there is a word yet to describe what we have gone through in 2020. I remain hopeful for 2021 with vaccines on the way. As the Flex Project Officer team reviews your Fiscal Year (FY) 2019 End of Year Reports, we are so impressed with all that you have accomplished in the midst of a program year unlike any other. Here are some important deadlines for 2021: - January 30, 2021: FY 2019 Flex Annual Federal Financial Report (FFR)
- As of October 1st, there have been some changes made to the FFR submission process. Details on the change can be found here.
- Note, you must use the FFR Remarks Section to express your intent to carryover funds. If you intend to carryover funds and do not make a note in this section, you will be required to resubmit your FFR.
- For any program that submitted a No Cost Extension for leftover H54 funds, you will have to submit 2 FFRs, one for your FY 2019 U2W award and one for the No Cost Extension H54 award.
- March 1, 2021: Prior Approval Carryover Request
- If you have an Unobligated Balance (UOB) for your U2W award, you have the option to carry over those funds to your current budget period, to be spent by August 31, 2021.
- Please discuss your plan to utilize your carryover with your Project Officer.
- You can then submit a Prior Approval - Carryover Request in the Electronic Handbook (EHB). Please see this helpful video about the carryover request process.
- March 24, 2021: FY 2021 Non-Competing Continuation (NCC) Progress Report available
- March 25, 2021 at 2:00 p.m. Central Time there will be an NCC technical assistance webinar.
- The NCC report will be due in EHB on May 14, 2021.
FORHP, within the Health Resources & Services Administration (HRSA), is pleased to announce a new website dedicated to the pilot grant program Rural Maternal and Obstetric Management Strategies (RMOMS). Introduced in 2019, RMOMS seeks to improve maternity care in rural communities by building networks to coordinate care, leveraging telehealth, collecting data, and improving financial sustainability. The website lists the three rural networks funded last year and provides a fact sheet with more detailed information on their activities. Have a healthy and safe holiday season, Tori
CAH Regulatory Update
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This month, we welcome to Nicole Threadgold and Ashley Folarin of North Dakota. Welcome to you both!
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CAH Recognition Spotlights! Innovative Approaches to Post-Acute Care
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Critical Access Hospital Recognition was established by The National Rural Health Resource Center (The Center) and FORHP to recognize the excellent work in critical access hospitals (CAHs) and other rural safety net providers throughout the country. In this round of CAH Recognition, the following three hospitals received national recognition for demonstrating an innovative approach to post-acute care that supports a patient's continued recovery from illness, or management of a chronic illness or disability:
- Harrison County Community Hospital -- Bethany, Missouri (Featured in the November Newsletter)
- Pinckneyville Community Hospital -- Pinckneyville, Illinois (Featured in the October newsletter)
- UPMC Cole -- Coudersport, Pennsylvania (Featured in this newsletter)
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UPMC Cole, located in Coudersport, Pennsylvania, is one of three critical access hospitals (CAHs) that received national recognition for demonstrating an innovative approach to post-acute care that supports a patient's continued recovery from illness or management of a chronic illness or disability.
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Coudersport and the surrounding region is considered to be one of the most remote areas in Pennsylvania. The area includes the Allegheny National Forest with much of the area accessed by a few two-lane mountainous roads, which are often impassable in the winter months. As the only hospital in the area within 35 miles, UPMC Cole has been dedicated to ensuring that they meet and exceed the needs of the communities they serve. Comprehensive community needs assessment activities identified a population of high risk, vulnerable patients who experience a lack of support for comprehensive palliative services.
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Existing hospital services did not adequately meet and support the physical, emotional, spiritual, and social needs of those suffering from a serious or life-threatening illness. End of life care services were limited to a home-based hospice program or placement in a skilled nursing facility. In response, UPMC Cole developed a robust and innovative palliative care service. UPMC Cole appointed physician champions to lead this program to implement palliative services across the continuum of care. These palliative care services emphasize pain and symptom management, care coordination, emotional support, advanced care planning, and spiritual care.
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"An interdisciplinary team, passionate about palliative and end of life care, met routinely to identify service gaps and community needs and formulated concise goals utilizing best practices for end-of-life care," said Timothy Brown, President, Vice President of Operations, UPMC Cole Medical Group. "Kristin Kratzer and Andrea Heller, MD, were appointed to lead this program to implement palliative services across the continuum of care. The team provided community education to ensure that palliative care services did not replace primary care, but rather supported and complemented established and trusted services."
Positive Outcomes
- Continued expansion of palliative care services to include the addition of patients in three local skilled nursing facilities and rehabilitation facilities.
- An overall increase in Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores rating of 4 (above average) and willingness to recommend score of 4 (above average).
- Inpatient palliative care penetration rates increased from 3.83% in 2018 to 11.55% in Quarter 1 2020.
Top Accomplishments
Over the past year, palliative care services have grown to become a premier service in UPMC Cole's post-acute care program. Patients and families now receive the support they need when dealing with advanced illnesses, which were lacking prior to program implementation. Patients, families, and the community also have expressed appreciation for the palliative care program as evident by the increased community support and increased contributions to the hospital's philanthropic unit, the Cole Foundation. UPMC Cole has also seen an increase in patient census requesting specific services from the palliative program to include pain and symptom management, care coordination, emotional support, advanced care planning, and spiritual care.
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"UPMC Cole is dedicated to providing a comprehensive system of high-quality health care to include premier post-acute and palliative care services for their patients," said Jennifer Edwards, Rural Health Systems Manager and Deputy Director from the Pennsylvania Office of Rural Health. "This program is a shining example of innovation, and commitment to the transition to value that the CAHs in Pennsylvania are pursuing every day."
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TASC Updates
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2021 Flex Fundamentals Guide
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TASC, in cooperation with FORHP, is pleased to announce that the updated 2021 Flex Program Fundamentals: An Introduction to the Medicare Rural Hospital Flexibility Program manual was recently mailed to your Flex Program offices.
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The Flex Program Fundamentals is a manual for those intimately involved with the Flex Program. We hope this is a useful resource for current Flex Program staff, and as an orientation manual for new staff. An online version of the updated manual can also be found here.
Recently updated: COVID-19 Funding Sources Impacting Rural Providers
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This month, we were also pleased to provide another update of the COVID-19 Funding Sources Impacting Rural Providers guide. This funding resource is intended to support rural health care providers, along with their state and local partners, navigate the availability of federal funds to support the novel coronavirus (COVID-19) pandemic response and recovery efforts. This guide is updated regularly to capture changes in funding sources.
Seven tables, or matrices, are provided for quick reference at the beginning of this resource. The tables can be used to check eligibility of participation in funding sources by provider types: rural prospective payment system (PPS) and critical access hospitals (CAH), rural health clinics (RHC), federally qualified health centers (FQHC), long-term care (LTC) or skilled nursing facilities (SNF), tribal facilities, and emergency medical services (EMS). The tables also provide an at-a-glance view for each provider type sharing the different types of funds that may be accessed from various funding sources dependent on their participation eligibility. Each funding source is described in its own section of this resource with an executive summary followed by further detail on the use of funds, reporting requirements, hyperlinks to the legislation and detailed information.
One of the main updates for this version is the addition of the RHC COVID-19 Testing Program found on Page 57.
 Flex VKG Webinar Recording and 1:1 Coaching Opportunity
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Thank you to everyone who participated in the November Flex VKG Webinar around the topic of Evaluation Performance Improvement. The webinar recording is available in the Flex Forum. As a part of the VKG event, we are excited to offer the opportunity to connect with subject matter expert (SME) Rochelle Schultz Spinarski on a 1:1 coaching opportunity through the month of December. This service is free of charge, supported by TASC and FORHP, and available to all state Flex Programs. space
Through the accompanying self-assessment, you were able to recognize your Flex Program's strengths, challenges, and barriers with program evaluation. This 1:1 coaching opportunity is driven by you for you, while allowing space to review your program, your needs, and the opportunities available. Rochelle will help coach you through planning and prioritizing your evaluation needs, while also providing samples and tools and further data when needed.
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Please contact the TASC team, [email protected], to schedule your coaching call today!
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Announcing the New Rural Healthcare Provider Transition Project (RHPTP)
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With the support of the HRSA's FORHP, the National Rural Health Resource Center provides selected small rural hospitals and rural health clinics technical assistance through the Rural Healthcare Provider Transition Project (RHPTP). This project is designed to help strengthen their foundation in key elements of value-based care (VBC) including but not limited to efficiency, quality, patient experience, and safety of care.
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RHPTP's goal is to guide small rural hospitals (SRH) and rural health clinics (RHCs) not currently participating in VBC to prepare for and position their organizations for future participation in alternative payment and care delivery models (APM).
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"Eligible Small Rural Hospital" is defined as a non-federal, short-term general acute care hospital that: (i) is located in a rural area as defined in 42 U.S.C 1395ww(d) and (ii) has 49 available beds or less, as reported on the hospital's most recently filed Medicare Cost Report.
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SRH and RHC are encouraged to apply under a single application for TA.
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View more eligibility and application information here.
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CMS: Frequently Asked Questions for the CHART Model
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The Centers for Medicare and Medicaid Services (CMS) recently released a frequently asked question document addressing stakeholder questions regarding the Community Health Access and Rural Transformation (CHART) Model. The FAQs are posted on the CHART website.
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Community Health Access and Rural Transformation (CHART) Model
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Through the new CHART Model, CMS aims to continue addressing disparities by providing a way for rural communities to transform their health care delivery systems by leveraging innovative financial arrangements as well as operational and regulatory flexibilities.
The Rural Health Value team has been hosting " Let's Talk About CHART" virtual discussions to help rural communities and stakeholders identify opportunities, questions, and potential next steps regarding the CHART Community Track application. Webinars:
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- Lead Organization
- Transformation Plan
- Hospital Payment
- Partners
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- What it takes to serve as a Lead Organization
- Key planning and readiness activities
- Partners Lead Organizations will need and want to engage
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- December 14, 2020: Let's Talk about CHART... Transformation Planning: This webinar focused on understanding and facilitating rural health transformation:
- Key requirements and components for Transformation Planning
- Best practices for using Community Health Needs Assessments
- Lessons learned in engaging multiple stakeholders
- Opportunities for expanding telehealth use
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National Consortium of Telehealth Resource Centers (NCTRC) Telehealth Hack
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NCTRC is now hosting the Telehealth Hack, an extension of the previously held HHS Telehealth Hack. This webinar series will continue to deliver virtual peer-to-peer webinar learning sessions to support the adoption of telemedicine across the nation. Through the end of 2020 and into the spring of 2021, NCTRC has planned several core telehealth related topic areas. The first installment was a two-part webinar series recorded in October, focused on technology and Americans with Disabilities Act (ADA) compliance. In November, expert speakers will familiarize attendees with the application of legal requirements within telehealth, and the December series will provide an overview of school and college-based telehealth.
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Upcoming Events
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Flex VKG hosted by TASC -- Tuesday, January, 12, 2021 from 1:00 p.m. - 2:00 p.m. Central Time.
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Office hours hosted by RQITA -- Tuesday, January, 12, 2021 from 2:00 p.m. - 3:00 p.m. Central Time.
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MBQIP Updates
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Updated Resources
Please send your MBQIP questions to [email protected]. TASC will ensure your question reaches the appropriate person.
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Webinars, Recordings & Events
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Webinar Playbacks
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