The purpose of this cooperative agreement is to enable state Flex programs to support critical access hospitals (CAHs) in quality improvement, quality reporting, performance improvement, and benchmarking; to assist facilities seeking designation as CAHs; and to create a program to establish or expand

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the provision of rural emergency medical services (EMS).

The aim of the Flex Program is to provide training and technical assistance to build capacity, support innovation, and promote sustainable improvement in the rural health care system.

The overall goal of the Flex Program is to ensure that high quality health care is available in rural communities and aligned with community needs.

Health care services include appropriate preventative, ambulatory, pre-hospital, emergent, and inpatient care.

High quality rural health care will deliver high value to patients and communities and result in healthier rural people.

The long-term objectives of the Flex Program are to enable CAHs, including CAH-owned clinics, and rural EMS agencies to:
? Show and improve quality of care; ? Stabilize finances and maintain services; ? Adjust to address changing community needs; and ? Ensure patient care is integrated throughout the rural health care delivery system.

State Flex funding for this period of performance will act as a resource and focal point to address needs and demonstrate outcomes in the following six program areas with an emphasis and priority on quality, operational, and financial improvement in CAHs:
Program Area 1:
CAH Quality Improvement (required) Program Area 2:
CAH Operational and Financial Improvement (required) Program Area 3:
CAH Population Health Improvement (optional) Program Area 4:
Rural EMS Improvement (optional) Program Area 5:
Innovative Model Development (optional) Program Area 6:
CAH Designation (required if assistance is requested by rural hospitals)