Development Process

History

In 2007, the U.S. Department of Health and Human Services (HHS) Health Resources and Services Administration (HRSA) Office of Rural Health Policy (ORHP) required all states that participate in the federal Medicare Rural Hospital Flexibility Grant Program (Flex) to revise their original State Rural Health Plan (SRHP). By program guidance, states were urged to create a revised SRHP that would be a roadmap toward using grant funds to support Critical Access Hospital (CAH) facilities, CAH eligibles and the communities they serve in a strategic fashion that helps support rural health care delivery broadly and that builds on the success of past Flex-supported efforts. Virginia was among the states required to revise the original SRHP.

Virginia’s original SRHP focused on the (1) conversion of eligible hospitals to Critical Access Hospital (CAH) status and the support these hospitals through the conversion process; (2) identification of other potential hospitals that were eligible for CAH status and assisted with their financial feasibility analysis; (3) development of a taskforce to implement the Flex program; and (4) development of administrative support for federal and state regulatory requirements of the plan.

Current

In July 2007, Virginia embarked on a quest to develop a state rural health plan. Virginia held the VA-SRHP kick-off session during a 2007 statewide rural health strategic planning session with over 40 prominent partners. Instead of limiting the plan to CAH, CAH eligibles and health care delivery services, Virginia sought to develop a 3-5 year plan that would:

  • Provide a comprehensive analysis of health in rural area
  • Develop practical strategies that will lead to improvements in rural health, not just to improvements in the delivery of services
  • Remain an active collaboration effort among various partners

The first study year was divided into four broad topic areas, each represented by a stakeholder driven workgroup.

Access Work Group - Examined rural health care access issues related to primary care, specialty care, emergency medical services, and mental and dental health care in order to make recommendations for improving health care access.

Quality Work Group - Examined rural health care quality issues in order to make recommendations for quality improvement efforts and/or activities.

Data and Rural Definitions Work Group - examined available rural health data and identifies data gaps in order to make recommendations for future data collection efforts and/or activities.

Workforce Work Group - Examined available resources and issues in order to make recommendations for improving the health care workforce in rural Virginia.

Future

Throughout this first study year, it became apparent that there were many more components to rural health than the access, quality, data/rural definition and workforce. Over the next 3-5 years, Virginia will move the VA-SRHP from a plan into action and implementation, and will seek to conduct more extensive study, analysis and integration of the following areas (as it relates to rural health):

  1. Mental/behavioral health
  2. Long-term Care/Aging
  3. Emergency Medical Services (EMS)
  4. Health Information Technology (HIT)
  5. Funding
  6. Education
  7. Transportation

It is our desire that, as VA-SRHP moves forward in advancing health in rural Virginia, you and your organization will join us in this effort.