SORH PIMS Example

State Offices of Rural Health
Grant Number: H95RH00100
Organization: ALABAMA DEPARTMENT OF PUBLIC HEALTH
Start Date:

07/01/2017

End Date:

06/30/2018

Report Due Date:

08/30/2018

Submitted Date: 08/24/2018
Public Burden Statement: An agency may not conduct or sponsor, and a person is not required to
respond to, a collection of information unless it displays a currently valid OMB control number. The
OMB control number for this project is 0915-0322. Public reporting burden for this collection of
information is estimated to average 12.5 hours per response, including the time for reviewing
instructions, searching existing data sources, and completing and reviewing the collection of
information. Send comments regarding this burden estimate or any other aspect of this collection of
information, including suggestions for reducing this burden, to HRSA Reports Clearance Officer,
5600 Fishers Lane, Room 14N39, Rockville, Maryland, 20857.
Total number of technical assistance (TA) encounters provided directly to clients within your State
by SORH: 1342
Examples of Different Types of TA Provided
Types of TA Provided

Number

Description

R In-Depth Telephone and
email interactions

1029

Frequent email and telephone communications were held
with rural health clinics and community health centers,
community health centers, Area Health Education Centers
(AHECs) and the Primary Care Association (PCA) regarding
the establishment and staffing of health care safety nets in
rural and medically underserved communities. Examples of
these communications included an overview of a 3RNet
webinar series called “3RNet Academy” which provided indepth information and strategy to improve recruitment and
retention of health care professionals, and an extensive
phone interaction with Phyllis McCain, a pharmacist in
Hurtsboro, AL, regarding establishing a rural health clinic.

R Webinar Technology

69

A wide array of webinars were supported, through both
attendance and dissemination to rural health providers and
stakeholders. These webinars included coverage on a wide
array of topics, from the current opioid epidemic to
stabilizing the financial and operational viability of small rural
hospitals. Specific webinars were developed and hosted for
rural safety net providers, including a joint webinar with
3RNet on recruitment and retention, and a webinar on
emergency preparedness with The Compliance Team staff
to address new federal rural health clinic regulations.

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State Offices of Rural Health
Grant Number: H95RH00100
Organization: ALABAMA DEPARTMENT OF PUBLIC HEALTH
Start Date:

07/01/2017

End Date:

06/30/2018

Report Due Date:

08/30/2018

Submitted Date: 08/24/2018
R Thru Teleconference

27

Frequent teleconferences were held with partners and
stakeholders on matters of common interest to the rural
health community, and in the development of new
relationships and venues. Examples of outcomes include a
new partnership between the Alabama Hospital Association
and a consulting firm to assist rural hospitals in addressing
population health needs; a consulting relationship with the
rural hospital program in another state on a new “Global
Payment” model for financially vulnerable hospitals; and,
dialogue with the state’s medical schools on a partnership to
sensitize community leaders and health care providers to
their specific health care deficiencies and resources which
are available to address those needs.

R Face to Face

93

Collaborative meetings were held with the state’s three
regional Area Health Education Center (AHEC) Directors to
share information and resources; with the Alabama
Medicaid Agency and ADPH Office of Community Affairs to
collaborate on information dissemination for a billing/coding
procedure change for independent rural health clinics; and
with the Alabama Rural Health Association (ARHA) to
organize and promote an in person training event regarding
Medicaid billing procedures. Other meetings included
presentations to the newly appointed State Health Officer on
rural health issues and concerns, with the Alabama Hospital
Association on hospital stabilization activities, with ARHA
board members on future rural health priorities, and with the
State Committee of Public Health on policy changes for the
recruitment of foreign medical graduates.

R Other

124

The SORH worked in close concert with the department’s
Chronic Disease Division to address community health
needs in the ten counties which have been identified as
having the greatest health disparities. This initiative will
involve the development of a community report card, with
data highlighting each community’s specific health care
issues, and recommended actions the community can take
to address those issues. The report will also identify
resources that are available within the ADPH to assist the
community

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State Offices of Rural Health
Grant Number: H95RH00100
Organization: ALABAMA DEPARTMENT OF PUBLIC HEALTH
Start Date:

07/01/2017

End Date:

06/30/2018

Report Due Date:

08/30/2018

Submitted Date: 08/24/2018
Total number of clients within your State that received TA directly from SORH:

508

Examples of Different Types of Clients that Received TA
Types of Clients that
Received TA

Number

Description

R Communities

33

An annual rural health conference was sponsored in
collaboration with ARHA, to provide updated information and
networking opportunities for the state’s rural hospitals and
health care professionals. The agenda included national
and rural policy updates, and separate tracts devoted to the
informational needs of RHCs, small rural hospitals, and
community leaders. Emphasis was placed on heightening
community interest and action to address the causes of
health disparities at the grass roots level.

R Government Officials

127

SORH participated in a regional collaborative with the
Centers for Disease Control (CDC), Federal Office of Rural
Health Policy (FORHP), Health Resources and Services
Administration (HRSA), and other stakeholders, to address
the high incidence of health disparities and chronic disease
within the southeast. This has resulted in a closer working
relationship with these entities to target the root causes of
these health problems. The SORH is now working closely
with the ADPH Chronic Disease Division to identify
community level initiatives and partners to address these
root causes, such as obesity and substance abuse.

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State Offices of Rural Health
Grant Number: H95RH00100
Organization: ALABAMA DEPARTMENT OF PUBLIC HEALTH
Start Date:

07/01/2017

End Date:

06/30/2018

Report Due Date:

08/30/2018

Submitted Date: 08/24/2018
R Academic Institutions

30

The plight or rural hospital closures was brought to the
attention of state legislators and policy makers, resulting in
legislation to create a new Rural Hospital Resource Center
(RHRC) within the University of Alabama at Birmingham.
This crisis was highlighted with the recent closure of a major
regional medical center and a rural hospital, and circulation
of a financial analysis report by a national consulting entity
that depicted a negative operating margin among the
majority of the state’s small, rural hospitals. The academic
freedom of the RHRC will be leveraged to develop and
promote innovative practices, such as the employment of
insurance-exempt FQHC providers in hospital emergency
departments to minimize the financial burden of providing
health care to uninsured patients.

R Associations

42

The absence of a stateside Rural Clinic Association was
addressed with the newly appointed executive director of
ARHA. The ARHA will continue to represent interests which
are common to both ARHA and RHCs, before such
organizations as the state legislature and other policy
making bodies. SORH continued to identify and provide for
the RHC’s training, educational, and workforce needs by
leveraging resources of national associations such as
Association of State and Territorial Health Officials
(ASTHO), National Organization of State Offices of Rural
Health (NOSORH), Alabama Public Health Association
(ALPHA), and Primary Care Association (PCA).

R Agencies

1

SORH worked in close coordination with the Alabama
Medicaid Agency, State Health Officer, State Committee of
Public Health, and Alabama Board of Medical Examiners to
establish a more accurate database of the state’s primary
care and mental health workforce. This database will be
useful in planning and preparing for the state’s future
workforce needs, and will serve as a community-level point
of contact for substance abuse initiatives.

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State Offices of Rural Health
Grant Number: H95RH00100
Organization: ALABAMA DEPARTMENT OF PUBLIC HEALTH
Start Date:

07/01/2017

End Date:

06/30/2018

Report Due Date:

08/30/2018

Submitted Date: 08/24/2018
R Networks

13

Networking opportunities were established with the creation
of a Rural Hospital Resource Center within the University of
Alabama Birmingham, and renewed partnerships with the
Medical Association of Alabama, Pennsylvania Office of
Rural Health, and ADPH Division of Emergency Medical
Services (EMS). As a result, EMS collaborated on a joint
grant application to increase training of first responders in
the treatment of opioid overdoses, and activities have begun
to plan the extension the state’s formal trauma system to
include the state’s rural hospitals.

R Emergency Medical
Service

1

A needs assessment identified one of the state’s six EMS
regions as having a minimal EMS personnel pool, and a
high incidence of toxicological emergencies, including
deaths from opioid abuse, over the previous five or more
years. The assessment also discovered that the region,
consisting of ten rural counties, were underserved by
volunteer fire rescue agencies which typically provide rapid
first response on emergency calls such as drug overdoses.
Based on this assessment, a project was developed to
provide specialized continuing education training to all EMS
providers in the region, including first responders,
Emergency Medical Technicians (EMTs) and paramedics.

R Clinics

171

Continual technical assistance was provided to rural health
providers in underserved areas to assist in their conversion
to more sustainable payment models, such as CMS-certified
RHCs and FQHC Look-a-likes. These models provide a
higher reimbursement rate for treatment of the large
numbers of medically indigent and uninsured patients that
are prevalent throughout each of the state’s rural
communities. This technical assistance resulted in one
clinic submitting a formal request for conversion to Look-alike status, and three other clinics requesting conversion to
RHCs.

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State Offices of Rural Health
Grant Number: H95RH00100
Organization: ALABAMA DEPARTMENT OF PUBLIC HEALTH
Start Date:

07/01/2017

End Date:

06/30/2018

Report Due Date:

08/30/2018

Submitted Date: 08/24/2018
R Hospitals

47

Emphasis on the desperate financial situation among the
state’s rural hospitals was accentuated by the recent closure
of a major regional medical center and another small
community hospital. In addition, two other small hospitals
were narrowly saved by being taken over by a large tertiary
care center. These closures and takeovers accentuated the
plight of virtually all small, rural hospitals throughout the
state, and prompted the legislative creation of a new Rural
Hospital Resource Center, hosted by the State’s largest
medical schools. Collaboration is ongoing with this new
center to explore the development of alternate payment
models, such as the global budgeting model being tested in
Pennsylvania, and to develop technical resources that serve
common needs.

R Providers

42

Collaboration with the state medical association produced a
venue for outreach to all member physicians, which
comprise the vast majority all physicians throughout the
state. As part of this venue, the association provided a
database with a list of each County Medical Society, and the
name and contact information for the physician who serves
as the society’s president. This venue will enable timely
dissemination of important information to providers, such as
health alerts and grant opportunities, and will provide a
means to affirm the need for additional physician
placements through recruitment programs such as the J-1
Visa Waiver Program and national 3RNet.

R Other

1

Being defined as ‘rural’ is important to health care providers
since this is one of the major qualifiers to apply for more
sustainable payment models, such as RHCs. CMS
recognizes federally-defined rural areas, and also
recognizes areas that are so defined by state law or
regulation. Accordingly, a hospital located on the fringe of
an urban area petitioned the State Health Officer to have its
area decreed as being ‘rural.’ Exhaustive research and
coordination with other state entities revealed that a state
definition of ‘rural’ had been embodied in a bill recently
approved by the state legislature. This bill essentially
extended the federal census definition of ‘urban cluster’ to
be to be one and the same as rural.
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State Offices of Rural Health
Grant Number: H95RH00100
Organization: ALABAMA DEPARTMENT OF PUBLIC HEALTH
Start Date:

07/01/2017

End Date:

06/30/2018

Report Due Date:

08/30/2018

Submitted Date: 08/24/2018

Any Comments About this Form or the Data You Entered:
Efforts are ongoing to streamline the means by which information is collected and disseminated to rural
providers and other stakeholders. This is essential in light of the exponential growth in data, programs,
and rural health initiatives flowing from governmental agencies, educational institutions, and research
organizations. Information is standardized and disseminated through website posts and other media to
the extent feasible. This greater efficiency in dissemination has tended to diminish the number of direct
encounters between staff and clients, as reflected in this report.
Is this Form Complete?

Yes
OMB Number: 0915-0322
Expiration Date: 01/31/2020

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