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California Flex State Profile

The Technical Assistance and Services Center (TASC), a program of the National Rural Health Resource Center, provides technical assistance for the Rural Hospital Medicare Flexibility (Flex) Program in the form of information, tools and resources. State Flex Programs benefit from sharing information with one another and the Flex State Profiles are meant to be a method to encourage that sharing.

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State Contacts

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Survey Results


In each core area, what are the top Flex activities in your state?

Core Area 1: Support for Quality Improvement
  • Support critical access hospital (CAH) participation in Qualith Health Indicators (QHi) through project administration, data monitoring and reporting via the QHi data collection and multi-hospital benchmarking tool.
  • Exchange data through peer group sessions. 
  • Provide electronic health records (EHR) meaningful use trainings and information sharing.
  • Provide health information technology (HIT) grant information and California Regional Extension Centers, Cal-eConnect resources.
  • Support and track CAH participation in the Medicare Beneficiary Quality Improvement Project (MBQIP) through education, networking and data use as part of the quality improvement organization (QIO) and QHi.
Core Area 2: Support for Operational and Financial Improvement

The California Flex Program: monitors the performance of critical access hospitals (CAHs); identifies potential areas of financial and operational distress; and, plans and implements evidence-based strategies for improving financial performance. The following services are available to CAHs:

  • Targeted consulting and technical assistance such as operational assessments, charge master review, strategic planning, contractual reviews, revenue cycle and charge capture reviews.
  • Ongoing financial support and technical assistance.
  • Evidence-based strategic planning, performance improvement workshops and financial trainings.
  • Statewide financial workshops through the California Rural Health Symposium, state and regional meetings and conferences including the Western Regional CAH Conference, and the Northern Regional Conference.
  • Planning and implementing interventions for improving operational processes.
  • On-site and web-based Lean educational and trainings sessions.
Core Area 3: Support for Health System Development and Community Engagement

The California Flex Program has partnered with the California Emergency Medical Services Agency (EMSA) and the Local Emergency Services Agency (LEMSA) to improve EMS quality and performance through coordination of the following services offered to critical access hospitals (CAHs):

  • Inclusion of EMS into local and regional systems of care.
  • Bi-monthly EMS work group meetings.
  • Local EMS performance improvement trainings .
  • CAH emergency department and paramedic staff Rural Trauma Team Development (RTTD) trainings.
  • Technical assistance support.
  • Case studies to assess and identify unmet EMS community health and health service needs.

Currently, seven CAHs have been designated as trauma centers (five CAHs have Level IV designation and two CAHs have Level III designation). Five additional CAHs are working towards a trauma designation status. Our goal is to have these five CAHs acquire trauma center designation by 2015.

Please describe a success story or innovative program from the Flex program in your state:

Tahoe Forest Hospital District (TFHD) located in Northeastern California was named one of the top 100 critical access hospitals (CAH), in the United States from the National Rural Health Association (NRHA). To be recognized as a Top 100 CAH, TFHD had to earn top scores on the iVantage Health Analytics’ Hospital Strength Index. This Index offers an objective way to measure the hospitals’ relative performance among their peers. The results recognized the top hospitals that are the safety net to communities across America – measuring them across 56 different performance metrics, including quality, outcomes, patient perspective.

No two Flex programs are alike! What is one unique thing that you would like others to know about your Flex program?

One thing that makes us unique is that we are passionate about the work we do because we are:

  • Committed to ensuring that rural communities are healthy
  • Available to educate and assist
  • Loyal to our mission and goals
  • Inspired by the people we serve
  • Fostering partnerships to meet or goals and objectives
  • One team orchestrated by multiple key players
  • Rural health visionaries
  • Navigators of solutions
  • Improving and promoting rural health care services
  • Amicable to challenges

State Contact Details

Sandra Willburn

State Office Director, California
(916) 449-5770

Corinne Chavez

Health Program Manager, California
(916) 449-5752

Angélica Perez

Flex Coordinator, California
(916) 449-5779

Flex Coordinator Since August 2011

 

April Freitas

Program Analyst, California
(916) 449-5770
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