Allowable Investments Search Tool
In general, SHIP allowable investments include activities to assist small rural hospitals with their quality improvement efforts and with their adaptation to changing payment systems through investments in hardware, software and related trainings. This includes aiding with value and quality improvement.
Unallowable investments include, but are not limited to, travel costs, hospital services, hospital staff salaries, or general supplies. Hospitals should contact their State Office of Rural Health (SORH) with questions regarding the appropriateness or fit of a certain activity or hardware/software purchase. For additional clarifications, refer to Frequently Asked Questions (FAQs).
This tool classifies a number of example investment activities as Allowable, Unallowable, or PO Pre-Approval. This is not a comprehensive list. It is only intended to provide examples of allowable SHIP activities.
Updated May 2022
Hospital staff salary, benefits, incentives, and bonuses, of any kind, are unallowable.
See also: COVID
Costs or fees associated with a physician-waiver to prescribe and dispense Buprenorphine do not qualify as a SHIP allowable investment.
Providers may apply for a waiver with the Substance Abuse and Mental Health Services Administration’s (SAMHSA) Become a Buprenorphine Waivered Practitioner since this has an opioid component. This process is free of charge; therefore, SHIP funds should be applied to other activities.
Updated May 2022
Unused SHIP funds cannot be transferred to another participating hospital.
Updated May 2022
Indirect costs are deducted from the total award amount per state.
Indirect Cost Calculation - Grantee may request the lesser of 15 percent of the award total or their current federally negotiated indirect cost rate agreement. Indirect costs are deducted from the total award amount, not in addition to the total award amount. Grantees are not required to take indirect costs.
Updated May 2022: See definitions "Telehealth," "Training," "Hardware," and "Software."
Training, hardware, and software that support the application and implementation of remote pharmacy (telepharmacy) services are allowable.
Some examples of allowable expenses include but are not limited to:
Telepharmacy software, telepharmacy software/apps to support after-hours pharmacy services, telepharmacy machines, telepharmacy machines that can dispense pre-packaged medication, printer and printing supplies used for telepharmacy operations (i.e., printing instructions with pre-packed medication), computers, and accompanying hardware to support telepharmacy operations.
See also: telehealth, hardware, software, office supplies, training.
NOTE: The cost of personnel, medications, medication delivery, refilling pre-packaged medication, assistants, or hardware for direct patient care are unallowable.
Project ECHO educates health care professionals in underserved communities to treat chronic complex diseases in value-based care and payment models. This videoconferencing technology is used to create learning networks and may be a disease registry and population health training activity, and is an allowable SHIP investment.
Updated May 2022
ACO fees are an allowable investment under the ACO category.
The hospital should identify how they will define progress to align with the state office’s SHIP goals.
Updated May 2022, See definition: "Recurring Payment."
The Patient-Centered Medical Home (PCMH) process requires an initial fee at enrollment. Then the rural health clinic implements changes by going through training that provides quality or efficiency improvement in support of Value-Based Purchasing initiatives. This is an allowable investment.
Note: The application renewal fee after the initial enrollment is unallowable.
Software and web applications that facilitate swing bed services are allowable uses of SHIP Funds.
Updated May 2022
Software and hardware SHIP infrastructure for wellness streaming services as a population health project is an allowable use of SHIP funds.
Updated May 2022
Mobile language line workstations can potentially be allowable SHIP investments if used by hospital staff to support operational efficiency and increase equitable patient satisfaction.
Note: These investments require Project Officer pre-approval. If a hospital is interested in this investment, the State SHIP coordinator should email their project officer with the justification of how these services will support operational efficiency and increase equitable patient satisfaction.
Updated May 2022
Public messaging, marketing, and community outreach campaign costs are unallowable.
Unallowable expenses may include but are not limited to:
Signage, directional signage, message boards, books, pamphlets, one-sheets, push cards, information cards, video production, social media advertising, marketing, and community marketing.
See also: Supplies (Office)
Voice recognition system for dictation to support increased quality, efficiency, and/or coding is an allowable use of SHIP funds.
Updated May 2022, See definitions: "Training," "Contract," and "Consulting/Reviews"
Travel and lodging costs for vendors, contractors, or a subject matter expert (SME) to travel to and from SHIP-approved training are allowable. The hospital or network should request an invoice with all related training costs (including time, travel, and lodging) bundled as one single deliverable.
NOTE: SHIP Guidance doesn't approve travel for hospitals and state offices.
See also: Training
Updated May 2022 - Only HCAHPS Surveys are allowable.
Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys completed for inpatient services are an allowable use of SHIP funds.
NOTE: Currently, this is the only allowable SHIP survey. Costs associated with conducting surveys and assessments (including overhead, fees, payments, contractors, etc.) are unallowable. This category is consistently under review, and we encourage SHIP Coordinators to email SHIP-TA@ruralcenter.org and copy your PO with questions or concerns.
See also: Surveys and Assessments
Updated May 2022:
Reporting (prior, ongoing, or post-event) managing attendees, staff, or volunteers and event operations is not an allowable use of SHIP funds.
Costs for testing, including procuring, providing, or processing COVID-19 tests (including at-home testing kits).
Costs for testing using a simultaneous multi-disease test that must include COVID-19
Costs associated with mitigating the spread of COVID-19 and other related respiratory diseases. For the purpose of the SHIP Testing and Mitigation grants, activities that mitigate negative outcomes at the patient level through direct patient care are not allowable. See direct patient care.
The cost associated with COVID-19 testing education at hospitals and community locations including home health, hospice, and long-term care.
Supporting EMS as it relates to COVID-19 testing and mitigation efforts, and as part of a system improvement process
Alterations and renovations that do not qualify as construction to create isolation areas for potential COVID-19 patients
Alterations and renovations that do not qualify as construction to update surfaces to more sanitary materials to mitigate COVID-19
Alterations and renovations that do not qualify as construction to update laboratories or other key spaces for safer and more efficient COVID-19 testing.
Addition of automated doors, sinks, toilets, soap dispensers, etc. for the purpose of COVID-19 mitigation.
Creating negative pressure spaces within common spaces (such as waiting rooms and bathrooms), or in rooms to treat COVID-19 positive patients.
Installing tents, sheds, or other temporary structures to use for COVID-19 testing or mitigation activities.
Purchasing and installing HVAC and associated expenses to improve COVID-19 mitigation efforts.
Purchasing and installing ionized filtration systems for HVAC units to improve COVID-19 mitigation efforts.
Devices for masks, fit testing masks, respirators, or other personal protective equipment used to mitigate the spread of COVID-19.
Covid-19 related education materials (including vaccination education materials) for dissemination to the public.
Laboratory supplies and equipment for COVID-19 testing.
Portable equipment (such as a portable x-ray machine) used to prevent patients from being moved throughout a facility. To be allowable, all portable equipment must be part of a hospital's larger COVID-19 mitigation plan.
Sanitation and cleaning equipment (including disinfectant robots) to be used to mitigate the spread of COVID-19. Also includes ultraviolet sanitation devices.
Temperature screening systems to be used to mitigate the spread of COVID-19. See COVID-19 Screen Staff as well.
Upgrading or expanding for telemetry equipment as part of a larger COVID-19 mitigation strategy.
Cost of paying screeners placed at facility entrance doors to protect patients and employees and mitigate the spread of COVID-19.
Costs associated with staff couriering COVID-19 tests to a laboratory.
Digital meeting technology software purchases to conduct digital/virtual meetings to mitigate the spread of COVID-19 by maintaining physical distancing and reducing facility traffic.
Electronic health record (EHR) costs supportive of COVID-19 testing and mitigation.
Costs related to treatment or direct patient care.
Vaccine purchases, dissemination (including boosters) of vaccinations, or supplies associated with COVID-19 vaccination (considered direct patient care).
Construction costs, including, but are not necessarily limited to permanent building additions, new permanent buildings, permanent building expansions, modular buildings (and installations), increasing the footprint of the facility, significant new ground disturbance, and projects with a total cost of $500,000 or more.
Costs associated with purchasing, maintaining, or operating a GlideScope™ or other similar equipment which allows for video laryngoscope (considered direct patient care).
Costs associated with purchasing, maintaining, or operating ventilators or other similar equipment which allows for respiratory assistance.
Costs associated with increasing staff salaries, recruitment, retention, bonuses, incentives, or benefits such as hazard pay, employee childcare, housing allowances, travel allowances (not associated with COVID-19 courier services), meals, snacks, or other incentive benefits. See Screening Staff, Testing Staff, Courier Staff, or Travel Nurse for more information.
Costs associated with staff time spent on COVID-19 testing.
Costs associated with hiring, retaining, or relocating travel nurses or travel nurse services require pre-approval.
Minor alterations or renovations that exceed 50% of the hospital's total American Rescue Plan (ARP) award.
Costs associated with the purchase, maintenance, or usage of communication equipment including 2-way radios, electronic messaging boards for COVID-19 testing and mitigation, and video streaming equipment.