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.

Physician Waiver to Prescribe and Dispense Buprenorphine
Unallowable

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.

Efficiency or Quality Improvement Training in Support of ACO or Shared Savings Related Initiatives
Allowable
Accountable Care Organization (ACO)

Quality improvement training such as the IHI Plan-Do-Study-Act (PDSA), Root Cause Analysis (RCA), TeamSTEPPS, Lean Process planning, Community Care Coordination and Chronic Care Management, CMS Abstraction & Reporting Tool, and other efficiency and quality improvement trainings are allowable investments.

Systems Performance Training in Support of ACO or Shared Savings Related Initiatives
Allowable
Accountable Care Organization (ACO)

Systems performance training, including adopting a framework approach to transition to value-based system planning, is an allowable investment.

EMS Crew Equipment
Unallowable

Supplies and equipment used by emergency medical services (EMS) staff or EMS volunteers such as a stethoscope, watch, blood pressure cuff, and pulse oximeter do not qualify as SHIP allowable investment.

If the hospital and/or hospital-owned ambulance unit has a formal community paramedics program (CPP), hardware/software can be purchased to support the CPP to reduce EMS and emergency department misuse and readmissions. However, the use of SHIP funding for general EMS equipment is not allowable.

Community Paramedicine Hardware/Software
Allowable
Accountable Care Organization (ACO)

If the hospital and/or hospital-owned ambulance unit has a formal Community Paramedic Program (CPP), hardware and software to support the CPP to reduce emergency medical services (EMS) and emergency department misuse and readmissions are allowable investments. However, the use of SHIP funding for general EMS equipment is not an allowable investment.

COVID-19 EMS Support
Allowable
SHIP ARP COVID-19 Testing & Mitigation

Supporting EMS as it relates to COVID-19 testing and mitigation efforts, and as part of a system improvement process

340B Drug Pricing Program Training
Allowable
Payment Bundling (PB)

A 340B Drug Pricing Program training intended to increase efficiency or quality improvement in support of Prospective Bundling and Prospective Payment Systems initiatives is an allowable investment.

Mobile Language Line Workstation for Interpretation Services
PO Pre-Approval
Accountable Care Organization (ACO)

Mobile language line workstations, iPads, and tablets 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 justification of how these services will support operational efficiency and increase equitable patient satisfaction.

This project is/was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number UB1RH24206, Information Services to Rural Hospital Flexibility Program Grantees, $1,009,121 (0% financed with nongovernmental sources). This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.