2018 CAH Recognition Nomination

The Technical Assistance and Services Center (TASC), a program of the National Rural Health Resource Center, is accepting nominations for public recognition of critical access hospitals (CAHs) throughout the United States. CAH Recognition is supported by the Federal Office of Rural Health Policy (FORHP). The previous six CAH Recognition nomination periods were for CAHs demonstrating excellence and innovation in the areas of quality, community engagement, financial turnaround, value-based health care models, care coordination and emergency medical services (EMS). This round of recognition is focused on innovation and collaboration in the integration of behavioral or mental health into primary care.


According to Dr. Elinore F. McCance-Katz, the Assistant Secretary for Mental Health and Substance Abuse at the Department of Health and Human Services, “The present system facing our country’s citizens with serious mental illness is unacceptable...” Mental illness is not a rural versus urban issue, but services available in urban areas are very different than those available in rural with behavioral and mental health needs going unmet for various reasons.  

The information to follow is intended to provide an introduction to the fundamental challenges and benefits that support the integration of behavioral or mental health into primary care and the framework from which nominations from Flex Programs will be based. While this recognition certificate is for your CAHs, your state Flex Program’s support in promoting successful and innovative behavioral or mental health integration initiatives with your CAHs are a crucial component to the improvement of mental health care in your state's rural population and will be considered in the nomination process.

Innovation to Address Challenges

The current mental health care system in rural areas suffers from multiple challenges, including a lack of professionals providing services in the area, travel distance for patients, lack of public transportation and underinsurance. Additional issues include the social stigma often associated with mental illness and limited access to needed services due to provider reimbursement issues.

Research shows that rural patients in need of mental health services often see their primary care provider first or present in the emergency department (ED) when in crisis. Behavioral health is a very small part of the training and education that ED providers receive and finding mental health facilities with vacancies to transfer patients to is an issue as well. Integration of behavioral or mental health into primary care is one way of creating access to needed care in the appropriate setting.

Related resources:

For the purpose of this CAH recognition certificate, we are seeking CAHs that have taken innovative and collaborative steps to actively integrate behavioral or mental health services. We invite you to participate in this recognition process.

Nomination Criteria

The goals of the CAH Recognition are to support CAHs for the work they have accomplished related to innovative and collaborative behavioral or mental health integration initiatives and to share your involvement, as a state Flex Program, in supporting these initiatives now and in the future. If you have a CAH that is embracing behavioral or mental health integration, please consider nominating them for this recognition. We want to hear your story and provide recognition for your continued work with your CAHs. Additional insight related to resources and models and innovative approaches to behavioral or mental health integration initiatives can be found on the Rural Health Information Hub's (RHIhub) Rural Mental Health topic guide.

Scoring Criteria

The strongest nominations will tell a compelling story of innovative and collaborative behavioral or mental health integration initiatives, providing examples of documentation, an explanation of current or future state Flex Program involvement and description of how the outcomes of the initiatives are measured to assess effectiveness. 

  • Well-written, compelling story that provides background on why the hospital implemented the initiative(s) (0-3 points)
  • Detailed description of the hospital initiative(s) (0-2 points) 
  • Inclusion of how the state Flex Program supports the CAH in these efforts (0-2 points)
  • Clear description, including 2-5 qualitative and/or quantitative outcomes, that explains how the hospital has assessed that the initiative is successful and meeting community needs (0-5 points)

 Examples of Documentation to Support a Nomination

  • Meeting minutes from a workgroup or team
  • CAH, state and/or Flex program website information supporting innovative behavioral or mental health initiative(s)
  • Memorandums of Understanding (MOUs) related to innovative behavioral or mental health initiative(s) between agencies
  • Documentation showing current initiatives in collaboration/innovative plans are currently being implemented
  • Proof of additional funding sought for advancement of innovative behavioral or mental health initiative(s)

Flex Program Presentation of Recognition Certificate

If your nominated CAH(s) is chosen to be recognized, TASC will mail you a certificate for your CAH. We ask that you do the following:

  • Announce the news! Call the hospital’s CEO, notify her/him they are a certificate recipient and schedule a time with them to present the hospital with the certificate .
  • TASC will provide you a template press release. Use it as appropriate to highlight the CAH as appropriate in your and share it with the hospital so that they can customize it to share their success with their local media sources.
  • Send TASC a few photos, such as the staff holding the certificate, of you presenting it to them, etc. to include in the TASC e-newsletter, Rural Route and on the CAH Recognition spotlight webpage
  • Collect a quote from the hospital on what this recognition means to them. TASC will include this as well in Rural Route and on the CAH Recognition spotlight webpage.

Nominate a Hospital

The nomination period closed February 23, 2018. Please contact Nicole Clement at nclement@ruralcenter.org or (218) 216-7028 with any questions.

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, $1,100,000 (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.