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Managing the Flex Program

Future funding for the national Flex Program is dependent on strong program planning, operations and demonstrable outcomes through reporting. This can only be accomplished through competent program management on the part of state Flex Program leadership. State Flex Program proficiency in the following areas contribute to excellence in Flex Program management:

  • Managing the grant
  • Managing contracts and consulting services
  • Continuously assessing the program
  • Regularly reporting grant progress and outcomes

Related Content

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Flex Grant Guidance

The Medicare Rural Hospital Flexibility (Flex) Program was created by the Balanced Budget Act (BBA) in 1997 (revisions occurred through the Balanced Budget Refinement Act (BBRA); the Medicare, Medicaid and SHIP Benefits Improvement and Protection Act (BIPA); and the Medicare Prescription Drug, Improvement and Modernization Act (MMA)). The Flex Program is intended to preserve access to primary and emergency health care services, improve the quality of rural health services, provide services that meet community needs and foster a health delivery system that is both efficient and effective.

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2017 Flex Program Fundamentals

The Flex Program Fundamentals is a manual for those intimately involved with the Flex Program. We hope the Flex Program Fundamentals: An Introduction to the Medicare Rural Hospital Flexibility Program, is useful both as a resource for current Flex Program staff and as an orientation manual for new staff.

Executive Summary [PDF - 80 KB]

Section 1: Introduction to the Medicare Rural Hospital Flexibility (Flex) Program

Resource

Federal Grant Writing Manual

Author: National Rural Health Resource Center

Developed specifically to help grant applicants prepare for, and write, a federal grant proposal. It starts from the very basics of looking at what a grant is and assessing whether or not an applicant is qualified to apply for a federal grant.

Past Document

The Grant Project Life Cycle: A Grant Subcontract Management Guide

September 14, 2016

This guide is designed to target opportunities within the Flex grant to improve the scope of work requirements for subcontracted consultants. It will assist state programs in building greater accountability with their subcontractors to deliver more meaningful information to improve program deliverables, reporting and demonstrating measurable program outcomes.

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Flex Program Evaluation Toolkit

Provides information, tools and resources to effectively collect data and assess the activities performed for the Flex Program. The current direction of the Flex Program involves moving all of the state-level Flex Programs to a minimum standard of reporting on outcomes.

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Engaging Subcontractors and Partners in Demonstrating Outcomes

This presentation provides tips using examples from the Flex Program on working with subcontractors, stakeholders and partners in ways to demonstrate outcomes. The content includes a template budget tracking and program activity sheets as well as an example contract for services with a subcontractor.

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State Flex Program Logic Model

This document lays out the basic process for developing and integrating Logic Model into the state Flex Program.

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PIMS Data Collection Tool

An Excel-based data collection tool designed to collect participation and improvement data over one grant year to enable accurate reporting of PIMS measures at the end of the grant budget year.

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HRSA Electronic Handbook (EHB)

The HRSA Electronic Handbook (EHB) allows agencies to conduct their federal grants management activities and processes online using EHB. All the steps in the grants management process namely, planning and solicitation through closeout, can be efficiently carried out online, substantially reducing the turnaround time for awarding grants.

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Contact Information for State Flex Profiles

Annually, the Technical Assistance and Services Center (TASC) collects information from each of the 45 state Flex Programs. This information is shared with the goal of assisting and encouraging the programs to learn from each other. State Flex Profiles include information on program activities to support critical access hospitals, best practices and success stories, as well as information on the structure of the state Flex Program and contact information.

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.