Welcome from CRHC’s CEO             Table of Contents             Watch the Video

Welcome to the 2014 Annual Report

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Thank you on behalf of the staff and board of CRHC, your State Office of Rural Health and Rural Health Association in Colorado, for your continued support in 2014 as we grew both in staff and services. Enhancing resources and technical assistance is a key way our team supports and helps our members thrive. The healthcare system is experiencing one of the largest changes in history as we move from a volume-based delivery system to a value-based model. At CRHC, we recognize that this will continue to be a difficult transition for our rural health facilities and we know strong community partnerships are essential to achieving success. CRHC will remain dedicated to our mission and vision of assisting rural communities in addressing healthcare issues and advocating for policy change to ensure that rural Coloradans have access to comprehensive, affordable healthcare services of the highest quality.

In 2014, our programs kept us busy with several great projects. The HARC DataBank launched early spring, providing access to population health data specifically aggregated for rural and frontier counties in Colorado. During the legislative session, CRHC tracked a variety of bills and continued to act as the primary advocate for rural health providers. Our awareness campaigns during Safety Net Clinic Week and National Rural Health Day showcased the need for continued policy initiatives to support the rural healthcare delivery system. Videos proved instrumental in these efforts, most notably the debut of the National Rural Health Day video.

In September we launched our new website, reflecting our commitment to providing resources, tools, and a clearinghouse for rural health information. A month later we kicked off the fifth year of the Improving Communications and Readmissions (iCARE) program. Over the course of the program critical access hospitals (CAHs) have made great improvements in their readmission rates and the processes that contribute to readmissions.

Our workshops and conferences continue to connect, educate and inspire attendees, proven at the 2014 Forum, which marked the highest conference attendance in the event’s history. By the end of 2014, CRHC assisted 33 rural and CAHs and 261 providers at 67 rural clinics, in the adoption and meaningful use of electronic health records.

In 2014, our work with rural health facilities showed us that they are innovative and resilient in this time of change in healthcare. The facilities that make up the rural healthcare safety net are essential to the health and well-being of Colorado’s rural communities. CAHs, Rural Health Clinics (RHCs), Federally Qualified Health Centers (FQHCs), community safety net clinics, public health agencies, mental health centers, rural hospitals, long-term care centers, hospice and home health, and medical and dental practices to name a few are the backbone of the rural health infrastructure.

As the CEO of the Colorado Rural Health Center, it is my privilege to provide leadership, and to serve all of our rural communities in Colorado.


Michelle Mills, CEO

Watch the Video


Unity is strength…when there is teamwork and collaboration, wonderful things can be achieved.  

~ Mattie J.T. Stepanek

American Poet



1………………………….. Financials

2…………………………..By the Numbers


      a………………………. Critical Access Hospitals

      b………………………. Rural Health Clinics

      c………………………. Emergency Preparedness

      d………………………. Workforce

      e………………………. Health Information Technology

      f………………………. Policy & Advocacy

4………………………….. Thank You

5………………………….. Trivia Challenge



CRHC launched video production services in 2014

Watch the National Rural Health Day Video

Funding Sources

CRHC has a diverse funding base that includes public and private funds, government contracts, grants, and earned income.  Membership dues, registration fees, and fee-for-service revenue also contribute to CRHC’s income.


Private Foundation Grants……… $506,985
Federal Grants……………………… $997,027
Fee for Service Programs……….. $564,267
State Government Contracts…… $972,911
Membership and Donations……. $132,212
Registration Fees………………….. $122,672
Other………………………………….. $2,854

Other: 0.5%
Membership & Donations: 4%
Conference and Workshop Registration Fees: 4%
State Government Contracts: 30%
Fee for Service: 17%
Federal Grants: 30%
Private Grants: 15%

Thank you partners, donors, sponsors, and funders

By the Numbers

CRHC’s top accomplishments in 2014

Number of providers recruited to work at a rural facility

Number of hospitals participating in the iCARE program

Legislative bills tracked in 2014

AEDs distributed in rural communities

Number of CRHC Members in 2014: 209
Providers contracted with Colorado Provider Recruitment program: 1,052
Providers supported through CRHC HIT support: 317
Number of rural communities served via CRHC's support services: 220

Funds awarded for EMTS training


Total financial support facilitated


Economic impact of physician placed by CRHC


Funds distributed for new programs, equipment or education



Rural healthcare providers continue to play a critical role in the delivery of care to rural communities.  2014 was another amazing year mobilizing a variety of projects and programs across the state.

Critical Access Hospitals

Through the Medicare Rural Hospital Flexibility Grant (FLEX), Colorado Critical Access Hospitals (CAHs) are supported through quality improvement initiatives, educational webinars, financial education, HIT support, regional workshops, and peer learning opportunities.

Improving Communications and Readmissions (iCARE) provided technical support to 21 participating CAHs and their provider based clinics across Colorado in 2014.

About CAHs

What is a CAH?

A Critical Access Hospital (CAH) is a hospital certified under a set of Medicare Conditions of Participation (CoP), which are structured differently than the acute care hospital CoP. Some of the requirements for CAH certification include having no more than 25 inpatient beds; maintaining an annual average length of stay of no more than 96 hours for acute inpatient care; offering 24-hour, 7-day-a-week emergency care; and being located in a rural area, at least 35 miles drive away from any other hospital or CAH (fewer in some circumstances).

How many CAHs in Colorado?

There are 29 CAHs in Colorado.

Colorado CAH Map


What is iCARE?

The three primary goals of CRHC’s iCARE project are to:

1.  Improve communications in transitions of care
2.  Improve the clinical process and systems to reduce readmissions, particularly for heart failure, pneumonia, and diabetes patients
3.  Maintain low readmission rates

Learn More


By the Numbers

In 2014, the iCARE program:

• 21 of Colorado’s 29 CAHs participated in iCARE

• The average 30-day readmission rate for iCARE hospitals is four percent, compared to the national average of 17.5%.

• The average pneumonia immunization rate for iCARE hospitals (84.3 percent) has continued to be above the state average (74.6 percent).

Rural Health Clinics

Colorado’s 52 Rural Health Clinics (RHCs) were supported through mock surveys, billing and coding workshops, health clinic assessments, gap analysis studies, HIT support, feasibility studies and quality improvement initiatives.

In 2014, 14 rural health clinics participated in the iCARE program, examining the clinics’ role in reducing readmission rates, communications in transitions of care and improving clinical processes, especially for their diabetic populations.

About RHCs

What is a RHC?

RHCs are clinics that are located in areas designated by the Bureau of the Census as rural and by the Secretary of the Department of Health and Human Services (DHHS) or the State as medically underserved.

Learn More

How many RHCs in Colorado?

There are 52 RHCs in Colorado.

Across Colorado, over 178,000 patients rely on rural clinics for outpatient primary health care services. Rural clinics have a significant impact on the communities they serve as they are often the only health provider in the county offering primary care services.

Colorado RHC Map


What is a Healthy Clinic Assessment?

CRHC helps RHCs by completing the Healthy Clinic Assessments (HCAs) on the clinic’s daily operations and processes.  The HCAs focuses on streamlining processes and workflow which increase efficiency and clinic revenue by assessing and optimizing basic business operations, while creating an overall improvement in quality. The HCA helps provide a solid foundation for clinics so they can move on to other, more intensive quality improvement programs, such as patient centered medical home.

Learn More About RHC Programs


By the Numbers

In 2014, the RHC program:

• Completed more than 30 HCAs

• CRHC saw an increase in 78% of the individual HCA scores from 2013 to 2014

• 22 clinics, both provider-based and independent, participated in the iCARE program in 2014.

• One of the process measures being collected at RHCs is diabetic patients with an A1c>9%, which decreased by an average of 3 percent and a percent change of 26% from 2013 to 2014.

60% of clinics documented A1c scores in 2014

Emergency Preparedness & Training

The Rural Access to Emergency Devices (RAED) Grant Program provided funding for hospitals, RHCs, and others to support purchasing emergency preparedness supplies, equipment and training.

The Colorado Resource for Emergency and Trauma Education (CREATE) provides education and training for emergency medical and trauma service providers working in Colorado.

Emergency preparedness is planning for natural or man-made disasters–what you, your organization, and your community can and will do in case of an emergency. Within this program is the Hospital Preparedness Program (HPP), which enhances the ability of hospitals and other healthcare entities to prepare for and respond to all hazards and other public health emergencies.

About EMS

What is the RAED Program?

As Colorado’s State Office of Rural Health, CRHC was the lead applicant and fiscal agent for this statewide RAED program. The purpose of the program was to develop community partnerships to purchase automated external defibrillators (AEDs), provide defibrillator and basic life support training (CPR), and place the AEDs in rural communities with local organizations.

Learn More

By the Numbers

In 2014, the Rural Access to Emergency Devices Grant Program:

• During the three year program, 167 AEDs were placed with rural first responder agencies and community organizations and 1470 individuals were trained to use AEDs with CPR.

• In 2014, 56 AEDs were placed with a total value of $74,345.

• CRHC worked in tandem with 11 Colorado Regional Emergency Medical and Trauma Advisory Councils (RETACs) to help facilitate the placement of AEDs and training of first responders and community members in the use of AEDs and CPR.

What is CREATE?

Funding for the CREATE program is issued by the Colorado Department of Public Health and Environment (CDPHE), as part of Colorado Senate Bill 34 – an emergency medical and trauma services (EMTS) grant program that began in 1989 – which is now governed under Colorado Revised Statute (CRS) Sec. 1,25-3.5-60.

The CREATE program is designed to assist public and private EMTS across the state with a 50 percent cash match grant for continuing education and initial training, exclusive to emergency and trauma education.

Learn More


By the Numbers

In 2014, the CREATE program:

• Reviewed 178 applications submitted and awarded over $386,398 dollars in grant funds distributed, training 478 students to better serve their communities.

• CREATE supported 68 new Nationally Registered EMTs and 36 new Nationally Registered Paramedics serving in Colorado.

• Program results indicate that 55 percent of EMTS providers funded by CREATE are volunteer providers, with over 90 percent of all grantees reporting that it would be difficult to meet education and training expectations and requirements if funding support through CREATE was not available.

What is HPP?

The Hospital Preparedness Program (HPP) provides leadership and funding to help Healthcare Coalitions, hospitals and other healthcare organizations strengthen medical surge and other Healthcare Preparedness Capabilities. The HPP funding helps to build community preparedness and resilient healthcare systems prepare for all events including pandemics. Recent incidents have highlighted the kinds of challenges the healthcare system is likely to face in a major disaster.

This funding is used to support programs to help strengthen public health emergency preparedness in several ways:

Enhanced Planning:  HPP funding is used to enhance Healthcare Coalitions, hospitals and other healthcare organization’s collective system planning and response at the State, local, and territorial levels.

Increasing Integration:  HPP facilitates the integration of public and private sector medical planning and assets to increase the preparedness, response, and surge capacity of Healthcare Coalitions, hospitals, and other healthcare organizations.

By the Numbers

In 2014, the HPP program:

•Helped support 30 RHCs with Emergency Preparedness

•Assisted 81 acute care hospitals with their Emergency Preparedness measures.

Number of EMTS trained via the CREATE program: 478
Number of first responders trained in CPR/AED via the RAED grant program: 490

Rural Workforce Recruitment and Retention

The Colorado Provider Recruitment program identifies, tracks and addresses the primary care workforce shortage by offering recruitment and retention services to healthcare providers and employers.


About CPR

What is unique about the rural healthcare workforce?

A career in rural health is very rewarding; rural practice presents plenty of variety, is exciting and allows providers to play a pivotal role in the well-being of the whole community.

• There are just under 14,000 physicians in Colorado – 16 counties – all rural – have 3 or fewer practicing physicians – 2 counties have no practicing physician

• 14 rural counties in Colorado have no hospital or ER

• Colorado has an aging physician workforce

• About 2,000 practicing physicians are over the age of 60

What provider types does CPR recruit?

• Allied Health Professionals
• Certified Nurse Midwife
• Dental Hygienists
• Dentists
• Emergency Medicine Physicians
• Family Physicians
• General Surgeons
• IM/Ped
• Internal Medicine Physicians
• Medical Directors
• Nurse Practitioners
• Physician Assistants
• Pediatricians
• Registered Nurses

What is CPR's retention rate?

CPR maintained a 64% three-year retention rate (2012-14)


By the Numbers

In 2014, the CPR program:

• Over 170 healthcare professionals were referred to rural communities with job openings

•  CPR posted and recruited for 76 jobs

• CPR exhibited at 15 job fairs and conferences which contributed to an 8% growth of provider candidate pool from 2013

•Realizing the need to increase student interest in rural practice, CPR conducted 12 presentations to students and residents


CPR launched a new job board in 2014

Health Information Technology

Health information technology or HIT is the use of applications to record, store, protect, retrieve and transfer information electronically.

Rural areas experience unique barriers to HIT adoption and utilization, due in part to the limited access to capital and infrastructure.  Through Technology for Healthcare Excellence (THE) Consortium, CRHC assists rural facilities to advance their HIT solutions.


About HIT

What is THE Consortium?

THE Consortium, operated by CRHC, began in 2010 to provide expert consultation, education and resources to facilities seeking to adopt new or support their current HIT efforts.

Learn More


What other programs support HIT?

Many federal policies and programs address the HIT challenges rural facilities face, including the Small Rural Hospital Improvement Program (SHIP), and the Medicare Rural Hospital Flexibility (Flex) Program.  As the State Office of Rural Health, CRHC manages both these programs in the state of Colorado.

About SHIP:

The Small Rural Hospital Improvement Grant Program (SHIP) provides funds to more than 1,600 participating hospitals in 47 participating State Offices of Rural Health (SORH).

About Flex:

Through the Medicare Rural Hospital Flexibility Grant (FLEX), Colorado Critical Access Hospitals (CAHs) are supported through quality improvement initiatives, educational webinars, financial education, HIT support, regional workshops, and peer learning opportunities.

By the Numbers

In 2014, CRHC:

• Helped 20 Colorado safety net clinics (60 medical providers) achieve and attest to EHR meaningful use. The final 4 rural Colorado hospitals also achieved and attested to EHR meaningful use – making Colorado 3rd in the nation to finish the REC Hospital program.

• Trained 422 people through 17 educational webinars about ICD-10

• Hosted 6 different 2-day ICD-10 Bootcamps, training 161 SHIP Hospital attendees.

Health Information Technology

Policy & Advocacy

In 2014, CRHC’s policy and advocacy program tracked state and federal legislation and regulations that had the potential of impacting access and delivery of care for rural health providers and communities.


About Policy and Advocacy

What legislation did CRHC track in 2014?

CRHC tracked a variety of bills in 2014. Issues ranged from Family Medicine Residency Programs In Rural Areas (Supported, signed into law 5/31/14) to a bill supporting Family Medicine Residency Programs In Rural Areas (Supported, signed into law 5/31/14) to the establishment of a Suicide Prevention Commission (Monitored).

To read the full report on CRHC’s policy positions in 2014, click here.


How else does CRHC advocate for rural?

CRHC raised awareness of rural health facilities and their communities through the promotion of Safety Net Clinic Week and national Rural Health Day.

By the Numbers

In 2014, CRHC’s policy and advocacy program:

• Tracked 29 bills for their relevancy to rural Colorado

• Supported 6 bills for their potential to positively impact rural health across the state.

• Celebrated Safety Net Clinic Week to draw attention to the importance of the state’s system of safety net providers.

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Engaging with the Legislative Process

Thank You

The accomplishments of the CRHC would not have been possible were it not for the contributions of time, effort, and resources made by the membership.

2014 Membership List


Meet the team at CRHC

Staff & Board of Directors

CRHC Trivia Challenge

Learn about the history of CRHC

When you think you know the answer, hover over the box to reveal.  Were you correct?

What year was CRHC founded?

What year was CRHC founded?

CRHC was established in 1991 by members of the Colorado Rural Health Consortium, with start-up support from the Federal Office of Rural Health Policy and several other public and private organizations around the state.

CRHC is the State Office of Rural Health. True/False

CRHC is the State Office of Rural Health. True/False

True.  CRHC is the State Office of Rural Health and is one of three offices functioning as a nonprofit. Other Offices are located in State health departments (37), or in academics institutions (10).

What was CRHC previously called?

What was CRHC previously called?

The Colorado Rural Health Center (CRHC) was originally called the Colorado Rural Health Resource Center ( or the Center).

CRHC is a member-based association. True/False

CRHC is a member-based association. True/False

True. CRHC was created by members of the Colorado Rural Health Consortium, who became the “members.” Since that time, membership has grown to more than 200 organizations.

Who is the CEO at CRHC?

Who is the CEO at CRHC?

CRHC’s CEO is Michelle Mills.

Where was first Rural Health Conference held?

Where was first Rural Health Conference held?

Glenwood Springs, Colorado.

Who received 1st Rural Excellence Award?

Who received 1st Rural Excellence Award?

Vivian Gallegos, RN and Public Health Nurse, San Luis Valley.  Learn more about the Rural Health Excellence Award, click here.

What was the CRHC logo in the early years?

What was the CRHC logo in the early years?

A mailbox.