There are 29 CAHs in Colorado.

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

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).

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.

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.

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.

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.

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.

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.

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.

In 2014, the HPP program:

•Helped support 30 RHCs with Emergency Preparedness

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

• 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
• OB/GYN
• Pediatricians
• Registered Nurses

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

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

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.

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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.

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.

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.

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.