Alabama Flex Grant Program

The Medicare Rural Hospital Flexibility Program (Flex) was authorized in 1997 to focus on the following:

  • Improvement of quality of care in Critical Access Hospitals (CAHs) and other rural care providers;
  • Improving the financial and operational performance of CAHs; and
  • Encouraging health system development through the engagement of the rural community with CAHs and other care providers, and integrating rural Emergency Medical Services (EMS) into the health care system while assuring the quality of services provided.

Alabama's Flex Grant Program is administered by the Alabama Department of Public Health (ADPH) through the Office of Primary Care and Rural Health (OPCRH) and a grant agreement with the Alabama Hospital Association (AlaHA). The Flex Grant Oversight Committee provides direction to the program. In 2018, thirty-four hospitals are eligible to participate as non-Federal, short-term, general acute care facilities, with forty-nine staffed beds or less, located in rural Alabama. Four of these hospitals are designated CAHs--Choctaw General, Red Bay Hospital, St. Vincent's Blount, and Washington County Hospital.

OPCRH and AlaHA support Flex hospitals by assisting in their pursuit of financial viability and quality improvement, and as they serve as essential access points for Medicare, Medicaid, and uninsured patients. They further support Flex hospitals by collecting and disseminating health related information, coordinating rural resources, providing technical assistance, promoting recruitment to improve access to rural health care, and strengthening partnerships.

The 2013-2014 Flex Work Plan includes:

  • Rural Quality Network (RQN) - supporting benchmarking and sharing of core measure scores and supporting the RQN Readmission Project
  • Supporting the CAHs in the Medicare Beneficiary Quality Improvement Project (MBQIP)
  • Providing ICD-10 training
  • Providing CMS Reporting and Benchmarking mentoring to one qualified hospital
  • Providing health information technology information and resources
  • Promoting telehealth across the state
  • Supporting the Mid-South CAH Conference
  • Deliver evidence-based strategies, resources, and linkages
  • Provide rural health clinic conversion information and support
  • Support capnography training statewide for EMS providers
  • Facilitate CAH conversion information and support
  • Financial Improvement Network (FIN) - Promote financial improvement through collaboration, expertise, and assessment
  • Support telehealth expansion by identifying and distributing information, funding sources, and technical assistance

Any questions about the Flex Grant Program should be directed to either Karl Bryant at or (334) 206-5517, or Jane Knight at or (334) 272-8781.

Page last updated: November 21, 2019