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Rural Health


The State Offices of Rural Health (SORH) Program is a 3:1 matching grant program that began in 1991 and has accomplished the creation of state offices in all 50 states. Each office's mission is to help their individual rural communities build health care delivery systems. The SORH Program provides an institutional framework that links communities with State and Federal resources to help develop long-term solutions to rural health problems.
The five core functions of the SORH program are to:

  • Serve as a clearinghouse of information and innovative rural health service delivery approaches.
  • Coordinate state activities related to rural health in order to avoid duplication of efforts and resources.
  • Identify Federal, State, and nongovernmental rural health programs and provide technical assistance to public and private, nonprofit entities serving rural populations.
  • Strengthen Federal, State, and partnerships in rural health.
  • Promote recruitment and retention of a competent healthcare workforce.

The Indiana State Office of Rural Health supports the Critical Access Hospital Medicare Rural Hospital Flexibility (Flex) Program and the Small Rural Hospital Improvement Program (SHIP). 
The State offices created the National Organization of State Offices of Rural Health to ensure that the states' perspectives on rural health were recognized nationally.
The mission of the Indiana State Office of Rural Health is to enhance the growth of public health services, funding sources, and education opportunities for every Indiana rural resident. The Indiana SORH is located in the Indiana Department of Health’s (IDOH) Division of Primary Care, Chronic Disease and Rural Health.

State Office of Rural Health Manager
Joyce Fillenwarth
(317) 233-7734



  • Rural Hospital Flexibility (Flex) Program

    The Flex Program was established from the Balanced Budget Act of 1997 (Public Law 105-33) to assist rural hospitals and improve access to care through Critical Access Hospital (CAH) designation. The Flex funding initially provided funding to State Offices of Rural Health for designation of CAHs in rural communities. With the majority of CAHs having been converted, the Flex Program now assists CAHs with quality and performance improvement activities, stabilizing hospital finances, and integrating emergency medical services (EMS) into health care systems.

    The Flex Program focuses on three core areas:

    • Support for Quality Improvement in CAHs.
    • Support for Operational and Financial Improvement in CAHs.
    • Support for Health System Development and Community Engagement, including integrating EMS in regional and local systems of care.

    Flex Grant Coordinator
    Nereah Kojwang                                                                                                                                                                                                                                 

  • Small Rural Hospital Improvement Grant Program (SHIP)

    The purpose of the SHIP is to help small rural hospitals do any or all of the following: pay for costs related to implementation of prospective payment systems (PPS), comply with provisions of the Health Insurance Portability and Accountability Act (HIPAA) and reduce medical errors and support quality improvement. The SHIP Grant Program was first authorized by the Balanced Budget Refinement Act of 1999 of the Social Security Act.

    Eligible hospitals apply for this grant program, through the Indiana State Office of Rural Health (SORH). Indiana SORH receives funding based on the number of eligible hospitals that apply. The SORH acts as a direct pass through and distributes the funding through one contract to the Indiana Hospital Association. This pooling of resources and partnership with IHA creates the Indiana SHIP Hospital Network and ensures that the projects offered to the hospitals create meaningful impact in a collaborative learning atmosphere. The projects being offered to hospitals in the network fall into the following categories:

    • Value Based Purchasing (such as improving data collection activities in order to facilitate reporting to Hospital Compare)
    • Accountable Care Organizations (such as activities that support quality improvement including, reduction of medical errors and education and training in data collection, reporting, and benchmarking)
    • Payment Bundling (building accountability across the continuum of care)

    SHIP Grant Coordinator
    Joyce Fillenwarth
    (317) 233-7734

  • Indiana's I-HOPE Grant Program

    The Indiana Department of Health received $34,800,194.00 from the CDC as part of the National Initiative to Address COVID-19 Health Disparities Among Populations at High-Risk and Underserved, Including Racial and Ethnic Minority Populations and Rural Communities. Indiana’s initiative has been titled I-HOPE: Indiana Healthy Opportunities for People Everywhere.

    Part of these funds have been dedicated to programs and services in rural areas of Indiana.  CLICK HERE to view a map showing organizations that have received these funds and where they are working throughout Indiana to achieve the objectives of this grant.

    To move toward greater health equity, the Indiana Department of Health continues to work with organizations, agencies, and communities to ensure resources are available to maintain and manage physical and mental health, including easy access to information, affordable testing, and medical and mental health care.

    Additional resources for this grant may be found below:
    Purdue University I-Hope
    Together We Will Mini Grants

Program Contacts

Joyce Fillenwarth
State Office of Rural Health Manager
(317) 233-7734

Nereah Kojwang
Flex Coordinator
(317) 233-7547