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Indiana State Office of Rural Health Programs


2017 National Rural Health Day is November 16, 2019

The third Thursday in November has been set aside to highlight rural communities as wonderful places to live and work, increase awareness of rural health-related issues, and promote the efforts of State Offices of Rural Health and the National Organization of State Offices of Rural Health in addressing these issues.

National Rural Health Day highlights the unique health care challenges and opportunities in rural areas.

Ideas for celebrating:

  • Issue a proclamation for your community or organization.
  • Share your Community Success Story, photos or video.
  • Write a letter to the editor or contact a local legislator to stress the importance of addressing the health needs of rural communities.
  • Plan/host a community health fair.
  • Give tours of your facilities.
  • Display National Rural Health Day banners/posters.
  • Link to National Rural Health Day website from your website.
  • Have a “staff appreciation” luncheon.

Learn more about National Rural Health Day by visiting www.celebratepowerofrural.org

Share with the SORH how you are participating in National Rural Health Day by clicking here.


State Office of Rural Health (SORH)

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 approaches to rural health services delivery.

  • 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 health care 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 Indiana State Department of Health’s (ISDH) Primary Care Office.  The office is supervised by the Director of Chronic Disease, Primary Care and Rural Health.



The Indiana State Rural Health Plan

     2012 Indiana State Rural Health Plan




Indiana Rural Health Association  http://www.indianaruralhealth.org/

Lugar Center for Rural Health  http://www.lugarcenter.org/

Indiana Health Education Centers  http://ahec.iupui.edu/

Indiana Hospital Association   http://www.ihaconnect.org/


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. 

The Direction of Flex in Indiana for 2016-2018

The primary goal of the Indiana Flex Program is to support the 35 Indiana Critical Access Hospitals (CAHs) and other rural providers with information and opportunities to measurably improve service accessibility, quality, financial stability, and system development. Since the 2011 Flex grant, CAHs participating in and benefiting from the Flex Program initiatives are receiving services and resources that would otherwise be unavailable. These advantages include:

1.  Technical assistance from Indiana’s Quality Improvement Organization on data reporting. 
2.  Technical assistance from Indiana’s Quality Improvement Organization on reducing readmissions of patients with diagnoses of heart failure or pneumonia. 
3.  Education programs through the Indiana Rural Health Association tailored to CAH leadership staff for the purposes of improving finances, operations, or quality. 
4.  Lean Healthcare Training offered through Purdue Healthcare Advisors. 
5.  Support for review of CAH cost reports and preparation of market comparisons for the purposes of financial improvement. 
6.  Funding for a Lunch and Learn series through Indiana Rural Health Association to provide education to CAH staff and reduce the burden of travel. 
7.  Community Health Needs Assessment technical assistance to meet the requirements of the Indiana Revenue Service.

Flex Grant Coordinator:
Jessica Thomas, MPH

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 evenly to each eligible hospital; awards of approximately $9,000 are given per hospital. Thirty-four Indiana Critical Access Hospitals, and eight Rural Indiana Hospitals, are participating in the 2015 – 2016 SHIP grant program. The SHIP grant program funds are geared towards assisting small rural hospitals that are essential access points for Medicare and Medicaid beneficiaries. The program assists hospitals with 49 beds or fewer to participate in delivery system reforms outlined in the Affordable Care Act:

  • 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:
Margo Knefelkamp, MBA
317- 233-7197