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Alabama's Rural Health Plan

The Alabama Rural Health Plan was originally developed to strategically plan the Medicare Rural Hospital Flexibility (FLEX) Program and how federal funding would be spent. Initially, funding was used to assist hospitals in converting to Critical Access Hospital (CAH) status, but since the elimination of the necessary provider rule in January 2006, there have been very few conversions. Most of Alabama's subsequent Flex funding has been used for quality improvements, financial and operational improvements, emergency medical services, and support health system development.

The Alabama State Rural Health Plan was developed in coordination with representatives from rural hospitals, the Alabama Hospital Association, and the Alabama Office of Primary Care and Rural Health, as required by federal legislation.

The State Rural Health Plan, published in July 2008, has been updated to include Critical Access Hospital Conversion Application Instructions, Change in License Application, and the Change in License Supplement A Application.

In order to be designated as a CAH in Alabama, a hospital must meet the following criteria:

  • Be located in a rural area or be treated as rural under a special provision that allows qualified hospitals in urban areas to be treated as rural for purposes of becoming a CAH.
  • Provide no more than 25 inpatient beds. If participating in the Medicare Swing Bed Program, no more than 10 of these 25 beds may be occupied at any one time by swing bed patients.
  • Have an average length of stay of 96 hours or less.
  • Be located either more than 35 miles from the nearest hospital or CAH, or more than 15 miles in areas with mountainous terrain or only secondary roads.
  • Meet all general acute care hospital standards as set forth by the Alabama Department of Public Health licensure rules.

Alabama State Rural Health Plan(2.5 MB)

For more information on Critical Access Hospital designation, visit the Rural Assistance Center.

For inquires regarding the State Rural Health Plan, please contact Debra Robbins at debra.robbins@adph.state.al.us or at (334) 206-5441.


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