Medicare Rural Hospital Flexibility Program – Emergency Medical Services Supplement | HRSA 19 095

Opportunity Information: Apply for HRSA 19 095

The Medicare Rural Hospital Flexibility Program Emergency Medical Services (EMS) Supplement (Funding Opportunity Number HRSA-19-095; CFDA 93.241) is a discretionary grant opportunity offered by the U.S. Department of Health and Human Services through the Health Resources and Services Administration (HRSA). It is structured as supplemental funding connected to the broader Medicare Rural Hospital Flexibility Program (commonly called the Flex Program). In this notice of funding opportunity, the Flex Program is the main statewide rural health improvement program, while the Flex EMS Supplement refers specifically to the add-on projects being funded through this announcement. The overall purpose of the supplement is to strengthen access to high-quality emergency medical care in rural communities, with an emphasis on practical demonstration work that can be studied, replicated, and built into longer-term Flex Program efforts.

A central theme of the supplement is building an evidence base for what actually improves rural EMS performance and patient outcomes. Instead of funding general operations, the opportunity is designed to support structured demonstration projects that test and document approaches states can later scale. Rural EMS systems often face unique challenges such as long transport times, sparse call volume, workforce shortages, financial instability, and limited access to training and clinical resources. This funding aims to support targeted projects that address those real-world constraints while producing lessons and data that can guide future interventions across rural settings.

Applicants are expected to choose and design a project around one of two specific focus areas. Under Focus Area 1, funding supports demonstration projects that implement sustainable models of rural EMS care. The intent here is to help vulnerable rural EMS agencies move toward models that can survive financially and operationally over time, while still delivering safe, reliable emergency response and medical care. Projects in this area are meant to pilot promising solutions, put them into practice, and generate usable evidence about what works, for whom, and under what conditions. While the notice does not prescribe a single model, the emphasis is on sustainability and on producing information that can inform appropriate interventions for rural EMS agencies that are at risk due to limited resources or systemic barriers.

Under Focus Area 2, funding supports demonstration projects focused on data collection and reporting for a set of EMS quality measures that are relevant to rural contexts. The main goal is to accelerate the development and implementation of a core group of validated, rural-relevant EMS quality measures. This responds to a longstanding gap in emergency medical services: many quality measurement approaches are designed around higher-volume urban or suburban systems, while rural agencies may have different patterns of calls, longer distances, fewer staff, and different resource availability. Projects in this area are intended to improve the ability of rural EMS systems to collect meaningful data, report it consistently, and use it to monitor and improve care, while also contributing to the broader field by helping define which measures are valid and useful in rural environments.

Eligibility is targeted to state Flex programs that elect to apply for this supplement, with the expectation that the applicant will propose a project aligned to one, and only one, of the two focus areas. The opportunity was posted on January 24, 2019, with an application closing date of April 5, 2019. HRSA anticipated making about eight awards. The award ceiling is listed as 0 in the source data, which typically signals that the ceiling was either not specified in the summary field or is defined elsewhere in the full notice rather than as a fixed cap in the listing. Overall, the supplement is best understood as a time-limited, evidence-generating investment meant to help state Flex programs test sustainable rural EMS strategies or strengthen rural EMS quality measurement in ways that can be replicated and incorporated into longer-term rural health system improvement work.

• The Department of Health and Human Services, Health Resources and Services Administration in the health sector is offering a public funding opportunity titled "Medicare Rural Hospital Flexibility Program – Emergency Medical Services Supplement" and is now available to receive applicants.
• Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.241.
• This funding opportunity was created on Jan 24, 2019.
• Applicants must submit their applications by Apr 05, 2019. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
• The number of recipients for this funding is limited to 8 candidate(s).
• Eligible applicants include: Others (see text field entitled Additional Information on Eligibility for clarification).

Apply for HRSA 19 095

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