New Clinic Development
Opening a New Rural Health Clinic in Louisiana
Access to primary care has been a driving force in establishing health clinics in rural communities, better known as rural health clinics. A rural health clinic is a primary care clinic located in a non-urbanized area that has been shown to have a shortage of healthcare services or providers. Rural health clinics function as a team approach of physicians working with non-physician providers such as nurse practitioners (NP), physician assistants (PA) and certified nurse midwives (CNM) to provide services.
Although establishing a rural health clinic is a lengthy and challenging process, once certified, the clinic serves as a large portion of the safety net for our rural residents in Louisiana. Providing quality healthcare and services to rural communities, rural health clinics also provide recruitment and retention of healthcare providers and ongoing contributions to the long-term economic and health factors of rural and underserved areas.
Rural Health Clinic Types
Rural health clinic regulations distinguish between independent and provider-based clinics. The independent clinic is a freestanding practice that is not part of a hospital, skilled nursing facility, or home health agency. The provider-based clinic is an integral and subordinate part of a hospital, skilled nursing facility, or home health agency.
Benefits of Rural Health Clinics
- Access to primary care that would otherwise be limited or non-existent
- Provides local basic emergency care and life-saving services
- Combats physician shortages by using mid-level providers
Establishing a Rural Health Clinic in Louisiana
Certifying an Area for Rural Health Clinic Eligibility
Well-Ahead advises to check the potential rural health clinic location to be sure it meets rural and HPSA requirements. To submit a request for the location to be determined as a rural health clinic, please contact Well-Ahead in the form located at the bottom of the page.
Note: Be sure to include the specific address of the location you are considering for rural health clinic development.¬†
Well-Ahead uses these sources to verify the address is in a rural/HPSA area:
Rural is defined by the Bureau of the Census, as an area that is not an urbanized area. To be classified as a rural health clinic, the facility:
- Must be located in a rural area and not in an urbanized area. An urbanized are is defined by two methods:
- Comprises one or more places (central place) and the adjacent densely settled surrounding territory (urban fringe) that together have a minimum of 50,000 persons (urbanized area)
- Meets one of the following definitions:
- Census designated places of 2,500 or more persons which are incorporated as cities, villages, boroughs (except in Alaska and New York), or towns (except in New England, New York and Wisconsin), but excluding the rural portions of extended cities
- Census designated places of 2,500 or more persons
- Other territories, incorporated or unincorporated, included in an urbanized area
- Located in either a currently medically underserved area/population (MUA/MUP), health professional shortage area (HPSA) or governor designated area. Find out if you are in a HPSA area.
- Must employ a mid-level practitioner (MLP) at least 50% of the time the practice is open
- May be either for profit or non-profit; public or private
- May be any primary care practice (FP, PED, OB/GYN, IM)
- Must have a Community Advisory Committee that meets at least annually
- Must be certified by Well-Ahead
The rural health clinic must offer the following services/requirements:
- Primary care services delivered by both physicians and MLPs;
- First response emergency care¬†
- X-ray services¬†
- Arrangements with other Medicare/Medicaid providers for inpatient/specialty care
- Physicians licensed by the State;
- Hospital services must be available to patients;
- Provide the following minimum lab services on site: (1) Chemical examination of urine by stick or tablet (2) Exam stool specimens for occult blood (3) Primary cultures for transmittal to a certified lab (4) Hemoglobin or hematocrit (5) Blood sugar/glucose testing; and (6) Pregnancy tests
- Other lab services required through arrangements
- 2017 CMS requirement: Emergency Preparedness Plan. All rural health clinics must have an emergency plan in place.¬†Click here to view required emergency preparedness information¬†.
- CMS Emergency Preparedness Survey Checklist¬†- The CMS Emergency Preparedness Survey Checklist is a tool rural health clinics can use in creating an effective emergency plan.¬†
- Kaiser Permanente Medical Center Hazard and Vulnerability Analysis (Emergency Preparedness)¬†- The Hazard and Vulnerability Analysis (HVA) for emergency preparedness planning can be used to determine the types of disasters clinics may face. The worksheets provide a method to rate the possibilities of natural disasters, technological hazards, human hazards, and hazardous material that may impact the clinic. ¬†
- Primary care for all lifecycles;
- Preventive dental;
- Specific hours of operation (you set them);
- Case management;
- After hour coverage (as required by Medicaid plans);
- Preventive health;
- Sliding fee scale; and
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- Rural Health Clinics Rules and Guidelines¬†provides a list of rules and guidelines regarding rural health clinics from the Nation Rural Health Association (NARHC).¬†
- CMS to Suspend Action on RHC Changes¬†provides an overview of previous changes and clarifies the current RHC and FQHC regulatory requirements.
- CMS Releases RHC Regulatory Relief Regulation¬†discusses changes to the rural health clinic rules regarding minimum on-site requirements.¬†
- 5th Circuit Court of Appeals Decisions¬†is the court decision which allows Louisiana rural health clinics to function as part of the Department of Health.