More rural counties have fewer residents who often live further from health care resources than their more urban counterparts. Arkansas has a variety of safety net providers to compensate for the shortage of health care providers and improve access to care in those areas, especially for the low-income and uninsured population. This is done through a number of initiatives operating in concert with other agencies and organizations dedicated to providing access to health care. The following is a list of grant funding programs within the Office of Rural Health and Primary Care.

Charitable Clinics Grant Program 

The Arkansas Department of Health (ADH) Arkansas Charitable Clinics Grant Program provides funding to assist charitable clinics in the provision of patient care in the areas of primary care, pharmacy, dental care, optometry and behavioral health services, for free or at low cost to those persons unable to pay for medical care.

Definitions:

• Charitable clinic: A charitable clinic is a volunteer-based, safety-net health care organization located in Arkansas that provides a range of medical, dental, pharmacy, and/or behavioral health services to economically disadvantaged individuals who are predominately uninsured. A charitable clinic is a member of the National Association of Free Clinics or the Arkansas Association of Charitable Clinics. A charitable clinic must be a 501 (c) 3 tax-exempt organization or operate as a program component or affiliate of 501 (c) 3 organizations.  A charitable clinic may charge a nominal administrative fee to patients. A charitable clinic may bill Medicaid but must provide essential services of primary care, pharmacy, dental, and or behavioral health, regardless of the patient’s ability to pay.
• Patient care: The diagnosis and treatment of patient’s complaints by clinically trained and licensed individuals.

Eligibility requirements:  

• Must be a volunteer-based, safety-net health care organization located in Arkansas that provides a range of medical, dental, pharmacy, and/or behavioral health services to economically disadvantaged individuals who are predominately uninsured.
• Must be a member of the National Association of Free Clinics or the Arkansas Association of Charitable Clinics.
• Must be a 501 (c) 3 tax-exempt organization or operate as a program component or affiliate of 501 (c) 3 organizations.
• There is a mandatory 25% funding match (in-kind) requirement that can be met by: volunteer hours, depreciation, rent, etc. Federal, county, foundation, private contributions as well as any other in-kind resources.
• Must be in good standing with ADH and fully operational at the time of application (these are not planning grants).

Notice of Funding and application review and award

• Notice of Funding Opportunity is issued annually. 
• ADH will collect applications via email and accept all applications that meet requirements. The order of receipt of applications will be identified by the State’s email system.
• ADH will review each application packet to verify requirements. Applications that do not meet requirements will be disqualified.

Funding:

• Grant award funding amounts may vary from year to year and may be adjusted during the year as necessary due to the availability of appropriated funds.
• Examples of scope of work approved for reimbursement by this grant are specific to the provision of clinical services:
• Patient care services including referred services (i.e., lab work, prescriptions, prescription eyeglasses, referrals to specialists, counseling services, clinical staff salaries)
• Patient care clinical equipment/tools/supplies (i.e.:  Xray equipment, dental equipment, exam room tables, hard copy medical charts, stethoscopes)
• Patient-specific medications/supplies (i.e.  prescriptions, diabetic supplies, prescription eyeglasses)
• Clinic operational and patient care supplies (i.e.: paper for exam tables, PPE, swabs, testing supplies, office supplies)
• Health information technology (i.e.  computers, electronic medical records software, internet service for the clinic)
• Training for staff
• Patient-focused health education materials and other types of patient care assistance (i.e., assistance with insurance application, translation services, medical appointment transportation)
• Maintenance and operations of the clinical equipment and clinic spaces.

Grant Performance Standards  

• State law requires that all contracts for services include Performance Standards for measuring the overall quality of services provided. 
• The State may be open to negotiations of Performance Standards prior to contract award, prior to the commencement of services, or at times throughout the contract duration. 
• The State shall have the right to modify, add, or delete Performance Standards throughout the term of the contract, should the State determine it is in its best interest to do so.  Any changes or additions to performance standards will be made in good faith following accepted industry standards and may include the input of the vendor to establish standards that are reasonably achievable. 
• All changes made to the Performance Standards shall become an official part of the contract. 
• Performance Standards shall continue throughout the term of the contract. 
• Failure to meet the minimum Performance Standards as specified shall result in the assessment of damages. 
• In the event a Performance Standard is not met, the vendor will have the opportunity to defend or respond to the insufficiency.  The State shall have the right to waive damages if it determines there were extenuating factors beyond the control of the vendor that hindered the performance of services.  In these instances, the State shall have a final determination of the performance acceptability.  
• Should any compensation be owed to the agency due to the assessment of damages, the vendor shall follow the direction of the agency regarding the required compensation process.

Notice of Funding and application review and award

• Notice of Funding Opportunity is issued annually.
• ADH will collect applications via email and accept all applications that meet requirements. The order of receipt of applications will be identified by the State’s email system.
• ADH will review each application to verify requirements. Applications that do not meet requirements will be disqualified. If an application is disqualified, ADH will review the next consecutive application.
• Grant award funding amounts may vary from year to year and may be adjusted during the year as necessary due to the availability of appropriated funds.

Reimbursement of approved expenses 

• This grant is a reimbursable subgrant.  Clinics must pay for approved expenses prior to requesting reimbursement.
• No reimbursement will be made for any expenses that do not include proof of payment.
• No reimbursement will be made for the purchase of equipment or services made prior to the grant award.
• No state grant funds shall be used to provide goods or services to out-of-state residents.
• The Arkansas Department of Health will have the final decision on allowable expenditures.
• Specific funding restrictions include:
  • Professional services such as legal or financial consultants.
  • Indirect and administrative costs and fees such as, but not limited to, membership fees/dues to professional organizations, country clubs, etc., financial audits, subscription fees, and license renewals.
  • Payment to any state agency for professional registrations, fees, and licenses.
  • Real property, construction, or renovation costs. Materials promoting the health center name or logo, i.e., clothing, pens, cups, bags, etc. This does not include educational materials.

 Health Professional Clearinghouse

• Professionals are matched with communities/healthcare facilities that have been actively recruiting. These activities are coordinated through a variety of ORHPC partners and other organizations and communities. 

Health Resources and Services Administration

• The ORHPC compiles, analyzes, and submits requests to Health Resources and Services Administration for designations of Medically Underserved Areas (MUAs) and primary care, dental, and mental Health Professional Shortage areas (HPSAs). HRSA provides oversight of the Primary Care Office Grant and the National Health Service Corps.

Primary Care Office Grant

• Provides federal-level funding to states to improve access to care for underserved populations. The Office of Rural Health and Primary Care provides technical assistance to parties that may qualify for these programs. 

National Health Service Corps

• Health care professionals are matched with requesting sites in Arkansas qualifying as Health Professional Shortage Areas (HPSAs). These professionals are able to repay their loans or scholarships (payback through service) through a commitment to work in a designated area of the state.

J-1 Visa Waiver Physicians

• Foreign physicians who attend medical school and receive a medical degree in a foreign country are permitted to come to the United States for residency training on a J-1 Visa. After completion of the residency training, these physicians are required to return to their home country for two years before applying for a new U.S. Visa. The two-year home return requirement may be waived if the physician is willing to practice medicine, full-time for three years, in an underserved area of the United States.
• View more J-1 Visa Waiver information.

Medicare Rural Hospital Flexibility Program

• The federal program created the program to assist limited-service hospitals to become eligible as Critical Access Hospital (CAHs) for Medicare reimbursement. Currently, there are 29 CAH in Arkansas.
   

Small Rural Hospital Improvement Program

• Provides funds to small rural hospitals to improve quality and enhance their ability to meet federal hospital guidelines.
   

State Office of Rural Health Grant

• Focuses on maintaining and increasing quality health care services to rural and underserved areas of the state. By partnering with other agencies and organizations, the initiative improves access to health care services.