Rural Health Clinics
The new "How To Establish A Rural Health Clinic In Louisiana, 2016 Manual" is now available by clicking here.
About Rural Health Clinics
The Rural Health Clinics Act was passed by Congress in 1977 and implemented in 1978. The federal government developed Rural Health Clinics (RHC) to encourage and stabilize the provision of outpatient primary care in rural areas through cost-based reimbursement provided by physicians, nurse practitioners, physician assistants and certified nurse midwives. RHC regulations distinguish between two types of Rural Health Clinics: independent and provider-based. The independent RHC is a freestanding practice that is not part of a hospital, skilled nursing facility, or home health agency. The provider-based RHC is an integral and subordinate part of a hospital, skilled nursing facility, or home health agency.
Basic Eligibility Criteria
- Located in a rural area
- Rural is defined as an area “that is not an urbanized area as defined by the Bureau of the Census.”
- An urbanized area is basically defined by one of two methods:
- 1.It 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).
- 2. It 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; or
- 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;
- 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; and
- A board of directors is not required. However, the RHC must have a Community Advisory Committee that meets at least annually.
- Certification by the Louisiana Department of Health
Certifying An Area for RHC Eligibility
It is advisable to check the address of a potential RHC location to see if it meets rural and HPSA (Health Professional Shortage Area) requirements before proceeding financially. Please let us check Am I Rural, HPSA, and the U.S. Census American Fact FInder for you. E-mail your request which includes the specific address of the location you are considering for RHC development and wish to have reviewed for eligibility to Denise Dowell at firstname.lastname@example.org.
*If the established RHC is being relocated, you must contact Health Standards and also contact Tracie Ingram, State Rural Health Officer in the Bureau of Primary Care and Rural Health, so that eligibility of the new location site can be determined in order to minimize the risk of losing the RHC license.
Scope of Services
- Primary care services delivered by both physicians and MLPs;
- May be any primary care practice (FP, PED, OB/GYN, IM);
- First response emergency care required;
- X-ray services required through arrangement;
- Must have arrangements with other Medicare/Medicaid providers for inpatient/specialty care;
- Physicians must be licensed by the State;
- Hospital services must be available to patients;
- Required to provide the following minimum lab services on site:
- Chemical examination of urine by stick or tablet;
- Exam stool specimens for occult blood;
- Primary cultures for transmittal to a certified lab;
- Hemoglobin or hematocrit;
- Blood sugar/glucose testing; and
- Pregnancy tests
- Other lab services required through arrangemnts
- New CMS requirement in 2017 - Emergency Preparedness Plan
Not required by RHCs:
- 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
Resources About Rural Health Clinics
- Rural Health Clinics Rules and Guidelines
- 5th Circuit Court of Appeals Decision on Uncompensated Care Payments to Provider-based Rural Health Clinics in Louisiana
- CMS to Suspend Action on RHC Changes
- CMS Releases RHC Regulatory Relief Regulation
- The Health Standards Section information on Rural Health Clinics (RHCs) can provide information on new development and changes such as Change of Ownership (CHOWS).
For more information, contact:
Tracie Ingram, State Rural Health OfficerBureau of Primary Care and Rural Health
Louisiana Department of Health Office of Public Health
Physical Address: 628 North 4th Street, 8th Floor, Baton Rouge, LA 70802
Mailing Address: P.O. Box 3118, Baton Rouge, LA 70821-3118
Phone: (225) 342-1889
Fax: (225) 342-5839