Georgia Sends Small Hospital Execs, Board Members to the Classroom

The curriculum addresses financial and regulatory issues facing rural hospital in Georgia.

A new law in Georgia requires rural hospital executives and board members to attend eight hours of classroom time to bone up on the issues and economics that smaller hospitals face.

The law, which allows the state to withhold funding and tax credits for hospitals that don't comply, was passed by the state legislature last year, and comes as the Peachtree State has seen seven rural hospitals shuttered since 2010. Another 26 small hospitals are considered to be at "high financial risk," according to the consulting firm Navigant.

Chuck Adams, a former rural hospital CEO and now executive vice president of the Georgia Hospital Association, and director of the Center for Rural Health, spoke with HealthLeaders about the program, and what it hopes to achieve. The following is a lightly edited transcript.

HLM: Where did this idea come from?

Adams: The state set up a $60 million a year rural hospital tax credit program that allows companies and individuals to donate directly to the hospital and get that tax credit back. Because of that and because the state was putting other resources into rural healthcare they wanted to make sure that the education and resources at the local level were adequate. The legislators felt like it would set a baseline and help our rural hospitals.

The landscape of rural healthcare is changing, and these boards and leaders need to be open to all the new technology and new models that are out there.

HLM: How long is the course, and what does it cover?

Adams: It's very flexible.  They selected Mercer School of Medicine in Macon, Georgia to be the institution that develops the Georgia Rural Health Innovation Center, which then developed the curriculum and training guidelines.

The guidelines came out in June and it involves eight hours of training for eight different standards. Current board members have to be trained by the end of 2020. They get their initial eight hours and it's good for two years.

It covers governance, regulatory agencies, financial and judiciary responsibilities, compliance, ethics, continuum of care, strategic planning, and grant management.  

How much will this cost?

Adams: It's going to be about $2,500 per facility for unlimited participants. We're going to have training throughout the year in many different formats, live in person, live interactive webinars, on demand modules. We want it to be convenient for our hospitals and board members so they can do it on their own time.

HLM: This seems to be designed mostly for board members. Why should CEOs and CFOs be required to take these courses?

Adams: The state wants them to see the training that their board members are going through as well, so everybody's on the same page.

HLM: Describe is the typical rural hospital board member that this course is designed for.

Adams:  They're leaders in the community who have a vested interest in that community and that hospital. They might not necessarily have a wealth of knowledge with respect to how hospital runs, but they've got the commitment.

HLM: What metrics will you use to determine if this program is working?

Adams: Every session will have a test. If they don't pass, they have to retake the course and can't go to the next course until they get through it. And there will be course evaluations that are the required. Every participant, once they take a course, will give us feedback so we can use our own quality control to make sure we're teaching what they need to be taught.

HLM: When does the course begin?

Adams: Right now they are no approved trainers in Georgia. Our application is in process and we know it will be approved. So, we're going to kick ours off on January 1st.

HLM: Are there penalties for hospitals that do not comply with the law?

Adams: If you read the legislation, it says the state "may" discontinue their involvement in the rural hospital tax credit program and other state funded grants.

HLM: If the Georgia Legislature is sincere about helping rural hospitals, why don't they expand Medicaid?

Adams: They're working on it. They did pass last year some legislation to begin the Medicaid waiver process, and the state has hired a consulting firm. We're hopeful that there will be some increased access of care through that.