The Georgia and Alabama State Offices of Rural Health (SORHs) have been working together to help provide training and technical assistance to the 165 Rural Health Clinics (RHCs) in their states, which lack RHC associations. The SORHs are also engaging with their state rural health associations (RHAs) in the effort.

Over the last three years, RHCs in Georgia identified three issues they were struggling with: HIT implementation, technical assistance and ICD-10 conversion, according to Charles Owens, director of the GA SORH. There is no RHC association (RHCA) in the state, and Owens describes the RHCs there as “low-hanging fruit—under-represented, and begging for resources and technical assistance.

“So, in Georgia, we started hosting RHC meetings,” Owens said. “We then realized we could work with Alabama—I’m not sure who called who first. We frequently talk with the AL SORH about different issues since our states are similar and we have borders that cross over the state line.” The multi-state NOSORH networking funding was instrumental in moving them to the next level of collaboration, Owens said.

The first AL-GA RHC Conference was held in Opelika, Ala., last summer. The conference has been followed by a series of webinars that focus on RHC technical assistance. The first was on RHC compliance and regulation, the second was on RHC billing, and the last webinar, which will be held on December 10th, will be on RHC Medicare bad debt.

“Alabama would like to partner with Georgia to have another joint conference,” said Rob Boyles, Rural Programs Coordinator and Recruiter at the AL SORH. “However, funding is the main barrier. The joint conference in June would not have happened without the grant funding provided by NOSORH.”

Another barrier with multi-state collaboration, Owens said, is geography, particularly in larger states. “Georgia and Alabama border each other, but our RHCs in the extreme north points and the east coast of Georgia were reluctant to travel all the way across the state.” But, he added, the benefit of multi-state collaboration is “learning from nontraditional sources—it’s not the people you hear from everyday. So that’s why a lot of people, including the federal government, are encouraging us to do this.”

As a result of conference participant feedback, Boyles said, it was apparent that Alabama RHCs also desire training opportunities, particularly on ICD-10. The GA and AL RHAs, in coordination with the Association of Rural Health Professional Coders, have provided two, one-day training sessions. The AL RHA will also provide two, multi-day ICD-10 “bootcamp” sessions after the first of the year. (The AL SORH has had a special training tract for RHCs in its annual rural health conference for the past two years, co-sponsored by the AL RHA.)

Owens thinks that other SORHs should consider reaching out and supporting their RHCs when there is no state RHCA or when those associations are struggling. “This is something that SORHs can do and NOSORH can help with.” Owens said. “In the Southeast, the RHC organizations are small and struggle with finances, so it’s very reasonable that SORHs could serve those RHCAs, especially since they are never going to be very large administratively.”