R.I. getting $4.2M to reduce use of hospital ERs

WASHINGTON – The U.S. Centers for Medicare and Medicaid Services (CMS) last week announced grants of $37.5 million to support 29 programs in 20 states, including $4.2 million for a project in Rhode Island, to help improve access to primary care and reduce the inappropriate use of hospital emergency rooms by Medicaid beneficiaries.

Rhode Island’s share of the money will be used to build on an existing public-private collaboration among the state, the Rhode Island Community Health Center Association and the Hospital Association of Rhode Island to reduce emergency-room use, a CMS spokeswoman said. The local grantee is the R.I. Executive Office of Health and Human Services.

The Ocean State’s $4.2 million covers two years’ work on the Alternate Non-Emergency Provider Network Project. The effort also includes a project to expand access to behavioral health care for adults and children, to try to keep patients with serious mental-health problems from ending up in the ER.

The Mass. Office of Medicaid also received a grant, for $4.6 million over two years, for an ER diversion project to be implemented in two phases: Phase One will focus on five major urban centers in two regions of the state that are designated as Medically Underserved Areas or Populations and Health Professional Shortage Areas. Phase Two is to include an assessment of other areas of the state where community health centers are beginning to work with their local community hospitals to identify ER diversion strategies, and provide technical assistance to those efforts.

The grants were created by the U.S. Deficit Reduction Act of 2005 to help Medicaid programs fund local and rural initiatives that provide alternative health care settings for individuals with non-emergency medical needs. Congress provided $50 million to be distributed over four years, 2006 to 2009, for underserved areas and collaborations with community hospitals. The remaining $12.5 million will be available to the grantees in 2009.

“These grants provide new programs and services to help people get the non-emergency care they need in the most appropriate setting,” CMS Acting Administrator Kerry Weems said in a news release. “We are committed to working closely with the states to implement effective reforms to slow spending growth while maintaining access to coverage.”

Additional information about the grants – including the text of the grant proposals and the amount each program will receive – is available from the U.S. Centers for Medicare and Medicaid Services at www.cms.hhs.gov/GrantsAlternaNonEmergServ/.