Sustainability Strategies

A key component of sustainability planning for rural services integration programs is identifying a specific funding strategy (see Sustainability Strategies in the Rural Community Health Toolkit). Many services integration programs sustain program funding through specific contributions from partner organizations, grants and contracts, and funding from state agencies. They also seek reimbursement for:

• Medicaid case management services
• Medicaid and SCHIP services provided through school based health centers
• Medicare Transitional Care Management services
• Medicare Health and Behavior Assessment and Intervention services
• Medicare PACE program
• Medicare and Medicaid telemedicine services

One rural services integration program stressed the importance of having conversations with partners about the vision for program sustainability. The sustainability plan may alter the original implementation approach. For example, a school-linked health program in the Delta worked to transfer ownership of the program over to the schools at the conclusion of the program. Since the teachers were already trained to implement the program, operation costs are minimal.