(a) Subject to the availability of rural health transformation funds and subsection (b) of this section, the department is authorized to expend funds for time-limited initiatives in amounts that seek to achieve the following percentage targets: (i) Thirty-six and four-tenths percent (36.4%) of amounts available for time-limited initiatives for integrated primary care. Expenditures under this paragraph shall be for competitive grants to expand the number and geographical reach of federally qualified health centers in the state through conversion of existing facilities and practices for the integration of primary care delivery models that coordinate primary medical care with behavioral health services, obstetric and gynecological care, dental services and preventive health services; (ii) Fifteen and one-tenths percent (15.1%) of amounts available for time-limited initiatives for a technology adoption challenge program. Expenditures under this paragraph shall be for competitive grants for health care technology procurement. Grants under this paragraph shall be awarded only to joint applications submitted by two (2) or more health care providers and shall be limited to projects that improve care delivery closer to patients' homes, enhance interoperability and coordination among providers and reduce administrative activity; (iii) Nine and eight-tenths percent (9.8%) of amounts available for time-limited initiatives for exercise and diet programs. Expenditures under this paragraph shall be for competitive grants to Wyoming-based entities to promote physical activity and healthy nutrition. Projects that demonstrate measurable increases in participation in exercise, outdoor recreation or evidence-based nutrition practices shall be prioritized for the grants under this paragraph; (iv) Eight and two-tenths percent (8.2%) of amounts available for time-limited initiatives for a statewide tele- specialist platform. Expenditures under this paragraph shall be for the procurement and operation of a centralized tele- specialty platform to deliver physician-level specialty consultations to health care providers statewide; (v) Eight and two-tenths percent (8.2%) of amounts available for time-limited initiatives for workforce education startup costs. Expenditures under this paragraph shall be for competitive grants to support health care workforce training programs operated by educational institutions within the state. Grants under this paragraph shall be awarded to recipients that commit to establishing and maintaining a specified number of training positions for nurses, emergency medical service personnel, physicians, clinical behavioral health providers and other health care professionals; (vi) Eight and two-tenths percent (8.2%) of amounts available for time-limited initiatives for care coordination. Expenditures under this paragraph shall be for competitive grants to hospitals, health care providers and rural health facilities to propose clinically integrated care coordination models for one (1) or more counties to improve the management of chronic disease among persons who are dually eligible for Medicare and Medicaid and who are identified as high risk. Funding awarded under this paragraph may include capped start-up costs, a per-member, per-month care coordination payment for assigned persons and performance-based payments tied to demonstrated cost savings; (vii) Four and nine-tenths percent (4.9%) of amounts available for time-limited initiatives for centralized billing capacity. Expenditures under this paragraph shall be for centralized billing and revenue collection services for voluntarily participating emergency medical services agencies. This centralized billing capacity initiative may be expanded to other health care providers if the initiative demonstrates effectiveness and financial sustainability; (viii) Two percent (2.0%) of amounts available for time-limited initiatives for a nonemergency transportation coordination platform. Expenditures under this paragraph shall be for the procurement and operation of a centralized nonemergency medical transportation coordination platform to improve access to health care appointments for seniors, persons with disabilities and other eligible populations. The platform shall facilitate the scheduling, coordination and billing of nonemergency transportation; (ix) Two and six-tenths percent (2.6%) of amounts available for time-limited initiatives for administration. Expenditures under this paragraph include any administrative costs necessary to implement the rural health transformation program, including expenses of the advisory committee; (x) Four and six-tenths percent (4.6%) of amounts available for time-limited initiatives included in the Wyoming rural health transformation plan that are not specifically authorized in this subsection shall be redistributed for expenditure on the initiatives authorized under this subsection. (b) Upon a written recommendation of the advisory committee, the department may materially deviate from the percentage targets specified in subsection (a) of this section to the extent necessary to meet documented need and demonstrated demand for the time-limited initiatives specified in subsection (a) of this section. (c) The authority to administer the time-limited initiatives and any funds for the initiatives under subsection (a) of this section shall terminate upon exhaustion of all rural health transformation funds appropriated or otherwise made available for the initiatives specified in subsection (a) of this section.
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