State of Wyoming
Department of Health
Rural and Frontier Health Division
Office of Rural Health
Rules and Regulations for Wyoming Hospital Improvement Grants
Brent D. Sherard, M.D., M.P.H.
Director and State Health Officer
July 2008
State of Wyoming
Department of Health
Rules and Regulations for
Wyoming Hospital Improvement Grants
Rules and Regulations for
Wyoming Hospital Improvement Grants
Rural and Frontier Health Division
Office of Rural Health
Additional information and copies may be obtained from:
Rural and Frontier Health Division
Office of Rural Health
6101 Yellowstone Rd., Ste. 510, Cheyenne, WY 82002
Telephone: (307) 777-6512
Facsimile: (307) 777-8545
E-Mail Address: keri.wagner1@health.wyo.gov
This document is available in alternative format upon request.
Chapter 4. Wyoming Hospital Improvement Grants
Adoption
Statement of Reasons
The Wyoming Department of Health proposes the following Rule to comply with the provisions of the Wyoming Hospital Improvement Grants, 2006 Budget Session, Senate Enrolled Act No. 53, and the Wyoming Administrative Procedures Act at W.S. 16-3-101, et seq., which authorizes the Department of Health to promulgate a rule.
Enrolled Act No. 53, from the Fifty-Eighth Legislature Budget Session, is an act relating to public health and safety; requiring the Department of Health to establish a Magnet Hospital Grant Program and a Small Hospital Grant Program as specified; providing grant criteria and deadlines; providing for repayment of grants as specified; requiring matching fund expenditure by grant recipients; granting rulemaking authority; providing appropriations; and providing for an effective date.
The Proposed Rule includes the following provisions:
To establish the Magnet Hospital Grant Program to support efforts by Wyoming hospitals to reduce nursing shortages and improve patient safety.
To establish the Small Hospital Grant Program to provide grants and technical assistance to hospitals of less than one hundred (100) beds for the promotion of quality nursing practices, quality nursing working environments, increased retention of nursing staff and demonstrated improved outcomes for patients.
Each grant must be awarded by June 30, 2008.
As required by W.S. 16-3-103(a)(i)(G), the rule on Wyoming Hospital Improvement Grants meets minimum substantive state statutory requirements.
WYOMING HOSPITAL IMPROVEMENT GRANTS
CHAPTER 4
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Section 1. |
Authority............................................................................................... |
4-1 |
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Section 2. |
Purpose and Applicability..................................................................... |
4-1 |
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Section 3. |
Special Provisions................................................................................ |
4-1 |
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Section 4. |
Definitions............................................................................................. |
4-2 |
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Section 5. |
Authority to Award and Administer Grant Funds................................. |
4-3 |
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Section 6. |
Criteria for and Priorities Given to Magnet Hospital Grant Program Awards................................................................................................... |
4-4 |
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Section 7. |
Criteria for and Priorities Given to Small Hospital Grant Program Awards………………………………………………………………... |
4-5 |
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Section 8. |
Application Form for Magnet Hospital Grant Program............................ |
4-5 |
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Section 9. |
Application Form for Small Hospital Grant Program.............................. |
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Section 10. |
Application Process…………………………………………………... |
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Section 11. |
Reporting Requirements........................................................................ |
4-7 |
CHAPTER 4
Section 1. Authority.
These rules are promulgated by the Department of Health pursuant to Senate Enrolled Act No. 53, enacted during the 2006 Budget Legislative Session, and the Wyoming Administrative Procedures Act at W.S. 16-3-101, et seq.
Section 2. Purpose and Applicability.
(a) These rules implement a method of selecting recipients for three (3) hospitals in the state to achieve magnet hospital certification and for small hospitals to achieve quality nursing practices, quality nursing working environments, increased retention of nursing staff, and demonstrated improved outcomes for patients.
(i) The three (3) hospitals seeking Magnet Recognition Program designation shall be eligible for up to two hundred fifty thousand dollars ($250,000) to meet the criteria developed by the American Nurses Credentialing Center in effect on January 1, 2006. Any subsequent changes in the Magnet Recognition Program shall continue to promote quality that supports professional practice and excellence in the delivery of nursing services to patients. If subsequent changes do not reflect these elements, the unexpended amount of grant funds shall be returned to the Department.
(ii) The small hospitals, with under one hundred (100) beds, seeking grants for technical and professional assistance to promote quality nursing practices, quality nursing working environments, increased retention of nursing staff and demonstrated improved outcomes for patients shall be eligible for up to fifty thousand dollars ($50,000) as a single entity. Small hospitals of three or more organizations may form a consortium to address the four required areas at each hospital and be eligible for up to two hundred thousand dollars ($200,000). One organization shall be named the lead entity, negotiate the contract, and be responsible for organizing the matching funds requirement.
(iii) The technical and professional assistance may be contracted to a Wyoming hospital that has previously prepared or submitted a Magnet Recognition Program application or to the University of Wyoming’s Nightingale Center.
Section 3. Special Provisions.
(a) If any portion of these rules is found to be invalid or unenforceable, the remainder shall continue in effect.
(b) The incorporation by reference of any external standard is intended to be the incorporation of that standard as it is in effect on the effective date of this Chapter.
Section 4. Definitions.
The following definitions shall apply in the interpretation and enforcement of these rules. Where the context in which words are used in these rules indicates that such is the intent, words in the singular number shall include the plural and vice versa. Throughout these gender pronouns are used interchangeably except where the context dictates otherwise. The drafters have attempted to utilize each gender pronoun in equal numbers, in random distribution. Words in each gender shall include individuals of the other gender.
(a) “Beds” means operating beds for the care of patients staying twenty-four (24) hours or more according to the American Nurses Credentialing Center Magnet Recognition Program. This category does not include bassinets.
(b) “Designation” means a process required by the American Nurses Credentialing Center in order to receive Magnet Recognition. The process requires the appraisal of both qualitative and quantitative data about nursing care within a specific hospital, submission of an application of intent, submission of documentation and a site visit.
(c) “Consortium” means a group of three (3) or more small hospitals, with each under one hundred (100) beds, joining efforts to address the four required areas of the grant at each hospital.
(d) “Department” means the Wyoming Department of Health, Rural and Frontier Health Division, Office of Rural Health.
(e) “Eligible recipient” means any licensed Wyoming hospital that accepts Medicaid (Title XIX of the Social Security Act or the Wyoming Medical Assistance Services Act), Medicare (Title XVIII of the Social Security Act) and the State Child Health Insurance Program (Kid Care CHIP).
(f) “Grant” means a grant of funds under a contract agreement.
(g) “Grant amount” means the state program funds plus the matching funds from the local hospital.
(h) “Grant Application” means a written document required by the Department of Health, Rural and Frontier Health Division, Office of Rural Health, in order to request funding under the Magnet Hospital Grant Program or the Small Hospital Improvement Grant Program.
(i) “In-kind services” means services that directly contribute to preparation of the application for Magnet Recognition or for achieving quality nursing practices, quality nursing working environments, increased retention of nursing staff and demonstrated improved outcomes for patients. These services may include salary and expenses for staff who are directly working on aspects of the application or specific forces of magnetism, such as self-assessment, data collection regarding patient outcomes or nursing satisfaction surveys; costs to educate and support nursing staff working directly on components of Forces of Magnetism; and/or costs for materials needed for the application for Magnet Recognition or for achieving designated Forces of Magnetism.
(j) “Lead Entity” means the small hospital signing the grant contract and organizing the consortium members for responsibilities to address the four (4) required areas of the grant and the matching funds.
(k) “Magnet Recognition” means a formal designation given by the American Nurses Credentialing Center.
(l) “Magnet Recognition Program Application” means submission of a letter of intent, followed by submission of written documentation by March or July of the following year based on scheduling by the American Nurses Credentialing Center (ANCC).
(m) “Magnet Recognition Criteria” means the fourteen (14) Forces of Magnetism and associated specific components identified by the American Nurses Credentialing Center as of January 1, 2006, that reflect high quality nursing practices, quality nursing working environments and demonstrated improvement in patient outcomes.
(n) “Recipient Hospital” means a hospital licensed in Wyoming that accepts Medicaid, Medicare, and Kid Care CHIP.
(o) “Small Hospital” means a hospital licensed in Wyoming with less than one hundred (100) beds.
(p) “This Act” means Senate Enrolled Act No. 53 in the State of Wyoming Fifty-Eighth Legislature 2006 Budget Session.
Section 5. Authority to Award and Administer Grant Funds.
(a) The Department shall have the following responsibilities with regard to administering the grant awards:
(i) It shall develop a Request for Proposal (RFP), in consultation with the Office of Rural Health, for funding for up to three (3) grants to any Wyoming hospital seeking Magnet Recognition and for small hospitals of less than one hundred (100) beds to promote quality nursing practices, quality nursing working environments, increased retention of nursing staff and demonstrated improved outcomes for patients. The RFP developed by the Department and the Office of Rural Health shall comply with all of the Department of Administration and Information’s RFP requirements. The RFP shall prioritize grant recipient requirements;
(ii) It shall provide technical and professional assistance to eligible recipients making an application through the RFP for the grant funds for the purpose of completing a Magnet Recognition Program application or for promoting quality nursing practices, quality nursing working environments, increased retention of nursing staff and demonstrated improved outcomes for patients by addressing the selected criteria of the Magnet Recognition Program;
(iii) It shall collect and analyze the RFP applicant information and shall, in consultation with the Office of Rural Health, select grant recipients pursuant to the priorities outlined in the RFP;
(iv) It shall enter into a contract with the grant recipient that further outlines the project requirements, detailing how measurable outcomes will be achieved, and ensuring that the grant funds are used to effectuate the goals of the project;
(v) It shall fund three (3) hospitals to achieve Magnet Recognition Program designation;
(vi) It shall fund small hospitals to promote quality nursing practices, quality nursing working environments, increased retention of nursing staff and demonstrated improved outcomes for patients by meeting the selected criteria; and
(vii) It shall inform the Joint Labor, Health and Social Services Interim Committee if legislation is needed to authorize any additional rules and regulations to effectuate the goals of the projects.
Section 6. Criteria for and Priorities Given to Magnet Hospital Grant Program Awards.
The following criteria and priorities shall be considered in awarding funds under this project:
(a) Demonstrated provision of medical care to patients qualified under Medicaid, Medicare, and Kid Care CHIP;
(b) Indication in writing the hospital’s commitment to acquisition of Magnet Recognition Program designation within a five (5) year period following receipt of the grant;
(c) Indication in writing and in their grant budget a match of forty percent (40%) of the grant award with in-kind or in-cash funds to be expended in achieving Magnet Recognition Program designation;
(d) Agreement to submit periodic reports of progress in preparing, submitting and acquiring Magnet Recognition Program designation to the Department of Health, Rural and Frontier Health Division, Office of Rural Health as specified by that Department; and
(e) The grant application shall include a budget that specifies how grant funds will be expended.
Section 7. Criteria for and Priorities Given to Small Hospital Grant Program Awards.
The following criteria and priorities shall be considered in awarding funds under this project:
(a) Demonstrated provision of medical care to patients qualified under Medicaid, Medicare, and Kid Care CHIP;
(b) Indication in writing the hospital’s commitment to meet the selected characteristics which address quality of nursing practice, quality of nursing working environments, increased retention of nursing staff and outcomes for patients within a five (5) year period following receipt of the grant;
(c) Small hospitals commitment in writing and in their grant budget a match of twenty percent (20%) of the grant award with in-kind services or in-cash funds to be expended with the grant funds;
(d) Agreement to report periodically to the Department regarding the use of grant funds and measurable results obtained with those funds; and
(e) The grant application shall include a budget that specifies how grant funds will be expended.
Section 8. Application Form for Magnet Hospital Grant Program.
(a) Application for the Magnet Hospital Grant Program will be submitted per the RFP process.
(b) Application for the Magnet Hospital Grant Program shall include:
(i) Narrative description of how the hospital shall achieve Magnet Recognition Program designation within five (5) years. The narrative shall include annual objectives, activities, timelines, outcomes and measurements to be achieved in each year of the grant;
(ii) A detailed budget and budget narrative that specifies how grant funds shall be expended annually in a format to be established by the Department for each year of the requested grant including budget for forty percent (40%) match; and
(iii) A verification of understanding of the obligation to repay one hundred percent (100%) of the grant if the Office of Rural Health determines no progress has been made toward Magnet Recognition Program application in the first year, or fifty percent (50%) if the Office of Rural Health determines a lack of progress or failure to achieve Magnet Recognition Program designation in the subsequent four (4) years after the grant award date.
Section 9. Application Form for Small Hospital Grant Program.
(a) Application for the Small Hospital Grant will be submitted per the RFP process.
(b) Application for Small Hospital Grant Program shall include:
(i) A statement of how the hospital shall achieve the key elements of the excellence in nursing. The narrative shall include a description of quality nursing practices; quality work environment; increased retention of nursing staff; and improved outcomes for patient care;
(ii) A detailed budget narrative that specifies how grant funds shall be expended annually in a format to be established by the Department for each year of the requested grant including budget for twenty percent (20%) match; and
(iii) A verification of understanding of the obligation to repay one hundred percent (100%) of the grant if the Office of Rural Health determines no progress has been made toward excellence in nursing in the first year, or fifty percent (50%) if the Office of Rural Health determines a lack of progress or failure to achieve excellence in nursing in the subsequent four (4) years after the grant award date.
Section 10. Application Process.
(a) The Manager of the Office of Rural Health or his/her designee shall administer this program according to the rules of this program, and shall determine whether the applicant is eligible under these rules;
(b) The funds appropriated by the legislature will be allocated by the Office of Rural Health to recipient hospitals as contracted and budgeted per the application and resulting individual contract;
(c) The Department shall provide the application written notice of its determination;
(d) Documentation of the action taken and the reasons for the action shall be placed in the applicant’s file; and
(e) The Manager of the Office of Rural Health or his/her designee may request documentation to collaborate any information requested in the application before a determination is made.
Section 11. Reporting Requirements.
(a) The Department may require an award recipient to provide information on an annual basis.
(b) The Department may request a site visit to verify and collaborate information submitted.