Medicare Rural Hospital Flexibility/Critical Access Hospital (FLEX/CAH) Program 

The California State Office of Rural Health (CalSORH), in partnership with the Federal Health Resources and Services Administration, participates in the Flex Program.

Established by Congress in 1997, the Flex Program strives to stabilize America's smallest and most vulnerable rural hospitals, as well as improve hospital-based healthcare access for rural communities.

The CalSORH supports small rural hospitals through the Flex Program annual grant. The Flex Program grant allows CalSORH to fund technical assistance, quality assurance studies, network development, and statewide emergency network support systems.

Additionally, the Flex Program assists California's financially vulnerable rural hospitals obtain a CAH designation. Hospitals designated as CAHs receive increased revenues through the cost-based reimbursement Medicare Program, and are certified under a different set of eligibility rules called Medicare Conditions of Participation. As of May 2014, California has thirty-four small rural hospitals designated as CAHs.

For more information about the CAH designation process, please contact Jennifer Brooks, Flex Coordinator at (​916) 713-8626 or email at



Contact Information

Jennifer Brooks, Program Coordinator

(916) 324-7942 

Last modified date: 7/1/2021 2:36 PM