Provider-based Rural Health Clinics (RHCs) can be an important strategy to support primary care services in rural communities and other essential services including mental health, substance use, chronic care management, and oral health services. This project will build on the Flex Monitoring Team’s previous work on Critical Access Hospital (CAH)-owned RHCs by evaluating RHC-supportive State Flex Program initiatives to provide information to other states interested in undertaking work with CAH-owned RHCs.