As a key player in local systems of care, Critical Access Hospitals (CAHs) are called upon to respond to a wide range of emergency situations in their communities and may be at the center of these crises. However, CAHs face financial challenges and resource limitations in complying with federal emergency planning and preparedness requirements. Additional barriers include resource and infrastructure limitations, reduced access to higher levels of care, geographic isolation, low population density, and communication challenges. In this brief, the authors describe health care coalitions (HCCs) and their support for emergency preparedness planning of CAHs. They also explore the opportunities for collaboration between State Flex Programs (SFPs) and HCCs to improve CAH emergency preparedness and response capabilities as part of Medicare Rural Hospital Flexibility (Flex) Program funded activities under Program Area 3, CAH Population Health. Key findings include:

• HCCs foster collaboration between CAHs, other hospitals, public health, and community organizations to improve local emergency response capacity.

• The level of engagement between HCCs and SFPs varies across the states.

• HCC and SFP partnerships provide opportunities to engage CAHs in HCC activities and leverage resources to improve emergency response capacity in rural communities. 

• HCCs provide resources, tools, and technical assistance that can be used to enhance CAH emergency preparedness planning and response.