By Stephen Smoot
On July 4, President Donald Trump signed into law the One Big Beautiful Bill Act that served as a comprehensive funding vehicle for his administration’s priorities while making cuts in areas officials deemed expendable.
One of the priorities that President Trump shared with United States Senator Shelley Moore Capito was the inclusion of the Rural Health Transformation Program. In a release at the time, she stated that “we’re talking with (Centers for Medicare and Medicaid Services Administrator) Dr. Oz’s team daily to find out the exact impact to West Virginia, but it will be millions and millions of dollars.”
As a website with the United States Department of Health and Human Services described the initiative as a “new federal program (that) aims to transform rural health care nationwide.”
Department Secretary Rober F. Kennedy Jr, whose uncle, President John F. Kennedy, traversed some of the most economically challenged areas of West Virginia during his 1960 campaign, said “rural communities are the bedrock of America. They have waited too long for Washington to act. Now, at last, we are acting with the largest investment ever to improve health care for rural Americans.”
“This $50 billion program is about delivering dignity and dependable care to rural communities,” Secy. Kennedy added.
The program’s vision rests on five strategic goals. The first aims to “make rural America healthy again” by supporting “rural health innovations and new access points.”
Sustainable access serves as the second goal, seeking to “help rural providers become long-term access points for care.” The program also looks to develop a deeper workforce pool of health care workers, “spark the growth of innovative care models to improve health outcomes” and promote coordination with flexibility.
Finally, the initiative will “foster use of innovative technologies that promote efficient care delivery, data security, and access to digital health tools.”
In some ways, Potomac Highlands Guild has already checked a few of those boxes with a recent innovation of its own. It has developed a program, among a number of innovations, to use mobile vans connected to the internet to bring mental health access to the most remote of communities. Ground level innovations such as these are one of the important developments the program seeks to support.
The program will distribute among the states $10 billion per year for a period of five years with “half of the funding . . . evenly distributed to all states with an approved application. The other half will be awarded to approved states based on individual state metrics and applications that reflect the greatest potential for and scale of impact on the health of rural communities.”
A State application must reflect three or more approved uses of funds, including “evidence-based, measurable interventions to improve prevention and chronic disease management”, direct payments to health care providers, “consumer-facing, technology-driven solutions for the prevention and management of chronic diseases”, workforce development, cybersecurity and other information technology advances, helping rural communities to “right size” their systems in a number of aspects, including ambulatory and emergency, supporting opioid addiction services, developing projects that support innovative care, and additional ideas “designed to promote sustainable access to high quality rural health services.”
Applications from states are due on Nov 5. Awards will come out on Dec 31, 2025.
Sen. Capito added “we need to make sure we’re teed up as a state to apply for those dollars.”
To get the state prepared, Governor Morrisey requested responses from stakeholders and other residents concerned about rural health care access and delivery.
That portal closed on Sept 29, but it asked of respondents a number of specific questions under a set of categories.
The first category’s questions gathered the scope of the need for transformation. These included requests for information such as “What are the most significant health care needs and gaps in outcomes in rural West Virginia that the state should make a priority?”, “What are the root causes of these needs and gaps in outcomes?”, “What parts of the population face the greatest challenges?” and asking about “how chronic conditions, including mental health and substance use disorders, contribute to overall challenges for improving health care in the state.”
Next, the Governor asked for examples of areas of success that could be duplicated. After that came a category focused on ideas for the best use of funding, followed by a category asking about legal and regulatory barriers on the State level and various processes and policies.
One of the most important issues in rural health lies in funding for emergency ambulance services to get injured and ill individuals to needed care. Governor Morrisey in Franklin last week stated that he was working with the State Legislature on EMS funding, but remained wary of “one shot” solutions that could put local governments and agencies on a fiscal “cliff.” He expressed his preference for a permanent fix.
Morrisey stated during the press conference announcement at the time that “I am grateful to the Trump administration, HHS Secretary Robert F. Kennedy Jr., and CMS Administrator Dr. Mehmet Oz for this historic investment in West Virginia’s healthcare, our economy, and our workforce,” added Governor Morrisey. “We are going to be working very hard to submit our proposal and ensure this funding lifts up as many people as possible.”
