With many rural hospitals on the financial critical list, Congress created a Rural Emergency Hospital model in 2021 to help deliver critical care to struggling communities in Kansas and elsewhere.

Two years in, the Bipartisan Policy Center has issued a report which showed care is improving where the system has been implemented but more work is needed. Under the model, 32 Rural Emergency Hospitals in 14 states have been established.

Julia Harris, health program director at the center, said the plan is preserving health care options for rural residents.

"If you start seeing hospital closures go down, that's a success measure," Harris explained. "Because this should be what helps them meet the needs of the community and stay open rather than being forced to close."

Harris said under the model, a rural facility can offer emergency department, observation, outpatient care and skilled nursing facility services in a distinct unit. Mercy Hospital in Moundridge and South Central Kansas Medical Center in Arkansas City are the only two such facilities in Kansas.

Harris pointed the growth of Rural Emergency Hospitals is reducing the number of rural hospital closures. She acknowledged challenges remain in operational flexibility and the availability of financial assistance. They studied states across the Midwest, looking for hospitals and communities to potentially benefit from Rural Emergency Hospitals.

"The reason we chose Kansas and Nebraska is because there was some modeling done to see which states would have the most hospitals eligible for this model," Harris noted. "Those were two states that had a lot of potential REHs."

Other recommendations in the report included support for prescription drug discounts, more flexibility in converting to Rural Emergency Hospital status, timely payments to speed the process and more funding for providing technical and operational assistance through technical assistance centers.

"There is a federal TA center to help hospitals that are trying to consider their pros and cons," Harris explained. "We advocate for continued funding for that TA center to be able to continue to do this sort of advising and help states make these choices."

A new program aims to ensure rural Mainers can take full advantage of expanding high-speed internet service.

Grant applications open this week for nonprofits, tribal entities and others to train underserved communities in technical skills and online safety.

Maggie Drummond-Bahl, senior director of digital equity and partnerships for the Maine Connectivity Authority, said the funds are directed at those most affected by the so-called 'digital divide,' including older Mainers, veterans and people with disabilities.

"We know the needs are pretty significant," Drummond-Bahl acknowledged. "This is really a down payment in starting to address some of those needs."

Drummond-Bahl pointed out the goal is to fund the agencies and organizations already connected and working to improve their communities. Maine has been awarded nearly $6 million to implement its Digital Equity Plan, which includes expanding broadband service and ensuring its affordability. Roughly 5% of rural areas in Maine still struggle with slow or unreliable internet.

The Maine Connectivity Authority aims to secure at least 25,000 donated devices for refurbishment, including laptops and tablets. Part of the new funding will be used to promote a statewide campaign to encourage businesses and organizations to contribute. Drummond-Bahl noted previous surveys revealed many Mainers are not confident in their digital skills but can learn to better use these devices in a familiar setting.

"If you're an older adult and you are already connected to your local Area Agency on Aging or another partner like that, it is a real benefit to have a digital skills training with an organization you're comfortable and already connected to," Drummond-Bahl emphasized.

Drummond-Bahl explained the campaign to recycle and reuse devices feeds into the state's environmental and climate goals to reduce waste and greenhouse gas emissions. She added funds will also help develop a new online tool to help people locate community resources and the digital skills training they need.


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By the end of June, students in seven very remote rural New Mexico school districts will get access to high-speed home internet through a state grant program.

The "Student Connect" program was established by the legislature in 2021.

Mike Curtis, public relations coordinator for New Mexico's Office of Broadband Access and Expansion, said the disparity in students with and without internet to complete homework was a source of frustration during the pandemic.

"A lot of kids who live in rural areas, while they get internet at schools, once they get home or in other parts of their communities, there's no internet," Curtis explained.

Curtis pointed out statewide, $70 million has been designated to expand broadband in unserved and underserved areas and all projects are scheduled for completion by June 30.

Curtis noted $56 million has been awarded through the Connect New Mexico Fund so far and the recent award is from a subprogram created specifically to help students. He emphasized the new broadband infrastructure will connect more than 4,600 homes, businesses, farms and other locations.

"It's an assistance program. It's not a merit program, so they're not competing with any other entities," Curtis stressed. "They apply for the money and then, within six months they'll be getting service. And they also get three years of free internet if they apply."

He said the money will go toward building towers, installing fixed wireless service and providing receivers to homes.


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Several rural communities across North Dakota are strategizing how to slow the pace of local grocery stores shutting down.

Some are making use of state grant money to aid their efforts, but challenges remain.

In North Dakota's Walsh County, the Rural Access Distribution Cooperative has been on the leading edge of establishing local grocery store co-ops, where a handful of smaller shops buy items in bulk together.

The initiative was eventually awarded a state grant to buy a bigger truck and van, making supply deliveries more manageable.

Cooperative President Alexander Bata said they continue to see progress with increased sales, and better options for area residents.

"So, there's less waste, less cost," said Bata, "and we've significantly improved the quality of food."

However, other elements of the initiative still face hurdles.

That includes utilizing food lockers, where customers can buy their food online and pick it up when they choose. But Bata said they haven't been able to make the technology work.

In 2023, the Legislature approved $1 million for interested communities to sustain grocery service in smaller towns with limited access.

The town of Milnor, with a population of around 600, was one of the early grantees - and used its money for a feasibility study.

Milnor's Community Economic Development Coordinator Carol Peterson said those findings were clear - their lone grocery store needs more storage space to stay afloat.

"It makes it very hard," said Peterson, "to order in enough product to service the community."

That limits the store from keeping prices lower.

Peterson said she worries more customers will then look at far away options, taking their tax dollars with them. While local leaders did get a read on what's needed, they haven't been able to secure additional funding for the next phase.

A key legislative sponsor of the pilot grant program says there's interest in extending it next session, but she's still gathering feedback.


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