Impact Extra Episode - Rural Health on Life Support Emergency Rural Health Care Grants
Michelle Rathman: Hello and welcome to a very special Rural Impact Extra. I'm Michelle Rathman, and as always, it's great to be with you. Now, if you're wondering, what is this Rural Impact Extra? Well, simply put, in these episodes, we will continue conversations from previous series, we're going to share breaking and timely news, and we're going to talk with people in the know and in the news.
Now, today we're continuing our conversation from our Rural Health on Life Support Series. Specifically, we're talking about rural emergency healthcare grants, which is critical funding to help expand access to rural healthcare through the Biden Harris investing in America Agenda. Now, joining me for this extra conversation is Deputy Under Secretary for USDA Rural Development, Farah Ahmad.
Deputy Undersecretary Ahmad works to advance policies and programs that create economic inclusion and opportunities in rural communities. Previously, she served as Chief of Staff, and prior to these roles, the Deputy Under Secretary led rural, community, and economic development programs for USDA's Rural Business Cooperative Services, managed programs at the Consumer Financial Protection Bureau, and served as Senior Policy Analyst for the Center for American Progress.
You know, we say often that all roads to quality of life are paved by policy. And I think in this conversation, you'll get to understand the kind of policies that support making sure that our rural hospitals, you know, not only survive, but thrive. So here now is my conversation with Deputy Under Secretary Farah Ahmad.
Thanks for joining us.
Michelle Rathman: Well, it is really great to start off this Rural Impact Extra episode, and I'm so grateful for you to join us, Deputy Under Secretary Farah Ahmad. We are going to have a conversation about a topic that we've been talking about earlier. We had an episode called Rural Health on Life Support, and you and I just talked a few minutes ago, and I told you what a passion this is for me because I've been watching far too many rural and critical access hospitals struggle over these years and COVID certainly did not help them.
And we know that even though COVID is officially, you know, declared over, the struggles and the pain points for rural hospitals just continue to linger. And I fear, you know, going into the fall with more illness and so forth, that it's just going to, we're going to kind of have a new cycle. So first of all I'm fascinated at the work of the USDA Office of Rural Development.
A lot of people don't know what it is, which surprises me. So I thought maybe we could just kick off the time that we have together. First, just give our listeners a bit of a lay of the land of USDA Rural Development and the functions of the office and what is the intersection with rural health?
Farah Ahmad: Absolutely. Well, thank you so much for having me today. It is such a pleasure to get to spend this time with you and talk about what we share in common, which is really about supporting rural communities, and some of the listeners, as you said, may not be familiar with USDA Rural Development.
So, we are a part of the U. S. Department of Agriculture. And we have a really important and specific mission, which is about supporting rural communities, supporting rural prosperity and really helping support them in their vision and moving their vision to reality when it comes to their long-term future and their community needs and economic development needs in those areas.
One thing that we say all the time is, you know, you've been to one rural community. That means you've been to one rural community um, that there's so much diversity. I think there's a little bit of this myth out there that rural communities are kind of this monolithic entity and they're not whether that's, you know, looking at communities in the West, to the Delta, to up North, they're so different in terms of geography, in terms of their natural assets and it's our job at USDA Rural Development to actually listen to those communities, hear what their vision is, what their assets are, their challenges are, and then fit our programs into their needs.
And so you may be wondering, well, what is it that we do? What are our programs? We do a little bit off everything, which is sometimes we kind of view ourselves as a Swiss Army Knife in the federal government because we have programs that help invest in infrastructure. So, you know, that's everything from high-speed internet to water and wastewater infrastructure to electric and renewable energy infrastructure.
And then we also support you know, the economic vitality of a place through our business program. So that's helping support and grow businesses and rural communities. And then last, but certainly not least, we really invest in facilities and in housing. So affordable housing, whether that's helping folks get into a home and become a homeowner or really supporting, you know, multifamily housing properties and workforce housing and other things like that.
And I also mentioned facilities, which is kind of what, what I think we're going to focus on today is that we focus on investing in facilities that provide what we call an essential community benefit. So that's making sure that we have grant and loan programs for things like hospitals and health clinics in rural communities, schools you know, town halls fire stations, and all those kind of essential community facilities that the public relies on in every town.
Michelle Rathman: Thank you so much for that. It's interesting because every single thing that you just ticked off; those are topics all unto themselves. And we are going to talk about rural housing in an upcoming episode because one of the struggles, how this relates to health care, one of the struggles that so many rural communities and hospitals have right now in terms of recruitment and retention is there's no housing.
So we'll put that kind of a pin in that one because this is a really big topic of conversation for so many communities. With respect to health care, you know the saying you've seen one rural community you've seen one goes with the same with the hospital. You've seen one rural hospital, you've seen one. What we do know what they do have in common is so many of the rural health facilities are struggling in so many ways so supply chain, workforce, not the least of which is their infrastructure, and for you know for a facility that might be 50, 60, 70 years old, you know, the useful life term comes to mind, but these rural health grants, the emergency rural health grants, I was looking through the list of grantees, and to your point, there is such an incredible diverse set of needs.
So let's just talk a little bit about the rural emergency, rural health care grants. It kind of break down the investment, if you will, because this is not something that people are applying for now. Correct. They've applied, the grantees have been selected and now it's kind of, I will just throw this in there.
We say all roads to quality of life are paved by policy. This policy is literally allowing millions of people in communities to have a better quality of life because fill in the blank. What is the grant? How much? What's what it's intended to do? And let's just maybe walk through a few case studies of how it's being applied.
Farah Ahmad: Yeah, well, you brought up a couple of really good points, and I want to underline a few things here. So you're right. The Emergency Rural Health Care Grant Program that we're talking about today was funded by the American Rescue Plan and has really been championed by this administration as a really important cornerstone program.
It's something different. It's a different tool than we've been able to have before and I'll talk about, you know, some of the things that make it really unique and special and especially from that policy aspect that you talked about, but this was a onetime program through the American Rescue Plan.
There was 500 million allotted for this grant program. And the way it was designed has two really important elements to it. Knowing that, like you said, you've been to one rural hospital or health clinic, you've only been to one, we knew that the needs were really different. And as you mentioned, hospitals and health clinics and rural communities weren't just struggling at the start of the pandemic.
I mean, we know since 2010, over 135 rural hospitals have closed and financial sustainability oft hospitals and health clinics in rural communities is critical. Critical to the health and well being not only of patients, but to the whole community be able to access those services, and to be a place with that quality of life and those services that people need and deserve in those communities.
And so, what the emergency rural health care grant program did is, it helped those really critical rural health facilities do a couple of different things. One, improve their facilities if they needed that much needed upgrades like you were talking about. If they're 50, 60, 70 years old, it's actually improvement of the facility itself.
But it also helped with that financial sustainability piece that I mentioned earlier. So something we haven’t been able to fund typically at USDA Rural Development is helping with things like staffing, helping with the balance sheets of hospitals to make sure that they not only exist right now, but that they have a strong financial future.
They can be long lasting in these communities. And so we could actually use this funds to help these rural hospitals and health clinics pay for some previously incurred expenses to help make sure that they were financially strong and stable. And some of these funds also helped for other long term planning pieces, like supporting strategic plans to make sure that their healthcare systems were more effective and more resilient.
Knowing that one facility necessarily can't do it all in a community, but it relies on on regional approaches many times to make sure that things like maternal care, specialty care, emergency care are all kind of interconnected throughout a region and are accessible by all rural communities. So we were really excited to be able to do some of those different kinds of funds, some of those different kinds of pieces that we haven't been able to in the past.
And there were two tracks in this grant program. One track was for smaller grants that were really more focused on kind of short term needs right now, equipment, supplies, like needed in the middle of the heat of the pandemic. And then we had a second track that were really larger grants of between 5 and 10 million dollars for developing that sort of long term, larger regional system investments that I mentioned earlier.
Michelle Rathman: Yeah, I was looking down the list. I mean, things such as project and I think in Alabama was used to allow a county health association to purchase materials to revitalize and remodel a school building into a health care clinic with medical equipment. I mean, those historically are not things that we hear, you know, are coming out of the USDA.
I think what I love so much about it is that it champions collaboration as well. So, yeah. Can we just touch a little bit? Because again, the funding priorities, the two tiers, but how will the success of these investments be measured? Because I know that's so important too, because it's never wise to just throw money at problems.
We want to see the investments then turn into p projects that are sustainable, helping to do what you intend it to do, which is to increase access and so forth. So how will the success of these programs be measured? So they're telling you what they're going to do with it. How does USDA Rural Development kind of track that?
And then, kind of showcase best practices, I guess, for others to be able to take these projects and say, maybe we could do that in our own community.
Farah Ahmad: It's a really fantastic question. And because we had some new flexibilities with this kind of funding since this was a brand new program we wanted to take the opportunity to actually capture the successes, right? Capture how we actually measure success and what those metrics are. So, and then share those as you mentioned.
So we're actually partnering with the rural hospitals and health systems that were funded through those bigger grants, those like kind of second tier second track I mentioned to actually figure out how we measure the success of projects. So that could be things like looking at the percentage of funds dedicated to things like inpatient, outpatient, or mental health services, and then actually look at some of the outcomes that come from that. And so we actually have here at USDA Rural Development, something called the Innovation Center. And those are where our data experts are. And so they're working with some of these grantees to actually do that evaluation. So we can tell the story because the story isn't just about how much money went to these rural hospitals and health clinics.
It's about the outcomes for the people in that community and the increased access to services, better outcomes for folks using those services. So we're excited to be able to embark in that evaluation process with these projects so we can actually do a really good job telling those stories and telling about why investments like these matter, matter now, and will matter into the future as well.
Michelle Rathman: I think that's excellent. You know, I think it's unfortunately so many places they work. It's kind of a best kept secret and we don't want to be secret. We want people to understand that USDA Rural Development out of all the things happening in our world. Rural hospitals can look squarely at USDA Rural Development and, and there's more than just one avenue.
I mean, grants is just one way you do it. So before I just have my one last question for you, for a rural hospital CEO or a rural health leader the grants weren't the, it's not the end of the story, USDA Rural Development. You know, if you have an idea, if you have a need, what do you recommend for people to do to even where to start?
Is it just as simple as sending an email or picking up a phone and calling a USDA Rural Development office in your state? What do you suggest?
Farah Ahmad: Yes, that's exactly it. I couldn't have said it better myself. So, one thing that I think is really special about USDA Rural Development is that we have We have over 400 offices across this country, many of them, most of them located in rural communities. So our staff are living and working in the communities that they serve.
And so, we were designed that way because we want to be accessible to the public. We want to be able to build relationships in communities and in states and really just start with a conversation. So, if you go online and you just, you can Google USDA Rural Development and your state. You know, whatever state that is.
And our phone number will come up. A list of our offices in your state will come up, pick up the phone or send an email to any of that contact information there. And we'd be happy to have a conversation because we have, you know, over 70 programs right now across the spectrum. So. You know, rural hospitals don't exist in a vacuum.
They're anchor institutions in their community. They're connected to other community leaders, to schools, to businesses. And we have a lot of different programs to support that community holistically. So that is the best place to start. We have a state director in every state who provides leadership to all our state across to every single state.
And I'll just give one quick example of, I think how this can work. Especially because, you know, I said the emergency real health care grant programs. It's a one time program, but our other programs aren't there. They're their annual programs. And they have a place in all rural communities. So one great example was a couple of months ago.
I visited. A rural hospital in New Jersey called the Deborah Heart and Lung Center, and they were a recipient of the an Emergency Rural Health Care Grant, and they had this incredible story where that hospital was started 100 years ago, right? And it was started at a time where There was another pandemic going on the tuberculosis pandemic, and so this hospital was started in a rural place to actually support people from all over the region and actually multiple states, including urban areas where people needed specialty care and they also needed fresh air to breathe right at a place to do recovery. So they picked this really amazing location in a rural community in New Jersey and they kind of became a place of specialty care for heart and lung specialty care. And so fast forward over the years, we've been investing through our Regular Community Facilities Program in the hospital as it's expanded as it's grown even more specialty care services.
And then when the pandemic hit. They actually applied for an Emergency Rural Health Care Grant Program because they were heart and specialists, heart and lung specialists. They had the right kind of providers to help support people during that really hard time during the beginning of the pandemic. And they got our emergency oral health care grant from us to actually upgrade their patient rooms to actually treat the most contagious and highly ill patients.
And it was just a really exciting moment for me when I got to go meet with that hospital, talk about them, about how we've been a long term partner in investing in that hospital, and how they were able to access this emergency real health care grant to actually meet the current need in the moment during a time of real urgency.
And when I was there, I actually got to... meet with the executive vice president and a couple of other leadership members. And what was really amazing about working at that rural hospital is they partnered with the foundation. And anyone who comes into that hospital never leaves with a hospital bill.
Because the foundation helps cover the gaps between you know, insurance and what they're kind of left over with. And that's their motto. It's actually, there's no price on life. And those are the kinds of rural hospitals that we want to partner with long term and that are the recipients of, you know, such amazing programs like the Emergency Rural Health Care Grant Program.
Michelle Rathman: Outstanding. Outstanding. I know you; your time is so valuable. I have one more quick question because I think that's fascinating. Stories matter. They really do because it helps take the numbers and bring them to life and, you know, puts that human emotion to it. Real quick, we're just closing up our food insecurity series and we know this is another challenge.
It's also related to health and well being in rural communities. I wonder if you could just quickly touch on the department partnering with Reinvestment Fund to invest $22. 6 million I believe is the number to improve access to healthy foods in underserved communities across the country. Can you just share a little snippet about that program, please?
Farah Ahmad: Yeah, absolutely. So that's our Healthy Food Financing Initiative. We've run this program for a couple of years now, and in the early stages, that program really focused on working with grocery stores with retailers to make sure that they could provide access to healthy foods in those places where people are shopping every week.
And so, we've expanded that program. That's what this 22. 6 million is. And we're now actually providing funding to, you know, partnerships, whether that's local partnerships, regional or states to actually create their own food financing programs within their state to make sure that it fits the unique needs of their communities and their states.
So we're excited to be able to expand this program even further and to allow states and regions to actually shape it in a way that makes sense for them to improve access to healthy foods in their community.
Michelle Rathman: Thank you so much, Deputy Under Secretary Farah Ahmad. You are welcome back anytime to this podcast to share more news with us about what's going on at USDA Rural Development. It's been truly an honor to meet you, to have some time with you. I thank you so much for all the great work. You know, I tell the audience all the time, these are not light subjects. And we hope that every episode and especially these new Rural Impact Extra moments that we are enlightening you through some of these challenging issues. So thank you again. And we'll talk to you again on the next time on The Rural Impact. Take care.
Farah Ahmad: Thank you so much.
