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."

Researchers at the University of Oregon say a new online parenting skills program has helped improve mental health for rural Oregon families.

After using the app, called Family Check-Up, for three months, parents reported a decrease in depression symptoms and increased confidence in their parenting.

Kate Hails, research associate for the Prevention Science Institute at the University of Oregon, said the program uses techniques like focusing on parents' strengths and children's positive behaviors.

"Family Check-Up really views the parent as the expert on their own parenting in their own family and focuses on their own personal goals," Hails explained.

Hails pointed out the app is for families with young children and is based on an in-person program. She added it is designed to help rural families who face challenges with transportation, scheduling or stigma, preventing them from getting mental health support.

About a third of the parents in the study had significant levels of depression when they enrolled, and about a third were at risk for opioid misuse. Hails stressed the program starts with parents' own wellness.

"We know from research that parents really need to be able to regulate their emotions in challenging moments with toddlers because that will happen regardless of how effective of a parent you are," Hails emphasized.

Parents access the program through their smartphones. It has science-backed lessons and opportunities to meet online with trained parenting coaches. Hails explained parents can work through the program at their own pace and meet with counselors on their own time, allowing them to multitask if needed.

"That kind of squeezing it into life is not really possible when we think of traditional mental health or even like kind of telehealth zoom sessions," Hails observed.

The next step, Hails added, is to gauge the effectiveness of the program over a longer time period with trained providers who are not involved in the research.


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Rural West Virginia counties are already facing shortages of home health care services and nursing home workers. Now, they are facing accusations of alleged misconduct by contract workers in state nursing homes.

A new lawsuit cited a "systems failure" from top to bottom, where officials have allowed front line workers to act in ways that harm patients.

Michael Folio, legal director for the nonprofit Disability Rights of West Virginia, the group behind the lawsuit, outlined its goals.

"What we've identified is even the regulatory bodies in West Virginia that are charged with overseeing these facilities are so understaffed, so underfunded, that we oftentimes are reporting incidents to them, even though it's their job to actually uncover these incidents and take appropriate action," Folio explained.

The lawsuit alleged state officials knew about abuse, harassment, and retaliation of fellow employees and patients. According to the health care advocacy group KFF, there were more than 9,400 people living in certified nursing home facilities in West Virginia in 2024.

Folio pointed to documented incidents of abuse and neglect over the past year in state long-term care facilities. One case is now under criminal investigation, where hot water temperatures were said to reach between 134 and 140 degrees.

"What did they do? They ignored it for five months," Folio contended. "They placed an elderly gentleman who had dementia and he was nonverbal in this water and left him there."

According to the National Rural Healthcare Association, rural health facilities still have severe staffing shortages with fewer clinicians per capita, and sicker and older patients on average compared to urban areas.


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A new report highlighted how regional commissions are helping improve infrastructure in rural America.

According to the Brookings Institution, the Appalachian Regional Commission has directed nearly 70% of its infrastructure funding to distressed rural areas, addressing gaps left by traditional federal programs. The report said in Alabama and surrounding states, the commission has been a vital resource since 1965, completing 91% of its goal to build highways through the Appalachian Mountains.

Now, the commission said it is shifting its focus to modern priorities like broadband.

Gayle Manchin, federal co-chair of the commission, called broadband the "second highway," underscoring its role in expanding education, health care, and economic opportunities in rural communities.

"When our children were sent home to go to school virtually, they had no internet in which to do that," Manchin recounted. "Parents could not go home and work. There was no telehealth and so that has become obviously the second highway system that we are building."

Manchin explained the goal is to reduce the number of distressed counties and poverty rates. Since its creation, she said the commission has decreased the number of distressed counties by 60% and halved poverty rates. Manchin added there is still much more to do.

Manchin stressed collaboration is key to securing infrastructure funding for rural Alabama but matching requirements for federal grants remain a significant hurdle for many distressed communities. She noted commission grants, unlike federal loans, are designed to be more accessible for small towns with limited budgets.

The Brookings report highlighted how partnerships between commissions, nonprofits, and local organizations play a vital role in helping communities overcome obstacles and access critical resources.

"It's about the federal agencies working together," Manchin emphasized. "How they can help be a bridge to these communities by sharing their knowledge and their funding."

Manchin underscored the importance of building technical expertise in rural areas, acknowledging many communities lack the staff or resources to navigate complex grant applications without outside support.