File photo: Jacob Wackerhausen/Getty Images.
Ohio Department of Health Director Dr. Bruce Vanderhoff unveiled plans for a $202 million federal award for rural health in the wake of drastic Trump/Republican Medicaid cuts that will hit Ohio with $33 billion over 10 years.
During general budget testimony before the Ohio House of Representatives Health Committee, Vanderhoff outlined various priorities for money allocated to the state through the Rural Health Transformation Program, which the Trump administration portrayed as an attempt to offset cuts in other areas, such as cuts in Medicaid funding.
Federal funds for rural health will come to Ohio, but won’t be enough to offset cuts, advocates say
Trump/Republican Medicaid funding cuts in Ohio will total $33 billion over 10 years, experts say. These and others the cuts will disproportionately affect rural hospitals and health care facilities.
“According to the federal government, we are not the most rural state,” Vanderhoff said. “But we have important rural areas and we do have important rural needs.”
Vanderhoff said the department “felt rewarded” and “felt like it hit the nail on the head” after his request raised more federal funds than he expected.
According to Vanderhoff, the largest pool of money received through the fund is $92 million and will go toward rural health innovation centers and clinically integrated networks.
Services would include hospital support and access to health care for struggling areas, as well as “primary care services particularly impacting students.”
Rural and safety-net hospitals in Ohio will suffer large losses under the up-to-date Medicaid rules, the analysis shows
A program to establish rural health centers in schools in Ohio will also receive $21.1 million in funding, and $13.5 million will go to workforce programs, according to Vanderhoff.
The director said a large issue the department hopes to address is maternal and infant health.
“We already know about a number of efforts that are in the early stages in some places in Ohio, so we have a lot of optimism that these kinds of efforts will prove to be the real fuel that will help them continue to grow,” Vanderhoff told the committee.
He said the state has a persistently high infant mortality rate compared to other states, as well as high rates of maternal morbidity and mortality that are “directly impacted” by rural work.
However, “doing more of what we have done in the past without success is probably not the right solution,” the director noted.
He is prepared for grant proposals to come from groups in the state that want to do more groundbreaking work.
“I’ve heard enough to say that I would be very surprised if we didn’t recognize this as one of the most important issues that some regions decide to seriously address,” Vanderhoff said.
(Screenshot courtesy of The Ohio Channel)
Committee members from various parts of the state recognized the challenge of providing and maintaining health care in rural regions of the state.
Maternity care in rural areas has declined, in part because of Medicaid cuts and other funding losses.
“A lot of maternity care is provided outside of rural areas because of (maternity) departments that have closed in several of our rural hospitals or have been merged,” said state Rep. Anita Somani, D-Dublin.
Committee members noted the comprehensive impact of unavailability of health care in rural areas on health care in the state.
“While I do not live in or represent a rural area, there will be adverse impacts on health care access across the state, as well as potential increases in costs due to lack of early access or prevention,” said state Rep. Karen Brownlee, D-Symmes Twp.
Vanderhoff said that while he believes there is “very little flexibility” in using the funds beyond what is already specified in the funding request, he believes the Rural Health Innovation Hub/Clinically Integrated Networks funding could provide room for change, as discussions with the Trump administration and those overseeing the rural health program have shown.
“We’ve been able to… we’ve actually already had some conversations with them about… well, but can any of this help some of these more challenging rural hospitals that maybe need a little bit of support to be able to existentially participate in a node or a clinically integrated network,” Vanderhoff said.
The health director acknowledged that the funding would not be enough to ensure a sustainable, long-term future for the state’s rural hospitals.
His comments echo other lawmakers and rural advocates who say the money won’t be enough to offset other cuts in federal funding and increases in health care costs.
“But I think this is a real opportunity and incentive for many of them to take a partnership and collaborative approach to changing the care paradigm in rural Ohio,” Vanderhoff said.
The director stated that for the first year, the state would have to “stay agile” and work without flexibility on the programs detailed in the application, in the hope that later that work would merit more flexibility.
“I think we’re going to have to push it hard, show that Ohio can get things done and put ourselves in a position to get a chance to maybe get more or at least get some flexibility because it’s obvious that Ohio is going to keep playing,” Vanderhoff said.
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