1. Rural “Hope Center” Initiative

• Integrated Healthcare: Primary and behavioral healthcare.
• Transitional Housing with Wraparound Services: Designated transitional housing beds for individuals with SMI and substance use disorders, providing evidence-based treatment including cognitive behavioral therapy, MAT, life skills training, relapse prevention, and employment support.
• Intensive Case Management: Individualized care planning, benefits enrollment, and assistance with rapid permanent housing placement.
• Self-Sufficiency Programs: Connections to vocational training and workforce readiness programs.
• Community Coordination: Robust coordination with local social service agencies and community support networks.

2. Rural Community Health Hubs

Establish a comprehensive network of mobile health units throughout rural Sussex and Kent Counties to eliminate transportation barriers and deliver evidence-based preventive care, chronic disease management, behavioral health services, and specialty care directly to underserved rural communities. This initiative responds to persistent provider shortages and high rates of chronic disease in rural Delaware, where geographical and financial barriers continue to limit access to essential health services and insurance coverage.

3. School-Based Health Centers Expansion Initiative

Expand Delaware's network of school-based health centers (SBHCs) in rural Sussex and Kent Counties to provide comprehensive physical, behavioral, and preventive health services directly to students and families, eliminating transportation barriers and improving access to primary care, mental health services, chronic disease management, and nutrition counseling.

4. Food is Medicine Infrastructure Initiative

• Element 1 (Payment Infrastructure & Research): Vendors and participating rural health providers will develop and implement sustainable billing mechanisms including CPT code 99213 culinary medicine consultations, Medicaid “in lieu of services” pathways, and Accountable Care Organization (ACO) payment arrangements. This element also includes deployment of an EMR-integrated billing toolbox for provider use and establishment of a rigorous evaluation framework with published findings. The goal is to secure value-based payment arrangements with at least two payers.
• Element 2 (Technology & Workforce): Vendors will hire 4-5 community health workers and 1 registered dietician to serve patients in rural health practices across Kent and Sussex counties by providing nutrition counseling, education and coordination. Vendors will also deploy an EMR-decision support tools for participating providers, a telehealth nutrition consultation platform, a patient-facing mobile application, and remote patient monitoring systems.
• Element 3 (Training & Pilot): The program will certify 15 Culinary Medicine Teachers to train 150 rural practitioners (70% rural serving) and implement a pilot for 375 participants with diabetes or hypertension in rural Kent and Sussex counties. Specific communities will be identified in consultation with the Delaware Council on Farm & Food Policy. The pilot will provide a six-month intervention including nutrition education, culinary medicine consultation, and remote monitoring.

5. Rural Libraries Health Access Initiative

Expand health access services and operating hours at nine rural libraries up and down Delaware to deliver telehealth, health navigation, and social services support at locations within seven miles of most rural residents.

6. Rural Provider and FQHC Value-Based Care Readiness Initiative

1. Innovative Technology Investments:

• AI Scribes: HIPAA-compliant tools that reduce documentation burden.
• Software and Technical Assistance to Model Financial Impact of Value-Based Payment Methodologies.
• Value Based Payment EHR Integration within Epic.
• Hub-and-Spoke Telehealth platforms that position community health centers, rural health clinics, hospitals, and other community based organizations as central hubs coordinating care delivery.
• Cybersecurity to protect sensitive patient data, ensure compliance with federal standards, and safeguard continuity of care.
• Remote Patient Monitoring (RPM) devices and services not covered by insurance.

2. Innovating and Strengthening the Rural Health Care Delivery Model: Funding will directly support providers in expanding services.

• Strategic planning for patient-centered care in a tech-enabled world
• Adding in-house laboratory, imaging, pharmacy, and behavioral health.
• Additional care managers, patient navigators, clinical pharmacists, and other care team members focused on primary care, maternal health, long-term care, and behavioral health.

3. Framework for Sustainable, Ongoing Collaboration:

DOI OVBHCD will convene payers, public health professionals, rural providers, FQHCs, food is medicine hubs, community organizations, employers, and other stakeholders to assess value-based care participation benefits and barriers.

7. Catalyst Fund for Telehealth and Remote Monitoring

Delaware will establish a Catalyst Fund to encourage the development and adoption of emerging health tech innovation focused on rural populations.

8. Rural Delaware Diabetes Wellness Pilot Program

This initiative will bring together the Delaware Information Network (DHIN) - the state health information exchange (HIE) which also serves as its all-payer claims database (APCD)- a technology partner, rural Delaware diabetes patients, providers and payers in a three-year pilot study to understand the impact of hands-on care management paired with continuous glucose monitoring (CGM) devices to 500 patients.

9. Delaware Medical School

Governor’s Office will conduct an expedited competitive procurement process to select a partner institution to establish a “Primary Care –Rural Health” track medical school program.

• Building conversion and renovation
• Medical equipment and technology
• Furniture, fixtures, and educational infrastructure
• IT equipment and software
• Faculty recruitment, program administration, and curriculum development

10. Medical School Rural Workforce Development Program

The State will establish a Medical School Rural Workforce Development Program, administered by the Delaware Health Care Commission, which will provide comprehensive financial awards to medical students enrolled in the new medical school who commit to practice and care of Delaware’s rural population.

11. Rural Medical Residency Recruitment Program

This initiative establishes a Rural Medical Residency Recruitment Program administered by the DHCC that provides awards for wraparound services, short-term housing, and relocation expenses to medical residents committed to serving rural Delawareans.

• Temporary housing and wrap-around services awards of up to $2,000 per month for a maximum of 6 months ($12,000 total) to offset initial rental and other costs as residents and clinical program participants transition to rural Delaware practice locations.
• One-time relocation awards of up to $8,000 to cover moving expenses, security deposits, and initial setup costs.

12. Training Programs for Clinical Support Roles in Rural Areas

A competitive grant program to fund health systems, facilities, and educational institutions to expand clinical training programs for Non-Physician Practitioners, “physician extenders”, community health workers (CHWs), dental professionals, and clinical support staff in rural Delaware

13. Rural Health Workforce Education Program

Financial awards to those enrolled in clinical training programs who pledge to serve in Delaware's underserved rural communities.

14. Healthcare Workforce Data Center Initiative

Establishes a dedicated Health Care Workforce Data Center that leverages the expanded authority granted in SB122 to develop robust database infrastructure capable of tracking granular health workforce insights.

15. Statewide Health Information Technology Infrastructure for Real-Time Insurance Verification and Prior Authorizations

Creates a comprehensive digital infrastructure connecting all rural providers, payers, hospital systems, and patients through the Smart Health Network (SHN) and the DHIN.