Healthcare Resiliency Program (HRP) model aims to expand and integrate access to primary, specialty, BH, and social health services within hospital and healthcare settings.

• Fund innovative projects designed to increase the capacity of primary care
• Supports rural hospitals, CAHs, and co-located clinics in implementing or expanding strategic priority service lines within existing facilities.
• Focus include perinatal care, BH, ED services, primary care, pediatrics, chronic care coord, specialty services, and targeted diagnostic capacity

Activities include: co-location of services (i.e.; adding BH in a primary care setting), minor alterations and renovations within existing footprint to retrofit underutilized space; acquisition and installation of clinical equipment; limited staffing supports and retention incentives tied to 5-year rural service commitments; simulation-based training and credentialing for high-acuity, low-occurrence events; development of clinical protocols and workflow redesign; coverage models and on-call strategies; and integration of telemedicine.

• Fund a new ambulance in every county, comprehensive new program to expand EMT training and support, launch and scale Community Paramedicine programs in high-need counties, and embed neonatal resuscitation and perinatal readiness into rural EMS operations statewide, while deploying mobile BH units or Mobile Health Clinics through an expansion of Project Rural Recovery.
• Regional Healthcare Coalitions (HCC) will build the TN Healthcare Resilience, Integration, and Value Expansion initiative, a platform for innovation to address persistent gaps in healthcare preparedness. Initial efforts focus on HCC effectiveness, system interoperability, operational readiness, supply chain resilience, continuous QI, and federal alignment.
• Medical Operations Coordination Centers to streamline patient movement and placement
• HL7 FHIR/US SAFR standards to enhance data interoperability and create a comprehensive common operating picture during response efforts, and developing deployable medical teams for field, triage, and surge support operations.
• Build upon the core Community Health Access and Navigation in Tennessee program by connecting pregnant and postpartum women to critical resources, comprehensive referrals, and individualized care coord with increased intensity and education components

TN will leverage its unparalleled network of local health departments (LHDs) in 89 rural counties to align public and private resources, expand high-value direct services, and help patients navigate a complex system. Core activities include:

1. Statewide sustainability plan, which includes an assessment to align TDH clinical capacity with community demand and private-sector partners;
2. Targeted direct services for uninsured/underinsured residents—eConsults for specialty care, medication assistance through increasing on-site formularies, transportation/telehealth access, expanded dental capacity/equipment, tobacco/vaping cessation, and colorectal cancer screening; and
3. Clinical Care Navigation Teams (≈21 staff) embedded in LHDs to connect patients to specialty care, food, housing, and social supports.

• Create a hub-and-spoke network connecting specialized Memory Assessment Clinics with existing urban Neuropsychiatry resources, leveraging a dramatically expanded Dementia Navigator network.
• Utilizing telehealth and trained non-clinical staff, the program will effectively address geographic and workforce barriers to enhance access and care for individuals with ADRD and their caregivers.

(1) Developing executive leadership pathways to place trained rural health leaders in within priority communities. Tennessee will enhance rural capacity through targeted partnerships with existing academic centers that can provide technology and workflow integration support for rural providers.

(2) An expanded BH workforce will utilize co-location at high demand locations such as Local Health Departments (LHDs) and EDs to reduce bottlenecks in emergency care, facilitate quicker access to appropriate services, and ensure individuals have easy access to crisis intervention, intake/assessments, peer support, and ongoing MH and SUD treatment.

(3) Accelerate the CHW program to rural communities to improve health outcomes for rural Tennesseans. RHT funds will support rural providers to launch evidence-based CHW programs, obtain accreditation, and receive short-term bridge support while TennCare explores sustainable reimbursement pathways for CHW services.

• Expand dental provider recruitment, establish new rural dental access points, and integrate preventive oral health services into Dental HPSAs

• Strengthen rural systems of care through aligned investments across facilities, workforce, and digital infrastructure. The Healthcare Resiliency Program (HRP) will fund projects that expand rural maternity care capacity, improve perinatal education and emergency response, and enhance data systems that connect families to services.
• Grants to upgrade rural birthing facilities, with an emphasis on those serving high proportions of TennCare births and persons.
• Expand the capacity of the state’s existing perinatal centers, strengthen community partnerships, and implement new training and tech-enabled consultation supports.
• Technology infrastructure investments will be made in BH teleconsultation for maternal and pediatric providers, modernization of TDH’s Call Center and referral interoperability, and the launch of a mobile pregnancy app to deliver evidence-based education and resource linkage.

• Expand VBP to rural hospitals, obstetric providers, and dental clinics to strengthen infrastructure, workforce readiness, and quality improvement systems

Investments focus on three coordinated models:

• the Patient-Centered Obstetric Medical Home, incentivizing coordinated maternal care & postpartum follow-up;
• the Rural Hospital VBP Capacity Program, providing infrastructure funding for rural hospitals to meet quality benchmarks and be successful under the TennCare Hospital Investment Program (HIP-QC); and
• the Patient-Centered Dental Home, engaging rural dental providers to expand preventive care, reduce emergency visits, and promote integrated oral and physical health.

• allocate funds to help providers and community-based organizations deliver integrated, high-quality, comprehensive prevention and health services that address the root causes of poor health outcomes.
• fostering collaboration among local healthcare providers to create a robust network that promotes holistic health and well-being for residents in underserved areas
• investments may include innovative projects that expand access to health and healthcare services in rural areas and support transitions to alternative care models that meet community needs
• example, establishing community health centers with extended hours and same-day appointments can greatly improve primary care access
• expand telehealth through provider training and tech investment, reducing the need for long-distance travel
• building mobile and in-home clinical capacity—licensed teams delivering diagnostics and preventive services through a scalable, tech-enabled infrastructure that enhances reach, continuity, and reduces emergency use.
• initiatives could hire more school health nurses to ensure timely screenings and care for students with chronic conditions

• Establish County Health Council Collaborative Action for Rural Engagement (CARE) Grants move from planning to action by funding locally prioritized health improvement projects and building community capacity for long-term sustainability.
• Enhance Healthy Built Environments (HBE) Grants, and Integrated Policy, Systems, Environmental (PSE) Grants to expand rural access to health-promoting environments, nutrition security infrastructure, and evidence-based prevention initiatives.

The Tennessee Rural Non-Emergency Transportation (RNET) Initiative will bridge the distance between health and home by transforming how rural Tennesseans are able to access primary, preventive, and specialty care.

RNET will launch as a competitive grant program under the Healthcare Resiliency Program (HRP) model, allowing hospitals, critical-access facilities, or other third-parties to apply for funding to implement or expand transportation programs. Key features may include a Statewide Coordination Platform, shared data-driven decision support, local innovation and flexibility, and cross system integration with electronic health records (EHRs), the Tennessee Community Compass (closed-loop referral system), and regional EMS coordination hubs.

• TN Healthcare Resiliency Program (HRP) Health-Tech Initiative will modernize the digital backbone of rural healthcare, empowering providers to deliver faster, safer, and more coordinated care. Rural hospitals, clinics, and health systems will receive competitive grants to implement scalable, interoperable, and secure digital solutions that expand access, strengthen clinical integration, and reduce administrative burden.
• RHTF investments will target high-impact areas of need, such as virtual care expansion, interoperability and data integration, advanced analytics and AI-enabled tools, wearable tech, cyber-security modernization, and workflow automation to improve provider efficiency.
• TDH’s Office of Strategic Initiatives will provide technical assistance, shared procurement support, and cybersecurity readiness assessments.

• Formalize the existing HIE workgroup to develop an implementation plan, aimed at creating a cohesive statewide network. The development of the HIE by a public-privatecpartnership will leverage existing cloud infrastructure and technologies for its build and launch.
• The HIE will enable seamless data sharing across providers, strengthen emergency and disaster response, and reduce provider burden, ultimately enhancing population health management and a more integrated healthcare system that meets the diverse needs of rural communities.

• Expand rural access to TN Community Compass (TNCC), a statewide closed-loop referral platform that connects individuals to community-based organizations addressing health-related social needs (HRSN) such as food, housing, and transportation.
• RHT support will significantly scale integration across key state agencies to build a single, interoperable referral platform.
• A TDH Project Supervisor and Project Coordinator will oversee TNCC implementation and coordination.

Health technology innovation and targeted technical assistance with rural providers who lack health-tech tools.The initiative deploys planning and implementation grants to advance projects that:

• Support the development and deployment of health-tech innovation planning and purchasing in rural clinics and hospitals
• Strengthen integration between health and social service systems.
• Expand access to primary, specialty, and behavioral health care through telehealth and digital platforms.
• Enhance chronic disease management and population health analytics.
• Build local capacity for technology adoption and data-driven decision-making.

• Secure digital system that allows primary care providers (PCPs) to consult with specialists electronically, eliminating the need for patients to be physically present. Asynchronous telehealth solution, eConsult streamlines the consultation process by enabling PCPs to submit cases and receive specialist recommendations at their convenience.
• Expand Healthcare Resource Tracking System (HRTS) and Patient Bed Matching (PBM) platforms—transforming them from emergency-use tools into sustainable engines of coordination and care delivery.
• Contracted specialists will train and support rural hospitals to integrate their EMRs directly into HRTS, allowing real-time sharing of capacity, specialty services, and disease data while automatically meeting CMS and NHSN reporting requirements.

Investments include:

• (1) MD/DO and Psychiatry Residencies to retain graduates in rural regions;
• (2) Advancing Rural Behavioral Health careers;
• (3) Recruitment Incentives to attract providers to underserved areas;
• (4) Early Exposure Programs in high schools and colleges;
• (5) Academic Health Department partnerships connecting urban academic training with rural Universities and partners, and Rural Workforce Development partnerships offering paid internships and field placements in rural health;
• (6) Mental Health First Aid training for frontline staff and other health professionals; and
• (7) expansion of the TRAIN Learning Management System for CE-credit learning across disciplines, allowing Tennessee providers to continue their professional development in isolated training environments.