Strain and challenges for rural hospitals persist, but awareness is growing as lawmakers prioritize funding and programs for rural health issues. As hospital leaders engage local stakeholders and advocates, the response includes a groundswell of support among legislators recognizing their constituents’ reliance on rural providers.

From ongoing workforce shortages to strengthened cyber attacks and commercial insurance challenges, rural healthcare continues its uphill climb. The recognition by elected officials of these issues in recent years has been a bright spot as state and federal legislation bolstered investment in technology and infrastructure.

Whereas the political morass tends to bog down some areas of healthcare finance and funding (such as Medicaid expansion, women’s health issues, and social determinants of health), two recent programs highlight areas where elected leaders have moved beyond the fray to support rural health.

• 2024 Rural Nursing Recruitment & Retention Program through the State Office of Rural Health, offers up to $15,000 to rural Texas health care facilities to provide recruitment and retention stipends to nurses working full-time in their facility.
  • Awards a $15,000 stipend to an eligible rural health facility to provide to an RN or LVN for a 36-month service commitment (paid out after completion of service commitment).
  • Can be used to either recruit or retain nurses.
  • Deadline to apply is June 27.
• A new National Cyber Workforce and Education Strategy from the Biden White House secured support from Microsoft and Google for reduced-cost cyber security services. According to the White House, the program offers:
  • Optimized security software from Microsoft suited for rural hospitals.
  • For select organization, an advanced security suite at no additional cost for one year.
  • Free cybersecurity assessments by qualified technology security providers and free training for frontline and IT staff at eligible rural hospitals to deepen resiliency to malicious cyberattacks.
  • Endpoint security advice from Google at no cost and a pool of funding to support software migration.

Google also committed to launch a pilot program to develop a package of security capabilities specifically for rural hospitals. Though much of the White House effort also focused on securing jobs for a large population of unemployed tech workers, as well as infrastructure investments.

While recent attention focused more on largescale attacks such as the Change Healthcare attack and resulting ransom, rural hospitals are especially vulnerable given the resourceful tactics of hackers and the distribution of roles and responsibilities that leave many rural hospitals spread thin.

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Many of the leaders I worked with over the last 20 years position themselves as an advocate for their organizations and teams. Some are hesitant to take on this role, allowing the industry to delegate the responsibility to advocates or advocacy organizations. Despite that representation, a variety of voices and contextualized experiences are needed to solidify effective advocacy efforts. Without actual cases — either from patients or members of a team — some advocacy efforts are seen as anecdotal. More cynical views might lead to them being ignored entirely without a local voice to highlight the experience.

While not often explicit in a healthcare leader’s job description, the responsibility to outline the challenges facing a rural healthcare team has become increasingly important. Maintaining a reliable voice to local stakeholders and local elected leaders helps ensure support for addressing workforce shortages and cybersecurity. Frequently engaging in a systematic operation can lead to the kind of proactive support from legislators and regulators that call them to action.