The delaware rural health transformation plan addresses critical healthcare access and outcome disparities affecting approximately 400,000 residents in rural sussex and kent counties. - delaware rural…

The Centers for Medicare and Medicaid Services awarded a $472,184,891.58 Cooperative Agreement to the Executive Office of the Governor of Delaware, Division of Public Health, on December 29, 2025, under the Rural Health Transformation Program (CFDA 93.798). The award funds Delaware's Rural Health Transformation Plan, a five-year initiative through October 30, 2030, addressing healthcare access and outcome disparities affecting approximately 400,000 residents in rural Sussex and Kent counties.

The plan delivers 15 integrated initiatives across three core strategies. Access expansion includes establishing HOPE Centers for homeless populations, deploying mobile health units, creating school-based health centers, and expanding library-based health services to eliminate transportation barriers. Workforce strengthening establishes Delaware's first medical school with a primary care-rural health track, funds "Train Here, Stay Here" programs with education awards for medical students and residents, and expands training for nurse practitioners, physician assistants, community health workers, and other critical healthcare roles. Innovation initiatives build comprehensive health IT infrastructure for real-time insurance verification and prior authorizations and launch catalytic programs to address healthcare disparities.

Performance occurs statewide in Delaware. The Division of Public Health leads implementation in partnership with the Governor's Office and the Division of Public Health, working alongside the Delaware Department of Health and Social Services, state housing and library authorities, healthcare commissions, health information networks, multiple health systems including Tidal Health, Beebe Healthcare, BayHealth, ChristianaCare, Nemours Children's Health, and Highmark Health Options, as well as academic institutions and numerous community-based organizations.

Abstract

Lead organization: delaware department of health and social services (DHSS), in partnership with the division of public health (DPH) and the governor's office known partner organizations: delaware state housing authority, delaware health care commission, delaware division of libraries, delaware health information network (DHIN), smart health network, delaware council on farm & food policy, LA red health center, westside family healthcare, tidal health, beebe healthcare, bayhealth, christianacare, highmark health options, nemours children's health, delaware state university, university of delaware, delaware technical community college, and numerous community-based organizations total budget: $1 billion over five years ($935.5M in direct costs + $64.5M in indirect costs). Project goals: delaware's rural health transformation plan addresses critical healthcare disparities affecting approximately 400,000 residents in rural sussex and kent counties through 15 integrated initiatives. The plan aims to: 1. Expand access: establish hope centers for homeless populations, deploy mobile health units, create school-based health centers, and expand library-based health services to eliminate transportation barriers and bring care directly to rural communities. 2. Strengthen workforce: create delaware's first medical school with a primary care-rural health track, establish "train here, stay here" programs with education awards for medical students and residents, and expand training programs for nurse practitioners, physician assistants, community health workers, and other critical healthcare roles. 3. Drive innovation: build comprehensive health IT infrastructure for real-time insurance verification and prior authorizations, launch a catalyst fund for telehealth and remote monitoring technologies, and implement a diabetes wellness pilot integrating continuous glucose monitoring with care management. 4. Improve outcomes: deploy food is medicine infrastructure with billing mechanisms and workforce development, establish value-based care readiness programs for rural providers and fqhcs, and create a healthcare workforce data center for real-time tracking of progress use of funds: the $1 billion investment will transform rural healthcare delivery in delaware through infrastructure development ($97.5M for hope centers, $50M for health information exchange), workforce development ($274M for medical school and training programs, $60.25M for educational awards and recruitment), expanded access points ($23M for mobile units, school health centers, and library services), technology innovation ($106.5M for catalyst fund and diabetes pilot), and sustainable care delivery models ($308M for value-based care readiness and food is medicine infrastructure and $16.25M for workforce data infrastructure). By addressing root causes-workforce shortages, outdated care delivery models, and underutilized payment mechanisms-rather than providing temporary subsidies, this plan creates sustainable improvements in access, quality, and health outcomes for delaware's rural communities.