STATE OFFICE OF RURAL HEALTH - The Michigan Center for Rural Health (MCRH), housed on the Michigan State University campus, is Michigan's governor-designated State Office of Rural Health. Consistent with the purpose of the SORH Program, MCRH maintains the focal point for rural health in Michigan: an institutional framework linking small rural communities with state and federal resources to develop long-term solutions that improve access to and quality of care. Over the July 1, 2026-June 30, 2031 period of performance, MCRH will carry out the three required SORH functions—maintaining a statewide clearinghouse for information on rural health issues, research findings, and innovative care delivery approaches; coordinating rural health activities statewide to avoid redundancy; and identifying federal and state rural health programs and providing technical assistance so public and nonprofit entities can participate—plus recruitment and retention activities and new substance use disorder (SUD) programming. Fifty-three of Michigan's 83 counties are rural, covering 94 percent of the state's landmass but holding only 16 percent of its population across two peninsulas and four inhabited island communities. Nearly all rural counties are Health Professional Shortage Areas for primary care, behavioral health, or dental care, affecting an estimated 1.7 million residents. Six rural hospitals have closed since 2005, two in the last two years; 10 rural counties have no hospital, and more than one-quarter of remaining rural hospitals operate with negative margins. Nearly 40 percent of rural counties have no practicing OB/GYN. Rural counties skew older, and chronic disease, overdose mortality, poverty, and food insecurity exceed urban rates while broadband gaps limit telehealth. Population served. Residents of Michigan's 53 rural counties, the Upper Peninsula, northern Lower Peninsula, the Thumb, southern border counties, and island communities—and the providers who serve them: 35 Critical Access Hospitals, one Rural Emergency Hospital, 31 rural PPS hospitals, 210 certified Rural Health Clinics, 146 FQHC sites, rural EMS agencies, opioid treatment providers, and Recovery Homes. Proposed services. (1) Clearinghouse/information dissemination: monthly SORH newsletter reaching 7,000 people, monthly RHC newsletter, new quarterly SUD newsletter, social media, the Annual Rural Health Conference (330 attendees), a new Annual Rural SUD Summit, and monthly office hours for hospital CEOs, Recovery Home operators (new), and workforce recruiters (new). (2) Coordination: participation on statewide and national bodies (NOSORH, NRHA, FORHP, TASC, 3RNet) and working relationships with 100 percent of rural hospitals and opioid treatment providers, 90 percent of RHCs, and 60 percent of rural FQHCs by June 2027. (3) Technical assistance: grant-seeking TA for rural communities, new RHC and opioid treatment provider operations support to reduce decertifications, and roughly 3,500 annual continuing education contact hours through Grand Rounds and Project ECHO. (4) Recruitment and retention: 3RNet placements, outreach and rural visits for medical, PA, and NP students, the OsteoCHAMPS camp, and three new rural clinical rotations. (5) SUD: Recovery Home advocacy and sustainability work, Mental Health First Aid trainings, Jail Release Simulations, and opioid settlement guidance for county commissioners. Activities advance MAHA priorities including chronic disease prevention, mental health, primary care access, and preparation for value-based care. Expected outcomes include a consistent, reliable information source for rural stakeholders, increased federal and foundation dollars leveraged into rural communities, fewer RHC and OTP decertifications, more providers placed in rural practice, and an increase in rural Recovery Homes. The required non-federal match (three times the federal share) is met through state appropriation and program income.
