Maryland Rural Health Transformation Program: Transform the Rural Health Workforce; Promote Sustainable Access and Innovative Care for Rural Marylanders; Empower Rural Marylanders to Eat for Health - Maryland’s Rural Health Transformation Program will enable our State to improve the health and well-being of the one-third of our residents who call rural Maryland home. Maryland, via the Maryland Department of Health (MDH), proposes three bold goals to tackle longstanding challenges. We will implement critical initiatives through a combination of Immediate Impact Funds – quickly expanding “shovel-ready” activities, and Transformation Funds – issuing competitive opportunities for transformational projects that require longer planning. Goal 1. Transform the Rural Health Workforce: Maryland will expand existing and implement new efforts to develop, recruit, and retain a strong health workforce, addressing multiple types of clinicians and allied health professionals across medical, behavioral health, and dental fields. For example, Immediate Impact Funds will grow the number of apprenticeships and increase other employment and upskilling opportunities for community health workers and other occupations. Transformation Funds will build a pipeline of future health professionals in rural communities and expand training, recruitment, and retention for providers. Goal 2. Promote Sustainable Access and Innovative Care for Rural Marylanders: To achieve a world-class health system for rural Marylanders, we will expand existing and implement new efforts to bring healthcare services into rural communities. This comprehensive initiative includes multiple avenues to leverage technological advances, grow provider capacity, and increase access. Immediate Impact Funds will expand primary care, specialty care, and school-based health center capacity; optimize health information technology including through artificial intelligence modeling for patient risk predictive alerts; and expand the use of telehealth. Transformation Funds will expand an array of physical and behavioral health services, deploy technology-enabled chronic disease management including remote patient monitoring, expand mobile health, and help provider practices adopt innovative care models. Goal 3. Empower Rural Marylanders to Eat for Health: Addressing consistent access to food is important for health promotion, chronic disease prevention, and overall well-being. Immediate impact funds will invest in infrastructure to improve access to nutritious, locally grown and raised foods. We will increase the supply of healthy foods in Maryland’s rural hunger hotspots, for example by addressing farmers’ post-harvest needs and expanding mobile markets and grocery stores. We will support education to strengthen demand for fresh, unprocessed foods. Transformation Funds will link rural Maryland farmers to large-scale local buyers through aggregation that stimulates market access. Transformation Funds will also establish purchasing strategies that prioritize local sourcing among buyers of all sizes. The proposed total budget over five years is $1 billion. We are committed to ongoing collaboration with partners and engagement with stakeholders to actively involve rural Maryland in shaping transformation strategies. Known subrecipients include Maryland State Departments of Agriculture, Emergency Management, Labor, and Housing and Community Development; as well as the Rural Maryland Council, Chesapeake Regional Information System for our Patients (CRISP), Local Health Departments, Local Emergency Medical Services, and the Maryland Area Health Education Center. Maryland will determine additional subrecipients through competitive Transformation Fund processes.