Strengthen rural communities across New Jersey by improving their health through transformation of the healthcare delivery ecosystem. - New Jersey is home to over 1 million rural residents, who live in eleven of our twenty-one counties: Atlantic, Burlington, Cape May, Cumberland, Hunterdon, Mercer, Monmouth, Ocean, Salem, Sussex, and Warren. Our rural New Jerseyans live in 40 federally-designed “rural census tracts” and in 7 state-designated “rural” counties. Rural New Jerseyans are more likely to live in areas facing a healthcare workforce shortage, experience more SUD-related health impacts, and are less likely to make it to an annual pediatric well-visit appointment. The Division of Medical Assistance and Health Service (DMAHS) is the State’s Medicaid Agency and is applying on behalf of New Jersey to receive $1 billion in federal funding through the Rural Health Transformation Program. If awarded, this funding would strengthen our State’s ability to direct resources and focus towards transforming the healthcare of rural New Jerseyans over the next five years. DMAHS has been working closely with NJ’s State Office of Rural Health and other stakeholders for this application—and will continue to do so to achieve our goals of building our rural-serving healthcare workforce, and adapting care delivery to be responsive to rural residents’ wishes and needs. We propose directing funding in five Initiatives areas: 1. RHT1 supports recruitment, training, and retention of clinical and non-clinical providers 2. RHT2 provides funding for essential providers of behavioral health (CCBHCs), primary care (FQHCs), and emergency medical services (hospitals) 3. RHT3 encourages regional partnerships to strengthen care delivery outside of brick-and-mortar offices—including telehealth, remote patient monitoring, and mobile care 4. RHT4 funds community-level efforts to promote preventive health 5. RHT5 invests in an array of evidence-based interventions and data integration efforts to improve chronic disease treatment We will take a hybrid funding approach, where we blend directed funding with competitive funding. This allows us to jumpstart RHT-funded activities immediately when funded while still preserving our ability to fund the best ideas that can arise from a competitive application process. To support the success of NJ RHT, we have sought out partnerships with innovation leaders (like SciTech Scity, a public-private collaboration to support digital health adoption), hospitals (University Hospital, which leads statewide emergency response), and academic partners (Montclair University, a state leader in reflective supervision) to help with key activities. DMAHS will also rely on our strong partnership with public health partners at the Department of Health to leverage RHT funding to adapt our healthcare ecosystem to better meet the needs of rural New Jerseyans and help them thrive.