State-Funded Initiatives Underway to Ensure Rural Populations Have Access to High-Quality Physical and Mental Health Services; Addiction Supports
Efforts to Eliminate Barriers to Care, Reduce Stigma, and Address Shortages of Professionals Highlighted in Observation of National Rural Health Day
New York State highlighted state-funded efforts that are underway to ensure rural communities have access to high-quality physical and mental health care, in addition to addiction supports. In recognition of National Rural Health Day this week, the Office of Mental Health, Department of Health and Office of Addiction Supports and Services highlighted collective efforts to bolster access to care for the roughly 3.4 million New Yorkers living in rural areas of the state.
“All New Yorkers deserve high-quality, comprehensive health care,” Health Commissioner Dr. James McDonald said. “We are strengthening local health systems, investing in innovative models of care and working closely with our partners to ensure that geography is never a barrier to wellbeing. On National Rural Health Day, we recommit ourselves to improving access, expanding services, and supporting the dedicated providers who deliver care in every corner of our state.”
“Underserved populations including residents of rural communities can face unique health challenges. Our ongoing work to strengthen the continuum of mental health care includes a special focus on programs to reach New Yorkers who have traditionally lacked services,” Office of Mental Health Commissioner Dr. Ann Sullivan said. “Providing better access to flexible mental health supports in all settings is part of our dedication to reaching those in need whenever and wherever they are.”
“Working closely with our partners throughout the state, we have expanded health care services, including resources and supports for addiction, in rural areas across New York,” Office of Addiction Services and Supports Commissioner Dr. Chinazo Cunningham said. “These are places where people may face barriers to accessing care, such as a lack of reliable transportation, or long distances to travel to find the help they need. This observance is an important reminder of the need to remain committed to ensuring that all New Yorkers have access to these vital services no matter where they live.”
Founded by the National Organization of State Offices of Rural Health, National Rural Health Day is aimed at highlighting efforts by providers, organizations, and other stakeholders dedicated to address the unique healthcare needs of rural populations. New York State has roughly 43,000 square miles of rural land area, according to U.S. Census statistics, with about 3.4 million New Yorkers –more than 17 percent of the state’s population –living in areas considered rural.
Supporting Health Care
Earlier this month, the state Department of Health submitted New York's Rural Health Transformation Plan in an effort to improve access to care to these areas. This plan laid out initiatives leveraging local providers, regional partnerships, and statewide infrastructure to advance the state’s continued commitment to advancing high-quality affordable health care in rural communities.
The plan could secure New York critical federal funding this winter to implement four key initiatives. These include establishing coordinated rural health partnerships, strengthening these communities with technology-enhanced primary care, building a sustainable workforce, and investing in innovative technology and cybersecurity enhancements.
DOH also provided $19.5 million to 21 organizations through the Healthcare Education and Life-Skills Program, including to organizations serving rural communities. ‘HELP’ awards support health care education programs and improve retention at educational institutions, hospitals and area health education centers.
The agency provided 67 awards totaling $3.3 million to rural organizations as part of the federal grant to address health disparities. Also funded through this initiative were five mobile health vehicles to provide services in rural areas, $1 million through four large wellness contracts and more than $22,000 in personal protective equipment to communities designated as rural.
The Department also provided grants to 30 rural health networks to provide innovative, locally driven and evidence-based solutions to increase access to care. These networks focus on issues such as transportation, chronic disease management, workforce, food insecurity, overdose prevention, access to health insurance and prescription medications, health literacy, oral health, tobacco cessation and suicide prevention.
Mental Health Services
Under Governor Hochul’s landmark investments into mental health, New York is strengthening its system of care statewide, ensuring everyone has access to critical services and supports. Part of these efforts include building out community-based care statewide, with a particular focus on rural areas of the state.
Last summer, OMH established new Certified Community Behavioral Health Clinics in Cortland, Livingston, Yates, Ulster, Fulton, Jefferson, and Niagara counties, joining six others already serving rural communities. Developed in partnership with OASAS, these clinics expand access to care for individuals experiencing substance use or mental health issues, by providing an array of coordinated services –screening, assessments, and treatment planning – regardless of their ability to pay, place of residence, or age.
The agency also partnered with OASAS this summer to establish an Intensive Crisis Stabilization Center to provide 24-hour rapid behavioral health crisis intervention in the North Country. Staffed with psychiatric nurse practitioners, registered nurses, licensed mental health professionals, and peer support specialists, the Champlain Valley Family Center is now helping to reduce reliance on emergency room care for behavioral health issues and is addressing top regional health concerns, including suicide risk and increased overdose rates.
OASAS and OMH are developing two additional Intensive Crisis Stabilization Centers, which are slated for Elmira and Herkimer. These agencies are also jointly developing three Supportive Crisis Stabilization Centers to serve areas near Geneva, Binghamton, and the North Country.
There are now five OMH-funded Safe Options Support or ‘SOS’ teams canvassing areas in rural counties and providing outreach to people experiencing homelessness, offering the services they can rely on to secure housing and lasting stability in their lives. These teams have now helped permanently house roughly 200 people.
Given the challenges and barriers to serve individuals living in New York’s rural communities, OMH adapted existing programs to better serve these areas. For instance, the agency amended the model used for the Assertive Community Treatment and Critical Time Intervention programs to allow for smaller staff sizes to serve a condensed number of clients spread across larger geographic areas.
OMH is now funding 16 Critical Time Intervention teams –including six to serve youth –to provide New Yorkers with services during periods of transition in their care, such as from a hospital back into their community. The agency is also funding a rural Assertive Community Treatment or ‘ACT’ team operated by Children's Home of Wyoming Conference and providing around-the-clock person-centered care to individuals living in Chenango, Cortland, and Madison counties in Central New York.
Earlier this week, OMH hosted the Health Equity Summit in Albany, which focused specifically on addressing mental health inequities in rural communities. Attended by service providers, advocates, and others, the conference explored the social determinants of health and socio-economic factors that shape access to care, quality of services, and treatment outcomes for New Yorkers living in rural areas.
OMH has also been conducting statewide community engagement sessions –including 12 sessions in the North Country and four in Western New York –to gather input for improving local mental health services and advise new programs. These engagement sessions incorporated comments from more than 200 individuals living in rural areas and are ongoing.
OMH’s Farmers Supporting Farmers program is providing free, confidential consultation services to approximately 1,000 New Yorkers living in rural areas of the state, including many who are in need of mental wellness and behavioral health support. Earlier this year, the agency awarded $2 million to AIM Independent Living Center to operate a peer-driven culturally responsive program aimed at improving behavioral health outcomes and reducing suicide risk among farmers, agribusiness workers, and their families.
Addiction Services
OASAS has taken significant steps to expand addiction services in underserved areas of New York State, many of which are rural communities. This includes steps to increase access to medication through both brick-and-mortar programs and mobile medication units to bring services directly to people in their communities, in addition to offering a range of prevention, harm reduction, and recovery services.
OASAS expanded comprehensive outpatient and opioid treatment program clinics, which provide medication for addiction treatment and other addiction services in one location. There are now more than 40 of these programs in operation, with many focused on delivering life-saving care in rural areas.
To address transportation barriers, OASAS has provided nearly $22 million in opioid settlement funding to support non-medical transportation initiatives to help New Yorkers –including those in rural areas –access services to support their recovery goals, such as getting to treatment, doctors’ appointments, and job interviews. So far, this program has provided more than 43,000 rides statewide.
OASAS has also significantly advanced the distribution of harm reduction supplies statewide, including rural areas. To date, the agency has distributed more than 14 million fentanyl test strips, nearly 11 million xylazine test strips, and more than 371,000 naloxone kits for free through an online ordering portal.
The agency also provides direct treatment through state-operated Addiction Treatment Centers, which are in every region of the state and offer services to many individuals in rural communities. These centers provide individualized care that is responsive to the needs of New Yorkers, including those with co-occurring or underlying conditions such as psychiatric disorders.
Rural communities often face numerous healthcare challenges, including having limited access, provider shortages, an aging population, and individuals with complex needs.
The prevalence of depression and anxiety and suicide rates –particularly among youth and older adults –were significantly higher than the state average, according to a report released this fall by the New York State Association for Rural Health.
The state’s rural counties persistently reported higher rates of overdoses, binge drinking, alcohol-impaired driving, and tobacco use than other parts of the state, the report found. Likewise, the high prevalence of adverse childhood experiences was identified as a foundational driver of poor behavioral health.
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