Regional Convenings Surface Rural Health Priorities and Strategies for Oregon’s RHTP

ORH’s Oregon Rural Health Collaborative team conducted the first of many regional convenings in August and September to help communities prepare for future Rural Health Transformation Program (RHTP) funding opportunities in Oregon. Across eight regions, participants identified unique regional priorities and challenges. 
 
In Eastern Oregon, participants emphasized the need to expand models that bring healthcare directly to residents and called for greater flexibility in state and federal requirements related to education, licensing, staffing and insurance. Along the South Coast, participants stressed the importance of developing a coordinated regional strategy, not just simply expanding individual programs. In the Gorge, participants pointed to a gap between planning and action, identifying dedicated, paid coordination staff as a key solution. 
 
While each region raised unique concerns, several themes emerged consistently statewide. Workforce development and access to behavioral healthcare were the most frequently cited challenges both in the convenings and in pre-convening surveys, with housing and childcare repeatedly identified as underlying barriers to both recruitment and retention. 
 
Participants also shared candid feedback about the RHTP itself, a $50 billion investment in rural health nationwide established through H.R. 1, the 2025 federal budget reconciliation package. Organizations across every region described Oregon’s application process as complex and resource-intensive, particularly for smaller rural organizations. Many also expressed concerns about federal restrictions on the use of funding, including limitations related to capital projects, equipment replacement and long-term sustainability. 
 
Some participants even questioned the program's emphasis on innovation. 
 
“I am not in the innovation space necessarily,” one participant said. “I am in the keep people alive space.” 
 
While many participants expressed concern that H.R. 1 could deepen existing financial challenges facing rural healthcare providers, others viewed the RHTP as an opportunity to strengthen local healthcare systems and build long-term resilience. At the same time, participants voiced frustration with the state's rollout of the program. 
 
Sarah Andersen, ORH’s director of Field Services, said the feedback collected during the convenings will play a key role in shaping future regionally driven RHTP investments and funding opportunities, as well as informing the Oregon Health Authority’s (OHA) ongoing implementation of the program. 
 
“States were required to submit plans for RHTP funds very quickly and get money out the door within months during the program's first year,” Andersen said. “We know many organizations were frustrated by that process, but as an organization that has served rural Oregonians for nearly 50 years, we're grateful for OHA's commitment to directing these dollars to rural communities. That has not been the case in every state.”  
 
Andersen said that now that the state is beyond the initial phase of getting funds distributed quickly, OHA has the opportunity to be more proactive and collaborative. 
 
“That starts with these regional convenings hosted by ORH,” she said. “The ideas, priorities and partnerships emerging from these conversations will help shape Oregon’s implementation of the RHTP, as well as investments and grant proposals that strengthen rural healthcare and better position communities to navigate the challenges ahead under H.R. 1.” 
 
The discussions during the first round of convenings generated a wide range of ideas and priorities that ORH will continue refining with regional partners through virtual convenings during the winter before returning to in-person gatherings in the spring and summer. Those conversations will culminate in strong, regionally driven applications for RHTP funding in Years 2 and 3 of the program. 
 
The ORH Oregon Rural Health Collaborative team is evaluating the first round of convenings and will share a synthesis of findings with each region and OHA. In the meantime, an initial review reveals several common priorities and concerns that emerged across the state. Some of the most common issues and ideas center on workforce development, behavioral health, visibility of existing resources and shared staffing and resources.  
 
Workforce is the dominant statewide issue 
Organizations cited difficulties recruiting and retaining healthcare professionals and limited access to specialists. They called for expanding "grow-your-own" strategies, including rural training programs, apprenticeships, residencies and youth career pathways. Workforce challenges were also linked to broader issues including housing availability, wages and local economic development. 
 
In Northeast Oregon, participants suggested building on existing programs offered by Northeast Oregon Area Health Education Centers (NEOAHEC) and community colleges while extending career pathway programming to younger students, potentially starting as early as kindergarten. They also proposed creating a statewide health careers organization modeled after the National FFA Organization and Future Business Leaders of America. 
 
“That was one of our big ones,” said a participant while reporting out ideas from their table to the rest of the group at the August regional convening in La Grande. “To create something that would be all-encompassing, all statewide support, so that we can have a funnel from elementary and middle school all the way up.”  
 
While that concept alone is unlikely to become an RHTP grant proposal, elements of the idea have already received support through the program. 
 
NEOAHEC is part of Oregon AHEC, a statewide network within a national system designed to strengthen the healthcare workforce in rural and underserved communities. Through five regional centers and a program office housed at OHSU, Oregon AHEC provides educational and workforce development opportunities for students ranging from middle school through university health professions programs. Oregon AHEC received RHTP funding to expand healthcare career exploration camps, mobile training and clinical experiences to rural middle school and high school students. NEOAHEC also received a separate RHTP award to establish a preceptor payment program to support health professionals across Eastern Oregon in mentoring students in nursing, medicine, dentistry, pharmacy, physician associate and behavioral health programs. 
 
Participants across all regions noted that multiple organizations across the state offer workforce pathway programs. The regional convenings provide an opportunity to better coordinate those efforts, identify gaps in services and reduce duplication while identifying ways RHTP funding can support the existing infrastructure. 
 
Behavioral health and substance use 
Behavioral health was also a top priority across regions, with some calling it a “workforce problem.” Participants pointed to shortages of mental health providers, limited treatment capacity, barriers to access care and growing concerns around substance use and overdose response. At the same time, many regions identified persistent access challenges driven by geography, transportation barriers, specialty care shortages, state licensing barriers and the long distances people must travel to receive care. 
 
Need for better coordination and visibility 
Participants also emphasized that many communities already have strong partnerships and resources in place but need better coordination among them. Instead of creating new networks, organizations frequently called for stronger information sharing, clearer referral pathways, greater visibility into existing projects and services and more intentional collaboration among healthcare providers, community organizations and regional partners. Some ideas that came up included having staff dedicated to turning ideas into action. 
 
“Could there be a centralized project management effort to drive progress, action and results?” someone suggested at the convening in The Dalles. “If we don’t have somebody that we are paying to value their time to push along these action items, then it makes sense that we [stay stuck].” 
 
Shared staffing and resources 
One strategy that emerged across all regions for addressing workforce recruitment and retention challenges was sharing staff and resources across organizations, including specialty physicians, human resources support and costly software systems. 
 
During a group discussion in Burns, one participant described this approach as a form of “barrier mitigation,” allowing organizations with limited capacity to access regional resources, collectively hire staff or use shared funding without shouldering administrative and reporting requirements on their own. 
 
“There may be an opportunity there to pool resources regionally,” the participant said. 
 
Stay involved in the conversations 
The Oregon Rural Health Collaborative will continue the regional discussions with virtual regional convenings planned for November, January, February and March. Dates are to be determined. In-person convenings will resume in the spring, with four convenings scheduled in each region between April 2027 and July 2027.  
 
For more information and a complete list of convening dates and locations for each region, visit ORH’s RHTP website.