BY: Senator Tanya Storer

Amidst the focus on the looming budget shortfall, there is some good news to share. Nebraska recently received notification that we have been awarded $218.5 million dollars through the federal Rural Health Transformation Program, the eighth largest state allocation nationwide! This five year national initiative aims to modernize rural health care delivery across America. Governor Jim Pillen has called it a once in a generation opportunity to Make Rural Nebraska Healthy Again, with implementation beginning in 2026 through the Nebraska Department of Health and Human Services. The program addresses challenges including provider shortages, geographic distances, food insecurity, and an aging population in a state where nearly 95 percent of counties are classified as rural or frontier.

Through this initiative, the Nebraska Department of Health and Human Services will implement a prevention first, technology enabled strategy to strengthen rural health systems statewide. The program includes coordinated efforts to reduce chronic disease through Food as Medicine initiatives, expand access to maternal, emergency, and preventive care through regional hub and spoke networks, and address workforce shortages through a growing local approach that recruits, trains, and retains rural health professionals. Investments in eHealth, mobile health units, enhanced pharmacy services, and remote patient monitoring will bring care closer to home, while expanded rural emergency behavioral health services will strengthen crisis response and early intervention.

Within this broader framework of rural health issues, memory care for our elderly stands out as one of the most urgent needs facing rural Nebraska. Approximately 35,000 Nebraskans aged 65 and older currently live with Alzheimer’s disease, a number projected to grow significantly as the state’s population continues to age. Rural assisted living facilities often struggle to accept Medicaid memory care residents due to the high costs associated with specialized staffing, dementia specific training, and secure environments, forcing many families to make tough decisions to either place loved ones far from home or attempt to manage care without adequate professional support.

There is hope on the horizon. Last year I introduced LB 61, a bill to strengthen support for memory care in assisted living settings by creating a new waiver for higher Medicaid reimbursement. LB61 recognized the higher cost of providing memory care and the need for sustainable reimbursement structures that work for rural facilities. The bill reflected concerns raised by providers, families, and local communities and ultimately helped position Nebraska to pursue federal solutions aligned with these state priorities. Thanks

to the cooperative work of the Nebraska Health Care Association and the Governor’s team, the total Rural Health Transformation Program will specifically support the expansion of memory care services in rural Nebraska, an investment that mirrors the policy proposed in LB61!

For families across rural Nebraska these resources will support sustainable, community based care that preserves dignity and continuity of care for loved ones suffering with Alzheimer's or dementia. The program prioritizes rural, frontier, and tribal facilities and encourages partnerships between assisted living providers, Critical Access Hospitals, and Rural Health Clinics to improve coordination.