The presentation was held at the University of Arkansas Hope‑Texarkana’s Rapert Library Auditorium and was part of a statewide road‑show series aimed at explaining Arkansas’ newly approved Rural Health Transformation Plan and gathering local input. 

The audience included invited members of the community, health care leaders and elected officials, including Arkansas state Rep. Dolly Henley and Arkansas Sen. Steve Crowell, both of whom attended, as well as Jamie Pafford, CEO of Pafford Medical Systems, the operator of Southwest Arkansas Regional Medical Center.  Henley asked a question and Crowell commented during the discussion.

Nye said the purpose of the road show is not simply to explain a plan already written, but to listen.

“What we’re really doing is getting out in the communities and hoping to steal ideas from you that are doing health care in different parts of the state,” Nye said. “We’ve heard repeatedly that there’s a Little Rock bubble, and we’re trying to be very cognizant that this transformation program doesn’t need to be a one‑size‑fits‑all, Little Rock‑down solution.”

Nye said Arkansas’ Rural Health Transformation Plan, approved by the Centers for Medicare and Medicaid Services, spans 126 pages and outlines four major initiatives supported by 69 sub‑initiatives. Arkansas is expected to receive nearly $209 million over five years through the program.

“This is not ARPA money or CARES money,” Nye said. “We’re moving beyond one‑time infusions of cash. CMS has told us they want this to be transformative and sustainable beyond the five years of funding.”

David Long, a senior manager with the consulting team supporting the state’s Rural Health Transformation Program, said the initiative was created by Congress as part of the Big Beautiful Bill Act passed last year.

Long said the legislation established a $50 billion national Rural Health Transformation Program, funded over five years, with the goal of improving access, workforce, prevention and sustainability in rural health care across the country.

“These dollars are not about stabilizing the status quo,” Long said. “They’re about long‑term system redesign for how Arkansas delivers health care to rural populations.”

Long said Arkansas will receive its funding directly from CMS and distribute it to sub‑recipients based on the state’s approved plan. Funds must be obligated by October of each federal fiscal year and spent by the end of the following year.

Long outlined CMS’ five strategic goals for the program: improving rural population health, expanding access points, strengthening the health care workforce, encouraging innovative care delivery models and investing in technology. "CMS is really excited about innovation, new delivery models, telehealth, remote patient monitoring and the technology that supports those changes.”

Allowable uses of funds include workforce recruitment and training, care coordination, telehealth expansion, targeted facility renovations and planning for long‑term sustainability. New construction, paying down debt, covering operating losses or replacing existing funding sources are not allowed. Requests must stay within a limit of 20 percent of entities' annual budgets.

“These dollars cannot be used to supplant existing funding,” Long said. “If you spend money on something unallowable, CMS will make you send it back.”

Renovations, he said, must be tied directly to introducing or reintroducing services.

“It’s not about a shiny waiting room,” Long said. “It has to push tangible care forward.”

Nye added that renovation spending is capped at 20 percent of Arkansas’ annual allocation, which still allows more than $40 million statewide per year for targeted renovations

The Arkansas plan is organized around four initiatives: HEART, focused on prevention and community health; PACT, addressing access, care coordination and hospital stabilization; RISE Arkansas, targeting workforce recruitment and development; and THRIVE, expanding telehealth and digital infrastructure.

Under HEART, Long said the state is emphasizing early intervention, nutrition, physical activity and partnerships with schools, faith‑based organizations and community groups.

“CMS actually applauded Arkansas for including faith‑based communities,” Long said. “They told us we’re the only state that thought that broadly.”

PACT focuses on mobile units, specialty access, transportation, expanded scope of practice and regional collaboration through clinically integrated networks.

“The goal of stabilization is to lift facilities up so they can plug into regional networks,” Long said. “Not just a one‑time infusion.”

RISE Arkansas addresses workforce shortages through recruitment, retention, leadership training and career advancement, while THRIVE supports telehealth, remote monitoring, cybersecurity and revenue‑cycle improvements.

Throughout the presentation, both speakers emphasized sustainability.

“Every proposal has to answer the question: what happens after year five?” Long said. “That’s the word CMS uses more than any other.”

During a question‑and‑answer session, Nye said while collaboration is encouraged, individual hospitals may apply for funding when appropriate.

“Our preference is regional thinking,” Nye said. “But there are cases where a one‑off application makes sense.”

Asked about hospitals dealing with the results of deferred maintenance such as roofing or HVAC repairs, Long said CMS scrutiny will be high on those sorts of grants.

“If it’s tied to reintroducing services or maintaining access, there’s an argument,” Long said. “But deferred maintenance from bad leadership will be looked at closely.”

Sen. Crowell praised the pace of the program’s development, noting that Arkansas is ahead of most states.

“Government does not move this fast,” Crowell said. “Arkansas is further down the road than any other state.”

Nye said, in answer to Rep. Henley's question about the subject, final funding decisions will be made by DFA Secretary Jim Hudson, Health Secretary Renee Mallory and Human Services Secretary Janet Mann, with recommendations from staff and consultants.

He encouraged continued engagement through the program’s website, which appears new but which Nye said would be updated soon, and email inbox at info@arkansasrhtp.com

“This is meant to be grassroots,” Nye said. “If there’s a gap, we need you to tell us.”