Results from the Alabama Rural Health Roadshow – Alabama Rural Health Association
Alabama Rural Health Association Prioritizes Medicaid Expansion, mental Health Access
Updated June 4, 2025
Following a series of listening sessions across Alabama, the Alabama rural Health Association (ARHA) is focusing its efforts on Medicaid expansion, improved mental health access, and workforce progress to address critical rural health needs. The facts gathering roadshow, conducted in November 2022, engaged over 150 rural constituents and stakeholders in Montgomery, Hartselle, Atmore, and Livingston.
Participants discussed their experiences and suggested policy improvements related to rural health. The ARHA compiled the feedback, identifying key areas of concern and potential solutions to improve rural healthcare and promote healthy literacy.
the top policy needs identified were Medicaid expansion (41 votes), mental health access (34 votes), and workforce improvement (29 votes), encompassing recruitment, retention, compliance, and scope of practise. Rural transportation and health education also received meaningful attention,with 29 and 27 votes,respectively. These findings underscore the urgent need for extensive strategies to address healthcare disparities in rural Alabama and improve mental health access.
Other needs identified included telehealth utilization, social determinants of health, and broadband access. the association also noted concerns about provider rates,service coordination,and scope of practice for nurse practitioners and certified nurse midwives.These issues highlight the complex challenges facing rural healthcare providers and the need for innovative solutions to ensure access to quality care.
| Policy Needs | Results |
|---|---|
| Medicaid expansion | 41 |
| Mental health access | 34 |
| Workforce Improvement (recruitment, retention, compliance, scope of practice) | 29 |
| Rural transportation | 29 |
| Healthy literacy / health education issues | 27 |
| Increase in telehealth utilization, coordination and support | 20 |
| Social determinants of health (food insecurity, poverty, housing) | 15 |
| Broadband access | 11 |
| Increase provider rates with Medicaid | 9 |
| Coordination of services especially transportation | 9 |
| NPs/CNM increased scope | 8 |
| Food insecurities / food deserts | 8 |
| Standardized credentialing | 7 |
| Increase provider rates with Medicare | 7 |
| Expose students to health professions | 6 |
| Comprehensive sex education in k-12 | 6 |
| Not having enough doctors | 6 |
| Taking tools and skills away from rural/primary physicians (sending everything to specialists) | 6 |
| Rural residency training | 6 |
| Apprenticeships w/in health prof- tech schools, shadowing | 5 |
| Price gouging | 5 |
| Pharmaceutical cost | 5 |
| Family Support | 5 |
| elder/Disabled services | 5 |
| Too many people without insurance | 5 |
| Utilization of community health advocates | 5 |
| Increase state funding for ARMSA | 4 |
| Relationship building | 4 |
| Focus on multidisciplinary approach to PT care | 4 |
| Hospital vulnerability | 4 |
| EMS service availability | 4 |
| Physician fee schedule issues | 3 |
| High administration cost | 3 |
| Standardized claims filing | 3 |
| Safety in Schools | 3 |
| Community transportation | 3 |
| Knowing the community that’s being worked in | 3 |
| Funding | 3 |
| Awareness of resources | 3 |
| Health equity | 3 |
| Maintain Sources of income (post covid) | 3 |
| Not having docs in the correction locations in the state (incentive issues) | 3 |
| Delay in seeking services cost | 3 |
| Encourage physicians to recruit local | 2 |
| More cohesion w/ reg. agencies | 2 |
| Substance abuse (opioid, ETOH) | 2 |
Following the roadshow, the ARHA board convened in Clanton to discuss the findings and chart a course for the association. The board decided to prioritize advocacy for Medicaid expansion, enhance mental and behavioral health services, and improve health literacy through targeted education efforts. These action items reflect the ARHA’s commitment to addressing the most pressing healthcare challenges facing rural Alabamians and improving rural health outcomes.
What’s next
The ARHA will send a letter to Gov. Kay Ivey advocating for Medicaid expansion, aligning with National Rural Health Day.The association also plans to increase collaboration between mental health services and primary care, possibly through educational sessions, partnerships, or grant opportunities. Furthermore,the ARHA will focus on recruiting rural residents to expand its contact lists and provide direct assistance with health literacy and education.