Initiative Four

Initiative Four: Growing a Highly Skilled Healthcare Workforce in Rural Georgia 

  • RHT Program Strategic Goal: Workforce

  • GREAT Health Vision Alignment: Needs of Rural Populations. In Rural Places.

Together, these strategies form a coordinated approach to strengthening Georgia’s healthcare workforce pipeline, particularly in rural and underserved areas. Each strategy addresses a distinct stage of healthcare education, training, and retention, forming a comprehensive system that builds, supports, and sustains the workforce from early interest in health careers to advanced clinical practice and continuing education. Strategies include scholarships to recruit and train EMS professionals, efforts that encourage rural Georgians to work where they live, and programs that expand access to and depth of training across multiple provider types. Collectively, these efforts aim to increase not only the quantity but also the quality of Georgia’s rural healthcare workforce. By supporting every phase of the workforce journey, including education, training, placement, and retention, Georgia is establishing a pipeline that ensures rural communities have access to highly skilled providers committed to serving for years to come.

The following are key outcome metrics associated with this initiative. Additional metrics are included in the Metrics and Evaluation plan section. Unless otherwise indicated, baseline measures are zero and will be established at Year 0 of the program; the proposed outcomes will be observed by FY31. 

Outcomes

The outcomes of this initiative will be measured by: improved retention of students retained as rural providers (target rate is 15%); increased number of rural students trained in rural areas (target rate is 30%); decreased non-emergent ED visits (target is 24%); and reduced EMT turnover rates at the county-level (target is 15%) (Georgia Department of Community Health, 2024).

Overall Funding for this Initiative 

$36,876,730 in Budget Period 1.

Table 5: Strategies of Growing a Highly Skilled Healthcare Workforce in Rural Georgia

This table was reformatted as an ordered list for better readability.

  • Rural Medical Workforce & GME Enhancements
    • Key Context        
      • Clinicians trained in rural areas are more likely to remain in those communities (Ogden, 2020)
      • Early placement and engagement of student providers in rural communities can increase the number of primary care providers available to rural residents.
    • Transformative Care Solution: Four Strategies to Strengthen the Rural Medical Workforce        
      • Expanding graduate medical education (GME) residencies by funding 75 new residency slots per year in family medicine, obstetrics, internal medicine, pediatrics, psychiatry, and gerontology
      • Increasing funded fellowship opportunities by 12 per year
      • Establishing the state’s rural recruitment incentive grant program to recruit doctoral-level providers (e.g. physicians, optometrists, audiologists, and clinical psychologists) to rural areas for at least 5 years and providing up to $250,000 for relocation costs, equipment, technology, or clinic expansion. 
        • Note: The Georgia Board of Health Care Workforce’s statutory authority provides for the provision of various provider assistance programs. Their current, time-tested guidelines for ensuring provider compliance with service agreements includes annual reporting on service and 2x award recoupment if service is not completed.
      • Enhancing current programs by providing funding to two GME programs to expand primary care residencies to rural Georgia
    • Key Activities        
      • Establish a statewide consortium, build tracking systems, launch first recruitment and incentive grants, train first cohort of residents, scale up, conduct evaluation throughout, full implementation of training slots
    • Use of Funds        
      • E. Workforce
    • Technical Score Factors        
      • C.1. Rural provider strategic partnerships
      • D.1. Talent Recruitment
    • Key Stakeholders        
      • Academic medical institutions and teaching hospitals, FQHCs, physicians, doctoral level students and graduates, GA Board of Health Care Workforce (GBHCW)
    • Measurable Outcomes        
      • Number of GME residency slots (desired trend increase)
      • Number of fellows and distribution percentages across multiple specialties (desired trend increase)
    • Counties Impacted        
      • 126 HRSA-rural counties/portions of counties
    • Estimated Funding        
      • $148,000,000 total / $21,600,000 in Budget Period 1
    • Results and impact        
      • Georgia will become a nationwide leader in rural health innovation for provider recruitment, due to strong collaboration with the medical community, legislature, and state agencies.
         
  • Nursing Care Improvements
    • Key Metrics
      • Georgia will be facing the second highest nursing shortage by 2030 at 21% (Georgia Nurses Association, 2024)
      • The majority of University System of Georgia (USG) institutions are in rural areas.
      • Lack of qualified nursing faculty restricts program expansion and results in hundreds of qualified applicants turned away each year: between Q3 2024 and Q1 2025, USG denied admission to at least 583 qualified ASN & BSN applicants
    • Transformative Care Solution: Five-Part Nursing Workforce Strategy
      • Advancing Nursing Degrees program to support faculty advancement through work release time and tuition assistance
      • Clinical faculty orientation toolkit to standardize training and improve instruction
      • GA-CARE (Commitment to Assist in Recruitment of Educators) Tuition Reimbursement and Stipend Program4 to provide financial support for nurses wishing to earn teaching degrees. Note: Collaboration with the Georgia Board of Healthcare workforce will ensure existing provider rules for length of service are accounted for in benefits.
      • Nurse Summer Camps to inspire students to pursue nursing careers
      • Simulation Training Expansion at Georgia College & State University to grow the Healthcare Simulation Certification Program and provide rural nursing schools with simulated patient mannequins
    • Key Activities        
      • Establish program infrastructure and partnerships
      • Implement toolkit and camps
      • Expand program
      • Strengthen simulation training
      • Evaluate, refine, scale statewide
    • Use of Funds
      • E. Workforce
    • Technical Score Factors        
      • D. 1. Talent Recruitment
    • Key Stakeholders        
      • High schools, colleges and universities, nursing faculty, health systems
    • Measurable Outcomes
      • Number of nursing faculty earning an advanced degree (desired trend increase)
      • Number of attendees at nurse summer camp (desired trend increase)
    • Counties Impacted        
      • Statewide
    • Estimated Funding        
      • $22,375,000 total/ $5,315,000 in Budget Period 1
    • Results and impact
      • Creating sustainable pathways for recruiting, training, and retaining nursing faculty and students
      • Ensuring rural communities have the skilled nursing force they need
         
  • Telehealth Mentoring for Dementia
    • Key Metrics        
      • Number of adults 65 or over with Alzheimer’s and related dementias in Georgia: 188,000 or more (Alzheimer’s Association, 2025)
      • Projected Medicaid cost in 2025 for dementia in rural areas: $1.7 billion (Division of Aging Services, 2024)
    • Transformative Care Solution: Expand dementia care capacity        
      • Launch statewide Telehealth Mentoring Program
      • Establish Dementia Training Hub for education & resource delivery
      • Deploy micro learning modules and virtual convenings
      • Expand access to online training platforms (ALZPro)
    • Key activities        
      • Establish training hub, launch mentoring program with ECHO model, expand participation, deploy learning modules, introduce online training platform, evaluate, scale statewide
    • Use of Funds        
      • A. Prevention and Chronic Disease, 
      • D. Training and Technical Assistance,
      • E. Workforce
    • Technical Score Factors        
      • B.1. Population health clinical infrastructure
      • C.1. Rural provider strategic partnerships
      • E.2. Individuals dually eligible for Medicare and Medicaid
    • Key Stakeholders        
      • Patients and families of those with dementia, hospital associations, universities and academic medical centers, local hospital administrators
    • Measurable Outcomes        
      • Number of Project ECHO Learning Collaborative cohorts (desired trend increase)
    • Counties Impacted        
      • 126 HRSA-rural counties/portions of counties
    • Estimated Funding        
      • $10,394,001 total/ $2,008,730 in Budget Period 1
    • Results and impact        
      • Create strong, ongoing network of professionals
      • Ensure high quality & consistent dementia care
      • Expand support for family caregivers
      • Reduce avoidable hospitalizations and costs
      • Strengthen rural health systems
      • Enhance quality of life
         
  • Area Health Education Center (AHEC) Training & Housing
    • Key Context        
      • Georgia’s Area Health Education Centers (AHECs) coordinate community-driven solutions through student-centric programming
    • Innovative Care Solution: Workforce recruitment through AHEC Network        
      • Offer short-term (less than 6 months) housing for job shadowing & professional learning opportunities in rural areas
      • Update Health Careers in Georgia manual and expand/digitize informational resources on healthcare careers
      • Hold workforce transformation meetings & events and conduct rural workforce needs assessment
      • Expand Preceptor Tax Incentive program to support rural rotations and provide continuing education for preceptors. 
        • Note: In 2014, Georgia became the first state to institute a Preceptor Tax Incentive Program, allowing a tax deduction to community-based physicians who provide uncompensated training to medical students. Retrieved from: https://www.augusta.edu/ahec/ptip.php
      • Train students as Digital Health Navigators to teach in the community
    • Key Activities
      • Digitize manual, update videos, expand housing support, conduct needs assessment, expand high school and college pipeline programs, conduct regional meetings, train medical students as navigators, conduct evaluation
    • Use of Funds        
      • E. Workforce
    • Technical Score Factors        
      • C.1. Rural provider strategic partnerships
      • D.1. Talent Recruitment
    • Key Stakeholders        
      • Healthcare students, universities, Georgia Board of Health Care Workforce (GBHCW), providers, and patients
    • Measurable Outcomes
      • Number of continuing education and workforce development opportunities in rural counties (desired trend increase)
      • Number of community members reached through Digital Health Navigator student trainings (desired trend increase)
    • Counties Impacted
      • 126 HRSA-rural counties/portions of counties
    • Estimated Funding        
      • $650,000 total / $133,000 in Budget Period 1
    • Results and impact        
      • Increased exposure to rural health opportunities for students
      • Increased engagement for rural students
      • Expanded training, recruitment, & continuing education efforts
      • Enhanced professional satisfaction for preceptors
         
  • Emergency Services Scholarships
    • Transformative Care Solution: Establishing new scholarship program
      • Funding rural student participation in certification/Earn While You Learn programs removes financial barriers for new Emergency Medical Technicians (EMTs) and paramedics
      • Creates sustainable pipeline of responders
      • Requires at least 5-year commitment to servicing rural communities
      • Regulations will be developed in coordination with GBHCW for maximum impact
    • Key Activities        
      • Develop criteria for scholarships, launch program, select first cohort with EMS training programs and colleges, expand, offer mentor program, refine, scale, evaluate
    • Use of Funds        
      • E. Workforce
    • Technical Score Factors        
      • C.2. EMS
      • D.1. Talent Recruitment
    • Key Stakeholders        
      • EMS associations, communities, payers, training organizations/colleges
    • Measurable Outcomes        
      • Number of scholarships to qualified EMT and paramedic applicants (desired trend increase)
    • Counties Impacted        
      • 126 HRSA-rural counties/portions of counties
    • Estimated Funding
      • $39,100,000 total / $7,820,000 in Budget Period 1
    • Results and impact        
      • Expanded access to emergency care
      • Improved response times for better patient outcomes
      • Lasting impact on public health & safety

Sustainability Efforts

Sustainability planning for workforce development programs is essential to building a resilient, long-term healthcare workforce, ensuring continued impact beyond the initial infusion of support provided by RHT Program funding. In Georgia, these plans include creating public-private partnerships in which private organizations absorb training and residency activities in exchange for return-for-service commitments or tailored workforce pipelines. Some training opportunities may be embedded into revenue-generating services, such as clinical training within billable departments. Once the value of trainings is established, course fees may serve as a future funding source. The state’s Preceptor Tax Incentive Program, providing tax credits to providers who train medical students, will also ensure the viability of training programs. Additional options include income-sharing agreements and employer-sponsored tuition models, where learners commit to serving with the organization post-training.

The combined strategies of the GREAT Health Program Growing a Highly Skilled Healthcare Workforce in Rural Georgia initiative and the RHT Program workforce goal will ensure a future where all rural residents benefit from the recruitment and retention of a healthcare workforce that is empowered to engage patients for improved outcomes.