GROW Initiatives

Description: Establish Indiana Community Connect, a statewide coordinated care network that links hospitals, providers and community organizations to address needs such as food, housing and behavioral health. By integrating referrals into the EMR and ensuring follow-up, the initiative reduces preventable ER visits, improves health outcomes and strengthens support for vulnerable Hoosiers.

How will the 211 community connections initiative work with 988 and crisis services?
Indiana 211 and 988 serve different, but complementary roles. Indiana 211 has integrated resources with 988 contact centers throughout Indiana, who access the Indiana 211 guided resource search. This initiative will enhance opportunities for a multitude of providers to identify needs and connect individuals with resources at the point of contact.

If I need help with food or housing, how will this program connect me to resources?
Indiana 211 curates resources that help to connect individuals to local community programs based on their needs and geographic area served. The Indiana 211 community connections enhancements will facilitate direct referrals to these resources from a provider or care team with follow up and reporting on outcomes.

Will my doctor or hospital know if I get the help I was referred to?
When referrals are made through participating systems, specific follow-up information may be shared to support care coordination, consistent with privacy and consent requirements. Providers will have access to information if a referral was completed.

How does this reduce the number of people going to the ER for non-emergencies?
By addressing needs such as food insecurity, housing instability and access to services, this program helps to reduce situations that can lead to avoidable emergency room visits. Connecting individuals to appropriate community resources supports early intervention, improves stability and can potentially support better access to reduce the barriers to accessing health care.

Is participation required to receive care or services?
Participation is voluntary. Individuals may choose whether to accept referrals and pursue community resources. Consent is required for information sharing with community based organizations for the purpose of closing the loop to the referral.

Does this replace existing hospital or community programs?
No. This initiative complements existing programs by improving coordination and visibility of community resources rather than replacing current services.

What types of community organizations are included?
Participating organizations may include nonprofits, faith-based groups, local governments and other community providers that offer services addressing basic needs. You can locate the current guidelines for Indiana 211 resources by clicking here. Indiana 211 revisits these guidelines, and based on community needs, organizations that did not previously meet the guidelines may become eligible for the database.

What happens if resources are unavailable?
Availability of services varies by communities. When a need is not met in a community, Indiana 211 researches the situation to determine if there are resources that can be found.

How does this initiative support rural communities?
Indiana’s rural communities often face limited-service availability, transportation barriers and fewer points of access to support services. This initiative leverages the Indiana 211 as a statewide resource to help residents identify and access existing community resources regardless of location. By strengthening coordination and navigation, Indiana 211 helps ensure rural residents are not excluded due to geography.

Description: Modernize Indiana’s health information exchange (HIE) to connect rural healthcare facilities (hospitals, outpatient, long-term care, behavioral health), close data gaps and strengthen care coordination through EMR integration, technology enhancements, AI-driven dashboards and EMS collaboration.

What is an HIE?
A health information exchange (HIE) is a secure system that allows healthcare providers, hospitals, public health agencies and other partners to electronically share patient health information across different organizations and systems. By enabling timely access to this data, an HIE supports public health, clinical decision making and better care coordination. The Indiana Health Information Exchange (IHIE), founded in 2004, is the state’s primary HIE.

How does connecting rural healthcare facilities help patients get better care?  
Connecting healthcare facilities to a health information exchange improves patient care by giving providers timely access to a more complete picture of a patient’s health, regardless of where that care was delivered. This shared access has been shown to help reduce medical errors, avoid unnecessary or duplicative tests, and improve care coordination for providers across all healthcare settings.

What does it mean to “close data gaps,” and how does that affect me as a patient?
Closing data gaps refers to allowing different healthcare systems, technologies and providers to securely share and understand patient information with modern technologies, even if they use different electronic health record systems. When your health information can follow you through doctors’ offices, hospitals, pharmacies and other settings, providers have a more complete view of your medical history and don’t have to rely solely on what you remember or what exists in one system. For you as a patient, this contributes to an overall improvement in patient experience and smooth transitions between your providers.

How will EMS collaboration and improved interoperability make emergency care faster and safer?
Collaboration with EMS, through mobile integrated health (MIH), and improved interoperability will make emergency care faster and safer by extending care beyond traditional emergency response and ensuring critical patient information flows seamlessly between EMS, hospitals and community providers. Mobile integrated health programs allow EMS to assess, treat and connect patients to the most appropriate level of care, which will then be shared in near-real time to other systems. This combination may help reduce the number of times patients may have to visit the emergency room and allow you to receive timely care in locations that may be more convenient such as your home.

Description: Strengthening emergency care capacity in rural hospitals and EMS by ensuring readiness for pediatric and obstetric emergencies. Partnering with Indiana Emergency Medical Services for Children (IEMSC), Indiana Hospital Association (IHA) and Indiana Department of Homeland Security (IDHS), the initiative provides needs assessments, training, equipment and technical assistance.

What about hospitals that already provide obstetric services?
Birthing hospitals in Indiana are set to enhance the quality of maternal and newborn care by offering comprehensive education and support in collaboration with the Indiana Department of Health. As part of this initiative, each facility will have a thorough gap assessment to identify areas for improvement. This assessment will serve as a vital tool in ensuring that facilities meet the rigorous standards outlined by CMS for OB ED Readiness, ultimately promoting safer and more effective care for mothers and their babies.

How will rural hospitals be better prepared for emergencies with kids or mothers?
This program will support the development of policies and procedures, standardized training competencies, designated staff roles, and equipment to support hospitals in providing care for kids and mothers. This allows local healthcare providers and facilities to provide care to these populations and facilitate timely transportation to the most appropriate level of care.

The program, initiated by the Centers for Medicare & Medicaid Services (CMS), is dedicated to enhancing the preparedness of Obstetric Emergency Departments (OB ED) across various healthcare settings. Its primary objective is to promote safer and more effective care for mothers and their newborns, regardless of whether they are being treated in a birthing facility or a non-birthing emergency department. By developing a comprehensive and standardized approach to care, the program aims to ensure that every mother and infant receives consistent and high-quality treatment during critical moments in the emergency department, ultimately improving outcomes for both.

What kind of training or equipment will local EMS teams receive?
Local EMS teams may receive a combination of training and resources designed to enhance overall pediatric and obstetric readiness. This could include educational opportunities focused on best practices for emergency care, guidance on protocols, and access to equipment that supports safe and effective treatment for these populations. The specific details will vary based on local needs and available resources, but the goal is to strengthen capabilities and improve coordination across the continuum of care.

How does sharing information between hospitals and EMS make care faster and safer?
Sharing information between hospitals and EMS makes patient care faster, safer and more coordinated by closing critical information gaps before a patient reaches the hospital. Early awareness of incoming patients allows hospital care teams to be activated, ensuring diagnostic equipment and treatment resources are ready immediately. Information sharing reduces uncertainty and prevents errors. When hospitals receive accurate pre-hospital data, clinicians can avoid duplication of tests and procedures and make more informed treatment decisions upon arrival. This continuity of information helps reduced medication errors, missed diagnoses and inappropriate interventions. An improved continuity of care is achieved through information sharing. This allows for clear handoffs between EMS and emergency department staff, consistent patient histories from scene to hospital bed, and better documentation for follow-up care and quality improvement. When hospitals and EMS share timely, accurate information, patients get the right care faster with fewer risks.

Who is helping with this effort, and how will it improve care in my community?
This initiative is a collaborative effort between the Indiana Department of Health (IDOH), Indiana Department of Homeland Security (IDHS), Indiana Emergency Medical Services for Children (IEMSC) and Indiana Hospital Association (IHA).

This initiative will improve the quality and level of care for kids and mothers at rural hospitals in local communities. This allows local healthcare providers and facilities to provide care to these populations and facilitate timely transportation to the most appropriate level of care.

Description: Launch a statewide collaborative care model to combat obesity, diabetes and cardiovascular disease by establishing Cardiometabolic Centers of Excellence in each rural health region. The initiative equips 6,000 rural health professionals with Lifestyle Medicine training, embeds nutrition education in medical schools, and certifies up to 2,000 clinicians to lead preventive care. A feasibility study will also assess logistics for a rural Food is Medicine program, leveraging Hoosier-grown foods and telehealth-based nutrition therapy.

What is cardiometabolic health and why is it a priority for rural Indiana?
Cardiometabolic health refers to the overall functioning of the heart, blood vessels and metabolic systems, measured through indicators such as blood pressure, blood glucose, cholesterol, body composition and inflammation. Strong cardiometabolic health reflects optimal metabolic function and reduced risk of chronic disease.

Indiana ranks among the worst states nationally for obesity, diabetes and hypertension. Rural communities experience higher disease burden, fewer preventive services and limited specialty access, making cardiometabolic disease a major driver of avoidable hospitalizations, ED visits and long-term healthcare costs.

How do I identify my region’s cardiometabolic center of excellence? What information is required?
As part of Initiative 12: Make Rural Indiana Healthy Again Regional Grants, all eight rural regions must select a regional implementation site for the Rural Cardiometabolic Health program. These sites will become Centers of Excellence and serve as the regional hub for cardiometabolic health for their regions. These sites will be selected in Year 1 of GROW as part of the regional grant application process.

What kind of training will doctors and nurses get to improve care and prevention?
Lifestyle medicine is an evidence-based clinical approach that uses food, physical activity, sleep, stress management, social connection and avoidance of risky substances as first-line interventions to prevent, treat and even reverse chronic disease. By equipping clinicians with structured tools and training to address the root causes of cardiometabolic conditions, it shifts care upstream — reducing reliance on acute services, improving patient outcomes and strengthening the role of prevention in everyday clinical practice.

Up to 6,000 rural health workforce members (physicians, RNs, APPs, dietitians, CHWs, care managers, etc.) will receive Lifestyle Medicine training to improve care and increase preventive focus.

Up to 2,000 clinicians (MDs, NPs and RNs) will receive Lifestyle Medicine Board Certification.

How will the Food is Medicine program use local Hoosier-grown foods to support healthier living?
The purpose of the Food is Medicine (FIM) feasibility study is to evaluate the end-to-end logistics of delivering rural FIM programs, with a strategic focus on sourcing Hoosier-grown foods. The study will guide future implementation of FIM programming by assessing:

• Procurement/sourcing of local foods
• Storage and distribution
• Clinical integration
• Telehealth-based nutrition therapy
• Reimbursement pathways
• Infrastructure needs

Can GROW funds be used to purchase food?
No. Funding is solely for infrastructure, planning and feasibility analysis.

Description: Ensures patients receive prescribed medications before leaving the hospital, eliminating access and transportation barriers. By charging outpatient prices and providing bedside counseling, the program improves recovery readiness and reduces readmissions.

How does this affect reception of my medicine? Will this make it easier for me to get my medicine before leaving the hospital?
The goal of the initiative is to provide people with medication prior to leaving the hospital. This should make it easier for you to get your medicine since you won’t have to try to find a pharmacy after leaving the hospital. You will be able to go home and recover from your illness without immediately worrying about finding your medicine.

Will this initiative also include helping develop or expand retail pharmacy programs within our rural hospitals?
Local circumstances and approaches to the provision of medications prior to discharge may vary. However, for those interested in developing or expanding retail pharmacy programs within their hospitals, the initiative should assist in doing so.

Will the medications cost less because they’re charged at outpatient prices?
Yes, given at outpatient prices, they will cost less than inpatient medications. The medications will still be billed to insurance as if you are visiting a pharmacy in your community even though you are receiving them in the hospital.

How does bedside counseling help patients recover and avoid going back to the hospital?
Bedside counseling prior to discharge helps patients better understand how to care for themselves once they get home. In addition to receiving all the medications they need, the opportunity to discuss the proper timing and dosages ensures that patients optimize their home treatment. The result is that patients can continue improving once they get home and avoid going back to the hospital.

Description: This initiative assesses existing provider networks and specialty gaps while building a secure teleconsultation system to expand access to high-need specialties such as psychiatry and behavioral health. By addressing barriers like credentialing and payment incentives, and leveraging AI to optimize consultation availability, the initiative strengthens rural healthcare infrastructure. Competitive partnerships will support rollout across communities, ensuring sustainable, scalable access to specialty care.

What is the difference between telehealth and teleconsult?
Telehealth and teleconsultation (teleconsult) both use digital communication technologies to support remote patient care. Telehealth connects patients with healthcare providers, while teleconsult connects healthcare providers with specialists to assist with diagnosis and treatment of their patients.

What is a teleconsultation system, and how will it impact patients?
A teleconsultation system is an established network of specialty providers who are available for consultation by other health care providers, like primary care, via an electronic platform. This can significantly improve care for patients by expanding access to specialty expertise, reducing wait time and unnecessary referrals, and helping patient receive appropriate care closer to home.

How will this program make it easier for people in rural areas to have access to specialists like psychiatrists?
This program will make it easier for people in rural areas to access specialists by allowing their local healthcare provider to connect directly with specialist expertise without traveling to an office that could be miles away. Instead of waiting weeks or driving long distances for an in-person appointment, a provider can securely share patient information and clinical questions with a specialist, who can review and provide guidance remotely.

How does this initiative make sure there are enough specialists available when patients need them?
Specialists will be available through a network of providers who may not be located directly within an individual’s community but are able to consult with local providers. This consultation can be offered both directly in a patient setting or within a defined time frame, which can reduce the need for a patient to visit a specialist in person.

Description: Indiana will conduct a statewide feasibility study to assess rural provider networks, infrastructure gaps, and opportunities for remote health monitoring using wearable devices to reduce clinician burnout and improve patient outcomes. Findings will guide the rollout of a unified telehealth system, procured through competitive selection, with solutions designed for rural connectivity and enhanced by AI-driven decision support.

What is a unified telehealth system?
A unified telehealth system is an integrated, statewide approach that delivers virtual care through a coordinated platform and standards. Rather than solely relying on disconnected technologies that may be offered by a single health system or care network, a unified system aligns technology, workflows, scheduling, data sharing and governance so telehealth services work seamlessly together.

Would telehealth kiosks or similar be included under the telehealth initiative?
Yes, there is potential for telehealth kiosks or other similar technologies to be included under the telehealth initiative. Recommendations for the specific technologies that may be offered to rural communities will be informed by the statewide feasibility study and assessment of current provider networks and infrastructure.

Will psychiatry be one of key specialties?
Psychiatry may be one of the key specialties that will be incorporated in our implementation of expanded telehealth services. Like the technology implementations, the targeted specialty areas will be dependent on the outcome of our feasibility study and likely will be focused on high-priority areas including psychiatry and behavioral health, maternal health, and chronic disease management, among others.

Could the workforce requirement of five years of service spent in rural areas (e.g., tied to residency training programs or fellowships) be fulfilled by clinicians providing telehealth to rural communities?
Yes, delivering telehealth to rural communities may count towards service requirements; however, this is highly dependent on the program and is directly tied to state policies and licensure requirements. This will likely be incorporated in the overall statewide telehealth assessment with specific recommendations assessed throughout the duration of the program.

Description: Expands the rural health workforce by funding certification and upskilling for Community Health Workers (CHWs), who play a vital role in connecting patients to care, reducing hospitalizations and improving chronic disease outcomes. In partnership with a state-wide university system, the initiative will also launch career pathway programming for rural high school students, offering early exposure and training toward health careers.

Does this initiative include other paraprofessional workers or just CHWs?
Yes, this initiative will include other health career paraprofessional training and certifications including LPN, CNA, EMT, MedTech. We are also partnering with Initiative 11 to include the CPRC training.

How will this program help rural communities get more support from trained health workers?
This initiative will help rural communities by:

• Increasing exposure to healthcare career pathways for high school students
• Eliminating cost barriers for rural students and adult residents who pursue healthcare credentials and training
• Maintaining a trained workforce for employability at healthcare providers in rural communities
• Increasing healthcare employment opportunities in the rural communities where residents reside

What opportunities will high school students have to start learning about health careers early?
Through the Healthcare Academy, students living in rural communities entering grades 9 through 12 can attend free-of-charge an eight-week summer program on campus that will expose them to a spectrum of healthcare careers.

Description: Indiana will expand Graduate Medical Education (GME) capacity and incentivize physicians to practice in rural communities through targeted grants and stipends in key specialties such as primary care, pediatrics, OB/GYN and general surgery. To strengthen the training pipeline, the state will provide stipends for rural clinical preceptors, require rural rotations for medical students by 2028, and launch a statewide preceptor database to connect students with rural training opportunities.

Will psychiatrists be part of the GME initiative?
Yes, psychiatry residencies will also be included as part of the GME initiative. A strategic rural GME plan will help to identify critical specialties in rural areas to ensure that funding is supporting the most important community needs.

How will medical students get hands-on experience in rural hospitals and clinics?
A preceptorship program will incentivize rural clinicians, including physicians, to serve as mentors and train students in a community setting with real-world patient care.  Students will develop essential clinical skills, professional confidence and a deeper understanding of patient care within the context of a rural community.

How will this program encourage more doctors to work in rural communities?
Student exposure to rural clinical training correlates to eventual practice in rural areas. A study looking specifically at Family Medicine residency training found that fewer than 10% of medical school graduates had any rural clinical training. However, when rural clinical training was offered, it is associated with a five- to six-fold increase in subsequent rural practice.

Description: Indiana will grow and retain the rural behavioral health workforce by creating university-based certificate and degree programs, offering scholarships and stipends, and introducing career pathways for high school and college students. The initiative strengthens peer support by expanding Certified Peer Support Specialist training and continuing education, while sustaining internship programs that incentivize local practice. A statewide workshop will also equip rural paraprofessionals with threat assessment and management skills to improve crisis response and community safety.

Do workforce recruitment and retention programs focused on K-12 populations still need to meet the minimum five-year workforce requirement?
No

What is behavioral health?
Behavioral health refers to the connection between a person’s behaviors, emotions and overall well-being, encompassing mental health conditions, substance use and lifestyle habits that affect physical health. It is a holistic concept that integrates how thoughts, feelings and actions influence both mind and body.

How will this program bring more mental health professionals to rural communities?
By building a local talent pipeline, lowering financial barriers, and strengthening community infrastructure, Indiana ensures that rural areas are not just training grounds but sustainable places for behavioral health careers. This combination of education, incentives and support systems makes rural practice more appealing and viable, directly increasing the number of providers who choose to stay.

What opportunities will students and local workers have to get training, scholarships or internships in behavioral health? Do I need to apply?
This initiative is structured so that students and local workers can access multiple entry points — education, financial aid, peer support, internships and training workshops — each requiring some form of application or enrollment.

• Students will apply through their universities or colleges for certificate/degree programs and scholarships.
• Local workers will apply through state or community-based programs for peer support training, continuing education and workshops.
• Internships typically require placement applications, often coordinated through universities with behavioral health providers including state hospital systems.