(The Center Square) – Tennessee is receiving $206.9 million from the Rural Health Transformation Program, and lawmakers are calling on state health officials to ensure the money is truly “transformational.”
The money is from a $50 billion initiative approved as part of the Working Families Tax Cuts legislation. States were required to submit applications that identified how the money would be spent.
The Tennessee Department of Health outlined a strategy for the grant fund that focused on five different areas: Rural Health Transformation, Maternal and Child Health, Technology Infrastructure, Make Rural Tennessee Healthy Again and Workforce Development.
The Joint Finance Ways and Means Committee agreed to receive the money but had several questions.
Sen. London Lamar, R-Memphis, was among several lawmakers from both parties who had concerns about how the grant funds would be spent.
“I left the meeting with more questions than answers,” Lamar said in an interview with TCS. “I think they need to lean into legislators like myself who have been pushing effective and efficient solutions for maternal health in their decision making around this.”
Lamar is advocating for doulas to help pregnant women. Tennessee has the highest maternal mortality rate in the country, according to a report released by the Centers for Disease Control and Prevention last summer.
Lamar introduced a bill that would require Tennessee’s Medicaid program, known as TennCare, to cover doulas who assist women in childbirth.
“Half the women that are dying are on TennCare so we are not doing a good job thus far,” Lamar said in an interview with TCS.
Sen. Bo Watson, R-Hixson, said he didn’t hear anything “transformational” in the Department of Health’s plan.
“I kind of hear, ‘Hey we’re going to have additional dollars to put into the systems that we already have in place,'” Watson said during a meeting of the Finance, Ways and Means Committee. “I’m just not interested in more money into a system that we all recognize here is not delivering in the rural areas of the state.”
The state will initially receive $100 million. The rest of the dollars are “competitive” and based on the state’s “strength of our application and our commitment to meaningful reform,” according to Michael Hendrix, policy director for Gov. Bill Lee.
New questions were also raised about the state’s certificate-of-need requirements, which require health care providers to demonstrate a “need” for a new facility before construction. The application includes a promise to reform the state’s certificate-of-need requirements.
Only 12 states do not have certificate-of-need requirements, according to the National Conference of State Legislatures. The General Assembly passed a bill in 2024 that eased certificate-of-need restrictions on some imaging services and other facilities.
Watson and Rep. Johnny Garrett, R-Goodlettsville, have a bill pending that would remove certificate-of-need requirements for acute care hospitals. But as of Friday morning, there is no bill pending that would completely eliminate them.
Rep. Ryan Williams, R-Cookeville, asked if the state could lose some of the competitive money if it did not pass a bill eliminating certificates of need.
“Do you think that is going to be a $10 million loss, a $1 million loss or a $106 million loss?” Williams asked.
The state does not know at this moment, Hendrix said.
