Welcome to the Oklahoma RISE 25 and 25 RHTP podcast. This podcast is a production of the Oklahoma RISE 25 and 25 RHTP Task Force, an independent Oklahoma-led collaborative focused on turning one of the most significant rural health investments in our state's history into real, measurable outcomes for our communities. This podcast moves beyond headlines and funding announcements to provide clear, practical insight into what the Rural Health Transformation Program means, how it works, and what successful execution will require across Oklahoma. At its core, this series reflects a belief that Oklahoma's health care future can be stronger, more accessible, and more sustainable, especially for rural and tribal communities when we focus on coordination, accountability, and solutions grounded in the realities of our state.

In this episode we launch into a crucial component of the Rural Health Transformation Program: the School-Based Health Services Support Initiative. Hosts and RHTP Task Force leaders walk listeners through the initiative's purpose, structure, and the high-stakes strategy behind converting schools into permanent, Medicaid-billable care delivery sites. We explain why the $15.16 million, five-year investment (about $3.03M per year from FY2026–FY2031) is intentionally structured as bridge financing to close the sustainability gap and prepare schools for an anticipated state plan amendment (SPA) that would expand Medicaid billing eligibility beyond students with IEPs.

The episode covers who is leading implementation (the Oklahoma State Department of Education as the subrecipient), the target scope (approximately 100 rural schools), and the two primary budget buckets: $1M/year for startup technical assistance (roughly $10,000 per school) and $2M/year for provider recruitment subsidies to stabilize about 24 clinical providers annually. We dive into the operational design—the competitive NOFO approach, the shared-FTE staffing models, and the critical technical assistance components required for Medicaid billing setup, provider credentialing, and clinical workflow optimization.

Listeners will hear a detailed timeline and phased roadmap (foundational activities in FY2026, awards and TA in FY2027, rolling service launches through FY2029, and a targeted self-sustaining transition by Q1 FY2031) and why sequencing matters: TA must be in place alongside provider recruitment and the SPA approval to avoid untenable local financial risk. The episode emphasizes the central policy dependency—the SPA led by OHCA and the federal CMS approval—and explains the risks if approval is delayed or reimbursement rates are insufficient.

We examine the rural access crisis the initiative aims to address—75 of 77 counties designated HPSAs, average travel times of 80 minutes for comprehensive care, hospital closures—and why schools are a strategic entry point, particularly for youth behavioral health. The discussion highlights synergies with other RHTP investments (the statewide technology cooperative and behavioral-health integration efforts), the need for integration with the Oklahoma HIE (OKSHINE), and how interoperable data flows will support quality care and accountability.

The episode also identifies top execution risks—limited administrative staffing (an approximate 0.2 FTE coordinator in the OSDE administrative budget), reliance on high-quality TA vendors, workforce recruitment challenges, and the critical need for rigorous claims documentation and monitoring. Performance metrics covered include the number of schools credentialed and actively billing, service types and visit volumes (with a behavioral health emphasis), and the requirement for tight bottom-up reporting to ensure compliance and prevent claim denials.

Finally, the hosts synthesize the strategic importance of the initiative: an equity-driven effort to reduce rural health disparities by creating sustainable local access points, stabilize and grow the rural clinical workforce, and build a replicable model of resilience for rural Oklahoma. The episode closes with a call to leaders to pursue dual-tracked action—expedite the SPA with OHCA and secure high-quality technical assistance—while planning contingencies for potential SPA delays or lower-than-expected Medicaid revenue to ensure the bridge to sustainability is durable. Listeners are invited to join the Oklahoma Rise 25 in 25 RHTP Task Force at Rise25in25.org or email info@rise25in25.org for more information. The Oklahoma Rise 25 and 25 RHTP Forum is produced and directed by Dr. Keley John Booth, MD.