Attending the Rural Health Association of TN conference was an experience. I enjoyed learning more about health care statistics/concerns specific to Tennessee and the role ancillary health care workers like billing staff, CMS inspectors, and social workers fulfill in providing patient education and facility compensation. The speakers were knowledgeable and seemed to be passionate about improving the rural healthcare system. I also enjoyed the collaborative atmosphere of the conference. It was nice to see how excited the RHAT members were to network and learn from each other. Some of my key takeaways from the conference include the following:

1. Politics and restrictive legislation are major barriers to rural healthcare reform/improvement in Tennessee. Initiatives to improve teen pregnancy rates are handicapped by legislature such as the Gateway Sexual Activity Bill. This bill focuses on abstinence only sexual education and severely limits the educators’ ability to teach about sexual activities that can contribute to STI transmission like oral or anal sexual activities. Presenters at the conference also spoke about how the bill prohibits them from demonstrating how to apply condoms.  Teach back verify is a powerful, evidence-based patient education tool we speak about frequently in nursing school. In my opinion, the state of Tennessee is doing at risk adolescents a disservice by not allowing the educators to use this strategy. I also feel like the lack of comprehensive, medically accurate sexual education negatively impacts other areas of rural health care like maternal care. We learned that Tennessee has a high rate of congenital syphilis in one of the maternal care breakout sessions. Additionally, the presentations on the One Big Beautiful Bill were eye-opening. I think the bill is going to put a lot of strain on an already strained health care system and make rural health disparities worse. Many rural Tennesseans are going to be without health insurance due to Medicaid cuts and the loss of ACA insurance plan premiums. I believe loss of insurance is going to reduce rural hospital compensation and increase the burden on rural emergency departments because preventative care will be harder for patients to access. Political activism/outreach educating political figures and the public about evidenced based practices is going to be very important for improving the rural health care system and reducing rural healthcare barriers.
2. Limited funding and low reimbursement rates are a problem for many rural healthcare facilities and rural healthcare improvement programs. Making sure rural healthcare facilities are compliant with CMS regulations and educating rural healthcare organizations about grant opportunities and other funding sources are strategies being used to combat these struggles.