While the many efforts of funders in response to COVID-19 have been deservedly recognized, the work of those responding to rural communities’ COVID-19 crisis is less well known. Rural cases continue to grow at a quicker rate than urban cases do—and like in urban areas, the impacts are disproportionately on rural communities of color.

There are a number of rural-focused funders that have recognized the responsibility of philanthropy to elevate and financially support the needs of these communities in ways that anticipate continued engagement over the long term—whether that be support of rural health care, advocacy, communications, or anything else along the convergence of rural community health and ensuring viability of rural communities. Here are just a few examples.

Foundations’ Efforts

The Maine Health Access Foundation (MeHAF) is one of the largest health funders in Maine—the most rural state in America. Barbara Leonard, MeHAF’s president and CEO, reported in an e-mail that the foundation began its rapid response actions by asking, “As we plan our response, which organizations need to be there on the other side of this crisis? How can we best help them to survive?” MeHAF’s first wave of funding included directed general operating support focused on bolstering organizations in key infrastructure areas that are unlikely to receive federal funding, such as mental and oral health, as well as rapid response grants to support organizations with immediate technical and operational needs, such as capacity and technology for telehealth, Leonard said. These grants included funding for the five tribal governments in Maine. In the first four weeks, MeHAF was able to pay out more than $1.1 million through 84 grants, she noted.

An initial focus of Missouri Foundation for Health’s (MFH’s) response was to ensure that rural Missourians were receiving accurate, consistent public health messaging. “With public health officials at the thrust of the rapidly changing pandemic response in our communities, we knew we needed to make it easy for local public health agencies to disseminate fact-based information on what the public could do to protect themselves,” Courtney Stewart, MFH’s vice president of strategic communications, said in an e-mail. The foundation recognized the importance of trusted messengers “as well as consistency in what people living in adjacent communities were hearing and reading.” In collaboration with a task force of local public health professionals, a campaign was developed that includes a radio, print, and social media presence as well as regularly updated “plug-and-play” materials for use by local public health agencies.

In east Texas, the Episcopal Health Foundation (EHF), which serves Houston and more than 50 rural counties, made $3 million in grant funds available to help realign grantees’ efforts to address health needs to fit within a COVID-19 reality, such as ramping up telehealth capabilities, Elena Marks, president and CEO, told me. Further, within the EHF COVID-19 grant application, the foundation inquired about other types of support needed by applicants to maintain business continuity. The EHF learned that smaller rural nonprofits needed technical assistance to apply for government and foundation financial support through loans and grants. To address these needs, the EHF engaged consultants to work with these partners.

An additional concern has been the health implications of social isolation across communities in EHF’s funding area, Marks said. With 155 Episcopalian congregational partners—many in rural areas, the EHF delved into the issue to provide guidance on how congregations can address social isolation by incorporating that concern into their existing work.

Efforts At The Federal And State Levels And More

On the federal side, funding for rural COVID-19 response has included $10 billion for rural hospitals, $500 million for tribal health care, and a variety of other supports for rural federally qualified health centers, rural clinics, and rural telehealth, according to the Federal Office of Rural Health Policy.

State offices of rural health are key funders and program implementers. For example, the South Carolina Office of Rural Health’s (SCORH’s) COVID-19 response has included aiding providers in implementing telehealth solutions, securing and delivering personal protective equipment, helping community coalitions distribute healthy food, and partnering with the state health department and others to stand up rural testing sites.

In South Carolina, rural communities comprise more than 84 percent of the land mass, according to the SCORH, and 27 percent of the population resides in rural areas. “We’ve had to change the way we offer technical assistance,” said Graham Adams, CEO of the SCORH. “Our staff normally spends a lot of time in rural practices, hospitals, and communities, but due to COVID-19, we’ve had to transition to offering that assistance remotely,” he said in an e-mail. He added that the SCORH staff spent much time helping providers ensure that they are accessing all of the federal and state relief they are eligible for.

Teryl Eisinger, CEO of the National Organization of State Offices of Rural Health, observed, “Helping rural communities and health care providers get what they need during this pandemic is a challenge in every state.” Rural communities are innovating and “stepping up to deal with the needs of their citizens, small businesses, and local [health care] providers.”

The North Carolina Healthcare Foundation’s Fill the Gap Response Fund recently made its first round of 19 grants for $1.6 million with a focus on rural communities and frontline workers not receiving the benefit of other private or public support. This initial round of grants included support of farmworkers’ health and human services organizations, youth programs serving rural communities of color, and support of rural emergency medical services. The fund is supported by numerous private donors. The State Employees’ Credit Union Foundation, the Duke Endowment, and the Kate B. Reynolds Charitable Trust are among those making major gifts.

Looking Ahead

The story of COVID-19’s impact on rural America is still developing—be it devastation of Native American communities in the Southwest, weakening of an already fragile rural health care system, technical challenges to delivering services by broadband, or social isolation of rural older adults.

With fewer nonprofit and governmental resources available now, rural funders are not only particularly vital because of their role in immediate response, but also, importantly, because they are helping rural communities to face the longer term consequences. Rural funders’ deep connectivity to community for the long haul is the key to their philanthropic impact.

This article originally appeared on the Health Affairs blog in July 2020.

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