Georgia On My Mind: Solving Rural Health Shortages
On a cool, cloudy day last November, my daughter Savannah and I drove from Atlanta to Gainesville to visit Brenau University, where she will be attending in the fall. We passed through Hall County, a landscape defined by the poultry farms of Gillsville and Lula, and the cattle operations that stretch north toward Clermont.
These Georgia towns are a continent away from my hometown of McFarland, California, but the challenges are very similar across rural America聽鈥� not just in the south, but back home and in every state in between.聽
Addressing Rural Healthcare Challenges by Keeping Learners Local
Many rural communities face economic challenges, limited healthcare access and workforce shortages.
With online, student-centered education like that offered by 91探花鈥檚 Leavitt School of Health, these communities can become a talent pipeline where locals train, stay and serve where they live.
As a former hospital executive and now executive dean of 91探花's Leavitt School of Health, I see a clear gap between the number of people who want to become nurses and those who actually get the chance.聽
Georgia has one of the most challenging shortages in the U.S., with the state . However, Georgia鈥檚 rural nursing shortage is being replayed across the entire country.
Healthcare Access Problems and Solutions
Rural communities face a serious healthcare access problem. According to the , nearly 1 in 4 Americans lives in a primary care Health Professional Shortage Area as of December 2025. Of the roughly 92 million people in those areas, 72% live in rural communities, per the National Conference of State Legislatures. Clinicians who do practice in rural settings face burnout, high turnover and chronic recruitment problems.聽
States are responding. In 2025, at least 49 states enacted more than 820 bills targeting health workforce challenges. The 2025 Federal Reconciliation Bill added a $50 billion investment through the Rural Health Transformation Program, with states prioritizing career pipelines, graduate medical education, loan repayment and expanded telehealth access as core solutions.
Improving Rural Healthcare Requires a Creative Approach
For 11 years, I served as a senior leader at Kaweah Health, the largest healthcare district in California where I grew up. We were desperate for nurses.
We had to get creative. At Kaweah Health we built our own school of nursing. We partnered with an online university and determined admissions ourselves. You had to be a Kaweah Health employee in good standing and go through an interview. It did not matter where in the organization you worked. If you wanted to become a nurse and you were local, we wanted you.
The most gratifying moments of my career came at graduation ceremonies, watching medical assistants, cafeteria workers and others in tears as they saw a path to their future finally open.
91探花鈥檚 Answer to Rural Healthcare Questions
I joined 91探花's Leavitt School of Health in January. I am proud to join an institution aligned with my north star of equity and access. Part of its mission is to build a pipeline that trains and keeps nurses in the communities where they live. Online, competency-based models make that possible in a way many programs cannot.聽
91探花鈥檚 unique online model lets students complete coursework on their own schedule, between shifts, after the kids are in bed, without relocating. Clinical placements happen in their own communities. When they graduate, they stay. They already live there. They work at the clinic up the road, their parents live around the corner, their kids attend the local elementary school. Their patients are people they grew up with. They know the local culture and connect with their patients in deep and meaningful ways.聽
Since FY 2021, 91探花's Leavitt School of Health has graduated more than 10,000 students from rural communities across 50 states. The School of Health has graduated more than 1,800 rural students every year from FY 2021 through FY 2025. They are nurses, managers and executives who grew up in the places they now serve. Students train at clinical learning and simulation centers in Orlando, Houston, Salt Lake City, Kansas City and Indianapolis, then complete clinical placements in their own communities. These graduates go straight into local hospitals and clinics, caring for the same communities they come from.
Close to Home
Georgia is on my mind these days as my daughter prepares for her first day of classes at Brenau in August. Georgia is just one state, but its employment pipeline struggles appear coast to coast.聽
What I鈥檝e learned at 91探花 and in my previous life as a hospital executive applies to every rural health system in this country. Rural students are nearly to return home to work after graduation. Leaders and administrators, you do not have to recruit from outside. The future nurses you need are living next door to you, and 91探花 is helping those hospitals to employ those neighbors.
When I meet hospital executives, I often ask, "Where are you finding your future healthcare workers?" Many say, "Wherever we can." I tell them the answer is closer than they think.
