Rural communities face persistent barriers to behavioral health care, including workforce shortages and limited local services. Health care providers and community-based organizations (CBOs) are increasingly using community-based workers — including peer support professionals, community health workers, and community paramedics — to extend the reach of care and connect rural residents to behavioral health services.
To explore how these approaches are being implemented, the Center for Health Care Strategies interviewed rural providers and CBOs across 10 states. A brief highlights key findings and practical considerations for providers seeking to expand behavioral health care access. This profile series builds on the brief by highlighting how community-based workforce approaches are being put into practice in rural Georgia, North Carolina, and Tennessee. The profiles offer practical approaches for strengthening service delivery, addressing access barriers, building local workforce capacity, and creating more coordinated systems of care.
- Addressing Behavioral Health Needs in Rural North Carolina: A Community Paramedicine Approach — McDowell County, in rural western North Carolina, uses a community paramedicine model through which paramedics work alongside physicians, nurses, social workers, and peer support specialists to serve people with complex needs. The profile describes the program’s design, implementation lessons, and outcomes. (October 2026)
- Leveraging the Community-Based Workforce to Strengthen Behavioral Health Care in Rural Tennessee — River Valley Health in eastern Tennessee integrates peer recovery specialists and community health workers into care teams to address behavioral health workforce shortages and strengthen patient trust and engagement. The profile outlines River Valley’s staffing model, funding approach, and strategies for improving patient engagement. (October 2026)
- Expanding Peer Recovery Services in Rural Georgia: A Recovery Community Organization’s Approach — Walton Empowers, a recovery community organization in rural Georgia, uses a peer-led model to connect people and families affected by substance use with recovery support, treatment, and other community resources. The profile describes the organization’s implementation approach, staffing model, funding mechanisms, and outcomes. (September 2026)
