An overview of the RAFT Program

by Timothy Page

In central Vermont, Central Vermont Medical Center is launching a program that takes care out to people instead of waiting for them to show up at the hospital or a clinic. Called RAFT — Rural Access and Field Team — it is a hospital-anchored mobile health effort run by CVMC in Berlin as part of the University of Vermont Health Network. Funding comes through the federal Rural Health Transformation Program, which is designed to strengthen rural health systems.

The Rural Health Transformation Program was created under Section 71401 of the One Big Beautiful Bill Act (Public Law 119-21). It gives states money and flexibility to improve healthcare access, quality, and results in rural areas by changing how care is delivered.

Vermont received $195,053,740 for the first year of that federal program. Governor Phil Scott described it as one of the highest awards per person in the country. The state is distributing the money across many projects, and its list of executed awards and contracts is updated as agreements are finalized. RAFT’s piece, awarded through the Department of Vermont Health Access, is $1,044,158.97 for the period running from August 1, 2026, to July 31, 2027. The grant agreement shows most of that money covering staff and a mobile clinic vehicle (roughly $400,000 of the total), with CVMC reimbursed for costs through monthly invoices.

The team is built around a full-time nurse practitioner, backed by a part-time physician, a clinical pharmacist, a social worker, a community paramedic, a medical assistant or licensed practical nurse, and a part-time program coordinator. According to the grant agreement, the clinic will handle checkups and preventive care, management of long-term conditions such as diabetes and heart failure, mental health screening, treatment for substance use disorders, wound care, vaccines, and help with practical needs like food, housing, and insurance paperwork. The mobile unit is intended to park on a regular schedule in familiar places — town halls, senior centers, libraries, food pantries, and similar community spots — so people know when to expect it. For those who are homebound or have no reliable way to get to a site, the team plans home visits.

RAFT is based at CVMC and focuses on Washington, Orleans, Essex, and Caledonia counties. The agreement describes these areas as having long travel distances, workforce shortages, and higher rates of avoidable emergency room visits. Anyone can use the mobile clinic regardless of insurance status, though the program pays particular attention to people on Medicaid, older adults, those with complex chronic illness, and people dealing with mental health or substance use challenges.

One of the program’s clearest priorities is supporting people right after they leave the hospital, a stretch when medication mix-ups or missed warning signs often send patients back. High-risk patients can receive a home visit within 24 to 72 hours of discharge. During that visit the team reviews symptoms, goes over medications, makes sure discharge instructions are understood, watches for early complications, and sets up follow-up care. Care managers at UVM Medical Center, CVMC, and Porter Medical Center can refer patients the same day or the next day through an existing UVM Health pathway. Visit notes go into the shared electronic health record so a patient’s regular providers can see what happened.

The grant calls for formal partnerships with local EMS agencies, area agencies on aging, home health agencies, community mental health centers, and Vermont 211. Exact EMS partners and the day-to-day mechanics of those collaborations are still light on public detail, although personal experience of the author can very Barre Town EMS as part of it. That approach lines up with the state’s broader interest in community paramedicine as a way to reduce avoidable emergency visits and hospital readmissions through post-discharge and follow-up care at home. The state has also opened a separate funding round for mobile integrated healthcare services.

CVMC has committed to specific targets: 375 unique patients and 1,125 visits each quarter. The state will also track retention in addiction treatment, improvements in blood pressure and blood sugar control, help connecting people to Medicaid or Vermont Health Connect, and patient satisfaction (aiming for at least 80 percent “very satisfied”). Results are reported quarterly. If the model works, the agreement notes it could expand to Porter Medical Center and other hospitals in the UVM Health Network.

Because RAFT is new, some practical questions — what patients might be billed for home visits, how service schedules will land in individual towns — are not fully answered in the public documents. People looking for more information can contact CVMC or the Department of Vermont Health Access, which oversees the grant.

As the author of this article can testify personally after a recent surgery, Barre Town EMS, under the Program’s auspices, has been a boon to his recovery.