Our previous piece discussed the broader implications of federal budget decisions in our community; this time, we’re narrowing in on how those choices directly affect two Vital Conditions in the Twin Counties: Basic Needs for Health & Safety and a Thriving Natural World.
Basic Needs for Health & Safety
The first specific Vital Condition we cover relates to our ability to go to medical and counseling appointments, get prescriptions, have enough food, and receive help in an emergency. Meeting these Basic Needs for Health & Safety is essential for people to live healthy, full lives. When these conditions are strong, our whole community does better.
Many of the organizations that support these vital conditions get help from the federal government. If that money goes away, it’s not just programs that get hurt; it’s the people who count on them. For example, our local Area Agency on Aging helps older adults and people with disabilities. Because of federal funding cuts, some of their services have already been impacted: Friendship Cafes (to reduce loneliness and give access to nutritious food) have been reduced to once a week and their Home Delivery Meals service will be reduced if any more cuts come down. And the consequences don’t just impact our older neighbors, essential health care access is also on the line.
In our area, Medicaid isn’t just a safety net; it’s a lifeline. One in five residents relies on it for health coverage, including 38% of children, 18% of adults, and 10% of seniors. In fact, more children are enrolled in Medicaid than the total number of students in Grayson and Galax schools combined — over 3,800 kids.
The new federal budget includes a program called the Rural Health Transformation Program. It promises $50 billion over five years to help small-town hospitals and clinics in communities like Carroll County, Grayson County, and Galax. This money is supposed to replace other health care funding that’s being cut, like Medicaid. But here’s the big question: Will the money come to the hospital and clinics that serve our communities, or will it end up going to hospitals in the cities that say they are helping rural areas, but don’t provide services out here? Each state is supposed to submit a plan to ask for the money, and the governor just issued an executive directive related to this funding. We need to make sure that the hospital, clinics and other organizations in the Twin Counties are part of the conversation when decisions are made about who is going to get money.
When funding decisions are made far from home, what’s really at stake is the care, connection and dignity we work so hard to protect right here. We urge the members of the General Assembly and the governor’s office to direct the Virginia Department of Medical Assistance Services to submit a plan that focuses on the “rural” part of this program. The money should be mandated to go directly to the rural communities impacted, not to urban centers or companies headquartered in cities that have some link to rural communities, to be distributed as the city folk see fit.
Thriving Natural World
Here in the Twin Counties, our natural world is part of who we are. The Blue Ridge Mountains, the New River, the rolling farmland and our forests are more than scenery. They are our food, our water, our air and our way of life. A Thriving Natural World isn’t just about beauty; it’s essential to our health, our economy, and our identity.
A Thriving Natural World means clean water to drink, safe air to breathe, and land that supports farming, recreation, and tourism. When we take care of our environment, we take care of ourselves and our local economy.
And in the Twin Counties, our natural resources are a major part of how our economy grows. The New River draws visitors for kayaking, tubing and fishing. Local outfitters, campgrounds and restaurants depend on this tourism. The Blue Ridge Parkway brings in thousands of visitors each year. These tourists don’t just enjoy the views; they spend money in our towns, support local jobs and generate tax revenue that helps fund schools, roads and emergency services. But all of this depends on keeping our natural world clean, safe and accessible.
Federal funding plays a quiet but powerful role in caring for our natural resources. Programs help keep our drinking water clean, support flood control, protect farmland and maintain parks and trails. These programs protect our land for farming, our rivers for fishing and our forests for recreation. When this funding is reduced, we risk these valuable natural resources and the environmental protections that keep our roads safe, water clean and mountains healthy.
We’ve also seen what happens when disaster strikes, like when Hurricane Helene brought flooding and landslides to our communities. And this winter, when the ice storms knocked power out to over 12,000 homes across the Twin Counties. After these severe weather events, roads were blocked, trees were down and families were left without power for days or weeks.
In both cases, federal emergency support was critical — not just for cleanup and repairs, but for coordination, shelter, and long-term recovery. But if federal funding to our area is cut, these programs will shrink or disappear. That means more pollution, more risk during storms and fewer resources to help when disaster strikes. Without that help, our local governments and nonprofits will be overwhelmed.
Federal funding is one of the tools that allows us to help each other every day and during disasters. If we lose it, we lose more than programs. We risk losing some of the support that makes our communities the places we’re proud to call home. We need to make sure our voices are heard and not just to ask for help, but to make sure help is fair and reaches the people who need it most.
We expect our elected officials will listen and remember that we are still here, doing all we can for each other, and realizing that we cannot do it alone. The Twin Counties Rural Health Network, with over 40 local organizations, is working hard to protect these vital conditions. But we need everyone’s help, locally and in Richmond.
The authors:
Sandy Bryant, Mount Rogers Community Services
Meagan Helmick, Mount Rogers Health District
Melissa Munton, Ohlen R. Wilson Health Center
Terri Gillespie, Rooftop of Virginia
James Werth, Jr., Tri-Area Community Health
