A patient sits in a rural clinic waiting room in eastern Kentucky, seeking help for Opioid Use Disorder (OUD). They are ready for recovery, but the clinic's capacity is completely stretched. They are added to a waiting list that grows by an average of six new calls every single day. For hundreds of individuals in this region, the gap between reaching out for help and actually receiving care is a barrier that too often leads to preventable, tragic outcomes.
Stories like this are pervasive across the Appalachian region of eastern Kentucky. For clinicians at AdventHealth Manchester, the reality on the ground was clear: a massive local waiting list, paired with an acute shortage of specialized behavioral health providers, left vulnerable patients trapped without local access to continuous, comprehensive care.
Over a 15-year partnership, Communication Mark has worked alongside AdventHealth Manchester to help turn those realities and many others into structured, fundable strategies. That work has contributed to securing more than $10 million in grant funding and supported the hospital’s expanding role in the region’s response to the opioid crisis. A key milestone in this partnership was a $349,091 Kentucky Opioid Response Effort (KORE) grant designed to systematically eliminate barriers to care at the hospital’s Whole Person Recovery (WPR) center.
Clay County, Kentucky, has long faced significant economic hardship. The decline of the coal industry removed a major source of economic stability, leaving behind a community shaped by generations of economic strain.
AdventHealth Manchester extends its reach to a six-county rural region—including Clay, Jackson, Laurel, Lee, Leslie, and Owsley counties—encompassing a population of roughly 115,000. In many ways, the hospital serves as essential community infrastructure alongside schools and social services.
The entire service region is plagued by deep generational poverty; in Clay and Leslie counties, 38.2% and 30.8% of residents live below the poverty line, respectively. Furthermore, the Centers for Disease Control and Prevention (CDC) placed all six counties in the top 5% of US counties most vulnerable to outbreaks of HIV and Hepatitis C as a direct consequence of the opioid epidemic.
At the same time, recruiting experienced grant professionals and specialized medical staff to the region remains an ongoing challenge, limiting internal capacity to consistently identify, pursue, and manage complex federal and state funding opportunities.
The primary barrier to addressing the region’s opioid crisis is a critical deficit of the behavioral health personnel required to support patients on their recovery journeys. The U.S. Health Resources & Services Administration (HRSA) designated all six target counties as Mental Health High-Needs Geographic Health Professional Shortage Areas (HPSAs).
To put the shortage into perspective, while the broader state of Kentucky averages 490 residents per behavioral health provider, Leslie County faces a ratio of 2,070 to 1, and Clay County climbs to a staggering 4,070 residents per single provider.
Because of this severe bottleneck, AdventHealth Manchester’s WPR center accumulated a waiting list of 211 new individuals actively requesting MOUD support. Furthermore, the hospital has to refer 320 patients with complex conditions to providers in Corbin and London, Kentucky, over 20 to 32 miles away on mountain roads. Due to rural transportation barriers, the vast majority of these high-risk patients never followed through with their referrals, dropping out of the care continuum entirely.
AdventHealth Manchester is part of AdventHealth, one of the largest nonprofit hospital systems in the United States, with more than 40 hospitals nationwide.
That scale provides structure and resources, but it also introduces complexity. Funding initiatives move through multiple layers of leadership, including local hospital administration, regional oversight, and corporate headquarters in Orlando. State and federal grants add another layer of requirements, including legal review, compliance processes, and formal approval pathways.
At the same time, clinical teams are focused on delivering patient care, not developing grant strategies or translating community needs into funding narratives. The hospital’s roots in the Seventh-day Adventist faith deeply emphasize a holistic, "Whole Person" medical approach, but translating this clinical philosophy into highly technical state and federal applications required a tailored strategic bridge.
At Communication Mark, our work is guided by the FOCUS™ (Framework for Open Communication and Unified Strategy), a structured 10-step process designed to turn fragmented services into comprehensive, concise, fundable projects.
In this engagement, the process helped translate frontline clinical experience into measurable funding outcomes while also strengthening the hospital’s long-term internal capacity.
Our first priority was ensuring the funding strategy was embedded within leadership rather than treated as a separate or reactive function.
We worked closely with AdventHealth Manchester to integrate grant strategy into senior leadership discussions so funding priorities could be evaluated alongside broader organizational goals. This required coordination across local leadership, regional oversight, and AdventHealth’s corporate structure in Orlando.
Over time, grant funding became part of ongoing leadership conversations rather than an occasional initiative pursued only when opportunities surfaced.
Unlike traditional grant writing engagements, our work focused on building internal systems and alignment that could support sustained fundraising efforts over time, even without dedicated development staff.
This phase represented the most important shift in translating the hospital’s work into a viable funding strategy. Our team worked directly with clinical staff to move beyond describing services and toward identifying where interventions could realistically improve community outcomes.
Through a structured review of clinical experience, hospital data, and community input, a clearer picture emerged. The core of the "fundable story" was that while the WPR center had successfully scaled its active patient base from 280 to 406 individuals under a previous funding cycle, the exploding local demand meant they were losing vulnerable patients to out-of-county provider gaps.
Communication Mark worked with the clinical team to pinpoint three highly specific, actionable intervention points:
Once these precise systemic gaps were defined, our team developed a comprehensive funding narrative to pitch to the state. The solution involved securing a dedicated on-site Psychiatric Nurse Practitioner to deliver evidence-based Eye Movement Desensitization and Reprocessing (EMDR) therapy to treat underlying trauma, deploying an innovative "Contingency Management" incentive program to dramatically lower drug screen failure rates from 25% to 10%, and purchasing telehealth infrastructure for ongoing needs.
Our role was to translate frontline clinical experience into a structured funding narrative aligned with the criteria of the Kentucky Opioid Response Effort (KORE) and federal regulations.
We synthesized hospital data, county health records, and external public health sources into a unified evidence base that clearly supported the hospital’s proposed interventions. What had previously existed as dispersed clinical observation was organized into a narrative with defined intervention logic, measurable outcomes, and clear public health relevance.
Medical terminology, such as medication-assisted treatment and opioid use disorder, was reframed within a broader story centered on preventable overdose deaths, continuity of care, and practical intervention opportunities.
The result was a case for support that remained clinically grounded while presenting the information in a way federal reviewers could evaluate clearly and consistently.
Once the narrative framework was established, our team focused on identifying funding opportunities that closely aligned with the hospital’s intervention model and strategic goals.
A key priority was ensuring each opportunity represented a strong return on investment before the application process began, allowing internal resources to remain focused on the highest-potential opportunities.
One major opportunity was the Kentucky Overdose Response Effort (KORE), which was actively funding statewide initiatives aimed at reducing overdose deaths, particularly during high-risk transition periods.
Because the hospital’s proposed approach directly aligned with these priorities, the application could be positioned as part of a broader statewide response strategy rather than as a standalone funding request.
After the grant was awarded, our role shifted from strategy development to stewardship support and implementation readiness.
We translated grant requirements into clear, actionable guidance so clinical and program teams could understand how funding was intended to be used, how outcomes needed to be documented, and what reporting expectations would follow throughout the grant cycle.
Working across clinical teams and hospital leadership, we helped fund staffed positions, purchase equipment, align reporting and documentation processes, and fund utilization across departments. Existing systems, including Epic electronic health records, were mapped to support the tracking of key outcomes such as Narcan administration, participation in MAT, and treatment completion metrics.
A major priority throughout implementation was reducing administrative burden while maintaining reporting accuracy and consistency. By integrating outcome tracking into existing workflows, teams were better equipped to manage compliance requirements within already high-demand clinical environments.
A core principle of our approach is that long-term funding sustainability depends on the quality of stewardship and reporting.
As we often emphasize with partners, unclear or inconsistent reporting can limit future funding opportunities. Most funders have reporting requirements that must be met before new support is considered.
At AdventHealth Manchester, this mindset became integrated into implementation practices over time. Reporting was no longer viewed as a separate compliance obligation, but as an essential part of demonstrating program effectiveness and long-term impact.
That shift strengthened continuity with funders, improved readiness for future grant cycles, and helped position early investments as the foundation for sustained funding relationships and program growth.
Over the course of the partnership, AdventHealth Manchester secured more than $10 million in grant funding, including:
These results reflected not only sustained growth in funding volume but also the hospital’s increasing ability to compete for complex federal funding opportunities.
AdventHealth Manchester became an active contributor to Kentucky’s broader response to the opioid crisis, including participation in KORE. Expanded medication-assisted treatment programs increased access to evidence-based care, while broader Narcan distribution strengthened overdose response capacity across the region.
Grant funding also supported care beyond acute treatment settings. HUD-funded home modification projects, including wheelchair ramps for newly disabled patients, provided critical safety and mobility improvements for seniors and vulnerable residents. These projects, which often cost between $5,000 and $10,000 per home, had previously been completed inconsistently without dedicated funding support.
The financial impact of grant funding was especially significant within a resource-limited rural healthcare environment. For every $100,000 secured through charitable grants, AdventHealth Manchester would have needed approximately $35.5 million in operating revenue to support charitable initiatives.
This disparity reinforced the role of grant funding as a critical mechanism for sustaining access to care in underserved communities.
Over 15 years, our partnership helped shift AdventHealth Manchester from an organization without a dedicated grant infrastructure into one where funding strategy became integrated into leadership operations and long-term planning.
Internal teams developed stronger capabilities in grant reporting, compliance management, and stewardship practices. As a result, the hospital became better positioned to pursue, manage, and sustain future funding opportunities with greater consistency and independence.
“By securing over $7 million in just the last few years for renovations and substance use treatment, Communication Mark provided the life-saving resources this community otherwise would never have had.” – Mark Goldstein, President & CEO, Communication Mark
Many large healthcare systems operate rural or satellite hospitals that serve high-need communities but lack the internal infrastructure needed to consistently pursue complex federal funding opportunities.
In many cases, the challenge is not clinical expertise. It’s the ability to translate that expertise into a clear, competitive funding strategy that aligns with funder priorities and organizational goals. Without that strategic bridge, important programs can remain underfunded despite well-documented community needs and strong clinical leadership.
An external grant strategy partner can help close that gap by combining proposal development with broader systems thinking, leadership alignment, funder research, and long-term stewardship support.
The result is not only increased funding, but stronger internal readiness to manage, sustain, and expand those investments over time.
Discover how an external grant strategy partner can help navigate complex healthcare systems and identify high-impact funding opportunities within your organization. Reach out to Communication Mark now.