USDA/HHS Rural Health Roundtable Planning continues for our August 24 Rural Development Stakeholder Roundtable at STHCS. In addition to Director Richard Mayfield, we will be joined by USDA Rural Development Pennsylvania State Director Chris Hoffman and John G. McGough, New York/New England Regional Director for the U.S. Department of Health & Human Services. We have a strong group of regional partners planning to participate. I am structuring the discussion around several of the challenges and opportunities we continue to see across rural health care, including keeping people out of the hospital when appropriate and improving transitions of care, rural hospital and community health system sustainability, and rural EMS workforce and sustainability. PTC – Medication Reconciliation Our Pathways to Care (PTC) team continues to place a strong focus on medication reconciliation during patient visits. Staff review medications, dosage and frequency, identify concerns, and provide education when needed to help patients better understand and safely manage their medications. This also gives us another measurable way to demonstrate the impact of the program by documenting when patients move from needing education or taking medications incorrectly to using them correctly. These interventions can help support patients at home and reduce the risk of avoidable complications, emergency department visits, and readmissions.

EMT Academy Update Congratulations to all of our EMT Academy students who successfully passed their Practical Skills Exam (PSE)! This is an important milestone in their training, and they are now awaiting authorization to sit for the NYS written certification exam. A special thank you and congratulations to Ellie for coordinating the class and for the time and effort she has dedicated to supporting our students throughout the program. Ellie is also continuing to work toward completing the requirements for her Certified Instructor Coordinator (CIC) credential, which will further strengthen our EMS education capabilities here at STHCS. We are proud of our students, our instructors, and the continued work being done to strengthen the rural EMS workforce across our region. NYS Rural Health Transformation Program On Wednesday, I participated in a New York State Rural Health Transformation Program meeting as the State continues to move this important work forward. The discussion included updates on several priority areas, including a new cybersecurity initiative focused initially on rural hospitals, with future phases expected to expand to other rural health care providers. Thank you to the NYS Department of Health team for continuing to keep rural partners informed and engaged as this work moves forward. For situational awareness, additional information and updates can be found on the State’s Rural Health Transformation Program webpage: https://www.health.ny.gov/facilities/transforming_rural_healthcare/

Preparing to Hit the Ground Running on RCHI This week, I shared an Organizational Capacity & Role Planning Survey with our regional partners to better understand where organizations have the expertise, capacity, and interest to participate across all five deliverables. The survey asks partners to identify how they may be able to contribute and what resources may be needed. My goal is simple: if we are awarded the NYS Rural Community Health Integration Funding, I do not want to spend the first month trying to figure out who can do what, especially since all work must be completed by June 30, 2027. The responses will help us better understand our regional capacity, begin putting the right teams together, and be ready to move quickly if funding is awarded. Supporting Mothers and Babies Across Our Region August is National Breastfeeding Month, a time to recognize the importance of supporting mothers and families as they make feeding decisions that are best for them and their babies. Families need education, encouragement and access to support throughout pregnancy and after delivery. We are fortunate to have hospitals across our region committed to maternal and infant health. Olean General Hospital and UPMC Chautauqua have both earned Gold-level national Safe Sleep certification, and Jones Memorial Hospital is working toward achieving the same Gold-level designation. Thank you to their maternity teams and all of our regional partners who work each day to give babies and families a healthy and safe start.

Karen Madden Recognized for Her Impact on Rural Health Congratulations to Karen Madden, Director of the Center for Health Care Policy and Resource Development at the New York State Department of Health, on receiving the 2026 Calico Quality Leadership Award. I have had the privilege of working with Karen for the last 25 years and have seen firsthand her unwavering commitment to improving health care in rural New York. This recognition is incredibly well deserved and reflects the lasting impact Karen has had on rural communities and the many people fortunate enough to work alongside her. Congratulations, Karen, on this outstanding achievement! 1115 Waiver Community Impact Our 1115 Waiver work continues to make a real difference for the individuals and families we serve. Through screening and navigation, our team has helped families remain safely housed, access food and other needed resources, and reduce the stress that comes with financial and housing instability. In one case, the support helped a single parent remain housed, complete nursing school, and secure employment. In another, rental and food assistance helped prevent a family from losing their housing. I want to thank our staff who complete the screenings, listen carefully to what each person needs, and work to connect them with the right resources. This work takes time, compassion, and follow-through, and these outcomes are a direct reflection of the commitment you bring to this program every day.

Strengthening Community Partnerships I am pleased to share that we were awarded a $2,000 NSG Collaboration Scholarship through the NY Funders Alliance. These funds will support our efforts to strengthen collaboration and partnerships among nonprofit organizations throughout our region. Thank you to the NY Funders Alliance for this investment in regional collaboration, and a special thank you to Katie Pieri, Director of the Nonprofit Support Group, for her leadership and commitment to supporting nonprofits. We are grateful for this opportunity and look forward to using these funds to continue building strong partnerships that benefit our communities. County EMS Planning Support As the EMS Program Agency for Allegany, Cattaraugus, and Chautauqua Counties, we recently reviewed the New York State County EMS Plan Framework and reached out to each county to share how STEMS can support their planning efforts. We offered our expertise in workforce development, education and training, emergency preparedness, community paramedicine, and system assessment. I am proud that our team continues to be recognized as a trusted resource and collaborative partner throughout the Southern Tier.

Pathways to Care: Making a Difference We continue to make steady progress with the Pathways to Care (PTC) program as Southern Tier Health Care System and Trans Am work together to strengthen this innovative model of care. Leadership recently met to review operations and discuss staff feedback as we continue refining and improving the program. I want to sincerely thank everyone involved in PTC. I appreciate those who took the time to share their ideas and feedback—your input is valued and plays an important role in helping us grow. I also want to recognize the outstanding work being done every day. Every time we help someone remain safely at home, connect them with needed resources, or potentially prevent an unnecessary emergency department visit, we are making a meaningful difference in our communities. Thank you to our Trans Am partners and every member of the Pathways to Care team for your flexibility, professionalism, and commitment to building a stronger, more connected healthcare system for the people we serve. Building the Rural EMS Workforce Pipeline This week, I had the opportunity to present Southern Tier Health Care System’s Building the Rural EMS Workforce Pipeline proposal to the Appalachian Regional Commission. It was an honor to highlight the incredible work our team and partners are doing to address one of the most significant challenges facing rural healthcare—developing and sustaining a strong EMS workforce. The presentation focused on our vision for creating a sustainable workforce pipeline that recruits, trains, certifies, and connects individuals to careers in EMS while strengthening healthcare access throughout the Southern Tier. It also showcased STHCS’s more than 30 years of leadership in EMS education, workforce development, and regional collaboration. I am incredibly proud of the work our staff, instructors, and community partners do every day to support EMS and rural healthcare. Opportunities like this allow us to share the impact of that work and reinforce STHCS’s commitment to building a stronger healthcare workforce for the communities we serve. We now look forward to the next phase of the ARC review process.

Rural Community Health Integration Planning Grant Update We're entering the final stretch of completing our application for the New York State Department of Health Rural Community Health Integration Planning Grant. While the timeline has been incredibly compressed, it has also been an exciting opportunity to work alongside our partners to help shape the future of rural health care in Cattaraugus County. I want to extend my sincere thanks to everyone who participated in the Cattaraugus County assessment process. Your insights, feedback, and willingness to share your perspectives helped identify the priorities and opportunities reflected throughout this application. I also want to extend a special thank you to my staff for the countless hours spent helping pull this application together. From coordinating information and tracking details to proofreading, reviewing drafts, and ensuring everything was submission-ready, your dedication, flexibility, and commitment have been invaluable. This truly has been a team effort, and I couldn't have accomplished it without your support. We're not quite at the finish line, but we're close. I sincerely appreciate everyone's collaboration, encouragement, and support throughout this process. I look forward to submitting a strong application on behalf of Cattaraugus County and continuing to build the partnerships that will help improve the health and well-being of the communities we serve. EMT-B Academy Begins with 12 Future EMS Professionals This week, we officially kicked off our 2026 EMT-B Academy, with 12 students beginning their journey toward becoming New York State Emergency Medical Technicians. It has been a great first week, with students already building the foundational knowledge and hands-on skills that will prepare them to serve our communities. As part of their training, the class had the opportunity to visit the City of Olean Fire Department, where they gained valuable insight into emergency response operations and the critical role teamwork plays in delivering high-quality patient care. We are grateful to the City of Olean Fire Department for welcoming our students and providing such a meaningful hands-on learning experience. Partnerships like these are essential to preparing the next generation of EMS professionals and strengthening the future of emergency medical services across our region. We look forward to watching this outstanding group grow throughout the program and ultimately join the EMS workforce, where they will make a lasting difference in the communities they serve.

Welcoming Our Newest Granddaughter I am excited to share that my daughter and son-in-law, Abbe and Michael, welcomed our granddaughter, Colette Kahm Mostowy, on June 30, 2026, at 10:31 p.m. Colette weighed 6 lbs. 10 oz. and measured 21 inches long. In true Mostowy fashion, she made quite the entrance, arriving just 14 minutes after they reached Olean General Hospital! Mom and baby are both doing well, and we couldn't be more grateful. She is already so loved, and her big sister, Kallahan, and big brother, Koen, are excited to welcome their new baby sister. Dave and I are overjoyed to welcome our third grandchild and look forward to watching her grow and making many wonderful memories together. Seeing another healthy baby welcomed into the world is a wonderful reminder of why strong healthcare systems and dedicated healthcare professionals matter so much to our communities. We are incredibly grateful to Dr. Chaudhry, the OB nurses, and staff at Olean General Hospital for the exceptional care they provided to Abbe and Colette. Giving Back Through Blood Donation This week, Southern Tier Health Care System was proud to host a ConnectLife Blood Drive, generously sponsored by Senator George Borrello. Every blood donation has the potential to save lives, and we're grateful to everyone who took the time to donate and support this important effort. Thank you to Senator Borrello for sponsoring the blood drive and to ConnectLife for their partnership and commitment to ensuring our region has the blood products patients depend on every day. Happy Fourth of July!

Lower Level Renovation Update Our lower-level renovation continues to make great progress, and it is exciting to see the vision becoming a reality. Over the past several weeks, Mazza Mechanical has been installing the new HVAC system and ductwork, while Cummins Construction has been busy framing the new offices, training rooms, and collaborative workspaces. Each week brings visible progress, and we are one step closer to creating a modern, functional environment that will better support our staff, community partners, and the many programs and services we provide throughout the Southern Tier. Thank you to everyone involved for keeping this project moving forward. USDA Distance Learning and Telemedicine Grant This week marked another important milestone as our team finalized and submitted our application for the USDA Distance Learning and Telemedicine (DLT) Grant. This highly competitive funding opportunity would allow Southern Tier Health Care System to expand telehealth services, strengthen distance learning opportunities, and enhance access to healthcare and education for rural communities across our region. The proposal reflects months of planning, collaboration, and partnership, and I want to sincerely thank everyone who contributed their expertise and time throughout the process. Regardless of the outcome, this application demonstrates our continued commitment to developing innovative solutions that improve access to care and strengthen the healthcare workforce in the communities we serve.

Community Partners Explore Planning Opportunity I would like to thank Dr. Watkins for bringing community partners together this past Tuesday to discuss the Rural Community Health Integration (RCHI) Planning Grant opportunity recently released by New York State. The RCHI initiative provides up to $500,000 per rural county to support planning efforts focused on strengthening healthcare coordination, improving access to services, and addressing health and social needs. The meeting provided an opportunity for partners to learn more about the funding opportunity, discuss potential approaches, and begin identifying priorities and partnerships that could support a successful application. Given the short application timeline, with proposals due July 9, 2026, several questions were submitted through the state's Q&A process before the June 18 deadline. Responses are expected on June 25 and will help guide next steps as partners continue evaluating this opportunity. Organizations interested in participating in a Cattaraugus County planning effort are encouraged to reach out. We would also welcome hearing from organizations or counties that may be considering an RCHI application, as Southern Tier Health Care System may have an interest in participating as a partner and contributing to planning efforts that strengthen rural healthcare across the region. Thank you again to Dr. Watkins for his leadership in convening this discussion and to all those who participated. Rural Health Council Meeting I participated in the New York State Rural Health Council meeting on June 18, where Commissioner of Health Dr. James McDonald discussed efforts to improve healthcare access in rural communities. The Council received updates on oral health initiatives from Bridget Walsh, from Schuyler Center for Analysis and Advocacy and the Rural Health Transformation Program from Karen Madden, Director of the program, including discussion of the recently released Rural Community Health Integration (RCHI) planning grants. The discussion reinforced the importance of collaboration and innovation in addressing the healthcare needs of rural New Yorkers.

Certified Instructor Update On Wednesday, 45 EMS professionals participated in the Certified Instructor Update (CIU) Course, attending both in person and virtually from across New York State. The program brought together EMS instructor coordinators and lab instructors committed to strengthening the quality and consistency of EMS education throughout the state. The level of engagement and discussion demonstrated the dedication of these professionals to developing the next generation of EMS providers. Thank you to our presenters, Bryan Goyette, Suzanne Soltysik, and Mickey Forness, for sharing their expertise and helping make the program a success. We are also grateful to the EMS instructors who invested their time in this educational opportunity. Their commitment to professional development and high-quality instruction directly impacts EMS education and patient care across New York State. Working Together to Meet Community Needs On Thursday, Jordan, Alicia, and I attended the Cattaraugus County Nonprofit Hub’s Stronger Together event at Holiday Valley. The session focused on nonprofit collaboration and brought together leaders from organizations across the region to discuss how we can better work together to address community needs. The panelists shared their experiences with partnerships, shared services, and organizational collaborations, including both the successes and challenges they encountered along the way. The discussion reinforced the importance of building strong relationships, leveraging resources, and finding opportunities to collaborate in an environment where funding is increasingly competitive and community needs continue to grow. As we continue to grow and respond to the needs of our communities, these conversations help us identify opportunities to collaborate, leverage resources, and strengthen the services available throughout the region.

Time Is Brain: A Simple Tool Making a Difference Over the past several weeks, we have been encouraged to see EMS crews consistently using the Stroke Information Stickers. We want to thank our EMS providers for embracing this simple tool and recognizing the difference it can make in patient care. Last week at Olean General Hospital, staff reported a great example of the sticker's value. During a time-sensitive stroke response, CT services were unavailable and MRI was being used as a backup. The patient was unable to complete the MRI screening process, but because family contact information was documented on the stroke sticker, the care team was able to quickly reach the family, complete the necessary screening, and move the patient directly to MRI without unnecessary delays. When it comes to stroke care, time is brain. This simple process helps streamline communication, reduce delays, and support faster decision-making when every minute counts. For a quick overview of the Stroke Information Sticker initiative, check out the STEMS Monthly Minutes. Thank you to our EMS crews and healthcare partners for your continued commitment to improving patient outcomes across our region. We look forward to sharing more information as we prepare for our upcoming Tele-Stroke go-live. Recognizing Milestones This week marked a couple of personal milestones for me. I celebrated my 35th wedding anniversary with Dave (June 1) and my 25th year with Southern Tier Health Care System (June 4). As I reflected on both milestones, I was reminded that none of us achieve these accomplishments alone. The support, encouragement, and patience of my family over the years have been invaluable and have played a significant role in allowing me to serve as CEO of Southern Tier Health Care System. I am grateful not only for my family's support, but also for the opportunity to work alongside so many dedicated staff, board members, community partners, healthcare providers, EMS professionals, and community leaders over the past 25 years. The relationships built along the way have made this journey both meaningful and rewarding. Together, we have accomplished a great deal, and I am excited about the opportunities that still lie ahead for our organization and the communities we serve. And, as Rob was quick to remind me, turning 55 this year comes with a new milestone of its own: I am now officially eligible for Total Senior Care. Thankfully, I am not planning to take advantage of that eligibility just yet! Thank you all for being part of my journey.