On late Friday, Oregon published 12 non-competitive awards.

Tomorrow Oregon will host a webinar on the competitive Catalyst Awards:

On April 14, 2026, OHA will host an informational webinar on the Request for Grant Proposals (RFGP) process for the Catalyst Awards that will be offered by the Rural Health Transformation Program (RHTP).

Webinar Information

Date: April 14, 2026

Time: 12:00-1:00PM PST (1:00PM-2:00PM MST)

Platform: Teams Webinar

Registration Link

Legislative Watch

Kansas veto override

The Senate restored 10 line-item vetoes on a 28–11 vote, while Alaska’s operating budget advanced to third reading and the supplemental appropriations bill took effect.

Kansas HB2513: The Senate voted 28–11 to override 10 of Governor Kelly’s line-item vetoes on the mega-appropriations bill, restoring funding in Sections 26(a), 53(b), 54(w), 54(u), 78(dd), 81(h), 88(k), 96(d), 153, and 155. Kelly had used her line-item authority to strike more than 30 provisions from the budget, including a 4.4% pay raise for state legislators, a 1.5% across-the-board cut to selected agencies, and a $50 million taxpayer-backed loan to Yingling Aviation. The override restores a subset of those items — the House must still vote to sustain the overrides for them to take effect. Kansas Reflector

Kansas has a separate dedicated RHTP bill (HB 2463) establishing the Rural Health Transformation Fund in the State Treasury, but HB2513 sets the broader fiscal framework. Whether the overridden sections include rural health-adjacent spending requires review of the specific line items — the veto session focused primarily on education, mental health, and agency spending authority. Lawrence Journal-World

The bill is law; the override process is ongoing in the House.

Alaska advances

Alaska HB263: The FY2027 operating budget has automatically advanced to third reading on the House floor — the final procedural step before a floor vote. Alaska’s $272 million annual RHTP award requires this budget to establish spending authority, and separately, lawmakers introduced licensure compact bills (SB 281/HB 352) on April 10 as RHTP prerequisites, though sponsors acknowledged passage isn’t the immediate goal. Alaska’s News Source

Alaska must pass enabling legislation by December 31, 2027 to keep its full $1.36 billion federal award. Alaska Public Media

HB263 is positioned for a House floor vote.

Alaska HB289: The supplemental appropriations bill signed April 2 is now fully effective — effective dates are set per chapter. No further legislative action required. Alaska Beacon

Ohio is still unappropriated

Ohio HB730: The capital reappropriations bill for the biennium ending June 30, 2028, signed by the Governor with operating appropriations effective March 31 and capital appropriations effective June 30. The bill passed the House 66–29 and the Senate 24–7, meeting a hard March 31 deadline for passage. Ohio Legislature

What makes HB730 relevant to the RHTP is what didn’t survive. The Senate Finance Committee added amendments that would have appropriated approximately $404 million in federal rural health funding — covering Ohio’s $202 million FY2026 RHTP award and presumably a second year’s allocation. Those amendments were pulled on the Senate floor Wednesday to avoid jeopardizing the must-pass reappropriations bill. Speaker Matt Huffman said he had been under the impression the chambers were in agreement on the rural health language, but that wasn’t the case when it reached a full Senate vote — so the cleanest path was to strip the amendments and deal with RHTP appropriations separately. ZHF Consulting

Ohio’s $202 million FY2026 RHTP award remains unappropriated at the state level. The Ohio Department of Health director outlined priorities in February — including $92 million for Rural Health Innovation Hubs and Clinically Integrated Networks, $21.1 million for rural school-based health centers, and $13.5 million for workforce programs — but advocates note the funding is not enough to offset concurrent federal Medicaid cuts affecting the same rural communities. Ohio Capital Journal

HB730 is now law, but without the RHTP language. Watch for a standalone RHTP appropriations bill — Ohio’s $202 million is sitting in federal limbo until the legislature acts.

Oregon announced its first round of Immediate Impact Awards on April 10, funding 12 projects totaling roughly $6.5 million.

Unlike the larger Catalyst Award RFPs due May 26, these were non-competitive direct grants — OHA picked the projects, matched them to Year 1 metrics CMS will use to judge whether Oregon keeps its funding, and wrote the checks. Every project must be operational within two months.

Three projects target maternal and newborn care:

• A mobile obstetrics simulation unit run by the Oregon Perinatal Collaborative that will bring hands-on OB training to rural hospitals that haven’t seen a delivery team drill in years

• A 24/7 obstetric addiction advice line operated by OHSU’s departments of Maternal & Fetal Medicine and Addiction Medicine

• A statewide nurse home visiting expansion through Family Connects Oregon in partnership with local public health authorities

Together, they form a cradle-to-postnatal safety net designed to move the needle on the maternal mortality metrics CMS is watching.

The workforce pipeline plays are equally pointed.

• On the North Coast, Northwest Regional ESD is partnering with Clatsop Community College and Providence Seaside Hospital to build a medical assistant education pathway for high school students — a grow-your-own model that puts clinical training in front of teenagers

• Healthcare Safety Solutions, working with the Idaho Simulation Network, will run up to 12 EMS simulations across rural provider sites, keeping emergency skills sharp in places where a critical call might happen once a quarter

Behavioral health and substance use get three awards.

• Mosaic Community Health will embed school-based substance use and mental health early intervention in Sisters School District, Enterprise Middle/High, and Grant County ESD, backed by the Alcohol and Drug Policy Commission

• The Alano Club of Portland and Comagine Health are partnering with OHA’s Addiction Treatment Recovery & Prevention Services to expand naloxone access in rural communities

• The Oregon Rural Practice-based Research Network (ORPRN) will deliver remote ACE education to healthcare providers through the Oregon ECHO Network

Chronic disease, aging, and prevention round out the list.

• ORPRN picks up a second award for community health worker training in chronic disease management

• Columbia Gorge Health Council will launch a CHW-led senior visiting model out of local clinics

• Portland State University is leading a brain health promotion and dementia initiative aimed at rural populations where diagnosis rates lag behind the rest of the state.

The Oregon School Nurses Association lands the remaining award: a school nursing access pilot across North Central, Southern Oregon, and Wallowa County educational service districts — regions where a single nurse may cover an entire district.

Every project maps to a measurable outcome CMS can audit: births attended, naloxone kits distributed, simulation hours logged, home visits completed.

More on the Catalyst Awards

On April 14, 2026, OHA will host an informational webinar on the Request for Grant Proposals (RFGP) process for the Catalyst Awards that will be offered by the Rural Health Transformation Program (RHTP).

Webinar Information

Date: April 14, 2026

Time: 12:00-1:00PM PST (1:00PM-2:00PM MST)

Platform: Teams Webinar

Registration Link

Nevada updates RFA questions

Tennessee webinar re: Rural Health Transformation Additional Opportunities

Wednesday, April 15, 2026 1:00 PM - 2:00 PM

(UTC-05:00) Central Time (US & Canada)

Host: Olivia Hall

South Dakota publishes as Tips Sheet

CMS publishes new FAQ

Includes authoritative clarifications on unexpended funds, the checkpoint model, government shutdown continuity, healthcare worker non-compete agreements, an implementation rigidity on program design and budgets.

Notable: Florida has already published the CMS guidance on their homepage":

The RHT-centric program allows for specific relocation and retention amounts for healthcare professionals.

The Nebraska Rural Health Workforce Incentive Program offers monetary incentives to health care providers in exchange for a service commitment to work in a rural county for a 5-year period. The program supports recruitment, retention, and expansion of clinical services in rural communities as described by the Rural Health Transformation Program (RHTP).

This program is separate and distinct from the other loan repayment programs​.​​

New Jersey publishes RFA for Doula Integration in Rural New Jersey

The New Jersey Department of Health (NJDOH) is requesting proposals to integrate NJ FamilyCare Community doulas into the maternal child health care landscape. The program is intended to bolster services offered by maternal health professionals in healthcare institutions that serve rural NJ residents.

The primary goal of this RFA is to grow the size and capacity of the NJ FamilyCare Community doula workforce serving rural NJ and support their engagement in various health environments. The opportunity for such workforce development will expand the possibilities for pregnant and post-partum women who reside in rural areas of our State and help to reframe the current healthcare model.

CMS publishes agenda for March 18, 2026 Summit

This appeared on the CMS website this morning. Not much news but interesting to see speaker list.

Legislation Watch

Alabama delivers on RHT

Alabama dominates this cycle with three bills now delivered to the Governor — two direct RHTP appropriations and a new antitrust immunity measure tied to the state’s RHTP application — while the previously reported Connecticut and Oklahoma Primary bills continue advancing.

Alabama HB591: The FY2026 supplemental appropriations vehicle for Alabama’s $203.4 million RHTP award, directing federal funds to the Alabama Department of Economic and Community Affairs (ADECA) and creating the Joint Legislative Oversight Committee on Rural Health Transformation Program Funds. The bill passed the House 104–0, cleared the Senate, and has been delivered to Governor Ivey for signature. Alabama Reflector

Alabama’s plan channels its award across 11 coordinated initiatives aimed at making rural facilities more financially viable, with ADECA serving as the lead fiscal agent. Governor Ivey convened the first meeting of the Alabama Rural Health Transformation Advisory Group in February to guide implementation. Yellowhammer News

Both chambers have now passed HB591, and it awaits the Governor’s signature — the companion SB368 was indefinitely postponed, making this the sole vehicle for FY2026 RHTP spending authority.

Alabama HB614: The FY2027 appropriations bill for the same $203.4 million RHTP award, also directing funds through ADECA. The bill passed the House 101–0, cleared the Senate, and has been delivered to Governor Ivey alongside HB591. Alabama Reflector

Alabama is running both fiscal years through the legislature simultaneously — HB591 covers the current year through September 2026, while HB614 establishes spending authority through September 2027. Rep. Rex Reynolds (R-Huntsville) sponsors both bills. Alabama Daily News

Both bills now sit on the Governor’s desk. Once signed, Alabama will have full legislative spending authority for its RHTP award through FY2027.

Alabama HB605: Creates the Rural Health Antitrust Immunity Act, authorizing collaboration among rural health care providers with limited immunity from state and federal antitrust laws. The bill establishes a certification and supervision framework through the State Health Planning and Development Agency (SHPDA) — and directly references Alabama’s Rural Health Transformation Program application submitted to CMS on November 5, 2025. Alabama Reporter

Alabama’s RHTP plan includes shared-service infrastructure and innovative care models that require provider collaboration — exactly the kind of arrangements that antitrust law can chill without explicit safe harbors. HB605 removes that barrier. A companion bill, SB350, is also moving. Governor’s Office

HB605 has passed both chambers and been delivered to the Governor.

Appropriation & Budgetary Links

Six broad budget or appropriations bills carry RHTP-relevant funding or establish the fiscal framework through which RHTP dollars flow — with two newly signed into law and Oklahoma’s $12.8 billion general appropriations bill headed to the Governor.

Oklahoma SB1177: Oklahoma’s FY2027 general appropriations bill, the $12.8 billion budget deal that passed the Senate 28–17 on April 7. The budget includes $450 million in health care investments overall and $250 million appropriated to the Oklahoma Health Care Authority for Medicaid maintenance — the fiscal architecture through which Oklahoma’s $223.5 million RHTP award operates. Oklahoma Voice

Legislative leaders announced the budget includes teacher pay raises, increased health care agency funding, and state employee pension adjustments. The appropriation is 1.27% higher than the current year but well short of the $13.6 billion agencies requested. KGOU

SB1177 has passed both chambers and been sent to Governor Stitt for signature.

Missouri HB2011: Missouri’s FY2027 Department of Social Services appropriations bill — the vehicle through which RHTP funds flow at the state level. Missouri’s $216 million RHTP award is administered by DSS, which released the full application narrative and has begun accepting grant applications for hospital infrastructure projects and new service delivery. Missouri Independent

A separate supplemental spending bill approved by the House earlier in the session included $100 million of Missouri’s $216 million RHTP award. The state plans to hire more than 100 people for a new Rural Health Transformation Office and has CMS approval for its Year 1 budget. KCUR

HB2011 has passed the House and a public hearing is scheduled in the Senate for Friday, April 17.

Alaska HB289: The FY2026 supplemental appropriations bill, signed into law on April 2 as Chapter 1, SLA 2026. Alaska’s $272 million annual RHTP award — totaling up to $1.36 billion over five years — requires both operating budget authority and specific enabling legislation for interstate compacts and scope-of-practice changes. Alaska Beacon

Separately, lawmakers introduced SB 281 and HB 352 on April 10 to enact Alaska’s participation in four interstate medical licensure compacts — a prerequisite for maintaining the full RHTP award. Notably, the bills’ sponsors acknowledged that immediate passage isn’t the point; the purpose is to hear from stakeholders and determine whether the compacts serve Alaska’s interests. Alaska must pass enabling legislation by December 31, 2027 to keep the full federal award. Alaska’s News Source

HB289 is now law. The operating budget (HB263) remains in play with Amendment 59 offered.

Alaska HB263: The FY2027 operating budget, still moving through the House with Amendment 59 offered. Nearly 1,800 Letters of Interest were submitted through the state’s RHTP portal for funding opportunities, with awards expected to begin in Spring 2026. Alaska Public Media

HB263 remains in second reading on the House floor.

Alabama SB146: The State General Fund appropriations bill for FY2027, now signed into law. While RHTP funds flow through the dedicated HB591/HB614 vehicles rather than the general fund, SB146 sets the broader fiscal context including state match capacity and administrative staffing.

The bill is now enacted.

Kansas HB2513: The mega-appropriations bill, signed by the Governor on April 8 with extensive line-item vetoes across dozens of sections. Kansas has a separate dedicated RHTP bill (HB 2463) establishing the Rural Health Transformation Fund in the State Treasury administered by the State Finance Council, but HB2513 is the broader fiscal vehicle that sets spending capacity. Kansas Action for Children

Whether any of the vetoed sections affect rural health-adjacent spending requires review of specific line items. The bill is now law.

The Nevada Health Authority has released an updated RHT timeline for 2026, featuring critical application deadlines and funding decision dates for Budget Period 1 (BP1). If your organization is planning to apply for funding, please mark your calendars with these newly announced deadlines:

• NV Rural Health System Flex Fund: Applications due April 30, 2026 (Decisions by May 29). Flex Fund Request for Applications Announcement-REVISED

• Workforce Recruitment & Rural Access Program (WRRAP) - 1st & 2nd RFAs: Applications due May 15, 2026 (Decisions by June 15). Nevada Workforce Recruitment and Rural Access Program Provider Recruitment and Retention Program Request for Applications Announcement

• Rural Tribal Health Transformation: Applications due May 29, 2026 (Decisions by June 29). Rural Correctional Health Transformation Request for Applications Announcement

• Rural Health Outcomes Accelerator Program (RHOAP): Applications due June 26, 2026 (Decisions by August 4).

• WRRAP - 3rd RFA: Applications due June 26, 2026 (Decisions by August 4).

Other Notable Changes & Reminders:

• RFP Window: When upcoming Requests for Proposals (RFPs) are published in May, they will now remain open for at least 42 days on Nevada ePro.

• Obligation Deadline: All BP1 subawards and contracts must be fully signed and obligated no later than October 30, 2026.

• Meeting Update: The Q3 RHT Steering Committee meeting has been slightly rescheduled and will now take place on September 10, 2026.

See also: Rural Veterans Health Transformation Request for Applications Announcement

Pennsylvania calls for RHTP Advisory Council members

Are you or one of your peers interested in being a part of the Rural Health Transformation Plan (RHTP) Advisory Council or a member of a regional RHTP Rural Care Collaborative (RCC)?

This is a reminder to complete the RHTP Advisory Council and RCC Nomination form by this Friday, April 10th at 5:00 PM.

Legislation Watch

Primary RHT Legislative Actions

Four bills across three states are moving to directly implement, fund, or govern the RHTP — with Alabama advancing two companion appropriations through the House on near-unanimous votes, Connecticut aligning state statute with federal program requirements, and Oklahoma standing up a revolving fund for workforce dollars.

Alabama HB591: The FY2026 supplemental appropriations vehicle for Alabama’s $203.4 million RHTP award, directing federal funds to the Alabama Department of Economic and Community Affairs (ADECA) and creating the Joint Legislative Oversight Committee on Rural Health Transformation Program Funds. The bill passed the House 104–0, sponsored by Rep. Rex Reynolds (R-Huntsville). Alabama Reflector

Alabama’s plan channels its award across 11 coordinated initiatives aimed at making rural facilities more financially viable, with ADECA serving as the lead fiscal agent. Governor Ivey convened the first meeting of the Alabama Rural Health Transformation Advisory Group in February to guide implementation. Yellowhammer News

HB591 has passed the House and now moves to the Senate, where a companion bill (SB368) was indefinitely postponed — making HB591 the live vehicle for FY2026 spending authority.

Alabama HB614: The FY2027 appropriations bill for the same $203.4 million RHTP award, also directing funds to ADECA and sponsored by Rep. Reynolds. The bill passed the House 101–0 and moves to the Senate. Alabama Reflector

Alabama is running both fiscal years through the legislature simultaneously — HB591 covers the current year through September 2026, while HB614 establishes spending authority through September 2027. A Senate companion (SB367) also exists but HB614 is the active vehicle. Alabama Daily News

Both bills advanced through the House during the March 31–April 2 legislative week and are now pending in the Senate Finance and Taxation General Fund committee.

Connecticut SB00093: An act implementing the Rural Health Transformation Program to expand health care access, aligning Connecticut statute with the federal RHTP requirements so the state’s $154 million award can flow. The bill passed the Public Health Committee 30–0 with 2 abstentions on March 2. CT Mirror

The Department of Social Services serves as lead agency, partnering across state government to implement dozens of projects organized across four core initiatives: population health outcomes, workforce, data and technology, and care transformation and stability. Innovative elements include a mobile clinic pilot with four primary care and four dental vans, a health workforce pipeline through the Area Health Education Center and UConn Health Center, and a community health navigator program. Connecticut Public

As per Connecticut Hospital Association: SB 93 adjusts statutory language so there is alignment with the federal requirements under the Rural Health Transformation Program.

The bill has been assigned File Number 44 and is advancing toward a floor vote.

Oklahoma HB3066: Creates the Rural Health Transformation Revolving Fund in the State Treasury for the Health Care Workforce Training Commission, establishing a continuing fund to receive and deploy RHTP dollars earmarked for workforce recruitment and retention in rural and underserved areas. The bill passed the House 87–5 on March 24. KGOU

The revolving fund will receive RHTP federal funds specifically designated for recruiting and retaining clinical workforce talent in rural areas, with a five-year service commitment requirement. Oklahoma’s $223.5 million RHTP award is already flowing — the state Department of Health can access approximately $202 million, with partner agencies including the Health Care Authority, Department of Education, and the Workforce Training Commission each leading specific projects. KGOU

HB3066 has been referred to the Senate Appropriations Committee after clearing the Senate Health and Human Services Committee. The bill carries an emergency clause with a July 1, 2026 effective date.

Appropriation & Budgetary Links

Four broad budget or appropriations bills carry RHTP-adjacent funding as line items or establish the fiscal framework through which RHTP dollars will ultimately flow.

Alabama SB146: The State General Fund appropriations bill for FY2027, covering executive, legislative, and judicial agencies. While SB146 does not specifically earmark RHTP funds — those flow through the dedicated HB591/HB614 vehicles — it sets the broader fiscal context within which Alabama’s rural health spending operates, including state match and administrative capacity. LegiScan

The bill has passed both chambers and a signature has been requested from the Governor.

Alaska HB263: The state operating budget for FY2027, the vehicle through which Alaska’s $272 million annual RHTP award — totaling up to $1.36 billion over five years — will require legislative spending authority. Alaska officials have acknowledged uncertainty about which specific enabling bills are needed to keep the full federal award, but the operating budget is the baseline fiscal mechanism. Alaska Beacon

Alaska kicked off its billion-dollar rural health transformation effort in January, with nearly 1,800 Letters of Interest submitted through the state portal for funding opportunities. Funding awards are expected to begin in Spring 2026. Alaska Public Media

HB263 has passed out of House Finance and was held in second reading for the April 9 calendar.

Kansas HB2513: The mega-appropriations bill authorizing payment of claims and making appropriations across state agencies, signed by the Governor on April 8 with extensive line-item vetoes across dozens of sections. Kansas has a separate dedicated RHTP bill (HB 2463) establishing the Rural Health Transformation Fund in the State Treasury, but HB2513 is the broader fiscal vehicle that sets spending capacity. Kansas Reflector

The Governor approved the bill with line-item vetoes of Sections 15(b) and (c), 26(a) portions, 30(a) portions, and dozens of other provisions. Whether any vetoed sections affect rural health-adjacent spending requires further review of the specific line items.

Maryland SB282: The FY2027 Budget Bill, signed by Governor Wes Moore as Chapter 4. The nearly $71 billion budget passed with bipartisan support and includes no new taxes or fees. Maryland’s RHTP funding flows through the state health department, and SB282 sets the overall fiscal framework. WTOP

The budget closed a $1.4 billion shortfall while maintaining the Rainy Day Fund at 8% and increasing the Fund Balance to $250 million. The bill is now law.

Indirect / Weak RHTP Link — Flagged for Review

Five measures across four states address policy areas covered by various state RHTP applications but do not reference the program directly — worth monitoring for convergence with RHTP implementation.

Hawaii SR24 / SCR27: A paired resolution and concurrent resolution urging Maui Health System to collaborate with the John A. Burns School of Medicine and other stakeholders to establish a full-time medical residency program on Maui. The resolutions explicitly reference the Hawaii Rural Health Transformation Plan as a primary funding vehicle for the residency program, making this a stronger indirect connection than most. Hawaii News Now

Maui County faces a 41% physician shortage — a deficit of approximately 179 full-time equivalent physicians — worsened after the 2023 wildfires destroyed West Maui healthcare facilities. Hawaii’s $188.9 million RHTP award includes the HOME RUN initiative (Hawai’i Outreach for Medical Education in Rural Under-resourced Neighborhoods), a workforce pipeline providing training, residencies, scholarships, and mentoring. The resolution directly urges leveraging RHTP funding to cover the high initial costs of a Maui residency program. KITV

Both resolutions received one-day notice on April 9. These are non-binding but signal legislative intent to steer RHTP dollars toward a Maui residency — keep tracking.

Nebraska LB958: Originally introduced to require legislative approval before the state could seek Medicaid waiver changes affecting home and community-based services for individuals requiring nursing-level care. The bill was substantially amended after the Governor removed a proposed cap on HCBS service hours, redirecting it toward assessment tool requirements for developmental disability service provision. Unicameral Update

The RHTP connection is contextual — Nebraska’s RHTP application covers HCBS expansion and care transformation, and waiver policy directly affects how rural Medicaid recipients access community-based services. The bill itself does not reference the RHTP. The amended version requires DHHS to report on assessment tool implementation by August 1. LB958 has passed both chambers and is in enrollment. Weak connection — flag only if Nebraska’s RHTP implementation touches HCBS waiver populations.

California AB1923: Injects $300 million into the Distressed Hospital Loan Program and broadens eligibility to all hospitals regardless of ownership type. Notably, the bill explicitly references the One Big Beautiful Bill Act as a factor that could cause financial distress justifying loan forgiveness — making this a rare case where state legislation acknowledges the OBBBA’s impact on hospital finances even while addressing a state-level program. The Business Journal

Assemblymember Esmeralda Soria (D-Fresno) introduced the bill to build on the 2023 law that created the program with $300 million in interest-free loans. The RHTP connection is indirect — the bill addresses hospital financial distress that RHTP funding is also meant to alleviate, and it names the OBBBA (the statute containing the RHTP) as a cause of that distress. But AB1923 does not implement or fund the RHTP itself. KFF Health News

The Assembly Health Committee hearing was scheduled for April 14 but canceled at the request of the author. Worth watching if it gets rescheduled — the OBBBA reference makes it relevant to tracking how states are responding to the federal law beyond the RHTP itself.

Minnesota SF5019: An omnibus human services provisions bill referred to the Health and Human Services Committee. No bill text or news coverage specific to SF5019 was available at the time of research. Minnesota’s RHTP application covers workforce and care transformation, and omnibus human services bills frequently contain provisions that overlap with RHTP implementation areas — but without visibility into the bill text, the connection remains speculative. Flag for review when text becomes available.

Advisory council

The advisory council provides strategic guidance and input to DHS as a part of the state’s implementation. The council offers an opportunity to contribute to shaping how rural health priorities are addressed, bringing diverse provider, community, and lived experience perspectives to the table. Visit the council’s webpage to learn more.

Timeline

DHS will receive federal funding for five years to implement the initiatives of the program. CMS has not yet announced award amounts for the subsequent four years of the program.

From their newsletter:

Electronic health records system proposals due April 20

DHS is seeking proposals for a statewide electronic health records (EHR) system. The selected vendor will build a system to transform how providers interact with each other and with patients. The goal is to facilitate high-quality care for patients in rural Wisconsin. The selected vendor will design, implement, maintain, host, and manage a full-service EHR system in partnership with DHS and participating providers. The system will give providers the option to join a shared system with appropriate facility and provider-specific customizations, privacy, and security. The system will enable provider organizations to upgrade existing clinical and revenue systems and achieve economies of scale through a single statewide procurement.

To view the request for services, visit the eSupplier portal and search for S-FMF1944 OGM-26 or Event Number 14009.

lmgtfy: Wisconsin RFP Digital Access to Care RFS_FMF_1944_OGM-26_Final,pdf

More

Upcoming grant funding opportunities

Listed below are several grant funding opportunities DHS plans to release in late spring or early summer, which will be open for a 10-week window. In addition to the list below, subrecipients will announce their funding opportunities over the course of the year. We will share those and related announcements with those signed up to receive these email updates, on the program webpage, and other forms of outreach.

Care coordination grants

These competitive grants will innovate care delivery in the state’s seven Healthcare Emergency Readiness Coalitions regions, and will improve access to preventive services, primary and specialty care, dental services, and/or behavioral health services through team-based models of care delivered in trusted sites close to home.

Successful grantees will implement multidisciplinary strategies that address health needs, increase the use of preventive care, provide care in lower-cost settings such as homes, and reduce preventable hospital admissions and emergency room visits. Applications should reflect collaborations between partners.

Community health worker grants

These competitive grants will seek to boost adoption of community health workers as an evidence-based model to improve outcomes for people with chronic health conditions, especially those who are low-income or underserved.

Dental provider grants

DHS will provide competitive grants to dental clinics to adopt efficient cleaning technologies and expand routine dental services for rural Medicaid beneficiaries. Wisconsin aims to increase the efficiency of current Medicaid providers and incentivize dentists to enroll as Medicaid providers by subsidizing the purchase of these efficient technologies. The competitive grant will be available to dental clinics in rural areas that agree to serve a certain quota of Medicaid members proportional to the community. Beyond Medicaid, this technology will increase dental service quality and availability for all rural patients at participating clinics.

Rural technology transformation fund

Wisconsin will allocate funds to rural facilities to purchase technology that removes barriers to care, maximizes provider productivity, and ensures patients benefit from modern digital health tools. This will be based on a formula-based or standardized allocation to a broad base of rural providers to ensure that technological advancements reach every corner of Wisconsin. Facilities can leverage this one-time investment to adopt emerging health tech innovation focused on rural populations to promote consumer-facing, technology-driven solutions.

Vermont posts Pharmacy Test-to-Treat RFP

Vermont received approval to invest funds targeted at expanding pharmacists’ scope and capacity to include test-to-treat in more scenarios. By leveraging pharmacists as accessible, community-based providers, this investment would enhance primary care capacity, reduce unnecessary emergency visits, and strengthen Vermont’s integrated rural health care delivery system.

Colorado sets Advisory Committee meeting for April 24

Rural Health Transformation Program Advisory Committee Meeting: Friday, April 24 from 2:00 to 4:00 p.m.

Zoom link: https://us02web.zoom.us/j/89203752406

Legislation Watch

Primary RHT Legislative Actions

Alabama is advancing four parallel appropriation bills to unlock its $203 million RHTP award across two fiscal years, while Iowa’s fund-creation bill clears the House unanimously and moves to a Senate subcommittee.

Alabama HB591 / SB368: Supplemental appropriation bills for the Rural Health Transformation Program for the fiscal year ending September 30, 2026. HB591, the House vehicle, has been read for the second time and placed on the calendar — the furthest any Alabama RHTP spending bill has advanced. SB368, the Senate companion, is currently indefinitely postponed. Alabama was awarded $203.4 million in federal RHTP funds under the One Big Beautiful Bill Act, with the Department of Economic and Community Affairs (ADECA) designated as the lead implementing agency. Alabama Daily News

Governor Ivey convened the Alabama Rural Health Transformation Advisory Group in February to shape spending priorities around the state’s 11-initiative rural strategy, which emphasizes making rural facilities more financially viable, expanding the healthcare workforce, and deploying telehealth infrastructure. The Legislature is expected to pass at least one of the supplemental appropriation vehicles before session ends. Alabama Reflector

Alabama HB614 / SB367: The forward-looking appropriation bills for the Rural Health Transformation Program for the fiscal year ending September 30, 2027. HB614, introduced on March 12, has been read for the second time and placed on the calendar. SB367 is currently indefinitely postponed. Both bills appropriate up to $203,404,327 in federal RHTP funds to ADECA — signaling that Alabama intends to lock in the same funding level for Year Two before it has even spent Year One. Alabama Reflector

Alabama’s four-bill approach — House and Senate vehicles for each of FY26 and FY27 — creates redundancy in case one chamber’s bill stalls. The House versions (HB591 and HB614) are clearly the active tracks, with the Senate companions serving as fallbacks.

Iowa HF2743: Creates the Iowa Rural Health Transformation Fund and appropriates the state’s $209 million first-year RHTP award to support Healthy Hometowns, the state plan Governor Kim Reynolds submitted to CMS in late 2025. The fund channels money toward hospital technology upgrades, healthcare provider recruitment, telehealth expansion, maternal transport, and cancer screening — the five pillars of Iowa’s application. The House passed the bill 93–0 on March 31. Western Iowa Today

Iowa was the first state in the nation to award Rural Health Transformation Program funding, and HF2743 places the Department of Health and Human Services in charge of administering the $209 million. The bill’s unanimous House vote reflects broad bipartisan support for getting federal dollars moving before the fiscal year spending window closes. KCRG

A Senate subcommittee hearing is scheduled for this week — a signal that leadership intends to move the bill quickly through the upper chamber before session ends.

Adjacent legislation

Several bills touch policy areas adjacent to the RHTP — antitrust reform, medical residency expansion, federal fund oversight, and state budget vehicles — without directly implementing program commitments.

Alabama HB605: The Rural Health Antitrust Immunity Act, which authorizes collaboration among rural health care providers and provides limited immunity from state and federal antitrust laws under a certification and supervision framework administered by the State Health Planning and Development Agency. The bill passed the House on March 31 and was carried over to the call of the chair in the Senate Healthcare Committee. A companion bill, SB350, is currently indefinitely postponed. Alabama Daily News

The antitrust immunity concept is gaining traction in multiple RHTP states — Missouri passed a similar bill this session. Alabama’s RHTP application includes policy reforms and shared-service infrastructure as key initiatives, and HB605 could be viewed as enabling legislation for provider collaboration envisioned in the state plan. However, the bill does not reference the RHTP directly. Worth tracking as potential enabling infrastructure. Missouri Independent

Hawaii HR163 / HCR173: Paired House resolution and concurrent resolution urging Maui Health to collaborate with stakeholders to establish a full-time medical residency program on the island of Maui. The House Finance Committee recommended passage unanimously (14–0). Hawaii was awarded $188.9 million through the RHTP, and the state’s Rural Health Transformation Plan includes workforce expansion as a core initiative — but these resolutions do not reference the program directly. Non-binding resolutions; track only if the state’s RHTP implementation plan references Maui residency expansion. Hawaii News Now

Connecticut SB00479: An act requiring legislative oversight of federal fund applications submitted by the Department of Social Services. DSS is the designated lead agency for Connecticut’s $154 million RHTP award, so this bill would give the General Assembly a formal review role over any future RHTP-related applications or amendments the department submits to CMS. Received a Joint Favorable vote (16–7) on March 19. CT Mirror

The bill does not name the RHTP, but its practical effect is to add a legislative check on the agency responsible for managing it. Connecticut’s RHTP award is already raising questions about oversight and implementation accountability. The bill was assigned File Number 480 and awaits scheduling on the Senate calendar. Recommend tracking — this is a governance bill with real implications for how Connecticut’s RHTP dollars are managed. CT Public

Idaho H0920: Appropriation to the State Board of Education and Board of Regents of the University of Idaho for health education programs for FY2027. The House passed it 47–22 and the Senate 22–11 before the Governor signed it on March 27 (Session Law Chapter 195, effective July 1, 2026). Idaho’s RHTP application emphasizes healthcare workforce training, and this appropriation funds the state’s medical education pipeline — including programs like WWAMI — but the bill does not reference the RHTP directly. Signed into law. Idaho Capital Sun

See HFS' project overview for more information.

The state is actively drafting Notices of Funding Opportunity (NOFOs). The timeline sets an aggressive schedule for 2026, including launching stakeholder processes for workforce funding in March, initiating the governance structure in March/April, making initial funding awards to collaborative entities by April and May, and developing grant standards for Hospital Transformation funding by July/August.

The doc also references the initiation of a “governance structure to include monthly partner meetings and Rural Health Advisory Workgroup” — potentially this presentation was made at a convening of that group?

Tennessee posts webinar materials

Informational Session for Statewide Partners

Visit the links below for information from the March 31st webinar on the Rural Health Transformation Program. The video and presentation provide a high-level overview of the RHT vision, key background and context, how these opportunities align with the state’s broader strategy, and a brief walkthrough of each competitive opportunity.

Watch this space for announcements of upcoming RHTP informational sessions and opportunities.

Watch the webinar recording

View the PowerPoint presentation

These materials lay out five distinct RFAs with detailed dollar amounts, scoring criteria, and timelines.

Tennessee’s approach leans heavily on its existing Healthcare Resiliency Program model, which has deployed “hundreds of millions” and supported 110+ projects since 2022.

The legislature is separately considering >$100M in capital funding to complement the federal investment, and TennCare is investing $125M of Shared Savings for targeted capital projects in hospitals and primary care.

RFAs will run 60-90 days, with all awards obligated by October 31, 2026 and BP1 spending due by September 30, 2027. Grants are reimbursement-based and scored on community need (35pts), project quality (35pts), sustainability (10pts), evaluation (10pts), and budget (10pts). Applications submitted via TDH’s Caspito system.

Legislation Watch

Primary RHT Legislative Actions

Iowa HF2743: Creates the Iowa Rural Health Transformation Fund and appropriates the state’s $209 million first-year RHTP award to support Healthy Hometowns, the state plan Governor Kim Reynolds submitted to CMS in late 2025. The fund channels money toward hospital technology upgrades, healthcare provider recruitment, telehealth expansion, maternal transport, and cancer screening — the five pillars of Iowa’s application. The House passed the bill 93–0 on March 31. Western Iowa Today

Iowa was the first state in the nation to award Rural Health Transformation Program funding, and HF2743 places the Department of Health and Human Services in charge of administering the $209 million. The bill’s unanimous House vote reflects broad bipartisan support for getting federal dollars moving before the fiscal year spending window closes. KCRG

A Senate subcommittee hearing is scheduled for April 7 at 2:00 PM in the Senate Lounge — a signal that leadership intends to move the bill quickly through the upper chamber before session ends.

Appropriation & Budgetary Links

West Virginia’s omnibus budget is signed, but RHTP spending authority ultimately ran through a separate supplemental appropriation — a pattern worth watching as other states navigate the same two-track problem.

West Virginia SB250: The state’s $21 billion-plus omnibus budget for fiscal year 2026, signed by Governor Patrick Morrisey with deletions on March 12. SB250 itself is not an RHTP-specific vehicle, but it is the broader fiscal framework within which the state’s $199 million RHTP award must be spent. WSAZ

The actual RHTP spending authority moved through a separate bill, SB570, which creates a dedicated supplemental appropriation for the Rural Health Transformation Program within the Department of Health. Governor Morrisey urged lawmakers to pass the authorization before session ended, warning that federal funds are time-sensitive and must be obligated within the allotted window or be forfeited. The House passed SB570 on a 96–0 vote, and the Governor signed it on March 17. WV MetroNews

West Virginia’s two-bill approach — general budget plus supplemental RHTP appropriation — may become a template for states that received their CMS awards after budget drafting was already underway. The state has begun hiring a leadership team to oversee implementation of the $199 million investment. WV Department of Health

Mississippi

Mississippi SB2477: Requires competitive bidding for all vendors, subcontractors, and entities providing goods or services funded through the Rural Health Transformation Program (Public Law 119-21). The bill carves out two procurement tiers. Under Section 2(a), state-level vendors — including those hired to build a health information exchange, conduct a statewide needs assessment, or procure equipment and software — must go through competitive bidding with no emergency-purchase shortcuts. Under Section 3, subgrantees receiving RHTP funds through a state-administered grant program are exempt from competitive bidding but subject to priority criteria: super rural zip codes, counties designated as primary care HPSAs, counties with the highest maternal and infant mortality rates, counties with per capita income at or below $45,000, DSH-receiving counties, counties lacking a hospital or containing only a critical access or rural emergency hospital, and areas outside a metropolitan statistical area. Every agency distributing RHTP funds must submit quarterly reports to the Legislature. The bill was authored by Senate Public Health and Welfare Chairman Hob Bryan (D-Amory). (Tippah News — Governor vetoes bill)

A companion bill, HB1067, carried the same competitive bidding and reporting requirements through the House, passing 121-1 on February 4, then clearing the Senate 50-0 as amended on March 11. The version sent to the governor on March 24 was described as a diluted version of the original oversight legislation, which would have applied competitive bidding requirements more broadly. Even in its weakened form, the bill represented the Legislature’s most direct assertion of authority over RHTP spending. Mississippi Today

Governor Tate Reeves vetoed the bill on April 3, saying it would “significantly slow down the awarding of RHTP federal funds by imposing redundant and unnecessary requirements on subgrants, thereby putting $205.9 million in already-approved funding at immediate risk of clawback.” Reeves cited a letter from CMS Director Dr. Mehmet Oz stating that the program has a firm obligation deadline of October 30, 2026, and that “any legislation that attempts to impede or restrict the procurement process will put Mississippi at serious risk of failing to obligate its funding on time.” The governor framed the potential loss at nearly $1 billion over the five-year life of the program. (Mississippi Today — Legislature sends transparency bill to governor)

As per DeSoto County News: Senator Bryan pushed back, saying he is “extremely concerned that so much apparently is taking place in secret behind closed doors” and called for a more open process. The legislation had received near-unanimous support in both chambers — only five votes in opposition in the House and none in the Senate — making the veto a stark illustration of the tension between executive speed and legislative oversight as states race to obligate RHTP funds.

Reeves separately signed two rural hospital bills in February and March — one easing certificate-of-need requirements for facility improvements, another creating a pilot program to help rural hospitals add new services — signaling he is not opposed to rural health action, but is determined to keep RHTP procurement authority within the executive branch. (Mississippi Today — Lawmakers push transparency bills)

SB2477 is dead. The veto stands unless the Legislature returns for an override vote, which has not been scheduled. The core question the bill raised — whether RHTP procurement in Mississippi will be subject to competitive bidding or remain at the governor’s discretion — is unresolved. With an October 30 obligation deadline, the window for legislative action is closing fast.

Other sources:

• Magnolia Tribune — Governor vetoes bill

• DeSoto County News — Reeves vetoes oversight bill

• LegiScan — HB1067

Maryland

Maryland SB282: The $70.8 billion FY2027 operating budget closes a $1.5 billion shortfall with no new taxes or fee increases. The bill serves as the appropriations vehicle for the Maryland Department of Health, which received a first-year RHTP award of $168.2 million from CMS — part of a proposed $1 billion five-year allocation. MDH’s State Office of Rural Health manages the RHTP implementation, with a designated oversight committee reviewing and approving funding requests on a quarterly basis. WellCheck

The House gave preliminary approval to the spending plan in late March, and the Senate and House reached a quick compromise with minimal disagreement. As Maryland Matters reported, the governor closed the gap without taxes or fees, relying instead on transfers from dedicated funding sources and swapping bonds for cash. Maryland Matters

The bill has passed both chambers enrolled. Maryland’s RHTP priorities — workforce pipeline expansion through AHECs, school-based health center capacity, telehealth infrastructure, and a food-access initiative targeting rural “hunger hotspots” — are administered by MDH under the budget authority this bill provides. The oversight committee held its first meeting in late February 2026 and meets quarterly. Maryland Department of Health

This is a new type of RFP I’m tracking under the RHT program— administrative RFPs that relate to a state’s overall program goals rather than tied to specific initiatives.

The Department of Public Health and Human Services (DPHHS) is seeking proposals for two distinct components of Montana’s Rural Health Center of Excellence (CoE) as part of the new Rural Health Transformation Program (RHTP).

The first request is for proposals to create the CoE; the second is for proposals to support facilities in implementing CoE recommendations.

Interested organizations can find the procurement details on the Montana Department of Administration website.

This CoE will serve as the heart of the RHTP and will be driven by three primary objectives:

• Data-Driven Strategy: The CoE will analyze rural health supply and demand to provide county- and facility-level recommendations, ensuring care delivery aligns with the specific needs of Montana’s rural and frontier communities.

• Long-Term Sustainability: Guided by a stakeholder governance board, the CoE will help participating facilities develop roadmaps to achieve independent, positive operating margins without the need for ongoing state support.

• Performance Incentives: Through a voluntary opt-in program, facilities that implement CoE recommendations and meet measurable improvements in care quality, patient access, and financial performance will be eligible for incentive payments. More information on how providers, facilities, and organizations can participate in the CoE and the associated funding opportunities will be released in the coming months.

North Carolina acknowledges ROOTS Hub application issues

Technical Difficulties Submitting ROOTS Hub Application Materials

We are aware of technical difficulties related to emailing ROOTS Hub application materials. It is recommended that applicants use Adobe to zip files and, if zipped files exceed 20MB, please break up the file attachments across multiple emails, labeling each email (e.g., email 1 of 3).

After you submit the application response, please send an email without any attachments to dhhs-ncroots.rfa@dhhs.nc.gov asking for confirmation that the application was received. If breaking up the application over multiple emails, please advise how many emails were sent. Please include a contact name and phone number.

Oklahoma publishes Quick Summary

Oklahoma published an updated Program Quick Summary Guide on April 1 laying out all 29 CMS-approved RHTP programs with confirmed Year One budgets and disbursement status for each. The $223,476,949 first-year allocation is now mapped program-by-program, and the procurement picture is sharper than any state has published to date.

The most actionable signal is the disbursement breakdown. Sixteen of the 29 programs are moving through inter-agency agreements — meaning funds flow directly between OSDH and partner agencies (OU, OSU, OHCA, OSDE, SWODA, HWTC, CareerTech) without competitive solicitation. One NOFO is live: the Community-Led Wellness Hubs Microgrants program, with $4M in Year One funding and applications due April 13, 2026. Three more programs — the Doula Program ($1.2M), Chronic Disease Management ($15.3M), and Rural Regional Reorientation Plan ($27.5M) — list NOFO as the planned disbursement mechanism but haven’t posted solicitation documents yet. Nine programs remain “Pending,” still in procurement design, including the massive Provider Collaborative Network ($43.1M Y1) and the Technology Cooperative for PCP and BH Providers ($13.8M Y1).

The Guide also reveals the full funding administrator roster for the first time. The Oklahoma Hospital Association appears as a formal RHTP funding channel — administering $7M across CHW expansion and lung cancer screening via subrecipient agreements. OU and OSU are co-administering three programs worth $28M combined in Year One, anchored by the $22.1M Rural Residency Programs standing up six new training sites. The Regional Collaboration bucket leads all categories at $75.1M Y1, driven by the still-forming Rural Health Collaborative Nonprofit that will anchor a statewide Clinically Integrated Network.

For anyone tracking RHTP procurement nationally: Oklahoma is front-loading. The Rural Regional Reorientation Plan alone is deploying $27.5M in Year One — a fifth of its 5-year total. And with 12 programs still awaiting procurement design or NOFO publication, the state’s solicitation pipeline will be active well into FY 2027.

Rhode Island publishes Budget Amendment Summary as of 4.2.2026

Rhode Island has filed a $142.7 million budget amendment SFY 2026–2027, reflecting spending plans under the state's $156 million Year 1 RHTP award following final CMS approval. The top-line allocation goes to value-based payment transition ($32.2M) and rural workforce ($28.0M), followed by health IT modernization ($16.7M) and the state's novel hospital-at-home program ($16.2M). The budget also bakes in a policy reform package that includes rolling back Certificate of Need requirements, expanding scope of practice for pharmacists and dental hygienists, and joining interstate licensure compacts — all conditions to keep the full federal award flowing.

South Carolina publishes RFPs on 4/5 of its RHT Program

Connections to Care

Expands digital infrastructure by implementing electronic health records, remote patient monitoring, telehealth services and a statewide resource database platform to improve care coordination and access

Connections to Care Grant Application

Leveling Up

Scales successful pilot programs statewide, focusing on chronic disease management, pediatric care quality and workforce development

Leveling Up Grant Application

Wellness Within Reach

Deploys mobile health units, crisis response teams and pop-up clinics to bring care directly to underserved populations

Wellness Within Reach Grant Application

Shoring Up to Sustainability

Strengthens rural healthcare systems through targeted investments in workforce recruitment and retention, facility upgrades, and provider training

Shoring Up to Sustainability Grant Application

Tech Catalyst Fund

Supports rural health technology startups and community-based innovations to drive long-term health and economic improvements. Funding opportunities for the fifth of South Carolina’s RHTP initiatives, the Tech Catalyst Fund, will be announced through a future stage of SCDHHS’ RHTP implementation.*

Tennessee posts info from their first webinar.

As a follow-up, on the RHTP website you can access the materials from the Rural Health Transformation Program (RHTP) Community Kickoff session below:

• Slides

• Recording and transcript

We’re also excited to continue the conversation in our second webinar, scheduled for April 15. You can register here:

• Registration link

Legislation Watch

Primary RHT Legislative Actions

West Virginia HB4740: Exempts the Department of Health from state purchasing restrictions when implementing the Rural Health Transformation Program, citing CMS compliance requirements and rigid federal deployment timelines that standard procurement rules would obstruct. The legislative findings explicitly reference the state’s commitments to CMS and the risk of losing funding if deployment targets are missed. It passed the House 92-1 and the Senate 33-0, and Governor Morrisey signed it on February 27 — making it one of the earliest RHTP-specific statutes enacted nationwide. (West Virginia Legislature)

Alabama HB591: Provides supplemental appropriations for Alabama’s Rural Health Transformation Program for the fiscal year ending September 30, 2026 — the current-year vehicle needed to begin spending the state’s $203.4 million CMS award administered through ADECA. It passed the House (Roll Call 1127, motion to read a third time and pass as amended adopted) and is now pending before the Senate Finance and Taxation General Fund Committee. (Alabama Legislature)

Alabama HB614: Appropriates funds for Alabama’s Rural Health Transformation Program for fiscal year 2027, establishing forward-year spending authority for the next tranche of the state’s RHTP award. It passed the House (Roll Call 1129, motion to read a third time and pass adopted) and is pending before the Senate Finance and Taxation General Fund Committee. (Alabama Legislature)

Alabama HB605: Creates the Rural Health Antitrust Immunity Act under the State Health Planning and Development Agency, authorizing rural health care providers to collaborate on service delivery, establishing a certification and supervision framework, and granting limited immunity from state and federal antitrust laws. The bill supports structural commitments Alabama made in its RHTP application to CMS — enabling the provider coordination necessary for its 11 rural health initiatives. It passed the House, crossed to the Senate, and was read for the second time and placed on the calendar. A companion bill, SB350, is moving in parallel. (Alabama Legislature)

Iowa HF2743: Creates the Iowa Rural Health Transformation Fund and grants the Department of Health and Human Services authority to distribute the state’s $209 million annual RHTP award under the Healthy Hometowns program. This bill supersedes the earlier HF2468, which was withdrawn. The Iowa House passed the bill (reported April 1) and it is now on the NOBA: House Floor, advancing to the Senate. Iowa was the first state in the nation to begin awarding RHTP subgrants, making this spending-authority bill a critical next step. (Iowa Legislature)

Mississippi SB2477: Requires competitive bidding for vendors, subcontractors, and other entities selected to provide goods or services funded through the Rural Health Transformation Program, with priority given to those located in super rural ZIP codes and counties outside metropolitan statistical areas. The bill was a transparency measure in response to the governor’s office awarding a consulting contract to BDO Government Services (formerly HORNE) before the legislature could establish oversight. Both chambers passed it unanimously, but Governor Reeves vetoed it. (Mississippi Legislature)

Appropriation & Budgetary Links

Idaho S1453: Appropriates funds to the Department of Health and Welfare for the Rural Health Transformation Program, providing the spending authority Idaho needs to draw down its $186 million first-year CMS award. JFAC voted 14-4 on March 31 to approve $3.7 million in federal funds for current-year program administration and 12 new limited staff positions, then separately approved roughly $295 million for fiscal year 2027 covering the remainder of the first-year grant and the full second-year allocation. The bill passed both chambers and has been signed by the Speaker and ordered delivered to the Governor. (Idaho Capital Sun)

Idaho H0920: Appropriates funds to the State Board of Education and the Board of Regents for health education programs in fiscal year 2027, including language that shifts $900,000 from the general fund to RHTP dollars and funds 15 new graduate medical education residency slots using federal Rural Health Transformation Program money. It passed the House 47-22 and the Senate 22-11, and the Governor signed it on April 2. (Idaho Legislature)

Kentucky HB500: Kentucky’s biennial budget bill covering fiscal years 2027-2028, providing appropriations for all state operations including the Cabinet for Health and Family Services, which administers the state’s $212.9 million RHTP award. The bill includes broad-based cuts of 4% in FY 2027 and 3% in FY 2028 with 2% salary increases for state employees. It passed both chambers and has been delivered to the Governor. (Kentucky Legislature)

Maryland SB282: Maryland’s omnibus budget bill for fiscal year 2027, encompassing all state agency appropriations including the Department of Health, which administers the state’s $168.2 million first-year RHTP allocation. The bill passed both chambers and has been enrolled. (Maryland General Assembly)

Ohio HB730: A capital reappropriations bill for the biennium ending June 30, 2028. The Senate Finance Committee attempted to attach amendments appropriating Ohio’s $404 million RHTP award, but the amendments were stripped on the Senate floor to meet the March 31 passage deadline. Speaker Huffman acknowledged the chambers could not reach agreement on the rural health language and opted to deal with it in a separate vehicle. The underlying reappropriations bill was signed by the Governor, but Ohio’s RHTP spending authority remains unresolved. (Ohio Capital Journal)

Submit a nomination to be a part of the RHTP Rural Care Collaboratives (RCCs) or the Advisory Council.

Please note you must complete this form to be considered for the Advisory Council. The form closes on Friday, 4/10, at 5 PM.

• RCCs – Planning body for the regions. Meetings will be open to the public.

• Advisory Council – Subject Matter Experts available to provide technical assistance to the RCCs. This is not a decision-making body.

Nebraska is seeking applications for RHTP Health Care Advisory Regions

• Emergency Medical Services (community or county-based) member application: https:​//dhhs.ne.gov/Documents/HCAR-Application-EMS-Provider.pdf

• Emergency Medical Services (hospital-based) member application: https://dhhs.ne.gov/Documents/HCAR-Application-EMS-Provider.pdf

• Ancillary Healthcare provider member application: https://dhhs.ne.gov/Documents/HCAR-Application-Ancillary-Provider.pdf

Washington is looking for Advisory Committee members

Apply for the Rural Health Transformation Program Advisory Committee

As part of Washington state’s RHT Program, we’re organizing an advisory committee (AC). The RHT-AC will help prioritize projects, make policy recommendations, and play a driving role for the RHT Program.

If you have experience in health care or public health, as well as passion for improving systems, we encourage you to apply. Your work could make all the difference for rural Washingtonians.

Apply by Friday, April 24:

• Review the position description

• Email your resume and cover letter to HCA Rural Health Transformation Program

California adds narratives

• CalRHT Project Narrative (March 27, 2026)

• CalRHT Budget Narrative (March 27, 2026)

Nevada adds RFP page

Hit it.

Oregon published a robust FAQ yesterday.

Vermont publishes RFP for stakeholder engagement

Closing date 4/24/2026 5:30 PM

Stakeholder Engagement & Development of a Statewide Health Care Delivery Strategic Plan

Montana launches Rural Health Center of Excellence (CoE) RFPs

As per email from DPHHS:

The Department of Public Health and Human Services (DPHHS) is seeking proposals for two distinct components of Montana’s Rural Health Center of Excellence (CoE), as part of the Rural Health Transformation Program (RHTP).

The first request is for proposals to create the CoE; the second is for proposals to support facilities in implementing CoE recommendations.

Interested organizations can find the procurement details on the Montana Department of Administration website.

Legislation Watch

Primary RHT Legislative Actions

Five bills across three states directly implement, fund, or govern state-level Rural Health Transformation Program operations — with Oklahoma and Alabama leading in volume.

Oklahoma HB3975: Designates the Oklahoma State Department of Health as the lead RHTP agency, establishes the Oklahoma Rural Health Transformation Revolving Fund, sets reporting requirements for partner agencies, and requires memoranda of understanding between participating state entities. The bill codifies the governance structure Oklahoma committed to in its CMS application and carries an emergency clause. It passed the House 86-4 on March 11 and has been referred to the Senate Health and Human Services Committee, then to Appropriations. (Oklahoma Legislature)

Oklahoma HB3066: Creates a Rural Health Transformation Revolving Fund within the Health Care Workforce Training Commission, enabling the commission to receive RHTP dollars, federal workforce grants, and other deposits earmarked for recruiting and retaining clinical talent in rural areas with a five-year service commitment. Sponsored by Rep. Ellen Pogemiller (D-Oklahoma City), it passed the House 87-5 on March 24 and has been referred to the Senate Health and Human Services Committee, then to Appropriations. (Oklahoma Legislature)

Alabama HB591: Provides supplemental appropriations for Alabama’s Rural Health Transformation Program for the fiscal year ending September 30, 2026 — the current-year funding vehicle needed to begin spending the state’s $203.4 million CMS award administered through ADECA. A motion to read a third time and pass as amended was adopted via Roll Call 1127, advancing the bill toward final House passage. (Alabama Legislature)

Alabama HB614: Appropriates funds for Alabama’s Rural Health Transformation Program for fiscal year 2027, establishing the forward-year spending authority for the second tranche of the state’s RHTP award. A motion to read a third time and pass was adopted via Roll Call 1129. (Alabama Legislature)

Alabama HB605: Creates the Rural Health Antitrust Immunity Act under the State Health Planning and Development Agency, authorizing rural health care providers to collaborate on service delivery, establishing a certification and supervision framework, and granting limited immunity from state and federal antitrust laws. The bill supports a structural commitment Alabama made in its RHTP application to CMS — enabling the provider coordination necessary for its 11 rural health initiatives. It passed the House and was read for the second time in the Senate, placed on the calendar as of late March. A companion bill, SB350, is moving in parallel. (Alabama Legislature)

Appropriation & Budgetary Links

Three bills carry RHTP funding as a line item or spending authority within broader budget vehicles.

Idaho S1453: Appropriates funds to the Department of Health and Welfare for the Rural Health Transformation Program, providing the spending authority the state needs to draw down its $186 million first-year CMS award. Idaho’s RHTP money had been in limbo for months while competing oversight bills (SB1264, HB862, HB916) stalled. On March 31, JFAC voted 14-4 to approve $3.7 million in federal funds for current-year program administration plus 12 new limited staff positions, then voted to approve roughly $295 million for fiscal year 2027 covering the remainder of the first-year grant and the second-year allocation. The bill was filed for second reading in the Senate as of April 1. (Idaho Capital Sun)

Missouri HB2011: The state’s omnibus appropriations bill for the Department of Health and Senior Services and Department of Social Services, which contains the spending authority Missouri needs before it can deploy its $216 million annual RHTP award. CMS approved Missouri’s revised budget earlier this year, but legislative appropriation remains the gating step. The bill passed the House and has been referred to Senate Appropriations for second reading. (Missouri House)

Alabama SB146: Alabama’s general State General Fund appropriations bill for fiscal year 2027. While not an RHTP-specific vehicle, the bill funds the executive agencies — including ADECA — that administer the state’s Rural Health Transformation Program. A motion to read a third time and pass as amended was adopted via Roll Call 1159, advancing it through the Senate. (Alabama Legislature)

• 1-Page Summary of the Application

• Governor Dan McKee’s Letter of Endorsement to Dr. Mehmet Oz of CMS

Their website also links to a Revised Project Narrative which was new to me and unique in that it directly lists immediate subrecipients:

Subrecipients: Block Island Health Services; Care Transformation Collaborative of Rhode Island (CTC-RI); Hospital Association of Rhode Island (HARI); Rhode Island League of Cities and Towns; Narragansett Indian Tribe; Rhode Island Health Center Association (RIHCA)

Vermont publishes Mobile Units Notice of Application

Application deadline is April 24, 2026.

The Department of Vermont Health Access (DVHA; the State) is seeking grant applications for Mobile Health Care Clinics with a focus on activities related to one or more of the following health care domains: health education, preventative primary care, dental care, maternal and child health care, mental health care, substance use disorder treatment, chronic disease management, and emergency stabilization services to expand access to care to some of the hardest to reach Vermonters. Preference will be given for proposals that are able to demonstrate, using available data, a clear gap in care specific to a region of the state or target population.

Tennessee info sesssion,10AM CT

Statewide Session March 31 to Highlight Tennessee Rural Health Transformation Program Funding Opportunities

The session will provide a high-level overview of the RHTP vision and how the RHTP goals align with the state’s broader health care vision. Information on competitive funding opportunities will be outlined for interested applicants. Session participants will get information on next steps in the RHTP’s grant process, how to submit follow-up questions, and where to find more information. Registration for the RHTP information session is available online.

Legislation Watch

Arizona SB1316: Establishes the Arizona Rural Health Transformation Fund as the state vehicle for receiving and distributing Arizona’s $167 million annual RHTP allocation from CMS. The bill passed the Senate 17-13 on February 10, crossed to the House, and cleared the House Health & Human Services Committee 6-5 on March 23 and the House Rules Committee 8-0 on March 30. It awaits a full House floor vote. (Arizona Legislature)

Iowa HF2743: Creates the Iowa Rural Health Transformation Fund and appropriates authority to the Iowa Department of Health and Human Services to distribute the state’s $209 million first-year RHTP award — the largest per-capita allocation in the program. Iowa was the first state to begin awarding RHTP subgrants under its “Healthy Hometowns” initiative, and this bill codifies the fund structure and spending authority that Governor Reynolds’ administration has been operating under by executive action. It was read for the first time and referred to Appropriations on March 20. (KCRG)

Idaho: Idaho state budget writers approve federal rural health grant funding (Idaho Capital Sun)

More

Apparantly Maine ran into some compliance issues? Susan Collins Preserves $190M in Federal Funding for Maine’s Rural Hospitals

Gearing up for active solicitations.

Funding Opportunities

How Arizona Is Distributing RHTP Funds

Beginning in Spring 2026, Arizona will use a range of competitive and direct award grant programs to distribute RHTP funding to organizations doing work on the ground.

Types of Funding Mechanisms

• Requests for Grant Applications (RGAs) — competitive, open solicitations for eligible organizations

• Cooperative Agreements — collaborative funding arrangements for larger, multi-year partnerships

• Intergovernmental Agreements (IGAs) — formal agreements with Tribal governments, local health departments, and other state agencies

• Contract Amendments — modifications to existing agreements with managed care plans and established providers

• Multi-Tier Grants — we’re designing flexible awards with grant tiers as small as $10,000 and up so organizations of all sizes can apply.

Also published the AHCCCS Grants Initiatives page.

Kansas publishes info from yesterday’s Evidence-Based Practice Program webinar

EBP Program Introductory Webinar: March 30, 2026 Meeting

• Slides (PDF)

• Frequently Asked Questions (PDF)

• Clinic Participation Agreement (PDF)

• Hospital Participation Agreement (PDF)

It goes pretty deep into Eligibility Determinations.

Washington calls out for Advisory Committee Members

Apply for the Rural Health Transformation Program Advisory Committee

As part of Washington state’s Rural Health Transformation (RHT) Program, we’re organizing an advisory committee (AC). The RHT-AC will help prioritize projects, make policy recommendations, and play a driving role for the RHT Program.

If you have experience in health care or public health, as well as passion for improving systems, we encourage you to apply. Your work could make all the difference for rural Washingtonians.

Apply by Friday, April 17:

• Review the position description

• Email your resume and cover letter to HCA Rural Health Transformation Program

California covers RHTP in Workforce Education and Training Council meeting

New to me (discovered via HCAI newsletter).

The March 4, 2026 meeting of the California Health Workforce Education and Training Council covered RHTP. From the agenda:

This session will provide an overview of HCAI’s proposal and highlight key proposed activities which includes transformative care, technology and tools, and workforce development.

Presenter: Hovik Khosrovian, Senior Policy Advisor, HCAI; Lemeneh Tefera, MD, Chief Medical Officer and Deputy Director for Clinical Innovation, HCAI

Legislation Watch

Idaho S1264: Establishes the Idaho Rural Health Transformation Fund in the state treasury and creates a Rural Health Transformation Committee to direct and provide legislative oversight of the state’s RHTP allocation — nearly $185 million in first-year funding that must be awarded by October 30 or be returned to the federal government. The bill is one of three competing RHTP governance vehicles in the Idaho legislature this session, alongside H0862 and H0916, and differs primarily in committee composition requirements, including a mandate that members represent rural districts. It passed the Senate and was read for the first time in the House, where it was referred to the Health & Welfare Committee. (Idaho State Legislature)

Hawaii SCR27: Urges Maui Health to collaborate with community stakeholders to establish a full-time medical residency program on Maui, explicitly citing Hawaii’s $188.9 million RHTP award as “an immediate and critical financial pathway” to cover the high startup costs. The resolution responds to a 41 percent physician shortage in Maui County — a deficit of roughly 179 full-time equivalent physicians — worsened by the 2023 wildfires that destroyed West Maui healthcare facilities and displaced medical workers. The Senate HHS Committee recommended passage with amendments on a 4-0 vote (one excused). (LegiScan)

Hawaii SR24: A Senate-only companion to SCR27 with identical language urging the Maui residency program and the same explicit reference to RHTP funding. It received the same 4-0 favorable recommendation from the HHS Committee. Track alongside SCR27 — whichever vehicle advances further will carry the policy signal. (LegiScan)

Mississippi HB1067: Requires vendors, subcontractors, and entities receiving goods-and-services contracts under Mississippi’s $206 million RHTP allocation to be selected through a competitive bidding process — covering statewide health needs assessments, medical equipment procurement, workforce programming, and health information system design. The bill gives priority to vendors located in CMS-designated super-rural ZIP codes and counties outside metropolitan statistical areas. It died in conference after the chambers could not reconcile differences, though companion bill SB2477 containing similar competitive-bidding language was sent to the governor. (Mississippi Today)

West Virginia HB4951: Requires MDs and DOs to incorporate two hours of nutrition-focused continuing medical education into their existing license renewal requirements (50 hours per two years for MDs, 32 for DOs) — a policy pledge West Virginia made in its RHTP application to CMS to secure a larger discretionary allocation. The bill passed the House 58-35 and the Senate 34-0, completing all legislative action on March 14, and was approved by the Governor on March 27. (West Virginia Watch)

As many of you know, I am still considering how to structure subscriptions here on the Rural Health Transformation Grant Tracker. Your feedback on various product/ service offerings has been invaluable. I will roll out the plan in the next few months, but in the meantime I thought I’d publish some interim data in honor of the closing of the first quarter of the program.

CMS Rural Health Transformation Program Q1 RFP Review / Q2 RFP Watcher

Here’s a PDF I put together with full links to all current RFPs and my analysis of which states are likely to publish soon.

Again, access the document here: CMS Rural Health Transformation Program Q1 RFP Review / Q2 RFP Watcher. Includes:

Rural Health Transformation Program — Published Procurements Q1 2026

Every published RFP, RFA, NOFO, and award from the CMS Rural Health Transformation grant program through Q1 2026. Sourced from the Rural Health Transformation Daily Brief newsletter and associated systems (31 issues, Feb 21 – Mar 28, 2026).

Rural Health Transformation Program RFP Watch - Signal Chart

Analysis of potential new procurement opportunities published by states under the CMS Rural Health Transformation grant program. Sourced from the Rural Health Transformation Daily Brief newsletter and associated systems (31 issues, Feb 21 – Mar 28, 2026).

CMS SAM.gov outlay monitor stands at zero

Lastly, there have been no outlays of funds from the federal government to the states:

See you tomorrow!

First one since October 2025.

California Rural Health Transformation Program – Spring 2026 Webinar | April 21, 2026 | Register

Oregon posts materials

March 25, 2026 Informational Webinar

• Informational Webinar Recording​

• Presentation Slide Deck​

Some notes, via the transcript:

Funds Unrestricted as of March 20, 2026 The sing…

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Received yesterday via email.

MDH’s Office of Rural Health and Primary Care seeks Request for Proposals (RFP) for one or more vendors to provide professional technical advisory services related to a variety of health information technology purc…

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• Provider Payments Fact Sheet

• 5 Year Service Commitment Fact Sheet

Pennsylvania published info on upcoming webinar

Date: March 31, 2026
Time: 3:30 p.m.
Register: Register to participate here — Participants will recieve the link to attend the webinar at the day on March 30th.

The webinar will focus on the following topics:

• The operational str…

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The Alaska Department of Health (DOH) opened the first Letter of Interest (LOI) registration period for Alaska’s Rural Health Transformation Program (RHTP) on February 17, 2026. Organizations could submit LOIs through March 11, 2026. DOH has contracted with the Alaska Community Foundation…

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As per the Facebook page of the West Virginia Department of Health:

We will provide an overview of the RHT Program, highlight the program’s goals and key initiatives, provide updates on what to expect and ways to stay engaged in this important work for the State of West Virginia

The event w…

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The Evidence-Based Practice Program, part of the State’s Rural Health Transformation Plan, will launch with a webinar on Monday, March 30, 2026, from noon to 1:00 p.m. This webinar will introduce the Evidence-Based Program, which helps rural hospitals and clinics build and maintain the infrastructure to impl…

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Upshot:

On January 30, 2026, as required by CMS, California submitted a revised CalRHT budget that further describes CalRHT planning for the award. After receipt of the revision, CMS has up to 45 additional days to review the CalRHT revised budget and notify California if further revisio…

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I failed to include this in this morning’s edition due to a configuration error— caught it via email from the state and fixed scraper:

Workforce Retention Funding for Critical Access Hospitals and Their Owned and Operated Clinics

Minnesota published four Notices of Grant Opportunity yesterday

• Rural hospitals

• Rural FQHCs

• R…

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