Illinois and Tennessee add deep program details & RFP schedules + Legislation Watch IA & WV
Rural Health Transformation Program Daily Brief, Aptril 7, 2026
Illinois adds detailed presentation
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.
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