Indiana prohibits sub-recipients, Michigan publishes Budget Narrative, South Carolina funding forecast
Kansas participation agreeements, hiring in Nevada and Washington.
Indiana changed language on their FAQ around sub-granting
Here’s the exact change made between Thursday, April 17 and this morning:
ADDED (1 lines):
+ Primary subrecipients will be prohibited from awarding funds granted by the State to other subrecipients via sub-awards/sub-grants. Primary subrecipients may still award funds to contractors.
REMOVED (1 lines):
- Yes. If your project includes multiple partners, you can receive the full award amount and then sub‑grant or contract with your partners as needed. The lead applicant will serve as the fiscal agent
Michigan publishes Budget Narrative
Completely up-to-date detail on the implementation. I will publish the Michigan RHT deep dive Monday.
Kansas adds Participation Agreeements
Click here for the April 17 Hospital KS EBP Program Participation Agreement
Click here for the April 17 Clinic KS EBP Program Participation Agreement
Nevada is hiring
State Positions: We are looking to fill 4 vacant Management Analyst II positions. If you are interested in applying, don’t wait! This posting closes on Tuesday, April 21st at noon! Look for Requisition # 2026-01611.
Washington is hiring
Including Management Analyst 5 – Rural Health Transformation Program Business Analyst
South Carolina adds RHT Funding Forecast
Legislation Watch
Primary RHT Legislative Actions
Four bills in this cycle were written explicitly to govern, fund, or study state use of RHTP dollars — with Oklahoma and Kentucky moving fast on implementation architecture.
Oklahoma HB4040: Creates the Oklahoma Rural Health Transformation Program inside the State Department of Health and establishes a revolving fund to receive and govern the state’s $223.5 million first-year RHTP award — one of the five largest state allocations in the country. The bill, authored by Rep. Trey Caldwell and carried in the Senate by Sen. Hall, cleared the House 91-3 on April 14 and the Senate 45-0 on April 16 before heading to Gov. Kevin Stitt’s desk as an emergency measure. OKC Fox
The Oklahoma State Department of Health — advised by Boston Consulting Group under an $875,000 contract — shaped the state’s application around six initiatives: telehealth and expanded care teams, upstream prevention, a rural talent pipeline, regional collaboration, value-based care, and a statewide health data utility. The department has already been able to access roughly $202 million of the first-year award, but HB4040 supplies the statutory foundation for how the money moves. Oklahoma Watch KGOU
With the emergency clause, HB4040 will take effect the moment Stitt signs — a likely formality given the governor’s public embrace of the program.
Oklahoma HB3066: The workforce-side companion to HB4040, establishing a dedicated Rural Health Transformation Revolving Fund at the Oklahoma Health Care Workforce Training Commission. The fund holds RHTP dollars earmarked for recruiting and retaining clinical talent in rural and underserved areas, conditioned on a five-year service commitment, and the bill explicitly cites the “One Big Beautiful Bill Act of 2025” as the authorizing federal law. KGOU
HB3066 passed the House 87-5 on March 24 and cleared the Senate Health & Human Services Committee with a “do pass as amended” recommendation. It is now in Senate Appropriations — the last stop before a floor vote, and the committee where the workforce commitment dollar amounts will be tested against competing priorities. The bill is coauthored by Rep. Mickey Dollens and takes effect July 1, 2026 if enacted. Together with HB4040, Oklahoma is building a two-fund architecture: one for overall RHTP governance, and one dedicated to workforce.
Kentucky HCR113: A concurrent resolution creating a legislative Rural Health Transformation Task Force, charged with meeting at least monthly during the 2026 interim and reporting back to the Legislative Research Commission by December 1, 2026. Sponsored by Rep. Kim Moser, R-Taylor Mill, the task force is Kentucky’s first formal legislative oversight vehicle for the state’s $212.9 million first-year RHTP award — a plan that CMS accepted “in full” on December 29, 2025. NKyTribune
HCR113 cleared House Health Services on March 12 but was then recommitted to Appropriations & Revenue — a procedural signal that chamber leadership wants a budget review before the task force goes live. That referral is significant: even non-binding oversight structures now run through A&R, a sign that Kentucky legislators see RHTP as a funding story as much as a health policy one. Kentucky Health News
The task force would be the forum where Kentucky’s RHTP spending priorities — including the rural hospital stabilization work Rep. Hal Rogers highlighted when the award dropped — get legislative scrutiny rather than executive-only control.
Appropriation & Budgetary Links
Alaska’s operating budget is carrying its RHTP dollars through the appropriations process.
Alaska HB263: The FY2027 operating and supplemental appropriations bill, now engrossed in the House. This is the spending-authority vehicle for Alaska’s $272 million first-year RHTP award — the state ranks third nationally in Year One allocations behind only California and Texas, with a possible five-year total of $1.36 billion. Alaska Beacon
Alaska’s Department of Health has taken the position that general fund appropriations related to RHTP projects will not be necessary now or in the future because the program is structured for self-sustainability — meaning HB263 serves primarily as a pass-through authorization for the federal dollars rather than a state-match exercise. The first Letter of Interest window closed March 11, 2026, and the department received nearly 1,800 submissions it expects to update by mid-May. Alaska Public Media
A separate pair of bills — HB352 and SB281, enacting Alaska’s participation in four interstate medical licensure compacts — was introduced specifically to satisfy commitments the Department of Health made in the RHTP application. Their sponsors have acknowledged the bills are as much stakeholder discussion drivers as passage targets. Alaska’s News Source