North Dakota publishes three solicitations, Oklahoma details upcomng RFPs
Legislation moves forward in Oklahoma, Virginia, Missouri, and Alaska
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In this issue:
North Dakota posts 3 new RFPs with detailed info on program design, dollar amounts, and benchmarks
Oklahoma publishes slides — see detailed index of upcoming contracting opportunities. $223.5M Y1 awards now obligated
Detailed Maryland RFP calendar
Washington broadcasts rollout details
Legislation Watch covers 4 states
North Dakota drops three competitive sub-award solicitations
All fall under Program 1: Make North Dakota Healthy Again (one of ND’s four program pillars, alongside workforce stabilization, closer-to-home care, and tech/data). All three carry a May 22, 2026 deadline, a shared Qualtrics submission portal, a Sept. 30, 2027 performance end date, and a single rhtp@nd.gov staff mailbox. Together they obligate $3.5M in Year 1 across roughly 40 sub-awards:
Community-Based Walking Program (Solicitation 210-122) — $2.5M across 20 awards at
Community Gardens Project (Solicitation 210-113) — $300,000 across 10 awards at $30,000 each. The smallest of the three, aimed at 4-H, schools, Head Start, tribal councils/colleges, senior centers, worksites, and communities of faith. NDSU Extension Master Gardeners are named in the framework as the designated technical-assistance partner for awardees. TA call May 5.
Zero-Hour Physical Education Initiative (Solicitation 210-112) — $700,000 across 10 awards at $70,000 each. Restricted to rural/tribal public and private schools, regional education associations, and school consortiums. Explicitly modeled on the Naperville, IL before-school heart-rate-monitored PE program; heart-rate monitoring and de-identified pre/post data collection are non-negotiable.
Here’s links to RFPs and technical assistance calls:
Zero-Hour Physical Education (PE) Initiative
Learn more about the Zero-Hour Physical Education (PE) initiative.
Posted: April 22, 2026
Deadline to apply: May 22, 2026 at 5 p.m. CTTechnical Assistance Call
A Zero-Hour PE initiative technical assistance conference call has been scheduled for the following date and time:
Monday, May 4 at 3:30 p.m. CT.
Community Gardens Project
Learn more about the Community Gardens Project.
Posted: April 22, 2026
Deadline to apply: May 22, 2026 at 5 p.m. CTTechnical Assistance Call
A Community Gardens Project technical assistance conference call has been scheduled for the following date and time:
Tuesday, May 5 at 3 p.m. CT
Community-Based Walking Program - Apply Now
Learn more about the Community-Based Walking Program.
Posted: April 22, 2026
Deadline to apply: May 22, 2026 at 5 p.m. CTTechnical Assistance Call
A Community-Based Walking Program technical assistance conference call has been scheduled for the following date and time:
Wednesday, May 6 at 3 p.m. CT
This is in addition to the Workforce Retention Funding for Critical Access Hospitals and Their Owned and Operated Clinics
Oklahoma posts recording and slides of webinar
April 21, 2026 RHTP Touchpoint Webinar
Here’s a quick index of upcoming contracting opportunities and here’s my take:
45% of $223.5M Y1 awards now obligated; 13 competitive opportunities queued through Q4 FY26
Oklahoma’s State Department of Health delivered its April touchpoint webinar on April 21, 2026. Commissioner Keith Reed confirmed that $97.7M of Oklahoma’s $223.5M Year-1 award — roughly 45% — is now obligated or nearly so, with the balance flowing out through a published pipeline of 13 competitive procurement opportunities over the next two fiscal quarters. Microgrants drew over 300 applications before closing April 13 and are now in scoring; the Rural Regional Reorientation NOFO opened this week with up to $4M awards and a June 12, 2026 11:59pm CT deadline; and Chronic Disease Management goes live “early next week” per Program Director Lisa Rother, a timeline subsequently confirmed by Program Director Jackie Kneck.
Oklahoma has stood up 20 Regional Champions (two per district), established a biweekly cadence with CMS program managers, and is holding administrative spend below the 10% CMS cap — targeting 90% programmatic. Reed was explicit about why: “CMS is going to be looking for states that overperform on these grants and looking at states that underperform… Those decisions are made as they evaluate our performance in each year.”. The largest unreleased line item is a $40M Provider Collaborative (Q4 FY26, non-competitive, hospitals as funded entities), followed by a $20M RRR NOFO already live, a $12M Chronic Disease Management NOFO imminent, and a $7M PACE expansion slated for August. Upcoming engagement: Muskogee Roadshow June 10, Perry Roadshow June 18, and June Touchpoint Webinar June 17.
Washington gives Rollout Details for the WA Rural Health Transformation Program
Overview webinar recording (April 14, 2026)
Overview webinar slide deck (April 14, 2026)
On April 14, state agencies hosted their first webinar I outlining the implementation phases of Washington’s Rural Health Transformation (RHT) Program. Project leaders emphasized that the state is accountable for delivering on the six initiatives approved by CMS and cannot add new activities to the plan.
Here are the key takeaways from the presentation:
Upcoming Procurements: While the initial contracting phase focuses on organizations specifically named in the federal application, more opportunities are on the horizon. Several requests for proposals (RFPs), qualifications (RFQs), and information (RFIs) will be released in the coming months. Crucially, your organization does not need to be physically located in a rural area to participate, as long as your work directly supports and benefits rural communities. Interested partners should register on Washington’s Electronic Business Solution (WEBS) to be notified of upcoming bids.
Funding Guardrails: Officials highlighted several strict spending caps across the program. For example, administrative overhead is capped at 10%, EMR system replacements at 5%, and provider payments at 15%. Additionally, funds cannot be used for new construction, lobbying, or supplanting existing funding.
Advisory Committee Deadline: The deadline to apply for the 18-member RHT Advisory Committee is fast approaching. Applications are due April 24, 2026. The committee is anticipated to hold its first meeting in June to help guide future program investments.
Next Webinar: The next program update webinar will be held on September 16, 2026, from 1:00 to 1:45 p.m..
Maryland publishes detailed “Anticipated Funding Opportunities: Budget Period 1” table
Most of this was covered yesterday, but I wanted to post this entire table:
Legislation Watch
Primary RHT Legislative Actions
One state put the program on statutory footing this week — Oklahoma became the first state to pass and sign stand-alone RHTP implementation legislation.
Oklahoma HB4040: Legislation creating the Oklahoma Rural Health Transformation Program and establishing the Oklahoma Rural Health Transformation Revolving Fund inside the State Department of Health, which Governor Stitt designated as the lead agency administering the state’s $223.5 million first-year CMS award — the fourth-largest state award in the country. The revolving fund is the continuing appropriation vehicle OSDH will use to cash-flow program operations overseen by CMS. HB4040 cleared the House 91-3 on April 14 and the Senate 45-0 on April 16 before landing on the Governor’s desk. Oklahoma Watch
The statutory framework matters because OSDH had already begun drawing on federal dollars through an interim mechanism. Oklahoma gained access to approximately $202 million of its 2026 allocation in February once CMS cleared the state’s application — but long-term administration required the legislature to stand up the revolving fund structure. KGOU
Fiscal analysts have warned that the windfall arrives alongside the federal Medicaid cuts baked into the same underlying law, and that Oklahoma’s ability to sustain its rural-health posture after FY2030 depends heavily on non-RHT appropriations decisions the legislature makes in the meantime. Oklahoma Watch
HB4040 was approved by Governor Stitt on April 22, 2026.
Appropriation & Budgetary Links
Three state budget vehicles — Virginia’s biennial budget, Missouri’s DSS appropriations, and Alaska’s supplemental operating budget — are the appropriation tracks through which RHTP dollars will actually flow to grantees.
Virginia HB30: The Commonwealth’s 2026-2028 biennial budget bill, carried over from the prior session and now in conference. Virginia received a $189.5 million first-year RHTP award, administered by the Department of Medical Assistance Services under the state’s “VA Rural Vitality” branding, and HB30 is the appropriation vehicle through which state-level dollars to operate the program would flow. Cardinal News
Rural health policy experts have flagged concerns about Virginia’s ability to stand up administration, grant distribution, and reporting infrastructure at the pace CMS is demanding, amplified by yearly award reassessments that condition ongoing funding on demonstrable progress. House and Senate conferees met the March 4 conference deadline — Appropriations Chair Torian leading for the House and Finance Chair Lucas for the Senate — and HB30 is now working its way through reconciliation. Virginia Association of Counties
Missouri HB2011: The FY2027 Department of Social Services appropriations bill — the vehicle through which Missouri’s $216 million first-year RHTP award will be appropriated for spending. DSS is the lead agency on the state’s Rural Health Transformation plan, which calls for 10 hospital infrastructure grants and three new-service-line grants in 2026, along with technology contracts and staffing for a new Rural Health Transformation Office housed inside the department. KCUR
HB2011 has now been Third Read and Passed by the Senate, having cleared both chambers and positioned for conference.
Alaska HB263: The FY2026 supplemental operating budget carrying the formal spending authority for Alaska’s $272 million RHTP award — the second-largest state award nationally and, at $368 per resident, the highest per capita. A separate legislative committee already granted up to $200 million in receipt authority in November 2025, but HB263 carries the supplemental appropriation into the FY26 budget proper. Anchorage Daily News
HB263 now sits alongside a broader legislative project to meet Alaska’s RHTP compact and scope-of-practice obligations — separately introduced SB281 and HB352 enact four interstate medical licensure compacts, but both were filed this month explicitly to gather stakeholder feedback rather than to pass this session, a sign that compliance with RHTP prerequisites is still in discovery mode. Alaska’s News Source
HB263 has passed the House as CSHB 263(FIN) AM and has been referred to the Senate Finance Committee.
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