South Carolina publishes Updated Budget Narrative-- new subcontractor, new oversight methods
Montana and Colorado have new info for vendors, Alabama authorizes Year 2
South Carolina publishes Updated Budget Narrative
The plan cotains major updates to spenindg. Another changes :
Method of Accountability: Subrecipients will be held to a contract awarded as a result of the competitive grant application process. State staff will monitor compliance with deliverables identified as part of the grant application process. In addition, BDO Government Services LLC will monitor the overall RHT program, which will include the monitoring of the subrecipients.
Montana adds Information for Subcontractors
The Department of Public Health and Human Services is organizing a networking opportunity for vendors to explore potential partnerships before submitting their responses to the Rural Health Transformation Program solicitations. We are developing a shared directory to aid communication among potential collaborators. If your organization is interested in connecting with others who may participate in RHTP initiatives, please complete the form below to be included in the directory. Participation is intended to support networking and the exchange of information related to the upcoming RHTP solicitations. While some organizations may intend to submit as primary vendors, others may find value in exploring potential collaborations through this resource.
Disclosure: Participation in this form is entirely voluntary and optional. Submission does not guarantee a partnership, subcontracting opportunity, or contract award.
If you have any other questions about becoming a vendor with the Rural Health Transformation Program, please visit the Information for Vendors page.
Colorado updates Eligible Rural Health Providers and Partners
Legislative Watch
Primary RHT Legislative Actions
Alabama’s RHTP appropriations are now law — the first state to enact dedicated RHTP spending authority for two consecutive fiscal years. Oklahoma adds a second Primary bill to its portfolio, this one creating the Oklahoma Rural Health Transformation Act itself.
Alabama HB591 / HB614: Both RHTP appropriations bills have been signed by Governor Ivey and are now enacted. HB591 provides FY2026 supplemental spending authority for Alabama’s $203.4 million RHTP award, while HB614 extends that authority through FY2027. Both direct federal funds through the Alabama Department of Economic and Community Affairs (ADECA) and establish the Joint Legislative Oversight Committee on Rural Health Transformation Program Funds. HB591 passed 104–0 and HB614 passed 101–0 in the House. Alabama Reflector
Alabama is the first state to fully enact RHTP appropriations legislation covering two fiscal years. With HB605 (the Rural Health Antitrust Immunity Act) also delivered to the Governor, Alabama has moved three dedicated RHTP implementation bills through the legislature this session. Yellowhammer News
Both bills are now law.
Oklahoma HB4040: Creates the Oklahoma Rural Health Transformation Act within the State Department of Health, with an emergency clause. Based on the bill description, this is the overarching statutory framework for Oklahoma’s RHTP implementation — complementing HB3066 (which created the workforce-specific Revolving Fund) by establishing the broader program structure at the Department of Health. Oklahoma’s $223.5 million RHTP award is already flowing, with the Department of Health accessing approximately $202 million and partner agencies leading specific projects across 29 program initiatives. KGOU
Oklahoma now has two complementary Primary bills: HB3066 for the workforce revolving fund (in Senate Appropriations) and HB4040 for the broader program act (newly introduced with emergency clause). News coverage specific to HB4040 was not yet available at time of research — it appears to have been recently introduced. KGOU
HB4040 has been introduced with an emergency clause added.
Appropriation & Budgetary Links
Idaho’s RHTP appropriations bill is the headline — $299 million for the first two tranches of federal funding, after previous oversight bills stalled in the legislature. Oregon quietly signed its own RHTP-carrying budget bill, Kentucky’s $32 billion budget faces line-item vetoes, and Minnesota’s omnibus human services bill enters the pipeline.
Idaho S1453: The Joint Finance-Appropriations Committee’s vehicle for Idaho’s RHTP funding, appropriating $299.1 million to the Department of Health and Welfare and establishing the RHTF Committee for legislative oversight. The bill passed the Senate 20–15 and the House 46–20 — notably tighter margins than Alabama’s near-unanimous votes, reflecting Idaho’s contentious debate over RHTP governance. Idaho Press
The $299.1 million covers two components: a $3.7 million FY2026 supplemental for DHW staffing to administer the RHTF, and $295.4 million in federal funds spanning part of FY2026 and all of FY2027 to begin disbursing the first two tranches of Idaho’s $186 million annual grant. Previous oversight bills — including S1264 and H0916, which disagreed on the makeup of the oversight committee — failed to advance, prompting JFAC to bypass the policy debate and move the money directly. Idaho Capital Sun
Idaho was awarded nearly $1 billion ($929 million) over five years in $186 million increments. S1453 has been signed and is now law. Idaho Freedom
Oregon HB5204: The emergency biennial appropriations bill modifying General Fund allocations to state agencies, signed by the Governor as Chapter 129 (2026 Laws), effective April 7. The bill includes appropriations to the Oregon Health Authority covering the Rural Health Transformation Program — Oregon received $197.3 million from CMS for RHTP’s first year. Oregon Capital Chronicle
Oregon’s RHTP Request for Proposals for Grants (RFPG) opened on April 10, with OHA accepting applications from rural health providers for grant funding under the program. The state’s plan focuses on hospital financial stability, workforce, behavioral health integration, and telehealth expansion. NR Today
HB5204 is now law.
Kentucky HB500: The $32 billion biennial state budget covering FY2026–2028, now with line-item vetoes from Governor Beshear. The budget appropriates nearly $700 million less for Medicaid benefits than Beshear requested, though it sets aside $290 million in a reserve trust fund for potential shortfalls. Kentucky received $212.9 million through the RHTP, with the plan accepted in full by CMS. Kentucky Lantern
Beshear vetoed 35 bills and issued line-item vetoes on the budget during the 10-day veto period. Lawmakers return April 14–15 for the final two session days, where the Republican supermajority can override vetoes with a simple majority. Whether the vetoed line items include RHTP-adjacent provisions requires review of the specific veto message. Lane Report
HB500 has been vetoed with line items; override session begins April 14.
Minnesota HF4969: An omnibus human services bill covering aging and health care, behavioral health, housing, and related provisions. The bill was introduced and referred to Rules and Legislative Administration. Minnesota’s RHTP application covers workforce and care transformation, and omnibus human services bills frequently contain provisions that overlap with RHTP implementation areas. No bill text or news coverage specific to HF4969 was available at the time of research — the connection remains speculative pending text review. Minnesota Legislature
HF4969 has been introduced and referred to Rules.
Alaska HB263: The operating budget has advanced but now faces a notice of reconsideration filed by G. Nelson — a procedural step that pauses the bill’s progress toward a final floor vote. Alaska’s $272 million annual RHTP award requires this budget for spending authority. Alaska Public Media
HB263 remains on the House floor with reconsideration pending.