The Rural Health Transformation Program (RHTP): Your 2026 Funding Playbook
A Nationwide Guide for Eligible Agencies – From RFI to Subaward
By Jennifer Horn, JTS Grant Administrator
Imagine $50 billion cascading into rural America. Not a dream — reality, signed into law under the One Big Beautiful Bill Act (Sec. 71401). From 2026 to 2030, $10 billion annually will flow from CMS to states, then to you — the clinics, hospitals, tribal health programs, and nonprofits holding rural communities together.
You answered your state’s Request for Information (RFI) last fall. You poured hours into data, stories, and vision. That effort mattered. It shaped your state’s Rural Health Transformation Plan, submitted to CMS on November 5, 2025.
But let’s be brutally honest:
Your RFI was not an application.
It secured zero dollars.
It guaranteed nothing.
The real fight starts in 2026 — and it’s state-controlled.
How the Money Actually Moves
Funding Flow (CMS → 50 States → State DOH/Rural Health Office → Local Providers)
- $10 billion per year
- Even split: 50% equal state shares, 50% performance-based
- Subawards issued via state NOFOs, RFPs, and portals
- You will never apply to CMS — all funding flows through your state
Timeline: Mark These Dates
| Milestone | When | What Happens |
| CMS funds states | By Dec 31, 2025 | $50B over 5 years locked in |
| States receive funds | Early 2026 onward | Annual cooperative agreements |
| You apply | 2026+ | Only via state opportunities |
What Wins Funding? Hit At Least 3 Federal Goals
Your project must align with three or more of these mandated priorities:
| Focus Area | Real-World Winners |
| Chronic Disease & Prevention | Diabetes coaching, blood pressure kiosks, farmworker wellness |
| Workforce Development | RN residency programs, loan forgiveness, behavioral health hires |
| Innovative Care Models | Mobile units, care hubs, in-home monitoring |
| Technology Adoption | Telehealth networks, EHR interoperability, remote diagnostics |
| Provider Payments | ≤15% of award — e.g., access bonuses, rate stabilization |
Emotion + Evidence = Funding
Don’t just say “we’ll reduce ED visits.” Prove it. “Our 2024 telehealth pilot in County X cut non-emergent ED use by 18% — saving $420,000 and freeing 1,200 ambulance hours for true emergencies.”
Your 4-Step Battle Plan for 2026
- Stalk Your State DOH – Starting January
Subawards drop January–March 2026.
- Subscribe to DOH/Rural Health Office alerts
- Follow on social and email lists
- Set Grants.gov filters for your state
Miss the announcement? Miss the money.
- Get in the Room – Now
States are finalizing scoring rubrics, priority counties, and match rules in real time.
- Join workgroups (most are virtual)
- Speak up — your feedback shapes the game
- Learn what “high-impact” really means in your state
- Write Like Your Community Depends on It
Because it does.
Weak: “We need telehealth.”
Winning:
“In a county with one ER for 42,000 residents, our telehealth expansion will reduce avoidable ED visits by 18% (2024 pilot data), save $420K/year, and keep Grandma June out of a 3-hour ambulance ride.”
Include:
- Baseline metrics (current gaps)
- SMART goals (Specific, Measurable, Achievable, Relevant, Time-bound)
- Sustainability (how it lives past the grant)
- Budget with 15% indirect (de minimis rate) — federally allowed
- Speed Wins
Federal rules: Funds must be obligated within 2 years of state award. First in, best polished — that’s who gets funded.
How We Help You Win (Without Draining Your Award)
We’re rural grant specialists who live and breathe federal compliance. We’ve walked dozens of rural providers through complex state and federal awards.
Our Proven Process
| Phase | What We Deliver |
| Planning | Map your project to state priorities; build data-backed timelines |
| Proposal | Write compelling narratives, budgets, and ROI models |
| Submission | Navigate portals, fix errors, meet deadlines |
| Award Management | Ensure Uniform Guidance compliance, federal reporting, audits |
| Sustainability | Turn one-time funding into multi-year impact |
We’re paid only from awarded funds — using the federal 15% de minimis indirect rate — so 85%+ of every dollar fuels direct care.
We serve: Clinics • CHCs • Critical access hospitals • Tribal health • University partners • For-profit rural providers • Researchers • Small health startups
The Truth in One Breath
You shaped the plan. Now claim your share.
The $50 billion train leaves in 2026. Will your community be on it?
Just email Jhorn@jtsfs.com for a free 15-minute strategy call. No sales pitch. Just clarity.
Let’s turn federal dollars into healthier tomorrows!