Rural Health Transformation

 
 
 
 
https://public.govdelivery.com/accounts/NESTATE/subscriber/new?topic_id=NESTATE_834
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What you need to know

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Overview

The Rural Health Transformation Program (RHTP) is a $50 billion federal opportunity to improve health care in rural areas across the 50 states.

RHTP is a once-in-a-generation opportunity to modernize rural health care and make it more sustainable. Nebraska received a preliminary notice of award from the Centers for Medicare & Medicaid Services (CMS) for approximately $218.5 million in the first year. 

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    Updates

    Due to the increased award amount (an additional $18.5 million), Nebraska must revise the submitted application materials. Those revised documents must be submitted to and approved by CMS before work can begin.

    A project of this size and scope requires participation from many stakeholders across multiple fields. Nebraska intends to release multiple Requests for Applications (RFAs) over the next five years to provide organizations with multiple opportunities to apply for funds and assist in implementing this important work. There will be additional opportunities for applications in each funding year.


    Get Involved

    Application next steps and timeline

    DHHS aims to open RFAs throughout the year, starting in March. 

    • Funding awards are expected to begin in Spring 2026.
    • There will be additional opportunities for applications in each funding year.


    News

    Press release: December 29, 2025, Gov. Pillen Touts Huge Rural Health Transformation Program Award



    Applications and Proposed Initiatives

    As part of its application, Nebraska proposed seven statewide initiatives that reflect ideas and feedback from hundreds of stakeholders and community partners. These initiatives outline how Nebraska could use RHTP funds to strengthen the state's rural health infrastructure, address workforce gaps, and ensure access to care through consumer-facing technology.

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    Nebraska Initiatieve - Click to view an accessible PDF.
    View an accessible PDF.



    Funding Uses 

    Nebraska Rural Health Transformation Initiatives
    Initiative 1: Make Rural Nebraska Healthy Again Through Food as Medicine
        1.1 School Kitchen Modernization Grant supplies equipment for schools to serve whole fresh food
        1.2 Regional Food Pantry Development to increase availability of whole fresh foods
        1.3 Farm-to-School Procurement & TA enhances kitchen-ready local supply chain for rural schools
        1.4 Healthy Menu Design training for rural schools, hospital cafeteria staff, and clinic dieticians
        1.5 Nebraska Kids Fitness & Nutrition Day focuses on health literacy and healthy behaviors
    Initiative 2: Regionalized Rural Access and Navigation
        2.1 EMS & Perinatal Regionalization for referrals and provider-pairing program for high-risk cases
        2.2 Community Paramedicine program with billing support and workforce development
        2.3 Rural Health Hubs and Community Health Worker Networks across health care settings
        2.4 Veteran EHR Coordination to connect VA scheduling staff to local clinics and hospitals
        2.5 CAH to REH Conversion to ensure health care stays local  
    Initiative 3: Rural Workforce Acceleration
        3.1 Rural Provider Recruitment & Retention such as hiring incentives and apprenticeships
        3.2 Rural VR & Skills Acceleration Network to test competency during training
        3.3 Rural Health Care Workforce Incentive & Sustainability start up grants for new training sites
        3.4 School-Age Health Care Pipeline educating youth about jobs in health care
        3.5 Subsidized Short-Term Provider Housing to support employers in recruiting workforce  
    Initiative 4: eHealth and Mobile Care
        4.1 Mobile Maternal Care & Training in maternity deserts to decrease morbidity and mortality
        4.2 Oral Health programs including new student rotations and mobile services
        4.3 Technology-Enhanced Pharmacy Services for medication reviews and patient adherence data
        4.4 Chronic Disease Management & Remote Patient Monitoring in facilities and at home
    Initiative 5: Rural Emergency Behavioral Health
        5.1 Integrated Primary Care providing behavioral health services in clinics
        5.2 Telehealth Crisis Responders for Law Enforcement is 24/7 access to counselors for triage
        5.3 Modification of Existing Clinical Facilities for Crisis Stabilization Centers
        5.4 Behavioral Health Nursing Homes Pilot provides enhanced payments for complex care needs
    Initiative 6: Assisted Living Facility (ALF) Special Needs Population Incentive Model
        6.1 Incentive Payments for Memory Care and Complex Care including training and programming
        6.2 Facility Modernization Grant to support needs of staff and residents
    Initiative 7: Nebraska Rural Health Technology Catalyst Fund and Partnership Initiative​


    Background

    H.R.1, signed into law on July 4, 2025, enacted the Rural Health Transformation Program (RHTP), which allows for the allocation of funding to support the provision of health care in rural areas.​ ​​​​​

    RHTP fundi​ng consists of $50 billion ($10 billion per fiscal year) to be distributed to states ​​from fiscal year 2026 through fiscal year 2030. 

    $25 billion will be distributed equally amongst all approved states. The remaining $25 billion will be ​allocated by the CMS based on a variety of factors, including:

    • The state's rural population
    • The proportion of rural health facilities in the state
    • T​he situation of certain hospitals in the state
    • Other factors specified in the CMS Notice of Funding Opportunity (NOFO)​​

    Important Dates​

    • July 4, 2025: H.R.1 was signed into law, establishing the RHTP.
    • September 15, 2025: CMS posted the Notice of Funding Opportunity (NOFO) for the RHTP.
    • November 5, 2025: States that choose to apply for RHTP funding must do so by this date.
    • December 31, 2025: CMS must approve or deny applications by this date.
    • January 30, 2026: Revised plan documents submitted to CMS for approval. ​


    Why RHTP Funding Matters for Nebraska

    ​​​With 37% of Nebraskans liv​​ing in rural areas, RHTP funding ​​has the potential to make a significant impact in our state. 88 out of Nebraska's 93 counties are rural, with 30 of these ​classified as frontier counties. 


    Contact Us

    Email: DHHS.RHTP@nebraska.gov

     

     

    The Rural Health Transformation Program is supported by Centers for Medicare & Medicaid Services (CMS) of the U.S. Department of Health and Human Services (US HHS) as part of a financial assistance award totaling $218,529,075.01 with 100 percent funded by CMS/US HHS. The contents are those of the Nebraska Department of Health and Human Services (DHHS) and do not necessarily represent the official views of, nor an endorsement, by CMS/US HHS, or the U.S. Government.​

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