Participating in the Rural Health Transformation Program
Key Takeaways:
Everything moves through the state office designated by CMS. There is no grant portal or application.
Find your contact office here.
You need to reach out to them directly, and quickly; this is high-speed funding with high-accountability rules.
Each state has a plan for where funding needs to go, you can find a summary of it here.
Your order of operations will look like this:
1. Organize first. Make a plan for your funding that aligns with your state guidelines to improve rural health in your area. Work with local agencies, leaders, and initiatives wherever possible.
Remember your plan needs provable outcomes aligned with your state guidelines to be in compliance.
2. Contact your state’s designated funding channel to give them the information about your plan. They will be the ones to award the funding to you. Feel free to ask questions and to get involved in local county or community efforts. Use your state’s office as a resource as well as a funding source.
3. Stay engaged with that office. This program is five years and fifty billion dollars- this is not a one-and-done grant.
Do not wait to be invited to the table.
Step forward and take your place.
How does this funding work?
This program is built differently than any other funding source we’ve seen federally for rural health initiatives. The Rural Health Transformation program is a five-year, fifty-billion-dollar CMS initiative — and it directly includes EMS innovation, Community Paramedicine, Treatment in Place, and Mobile Integrated Health.
Funding authority is moving to the states. Every state has already submitted its spending plan.
These funds will flow through state-approved channels — not individual agency requests.
If you’re not engaged with your state Medicaid office, rural health partners, and transformation teams — someone else will define your role.
Where can we get funding?
EMS Leaders – Your seat at the table is not automatic. Rural Health Transformation dollars will fund innovative care delivery — including EMS-based models. But only where EMS leaders show up in state planning, partnerships, and implementation design.
Rural Health Transformation dollars must be deployed on tight timelines and follow federal procurement standards under the Code of Federal Regulations.
States must prove outcomes and plan compliance — or CMS can claw funds back.
That means shovel-ready projects, qualified vendors, documented outcomes, and strong governance. Rural systems that are organized and collaborative will move first.
Who do I talk to in order to get funding that was awarded to my state?
There are no open grant portals, no federal applications. Instead, start looking at your state’s flow; the money flows through your state’s approved transformation plan.
Each state defined their priority programs, eligible partners, funding routes, and has a spotlight on all of the areas where this money is intended to work. We have those listed here, in our key connections. If you are not aligned with your state’s pathway yet, you are behind the curve.
You will need to reach out to your state’s approved transformation management department. Go in quickly. Go in ready. Identify the key areas your state wants to use funding for, and have a plan that follows those guidelines.
There are many moments in leadership that are theoretical. This is operational. If we want to fix rural healthcare, it needs to be led by people like you. The ones who live rural, who deliver high-quality rural care today, the ones who are engaged early; local leaders and hometown heroes. You know rural healthcare, you know what your community needs. You have the ability to get them the funding they need.
