Using the Proper Method to Spend RHT Dollars

Rural Health Transformation dollars are public funds. Proper procurement and documentation protect your agency and your state.

Why Spending Method Matters

Rural Health Transformation funding is federally authorized and administered through state-approved transformation plans. While the opportunity is significant, these funds come with defined compliance standards. How your agency purchases equipment, services, and technology must align with public procurement requirements and state oversight rules.

Failure to follow proper spending methods can create risk not only for your agency, but for your state’s broader transformation plan.

Key considerations include:

RHT dollars are public funds and must meet competitive procurement standards.
States are required to document vendor selection and purchasing methodology.
CMS maintains oversight authority and can review compliance at any time.
Improper procurement can delay reimbursement, trigger corrective action, or jeopardize future funding participation.

Spending strategy is not an administrative detail. It is part of protecting the funding your agency worked to secure.

What Compliance Requires

Spending RHT funds requires more than selecting the right equipment or vendor. Agencies must follow purchasing methods that meet public funding standards and state oversight requirements.

Competitive Procurement

RHT dollars must be spent through approved purchasing pathways. This may include competitively awarded contracts, cooperative purchasing agreements, or other state-approved procurement methods. Informal vendor selection is not sufficient when public funds are involved.

Documentation

Agencies must maintain documentation that supports vendor selection, pricing methodology, and purchase justification. States must be able to demonstrate how and why funds were deployed in alignment with their approved transformation plan.

Audit Readiness

States are accountable to CMS for both financial integrity and program outcomes. Agencies participating in RHT-funded initiatives should expect oversight, performance review, and potential audit verification throughout the life of the program.

Cooperative Purchasing as a Compliant Path

Many public safety agencies use cooperative purchasing contracts to meet competitive procurement requirements while moving projects forward efficiently.

Cooperative contracts are publicly solicited and awarded through a lead agency. Vendors are evaluated in advance, pricing is competitively established, and documentation is maintained for transparency and audit support. This allows agencies to purchase through an already compliant pathway rather than initiating a separate bid process.

For RHT-funded initiatives, this approach can:

Reduce administrative burden
Support procurement compliance
Provide audit-ready documentation
Accelerate implementation timelines

Examples of Compliant Procurement Pathways:

Agencies should confirm that their selected procurement pathway aligns with their state’s MIH or transformation funding guidance.

What May Qualify Under RHT

Eligible uses of Rural Health Transformation funding depend on each state’s approved transformation plan. However, many states are prioritizing initiatives that expand community-based care, strengthen workforce capacity, and improve technology infrastructure.

Depending on state guidelines, qualifying investments may include:

Mobile integrated health equipment
Community paramedicine support tools
Behavioral health response equipment
Technology and interoperability systems
Workforce training and retention initiatives
Data collection, reporting, and infrastructure improvements

Agencies should review their state’s transformation priorities and confirm eligibility requirements before committing RHT funds.

Protect the Funding You Secure

Engaging early, aligning with state priorities, and following proper procurement pathways ensures your project remains funded and sustainable.