Rural Health Transformation Program (RHTP)

The Department of Health is developing an Alaska-specific application guide to help community organizations understand the RHTP opportunityfunding pathwaysand key requirements. This guide is intended to support prospective applicants and will be updated as additional federal guidance becomes available.

Organizations interested in applying for Alaska RHTP funding must begin by registering and submitting a Letter of Interest. The LOI portal for the first round of Alaska RHTP funding opened on February 172026and closed on March 112026.

Based on LOI submissionssome organizations may move forward to readiness or planning supportwhile projects ready for implementation may proceed to a full project application. Not all LOIs will move forward immediatelyand additional funding opportunities will occur over the life of the program. 

This document outlines three of the four funding pathways for Alaska’s RHTP: ReadinessPlanningand Project Implementation.  For each funding pathwaythe chart provides a brief description and details their intended recipientsthe typical stage of their project proposalsand examples of potential uses of funds. 

This document describes the eligibility requirements for organizations seeking to receive subaward grant funding from the Alaska DOH through the RHTP. Meeting the organization-level eligibility requirements does not guarantee funding. DOH will make funding decisions based on competitive reviewprioritizationand available funding. 

Alaska’s statewide application outlines the goalsinitiativesand priorities that guide how RHTP funding will be used in Alaska. All RHTP projects must align with and advance these initiatives and receive prior approval from CMS.

Applicants are strongly encouraged to review this section before submitting a Letter of Interestas proposals should clearly describe how they align with Alaska’s RHTP goals and initiatives.

Jump to Alaska’s proposed initiatives and statewide application below

Answers to common questions about Alaska’s RHTP.

Jump to RHTP FAQs below

All applicants will need to include a Unique Entity ID (UEI)  to apply for funding. A UEI is a federal identifier which allows you to bid on government contracts and apply for federal assistance.

Learn how to find out whether your organization has a UEI: 

Register your organization with Sam.gov and receive a UEI number:

 The video provides a walkthrough of the UEI process.

DOH opened a registration and Letter of Interest portal on February 172026 for this first round of RHTP funding that closed on March 112026.

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

Anticipated annually:

• Celebrate program successes
• Facilitate partnerships and collaboration across
  stakeholders

To foster collaboration and measure progress across Alaska’s health care landscapethe Alaska Department of Health will be partnering with leaders across the state to host regional RHTP meetings.

These in-person meetings intend to bring communities together to collectively discuss regional gaps and priorities across the six Alaska RHTP initiatives. DOH will utilize these meeting discussions to identify regional milestones and metrics to monitor progress in the state’s healthcare landscape for the duration of the RHTP five-year period. 

DOH will announce updates here as they become available. Questions can be directed to [email protected]. 

The RHTP is a new federal program created by Congress in 2025 to strengthen rural communities across America by improving healthcare accessqualityand outcomes by transforming the healthcare delivery ecosystem. Through innovative system-wide changethe RHTP invests in the rural healthcare delivery ecosystem for future generation.

The Centers for Medicare & Medicaid Services (CMS) provides a national framework for the RHTPbut each state is responsible for developing its own transformation plan. In Alaskathe RHTP is particularly important due to the state’s vast geographyremote and frontier communitiesworkforce shortagesand high cost of care delivery. The program provides a time-limited opportunity to strengthen local health systemsexpand access to care close to homeand invest in solutions designed for Alaska’s unique rural and remote context.

The RHTP is intended to make health care work better for all Alaskans by improving access and preventionexpanding workforceleveraging technologyand creating long-lasting changes that help people stay healthy. Specific goals are detailed further in Alaska’s Project Narrativeand include:

1. Promote lifelong health and wellbeing for ruralremoteand frontier Alaskans
2. Build sustainableoutcomes-driven health systems
3. Drive workforce and technology innovation.

Alaska’s RHTP Project Narrative explains the State’s plan for improving rural health care. It describes the goalsinitiativesand types of projects RHTP funding is meant to support. All RHTP-funded projects must align with this plan.

RHTP is a cooperative agreement with CMSwhich means the Department of Health (DOH) works closely with CMS and CMS must approve how funds are used. As the program moves forwardCMS may continue to review and clarify allowable activities and Alaska may make updates to its Project Narrative accordingly. Applicants should use the Project Narrative as a guide when developing project ideas.

Alaska is among the top recipients nationwide. Alaska’s year one award was $272,174,855.72 to support targetedsystem-level investments aimed at improving access to care while reinforcing the long-term stability of Alaska’s health care infrastructure.

Alaska’s first RHTP budget period runs from December 292025 through October 302026. First year award funds must be obligated by the end of the budget periodbut Alaska can finish spending those funds through the following federal fiscal year. This means that all first-year funds are required to be fully spent by September 302027. Any funds not expended by that date are subject to federal recapture and redistribution under the RHTP rules.

The Alaska DOH is the lead agency for Alaska’s RHTP. DOH administers the program through a cooperative agreement with CMSwhich provides federal oversight and approval of allowable uses of funds.

DOH is responsible for setting program prioritiesestablishing application and evaluation processesmaking funding recommendationsand ensuring compliance with federal requirements. Final funding decisions are made by the DOH Commissioner and are subject to CMS review and approval.

To support implementation and efficiently distribute funds to community-based organizationsDOH has contracted with the Alaska Community Foundation to manage the administrative subrecipient application processadminister subawards to approved projectsand assists subrecipients with administrative requirements under DOH’s direction.

Alaska’s RHTP Project Narrative has been accepted by CMS and serves as the approved framework for implementation. Because RHTP is administered through a cooperative agreementproject design and implementation details will continue to evolve over time in collaboration with CMS.

DOH is the lead agency for Alaska’s RHTP. DOH will work with federal partners at CMS to set program prioritiesapprove awardsand ensure federal compliance.

DOH will establish a statewide Subrecipient Administrator to help run the application process within the stateprovide technical help to applicantsprocess awardsand support reporting and compliance.

All funding decisions will be made by the DOH Commissioner with support from the RHTP Advisory Council.

The Alaska Community Foundation (ACF) is an Alaska-based philanthropic organization with deep roots and connections across the state. DOH has contracted with ACF to support implementation of RHTP in Alaska by managing the subaward process on behalf of DOH. This includes administering the application portalassisting organizations as they applyissuing and managing subawards for approved projectsprocessing paymentsand supporting required reporting and compliance activities.

ACF does not make final funding decisions. All award decisionsprogram prioritiesand oversight responsibilities remain with DOH and are subject to federal requirements and CMS approval.

RHTP funding is provided to states in annual awards. Each year CMS reviews Alaska’s progress in implementing the programincluding whether projects are moving forward on schedulefunds are being used as approvedand the state is making progress on the goals and commitments described in its RHTP plan. This annual review helps inform the amount of funding Alaska may receive in future yearsconsistent with federal program requirements and available appropriations.

Yes! Organizations anywhere in Alaska will be able to apply. Although the program is designed to improve health in ruralremoteand frontier regionsAlaska’s health system is deeply interconnected. Many rural residents receive care in regional hubs and larger communities. Projects based in urban areas can improve rural health outcomes. If a project supports the RHTP goalsstrengthens the health care systemor supports the health of rural Alaskans in any wayit may be eligible for funding.

Many types of organizations will be eligible for RHTP fundingincluding but not limited to:

• Health care providers
• Tribes and Tribal Health Organizations
• Hospitals and clinics
• Behavioral health and substance use treatment organizations
• Emergency Medical Services (EMS) and emergency care entities
• Social service organizations
• Local governments
• Health workforce and training programs
• Technology and innovation partners
• Schoolsuniversitiesvocational and other education partners
• Child care providers and early childhood development programs
• Provider and trade associations
• Other nonprofits or community-based organizations working on health or community well-being

For more information about what organizations may be eligible to apply for fundingsee the RHTP Organization-Level Eligibility document.

RHTP funds may be used to support a wide range of innovative projects that align with Alaska’s six RHTP initiativesas described in the RHTP Project Narrative. Eligible uses includebut are not limited to:

• Expanding access to primarymaternalbehavioralspecialtyor oral health care
• Trainingrecruitingor retaining health workers
• Upgrading clinicsEMS resourcesor other health care settings
• Strengthening value-based care and innovative payment models
• Launching new mobileitinerant or regionally shared services
• Investing in telehealthinteroperabilityand digital health tools
• Supporting community wellnesspreventionand chronic disease management efforts
• Implementing technology that improves coordinationsafetyor data sharing

RHTP funds may support planningcapacity-buildingstart-upand implementation costs necessary to carry out approved projectssubject to federal requirements and program funding limitations. Projects should be designed with a clear path to sustainability beyond the RHTP funding periodrecognizing that some activities may be time-limited demonstrations or pilots intended to inform longer-term system change.

All RHTP-funded activities must align with Alaska’s RHTP initiatives and fall within the uses of funds permitted under federal law and approved by CMS. The categories below describe the federally allowable uses of RHTP funds that Alaska may apply in support of its initiatives. All projects are subject to CMS review and approval.

• A. Prevention and chronic disease: Promoting evidence-basedmeasurable interventions to improve prevention and chronic disease management.
• B. Provider payments: Providing payments to health care providers for the provision of health care items or servicessubject to limitations described below.
• C. Consumer tech solutions: Promoting consumer-facingtechnology-driven solutions for the prevention and management of chronic diseases.
• D. Training and technical assistance: Providing training and technical assistance for the development and adoption of technology-enabled solutions that improve care delivery in rural hospitalsincluding remote monitoringroboticsartificial intelligenceand other advanced technologies.
• E. Workforce: Recruiting and retaining clinical workforce talent to rural areaswith commitments to serve rural communities for a minimum of 5 years.
• F. IT advances: Providing technical assistancesoftwareand hardware for significant information technology advances designed to improve efficiencyenhance cybersecurity capability developmentand improve patient health outcomes.
• G. Appropriate care availability: Assisting rural communities to right size their health care delivery systems by identifying needed preventativeambulatorypre-hospitalemergencyacute inpatient careoutpatient careand post-acute care service lines.
• H. Behavioral health: Supporting access to opioid use disorder treatment services (as defined in section 1861(jjj)(1) of the Social Security Act)other substance use disorder treatment servicesand mental health services.
• I. Innovative care: Developing projects that support innovative models of care that include value-based care arrangements and alternative payment modelsas appropriate.
• J. Capital expenditures and infrastructure: Investing in existing rural health care facility buildings and infrastructureincluding minor building alterations or renovations and equipment upgrades to ensure long-term overhead and upkeep costs are commensurate with patient volumesubject to limitations described below.
• K. Fostering collaboration: Initiatingfosteringand strengthening local and regional strategic partnerships between rural facilities and other health care providers to promote quality improvementimprove financial stability of rural facilitiesand expand access to care.

Federal rules do not allow funds to be used for certain costs and activities. Examples of unallowable uses include but are not limited to:

• Paying for health care services or activities that are already fully covered by MedicaidMedicareor another payerunless the funding is addressing a documented gap or supporting an approved demonstration or transformation activity
• Paying the non-federal share (state or local match) of Medicaid or other federal health programs
• Providing new direct student loans or repaying existing student loan debt
• Major construction projects or large-scale infrastructure development
• Replacing or supplanting existing funding for ongoing programs or routine operations
• Costs that duplicate or are already paid for by another federal grant or funding source
• Broadband infrastructure or major internet installation projectscertain telecommunications equipment prohibited under federal law (see 2 CFR 200.216)and household or individual internet installation or monthly service costs
• Lobbyingpolitical activitiesor advocacy intended to influence legislation or elections
• Activities that do not align with Alaska’s RHTP initiatives or that fall outside federally permitted uses of funds
• Costs that are unreasonablenot clearly justifiedor not directly tied to an approved RHTP project

Applicants must clearly demonstrate how proposed activities align with RHTP goalscomply with federal requirementsand do not duplicate other funding sources. All uses of funds are subject to review and approval by the Alaska Department of Health and CMS. 

Yes. Federal requirements place limits on how much of Alaska’s total RHTP funding can be used for certain types of costs. These caps apply across the full programnot just to individual projectsand help ensure that funds are used primarily to advance rural health transformation activities.

Key capped cost categories include:

• •Administrative costs (including program administration and grant management): 10% of total RHTP award
• Provider payments (payments for health care services that are not otherwise reimbursable): 15% of total RHTP award
• Capital expenditures and infrastructure: 20% of total RHTP award
• HITECH-certified electronic medical record (EMR) replacement: 5% of total RHTP award
• Technology Innovation Catalyst Fund activities: 10% of total RHTP awardcapped at $20 million

Because these limits apply at the program-wide levelnot every otherwise eligible project in a capped category can necessarily be funded. Applicants should be aware that:

• Inclusion of capped costs does not make a project ineligiblebut it may affect funding decisions if caps are reached
• Projects should clearly justify why proposed costs are necessaryreasonableand directly tied to RHTP activities
• Applicants may be asked to revise budgets to ensure compliance with federal limits

The Department will monitor cumulative spending across all funded projects to ensure ongoing compliance with federal funding caps throughout the life of the program.

Yes. RHTP funds may support technology and digital health investments that improve accesscoordinationsafetyor quality of careparticularly in rural or hard-to-reach settings. RHTP funds may also support planning activities related to major technology investmentssuch as needs assessmentsvendor selectiontechnical assistanceand implementation support. Examples includebut are not limited to: 

• Telehealth platformsinteroperability solutionsand care coordination tools 
• Communications and dispatch systems (e.g.EMS dispatch911-related systemsradiosphonesswitchesor care coordination platforms) 
• Remote patient monitoringdiagnosticsor clinical decision-support tools 
• Droneskiosksremote dispensing equipmentor other technologies that support medical deliverylogisticsdiagnosticsor emergency response 
• Pilots or demonstrations of emerging technologies (e.g.AI-enabled tools or wearables) to assess effectiveness and scalability prior to broader deployment 

Yes. RHTP funds may support capacity-building activities that enable organizations build the internal systems needed to sustainably deliver or scale services aligned with RHTP goals. This includes administrativebillingand operational enhancements when they are directly tied to implementing the proposed projectenable compliance with federal requirementsand are reasonably allocable to RHTP activities. 

RHTP funds cannot be used for ongoing operating expenses that are not directly tied to project implementationand each project must include a sustainability plan that extends beyond the RHTP funding period. Examples of potentially allowable capacity and administrative support expenses includebut are not limited to:

• Building billing and revenue cycle management capacity for organizations that do not currently have it 
• Technical assistanceplanningand project design support 
• Vendor assessmentssystem specificationsand implementation support for new programs or infrastructure
• Staff timetrainingand expenses directly related to executing project activities and meeting federal compliance requirements (e.g.financial reportinggrant management systems)

When proposing administrative or capacity-building costsapplicants should clearly describe how each cost is directly connected to delivering the proposed project. Costs that are routine overheadunrelated to project activitiesor support general operations will not be allowable.

Yesbut only in limited circumstances. RHTP funds cannot be used for:

• Broadband infrastructure or major installation projects that require construction activities
• Household or individual internet installation or monthly service costs
• Telecommunications or video surveillance equipment prohibited under federal law (see 2 CFR 200.216)

RHTP funds may be used for limited connectivity-related costs when they are necessary to carry out an approved RHTP projectdo not involve major constructionand are clearly tied to RHTP activities. Examples of potentially allowable uses include:

• Portable or deployable internet access equipment that does not require major installationsuch as temporary or mobile satellite-based connectivity used at a clinic or project site
• Internet service costs for a limited period (for exampleduring a pilotdemonstrationor testing phase) when connectivity is required to carry out RHTP-funded work

If internet services are used for both RHTP activities and general operationsonly the portion directly related to the RHTP project may be charged to RHTP funds. For exampleif connectivity is used roughly half the time for RHTP-funded activities and half for routine operationsonly 50 percent of the cost would be allowable. All connectivity-related costs must be reasonableclearly justifiedand directly tied to approved RHTP activitiesand are subject to CMS review and approval.

Under federal guidanceRHTP funds cannot be used for the following capital expenditures or infrastructure costs:

•    New construction or major building expansions or renovations
•    Purchase or acquisition of land
•    Demolition activities
•    Activities that materially increase the value of property

RHTP funds may be used for minor building alterations or renovations that enhance the functionality of an existing facility where the project will take place. These include limited modifications to an existing building footprintinfrastructureor interior spaces. The facility does not need to be an existing health care facilityand work that requires a permit may be allowable (depending on the nature of the work).

Examples of potentially allowable minor building alterations or renovations include:

• Interior modificationssuch as installing or relocating walls to create officesexam roomsor meeting space
• Lighting or electrical upgrades to improve efficiency or functionality
• HVAC or plumbing improvements to support clinical or operational needs
• Accessibility improvementssuch as installing automatic door openers
• Safety or security upgradesincluding access controls or cameras
• Workspace reconfiguration to better support care delivery or program operations

Illustrative examples include:

• Retrofitting underutilized or high-cost space within an existing facility to support clinicemergencyor community-based treatment functions
• Renovating existing commercial buildings (such as hotels) for rural medical resident housing or satellite training campuses
• Renovating space to establish childcare facilities that support rural health care workforce recruitment and retention

All capital-related costs must be directly tied to and support approved RHTP activities and are subject to CMS review and approval.

RHTP funding can generally be used to purchase or upgrade health care-related equipment and IT systems. Capital and infrastructure investments are generally intended to support facility-related needssuch as improvements to existing buildings or replacement of existing equipmentparticularly when those investments help right-size rural health care facilities and ensure that ongoing operating and maintenance costs are appropriate for patient volume.

New equipment purchases may be allowed. Rather than being considered capital expenditures and infrastructure (and counting toward the capped amount allowed for those types of expenses across the RHTP program)new equipment is typically evaluated based on what it is used for and how it supports RHTP goals. For examplenew equipment may be classified under areas such as expanding appropriate care availabilityimproving behavioral health servicessupporting prevention and chronic disease managementor enabling technology-driven care.

Whether an equipment purchase is allowable depends on how clearly it advances RHTP goalsresponds to a documented community or system needand represents a reasonable and well-justified use of RHTP funds. All equipment costs must be directly tied to approved RHTP activities and are subject to CMS review and approval.

CMS will review requests to purchase vehicles on a case by case basis and approval is not guaranteed.

RHTP funds are not intended to serve as an ongoing payer for routine clinical serviceswhether for insured or uninsured individuals. Federal rules prohibit using RHTP funds to supplant MedicaidMedicareprivate insuranceor other existing funding sources.

HoweverRHTP funds may support time-limited payments for services through pilot projectsstart-up costsor demonstration models that expand access to care (including services that are not currently reimbursable for certain populations or in certain settings) if the project aligns with RHTP initiatives and includes a sustainability plan. All uses must comply with federal requirements and receive CMS approval.

Alaska open its first Letter of Interest (LOI) and registration for the RHTP on February 172026. It is scheduled to close on March 112026. Additional LOI opportunities will be offered throughout the life of the program.

A Letter of Interest (LOI) is the first step in expressing interest in RHTP funding. The LOI collects basic information about your organizationthe communities you serveand the opportunity or need you are seeking to address. It also asks for a brief description of your proposed approachwho would benefithow the project aligns with one or more RHTP initiativesyour anticipated timeline and scaleand any potential partners.

LOIs are reviewed for eligibilitycompletenessand alignment with RHTP priorities. Based on that revieworganizations will be guided to the next steps within the appropriate funding pathway.

Community organizations may submit an LOI through the Alaska Community Foundation’s online portal.

Yes. If the LOI submission window is still open and you need to amend or withdraw your submissionplease email [email protected] for assistance.

Yes. DOH is committed to a transparentfairand consistent review process.

Applications will be reviewed for eligibilitycompletenessand alignment with RHTP initiatives and program goals. The evaluation framework and scoring rubric are publicly available so applicants can understand how proposals will be assessed. Final funding decisions will be made by the DOH Commissioner.

Sign up for Alaska RHTP updates and notifications. Additional guidancetemplateswebinarstraining opportunitiesapplication dates and instructionsand other information will be posted as soon as it becomes available.

For federal updatesmonitor the CMS Rural Health Transformation Program website.