If you run workforce development, simulation, rural operations, or clinical education programs, you've probably noticed a shift: more state-led funding conversations, fewer direct federal grant opportunities. The Rural Health Transformation (RHT) Program represents exactly this pattern—a major federal investment that flows through states to local partners via state plans, procurements, and subawards.
On December 29, 2025, CMS announced that all 50 states received first-year awards under RHT as part of a $50 billion, five-year program allocating $10 billion annually from 2026 through 2030.
This post addresses the people who will build and implement these projects: workforce development directors, healthcare simulation leaders, clinical educators, rural health network administrators, and hospital operational teams.
What RHT Is and Where It Came From
RHT exists because Congress created it through legislation. Public Law 119-21, enacted July 4, 2025, established the program by amending Section 2105 of the Social Security Act (42 U.S.C. §1397ee). The law appropriates $10 billion per fiscal year for FY 2026-2030.
Who "Applies," and What That Means for You
RHT awards are made to states. The formal application instructions target state applicants exclusively.
If you operate a rural hospital, simulation center, community college, university, AHEC, EMS training program, or regional network, your implementation path involves three steps:
Identify the state's RHT lead. This is typically the health department, Medicaid agency, or an office coordinating rural initiatives.
Position your initiative within the state plan. Get your project into the state's implementation pipeline.
Prepare for procurement. Be ready to execute through contracts, subawards, or participation as a named partner.
What the Money Can Pay For (In Applicant Terms)
CMS's overview describes major categories states are building around, including workforce development and technology innovation.
For most workforce and simulation leaders, practical opportunities appear as projects in two primary areas:
Workforce and Training Expansion
CMS highlights workforce development goals such as recruiting and retention, enabling providers to practice at the top of their license, and building broader care teams including community health workers, pharmacists, and navigators.
Technology-Enabled Training and Delivery Models
CMS also emphasizes technology innovation tied to remote care, data sharing, and cybersecurity improvements.
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The Statutory Language You Can Use in Your Project Write-Up
If you're writing a concept memo for your state, these clauses provide the most useful anchors.
Training and Technical Assistance for Technology-Enabled Solutions
The statute allows:
"Providing training and technical assistance for the development and adoption of technology-enabled solutions that improve care delivery in rural hospitals including remote monitoring, robotics, artificial intelligence, and other advanced technologies." (42 U.S.C. §1397ee(h)(6)(D))
How to use this as an applicant: Position simulation and education projects as training plus adoption support for technology-enabled workflows. Tie activities to staff enablement, curriculum updates, competency assessment, and ongoing technical assistance.
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Software, Hardware, and Technical Assistance for Significant IT Advances
The statute also allows:
"Providing technical assistance, software, and hardware for significant information technology advances designed to improve efficiency, enhance cybersecurity capability development, and improve patient health outcomes." (42 U.S.C. §1397ee(h)(6)(F))
How to use this as an applicant: If your program includes platforms, equipment, or secure data workflows, this clause provides direct justification. It supports purchases when you tie them to efficiency, cybersecurity capability development, and outcomes.
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State Plans Must Prioritize Technology and "Close to Home" Care
The statute requires state plans to include priorities such as:
"to prioritize the use of new and emerging technologies that emphasize prevention and chronic disease management;" (42 U.S.C. §1397ee(h)(2)(A)(i)(III))
"to prioritize data and technology-driven solutions that help rural hospitals and other rural health care providers furnish high-quality health care services as close to a patient's home as is possible;" (42 U.S.C. §1397ee(h)(2)(A)(i)(VI))
How to use this as an applicant: Link your project to rural access and reduced travel burden. Use "data and technology driven" language when describing evaluation, reporting, and workflow design.
Check out how Southeast Community College supported its rural healthcare community with technology that improved healthcare professional job preparedness. Read Full Case Study
What CMS Said States Will Do With the Money (Helpful for Your Pitch)
In the announcement, CMS described state plans that include:
- Expanding care access in primary, maternal, and behavioral health
- Strengthening rural emergency systems and coordination
- Workforce initiatives
- Technology, cybersecurity, interoperability, telehealth, and remote monitoring
Your concept memo should read like it belongs in one of these lanes.
What to Do This Week If You Want to Be in the First Wave
Here's a practical checklist for workforce development and simulation directors.
Write a One-Page Concept That Matches State Plan Language
Include:
- Target region(s) and rural counties served
- Partners: hospitals, EMS agencies, colleges, AHEC, FQHCs, and others
- A 12-18 month implementation plan
- Measurable outputs: people trained, sites supported, competencies assessed, reduction in travel, and other metrics
Use statutory quotes from above to support why your costs are allowable.
Choose One Primary "Use of Funds" Lane
Most applicant-led initiatives fit best under:
- Training and technical assistance for technology-enabled solutions (6)(D), or
- IT advances: technical assistance plus software plus hardware (6)(F)
Pick one as the main justification and treat others as secondary.
Be Ready for the State's Procurement Path
Even strong concepts can stall if you cannot execute quickly. States often prefer:
- Existing contract vehicles
- Pilot-ready scope
- Clear success measures and reporting
The Grants.gov instruction document describes the application as a structured plan with goals, strategies, and detailed initiatives required by statute.
If you’re considering an expansion, renovation, or new simulation space, use this guide to brainstorm. It includes topics and tools to use in your early planning stages, including key players, funding, and equipment evaluation. View Healthcare Simulation Planning Guide
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