State Agencies · Implementation · 6 min read
How can state agencies administering RHTP use Rural Health Transformation Program funding?
State agencies hold the cooperative agreement and are accountable to CMS, so their job is to translate the federal plan into solicitations, sub-awards, and reportable outcomes. In practice, state agencies administering RHTP can fund designing RFAs and grant mechanisms, sub-recipient monitoring and compliance, statewide measurement and reporting frameworks, and stakeholder convening across rural regions. These map most naturally to the additional uses that promote sustainable access, and evidence-based prevention and chronic-disease management categories, and State agencies are the hub: they receive the award and distribute it through their own competitive and formula mechanisms.
Where RHTP fits
State agencies hold the cooperative agreement and are accountable to CMS, so their job is to translate the federal plan into solicitations, sub-awards, and reportable outcomes.
Fundable program types
RHTP can support a range of work for state agencies administering RHTP:
- designing RFAs and grant mechanisms
- sub-recipient monitoring and compliance
- statewide measurement and reporting frameworks
- stakeholder convening across rural regions
How to engage with the funding
State agencies are the hub: they receive the award and distribute it through their own competitive and formula mechanisms.
Because states apply and are accountable; sub-recipients (providers, plans, vendors) deliver, the practical move is to track your state's solicitations and align your proposal to its plan.
A common pitfall to avoid
Slow solicitation design delays spend-down and risks under-obligation against annual federal expectations.
Frequently asked questions
- Are state agencies administering RHTP eligible for RHTP funding?
- Not directly: states hold the award. state agencies administering RHTP participate through state solicitations as sub-recipients or partners.
- Which allowable-use categories fit state agencies administering RHTP best?
- The additional uses that promote sustainable access, and evidence-based prevention and chronic-disease management categories are the most natural fit.
Figures reflect the CMS Rural Health Transformation Program NOFO and the December 2025 award announcement. RHTP Tracker is an independent resource by Moodr Health and is not affiliated with CMS.