Rural Health Transformation Program: HRP: Service Line and Co-Location

Rural Health Transformation Program: HRP: Service Line and Co-Location is sponsored by Tennessee Department of Health. As part of the Rural Health Transformation Program, this funding opportunity addresses service line and co-location strategies to strengthen rural health systems and expand access to care in underserved communities in Tennessee.

Tennessee Department of Health Rural Health Access for Tennessee's Future Information About the New Website for the Tennessee Department of Health Rural Health Access for Tennessee's Future How the State is Advancing Access, Innovation, and Quality Care for Rural Communities. RHTP Frequently Asked Questions A Future of Better Care, Closer to Home Tennessee’s rural communities are the heart of the state’s economy, culture, and identity.

The federal Rural Health Transformation Program (RHTP) presents Tennessee with a historic opportunity to improve healthcare access, quality, and outcomes in our rural communities for generations to come. Tennessee’s RHTP plan is foundational building a locally-led model for how rural America can become healthy, vibrant, and self-sustaining, and bring Better Care, Closer to Home .

The Tennessee RHTP Plan proposes investment that reverses rural hospital decline, extends care access, modernizes technology, and strengthens local economies, while improving outcomes for mothers, children, and older adults. Updates on Rural Health Transformation Click for a replay of the May 15th webinar highlighting the upcoming competetive opportunities in the Rural Health Transformation Program .

Download the presentation from the May 15, 2026, info session on RHTP competitive grant opportunities. Visit the RHTP Partner Portal for information on competitive grant opportunities and projects to build and sustain healthier communities across rural Tennessee. Visit the link below for a video replay from the 2nd Rural Health Transformation webinar on April 15, 2026.

Visit the link below for a video replay from the 1st Rural Health Transformation webinar on March 31, 2026.

Download the Full Version of Tennessee's Rural Health Transformation Plan See Tennessee Gov. Bill Lee's Announcement of Tennessee's Proposal Learn More at the CMS Rural Transformation Program Website Rural Healthcare Access Modernization Program (RAMP) The Rural Healthcare Access Modernization Program (RAMP) supports innovative projects that expand healthcare access and strengthen healthcare delivery in rural Tennessee communities.

Through modernization efforts, infrastructure improvements, and technology-enabled solutions, RAMP helps address healthcare challenges and improve access to care for rural residents. Learn More: Rural Healthcare Access Modernization Program (RAMP) If you have comments, feedback, ideas, proposals, or suggestions, even if it's providing a letter of support on behalf of Tennessee's effort, please send an email to RuralHealth@tn. gov .

This project is supported by the Centers for Medicare & Medicaid Services (CMS) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $206,888,882. 11 with 100 percent funded by CMS/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CMS/HHS, or the U.S. Government.

Rural Health is America's Health The CMS Rural Health Transformation Program is a major federal initiative designed to strengthen rural health systems across all 50 states. Authorized under the One Big Beautiful Bill Act , the program provides up to $50 billion nationwide over five years (FFY 2026–2030) to improve access, quality, workforce stability, innovation, and technology in rural communities.

Tennessee is participating in this historic opportunity to modernize and protect rural healthcare across the state, and build healthier, stronger rural communities for generations to come.. Click to go directly to the Partner Portal to create an account. Click to download a Partner Portal Quick Start Guide .

Click to search the Partner Portal for grant opportunities. Click to download a Partner Portal User Guide.

Upcoming Competitive Grant Opportunities Perinatal and Pediatric Behavioral Health Teleconsultation and Education Project Healthy Active Rural Tennessee (HART) End Zone for Chronic Disease Prevention (Nutrition Security) Service Line and Co-Location Memory Care Assessment Network (MCAN) Make Rural Tennessee Healthy Again (MaRTHA) Request for Proposal Opportunities The following Request for Proposals (RFPs) through the Rural Health Transformation Program will open from July 6, to July 20, 2026, with application details and submission information posted on the Tennessee Department of General Services RFP webpage.

Statewide eConsult Platform Community Health Access & Navigation (CHANT) Call Center HRP: Rural Non-Emergency Transportation Mobile App for Pregnancy and Post-Partum Rural Health Innovation Catalyst Community Health Access and Navigation (CHANT) Competitive Grant Project Lines Service Line Expansion & Co-Location – Expands integrated primary, specialty, behavioral, and diagnostic services in sustainable rural models.

Maternal and Child Health – Strengthens rural birthing care, perinatal quality, teleconsultation, and maternal and infant outcomes. MaRTHA – Expands prevention and access through primary care, telehealth, school health, and mobile services. Rural Non-Emergency Transportation – Improves access by reducing missed appointments through technology-enabled transportation.

Health-Tech – Modernizes rural clinic technology and digital workflows to boost efficiency and interoperability. CARE Grants – Funds Community Health Improvement Plan priorities through County Health Councils. Healthy Built Environment – Supports parks, trails, markets, and spaces that promote active living.

Policy, Systems & Environmental (PSE) Grants – Advances proven strategies to improve nutrition security and social connection. Organizations eligible to receive sub-awards under Tennessee’s plan include: Rural hospitals and health systems Federally Qualified Health Centers (FQHCs) Community-based organizations Other eligible healthcare partners Applicants must be properly registered with the State of Tennessee.

Organizations may apply for more than one Healthcare Resiliency Program (HRP) opportunity if applicable.

Evidence-based prevention and chronic disease programs Behavioral health and substance use treatment Rural workforce recruitment and retention Training on emerging care technologies Telehealth and digital infrastructure improvements Innovative care delivery models Benefits to Rural Tennessee RHT funding will help Tennessee: Strengthen rural hospitals and prevent closures Expand access to maternal, behavioral, and chronic care services Improve workforce stability in underserved areas Modernize rural healthcare technology Support innovative care models that improve outcomes Important Financial & Grant Information This is a reimbursement-based grant program : Sub-recipients pay costs upfront Submit required documentation Receive reimbursement after approval Administrative & Indirect Costs Subawardees must follow Tennessee’s approved indirect cost rates Administrative costs are capped at 10% There are currently no fixed budget maximums per opportunity.

Applicants should propose budgets that are realistic, scalable, and feasible. Click Frequently-Asked Questions for important information about limits on how funds can be used and funding caps. Building a Stronger Rural Health System The Rural Health Transformation Program represents a historic investment in Tennessee’s rural communities.

By strengthening infrastructure, expanding access, modernizing technology, and supporting workforce development, Tennessee is working to ensure that rural residents have access to high-quality, sustainable healthcare close to home. For updates on Healthcare Resiliency Program opportunities and application details, continue to check the program webpage.

Tennessee Will Deliver Change Tennessee’s Rural Health Transformation Plan reflects major federal priorities, while investing state-specific funding to ensure long-term viability. Make Rural America Healthy Advance rural health by expanding access and promoting prevention through evidence-based interventions in chronic disease management, behavioral health, and prenatal care.

Strengthen rural providers as sustainable access points by enhancing efficiency and collaboration with regional systems in care delivery, technology, and emergency services. Promote innovative care models and payment strategies to improve outcomes, coordinate services, and shift care to more efficient, cost-effective settings.

Recruit and retain skilled healthcare providers, health workers, and pharmacists in rural communities to meet local access needs. Advance digital health by expanding telehealth, improving data sharing and cybersecurity, and supporting adoption of emerging healthcare technologies.

Rural Health Transformation Goals Modernize rural clinics & hospitals, expand mobile care & specialty access 80% of rural residents within 30 minutes of care; 50+ upgraded facilities; fewer maternal & infant deaths Make Rural TN Healthy Again Prevent chronic disease by improving food, fitness & social support ≥25% rural population living near a health-promoting environment Bring rural providers into connected, modern data and telehealth systems 500 providers connected to statewide HIE; major increase in referrals through TN Community Compass Build a full pipeline from K-12 through advanced practice roles 250 rural residencies created; 150 new rural providers placed Keep rural hospitals open through new models & support Zero net loss of critical-access hospital services 1.

Expanding Care Access & Capacity Competitive Healthcare Resiliency Program grants: expand service lines, co-locate behavioral and specialty care Last Mile Teams : more ambulances, community paramedicine, mobile health & maternal care Strengthening the Safety Net through dental and primary care in every rural county Memory Care Assessment Network and Dementia Navigators to reach older rural adults sooner 2.

Maternal & Child Health Focus Competitive grants to address preventable poor outcomes, including facility upgrades and standards for rural birthing units Postpartum screenings, substance use prevention, behavioral health support Mobile apps, remote care, and triage networks Goal: 25% fewer rural maternal deaths; 15% fewer infant deaths 3.

Prevention & Community Health “ Make Rural Tennessee Healthy Again ” initiatives Grants to activate parks, trails, farmers markets , and school-based health Address nutrition insecurity and diseases of despair 4. Technology Modernization Statewide Health Information Exchange (first ever) Tele-specialty expansion via eConsult Secure, interoperable data systems that reduce paperwork burden 5.

Workforce Recruitment & Retention Career pipelines starting in high school Rural clinical rotations, fellowships & behavioral health scholarships Support for rural health administration leadership Frequently Asked Questions on Rural Healthcare Transformation 1. What is the CMS Rural Health Transformation (RHT) Program?

The RHT Program is a new federal initiative authorized by the Section 71401 of Public Law 119-21 under the Working Families Tax Cut legislation, also known as the One Big Beautiful Bill Act* that provides up to $50 billion over five federal fiscal years (FFY 2026–2030) to strengthen rural health systems in all 50 states.

It aims to improve access, quality, workforce stability, innovation, and technology across rural communities nationwide. * This project is supported by the Centers for Medicare & Medicaid Services (CMS) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $206,888,882. 11 with 100 percent funded by CMS/HHS.

The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CMS/HHS, or the U.S. Government. 2. Has Tennessee received RHT funding and how does the funding work?

Yes. CMS has awarded Tennessee approximately $206,888,882. 11 for Budget Period 1 through the RHT Program to support rural health transformation efforts.

CMS allows states through the end of the next fiscal year to spend those funds.

That means: Budget Period 1 funds can be spent through end of FFY 2027 (September 30, 2027) Budget Period 2 funds can be spent through end of FFY 2028 (September 30, 2028) Budget Period 3 funds can be spent through the end of FFY 2029 (September 30, 2029) Budget Period 4 funds can be spent through the end of FFY 2030 (September 30, 2030) Budget Period 5 funds can be spent through the end of FFY 2031 (September 30, 2031) CMS does not automatically give the same amount to states every year.

Each Budget Period’s funding level depends on: Completed annual reports and progress updates on approved initiatives and commitments to CMS Compliance with proposed use of funds Redistribution of any unspent funds from prior period The program’s scoring methodology (including technical and rural factors) 3. What are Tennessee’s main goals in its competitive Healthcare Resiliency Program (HRP) opportunities?

Tennessee’s RHT proposal centers around five broad categories: Healthcare IT and Technology: Projects that modernize rural health infrastructure to improve care coordination, quality, and access (e.g. central patient monitoring, eICU) and the use of technology to reduce provider burden and close gaps in rural service delivery.

Maternal & Child Health: Targeted interventions to address high maternal and infant morbidity and mortality in rural Tennessee; programs that improve continuity of care before, during, and after pregnancy; targeted interventions to improve adolescent and early relational health.

Make Rural Tennessee Healthy Again: Community-driven, prevention-focused initiatives that address chronic disease and social drivers of health; programs that go beyond clinical care and activate local partners to address substance use, active living, school-health, and isolation.

Co-Location and Expansion of Services: Efficient service delivery models that reduce fragmentation and patient travel; expansion of services that rural communities lack or are at risk of losing. Transportation: Practical, scalable solutions to one of the largest rural access barriers: getting patients to care; models that support non-emergency health needs. 4.

How does the RHT Program benefit rural communities in Tennessee? The RHT funding provides Tennessee with resources to: Strengthen rural health infrastructure and prevent hospital closures. Expand access to preventive, behavioral, maternal, and chronic disease care.

Promote workforce training and retention in underserved areas. Enhance digital infrastructure and telehealth services in rural settings. Foster innovative care delivery models that improve outcomes.

Eligibility & Participation 1. Who can apply for a sub-award? Local hospitals, health systems, non-profits, federally qualified health centers, community groups, and other organizations can participate as recipients of sub-awards under the state plan.

The organization must be registered with the state. 2. Our organization was a subrecipient of the Rural Healthcare Resiliency Program grant.

Can we apply for funds under RHTP? for this opportunity. Please note, RHTP funding is designed to support expansion and scale initiatives to better serve rural communities.

Funds may not be used to duplicate or supplant current federal, State, or local funding. Additional details can be found on pages 47 and 48 of the CMS‑prepared FAQs: Rural Health Transformation FAQ . 1.

Is this a reimbursement style grant? Yes. Sub-recipients will pay the cost up front, submit documentation for procurement (if necessary) and proof of payment, and then be reimbursed.

2. How do indirect cost rates & restrictions around the 10% administrative cost restriction flow down to sub-awardees? Sub-awardees are subject to the same cost restrictions as the state.

Sub-awardees are subject to Tennessee’s relevant indirect cost rates, and they are also subject to the 10% limit on program administrative costs. 3. What is the maximum award amount an entity can apply for?

Specific project requirements and additional details will be provided in the applications and supporting materials when they are published in the coming weeks. Webinar replays from the two information sessions - on March 31 and April 15 - are on the homepage . Continue checking the Department's Rural Health Transformation webpage for updates.

4. Are there any obligation or budget maximums within any of the Healthcare Resiliency Program opportunities? Details on obligation requirements, budget limits, and other funding parameters will be included in the grant application materials once the opportunities are published.

Until then, we recommend reviewing the relevant sections of Tennessee’s Rural Health Transformation Program (RHTP) application. Continue checking the Department's Rural Health Transformation webpage for updates. Application & Selection Process 1.

Can an organization apply for multiple Healthcare Resiliency Program (HRP) opportunities or just one? If a proposal’s scope of work spans multiple grant opportunity areas, applicants are advised to submit a separate proposal for each opportunity. Each application is reviewed independently based on its specific requirements and objectives.

Combining multiple grant areas into a single submission may impact the review process and could result in the proposal being deemed ineligible. Based on this, if your organization submits multiple applications, please clearly reference the related proposals within the narrative or project description and explain whether any project is dependent on or connected to another submission. 2.

Where can I find the application to submit a proposal? Once applications open, they will be posted to Tennessee’s Rural Health Transformation Program webpage under the “Opportunities” section. Continue checking the Department's Rural Health Transformation webpage for updates.

3. Will the Department of Health be soliciting five-year project proposals, even though only one year of funding is guaranteed, with continuation in subsequent years subject to annual renewal based on funding availability and performance outcomes? Each grant opportunity will outline its own requirements.

The scope of work and budget expectations may differ from one opportunity to another, and applicants should follow the instructions provided for the specific opportunity they are pursuing. All necessary details will be included in the published funding materials, so applicants should review those documents once released to determine what is required. 4.

If our proposal addresses multiple grant opportunity areas, do we need to submit a separate proposal for each, or can it be considered as a single combined application? / Is an organization allowed to submit multiple applications in more than one category?

For instance, one grant in Maternal Health and a second in Health Technology If a proposal’s scope of work spans multiple grant opportunity areas (for example, Service Line Expansion & Co-Location and Health-Tech Innovation), applicants are advised to submit a separate proposal for each opportunity. Each application is reviewed independently based on its specific requirements and objectives.

Combining multiple grant areas into a single submission may impact the review process and could result in the proposal being deemed ineligible. Based on this, if your organization submits multiple applications, please clearly reference the related proposals within the narrative or project description and explain whether any project is dependent on or connected to another submission. 5.

Do you have any general information or expected time for when the application process will open? Meanwhile, for general information on the HRP grant opportunities, we recommend reviewing the relevant sections of Tennessee’s Rural Health Transformation Program (RHTP) application and the recordings of the two webinars.

These resources are available on Tennessee’s Rural Health Transformation Program webpage: Tennessee Department of Health Rural Health Access for Tennessee's Future . 6. During the April 15 webinar, it was noted that only one RHTP grant will be awarded per entity per program pillar.

Will further clarification be provided on how “entity” is defined for the purposes of this limitation? For purposes of the RHTP competitive grant opportunities, an “entity” is defined as a legally recognized organization with a unique tax identification number (e.g., Employer Identification Number (EIN). 1.

What kinds of activities can Rural Health Transformation funds support in Tennessee? Evidence-based interventions to improve prevention and chronic disease management. Support for behavioral health, substance use treatment, and mental health services.

Workforce recruitment and retention strategies with rural commitments. Training and technical assistance for emerging care technologies. IT improvements like telehealth expansion and cybersecurity.

Innovative care models and alternative payment approaches. 2. What are there program-specific limitations?

Are there unallowable costs? New construction is unallowable. Supplanting funding for in-process or planned construction projects or directing funding towards new construction builds is unallowable.

Renovations or alterations, as described in category J of the program requirements and expectations use of funds section, are allowed if they are clearly linked to program goals. Category J funding cannot exceed 20% of the total funding CMS awards States in a given budget period. To replace payment for clinical services that could be reimbursed by insurance.

We will not accept payments to clinical services if they duplicate billable services and/or attempt to change payment amounts of existing fee schedules. If you plan to fund direct health care services, you must justify why they are not already reimbursable, how the payment will fill a gap in care coverage (such as uncompensated care or services not covered by insurance), and/or how they transform the current care delivery model.

Funding cannot be used for provider payments, as described in category B of the program requirements and expectations use of funds section, cannot exceed 15% of the total funding CMS awards States in a given budget period. Funding cannot be used for initiatives that fund certain cosmetic and experimental procedures that fall within the definition of a specified sex-trait modification procedure at 45 CFR 156.

400 because that is beyond the scope of this program. No more than 5% of total funding CMS awards to a State in a given budget period can support funding the replacement of an EMR system if a previous HITECH certified EMR system is already in place as of September 1, 2025.

Funding towards initiatives similar to the “Rural Tech Catalyst Fund Initiative” cannot exceed the lesser of (1) 10% of total funding awarded to a State in a given budget period or (2) $20M of total funding awarded to a State in a given budget period, and funding is subject to all restrictions and requirements described in the example initiative.

Clinician salaries or wage supports for facilities that subject clinicians to non-compete contractual limitations. None of the funding shall be used by the State for an expenditure that is attributable to an intergovernmental transfer, certified public expenditure, or any other expenditure to finance the non-Federal share of expenditures required under any provision of law.

SSA Section 2105(c) , paragraphs (1), (7), and (9) apply as funding limitations. These limitations are related to general limitations, limitations on payment for abortions, and citizenship documentation requirements for payments made with respect to an individual. 3.

Do we need sponsor hospitals to apply for a grant, and if so, how many? Should we base this on the number of hospitals that might sign an intent to participate if funding were available? To understand who should apply and the overall goals of the initiatives, we recommend reviewing the relevant sections of Tennessee’s Rural Health Transformation Program (RHTP) application, available on the homepage.

Specific project requirements and additional details will be provided in the weeks ahead. Continue checking the Department's Rural Health Transformation webpage for updates. 4.

During the Rural Health Transformation Kickoff webinar on March 31, 2026, the slide titled "Ineligible Uses of Funds within RHTP”, one of the listed items is "Provider Payments (<15%)". Can you provide additional information on what this means? For more information on provider payments, we recommend reviewing materials available on the CMS website including a recently published fact sheet.

Click for the CMS Fact Sheet covering provider payments. Rural Visit the CMS Rural Transformation Program website. Timeline & Key Milestones 1.

Does Tennessee Department of Health expect to release formal Notices of Funding Opportunity (NOFOs), RFPs, or similar mechanisms in the coming months? Continue checking the Department's Rural Health Transformation webpage for updates. 2.

Are there any upcoming webinars, office hours, or stakeholder engagement sessions that we could join to learn more about the program and application process? We encourage you to continue checking the Tennessee Rural Health webpage for updates, opportunities to participate, and upcoming events such as webinars. 1.

What activities are limited or not allowed within CMS’ framework? CMS does not allow the following costs: Meeting matching requirements for any other federal funds or local entities. Services, equipment, or supports that are the legal responsibility of another party under federal, State, or tribal law, such as vocational rehabilitation or education services.

Services, equipment, or supports that are the legal responsibility of another party under any civil rights law, such as modifying a workplace or providing accommodations that are obligations under law. Goods or services not allocable to the project. Supplanting existing State, local, tribal, or private funding of infrastructure or services, such as staff salaries.

Construction or building expansion, purchasing or significant retrofitting of buildings, cosmetic upgrades, or any other cost that materially increases the value of the capital or useful life as a direct cost. The cost of independent research and development, including their proportionate share of indirect costs. See 2 CFR 300.

477. Funds related to any activity designed to influence the enactment of legislation, appropriations, regulation, administrative action, or executive order. Purchase of covered telecommunications and video surveillance equipment ( See 2 CFR 200.

216 ) as well as financial assistance to households for installation and monthly broadband internet costs. Meals, unless in limited circumstances such as: Subjects and patients under study. Where specifically approved as part of the project or program activity, such as in programs providing children’s services.

·As part of a per diem or subsistence allowance provided in conjunction with allowable travel. Activities prohibited under 2 CFR 200.

450 and the HHS Grants Policy Statement, including but not limited to: Paying the salary or expenses of any grant recipient, or agent acting for such recipient, related to any activity designed to influence the enactment of legislation, appropriations, regulation, administrative action, or executive order proposed or pending before the Congress or any State government, State legislature, or local legislature or legislative body.

Lobbying, but awardees can lobby at their own expense if they can segregate federal funds from other financial resources used for lobbying. For guidance on some types of costs that we restrict or do not allow, see 2 CFR Part 200 Subpart E - General Provisions for Selected Items of Cost. Technical Assistance & Support 1.

Are the recording and PowerPoint presentation from the Rural Health Transformation Kickoff (informational session) webinar held on March 31, 2026 available? Yes, webinar recordings are available on Tennessee’s Rural Health Transformation Program webpage.

Tennessee Department of Health Rural Health Access for Tennessee's Future The Unique Healthcare Challenges in Tennessee's Rural Communities Tennessee’s rural communities face unique health care challenges that impact both physical and behavioral health.

Rural Tennesseans often experience diminished access to care, in part due to limited availability of health care facilities, long travel times to receive care, workforce shortages for high-demand health care professions, and a high cost of health care.

In recent years, Tennessee has prioritized programs and resources to improve rural health care, including the Health Care Modernization Task Force, Healthy Smiles Initiative, Tennessee Rural Hospital Transformation Act of 2018, Tennessee Broadband Accessibility Act, and the Small and Rural Hospital Readiness Grant Program.

Recognizing the opportunity to build upon these initiatives, Governor Bill Lee established the Tennessee Rural Health Care Task Force, led as a public-private partnership originating in the Tennessee Department of Health and charged with developing a set of recommendations to improve rural health care across Tennessee. This Page Last Updated: June 24, 2026 at 1:11 PM