For RHTP Applicants

Applicants are strongly encouraged to review the resources on this page before beginning or submitting an application.

In particular, please review:

• Updated Applicant Resource Guide: An Alaska-specific guide to the application process, funding pathways, project requirements, and other key RHTP program details.
• New Federal Budget Development Basics Training: this video tutorial outlines application components, federal cost categories, examples of budget narrative justifications and alignment with RHTP allowable uses, the difference between programmatic & administrative costs, and restrictions & unallowable uses.
• New Workforce Resource - Understanding and Applying the 5-Year Service Commitment: This video tutorial outlines essential information about the 5-year service commitment, including when it applies, guidance for applicants, training and verification requirements for subrecipients, and more.
• New Fall 2026 Application Walkthrough Webinar: A recording of the October 1, 2026 RHTP Year 2 Fall Cycle 2026 Application Walkthrough Webinar will be available for applicants who would like a guided review of the application process and materials following the live webinar.
• Updated Proposal evaluation resources: Updated proposal evaluation resources are currently under development and will be posted by mid-October. DOH is currently accepting public comments on the draft frameworks. View the online public notice here. 

The Year 2 fall funding cycle will include opportunities for both Planning Pathway and Implementation Pathway projects. 

In addition to an open call for projects that align with any of Alaska’s six RHTP Initiatives, the fall cycle will also include three areas of focus reflecting statewide priorities. Additional information about each focus area, including funding objectives and examples of permissible uses of funds, can be found in the document linked below each focus area. 

• EMS Implementation Pathway: Emergency medical services, emergency response
• Care Coordination Implementation Pathway : Hospital discharges, transitions between care settings, or follow-up care after hospitalization
• Pay for Value Readiness Implementation Pathway:  Value-based payment arrangements, population health management, or other approaches that reward quality, outcomes, or coordinated care

Each organization may submit up to five applications. 

Additionally, the following funding categories will be excluded from the fall funding cycle:

• Continuation: all multi-year continuation requests for Year 1 subrecipients will be reviewed in the Spring 2027 cycle
• Facilities and renovations: Category J funding requests for facility renovations will be reviewed in the reviewed in the Spring 2027 cycle. Limited equipment replacement funding will be available in the fall 2026 cycle. 

The Year 2 Spring application cycle is expected to open in early spring 2027, with awards beginning as early as July 2027. 

Additional information about the Spring application cycle is forthcoming. 

The selection of focus areas was based on community input from regional meetings across the state as well as key priorities identified in Alaska’s RHTP project narrative. 

Updates to the Year 2 funding cycle are largely operational in nature. These changes reflect feedback from applicants as well as DOH’s own lessons learned from the Year 1 funding cycle. Notable refinements include:

• Removal of the Letter of Interest (LOI) phase, simplifying the application process.
• Streamlined application design, including targeted questions for specific proposed uses of funds.
• Implementation of a five-application limit per organization.
• Enhanced guidance and technical support for applicants.
• New organization registration process that is separate from the project application, removing the need for applicants to duplicate information.
• Updated project evaluation and portfolio analysis criteria, including separate criteria for planning and implementation projects.

No. Applications within the focus areas will not be given priority over open call applications. Instead, DOH anticipates setting target funding amounts for each focus area. These amounts are intended to guide portfolio planning and may be adjusted based on the number and strength of applications received, available funding, and overall portfolio needs.

Final funding decisions will be based on competitive review, portfolio considerations, program priorities, and available funding.

Organizations with multiple facilities may submit five applications for each operating entity that serves a distinct community. For example, a hospital system with facilities in both Fairbanks and Nome may submit five applications on behalf of its Fairbanks location, and another five on behalf of its Nome location. Please note that these entities must register separate organizational profiles during the application process, rather than submitting ten applications under the same organizational profile. 

This policy does not apply for clinics or organizations that operate multiple locations in the same community. For example, an organization that operates multiple clinics within Anchorage cannot submit five applications for each location serving the same area. 

Yes, resubmitting proposals that were deferred in the Year 1 funding cycle is allowed. Resubmitted proposals count toward an organization’s five-application limit. 

Yes. DOH is committed to a transparent, fair, and consistent review process.

Applications will be reviewed for eligibility, completeness, and 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.

RHTP grants are a discretionary grant program. Under Alaska law and consistent with our CMS approved RHTP application, the DOH Commissioner retains final decision-making authority on all funding decisions.

Given the volume of applications received, DOH is unable to provide detailed feedback for each LOI. However, several common themes emerged across deferred and declined proposals. Strengthening proposals in the following areas may improve competitiveness in future funding cycles:

• Transformative potential. The purpose of RHTP funding is to support sustainable, lasting improvements across Alaska’s health care system. Many LOIs reflected legitimate community needs, but did not clearly describe how the proposed work would create broader or lasting improvements to health care access, delivery, coordination, workforce capacity, or system sustainability.
• Allowable uses and funding limitations. CMS funding restrictions include limitations or caps on certain categories of expenditures (for example, capital-related costs such as facility renovations and infrastructure improvements). In several expenditure categories, the total amount of requested funding substantially exceeded the funding available under the program. Reviewing allowable use guidance and clearly connecting proposed costs to RHTP initiatives may strengthen future proposals.
• Funding fit. Some LOIs reflected worthwhile community or organizational priorities, but the proposed activities may be better suited to other state, federal, philanthropic, or community funding opportunities. 
• Partnerships and community connection. Competitive LOIs generally demonstrated strong working partnerships with the communities, organizations, and stakeholders involved in or impacted by the proposed work. Future applicants are encouraged to continue strengthening local partnerships, coordination efforts, and community engagement. Out-of-state applicants, in particular, are strongly encouraged to develop relationships with Alaska-based partners and communities.
• Coordination and non-duplication. Some proposals reflected work already underway through existing programs or initiatives, or addressed areas where DOH anticipates pursuing more coordinated statewide or regional approaches. Applicants are encouraged to engage with partners across their regions and communities to better understand existing initiatives, identify gaps, and explore opportunities for coordination and collaboration. Regional planning meetings are intended to facilitate connections to help support this work.

Applications that were declined generally did not demonstrate sufficient alignment with RHTP priorities and/or included activities that are not allowable under the program (for example, new construction or other unallowable capital expenditures). 

If you wish to appeal a funding decision, you must submit a written request for an appeal to the Commissioner of the Department of Health within fifteen days from the date you were notified of the decision. The request must contain the reasons for the appeal and must cite the statute, regulation, or terms of the grant upon which the appeal is based. More information can be found in the DOH grant appeal regulations at 7 AAC 78.305-.310. Please cc RHTP@alaska.gov on all appeals. 

The first LOI cycle offered valuable lessons that will help inform future funding rounds. As DOH prepares for Year 2 funding, we are focused on improving clarity in program guidance, streamlining the application process, and providing further detail around funding pathways, priorities, and review considerations.

During this cycle, DOH also refined its approach to one of the originally proposed funding pathways, the “readiness pathway.” Based on federal program requirements, applicant characteristics, and review findings, DOH determined that applicant readiness support could be more effectively delivered through future technical assistance and implementation support efforts, rather than maintaining readiness support as a standalone funding pathway. This adjustment will help simplify the overall program structure while continuing to support organizations and projects at different stages of development.

Many types of organizations will be eligible for RHTP funding, including 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
• Schools, universities, vocational 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 funding, see the RHTP Organization-Level Eligibility document.

Alaska's statewide application outlines the goals, initiatives, and 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 the statewide application before submitting a Letter of Interest, as proposals should clearly describe how they align with Alaska's RHTP goals and initiatives.

Jump to Alaska's proposed initiatives and statewide application

Alaska is among the top recipients nationwide. Alaska’s year one award was $272,174,855.72 to support targeted, system-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 29, 2025 through October 30, 2026. First year award funds must be obligated by the end of the budget period, but 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 30, 2027. Any funds not expended by that date are subject to federal recapture and redistribution under the RHTP rules.

RHTP funding is provided to states in annual awards. Each year CMS reviews Alaska’s progress in implementing the program, including whether projects are moving forward on schedule, funds are being used as approved, and 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 years, consistent 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 rural, remote, and frontier regions, Alaska’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 goals, strengthens the health care system, or supports the health of rural Alaskans in any way, it may be eligible for funding.

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

• Expanding access to primary, maternal, behavioral, specialty, or oral health care
• Training, recruiting, or retaining health workers
• Upgrading clinics, EMS resources, or other health care settings
• Strengthening value-based care and innovative payment models
• Launching new mobile, itinerant or regionally shared services
• Investing in telehealth, interoperability, and digital health tools
• Supporting community wellness, prevention, and chronic disease management efforts
• Implementing technology that improves coordination, safety, or data sharing

RHTP funds may support planning, capacity-building, start-up, and implementation costs necessary to carry out approved projects, subject to federal requirements and program funding limitations. Projects should be designed with a clear path to sustainability beyond the RHTP funding period, recognizing 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-based, measurable 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 services, subject to limitations described below.
• C. Consumer tech solutions: Promoting consumer-facing, technology-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 hospitals, including remote monitoring, robotics, artificial intelligence, and other advanced technologies.
• E. Workforce: Recruiting and retaining clinical workforce talent to rural areas, with commitments to serve rural communities for a minimum of 5 years.
• F. IT advances: Providing technical assistance, software, and hardware for significant information technology advances designed to improve efficiency, enhance cybersecurity capability development, and improve patient health outcomes.
• G. Appropriate care availability: Assisting rural communities to right size their health care delivery systems by identifying needed preventative, ambulatory, pre-hospital, emergency, acute inpatient care, outpatient care, and 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 services, and mental health services.
• I. Innovative care: Developing projects that support innovative models of care that include value-based care arrangements and alternative payment models, as appropriate.
• J. Capital expenditures and infrastructure: Investing in existing rural health care facility buildings and infrastructure, including minor building alterations or renovations and equipment upgrades to ensure long-term overhead and upkeep costs are commensurate with patient volume, subject to limitations described below.
• K. Fostering collaboration: Initiating, fostering, and strengthening local and regional strategic partnerships between rural facilities and other health care providers to promote quality improvement, improve financial stability of rural facilities, and 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 Medicaid, Medicare, or another payer, unless 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 projects, certain telecommunications equipment prohibited under federal law (see 2 CFR 200.216), and household or individual internet installation or monthly service costs
• Lobbying, political activities, or 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 unreasonable, not clearly justified, or not directly tied to an approved RHTP project

Applicants must clearly demonstrate how proposed activities align with RHTP goals, comply with federal requirements, and 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 program, not just to individual projects, and 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 award, capped at $20 million

Because these limits apply at the program-wide level, not 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 ineligible, but it may affect funding decisions if caps are reached
• Projects should clearly justify why proposed costs are necessary, reasonable, and 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 access, coordination, safety, or quality of care, particularly in rural or hard-to-reach settings. RHTP funds may also support planning activities related to major technology investments, such as needs assessments, vendor selection, technical assistance, and implementation support. Examples include, but are not limited to: 

• Telehealth platforms, interoperability solutions, and care coordination tools 
• Communications and dispatch systems (e.g., EMS dispatch, 911-related systems, radios, phones, switches, or care coordination platforms) 
• Remote patient monitoring, diagnostics, or clinical decision-support tools 
• Drones, kiosks, remote dispensing equipment, or other technologies that support medical delivery, logistics, diagnostics, or 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 administrative, billing, and operational enhancements when they are directly tied to implementing the proposed project, enable compliance with federal requirements, and are reasonably allocable to RHTP activities. 

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

• Building billing and revenue cycle management capacity for organizations that do not currently have it 
• Technical assistance, planning, and project design support 
• Vendor assessments, system specifications, and implementation support for new programs or infrastructure
• Staff time, training, and expenses directly related to executing project activities and meeting federal compliance requirements (e.g., financial reporting, grant management systems)

When proposing administrative or capacity-building costs, applicants should clearly describe how each cost is directly connected to delivering the proposed project. Costs that are routine overhead, unrelated to project activities, or support general operations will not be allowable.

Yes, but 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 project, do not involve major construction, and are clearly tied to RHTP activities. Examples of potentially allowable uses include:

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

If internet services are used for both RHTP activities and general operations, only the portion directly related to the RHTP project may be charged to RHTP funds. For example, if connectivity is used roughly half the time for RHTP-funded activities and half for routine operations, only 50 percent of the cost would be allowable. All connectivity-related costs must be reasonable, clearly justified, and directly tied to approved RHTP activities, and are subject to CMS review and approval.

Under federal guidance, RHTP 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 footprint, infrastructure, or interior spaces. The facility does not need to be an existing health care facility, and 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 modifications, such as installing or relocating walls to create offices, exam rooms, or meeting space
• Lighting or electrical upgrades to improve efficiency or functionality
• HVAC or plumbing improvements to support clinical or operational needs
• Accessibility improvements, such as installing automatic door openers
• Safety or security upgrades, including 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 clinic, emergency, or 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 needs, such as improvements to existing buildings or replacement of existing equipment, particularly 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 example, new equipment may be classified under areas such as expanding appropriate care availability, improving behavioral health services, supporting prevention and chronic disease management, or enabling technology-driven care.

Whether an equipment purchase is allowable depends on how clearly it advances RHTP goals, responds to a documented community or system need, and 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 services, whether for insured or uninsured individuals. Federal rules prohibit using RHTP funds to supplant Medicaid, Medicare, private insurance, or other existing funding sources.

However, RHTP funds may support time-limited payments for services through pilot projects, start-up costs, or 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.