Rural Health Transformation Program (RHTP)

Organizations interested in applying for Alaska RHTP funding must begin by registering and submitting a Letter of Interest. The LOI portal opened on February 17, 2026, and is planned to close on March 11, 2026.

The LOI helps the Department understand project ideas, organizational readiness, and which funding pathway may be the best fit. All applicants use the same LOI portal, regardless of the type of funding they are seeking.

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 this section 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 below

Answers to common questions about Alaska’s RHTP.

Jump to RHTP FAQs below

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

Alaska Community Foundation, in conjunction with the Department of Health, will provide technical assistance related to registration and entering information into the RHTP Letter of Interest portal.

RHTP Office Hours webinars will be hosted noon-1 on February 17th, February 24th, and March 3rd:

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 17, 2026. This portal is scheduled to close on March 11, 2026: 

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

During Spring/Summer 2026:

• Develop community plans to coordinate RHTP-funded projects and maximize impact of funds
  in each region

Throughout the year:

• Share updates on program timelines, funding, and policies
• Clarify expectations and requirements
• Answer stakeholder questions

Anticipated annually:

• Celebrate program successes
• Facilitate partnerships and collaboration across
  stakeholders

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

The Centers for Medicare & Medicaid Services (CMS) provides a national framework for the RHTP, but each state is responsible for developing its own transformation plan. In Alaska, the RHTP is particularly important due to the state’s vast geography, remote and frontier communities, workforce shortages, and high cost of care delivery. The program provides a time-limited opportunity to strengthen local health systems, expand access to care close to home, and 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 prevention, expanding workforce, leveraging technology, and creating long-lasting changes that help people stay healthy. Specific goals are detailed further in Alaska’s Project Narrative, and include:

1. Promote lifelong health and wellbeing for rural, remote, and frontier Alaskans
2. Build sustainable, outcomes-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 goals, initiatives, and types of projects RHTP funding is meant to support. All RHTP-funded projects must align with this plan.

RHTP is a cooperative agreement with CMS, which means the Department of Health (DOH) works closely with CMS and CMS must approve how funds are used. As the program moves forward, CMS 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 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.

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

DOH is responsible for setting program priorities, establishing application and evaluation processes, making funding recommendations, and 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 organizations, DOH has contracted with the Alaska Community Foundation to manage the administrative subrecipient application process, administer subawards to approved projects, and assists subrecipients with administrative requirements under DOH’s direction.

No, Department of Health (DOH) submitted Alaska’s RHTP application on November 4, 2025 and it is currently under federal review. The RHTP is a cooperative agreement, and CMS may work with DOH to adjust the RHTP goals, initiatives, and potential uses of funding that are outlined in the application posted above.

DOH is the lead agency for Alaska’s RHTP. DOH will work with federal partners at CMS to set program priorities, approve awards, and ensure federal compliance.

DOH will establish a statewide Subrecipient Administrator to help run the application process within the state, provide technical help to applicants, process awards, and 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 portal, assisting organizations as they apply, issuing and managing subawards for approved projects, processing payments, and supporting required reporting and compliance activities.

ACF does not make final funding decisions. All award decisions, program priorities, and 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 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.

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

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.

Alaska open its first Letter of Interest (LOI) and registration for the RHTP on February 17, 2026. It is scheduled to close on March 11, 2026. 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 organization, the communities you serve, and the opportunity or need you are seeking to address. It also asks for a brief description of your proposed approach, who would benefit, how the project aligns with one or more RHTP initiatives, your anticipated timeline and scale, and any potential partners.

LOIs are reviewed for eligibility, completeness, and alignment with RHTP priorities. Based on that review, organizations 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 submission, please email rhtp@alaskacf.org for assistance.

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.

Sign up for Alaska RHTP updates and notifications. Additional guidance, templates, webinars, training opportunities, application dates and instructions, and other information will be posted as soon as it becomes available.

For federal updates, monitor the CMS Rural Health Transformation Program website.

• Day 1 webinar recap
• Recording of virtual meeting
• Slide deck for virtual meeting
• Recording of media availability

• Day 2 in-person meeting recap
• Day 2 event photos

• Day 3 event recap

• EMS webinar recap
• Recording of EMS webinar
• Slide deck for EMS webinar

• RHTP Funding Application Process recap
• Recording of Funding Application Process webinar
• Q&A from Funding Application Process webinar
• Slide deck for Funding Application Process webinar

• Applicant Office Hours 2/17 recap
• Recording of 2/17 Applicant Office Hours webinar

• Recording of 2/24 Applicant Office Hours webinar

• Recording of 3/3 Applicant Office Hours webinar

• November 6, 2025 draft
• October 27, 2025 draft
• October 10, 2025 draft