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Rural Health Transformation Program data is sourced from state Flex Program offices and federal agencies. Accuracy is not guaranteed — verify with official sources before making programmatic decisions.

Home/Reports/CMS Planned Initiatives vs RCJ
Research Report

CMS's Planned State Initiatives vs RCJ

CMS now publishes two state-level RHTP datasets: the State Data Maps (exact awards, initiative stages, policy commitments) and, since October 21, 2026, a 58-page deck of Planned State Initiatives for Budget Period 1. We checked every figure in both against RCJ's tracking. This report covers what differs, what RCJ has corrected, and where planned work hasn't yet turned into a solicitation.

Rural Care Journey · Live data, updated November 12, 2026

CMS source · Oct 21, 2026

Planned State Initiatives, Budget Period 1 ↗

43 focus areas and 176 subtopics, each with its states, a spotlight and a map.

CMS source · updated weekly

RHTP State Data Maps ↗

Exact awards, 322 initiatives with Stage 0–5 status, and 19 State Policy Action commitments per state.

13 of 43

CMS focus areas whose totals don't match their own state lists

7

RCJ discrepancies corrected

0 of 322

CMS initiatives past Stage 2

14 of 322

CMS initiatives still without a solicitation

1. What's different

CMS vs RCJ

RCJ's numbers were close; its structure wasn't

  • Funding: every RCJ state award was within 0.3% of CMS's Budget Period 1 figure, but rounded to the nearest million rather than exact.
  • Initiatives: RCJ built its initiative lists from state narratives, so only 69 of CMS's 322 official names appeared, and 25 states matched none.
  • Progress: RCJ showed four states as “Scaling”. CMS shows every initiative in every state at Stage 1 or 2 of 5.
  • Policy commitments: CMS tracks 19 State Policy Actions per state; RCJ had none of them.
  • Coverage: CMS's new deck places states in focus areas 1,553 times. RCJ holds source material for all but one: a Massachusetts digital health program CMS counts as a Tech Catalyst Fund. Seven programs CMS spotlights by name were checked individually; two had no RCJ record, one had no public source we could find (New Jersey's immunization system modernization), and the rest were tracked under different names.

CMS vs CMS

The deck disagrees with itself on 13 of 43 focus areas

Each focus area gives a headline state count, a shaded US map and subtopic lists naming the states. On 30 focus areas all three agree. On the rest they don't, by one to three states. Use the named states, not the headline totals.

Focus areaTotalMapNamedDetail
Physical Activity303333Total is 3 below both the map and the lists
CCBHCs272729CT and MD are named in subtopics but not shaded
Early Career / High School Programs434344DE is shaded but named nowhere; CO and CT are named but not shaded
Healthy Eating and Farming333131NM is shaded but named nowhere; HI is named but not shaded
Community Paramedicine / Treat-in-Place414039MA is shaded but named nowhere
EMS Modernization484847AZ is shaded but named nowhere
Aging-in-Place / Home Visiting171818Total is 1 below both
Tribal Health & Engagement262525Total is 1 above both
Alternative Payment Models393838Total is 1 above both
Clinically Integrated Networks / Regionalized Care454444Total is 1 above both
Mobile Health484747Total is 1 above both
HIE Connectivity / Data Sharing484747Total is 1 above both
Upstream Drivers of Health474646Total is 1 above both

Also: four subtopic counts on the deck's summary pages differ from its detail pages (Tribal-Specific Programs 8 vs 7, VA–Rural Provider Integration 5 vs 4, Clinical Training 22 vs 23, Allied Health 18 vs 17; the detail pages name the states), and Wisconsin's chronic disease spotlight misnames the Wisconsin Collaborative for Healthcare Quality.

2. What's been fixed

DiscrepancyCorrection in RCJ
4 states (MS, ND, VT, WV) labeled “Scaling” while CMS shows no initiative past Stage 2Moved to “Implementing”; phase refreshes now cap at what CMS's stages support
RCJ carried 69 of CMS's 322 official initiative names; 25 states matched noneAll 50 states now list CMS's 322 initiatives as their official list, with state-narrative detail kept as supporting activities
State awards were rounded to the nearest $1M (up to $490,641 off)Exact CMS Budget Period 1 figures, to the cent, with a CMS citation on every state page
No State Policy Action commitments or initiative stages anywhere in RCJNew CMS-reported status card on every state page (stages, 19 policy commitments), CMS columns in Compare, a cms block in the public API, and CMS changes in the daily brief
Massachusetts Rural Digital Health Sandbox (CMS: Tech Catalyst Fund) missing from RCJAdded as an upcoming RHTP opportunity with its program page and three application templates
Kentucky's STARS and Regional Medical Operations Coordination Centers missing from RCJAdded the Kentucky legislature's CMS-approved RHTP overview (June 3, 2026) that describes both
13 document titles carried another state's code or unreadable text (e.g. Florida's budget narrative titled “MI - 2026”)Retitled

See any state's CMS-reported status, or rank states by CMS stage and policy commitments on Compare.

3. What to watch: upcoming opportunities

Most Budget Period 1 procurement is still ahead. Every one of the 322 initiatives CMS tracks has finished Stage 0 (planning). 227 have also finished Stage 1 and 95 are still in it; none has started Stage 3. CMS hasn't defined Stages 1–5, but with nothing past Stage 2, most planned work hasn't reached the point where states contract it out.

All 43 focus areas

Planned work vs solicitations RCJ has tracked

For each focus area, the states CMS lists, split by whether RCJ has tracked a solicitation that funds that work there: open or announced, all closed, or none yet. Amber is planned work with no solicitation: the likeliest places for new ones. Click a bar to see the states and the actual opportunities behind it.

Drill down

Infectious Disease: state by state

Infectious Disease · Disease Prevention & Care · CMS lists 10 states.

What CMS says states plan: 5 subtopics
  • Immunization Infrastructure & Vaccine Accountability · 5 states

    MT ND NE NJ TN

    Spotlight, New Jersey: Modernizes the New Jersey Immunization Information System (NJIIS), the State's official immunization database and vaccine management system; strengthens vaccine accountability and improves outbreak surveillance; holds mobile unit vaccination and screening events; expands laboratory testing and courier services in rural healthcare facilities to improve access to laboratory diagnosis of infections and outbreak of diseases.

  • STI Screening, Maternal Infectious Disease & Perinatal Prevention · 4 states

    AZ HI NE TN

    Spotlight, Tennessee: Implements efforts to reduce congenital syphilis and other preventable causes of maternal and infant morbidity and mortality through the Rural Fetal and Infant Mortality Reduction initiative.

  • Infectious Disease via Telehealth & Provider Education · 2 states

    HI WA

  • Infectious Disease Comorbidities via OTP / SUD Programs · 1 states

    NE

    Spotlight, Nebraska: Creates antimicrobial stewardship partnerships with rural clinics; infection prevention/control TA embedded throughout the oral health initiative; medical countermeasure stockpiles support rural emergency preparedness.

  • Public Health Infrastructure & Community-Based Prevention · 4 states

    AK DE NJ TN

    Spotlight, Alaska: Implements potential projects under the Healthy Communities Initiative regarding clean water and sanitation as infectious disease prevention strategies in rural and frontier communities.

Solicitations, all closed · 2 states

Already competed this budget period; watch for a next round.

  • North DakotaCMS: Immunization Infrastructure & Vaccine Accountability

    • Rural Hospital Clinical Equipment GrantClosed Jun 30“Environmental Services o Strategic Priority: Strengthen infection prevention o Projected Outcomes: Reduced hospital-acquired infections o Clinical Equipment: UV-C Disinfection Robots, Automated Cleaners, Electrostatic sprayers, Air Purification”
  • NebraskaCMS: Immunization Infrastructure & Vaccine Accountability; STI Screening, Maternal Infectious Disease & Perinatal Prevention; Infectious Disease Comorbidities via OTP / SUD Programs

    • Nebraska RHTP 4.2b: Healthcare-Associated Infection (HAI) PreventionClosed May 9“assist healthcare partners in their efforts to reduce preventable infections, limit antibiotic resistance, and improve healthcare outcomes in rural Nebraska”

No solicitation yet · 8 states

CMS says the state plans this work and RCJ has found no solicitation for it: the likeliest places for new ones.

  • AlaskaCMS: Public Health Infrastructure & Community-Based Prevention

  • ArizonaCMS: STI Screening, Maternal Infectious Disease & Perinatal Prevention

  • DelawareCMS: Public Health Infrastructure & Community-Based Prevention

  • HawaiiCMS: STI Screening, Maternal Infectious Disease & Perinatal Prevention; Infectious Disease via Telehealth & Provider Education

  • MontanaCMS: Immunization Infrastructure & Vaccine Accountability

  • New JerseyCMS: Immunization Infrastructure & Vaccine Accountability; Public Health Infrastructure & Community-Based Prevention

  • TennesseeCMS: Immunization Infrastructure & Vaccine Accountability; STI Screening, Maternal Infectious Disease & Perinatal Prevention; Public Health Infrastructure & Community-Based Prevention

  • WashingtonCMS: Infectious Disease via Telehealth & Provider Education

Watch list

Focus areas with the most unsolicited planned work

Focus areaNo solicitation yetStates
Medicaid InnovationHealth System InnovationMostly carried out inside state Medicaid programs (plan amendments, payment models), so few solicitations are expected.34 of 35AK AZ CO DE FL GA HI IL IN KS KY LA MA MD ME MI MO MS MT NC ND NE NH NJ NY OH OK OR SD TN UT VA WI WY
Veterans’ HealthPopulation Health5 of 6AL MI NE TX WI
CCBHCsPayment & Service Models22 of 27AK CA CO FL GA HI IL IN KS LA ME MI MS NC ND NE NH NM NY OR WA WI
Infectious DiseaseDisease Prevention & Care8 of 10AK AZ DE HI MT NJ TN WA
PACEPayment & Service Models7 of 9KS LA MI ND OK PA RI
Patient Engagement PlatformsTechnology30 of 39AK AR CA CO CT DE FL HI ID IL KS KY LA MA MI MT NC NE NH NJ NM OH OK OR PA SD UT VA WA WI
Cancer Prevention & TreatmentDisease Prevention & Care17 of 23AK AZ DE FL HI IN KS MN NC NM NV NY OK PA RI SD UT
Dental CareDisease Prevention & Care30 of 42AK AL AR AZ CA CO CT GA HI ID IN KS MA MD MI MO MT NC ND NE NM NY OK OR PA RI UT VT WA WY
Hub-and-Spoke ModelsPayment & Service Models27 of 38AK AR AZ CA CT DE FL HI IL IN KS LA MA MN MO MT NC NE NH NJ NM NY PA RI VT WA WI
Physical ActivityHealth Promotion23 of 33AK AL AZ CT DE HI IL IN KS LA MI MN MS NC NH NM OR PA SC TN UT VA WY
PediatricsPopulation Health18 of 26AK AZ HI IL IN KY MA MS MT NC NE NM NY RI SD UT VA WV
Upstream Drivers of HealthHealth Promotion30 of 46AK AL AZ CA CO CT DE FL GA HI IA IL IN KY MA MN MO MT NE NH NM NY OK OR PA RI SC TX VA WA

CMS initiatives

14 of 322 CMS initiatives still have no solicitation

Each state's CMS initiatives, checked against the solicitations that implement them. 67 have a solicitation open or announced and 227 have had one that has since closed. We researched every initiative left over: 14 are being carried out directly by the state or a named partner, so no solicitation is expected. These 14 remain: 2 with a solicitation expected, and 12 with no public sign yet of how they will be procured.

StateCMS initiativeWhat we foundCMS stage
Rhode IslandStrengthening Rural Oral Health Delivery Through Innovation and IntegrationExpectedAn eohhs.ri.gov page for a Community and Home-Based Oral Healthcare Pilot application appears in search results but is currently access-restricted Source ↗Stage 1 complete
TennesseeValue-Based Payment: Maternal, Hospitals, Dental - Catalyzing Rural Health Value Based Payment ModelsExpectedTennCare's Tennessee Maternal Medical Home pilot begins in 2027 Source ↗Stage 1 complete
DelawareHealthcare Workforce Data Center InitiativeNo solicitation foundStage 2 in progress
DelawareRural Provider and FQHC Value-Based Care Readiness InitiativeThe state plan describes competitive funding for providers and FQHCs; no solicitation posted yetStage 2 in progress
HawaiiRural Respite Network (RRN)Five medical respite centers planned through the Department of Human Services; no solicitation found Source ↗Stage 2 in progress
North CarolinaEnsure Fiscal Sustainability of Rural Health Providers Through Innovative Financial Models$35.3M, including a primary care capitation model with actuarial support; no solicitation foundStage 2 in progress
New YorkRural Roots: Workforce$13M; no solicitation posted yet Source ↗Stage 1 complete
New YorkStrengthening Rural Health$30M for technology-enhanced primary care (Patient Centered Medical Home model); no solicitation posted yet Source ↗Stage 1 complete
OhioMaternal and Infant Wellness Home Visiting in Rural Ohio$6M to $8M for evidence-based home visiting; no solicitation foundStage 1 in progress
Rhode IslandBuilding Capacity for Block Island Health and Human ServicesNot yet on the state's procurement grid Source ↗Stage 2 in progress
Rhode IslandModernizing Health Care Delivery for the Narragansett Indian TribeA partnership with the Tribe on facilities, workforce and care coordination; not on the procurement grid Source ↗Stage 1 complete
Rhode IslandRural Community-Integrated and Mobile Health Services$5.57M for mobile units and telehealth sites in schools and community learning centers; not yet on the state's procurement grid Source ↗Stage 1 complete
Rhode IslandRural EMS Health Access and Integration$8.4M for mobile integrated health, a state EMS academy and island EMS; not yet on the state's procurement grid Source ↗Stage 1 complete
Rhode IslandRural Health Data and Workforce Tracking SystemNot yet on the state's procurement grid Source ↗Stage 1 in progress
14 carried out directly, without a solicitation
  • Colorado: Build Data and Evaluation Infrastructure for Chronic Disease Programs: Diabetes, Cardiovascular Disease, Hypertension, and Obesity. $1.31M for prevention data collection, a chronic disease dashboard and staff support, through state agencies (OeHI, CDPHE). Source ↗
  • Connecticut: Workforce. Funded through an Area Health Education Center (AHEC) award.
  • Hawaii: Pili Ola Telehealth Network. Built and operated by the University of Hawaiʻi. Source ↗
  • Hawaii: Rural Infrastructure for Care Access (RICA). Includes $13M for the Department of Health to buy ambulances for each county and upgrade emergency communications. Source ↗
  • Indiana: Growing Cardiometabolic Health Standards of Care in Rural Indiana. $15.3M; grant agreements with Purdue Extension and the Indiana Alliance. Proposals for a Food is Medicine feasibility study and a Double Up retail expansion are under review; the solicitations themselves were not found. Source ↗
  • Indiana: Growing Community Connections through Indiana 211. Funded through the Indiana Community Connect award (Indiana 211 referral platform).
  • Indiana: Growing Improved Patient Outcomes Through Enhanced Interoperability and Technology. $66.5M to connect 450+ rural facilities to the Indiana Health Information Exchange (IHIE). Source ↗
  • Indiana: Growing Specialty Provider Access through Expanded Teleconsult Capabilities. Funded through an award for a teleconsult and telehealth landscape assessment.
  • Tennessee: Dental Pilot - Enhancing Investments in the Rural Dental Workforce to Improve Oral Health Access. Department of Health pilot expanding dental school classes (Meharry, UT) with tuition forgiveness for rural service. Source ↗
  • Tennessee: Last Mile Teams - Unifying Multiple High-Impact Efforts to Expand Tennessee’s Rural Emergency Care Infrastructure and Bring Integrated Health Services Directly to Residents in Hard-to-Reach Areas. Includes a new ambulance for every eligible rural county: the county buys it and the state reimburses. Source ↗
  • Tennessee: TN Community Compass (TNCC) - Expansion of Tennessee’s Successful Closed Loop Referral System (CLRS). Expansion of the existing Findhelp-built closed-loop referral platform across TennCare and Department of Health programs. Source ↗
  • Texas: Unified Care Infrastructure and Rural Cyber Protection. Funded through subawards to rural hospitals and providers for care and cybersecurity infrastructure.
  • Washington: Invest in the Health of Native Families. 10% of Washington's award goes directly to tribes and Indian health care providers.
  • Washington: Prevent Disease and Manage Care in Community Settings. $18M year one through named subawardees: Area Agencies on Aging, 211, the Washington Medical Coordination Center, Care-a-Van. Source ↗

Announced, not yet open

23 solicitations to watch for

Including Massachusetts's Rural Digital Health Sandbox ↗: grants up to $475,000 for digital health companies, launched October 2026, with its notice of funding opportunity “coming soon”.

StateOpportunityType
GAGeorgia RHTP: AHEC Training and HousingGRANT
GAGeorgia RHTP: Consumer Engagement EnhancementsGRANT
GAGeorgia RHTP: Nursing Care ImprovementsGRANT
GAGeorgia RHTP: Public Health Investments — Newborn Screening ProgramGRANT
GAGeorgia RHTP: Support for Acquired Brain Injury (ABI) SurvivorsGRANT
ILIllinois RHTP: Disease Prevention Grants to HospitalsGRANT
ILIllinois RHTP: EMS and Mobile Healthcare — Mobile Health Infrastructure FundsGRANT
ILIllinois RHTP: EMS Enhancement Grants to Resource HospitalsGRANT
ILIllinois RHTP: Expansion of Incentives and Training Programs for Clinical ProfessionalsGRANT
ILIllinois RHTP: Expansion of Training and Certification Programs for Healthcare Support WorkersGRANT
ILIllinois RHTP: Investment in Technological Infrastructure for Rural ProvidersGRANT
ILIllinois RHTP: Primary Care and Behavioral Health Technical AssistanceGRANT
ILIllinois RHTP: Team-Based Care Grants for Primary Care and Behavioral Health ProvidersGRANT
MEMaine Rural Health Transformation: Alternative Payment Model (APM) TransitionGRANT
MOMissouri RHTP Digital Backbone Provider Application (official RFA pending)GRANT
MOMissouri RHTP Essential Care Certifications for rural hospitals (official RFA pending)GRANT
MOMissouri RHTP High-Risk Pregnancy Remote Monitoring, Southeast and Southcentral Missouri (official RFA pending)GRANT
MOMissouri RHTP Mobile Health Units capital awards (official RFA pending)GRANT
MOMissouri RHTP Telehealth Specialist Access for rural hospitals (official RFA pending)GRANT
MSCoordinated Regional Integrated Systems (CRIS) InitiativeRFA
OKOHCA HIE & EHR Assistance (Year 2 Application)GRANT
OROregon RHTP: Transformation FundsGRANT
TXRural Texas Strong Program – Initiative 2: Rural Texas Patients in the Driver’s Seat (HHS0017518)RFA

Deadlines

27 RHTP solicitations due in the next 30 days

DueStateOpportunityType
Nov 12NHGO-NORTH Access Initiative (Technology, Financial Sustainability, and Access for Rural Hospitals in New Hampshire) — 2026 Request for ApplicationsRFA
Nov 13KSKS - 2026 - Regional Partnership Grant ProgramRFA
Nov 13KSTransformative Capital Investment Grant Program RFA (Kansas, Year 2)RFA
Nov 13RICoding Consultant Services – Rural Health Transformation Program (RIHCA-RHTP-RFP-002)RFP
Nov 16INPreceptor and Rural Track Grant Program – Initiative 10: Rural GME EnhancementNOFO
Nov 16INInitiative 10: Rural GME Enhancement Curriculum Enhancement Grant ProgramNOFO
Nov 16MSMississippi RHTP Innovative Pilot ProgramGRANT
Nov 17IAIowa Cardiovascular Health Hub and Spoke Networks (RFP COMPADM26007)RFP
Nov 17NCNorth Carolina Rural Health Innovation FundGRANT
Nov 18KSCommunity Health Worker + Accountable Food Is Medicine Grant Program (CHW+AFIM) – Year 2RFA
Nov 18KSNon-Emergency Transportation Grant Program (NEMT) – Year 2 (Kansas RHTP 4.3)RFA
Nov 18OKCommunity Paramedicine Consulting Services RFPRFP
Nov 20CACalRHT 2026 Tribal Set-Aside Noncompetitive Grant Funding ApplicationRFA
Nov 20GAGREAT Health Rural Simulation Mannequin GrantGRANT
Nov 20NHHospital Consumer Assessment of Healthcare Providers and Systems ProjectRFP
Nov 20TNCounty Health Council Collaborative Action for Rural Engagement (CARE) GrantsRFA
Nov 20WVWV RHTP Personal Health Accelerator: Water Is Medicine (AFA GFO-0313-2700000000168-1)GRANT
Nov 23MSSmall Rural Health Provider EHR Replacement Grant ProgramGRANT
Nov 23VAVirginia RHTP Mobile & Hybrid Care RFA — Thomas Jefferson Planning District CommissionRFA
Nov 23VAVirginia RHTP Mobile & Hybrid Care RFA — West Piedmont Planning District Commission (Southside Regional Collaborative)RFA
Nov 23VAVirginia RHTP Mobile & Hybrid Care RFA — Central Shenandoah Planning District Commission (Roanoke-Alleghany/Central Shenandoah/New River Valley Collaborative)RFA
Nov 23VAVirginia RHTP Mobile & Hybrid Care RFA — Accomack-Northampton Planning District Commission (Eastern Shore Regional Collaborative)RFA
Nov 23VAVirginia RHTP Mobile & Hybrid Care RFA — LENOWISCO Planning District Commission (Rural Health Transformation SWVA)RFA
Nov 24NHRFP 212026957 for Marketing, Branding, Communications, and Digital Engagement Services supporting GO-NORTH RHT Workforce InitiativeRFP
Nov 30MEMaine RHTP Community Health Worker (CHW) Initiative RFA (Rural Community Health Worker Expansion)RFA
Dec 7MOMissouri RHTP Workforce Retention and Enablers Funding OpportunityRFA
Dec 11NVNevada CBHT WRRAP Provider Recruitment and Retention Program RFA (Children's Behavioral Health)RFA

The full, live list is on Opportunities.

Method. The deck's focus-area state lists come from its shaded maps, read from the PDF's vector shapes; they match the deck's subtopic lists exactly on all 30 focus areas where the two must agree. “Solicitation” means an approved, RHTP-funded RFA, RFP, NOFO or grant in RCJ. Each of the 719 solicitations was classified by AI against CMS's 43 focus areas and its state's CMS initiatives, from its title, summary and primary document, counting only what it funds rather than what it mentions; the quote under each solicitation is the evidence for that call. A second pass checked every initiative left without a solicitation against all of its state's solicitations. Classification can still miss a solicitation described in unfamiliar terms, so read “no solicitation yet” as where to look, not as a confirmed absence. CMS stage data is from the State Data Maps as captured November 11, 2026; RCJ data is live, updated November 12, 2026.