Program Overview
Washington is actively implementing the Rural Health Transformation Program, launching six major initiatives to advance rural hospital innovation, workforce development, care access, and community health. Current efforts emphasize system transformation with priorities shaped by stakeholder and tribal engagement, and explicit focus on behavioral health and technology. The first performance period begins December 2025, under a long-term strategy rather than short-term grantmaking. Current structured plan tracks 10 key initiatives and 7 strategic goals.
Updated
County-level estimates averaged across Washington — % of adults 18+ unless noted. Delta vs US county average shown in red/green.
pp = percentage points vs US county average
County Drilldown (39)
| County | Pop | Poverty | Uninsured |
|---|---|---|---|
| King County | 2,287,171 | 8.6% | 5.2% |
| Pierce County | 930,319 | 8.8% | 5.9% |
| Snohomish County | 844,430 | 8.0% | 5.5% |
| Spokane County | 549,056 | 11.7% | 7.3% |
| Clark County | 516,959 | 8.0% | 5.5% |
| Thurston County | 299,067 | 9.5% | 6.4% |
| Kitsap County | 277,881 | 8.2% | 5.4% |
| Yakima County | 257,152 | 15.5% | 11.7% |
| Whatcom County | 230,503 | 12.9% | 7.2% |
| Benton County | 212,905 | 11.0% | 8.2% |
| Skagit County | 131,328 | 11.6% | 7.4% |
| Cowlitz County | 112,360 | 12.2% | 8.0% |
AI source: WA - 2018 - Washington Department Of Health And Human Services Section 438.6(c) DRAFT Preprint – 06/24/20 Centers For Medicare & Medicaid Services STATE: CALIFORNIA (3 Of 6 Preprints) ________
AI auto-updated May 22, 2026
API refreshed May 7, 2026
Centers for Medicare & Medicaid Services (CMS)
Due Nov 5, 2025
7 related documents
WA - 2026 - CMS RHTP 50-State Spotlight (FY2026) — Washington
780,653 rural residents
Washington received over $181 million in RHTP federal funds as of December 29, 2025. State agencies are initiating procurement processes, stakeholder engagement, and advisory committee formation for six major initiative areas. Multiple requests for proposals (RFPs) are scheduled in the next several months, marking the official launch of the program, but subgrantees have not yet been selected. Preparations signal the shift from planning into the early launch phase. State opportunities: no active opportunities, $181.0M listed funding.
Washington’s RHTP strategy centers on sustainable, system-wide transformation of rural health care through multi-year initiatives. It focuses on rural hospital innovation, technology adoption, workforce development, tribal health investment, prevention, and behavioral health system expansion, leveraging robust public and stakeholder input and a strong alignment with federal and state priorities.
Model
Multi-sector, integrated delivery system transformation driven by infrastructure modernization, value-based models, tribal set-asides, and technology-enabled care, coordinated across state agencies and stakeholders.
Key Initiatives
Timeline: Application submitted in fall 2025; funding is allocated annually from 2026–2030, with each year’s funds available for two years. Implementation begins late 2025, progresses through distinct initiative phases, and includes annual performance reporting.
This reference highlights a Congressional delegation's letter urging CMS to adjust the Rural Health Transformation Program implementation. No Washington state-specific funding or recipient details are mentioned.
The 2026 federal budget will significantly impact Apple Health (Medicaid) in Washington, including major eligibility changes, reduced funding, and new rural health transformation funding to states. Washington is anticipated to be eligible for a share of $10 billion per year (2026–2030) for rural health transformation projects. Nearly 2 million people curr...
The Washington Reentry Initiative extends Apple Health (Medicaid) benefits for eligible youth and young adults in carceral settings, both pre- and post-adjudication in alignment with the 2023 Consolidated Appropriations Act. Implementation proceeds via facility cohorts, expanding mandatory reentry and case management services to prepare for individuals' r...
WA - 2025 - Washington RHT Webinar Q&A October 27, 2025
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WA - 2025 - Washington RHT Webinar Q&A 2025.09.25
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WA - 2025 - Washington RHTP 2025 Webinar
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WA - 2025 - Washington Public Engagement | RHTP 2026-2030 Application
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WA - 2026 - Washington RHTP An Overview Summary
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WA - 2025 - Dear Tribal Leader Letter | RHTP
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| FY↓ | Awardee↕ | Amount↕ | Activity↕ | Source |
|---|---|---|---|---|
| 2025-2030 | Washington Tribes and Indian Health Care Providers 10% of the total Rural Health Transformation award will go directly to tribes and IHCPs for strengthening rural healthcare and investments in maternal health. | $30.2M | Population Health |
Washington State plans to apply for the five-year Rural Health Transformation Program funding beginning fiscal year 2026. The document outlines tribal engagement and priority areas including workforce, technology, hospital support, and tribal set asides.
Event Schedule
Core Initiatives
Washington is planning its application for the federal Rural Health Transformation Program, potentially securing $100 million annually. The plan prioritizes technology-enabled care, workforce investment, chronic disease management, prevention, and infrastructure. Key partners include state agencies and tribal consultation, with public input and provider engagement underway.
Washington is preparing its application for a projected $100 million annual RHTP allocation. Stakeholder input has centered on rural hospitals, workforce, technology, prevention, and behavioral health. Application priorities include workforce and technology investments, supporting tribal health, and expanding access to essential services.
This compendium summarizes FY26 Rural Health Transformation Program applications from multiple states, each addressing rural health access, workforce, infrastructure, and innovation. Major funding requests and initiatives cover obstetric and maternal health, digital expansion, telehealth, prevention, value-based care, and hospital stabilization. Specific program or award recipient details are not provided—this is a federal-level executive summary.
Core Initiatives
This 2024 report identifies critical gaps in Washington State's mobile crisis response system for older adults, emphasizing fragmentation, workforce shortages, and accessibility challenges. It recommends improved funding, cross-sector collaboration, workforce development, enhanced facility capability, and prioritizing equity across underserved communities.
Core Initiatives
This reference highlights a Congressional delegation's letter urging CMS to adjust the Rural Health Transformation Program implementation. No Washington state-specific funding or recipient details are mentioned.
The 2026 federal budget will significantly impact Apple Health (Medicaid) in Washington, including major eligibility changes, reduced funding, and new rural health transformation funding to states. Washington is anticipated to be eligible for a share of $10 billion per year (2026–2030) for rural health transformation projects. Nearly 2 million people currently rely on Medicaid in the state, including substantial rural, maternal, and OUD populations. Key contacts: Evan Klein evan.klein@hca.wa.gov; Jon Noski jon.noski@dshs.wa.gov; Shirley Prasad shirley.prasad@wahbexchange.org Event schedule: - Federal budget (Continuing Resolution) signed - 07/04/2025 - Application deadline for rural health transformation funding - 12/31/2025
Contacts
Core Initiatives
WA - 2026 - RHTP News Digest
Jun 19, 2026 09:14
·EmailWA canonical state summary updated: progressSummary updated · transformationStrategy updated · strategicGoals updated
WA progress refreshed: implementationPhase: LAUNCHED · progressSummary updated
WA progress refreshed: implementationPhase: PLANNING · progressSummary updated
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Event Schedule
Core Initiatives
Event Schedule
Core Initiatives
The Rural Health Transformation Program (RHTP), authorized by the One Big Beautiful Bill Act of 2025, allocates $10 billion annually to states for rural health system transformation from 2026–2030. Washington must submit a state plan to access funds, with major priorities in rural health access, workforce, quality, partnerships, and financial stability. Large potential losses in Medicaid/ACA coverage could impact hundreds of thousands of rural WA residents along with critical access and rural hospital viability.
Event Schedule
Core Initiatives
Washington was awarded over $181 million for Budget Period 1 of the Rural Health Transformation Program, launching six major initiatives to strengthen rural hospital innovation, workforce, care access, and community health. Priorities were informed by extensive stakeholder engagement with explicit attention to Tribal health, behavioral health, and technological transformation. The RHTP aims for long-term, statewide system transformation, not just short-term grants. Key contacts: RHT Program Inbox Event schedule: - Application deadline: RHT Advisory Committee - 04/24/2026 - HCA RHT Webpage - Washington RHT Program Webinar #2 - September 16, 2026 - 1:00 PM PT - Teams meeting (online) - Budget Period 1 Performance Start - 12/29/2025
Contacts
Core Initiatives
The Washington Reentry Initiative extends Apple Health (Medicaid) benefits for eligible youth and young adults in carceral settings, both pre- and post-adjudication in alignment with the 2023 Consolidated Appropriations Act. Implementation proceeds via facility cohorts, expanding mandatory reentry and case management services to prepare for individuals' release. The program seeks to ensure continuity of coverage and care, including case management and medication access, for justice-involved populations statewide. Key contacts: hcavolunteerassister@hca.wa.gov; HCAAHEligibilityPolicy@hca.wa.gov Event schedule: - CAA Section 5122 (Pre-adjudication) Implementation Required - 07/01/2025 - PT - All CAA-only facilities - CAA Section 5121 (Post-adjudication) Implementation Required - 07/01/2025 - PT - All CAA-only facilities
Contacts
Core Initiatives
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