IL Dept of Healthcare and Family Services

The Rural Health Transformation (RHT) Program funding is available to States to support communities in transforming their health care delivery systems and improving access & health outcomes.

Section 71401 of Public Law 119-21

N/A

N/A

The Rural Health Transformation (RHT) Program aims to support communities in transforming their health care delivery systems and improving access & health outcomes.

Yes

All relevant project requirements and definitions outlined in the NOFO (CMS-RHT-26-001) apply to this award and have been incorporated into the Terms and Conditions of Award by reference.

None, State Agency Use;

Federal funds were received by HFS as a State Medicaid Agency.

Federal funds were received by HFS as a State Medicaid Agency.

Cooperative Agreements

Healthcare

State-level submissions only. States must submit an application to the Administrator that includes information including a plan for the State to use its allotment to carry out 3 or more Use of Funds defined in statute. States must also submit annual reports on the use of allotments.

Preapplication coordination is required. Environmental impact information is not required for this program. This program is excluded from coverage under E.O. 12372.

2 CFR 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards apply to this program. Application was submitted based on the requirements included in the NOFO which was posted on grants.gov.

Application will be subject to a review process. Applications that fulfill application information requirements as defined in statute. Applications that support use of allotment on 3 approved uses of funds as defined in statute. Applications that affirm allotments will not be used for restricted uses as defined in statute.

Following receipt of applications, Center for Medicare and Medicaid Services will review applications and whether they fulfill the criteria for selection. Assistance will be distributed as defined in statute (50% to all approved states, 50% among all States in an amount to be determined by the Administrator in accordance with statute).

Applications were due to be submitted by 11/5/2025.

Application review period will take 30-40 days. Awards are expected to be announced by 12/31/2025.

Not applicable.

This is a one-time application and approval process. There are no renewals or extensions. Continued funding is conditional on the availability of appropriated funds, recipient satisfactory performance and compliance with the Terms and Conditions of the grant award. Continued funding is subject to the submission of a Non-Competing Continuation (NCC) application each budget period to receive funding for each subsequent budget period.

Not applicable.

Uses: Funds must be used for purposes stated in the NOFO and the purposes approved by CMS in the approved grant application. Expected uses of funds may include the following: • Promoting evidence-based, measurable interventions to improve prevention and chronic disease management. • Providing payments to health care providers for the provision of health care items or services, as specified by the Administrator. • Promoting consumer-facing, technology-driven solutions for the prevention and management of chronic diseases. • 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. • Recruiting and retaining clinical workforce talent to rural areas, with commitments to serve rural communities for a minimum of 5 years. • Providing technical assistance, software, and hardware for significant information technology advances designed to improve efficiency, enhance cybersecurity capability development, and improve patient health outcomes. • 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. • Supporting access to opioid use disorder treatment services (as defined in section 1861(jjj)(1)), other substance use disorder treatment services, and mental health services. • Developing projects that support innovative models of care that include value-based care arrangements and alternative payment models, as appropriate. • Additional uses designed to promote sustainable access to high quality rural health care services, as determined by the Administrator. Restrictions: Funds may not be utilized for any category of expenses which are specifically excluded under the Terms and Conditions of the grant award. Funds allotted to a State in a given fiscal year must be used by the end of the following fiscal year. Not more than 10 percent of the amount allotted to a State for a fiscal year may be used by the State for administrative expenses. None of the amounts provided 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.

Progress Reports: Recipients will be required to submit quarterly, annual and final progress reports. Quarterly progress reports will be due approximately 30 days after the end of the reporting period, annual progress reports will be due 60 days before the end of the budget period and the final progress report will be due 120 days after the end of the period of performance. Progress reports should be reflective of progress made during the reporting period. Quarterly reports should include spending data broken down by use of funds and initiatives, milestone progress, and technical assistance requests. Annual reports should include qualitative progress updates on milestones and implementation, quantitative updates on metrics that recipient is tracking as part of their approved workplan, quantitative description of fund expenditures by initiative and use of funds, and any additional information that should be used as part of CMS' annual workload funding recalculation for the subsequent budget period. The final report should be a cumulative report of all activities completed during the entire period of performance. All progress reports should be completed according to guidance and templates provided by CMS. Expenditure Reports: Recipients will be required to submit annual and final expenditure reports. The recipient must record recipient expenses in real-time as well as submit an annual Expenditure Federal Financial Record (FFR). The annual report must be submitted no later than 90 days following the last day of the budget period through the Payment Management System (PMS). The final FFR must be submitted in PMS no later than 120 days following the end of the period of performance. Specific directions on filing the FFR can be found in the CMS Standard Terms and Conditions, Section 29(D), Financial Reporting.

Refer to the link below for 2 CFR Subpart F Audit Requirements. https://www.ecfr.gov/current/title-2/subtitle-A/chapter-II/part-200/subpart-F

Recipients are required to maintain grant accounting records 3 years after the date they submit the final Federal Financial Report. If any litigation, claim, negotiation, audit or other action involving the award has been started before the expiration of the 3-year period, the records shall be retained until completion of the action and resolution of all issues which arise from it, or until the end of the regular 3-year period, whichever is later.

N/A

$10B of allotments to States are available each year for fiscal year 2026 through 2030. Any amounts appropriated that are unexpended or unobligated as of October 1, 2032, shall be returned to the Treasury of the United States.

Section 71401 provides $10 billion for each fiscal year 2026 through 2030 to allot to states (except DC and territories) for approved Rural Health Transformation activities. Unused funding may be redistributed and unobligated/unexpended funds must be returned to the Treasury in FY32.

The RHT Program will focus on promoting innovation, strategic partnerships, infrastructure development, and workforce development. States will help rural communities meet these strategic goals: Make rural America healthy again; Sustainable access; Workforce Development; Innovative Care; and Tech Innovation.

2 CFR 200 and 2 CFR 300; https://www.cms.gov/priorities/rural-health-transformation-rht-program/overview

Statewide

Illinois Dept of Healthcare and Family Services 201 South Grand Ave E Division of Medical Program Services Springfield, IL 62763-1000

https://hfs.illinois.gov/info/fedresctr/ruralhealthtp.html

Not applicable.

Not applicable.

None

FY 2026 : $116,050,930
FY 2027 : $77,367,286